WorldWideScience

Sample records for left intraatrial thrombi

  1. Clinical study on the cardiac hemodynamics and the possibility of demonstration of the left intraatrial thrombi by echocardiography, angiocardiography and computed tomography and the neurological symptoms in patients with heart disorder and cerebral embolism

    Energy Technology Data Exchange (ETDEWEB)

    Nakajima, Kazuo

    1987-03-01

    In an attempt to elucidate risk factors for developing cerebral embolism (CE) in patients with heart disease, hemodynamic, sonographic or radiologic, and neurologic manifestations of heart disease developing into CE were retrospectively analyzed in 44 patients with CE and 122 patients with mitral valve disease (MVD). The most common underlying disease of CE was valve disease (50 %), followed by myocardial infarction, atrial fibrillation, and infectious endocarditis. In MVD patients, risk factors for CE were considered to be atrial fibrillation, mitral stenosis, and intraatrial thrombi. Combined use of various imaging modalities revealed the presence of intraatrial thrombi in 65 % of the CE patients. Cranial computed tomography showed hemorrhagic infarction in 22 %, and found the mid-arotic artery to be the commonest responsible region (81 %). The frequent initial neurologic symptom was hemiplegia. Half of the patients had disturbance of consciousness on admission. Prognosis was better in patients with MVD than those with the other types of heart disease. (Namekawa, K.). 117 refs.

  2. A Case with Recurrent Free-Floating Ball Thrombi in Left Atrium

    Science.gov (United States)

    Yoshioka, Takayuki; Mori, Takeshige; Taniguchi, Yayoi; Hirayama, Sonoko; Ozawa, Toru; Iwata, Sachiyo; Takei, Asumi; Inoue, Nobutaka

    2017-01-01

    Patient: Female, 74 Final Diagnosis: Left atrial ball thrombus Symptoms: Abdominal discomfort • dyspnea Medication: — Clinical Procedure: — Specialty: Cardiology Objective: Rare disease Background: A free-floating ball thrombus in the left atrium is a rare clinical condition. However, the diagnosis of this condition has been facilitated by the advent and development of echocardiography and multi-detector row computed tomography (MDCT) and several cases have been reported. Case Report: We report a case of a 75-year-old woman who had recurrent giant spherical thrombi in the left atrium. She was diagnosed with chronic atrial fibrillation at 52 years of age. A pacemaker implantation was performed at 54 years of age because of a complete atrioventricular block; and mitral valve replacement was performed for severe mitral regurgitation at 62 years of age. She had a history of cerebral infarction and she was under treatment for chronic heart failure. Despite intensive anticoagulant therapy, she developed ball thrombi in the left atrium three times in six months. During hospitalization for acute myocardial infarction treated with percutaneous catheter intervention, transthoracic echocardiography and computed tomography (CT) revealed a free-floating giant spherical thrombus in the left atrium. She was treated with intensive anticoagulation therapy and the left atrial ball thrombus disappeared; however, two ball thrombi in the left atrium and left atrial appendage recurred after three months. Surgical removal of the thrombi and closure of the left atrial appendage were performed. Unfortunately, a ball thrombus in the left atrium recurred again after a further three months. Conclusions: The present case highlights the difficulty of treating refractory thrombi in the left atrium. PMID:28360410

  3. Intraatrial conduction disturbances: vectorcardiographic patterns.

    Science.gov (United States)

    Zoneraich, O; Zoneraich, S

    1976-04-01

    Frank P loop vectorcardiograms were recorded in 30 normal subjects and in 40 patients who had intraatrial conduction disturbances alone or in association with cardiac disease. High magnification of the P loop (0.1 mv = 3 cm) permitted accurate measurement of the P loop duration, magnitude and direction. High-frequency recordings allowed optimal evaluation of the notches, bites and conduction delays in the PsE loop. Four vectorcardiographic patterns have been selected as counterparts of the four types of enlarged P waves seen in electrocardiograms of patients with atrial conduction disturbances. When intraatrial conduction disturbances coexisted with left atrial enlargment, the PsE loop was larger and smoother. The role of partial or complete block in the specific internodal or interatrial pathways is discussed. High magnification, high-frequency vectorcardiography of the P loop seems to be the best available method for determing a specific pattern of intraatrial conduction disturbance.

  4. Simultaneous Left Ventricular and Deep Vein Thrombi Caused by Protein C Deficiency

    Science.gov (United States)

    Nishiyama, Motohiro; Shirakawa, Motoaki

    2017-01-01

    Protein C deficiency is a risk of venous thrombosis because of poor fibrinolytic activity. It remains controversial whether protein C deficiency causes arterial thrombosis. A 21-year-old woman was referred with a chief complaint of right leg pain and numbness. Contrast-enhanced computed tomography revealed a low-density mass in the left ventricle (LV), splenic infarction, and peripheral arterial obstructions in her right leg. Thrombosis extending from the renal vein to the inferior vena cava was also detected. Electrocardiography revealed ST depression in leads II, III, and aVF. Transthoracic echocardiography revealed hypokinesis of the apex and interventricular septum and a hypoechoic mass in the LV (26 × 20 mm). She was diagnosed with acute arterial obstruction caused by the LV thrombus, which might have resulted from previous myocardial infarction. Protein C activation turned out to be low (41%) 5 days after admission. The anticoagulant therapy was switched from heparin to rivaroxaban 16 days after admission. The LV thrombus disappeared 24 days after initial treatment, and she has had no thrombotic episodes for 2.8 years under rivaroxaban therapy. Thrombophilia should be investigated for cases of simultaneous left ventricular and deep venous thrombi. Rivaroxaban can be effective in prevention of further thrombotic events. PMID:28194181

  5. Hypertensive Crisis and Left Ventricular Thrombi after an Upper Respiratory Infection during the Long-term Use of Oral Contraceptives.

    Science.gov (United States)

    Suzuki, Natsuko; Suzuki, Keisuke; Mizuno, Tomofumi; Kato, Yukari; Suga, Norihiro; Yoshino, Masabumi; Miura, Naoto; Banno, Shogo; Imai, Hirokazu

    2016-01-01

    A 34-year-old woman who had been using oral contraceptives for 10 years developed hypertensive crisis with papilloedema after an upper respiratory infection. Laboratory data showed hyperreninemic hyperaldosteronism and elevated levels of fibrinogen, fibrin, and fibrinogen degradation products. Echocardiography demonstrated two masses (18 mm) in the left ventricle. On the fourth hospital day, cerebral infarction, renal infarction, and upper mesenteric artery occlusion suddenly occurred despite the blood pressure being well-controlled using anti-hypertensive drugs. Echocardiography revealed the disappearance of the left ventricular masses, which suggested left ventricular thrombi. Cessation of the contraceptives and administration of heparin, warfarin, and anti-platelets drugs improved her general condition.

  6. Traumatic tricuspid regurgitation and right-to-left intra-atrial shunt--an unusual complication of a horse-kick.

    LENUS (Irish Health Repository)

    Byrne, R A

    2010-02-01

    A 63-year-old male presented with sudden onset chest pain and dyspnoea following a kick to the praecordium while gelding a horse. Transthoracic echocardiography showed evidence of flail tricuspid valve leaflets, severe tricuspid regurgitation and a widely patent foramen ovale with a right-to-left shunt. Due to progressive severe systemic hypoxemia the patient underwent emergent surgical intervention. Operative findings confirmed rupture of the anterior and septal tricuspid valve papillary muscles. Successful papillary muscle reattachment was performed in association with tricuspid annuloplasty and suture closure of his patent foramen ovale. Disruption of the tricuspid valve is well described as consequence of blunt trauma to the chest wall and is often well tolerated, coming to light many years post injury. Valve disruption due to rupture at the papillary muscle level, however, typically results in greater severity of tricuspid regurgitation and the abrupt rise in right intra-atrial pressure may lead to a right-to-left shunt across a patent foramen ovale. Where hemodynamic compromise ensues, prompt surgical intervention is mandated.

  7. Long-term fate of left atrial thrombi and incidence of cerebral embolism under continuous anticoagulation therapy; MR-tomographische Evaluation der Inzidenz zerebraler Embolien bei Patienten mit Vorhofflimmern und linksatrialen Thromben

    Energy Technology Data Exchange (ETDEWEB)

    Strach, K.; Meyer, C.; Hackenbroch, M.; Schild, H.; Sommer, T. [Radiologische Universitaetsklinik Bonn (Germany); Tiemann, K. [Medizinische Universitaetsklinik und Poliklinik II, Bonn (Germany); Haase, J. [Klinik Rotes Kreuz, Frankfurt/Main (Germany); Pizulli, L. [Petruskrankenhaus, Bonn (Germany); Omran, H. [St. Marien-Hospital, Bonn (Germany)

    2005-12-15

    Purpose: Patients (pts.) with atrial fibrillation (AF) and atrial thrombi are known to have an increased risk for cerebral embolism. However, little is known about the clinical course of atrial thrombi and the incidence of cerebral embolism in those patients during anticoagulation therapy. The high sensitivity of MR imaging (MRI) including diffusion-weighted imaging (DWI) suggests that this technique could provide an improved estimate of cerebral embolism associated with the presence of left atrial thrombi. The aims of this prospective study were to evaluate (1) the prevalence of clinically silent and apparent cerebral embolism in pts. with newly diagnosed AF and atrial thrombi using MRI/DWI, (2) the long-term fate of atrial thrombi under continued anticoagulation therapy and (3) the incidence of cerebral embolism during a follow-up period of 12 months with continuous anticoagulation therapy. Materials and methods: The study group consisted of 32 pts. with (1) newly diagnosed AF and evidence of left atrial (LA) thrombi detected by TEE and (2) a new start of anticoagulation therapy [International Normalized Ratio (INR) 2.0-3.0]. 19 pts. with (1) newly diagnosed AF and no evidence of atrial thrombi and (2) an equivalent anticoagulation regimen served as the control group. In both groups (a) MRI/DWI studies of the brain (weeks 0, 4, 8, 12, 20, 28, 36, 44, and 52), (b) transesophageal echocardiographic studies (TEE) for assessment of LA-Thrombi (weeks 0 and 52) and (c) clinical neurological assessments (weeks 0, 20 and 52) were performed. Results: In the study group (AF and LA-Thrombi) 11 out of 32 pts. (34%) displayed signs of acute (n=8) or chronic (n=3) cerebral embolism in the initial MRI studies. In 4 out of 32 pts.(13%), MRI/DWI depicted new or additional cerebral emboli (n=12) during the follow-up period despite continuous anticoagulation therapy. 2 (n=2/4; 50%) of these patients had clinically apparent neurological deficits. In the control group 1 out of 19 pts

  8. Two dimensional echocardiographic detection of intraatrial masses.

    Science.gov (United States)

    DePace, N L; Soulen, R L; Kotler, M N; Mintz, G S

    1981-11-01

    With two dimensional echocardiography, a left atrial mass was detected in 19 patients. Of these, 10 patients with rheumatic mitral stenosis had a left atrial thrombus. The distinctive two dimensional echocardiographic features of left atrial thrombus included a mass of irregular nonmobile laminated echos within an enlarged atrial cavity, usually with a broad base of attachment to the posterior left atrial wall. Seven patients had a left atrial myxoma. Usually, the myxoma appeared as a mottled ovoid, sharply demarcated mobile mass attached to the interatrial septum. One patient had a right atrial angiosarcoma that appeared as a nonmobile mass extending from the inferior vena caval-right atrial junction into the right atrial cavity. One patient had a left atrial leiomyosarcoma producing a highly mobile mass attached to the lateral wall of the left atrium. M mode echocardiography detected six of the seven myxomas, one thrombus and neither of the other tumors. Thus, two dimensional echocardiography appears to be the technique of choice in the detection, localization and differentiation of intraatrial masses.

  9. Direct thrombolysis of multiple thrombi in both right and left heart atrium in a patient on extracorporeal membrane oxygenation support following urgent double-lung transplantation: a case report

    Directory of Open Access Journals (Sweden)

    Pollert L

    2016-06-01

    Full Text Available Lukas Pollert,1 Zuzana Prikrylova,1 Jan Berousek,1 Frantisek Mosna,1 Robert Lischke2 1Department of Anaesthesiology and Intensive Care, 2nd Faculty of Medicine, 23rd Surgical Department, 1st Faculty of Medicine, Charles University in Prague and Motol University Hospital, Praha, Czech Republic Background: Lung transplantation is considered an established treatment for patients with end-stage chronic respiratory failure. Patients with acute respiratory failure requiring respiratory support with invasive mechanical ventilation while awaiting lung transplantation are at high risk of death. Extracorporeal membrane oxygenation (ECMO has been proposed as an alternative bridging strategy to mechanical ventilation. The shear stress created by the mechanical pumps causes changes in the hematological system in almost all patients treated with ECMO. An antithrombotic strategy to mitigate ECMO bleeding and thrombotic complications is necessary. The use of thrombolytic therapy is recommended for patients with acute symptomatic embolism with associated hypotension or shock. In this setting, the hemodynamic benefits of thrombolytic treatment far outweigh its bleeding risk.Case presentation: This case report describes a 32-year-old woman suffering from lymphangioleiomyomatosis, who underwent urgent double-lung transplantation. This patient was maintained on ECMO preoperatively, perioperatively, and postoperatively due to life-threatening hypoxemia caused by the progression of her pulmonary tissue damage. Multiple thrombi developed in the early postoperative period, in both right and left heart atria. Direct thrombolysis was successfully performed on the first postoperative day.Conclusion: According to the current published literature, direct thrombolysis of thrombi in both right and left atria in a patient supported on ECMO following urgent double-lung transplantation is an extremely rare treatment method. Even when taking into account all of the risks

  10. Intra-atrial tumor thrombi secondary to hepatocellular carcinoma responding to chemotherapy

    Directory of Open Access Journals (Sweden)

    Ajay Vallakati

    2011-01-01

    Full Text Available Context : Hepatocellular carcinoma accounts for 1-2.5% of all cancer in America with extension to inferior vena cava and right atrium in 1-4% of the cases. Patients with advanced hepatocellular carcinoma invading the right heart are considered poor candidates for surgery. In the past, such patients had dismal prognosis due to complications like pulmonary embolism and sudden death. Case Report : Our patient was admitted with worsening jaundice, abdominal pain and significant weight loss. Abdominal ultrasound, elevated alfa feto-protein levels and computerized tomography pointed to the diagnosis of hepatocellular carcinoma. Transthoracic echocardiography demonstrated two masses in the right atrium with the base of masses extending from inferior vena cava into right atrium. The patient was diagnosed to have stage IV heptaocellular carcinoma. This is associated with dismal prognosis. But after being started on sorafenib, the tumor regressed considerably and was barely discernable on echocardiography performed a month later. Conclusion : Though aggressive surgical resection is the best therapeutic approach for hepatocellular carcinoma, it may not always be possible and in such cases combination of different therapeutic approaches such as chemotherapeutic agents, radiotherapy and chemoembolization may improve survival.

  11. Successful Anticoagulation Therapy for Antiphospholipid Syndrome with Mobile Aortic Thrombi

    Science.gov (United States)

    Park, Hyun Oh; Moon, Seong Ho; Kim, Jong Woo; Byun, Joung Hun; Kim, Sung Hwan; Yang, Jun Ho; Lee, Chung-Eun; Kim, Jong-Duk

    2016-01-01

    Hypercoagulable states have been associated with aortic thrombosis. Antiphospholipid syndrome (APS) is one of the commonest types of acquired thrombophilia. We report the case of successful anticoagulation management in an APS patient with mobile thrombi within the aorta. A 58-year-old male patient presented to the emergency department (ED) with right-sided hemiparesis. His first symptoms were noted approximately 12–16 hours before presentation to the ED. Magnetic resonance imaging of the brain showed acute embolic infarction of the left frontal and parietotemporal lobes. Transesophageal echocardiography (TEE) and computed tomography angiography (CTA) demonstrated mobile thrombi attached to the wall of the ascending aorta and aortic arch. The patient was diagnosed with APS based on positivity of anti-beta-2 glycoprotein 1 antibodies, and was initiated on anticoagulation therapy. Repeated TEE and CTA revealed complete resolution of the thrombi after 12 days of treatment; the patient was discharged well. PMID:28042559

  12. [No Hodgkin Linfoma diagnosis with intra-atrial infiltration].

    Science.gov (United States)

    Alcocer Gamba, Marco Antonio; León González, Salvador; Castro Montes, Eliodoro; Loarca Piña, Luis Martín; Lugo Gavidia, Leslie Marisol; García Hernández, Enrique; González Galindo, Ulises; Paredes Serrano, Miguel Isaías

    2012-09-01

    Cardiac tumors are rare entities in clinical practice, with an incidence of 0.05%. Approximately 75% are benign and 25% malignant. Among these, Lymphomas are uncommon, representing about 0.25%. The non-Hodgkin lymphomas can occur in extranodal tissues in 20% of the cases and 80% of these non-Hodgkin lymphomas are composed of diffuse B cells. The extranodal presentation is most frequent in young adults, with a high degree of malignancy and rapid growth. It can present with primary infiltration of various organs; cardiac involvement occurs in 20 to 28% of cases, usually located in the right chambers and with nonspecific symptoms, depending on the location and extent of the tumor. The diagnostic test in these cases is undoubtedly the biopsy of the lymph node or the affected tissue. We present the case of non-Hodgkin disease of diffuse large cells, with right intra-atrial involvement in a 23-year-old-female patient, who presented with progressive dyspnea. A transesophageal echocardiography was performed and an intra-atrial tumor mass was detected. A biopsy was performed, by femoral venous catheterization, allowing the establishment of the histopathological diagnosis and treatment. At a one year follow up, the patient shows complete remission.

  13. Using optical coherence tomography to detect peripheral pulmonary thrombi

    Institute of Scientific and Technical Information of China (English)

    HONG Cheng; WANG Wei; ZHONG Nan-shan; ZENG Guang-qiao; WU Hua

    2012-01-01

    Background Optical coherence tomography (OCT) is a new imaging technique capable of obtaining high-resolution intravascular images of small vessels and has been widely used in interventional cardiology.However,application of OCT in peripheral pulmonary arteries in patients has been seldom documented.Methods Three patients who were highly suspected peripheral pulmonary arteries thrombi and had undergone CT pulmonary angiography but tested negative for thrombi in peripheral pulmonary arteries were enrolled.Subsequently,OCT imaging was performed in peripheral pulmonary arteries.The patients received more than three-month anticoagulative treatment if thrombi were detected by OCT.Thereafter,OCT re-evaluation of the thrombolized blood vessels detected earlier was performed.The changes of thrombi before and after anticoagulative treatment were compared.Results Three patients underwent OCT imaging of peripheral pulmonary arteries.Thrombi were found in most of imaged vessels in these patients.Red and white thrombi can be differentiated,according to features of the thrombus on OCT images.After anticoagulation treatment,these patients' symptoms and hypoxemia improved.Repeated OCT imaging showed that most thrombi disappeared or became smaller.Conclusion OCT may be used as a potential tool for detecting peripheral pulmonary artery thrombi and differentiating red thrombi from white ones.

  14. The prevalence and characteristics of intra-atrial right coronary artery anomaly in 9,284 patients referred for coronary computed tomography angiography

    Energy Technology Data Exchange (ETDEWEB)

    Opolski, Maksymilian P., E-mail: opolski.mp@gmail.com [Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw (Poland); Pregowski, Jerzy, E-mail: jerzypregowski74@gmail.com [Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw (Poland); Kruk, Mariusz, E-mail: mariuszkruk2000@yahoo.com [Department of Coronary and Structural Heart Diseases, Institute of Cardiology, Warsaw (Poland); Staruch, Adam D., E-mail: adstarman@gmail.com [Medical University of Warsaw, Warsaw (Poland); Witkowski, Adam, E-mail: witkowski@hbz.pl [Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw (Poland); Demkow, Marcin, E-mail: mdemkow@ikard.pl [Department of Coronary and Structural Heart Diseases, Institute of Cardiology, Warsaw (Poland); Hryniewiecki, Tomasz, E-mail: t.hryniewiecki@ikard.pl [Department of Acquired Cardiac Defects, Institute of Cardiology, Warsaw (Poland); Michalek, Piotr, E-mail: p.michalek@ikard.pl [Department of Immediate Diagnostics, Institute of Cardiology, Warsaw (Poland); Ruzyllo, Witold, E-mail: w.ruzyllo@ikard.pl [Department of Coronary and Structural Heart Diseases, Institute of Cardiology, Warsaw (Poland); Kepka, Cezary, E-mail: c.kepka@ikard.pl [Department of Coronary and Structural Heart Diseases, Institute of Cardiology, Warsaw (Poland)

    2014-07-15

    Objective: To determine the prevalence, radiologic patterns and clinical characteristics of intra-atrial right coronary artery (IARCA) among adult coronary computed tomography angiography (CCTA) population. Methods: We included 9,284 consecutive subjects who underwent CCTA at a single high-volume center. The presence of IARCA including the number, length and diameter of IARCA segments with accompanying atherosclerosis and coronary anomalies were evaluated. Additionally, clinical characteristics and midterm follow-up of IARCA patients were recorded. Results: The IARCA prevalence was 0.15% (14/9,284) with 15 intra-atrial segments. The intra-atrial segment length ranged from 14 to 53 mm, and the mean diameter proximal to the entry site was 3.3 ± 0.7 mm. IARCA was more often associated with intramuscular course of the left anterior descending coronary artery (29% vs. 4%, p = 0.001) and anomalous origin of the left circumflex artery from the right aortic sinus (14% vs. 0.3%, p = 0.001) compared with non-IARCA cases. The majority of IARCA patients were women (86%) presenting with supraventricular arrhythmia (71%). Compared with computed tomographic population without IARCA, IARCA subjects were younger (60 ± 12 vs. 54 ± 14 years, p = 0.037) and more often women (51% vs. 86%, p = 0.013). At a mean of 20 months follow-up of IARCA patients there were no adverse cardiac events except for supraventricular tachycardia episodes occurring in 36% of subjects. Conclusions: IARCA occurs rarely and is often associated with additional coronary anomalies. The clinical profile of IARCA patients is most often represented by middle-aged women with supraventricular arrhythmia showing favorable midterm prognosis.

  15. Coincidence of substantial right- and left-sided intracardiac thrombi

    NARCIS (Netherlands)

    Gorselen, van E.O.; Verhorst, P.M.; Birgelen, von C.

    2013-01-01

    A 63-year-old previously healthy man presented with deep vein thrombosis and dyspnoea. He developed atrial fibrillation during hospitalisation. A CT scan of the chest revealed filling defects of the atria and ventricles (Fig. 1, panel a and b). Upon transoesophageal echocardiography (TEE) (Fig. 1, c

  16. Can contrast-enhanced multi-detector computed tomography replace transesophageal echocardiography for the detection of thrombogenic milieu and thrombi in the left atrial appendage. A prospective study with 124 patients; Kann die kontrastmittelverstaerkte Mehrzeilen-Computertomografie die transoesophageale Echokardiografie bei der Detektion von thrombogenem Milieu und Vorhofohrthromben ersetzen? Eine prospektive Studie mit 124 Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Homsi, R.; Luetkens, J.A.; Schild, H.H.; Naehle, C.P. [Bonn Univ. (Germany). Dept. of Radiology; Nath, B. [SHG-KLliniken Voelklingen (Germany). Dept. of Medicine I - Cardiology; Schwab, J.O. [Bonn Univ. (Germany). Dept. of Medicine I - Cardiology

    2016-01-15

    To assess the diagnostic value of contrast-enhanced multi-detector computed tomography (MD-CT) for identifying patients with left atrial appendage (LAA) thrombus or circulatory stasis. 124 patients with a history of atrial fibrillation and/or cerebral ischemia (83 men, mean age 58.6 ± 12.4 years) and with a clinical indication for MD-CT of the heart and for transesophageal echocardiography (TEE) were included in the study. LAA thrombus or thrombogenic milieu was visually identified in TEE and MD-CT. In addition, MD-CT was analyzed quantitatively measuring the Hounsfield units (HU) of the left atrium (LA), the LAA and the ascending aorta (AA), and calculating the HU ratios LAA/AA (HU [LAA/AA]) und LAA/LA (HU [LAA/LA]). Sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) were calculated. The prevalence of a thrombus or thrombogenic milieu as assessed by TEE was 21.8 %. The HU ratio was lower in patients with thrombus or thrombogenic milieu (HU [LAA/AA]: 0.590 ± 0.248 vs. 0.909 ± 0.141; p < 0.001 und HU [LAA/LA] 0.689 ± 0.366 vs. 1.082 ± 0.228; p < 0.001). For the diagnosis of thrombus or a thrombogenic milieu, visual analysis yielded a sensitivity of 81.5 %, a specificity of 96.9 %, a PPV of 87.5 % and a NPV of 95.2 %. By combining visual and quantitative analysis with one criterion being positive, the specificity decreased to 91.8 %, the sensitivity to 77.8 %, the PPV to 72.4 %, and the NPV to 94.9 %. Visual analysis of the LAA in the evaluation of thrombus or thrombogenic milieu yields a high NPV of 95.1 % and may especially be useful to rule out LAA thrombi in patients with contraindications for TEE. Additional calculation of HU ratios did not improve the diagnostic performance of MD-CT.

  17. [Management of ischemic strokes derived from intraventricular thrombi: report of two cases].

    Science.gov (United States)

    Oberreuter, Gerardo; Silva, Natalia; Caba, Sheila; Morales, Marcelo; Nieto, Elena; Guevara, Carlos

    2014-09-01

    The origin of 20% of ischemic strokes is a left ventricular thrombus. We report two patients with strokes originating from cardiac thrombi, treated in two different ways. A 42-year-old diabetic man admitted with a left parietal and occipital stroke. An echocardiogram showed a left ventricular thrombus. The patient was subjected to a surgical cardiac revascularization procedure and left ventricular thrombectomy. The postoperative evolution was uneventful and the patient was discharged on oral anticoagulation. On ambulatory follow up, no neurological deterioration was evidenced. A 38-year-old male admitted with an acute ischemic stroke, was subjected to thrombolysis with human plasminogen activator. An echocardiogram showed a left ventricular thrombus, considered the cause of the stroke. The patient was anticoagulated with heparin and discharged ten days after admission with oral anticoagulation. A new echocardiogram performed one month later, did not show the left ventricular thrombus.

  18. AngioVac extraction of intra-atrial hepatoma masquerading as PICC-associated thrombus

    Science.gov (United States)

    Abboud, Samir; Raparia, Kirtee; Ubago, Julianne M.; Resnick, Scott

    2016-01-01

    Thrombus associated with peripherally inserted central catheterization is not uncommon. Treatment is typically conservative; however, more aggressive therapies can be considered in patients with tenuous medical condition. The authors present a patient with metastatic hepatocellular carcinoma masquerading as peripherally inserted central catheter-associated intra-atrial thrombus, subsequently removed via vacuum-assisted mechanical thrombectomy. PMID:26509915

  19. Detection of intracardiac thrombi and evaluation of antithrombotic therapy using /sup 111/In-oxine labelled autologous platelets

    Energy Technology Data Exchange (ETDEWEB)

    Yui, Tokuo; Uchida, Tatsumi; Muroi, Shuichi; Matsuda, Shin; Kariyone, Shigeo (Fukushima Medical Coll. (Japan))

    1982-12-01

    Detection of intracardiac thrombi by scintiphotography using In-111-oxine labelled autologous platelets was done in patients with various heart diseases. Their results were compared with those of two dimensional echocardiography. 1) Left atrial thrombi in 3 patients with mitral valve disease and left ventricular thrombus in a patient with myocardial infarction could be detected by the both methods. In 2 out of above 3 patients with mitral valve disease, 30 and 21 g of left atrial thrombus were certified at surgery. In the patient with myocardial infarction, no radioactivity on the thrombus was shown in the second scintiphotogram during antiplatelet therapy. 2) In a case with mitral stenosis, the image of thrombus by scintiphotography was observed, while none of abnormal echo by two dimensional echocardiography was detected. In this case, only 0.3 g of left atrial thrombus was confirmed at surgery. 3) In an another case of mitral stenosis, the image of thrombus by scintiphotography was not observed, while abnormal echo by two dimensional echocardiography was detected. The thrombus in this case may be hamatologicaly nonactive thrombus. Scintiphotography with In-111-oxine labelled platelets is considered to be an excellent method for the detection of intracardiac thrombi and for the evaluation of antithrombotic therapy in vivo.

  20. Detection of intracardiac thrombi by scintiphotography with /sup 111/In-labeled autologous platelets

    Energy Technology Data Exchange (ETDEWEB)

    Yui, T.; Uchida, T.; Matsuda, S. (Fukushima Medical Coll. (Japan))

    1982-04-01

    Detection of intracardiac thrombi by scintigraphy with In-111-oxine labeled autologous platelets was studied in 14 patients with various heart diseases. The results of platelet scintigraphy were compared with those of two dimensional echocardiography. In 4 of the 14 patients, the findings on platelet scintigraphy and echocardiography were both positive. Left atrial thrombi were detected in 3 patients with mitral valve disease (MVD), and left ventricular thrombus in a patient with myocardial infarction with left ventricular aneurysm (MI). The scintigraphy after antiplatelet therapy in the patient with MI did not show any radioactivity on the thrombus. In one of the 14 patients with MVD, the finding on platelet scintigraphy was positive, on the other hand echocardiography was negative. In one of the 14 patients with MVD, the finding on platelet scintigraphy was negative, on the other hand that on echocardiography was positive. The thrombus in this case may be hematologically nonactive thrombus. In-111 platelet scintigraphy is considered to be an excellent method for the diagnosis and in vivo assessment of antithrombotic therapy on intracardiac thrombosis.

  1. Cardiac thrombi mistaken for metastasis in recurrent melanoma.

    Science.gov (United States)

    Galiuto, Leonarda; Locorotondo, Gabriella; Fedele, Elisa; Danza, Maria L; De Vito, Elena; Masi, Ambra; Favoccia, Carla; Rebuzzi, Antonio G; Crea, Filippo

    2015-01-01

    Intra-cardiac thrombi can be incidentally found in recurrent melanoma and need careful assessment. An 81-year-old woman, with a history of malignant nasopharyngeal melanoma, was evaluated by echocardiography and cardiac magnetic resonance due to the detection of undefined masses localized both in right atrium and ventricle during contrast-enhanced thoraco-abdominal computed tomography.

  2. Clinical Significance of Histological Features of Thrombi in Patients with Myocardial Infarction

    Science.gov (United States)

    Sebben, Juliana Canedo; Cambruzzi, Eduardo; Avena, Luisa Martins; Gazeta, Cristina do Amaral; Gottschall, Carlos Antonio Mascia; de Quadros, Alexandre Schaan

    2013-01-01

    Background Percutaneous Coronary Intervention (PCI) is the most common strategy for the treatment of Acute ST segment elevation Myocardial Infarction (STEMI), and thromboaspiration has been increasingly utilized for removal of occlusive thrombi. Objectives To analyze the influence of histopathological features of coronary thrombi in clinical outcomes of patients with STEMI, and the association of these variables with clinical, angiographic, and laboratory features and medications used in hospitalization. Methods Prospective cohort study. All patients were monitored during hospitalization and thirty days after the event. Aspirated thrombi were preserved in formalin and subsequently stained with hematoxylin-eosin and embedded in paraffin. Thrombi were classified as recent and old. The primary outcome was the occurrence of major cardiovascular events within thirty days. Results During the study period, 1,149 patients were evaluated with STEMI, and 331 patients underwent thrombi aspiration, leaving 199 patients available for analysis. It was identified recent thrombi in 116 patients (58%) and old thrombi in 83 patients (42%). Recent thrombi have greater infiltration of red blood cells than old thrombi (p = 0.02), but there were no statistically significant differences between other clinical, angiographic, laboratory, and histopathological features and medications in both group of patients. The rates of clinical outcomes were similar in both groups. Conclusions Recent thrombi were identified in 58% of patients with STEMI and it was observed an association with infiltration of red blood cells. There was no association between histopathological features of thrombi and clinical variables and cardiovascular outcomes. PMID:24162472

  3. Clinical Significance of Histological Features of Thrombi in Patients with Myocardial Infarction

    Energy Technology Data Exchange (ETDEWEB)

    Sebben, Juliana Canedo; Cambruzzi, Eduardo; Avena, Luisa Martins; Gazeta, Cristina do Amaral; Gottschall, Carlos Antonio Mascia; Quadros, Alexandre Schaan de, E-mail: quadros.pesquisa@gmail.com [Instituto de Cardiologia / Fundação Universitária de Cardiologia - IC/FUC, Porto Alegre, RS (Brazil)

    2013-12-15

    Percutaneous Coronary Intervention (PCI) is the most common strategy for the treatment of Acute ST segment elevation Myocardial Infarction (STEMI), and thromboaspiration has been increasingly utilized for removal of occlusive thrombi. To analyze the influence of histopathological features of coronary thrombi in clinical outcomes of patients with STEMI, and the association of these variables with clinical, angiographic, and laboratory features and medications used in hospitalization. Prospective cohort study. All patients were monitored during hospitalization and thirty days after the event. Aspirated thrombi were preserved in formalin and subsequently stained with hematoxylin-eosin and embedded in paraffin. Thrombi were classified as recent and old. The primary outcome was the occurrence of major cardiovascular events within thirty days. During the study period, 1,149 patients were evaluated with STEMI, and 331 patients underwent thrombi aspiration, leaving 199 patients available for analysis. It was identified recent thrombi in 116 patients (58%) and old thrombi in 83 patients (42%). Recent thrombi have greater infiltration of red blood cells than old thrombi (p = 0.02), but there were no statistically significant differences between other clinical, angiographic, laboratory, and histopathological features and medications in both group of patients. The rates of clinical outcomes were similar in both groups. Recent thrombi were identified in 58% of patients with STEMI and it was observed an association with infiltration of red blood cells. There was no association between histopathological features of thrombi and clinical variables and cardiovascular outcomes.

  4. Effect of biologically active coating on biocompatibility of Nitinol devices designed for the closure of intra-atrial communications

    NARCIS (Netherlands)

    Kong, XQ; Grabitz, RG; van Oeveren, W; Klee, D; van Kooten, TG; Freudenthal, F; Qing, M; von Bernuth, G; Seghaye, MC

    2002-01-01

    Anti-thrombogenicity and rapid endothelialisation are prerequisites for the use of closure devices of intra-atrial communications in order to reduce the risk of cerebral embolism. The purpose of this study was therefore to assess the effect of bioactive coatings on biocompatibility of Nitinol coils

  5. Visualization of peripheral pulmonary artery red thrombi utilizing optical coherence tomography

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Cheng; Wang, Wei; Zhong, Nan Shan; Zeng, Guang Qiao; Zhang, Nuo Fu [The First Affiliated Hospital of Guangzhou Medical College, Guangzhou (China)

    2013-10-15

    Optical coherence tomography (OCT) is a new imaging technique capable of obtaining high-resolution intravascular images and has been used in interventional cardiology. However, an application of OCT in pulmonary arteries had seldom been documented. In this case, OCT imaging is performed in peripheral pulmonary arteries and shows mural red thrombi. Subsequently, the red thrombi are aspirated and confirmed by a histological examination. These findings suggest that OCT may be a useful tool to depict peripheral pulmonary artery thrombi.

  6. Bare Metal Stenting for Endovascular Exclusion of Aortic Arch Thrombi

    Energy Technology Data Exchange (ETDEWEB)

    Mahnken, Andreas H., E-mail: mahnken@med.uni-marburg.de [University Hospital Giessen and Marburg, Philipps University of Marburg, Department of Diagnostic Radiology (Germany); Hoffman, Andras; Autschbach, Ruediger; Damberg, Anneke L. M., E-mail: anneke.damberg@rwth-aachen.de [University Hospital RWTH Aachen, Department of Thoracic, Cardiac and Vascular Surgery (Germany)

    2013-08-01

    BackgroundAortic thrombi in the ascending aorta or aortic arch are rare but are associated with a relevant risk of major stroke or distal embolization. Although stent grafting is commonly used as a treatment option in the descending aorta, only a few case reports discuss stenting of the aortic arch for the treatment of a thrombus. The use of bare metal stents in this setting has not yet been described.MethodsWe report two cases of ascending and aortic arch thrombus that were treated by covering the thrombus with an uncovered stent. Both procedures were performed under local anesthesia via a femoral approach. A femoral cutdown was used in one case, and a total percutaneous insertion was possible in the second case.ResultsBoth procedures were successfully performed without any periprocedural complications. Postoperative recovery was uneventful. In both cases, no late complications or recurrent embolization occurred at midterm follow-up, and control CT angiography at 1 respectively 10 months revealed no stent migration, freely perfused supra-aortic branches, and no thrombus recurrence.ConclusionTreating symptomatic thrombi in the ascending aorta or aortic arch with a bare metal stent is feasible. This technique could constitute a minimally invasive alternative to a surgical intervention or complex endovascular therapy with fenestrated or branched stent grafts.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    N. D. Kaverin

    2014-07-01

    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. Surgical Intervention for Hepatocellular Carcinoma with Bile Buct Thrombi

    Institute of Scientific and Technical Information of China (English)

    PENGShuyou; LIUYingbin; WANGJianwei; CAIXiujun; MOUYiping; WUYulian; FangHeqing; LIJiangtao; WANGXinbao; XUBin; LIHaijun

    2003-01-01

    Objective: To summarize the experience of surgical intervention for hepatocellular carcinoma(HCC) with bile duct thrombi (BDT), and to evaluate the influence on prognosis. Methods: From 1994 to 2002, 15 patients with HCC and BDT who underwent surgical intervention were retrospectively analyzed.Results: The operative procedures included hepatectomy with removel of BDT (n=7), hepatectomy com-bined with extrahepatic bile duct resection (n=4), thrombectomy through choledochotomy (n=3), piggy back orthotopic liver transplantation (n=1). The 1-and 3-year survival rates were 73.3% and 40%, respec-tively. Two patients survived over 5 years. Conclusion: Surgical intervention was effective for patients with HCC and BDT. Operation for recurrent lesion can prolong survival period. Liver transplantation is a new treatment worthy of further investigation.

  10. Deposition of fibrinogen on the surface of in vitro thrombi prevents platelet adhesion.

    Science.gov (United States)

    Owaynat, Hadil; Yermolenko, Ivan S; Turaga, Ramya; Lishko, Valeryi K; Sheller, Michael R; Ugarova, Tatiana P

    2015-12-01

    The initial accumulation of platelets after vessel injury is followed by thrombin-mediated generation of fibrin which is deposited around the plug. While numerous in vitro studies have shown that fibrin is highly adhesive for platelets, the surface of experimental thrombi in vivo contains very few platelets suggesting the existence of natural anti-adhesive mechanisms protecting stabilized thrombi from platelet accumulation and continuous thrombus propagation. We previously showed that adsorption of fibrinogen on pure fibrin clots results in the formation of a nonadhesive matrix, highlighting a possible role of this process in surface-mediated control of thrombus growth. However, the deposition of fibrinogen on the surface of blood clots has not been examined. In this study, we investigated the presence of intact fibrinogen on the surface of fibrin-rich thrombi generated from flowing blood and determined whether deposited fibrinogen is nonadhesive for platelets. Stabilized fibrin-rich thrombi were generated using a flow chamber and the time that platelets spend on the surface of thrombi was determined by video recording. The presence of fibrinogen and fibrin on the surface of thrombi was analyzed by confocal microscopy using specific antibodies. Examination of the spatial distribution of two proteins revealed the presence of intact fibrinogen on the surface of stabilized thrombi. By manipulating the surface of thrombi to display either fibrin or intact fibrinogen, we found that platelets adhere to fibrin- but not to fibrinogen-coated thrombi. These results indicate that the fibrinogen matrix assembled on the outer layer of stabilized in vitro thrombi protects them from platelet adhesion.

  11. Pseudomonas aeruginosa Microcolonies in Coronary Thrombi from Patients with ST-Segment Elevation Myocardial Infarction

    Science.gov (United States)

    Hansen, Gorm Mørk; Belstrøm, Daniel; Nilsson, Martin; Helqvist, Steffen; Nielsen, Claus Henrik; Holmstrup, Palle; Tolker-Nielsen, Tim; Givskov, Michael; Hansen, Peter Riis

    2016-01-01

    Chronic infection is associated with an increased risk of atherothrombotic disease and direct bacterial infection of arteries has been suggested to contribute to the development of unstable atherosclerotic plaques. In this study, we examined coronary thrombi obtained in vivo from patients with ST-segment elevation myocardial infarction (STEMI) for the presence of bacterial DNA and bacteria. Aspirated coronary thrombi from 22 patients with STEMI were collected during primary percutaneous coronary intervention and arterial blood control samples were drawn from radial or femoral artery sheaths. Analyses were performed using 16S polymerase chain reaction and with next-generation sequencing to determine bacterial taxonomic classification. In selected thrombi with the highest relative abundance of Pseudomonas aeruginosa DNA, peptide nucleic acid fluorescence in situ hybridization (PNA-FISH) with universal and species specific probes was performed to visualize bacteria within thrombi. From the taxonomic analysis we identified a total of 55 different bacterial species. DNA from Pseudomonas aeruginosa represented the only species that was significantly associated with either thrombi or blood and was >30 times more abundant in thrombi than in arterial blood (p<0.0001). Whole and intact bacteria present as biofilm microcolonies were detected in selected thrombi using universal and P. aeruginosa-specific PNA-FISH probes. P. aeruginosa and vascular biofilm infection in culprit lesions may play a role in STEMI, but causal relationships remain to be determined. PMID:28030624

  12. Multiple Ascending Aortic Mural Thrombi and Acute Necrotizing Mediastinitis Secondary to Acute Pancreatitis

    Science.gov (United States)

    Chong, Byung Kwon; Yun, Jae Kwang; Kim, Joon Bum; Park, Do Hyun

    2016-01-01

    The formation of aortic thrombi is an extremely rare complication of acute pancreatitis. Here we report a case of acute pancreatitis complicated by a paraesophageal pseudocyst, necrotizing mediastinitis, and the formation of multiple thrombi in the ascending aorta. The patient was successfully treated by surgical therapy, which included extensive debridement of the mediastinum and removal of the aortic thrombi under cardiopulmonary bypass. Although esophageal resection was not carried out concomitantly, the lesions were resolved and the patient remained free of complications over 2 years of follow-up care. PMID:27734004

  13. Ultrasound-Accelerated Thrombolysis in Patients With Intracardiac Thrombi: A Case Series.

    Science.gov (United States)

    Yadlapati, Ajay; Sweis, Ranya; Schimmel, Daniel

    2016-03-01

    We describe a case series of 3 patients presenting with intracardiac thrombi treated with standard anticoagulation therapy and intervention with ultrasound-accelerated thrombolysis therapy. Right-sided intracardiac thrombi portend significant mortality due to their susceptibility for embolization and pulmonary embolus despite the continuation of current standard of therapy of parenteral anticoagulation and surgical embolectomy if warranted. We demonstrate the safety and clinical efficacy of ultrasound-accelerated thrombolysis therapy with the EkoSonic Endovascular System infusion catheter system (EKOS Corporation) and highlight its use in resolving intracardiac thrombi and impeding the propagation of pulmonary emboli.

  14. Intra-atrial reentry as a mechanism for atrial flutter induced by acetylcholine and rapid pacing in the dog.

    Science.gov (United States)

    Allessie, M A; Lammers, W J; Bonke, I M; Hollen, J

    1984-07-01

    In the isolated blood-perfused canine heart we produced episodes of rapid atrial flutter by continuous infusion of acetylcholine and rapid pacing. The spread of excitation during atrial flutter was mapped with the aid of two endocavitary mapping electrodes containing 960 leads and recording from 192 different sites simultaneously. The flutter maps clearly showed that intra-atrial reentry was the mechanism responsible for the arrhythmia. However, the localization and size of the intra-atrial circuits differed from case to case even in the same heart. The orifices of the venae cavae or the atrioventricular ring did not serve as a central anatomic obstacle for circus movement. We also failed to identify a special role of the internodal pathways in the formation of the loop. Instead, the intra-atrial circuits could be found everywhere, provided sufficient atrial mass was available to accommodate the circuit. The diameter of the circuits varied between 1.5 and 3 cm at a cycle length between 65 and 155 msec. The average conduction velocity of the circulating impulse varied between 60 and 80 cm/sec. Spontaneous termination of atrial flutter frequently occurred and was based on local conduction block in a narrow part of the circuit. Another interesting aspect of these studies is the finding that during continuous circus movement of the impulse, the amount of myocardium that is activated may vary considerably. This marked periodicity in excited tissue mass during atrial flutter could adequately explain the continuously undulating baseline or typical sawtoothlike F waves as seen in the surface electrocardiogram during atrial flutter.

  15. Medical image of the week: bilateral atrial appendange thrombi

    Directory of Open Access Journals (Sweden)

    Ateeli H

    2015-01-01

    Full Text Available No abstract available. Article truncated at 150 words. A 63-year-old man with a past history significant for hypertension, low back pain and polysubstance abuse (tobacco and marijuana presented with shortness of breath and hemoptysis for the last 8 days prior to admission. His initial exam showed elevated jugular venous pressure and bilateral basal crackles with reduced air entry on the right lower lung zone. The patient was found to be in atrial fibrillation with a rapid ventricular response. His initial chest X-ray showed a moderate right-sided pleural effusion. Immediate bedside echo was concerning for bilateral ventricular dysfunction with concerns of right-sided heart pressure and volume overload. A chest CT angiogram was obtained and showed acute lower lobe pulmonary embolism, with possible distal infarct, moderate right sided pleural effusion, and filling defects in both atrial appendages concerning for thrombi (Figure 1, Panels A & B. The patient was started on therapeutic anticoagulation and underwent therapeutic thoracentesis, gentle diuresis, and ...

  16. The hemodynamic and embolizing forces acting on thrombi--II. The effect of pulsatile blood flow.

    Science.gov (United States)

    Basmadjian, D

    1986-01-01

    A previous analysis (Basmadjian, J. Biomechanics 17, 287-298, 1984) of the embolizing forces acting on thrombi in steady Poiseuille flow has been extended to pulsatile blood flow conditions in the major blood vessels. We show that for incipient and small compact thrombi up to 0.1 mm height, the maximum embolizing stresses can be calculated from the corresponding 'quasi-steady' viscous drag forces and measured maximum wall shear. Their magnitude is from 5 to 30 times (tau w)Max, the maximum wall shear stress during the cardiac cycle in the absence of thrombi. For larger thrombi, inertial and 'history' effects have to be taken into account, leading to embolizing stresses in excess of 100 Pa (1000 dyn cm-2).

  17. Abnormal whole blood thrombi in humans with inherited platelet receptor defects.

    Directory of Open Access Journals (Sweden)

    Francis J Castellino

    Full Text Available To delineate the critical features of platelets required for formation and stability of thrombi, thromboelastography and platelet aggregation measurements were employed on whole blood of normal patients and of those with Bernard-Soulier Syndrome (BSS and Glanzmann's Thrombasthenia (GT. We found that separation of platelet activation, as assessed by platelet aggregation, from that needed to form viscoelastic stable whole blood thrombi, occurred. In normal human blood, ristocetin and collagen aggregated platelets, but did not induce strong viscoelastic thrombi. However, ADP, arachidonic acid, thrombin, and protease-activated-receptor-1 and -4 agonists, stimulated both processes. During this study, we identified the genetic basis of a very rare double heterozygous GP1b deficiency in a BSS patient, along with a new homozygous GP1b inactivating mutation in another BSS patient. In BSS whole blood, ADP responsiveness, as measured by thrombus strength, was diminished, while ADP-induced platelet aggregation was normal. Further, the platelets of 3 additional GT patients showed very weak whole blood platelet aggregation toward the above agonists and provided whole blood thrombi of very low viscoelastic strength. These results indicate that measurements of platelet counts and platelet aggregability do not necessarily correlate with generation of stable thrombi, a potentially significant feature in patient clinical outcomes.

  18. Abnormal whole blood thrombi in humans with inherited platelet receptor defects.

    Science.gov (United States)

    Castellino, Francis J; Liang, Zhong; Davis, Patrick K; Balsara, Rashna D; Musunuru, Harsha; Donahue, Deborah L; Smith, Denise L; Sandoval-Cooper, Mayra J; Ploplis, Victoria A; Walsh, Mark

    2012-01-01

    To delineate the critical features of platelets required for formation and stability of thrombi, thromboelastography and platelet aggregation measurements were employed on whole blood of normal patients and of those with Bernard-Soulier Syndrome (BSS) and Glanzmann's Thrombasthenia (GT). We found that separation of platelet activation, as assessed by platelet aggregation, from that needed to form viscoelastic stable whole blood thrombi, occurred. In normal human blood, ristocetin and collagen aggregated platelets, but did not induce strong viscoelastic thrombi. However, ADP, arachidonic acid, thrombin, and protease-activated-receptor-1 and -4 agonists, stimulated both processes. During this study, we identified the genetic basis of a very rare double heterozygous GP1b deficiency in a BSS patient, along with a new homozygous GP1b inactivating mutation in another BSS patient. In BSS whole blood, ADP responsiveness, as measured by thrombus strength, was diminished, while ADP-induced platelet aggregation was normal. Further, the platelets of 3 additional GT patients showed very weak whole blood platelet aggregation toward the above agonists and provided whole blood thrombi of very low viscoelastic strength. These results indicate that measurements of platelet counts and platelet aggregability do not necessarily correlate with generation of stable thrombi, a potentially significant feature in patient clinical outcomes.

  19. Spatial distribution of factor Xa, thrombin, and fibrin(ogen on thrombi at venous shear.

    Directory of Open Access Journals (Sweden)

    Michelle A Berny

    Full Text Available BACKGROUND: The generation of thrombin is a critical process in the formation of venous thrombi. In isolated plasma under static conditions, phosphatidylserine (PS-exposing platelets support coagulation factor activation and thrombin generation; however, their role in supporting coagulation factor binding under shear conditions remains unclear. We sought to determine where activated factor X (FXa, (prothrombin, and fibrin(ogen are localized in thrombi formed under venous shear. METHODOLOGY/PRINCIPAL FINDINGS: Fluorescence microscopy was used to study the accumulation of platelets, FXa, (prothrombin, and fibrin(ogen in thrombi formed in vitro and in vivo. Co-perfusion of human blood with tissue factor resulted in formation of visible fibrin at low, but not at high shear rate. At low shear, platelets demonstrated increased Ca(2+ signaling and PS exposure, and supported binding of FXa and prothrombin. However, once cleaved, (prothrombin was observed on fibrin fibers, covering the whole thrombus. In vivo, wild-type mice were injected with fluorescently labeled coagulation factors and venous thrombus formation was monitored in mesenteric veins treated with FeCl(3. Thrombi formed in vivo consisted of platelet aggregates, focal spots of platelets binding FXa, and large areas binding (prothrombin and fibrin(ogen. CONCLUSIONS/SIGNIFICANCE: FXa bound in a punctate manner to thrombi under shear, while thrombin and fibrin(ogen distributed ubiquitously over platelet-fibrin thrombi. During thrombus formation under venous shear, thrombin may relocate from focal sites of formation (on FXa-binding platelets to dispersed sites of action (on fibrin fibers.

  20. Prevalence, morphologic characteristic and predictors of organization of atrial auricle thrombi four weeks after anticoagulant preparation to scheduled electrical cardioversion of atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Kalashnykova O.S.

    2013-10-01

    Full Text Available Goal: to study thrombosis prevalence and predictors of thrombi organization in atrial auricles in persistent non-valvular atrial fibrillation (NVAF in patients undergoing transesophageal echocardiography (TEE 4 weeks after oral anticoagulant therapy (OAC. Materials and methods: a total of 133 consecutive patients with NVAF, who underwent TЕE before electrical cardioversion (ECV were included in the study. Results: The mean age of the participants was 60,3±0,9 years, 95 (71,4% were men. The mean term of the last AF episode was 6,5±0,6 months. Duration of AF less than 1 year was in 47 (35,3% patients, from 1 to 5 years – in у 61 (45,8% patients, over 5 years – in 25 (18,8% patients. 14 (10,5% patients had underlying coronary artery disease (CAD, 84 (63,2% patients had arterial hypertension, 31 (23,3% had both CAD and arterial hypertension, 4 (3,0% had cardiomyopathy, 80 (60,2% were obese. NYHA I FC of heart failure (HF was diagnozed in 8 (6,0% patients, II FC – in 94 (70,7% patients and III FC – in 31 (23,3% patients. GFR > 90 ml/min/1,73m² was in 9 (6,8% patients, in 74 (55,6% it was decreased to 60-89 ml/min/1,73m², in 50 (37,6% patients GFR was 30-59 ml/min/1,73m². In stratification of risk of thromboembolism complications (TEC 91 (68,4% fell into the high-risk group with the CHA2DS2-VASc score ≥ 2, 32 (24,1% patients were in the moderate-risk group and 10 (7,5% had CHA2DS2-VASc score 0. TEE was performed in all patients 4 weeks after effective OAC therapy. In 40 (37,6% patients thrombi were detected in the left atrial auricle and in 26 (65,0% patients they were organized. In 10 (7,5% patients thrombis were detected in right atrial auricles and in 7 (70,0% patients they were organized. In 63 (47,4% patients thrombi were found in both atrial auricles and in 25 (39,7% patients they were organized. Correlation was found between detection of non-organized thrombi, duration of AF less than 1 year and increase of total cholesterol

  1. Vanishing left ventricular thrombus in a woman with peripartum cardiomyopathy: a case report

    Directory of Open Access Journals (Sweden)

    Altuwaijri Wafa A

    2012-10-01

    Full Text Available Background Peripartum cardiomyopathy (PPCM is a rare cardiac disorder characterized by the development of heart failure in the last month of pregnancy or up to 5 months postpartum in women without other identifiable causes of cardiac failure. The combination of left ventricular (LV systolic dysfunction and hypercoaguability can cause thromboembolic complications including intra-cardiac thrombi. Case presentation A 25-year-old Caucasian female with PPCM demonstrated multiple thrombi in the LV on transthoracic echocardiography. Following anticoagulation with parenteral heparin, a cardiac MRI four days later demonstrated near resolution of the thrombi. Conclusion We review the presentation, diagnosis and management of LV thrombi in the clinical setting of PPCM.

  2. Successful resection of osteosarcoma pulmonary metastasis extending into left side of heart under cardiopulmonary bypass: a case report

    Institute of Scientific and Technical Information of China (English)

    柴(王莹); 沈钢

    2002-01-01

    @@ Cancerous thrombi of metastatic tumors rarely extend into the cardiac cavity, but such cases usually contraindicate surgery. Here, we report a patient in whom osteosarcoma pulmonary metastasis extended into the left side of the heart, which had metastasized to the left lung after surgery of the chondroblastoma of the left knee, was successfully excised in bloc under CPB.

  3. Optimal positioning of right-sided internal jugular venous catheters: Comparison of intra-atrial electrocardiography versus Peres′ formula

    Directory of Open Access Journals (Sweden)

    Joshi Anish

    2008-01-01

    Full Text Available Central venous catheters are routinely placed in patients undergoing major surgeries where expected volume and hemodynamic disturbances are likely consequences. The incorrect positioning may give false central venous pressure (CVP readings leading to incorrect volume replacement and other serious complications. 50 American Society of Anaesthesiologists grade II-IV patients aged 18-60 years were selected for right-sided internal jugular vein (IJV catheterization using Seldinger′s technique. In group A, central venous catheterization was done under electrocardiography (ECG guidance. In group B, the catheter was inserted blindly using Peres′ formula of "height (in cm/10". The position of the tip of central venous catheter was confirmed radiologically by postoperative chest X-ray. 92% of patients in group A had radiologically correct positioning of catheter tip i.e. above the carina, while in group B 48% patients had over-insertion of the catheter in to the right atrium. Intra-atrial ECG technique to judge correct tip positioning is simple and economical. It can determine the exact position intraoperatively and can justify a delayed postoperative chest X-ray to confirm CVC line tip placement.

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

    Science.gov (United States)

    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.

  5. Factor XIII activity mediates red blood cell retention in venous thrombi

    Science.gov (United States)

    Aleman, Maria M.; Byrnes, James R.; Wang, Jian-Guo; Tran, Reginald; Lam, Wilbur A.; Di Paola, Jorge; Mackman, Nigel; Degen, Jay L.; Flick, Matthew J.; Wolberg, Alisa S.

    2014-01-01

    Venous thrombi, fibrin- and rbc-rich clots triggered by inflammation and blood stasis, underlie devastating, and sometimes fatal, occlusive events. During intravascular fibrin deposition, rbc are thought to become passively trapped in thrombi and therefore have not been considered a modifiable thrombus component. In the present study, we determined that activity of the transglutaminase factor XIII (FXIII) is critical for rbc retention within clots and directly affects thrombus size. Compared with WT mice, mice carrying a homozygous mutation in the fibrinogen γ chain (Fibγ390–396A) had a striking 50% reduction in thrombus weight due to reduced rbc content. Fibrinogen from mice harboring the Fibγ390–396A mutation exhibited reduced binding to FXIII, and plasma from these mice exhibited delayed FXIII activation and fibrin crosslinking, indicating these residues mediate FXIII binding and activation. FXIII-deficient mice phenocopied mice carrying Fibγ390–396A and produced smaller thrombi with fewer rbc than WT mice. Importantly, FXIII-deficient human clots also exhibited reduced rbc retention. The addition of FXIII to FXIII-deficient clots increased rbc retention, while inhibition of FXIII activity in normal blood reduced rbc retention and produced smaller clots. These findings establish the FXIII-fibrinogen axis as a central determinant in venous thrombogenesis and identify FXIII as a potential therapeutic target for limiting venous thrombosis. PMID:24983320

  6. [Spontaneous course of myxoma of the left atrium].

    Science.gov (United States)

    Allal, J; Coisne, D; Ciber, M; Malin, F; Christiaens, L; Foullon, P; Barraine, R

    1988-10-01

    Little is known about the natural history of left intra-atrial myxomas. We report 3 cases of that disease where successive echocardiographic examinations provided figures of 11, 12 and 14 months respectively for the formation of the tumour in the left atrium. Echocardiography is perfectly reliable for the diagnosis of myxoma. False-negative results are rare and usually due to very small myxomas being beyond the resolution potential of the instrument; this seems to have been the case in 2 of our 3 patients. Two data, however, remain unknown: the beginning of formation and the rapidity of tumoral growth. These 3 cases raise the problem of repeat echocardiography some time after a cerebral accident of suspected embolic origin, when the initial examination is negative.

  7. In-vitro model for the ultrastructural study of the formation of thrombi in human platelets.

    Science.gov (United States)

    Cerecedo, Doris; González, Sirenia; Mondragón, Mónica; Reyes, Elba; Mondragón, Ricardo

    2006-03-01

    Platelets are cell fragments with dynamic properties involved in clot formation after tissue damage. Platelet activation causes a change in shape, secretion of intracellular granules and aggregation with each other through the cytoskeleton components and biochemical changes. Platelet adhesion, considered as the major event in haemostasis, has been studied in several in-vitro and in-vivo models to evaluate the feasible thrombogenicity of some materials, the dynamics of specific receptors, as well as the effect of different buffers and inhibitors in this process. In spite of the numerous reports about platelet activation, to date there is no information available about the fine structure of the platelet-platelet and platelet-substrate interactions. In the present report we describe an in-vitro system that allows the visualization of these interactions: platelets are adhered to an inert substrate, and interactions with suspended platelets as a process to initiate the formation of thrombi was followed by ultramicrotomy and transmission electron microscopy.

  8. Successful management of aortic thrombi resulting in spinal cord infarction in a patient with antiphospholipid antibody syndrome and acute cholecystitis

    Directory of Open Access Journals (Sweden)

    Izumi M

    2011-12-01

    Full Text Available Manabu Izumi, Shoko Teraoka, Keisuke Yamashita, Kenji Matsumoto, Tomohiro Muronoi, Yoshimitsu Izawa, Chikara Yonekawa, Masaki Ano, Masayuki SuzukawaDepartment of Emergency and Critical Care Medicine, Jichi Medical University, Tochigi, JapanAbstract: A 74-year-old man with coronary artery disease was suffering from acute nonobstructive cholecystitis and was admitted to a nearby hospital. Dual antiplatelet (aspirin and ticlopidine therapy was discontinued before preparation for surgical resection of the gall bladder. During his time in hospital he was aware of lumbar pain and weakness in both legs. He was transferred to our hospital for further evaluation and therapy. Diffuse intra-aortic thrombi were revealed by computed tomography with contrast media, and magnetic resonance imaging showed spinal cord infarction. However, computed tomography scans of the descending aorta obtained 4 months before admission exhibited no signs of atherosclerotic plaques or intra-aortic thrombi. Laboratory data suggest that antiphospholipid antibody syndrome might have caused these acute multiple intra-arterial thrombi. By restarting dual antiplatelet therapy and increasing the dose of heparin (from 10,000 IU/day to 15,000 IU/day we successfully managed the patient's clinical condition and symptoms. It is important to understand that stopping antiplatelet therapy may rapidly grow thrombi in patients with a hypercoagulative state.Keywords: intra-aortic thrombus, antiphospholipid antibody syndrome, spinal cord infarction

  9. Successful management of aortic thrombi resulting in spinal cord infarction in a patient with antiphospholipid antibody syndrome and acute cholecystitis.

    Science.gov (United States)

    Izumi, Manabu; Teraoka, Shoko; Yamashita, Keisuke; Matsumoto, Kenji; Muronoi, Tomohiro; Izawa, Yoshimitsu; Yonekawa, Chikara; Ano, Masaki; Suzukawa, Masayuki

    2011-01-01

    A 74-year-old man with coronary artery disease was suffering from acute nonobstructive cholecystitis and was admitted to a nearby hospital. Dual antiplatelet (aspirin and ticlopidine) therapy was discontinued before preparation for surgical resection of the gall bladder. During his time in hospital he was aware of lumbar pain and weakness in both legs. He was transferred to our hospital for further evaluation and therapy. Diffuse intra-aortic thrombi were revealed by computed tomography with contrast media, and magnetic resonance imaging showed spinal cord infarction. However, computed tomography scans of the descending aorta obtained 4 months before admission exhibited no signs of atherosclerotic plaques or intra-aortic thrombi. Laboratory data suggest that antiphospholipid antibody syndrome might have caused these acute multiple intra-arterial thrombi. By restarting dual antiplatelet therapy and increasing the dose of heparin (from 10,000 IU/day to 15,000 IU/day) we successfully managed the patient's clinical condition and symptoms. It is important to understand that stopping antiplatelet therapy may rapidly grow thrombi in patients with a hypercoagulative state.

  10. [Effectiveness of anticoagulant oral treatment in patients with thrombus in left ventricle after acute myocardial infarction].

    Science.gov (United States)

    Carrillo, A M; Valdespino, A; Solorio, S; Badui, E; Enciso, R; Lepe, L; Lara, A; Ocampo, S; Alonso, R; Romero, M A

    1997-01-01

    Left ventricular mural thrombi (LVMT) is a complication of acute myocardial infarction (AMI), that may produce peripheral embolism which could be fatal. In order to establish an adequate time of oral anticoagulant (OA) therapy, we undertook a prospective study that included 45 patients with AMI and left ventricular thrombi detected by echocardiographic study, in the first 5 to 10 days postinfarction, the study was repeated, in 3 and 6 months. Treatment with oral anticoagulant was initiated at the point of the detection of thrombi maintaining an INR of 1.5 to 2. Thirty nine patients (79%) were males and 6 (11%) were females, with an age of 29 to 85 years and a range of 62 +/- 11 years. Forty four patients (98%) presented anterior wall infarction and 1 (2%) posteroinferior infarction. In patients with anterior infarction, in 38 (85%) the thrombi was located at the apical wall (p < 0.05), 5 (11%) in the septal wall and other (2%) in anterior and apical walls. The patient with the posteroinferior infarction presented extension to the right ventricle, where the thrombus was located (2%). The contractility alterations related with thrombi were diskinesia, followed by hipokinesia and finally akinesia. The ejection fraction had not relationship with thrombi formation. LVMT dissolved in 32 patients (71%) at 3 months (p < 0.05), in 8 (18%) in 6 months and in 5 (11%) it was maintained for more than 6 months. None of the patients presented complications of OA. We conclude that the LVMT are more frequent in anterior infarctions, essentially in those that present diskinesia. The majority of LVMT are resolved in 6 months with OA therapy.

  11. Role of hybrid operating room in surgery for the right atrial thrombus, pulmonary thrombi, and ventricular septal rupture after myocardial infarction

    Science.gov (United States)

    Singh, Ajmer; Mehta, Yatin; Parakh, Rajiv; Kohli, Vijay; Trehan, Naresh

    2016-01-01

    Free-floating right heart thrombi are uncommon and need emergency treatment in view of their tendency to dislodge and cause pulmonary embolism. We report a successful surgical management of a patient who had large mobile right atrial thrombus, bilateral pulmonary thrombi, coronary artery disease, and postmyocardial infarction ventricular septal rupture (VSR). The patient underwent coronary angiography, inferior vena cava filter placement, removal of thrombi from the right atrium and pulmonary arteries, repair of VSR, and coronary artery bypass graft surgery in a hybrid operating room. PMID:27716704

  12. Microstructural evaluation by confocal and electron microscopy in thrombi developed in central venous catheters.

    Science.gov (United States)

    Lucas, Thabata Coaglio; Silva, Eliata Ester da; Souza, Danilo Olzon Dionysio; Santos, Amanda Rodrigues Dos; Lara, Maristela Oliveira

    2017-08-28

    Evaluating thrombi microstructure developed in central venous catheters using confocal and electron microscopy. An experimental, descriptive study carrying out a microstructural evaluation of venous thrombi developed in central venous catheters using Scanning Electron Microscopy and Confocal Laser Scanning Microscopy. A total of 78 venous catheters were collected over a period of three months. Different fibrin structures were distinguished: fibrin plates, fibrin network, and fibrin fibers. It was observed that the thrombus had thick fibrin plates adhered to the catheter wall openings in both a catheter with three days of permanence as well as in a catheter with 20 days of insertion in the patient. However, a greater amount of erythrocytes and fibrin fibers were found in the central region of the thrombus. This study contributes to improving health care and can have a positive impact on clinical practice, as easy adherence of platelets and fibrins to the catheter wall demonstrated in this study makes it possible to adopt thrombus prevention strategies such as therapy discontinuation for an extended period, blood reflux by a catheter, slow infusion rate and hypercoagulo pathyclinical conditions. Avaliar a microestrutura por microscopia confocal e eletrônica em trombos desenvolvidos em cateteres venosos centrais. Pesquisa experimental, descritiva, em que foi feita uma avaliação microestrutural de trombos venosos desenvolvidos em cateteres venosos centrais por Microscopia Eletrônica de Varredura e Microscopia Confocal de Varredura a Laser. Foram coletados 78 cateteres venosos centrais num período de três meses. Distinguiram-se diferentes estruturas de fibrina: a placa de fibrina, a rede de fibrina e as fibras de fibrina. Observou-se que tanto em um cateter com três dias de permanência quanto em um cateter com 20 dias inserido no paciente o trombo apresentou placas de fibrina espessas aderidas às paredes dos orifícios dos cateteres. Na região central do

  13. First report of vascular invasion of demodex mites with thrombi and dissemination to visceral lymph nodes in a dog.

    Science.gov (United States)

    Woldemeskel, Moges; Hawkins, Ian

    2017-03-15

    An adult-onset generalized canine demodecosis is a life threatening form of demodecosis often seen in immunocompromised dogs. A generalized, adult-onset canine demodecosis with an unusual vascular invasion, thrombi and dissemination to peripheral, and visceral lymph nodes was diagnosed in an adult, female, American Bulldog of unknown age. Organized thrombi with intralesional mites were observed in multiple lymphatic vessels and in a section of blood vessel. Vascular invasion of mites with dissemination of mites into visceral lymph nodes, is an unusual findings not previously recorded in canine generalized demodecosis. Dissemination of mites to visceral lymph nodes through vascular channels may be part of the pathogenesis of chronic, untreated, and disseminated, adult-onset generalized canine demodecosis.

  14. Ultrasound elastography for determination of the age of venous thrombi : evaluation of thrombus evolution in patients after sclerotherapy

    OpenAIRE

    Paluch, Łukasz; Nawrocka-Laskus, Ewa; Dąbrowska, Agnieszka; Popiela, Tadeusz; Walecki, Jerzy

    2017-01-01

    BACKGROUND: Venous thrombosis is a multicausal disease involving intravenous clot formation. It may occur spontaneously or after provoking events, such as traumatic injuries to the pelvis, upper and lower extermities, immobilization, intravascular procedures, including venous catheterization or injection. Color Doppler ultrasonography is a rapid and non-invasive technique for evaluation of venous disease. It is a very sensitive method for detection of thrombi, but has some limitations, e.g. i...

  15. Differentiation of neoplastic from bland macroscopic portal vein thrombi using dual-energy spectral CT imaging: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Qian, Li Jun; Zhu, Jiong; Zhuang, Zhi Guo; Xu, Jian Rong [Shanghai Jiaotong University School of Medicine, Department of Radiology, Renji Hospital, Shanghai (China); Xia, Qiang [Shanghai Jiaotong University School of Medicine, Department of Hepatic Surgery, Renji Hospital, Shanghai (China); Cheng, Yu.Fan [Chang Gung University College of Medicine, Liver Transplantation Program, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung (China); Li, Jian Ying [GE Healthcare China, CT Imaging Research Center, Beijing (China)

    2012-10-15

    To assess the feasibility and value of dual-energy spectral computed tomography (DESCT) imaging for differentiating neoplastic from bland macroscopic portal vein (PV) thrombi. Computed tomography (CT) images of 44 patients with macroscopic PV thrombus (bland group, n = 16; neoplastic group, n = 28) were reviewed. Iodine-based material decomposition images in the portal venous phase were reconstructed to compare the iodine indices between groups, including thrombus iodine density (I{sub T}), thrombus-aorta iodine density ratio (I{sub T}/I{sub A}), and thrombus-PV iodine density ratio (I{sub T}/I{sub P}). Differential diagnostic performances of DESCT were calculated in the subgroup of 21 patients with histopathological evidence (bland group, n = 12; neoplastic group, n = 9). The iodine indices of the neoplastic group were significantly higher than those in the bland group (P < 0.001). A threshold I{sub T} of 1.14 mg/mL, I{sub T}/I{sub A} of 0.17, and I{sub T}/I{sub P} of 0.17 in the portal venous phase yielded 100 %, 88.9 %, and 100 % sensitivity, and 91.7 %, 91.7 %, and 83.3 % specificity, respectively, in differentiating neoplastic from bland PV thrombi. DESCT imaging with quantification of thrombus iodine density in the portal venous phase appears to be a promising new method for distinguishing neoplastic from bland macroscopic PV thrombi. (orig.)

  16. Right atrial mural thrombi: An autopsy study of an under-diagnosed complication at an unusual site

    Directory of Open Access Journals (Sweden)

    P Vaideeswar

    2017-01-01

    Full Text Available Background: Right atrial mural thrombi (RAMT are often seen in association with cardiac diseases or foreign bodies. Unusual locations at the flutter isthmus and the atrial appendage prompted us to evaluate our 2-year autopsy data on such thrombi. Materials and Methods: In the 2-year retrospective autopsy, the clinical and autopsy records of patients with RAMT were reviewed, with particular reference to the presence of central venous catheter (CVC, its site of insertion, its type, material and size, its duration of placement, and the drugs infused through the catheter. Results: Of the 940 autopsies performed in 2 years, RAMT was seen in 24 hearts and was related to an insertion of a CVC in 23 patients (95.8%. The risk and/or associated factors for this complication were tunneled and polyethylene catheters, Intensive Care Unit admission, infused drugs, underlying cardiac diseases, and pregnancy. A noteworthy feature was the location of the thrombi in the flutter isthmus in 16 hearts (66.7% and atrial appendage in another six hearts. Localized endocarditis/myocarditis and pulmonary thromboembolism were observed in six and four patients, respectively.Conclusions: This autopsy study, which has a high incidence of catheter-related RAMT, does not reflect the true incidence but reiterates the importance of guided insertion of central venous and prompt recognition of thrombus formation.

  17. Morphological aspects of mural thrombi deposition residual lumen route in infrarenal abdominal aorta aneurisms Morfologia da deposição de trombos murais: trajeto da luz residual em aneurismas de aorta abdominal infra-renal

    Directory of Open Access Journals (Sweden)

    Thiago Adriano Silva Guimarães

    2008-01-01

    Full Text Available PURPOSE: To assess the most frequent deposition site of mural thrombi in infrarenal abdominal aorta aneurisms, as well as the route of the residual lumen. METHODS: Assessment of CT scan images from 100 patients presenting asymptomatic abdominal aorta aneurism, and followed at HC-FMRP-USP. RESULTS: In 53% of the cases the mural thrombus was deposited on the anterior wall; from these, in 22%, the residual lumen described a predominantly right sided route; in 22%, a left sided route; on the mid line in 5%; and crossing over the mid line in 1%. In 23%, the deposition of thrombi was concentric. In 11% it occured on the posterior wall; from these, in 5%, the route of the residual anterior lumen was predominantly right sided; in 5%, left sided; and crossed over the mid line in 1%. In 13% complex morfological deposition patterns were found. CONCLUSION: Mural thrombi formation was predominantly found on the anterior wall of the aneurismatic mass, with the route of the residual lumen projecting towards the posterior wall.OBJETIVOS: Avaliar o local mais freqüente de deposição do trombo mural em aneurismas de aorta abdominal infrarenal, bem como o trajeto da luz residual. MÉTODOS: Avaliação de tomografias de 100 pacientes do HC-FMRP-USP apresentando aneurisma de aorta abdominal assintomático. RESULTADOS: O trombo mural se deposita na parede anterior em 53% dos casos, sendo que a luz residual posterior descreveu um trajeto predominantemente à direita em 22% dos casos, à esquerda em 22%, na linha mediana em 5% e cruzando da direita para a esquerda em 4%. 23% dos casos apresentaram deposição concêntrica do trombo e 11% apresentaram deposição na parede posterior, sendo o trajeto da luz residual anterior predominante a direita em 5% dos casos, a esquerda em 5% e cruzando a linha mediana em 1%. Padrões morfológicos complexos de deposição do trombo foram encontrados em 13% dos casos. CONCLUSÃO: A formação do trombo mural predominou na parede

  18. Revascularização da artéria coronária direita intra-atrial Revascularization of intracavitary right coronary artery

    Directory of Open Access Journals (Sweden)

    Artur Lourenção Júnior

    1990-12-01

    Full Text Available A artéria coronária direita, em seu trajeto no sulco atrioventricular direito, pode, em raras ocasiões, penetrar na cavidade atrial direita. Esta variação anatômica poderá modificar a tática cirúrgica em operações de revascularização miocárdica. No presente trabalho, relatamos o caso em que a ponte de veia safena para a artéria coronária direita foi realizada em posição intra-atrial direita.The right coronary artery, during your course in the right atrioventricular sulcus, can sometimes penetrate the right atrial cavity. This anatomical variety can modify the surgical tactics in aortocoronary by-pass surgery. In this paper we present a patient in whom the by-pass with saphenous vein graft to the right coronary artery was made in right intracavitary position.

  19. RELATIONSHIP OF LEFT VENTRICULAR SIZE TO LEFT ATRIAL AND LEFT ATRIAL APPENDAGE SIZE IN SINUS RHYTHM PATIENTS WITH DILATED CARDIOMYOPATHY

    Science.gov (United States)

    Bakalli, Aurora; Georgievska-Ismail, Ljubica; Musliu, Nebi; Koçinaj, Dardan; Gashi, Zaim; Zeqiri, Nexhmi

    2012-01-01

    Introduction: Thromboembolic events are a frequent cause of mortality in patients with congestive heart failure. The aim of or study was to evaluate the relationship of left ventricular end diastolic diameter (LVEDD) to left atrial (LA) size and left atrial appendage (LAA) size in patients with dilated cardiomyopathy in sinus rhythm, as well as to determine the prevalence of thrombi in LV and LA /LAA. Methods: This was a prospective cross-sectional study, conducted from December 2009 until December 2011. The study included 95 patients with dilated cardiomyopathy in sinus rhythm. Patients with swallowing problems, acute myocardial infarction, atrial fibrillation/flatter, severe systolic dysfunction, and/or patients who were taking oral anticoagulation therapy were excluded. Results: Mean patient age was 58.6 ± 12.2 years and 68.4% were men. Mean LVEDD of our population was 66.5 ± 6.5 mm, while mean LA atrium, LA volume and LAA maximal area were 46 ± 5.1 mm, 87.2 ± 38.7 cm3 and 4.7 ± 1.2 cm2, respectively. LA diameter (p<0.001) and LAA maximal area (p=0.01) showed to be independent predictors of LV size. LV thrombus was detected in 13 (13.7%) patients, while LAA thrombus in 46 (48.4%) patients of our study population. Conclusions: In conclusion, dilated LV size is associated with enlarged LA and LAA size. On the other hand, dilation of LV, LA and LAA is related to high prevalence of left chamber cardiac thrombi. PMID:23322961

  20. Availability of /sup 111/In-labeled platelet scintigraphy in patients with postinfarction left ventricular aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Tsuda, Takatoshi; Kubota, Masahiro; Iwakubo, Akifumi and others

    1989-03-01

    Eighteen patients with postinfarction left ventricular aneurysm (LVA) were examined with indium-111-labeled autologous platelet scintigraphy to identify intracardiac thrombi and to investigate the effect of antithrombotic agents on thrombogenesitiy within the LVA. Indium-111-platelet scintigraphy had a sensitivity of 60% and a specificity of 100% in detecting LVA mural thrombi. Among 6 patients showing false-negative scintigraphic studies, 4 was managed on antiplatelet therapy. Of 9 patients showing active platelet deposition on initial study, including 8 not receiving antiplatelet therapy, 5 were treated with tichlopidine (300 mg/day) for 29.8+-5.0 days. For the 5 patients, 2 had resolution and the 3 others had interruption of intraaneurysmal deposition in the second platelet study. For one patient receiving the third platelet study after warfarin therapy, it took two weeks to completely interrupt platelet deposition within the LVA. ECG gated radionuclide ventriculography and thallium-201 myocardial SPECT were also performed to assess left ventricular wall motion of left ventricular ejection fraction (LVEF) and myocardial blood perfusion. Thallium-201 SPECT showed apical or anteroapical perfusion defects. Radionuclide ventriculography pinpointed all 18 apical and anteroseptal aneurysms. A comparison between the thrombus positive group and the thrombus negative group revealed no statistical differences in LVEF and the period from the last myocardial infarction to the initial platelet scanning. These results suggest that indium-111 labeled platelet scintigraphy may be useful for identifying active left ventricular mural thrombi and for judging antiplatelet and anticoagulant therapy. (Namekawa, K).

  1. Left Hand-assisted Laparoscopic Nephrectomy With Renal Vein Thrombectomy for Stage T3b Renal Cell Carcinoma.

    Science.gov (United States)

    Ghareeb, George M; Kenleigh, Dorian A; Brown, James A

    2016-04-01

    A 60-year-old male was found to have an 8.0 cm left renal mass and associated renal vein thrombus on computed tomography. The thrombus extended 3 mm beyond the right aortic border to within 1.6 cm of the left border of the inferior vena cava. The patient underwent left nephrectomy with renal vein thrombectomy using a hand-assisted laparoscopic approach. The tumor thrombus was "milked" proximally back into left renal vein, which was then divided with an endovascular stapler. Left renal vein thrombi extending to right margin of the aorta can be managed with hand-assisted laparoscopic approach.

  2. Phentolamine as a treatment for poor mixing in transposition of the great arteries with adequate intraatrial communication.

    Science.gov (United States)

    Galal, M O; El-Naggar, W I; Sharfi, M H

    2005-01-01

    Patients with transposition of the great arteries often show poor mixing for different reasons, even after adequate balloon atrial septostomy. We present a patient with such a lesion whose clinical status improved dramatically after phentolamine was applied. We believe this improvement is due to reduction in afterload caused by the alpha(2) blocker and also possibly as a response to a presumptive effect of the drug on the diastolic function of the right ventricle, allowing more left-to-right shunt across the atrial septal defect. Both phenomena can improve cardiac output in such a situation.

  3. 利用整体心脏96通道标测系统对心房激动模式的标测及初步应用%Using 96-channel atrial mapping technique to record intraatrial conduction and activation pattern in intact hearts

    Institute of Scientific and Technical Information of China (English)

    黄思慧; 梁玉芝; 杨巧梅; 卫晓红; 任璐; 吴林

    2015-01-01

    目的 采用96通道心房标测技术,探讨窦性心律(简称窦律)及心房颤动(简称房颤)时,心房内激动传导与激动模式的变化,以及传统钠通道阻滞剂普罗帕酮与选择性晚钠电流抑制剂雷诺嗪对心房传导性的影响.方法 雌性新西兰兔Langendorff灌流的整体心脏,使用96通道心房外膜标测技术同步记录左右心房在窦律和房颤时激动传导时间(n=6).房颤诱发采用S1S2心房程序右房刺激.观察不同浓度的雷诺嗪(1,3,10和30 μmol/L,n=7)和普罗帕酮(0.1,0.3,1和3μmol/L,n=8)在窦律时对左右心房传导的影响.结果 与窦律时相比,96通道心房外膜标测中房颤发生后出现心房激动传导发生紊乱和异位激动点,左右心房的激动传导时间和平均激动时间显著延长.窦律下,低浓度普罗帕酮(≤0.3 μmol/L)与雷诺嗪(≤3 μmol/L)引起左右心房房内激动传导时间和平均激动时间的延长较小,统计学不显著,较高浓度的普罗帕酮(≥1μmol/L)与雷诺嗪(≥10 μmol/L)均可显著延长房内激动传导时间和平均激动时间(与基础状态相比,P<0.05),但均不改变心房内激动传导模式.结论 应用新型96通道标测技术可以直观地显示出房颤发生发展过程中心房内的异位激动点的位置,以及心房传导性与激动模式的改变,评价抗房颤药物对心房激动传导性的影响.%Objective A 96-channel mapping technique was used to determine electrical conduction and activation pattern in Langendorff-perfused rabbit atria during sinus rhythm and atrial fibrillation (AF) and the effects of traditional sodium channel blocker propafenone and selective late sodium current inhibitor ranolazine.Methods New-Zealand White female rabbits' hearts were isolated and perfused with a Langendorff perfusion setup.Electrograms of the right and left atrium during sinus rhythm and AF were recorded with a 96-channel array mapping system (n =6).Electrograms were recorded

  4. ECG phenomena: pseudopreexcitation and repolarization disturbances resembling ST-elevation myocardial infarction caused by an intraatrial rhabdomyoma in a newborn.

    Science.gov (United States)

    Paech, Christian; Gebauer, Roman Antonin

    2014-01-01

    As is known from other reports, a rhabdomyoma or tumor metastasis may alter intracardiac electrical conduction, producing electrical phenomena like pseudopreexcitation or repolarization disturbances resembling ST-elevation myocardial infarction or Brugada's syndrome. We present a newborn with a giant atrial rhabdomyoma and additionally multiple ventricular rhabdomyomas. He presented with several electrocardiogram (ECG) phenomena due to tumor-caused atrial depolarization and repolarization disturbances. Except from the cardiac tumors, the physical status was within normal range. Initial ECG showed a rapid atrial tachycardia with a ventricular rate of 230 bpm, which was terminated by electrical cardioversion. Afterwards, the ECG showed atrial rhythm with frequent atrial premature contractions and deformation of the PR interval with large, broad P waves and loss of discret PR segment, imposing as pseudopreexcitation. The following QRS complex was normal, with seemingly abnormal ventricular repolarization resembeling ST-elevation myocardial infarction. The atrial tumor was resected with consequent vast atrial reconstruction using patch plastic. The ventricular tumors were left without manipulation. After surgery, pseudopreexcitation and repolarization abnormalities vanished entirely and an alternans between sinus rhythm and ectopic atrial rhythm was present. These phenomena were supposably caused by isolated atrial depolarization disturbances due to tumor-caused heterogenous endocardial activation. The seemingly abnormal ventricular repolarization is probably due to repolarization of the atrial mass, superimposed on the ventricular repolarization. Recognizably, the QRS complex before and after surgical resection of the rhabdomyoma is identical, underlining the atrial origin of the repolarization abnormalities before surgery.

  5. Incremental value of live/real time three-dimensional transesophageal echocardiography over the two-dimensional technique in the assessment of aortic atherosclerotic thrombi and ulcers.

    Science.gov (United States)

    Elsayed, Mahmoud; Bulur, Serkan; Kalla, Aditi; Ahmed, Mustafa I; Hsiung, Ming C; Uygur, Begum; Alagic, Nermina; Sungur, Aylin; Singh, Satinder; Nanda, Navin C

    2016-08-01

    We present two cases in whom live/real time three-dimensional transesophageal echocardiography (3DTEE) provided incremental value in the assessment of atherosclerotic disease in the aorta. In one patient, it identified additional atherosclerotic ulcers as well as thrombi within them which were missed by two-dimensional (2D) TEE. In both cases, the size of the large mobile atherosclerotic plaque was underestimated by 2DTEE as compared with 3DTEE. Furthermore, 3DTEE provided volume quantification of the thrombi and ulcers which is not possible by 2DTEE. The echocardiographic findings of atherosclerotic plaques were confirmed by computed tomography in one patient and by surgery in the other.

  6. Tratamento cirúrgico da artéria coronária direita intra-atrial

    Directory of Open Access Journals (Sweden)

    José Carlos R. IGLÉZIAS

    1997-07-01

    Full Text Available A localização intracavitária da artéria coronária é rara. Segundo Ochsner & Mills (1, ela ocorreu com a artéria coronária direita em 0,9% e com o ramo interventricular em 0,2%. A localização da lesão e as condições patológicas relacionadas ao comprimento e diâmetro da coronária podem auxiliar na exposição da coronária intracavitária para uma revascularização apropriada. Freqüentemente os cirurgiões não estão habituados com a posição intracavitária e, durante a dissecção, podem abrir uma câmara cardíaca onde o vaso penetra. Os problemas que podem advir dai são a entrada de ar para a cavidade, a dificuldade na exposição do vaso, o sangramento e a obstrução da artéria durante o fechamento da miotomia. São relatados os casos de 3 pacientes que necessitaram de revascularização cirúrgica do miocárdio e que apresentavam a artéria coronária direita intracavitária. A localização e o comprimento da porção intracavitária da artéria auxiliam no manejo intra-operatório. A técnica utilizada para o fechamento da cavidade variou entre a anastomose na posição intracavitária com o fechamento da miotomia ao redor do enxerto (Figura 1, a liberação da artéria coronária para uma posição superficial (Figura 2, seguida da anastomose e fechamento da cavidade com sutura simples, feita subepicárdica.An intracavitary location of a coronary artery is rare in our surgical experience with revascularization. This variant has occured in the right coronary artery (0.01% and in left anterior descending coronary artery (0.2%. The location of the lesion and the pathological condition, length and size of the coronary may dictate exposure of an intracavitary coronary artery for proper revascularization; more commonly surgeons are anaware of the intracavitary position and during intramyocardial dissection of an artery will open a cardiac chamber where the vessel traverses the cavity. Problems that arise are introducion

  7. An Endovascular Cannulation Needle with an Internal Wire for the Fragmentation of Thrombi in Retinal Vein Occlusion.

    Science.gov (United States)

    Asami, Tetsu; Kaneko, Hiroki; Miyake, Kensaku; Ota, Ichiro; Miyake, Goichiro; Kato, Seiichi; Yasuda, Shunsuke; Iwase, Takeshi; Ito, Yasuki; Terasaki, Hiroko

    2016-09-01

    We report a newly developed device to fragment thrombi in retinal vein occlusion. The new instrument consists of a 23-gauge (G) pipe and a 37-G needle with an internal wire. A total of 40 porcine eyes were used; 20 eyes for experiments in the branch retinal vein (BRV group) and 20 eyes for experiments in the central retinal vein (CRV group). We placed 25-G 3-port trocars, and core vitrectomy was performed. Another 23-G scleral incision was performed for insertion of the needle. The needle pierced the retinal vein at a distance of three- to four- or one-disc diameters from the optic disc (BRV or CRV group, respectively), and the internal wire was advanced toward the disc. The success rates of needle piercing and cannulation of the internal wire were recorded in each group. In the CRV group, the cannulation was deemed successful when the tip reached inside the optic disc. Real-time optical coherence tomography imaging also was performed using the Zeiss Rescan 700 device in porcine eyes. Histologic examination of the retinal vessel inserted with the internal wire was performed. The success rates of needle piercing into the BRV and CRV were 85% and 95%, respectively. The success rates of cannulation of the internal wire into the BRV and CRV were 85% and 0%, respectively. The process of cannulation was recorded successfully with the Rescan 700. Histologic examination showed no damages to the endothelial cell layer. The needle and internal wire intended to be used for recanalization of BRV occlusion were successfully pierced and cannulated into the BRV. This newly developed device could become a treatment modality for retinal vein occlusion to fragment thrombi that present treatment methods cannot reach and remove directly.

  8. Turning Left

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    An increasing number of left-wing political figures are holding power in Latin America, raising eyebrows in Washington This is a banner election year in Latin America, with nine countries heading to the polls to select new leaders. But the succession of victories by left-leaning politicians, with more likely in the coming months, is expected to draw mounting concern from the United

  9. When the Left is left!

    Directory of Open Access Journals (Sweden)

    Asha J Mathew

    2014-09-01

    Full Text Available Persistent left superior vena cava is an uncommon vascular anomaly; however it is the most common anomaly of the thoracic venous system. It may be stand alone or associated with other congenital heart diseases and even other extracardiac anomalies. It is due to a lack of regression and adsorption of the left anterior cardinal vein. The persistence of this vessel renders a left subclavian approach for interventions on the right heart a challenge. It may be responsible for arrthymiias. We present a report of a persistent left superior vena cava draining into the coronary sinus with a coexisting normal right superior vena cava. Keeping in mind its widespread implications on cardiac procedures and a causative factor of cardiac disturbances we have considered its course, embryological source and clinical significance.

  10. Computed tomography for the detection of free-floating thrombi in the right heart in acute pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Mansencal, Nicolas [Universite de Versailles-Saint Quentin (UVSQ), Ambroise Pare Hospital, Assistance Publique-Hopitaux de Paris (AP-HP), Centre de Reference des Maladies Cardiaques Hereditaires, Department of Cardiology, Boulogne (France); AP-HP, Hopital Universitaire Ambroise Pare, Service de Cardiologie et des Maladies Vasculaires, Centre de Reference des Maladies Cardiaques Hereditaires, Boulogne (France); Attias, David; Guiader, Julie; Abi Nasr, Imad; Dubourg, Olivier [Universite de Versailles-Saint Quentin (UVSQ), Ambroise Pare Hospital, Assistance Publique-Hopitaux de Paris (AP-HP), Centre de Reference des Maladies Cardiaques Hereditaires, Department of Cardiology, Boulogne (France); Caille, Vincent; Jardin, Francois; Vieillard-Baron, Antoine [Universite de Versailles-Saint Quentin (UVSQ), Ambroise Pare Hospital, Assistance Publique-Hopitaux de Paris (AP-HP), Intensive Care Unit, Boulogne (France); Desperramons, Julien; El Hajjam, Mostafa; Lacombe, Pascal [Universite de Versailles-Saint Quentin (UVSQ), Ambroise Pare Hospital, Assistance Publique-Hopitaux de Paris (AP-HP), Department of Radiology, Boulogne (France)

    2011-02-15

    The aim of this study was to assess the prevalence of free-floating thrombi in the right heart (FFT) and the accuracy of computed tomography (CT) for their detection in pulmonary embolism (PE). We studied 340 consecutive patients presenting with PE. All patients underwent CT and echocardiography. The prevalence of FFT was 3.5% in the global population of PE and 22% in high-risk PE. Dyspnoea, cardiogenic shock, cardiac arrest and tachycardia were more frequently found in patients with FFT (p = 0.04, p < 0.0001, p = 0.0003 and p = 0.01, respectively). Sensitivity and specificity of CT for the detection of FFT were 100% (95% confidence interval: 74%-100%) and 97% (95%-99%), whereas positive and negative predictive values were 57% (34%-78%) and 100% (99%-100%). Among patients with FFT, right ventricular dilation was always detected by CT, whereas no right ventricular dilation was found among patients with a false diagnosis of FFT performed by CT (p < 0.0001). Prevalence of FFT is 3.5% and differs according to the clinical presentation. Detection of FFT by CT is feasible and should lead to echocardiography being promptly performed for the confirmation of FFT. (orig.)

  11. Histopathological features of aspirated thrombi after primary percutaneous coronary intervention in patients with ST-elevation myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Miranda C Kramer

    Full Text Available BACKGROUND: Plaque disruption with superimposed thrombus is the predominant mechanism responsible for the onset of acute coronary syndromes. Studies have shown that plaque disruption and thrombotic occlusion are frequently separated in time. We established the histopathological characteristics of material aspirated during primary percutaneous coronary intervention (PCI in a large consecutive ST-elevation myocardial infarction (STEMI population. METHODOLOGY/PRINCIPAL FINDINGS: Thrombus aspiration during primary PCI was performed in 1,362 STEMI patients. Thrombus age was classified as fresh (5 day. Further, the presence of plaque was documented. The histopathological findings were related to the clinical, angiographic, and procedural characteristics. Material could be aspirated in 1,009 patients (74%. Components of plaque were found in 395 of these patients (39%. Fresh thrombus was found in 577 of 959 patients (60% compared to 382 patients (40% with lytic or organized thrombi. Distal embolization was present in 21% of patients with lytic thrombus compared to 12% and 15% of patients with fresh or organized thrombus. CONCLUSIONS/SIGNIFICANCE: Material could be obtained in 74% of STEMI patients treated with thrombus aspiration during primary PCI. In 40% of patients thrombus age is older than 24 h, indicating that plaque disruption and thrombus formation occur significantly earlier than the onset of symptoms in many patients.

  12. Left atrial strain: a new predictor of thrombotic risk and successful electrical cardioversion

    Directory of Open Access Journals (Sweden)

    Cátia Costa

    2016-06-01

    Full Text Available Background: Left atrial deformation (LAD parameters are new markers of atrial structural remodelling that seem to be affected in atrial fibrillation (AF and atrial flutter (AFL. This study aimed to determine whether LAD can identify patients with a higher risk of thrombosis and unsuccessful electrical cardioversion (ECV. Methods: Retrospective study including 56 patients with AF or AFL undergoing ECV, with previous transthoracic (TTE and transoesophageal echocardiography (TEE studies. Echocardiographic parameters analysed were as follows: left ventricle function, left atrium (LA dimensions, LAD parameters (positive and negative strain peaks, left atrial appendage (LAA filling and emptying velocities and the presence of thrombi. Strain values were analysed according to thrombotic risk and success of ECV. Results: Lower mean values of peak-positive strain (PPS in patients with prothrombotic velocities (<25 cm/s and a higher incidence of thrombi in LAA were observed compared with those with normal velocities. Multivariate analysis revealed PPS normalised by LA maximum volume indexed by body surface area (BSA to be associated with prothrombotic risk (odds ratio 0.000 (95% CI: 0.000–0.243, P 0.017, regardless of CHADs2VASC score. Peak-negative strain normalised by LA volumes indexed by BSA were associated with unsuccessful ECV. Conclusions: Atrial deformation parameters identify AF and AFL patients with a high risk of thrombosis and unsuccessful ECV. Therefore, these new parameters should be included in anticoagulation management and rhythm vs rate control strategies.

  13. 应用心房内心电图辅助PICC导管尖端定位的效果评价%The clinical application of intraatrial electrocardiogram-assisted Peripherally lnserted Central Catheter tip positioning technology

    Institute of Scientific and Technical Information of China (English)

    姜桂春

    2016-01-01

    目的:评价心房内心电图辅助PICC导管尖端定位的临床应用效果。方法:将我院2015年1-9月入院的1000例患者按抽签法随机分为对照组和实验组,两组均采用常规方法进行导管置入,两组患者在置管结束后均进行X线片定位确定导管尖端位置,而实验组在置管过程中增加应用心房内心电图辅助技术进行导管尖端定位,比较两组导管尖端的异位率及导管尖端位于理想位置的比例。结果:实验组导管尖端异位率比对照组低(χ2=30.548,P<0.001);不同置管静脉中两组导管尖端异位率均存在统计学差异(P<0.05);实验组导管尖端位于理想位置的比例高于对照组(P<0.05)。结论:应用心房内心电图辅助PICC导管尖端定位,可有效降低导管尖端的异位率,在判断导管尖端位于理想位置的灵敏度高。%Objective: To explore the clinical application of intraatrial electrocardiogram-assisted Peripherally lnserted Central Catheter (PICC) tip positioning technology. Methods: Totally 1000 hospitalized patients were recruited from January 2015 to September and randomly divided into the control group and the experimental group by random sampling method. The patients in two groups were catheterized using conventional method and the catheter tip position were determined by X-rays, while the experimental group added intra-atrial electrocardiogram assisted PICC tip positioning technology to position catheter tip. We compared the catheter heterotopia rate and the sensitivity of catheter tip located in the superior vena cava between the two groups. Results: The catheter heterotopia rate in the experimental group was signiifcantly lower than that in the control group (2= 30.548,P<0.001), while the sensitivity of catheter tip located in the superior vena cava had signiifcant difference (P<0.05). Conclusion: The application of intraatrial electrocardiogram-assisted PICC tip positioning

  14. ARE LEFT HANDED SURGEONS LEFT OUT?

    OpenAIRE

    SriKamkshi Kothandaraman; Balasubramanian Thiagarajan

    2012-01-01

    Being a left-handed surgeon, more specifically a left-handed ENT surgeon, presents a unique pattern of difficulties.This article is an overview of left-handedness and a personal account of the specific difficulties a left-handed ENT surgeon faces.

  15. Medical image of the week: persistent left superior vena cava

    Directory of Open Access Journals (Sweden)

    Hammode E

    2014-10-01

    Full Text Available No abstract available. Article truncated after 150 words. A 19 year old man with acute lymphocytic leukemia was admitted to the ICU with septic shock. Due to areas of cellulitis on the right side of the chest and neck and femoral venous thrombi, a left subclavian central access was attempted. The chest x-ray obtained after line placement is shown below (Figure 1. Blood gas done from the line was consistent with venous blood and venous tranduction was seen. A CT of the chest (Figure 2 confirmed the diagnosis of persistent left superior vena cava (PLSVC. A persistent left superior vena cava is the most common congenital thoracic venous anomaly, seen in 0.3-0.5% of the population (1. Incidence is increased in patients with congenital heart disease to 5%. In most patients a right sided SVC is also present; hence the term SVC duplication has also been used. Embryologically a PLSVC is formed when the left anterior cardinal vein is ...

  16. Comparison of Sarns 3M heparin bonded to Duraflo II and control circuits in a porcine model: macro- and microanalysis of thrombi accumulation in circuit arterial filters.

    Science.gov (United States)

    Larson, D F; Arzouman, D; Kleinert, L; Patula, V; Williams, S

    2000-01-01

    Heparin-bonded perfusion circuits have been reported to reduce the thrombus formation during various levels of systemic heparinization. The goal of this study was to compare the efficacy of thrombo-resistance of the Sarns 3M heparin-bonded circuit to Baxter Duraflo II and untreated control in a porcine model. Fifteen Yorkshire pigs (60-65 kg) were anesthetized, heparinized with 3000 IU, intravenously (i.v.) and surgically cannulated with an internal jugular outflow and a femoral vein inflow. All circuits consisted of a 22-Fr venous cannula, centrifugal pump, arterial filter, an 18-Fr cannula for return and connected with equal lengths of 3/8" polyvinyl chloride tubing. The flows were maintained at 2.0 l/min for 4 h. Thrombus formation in filter samples were morphometrically analyzed through macro-densitometry, light microscopy, and scanning electron microscopy (SEM). Our findings revealed that the 3M circuit had significantly less gross thrombus (p < 0.001), 66% and 84% less microscopic thrombi and fivefold less SEM-measured aggregates (p = 0.03) compared to the Duraflo II and uncoated groups. This study demonstrated that the 3M heparin-bonded circuit had significantly reduced the formation of micro- and macro-thrombi in the minimally heparinized pig model compared to the Duraflo II and untreated control circuits.

  17. Endoscopic Ultrasound for the Detection of Left Atrial Appendage Thrombus: A Useful Technique in Patients with Transesophageal Echocardiography Contraindication

    Science.gov (United States)

    Jurado-Román, Alfonso; López-Viedma, Bartolomé; Piqueras-Flores, Jesús; López-Lluva, María T.

    2016-01-01

    Endoscopic ultrasound is a diagnostic and therapeutic technique used in specialized centers for patients that have undergone digestive procedures. This technique enables highly precise real-time imaging of the digestive tract wall and surrounding organs. Endoscopic ultrasound is also useful in patients with cardiovascular diseases such as atrial fibrillation. In patients with contraindication for transesophageal echocardiography due to high risk of esophageal bleeding or complications that may require immediate intervention, endoscopic ultrasound may be a safer option for visualizing atrial chambers to rule out the presence of left atrial appendage thrombi before cardioversion. PMID:27642527

  18. Left ventricular thrombus formation after acute myocardial infarction as assessed by cardiovascular magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Delewi, Ronak [Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Interuniversity Cardiology Institute of the Netherlands (Netherlands); Nijveldt, Robin [Department of Cardiology, VU University Medical Center, Amsterdam (Netherlands); Hirsch, Alexander [Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Marcu, Constantin B.; Robbers, Lourens [Department of Cardiology, VU University Medical Center, Amsterdam (Netherlands); Hassell, Marriela E.C.J.; Bruin, Rianne H.A. de; Vleugels, Jim; Laan, Anja M. van der; Bouma, Berto J. [Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Tio, René A. [Thorax Center, University Medical Center Groningen, Groningen (Netherlands); Tijssen, Jan G.P. [Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Rossum, Albert C. van [Department of Cardiology, VU University Medical Center, Amsterdam (Netherlands); Zijlstra, Felix [Thorax Center, Department of Cardiology, Erasmus University Medical Center, Rotterdam (Netherlands); Piek, Jan J., E-mail: j.j.piek@amc.uva.nl [Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands)

    2012-12-15

    Introduction: Left ventricular (LV) thrombus formation is a feared complication of myocardial infarction (MI). We assessed the prevalence of LV thrombus in ST-segment elevated MI patients treated with percutaneous coronary intervention (PCI) and compared the diagnostic accuracy of transthoracic echocardiography (TTE) to cardiovascular magnetic resonance imaging (CMR). Also, we evaluated the course of LV thrombi in the modern era of primary PCI. Methods: 200 patients with primary PCI underwent TTE and CMR, at baseline and at 4 months follow-up. Studies were analyzed by two blinded examiners. Patients were seen at 1, 4, 12, and 24 months for assessment of clinical status and adverse events. Results: On CMR at baseline, a thrombus was found in 17 of 194 (8.8%) patients. LV thrombus resolution occurred in 15 patients. Two patients had persistence of LV thrombus on follow-up CMR. On CMR at four months, a thrombus was found in an additional 12 patients. In multivariate analysis, thrombus formation on baseline CMR was independently associated with, baseline infarct size (g) (B = 0.02, SE = 0.02, p < 0.001). Routine TTE had a sensitivity of 21–24% and a specificity of 95–98% compared to CMR for the detection of LV thrombi. Intra- and interobserver variation for detection of LV thrombus were lower for CMR (κ = 0.91 and κ = 0.96) compared to TTE (κ = 0.74 and κ = 0.53). Conclusion: LV thrombus still occurs in a substantial amount of patients after PCI-treated MI, especially in larger infarct sizes. Routine TTE had a low sensitivity for the detection of LV thrombi and the interobserver variation of TTE was large.

  19. Hypoplastic left heart syndrome

    Science.gov (United States)

    HLHS; Congenital heart - hypoplastic left heart; Cyanotic heart disease - hypoplastic left heart ... Hypoplastic left heart is a rare type of congenital heart disease. It is more common in males than in ...

  20. HMGB1 binds to activated platelets via the receptor for advanced glycation end products and is present in platelet rich human coronary artery thrombi.

    Science.gov (United States)

    Ahrens, Ingo; Chen, Yung-Chih; Topcic, Danijal; Bode, Michael; Haenel, David; Hagemeyer, Christoph E; Seeba, Hannah; Duerschmied, Daniel; Bassler, Nicole; Jandeleit-Dahm, Karin A; Sweet, Matthew J; Agrotis, Alex; Bobik, Alex; Peter, Karlheinz

    2015-11-01

    High mobility group box 1 (HMGB1) acts as both a nuclear protein that regulates gene expression, as well as a pro-inflammatory alarmin that is released from necrotic or activated cells. Recently, HMGB1-expression in human atherosclerotic plaques was identified. Therapeutic blockade of HMGB1 reduced the development of diet-induced atherosclerosis in ApoE knockout mice. Thus, we hypothesised an interaction between HMGB1 and activated platelets. Binding of recombinant HMGB1 to platelets was assessed by flow cytometry. HMGB1 bound to thrombin-activated human platelets (MFI 2.49 vs 25.01, p=0.0079). Blood from wild-type, TLR4 and RAGE knockout mice was used to determine potential HMGB1 receptors on platelets. HMGB1 bound to platelets from wild type C57Bl6 (MFI 2.64 vs 20.3, p 0.05). RAGE expression on human platelets was detected by RT-PCR with mRNA extracted from highly purified platelets and confirmed by Western blot and immunofluorescence microscopy. Platelet activation increased RAGE surface expression (MFI 4.85 vs 6.74, p< 0.05). Expression of HMGB1 in human coronary artery thrombi was demonstrated by immunohistochemistry and revealed high expression levels. Platelets bind HMGB1 upon thrombin-induced activation. Platelet specific expression of RAGE could be detected at the mRNA and protein level and is involved in the binding of HMGB1. Furthermore, platelet activation up-regulates platelet surface expression of RAGE. HMGB1 is highly expressed in platelet-rich human coronary artery thrombi pointing towards a central role for HMGB1 in atherothrombosis, thereby suggesting the possibility of platelet targeted anti-inflammatory therapies for atherothrombosis.

  1. Rationale and design of a study exploring the efficacy of once-daily oral rivaroxaban (X-TRA) on the outcome of left atrial/left atrial appendage thrombus in nonvalvular atrial fibrillation or atrial flutter and a retrospective observational registry providing baseline data (CLOT-AF).

    Science.gov (United States)

    Lip, Gregory Y H; Hammerstingl, Christoph; Marin, Francisco; Cappato, Riccardo; Meng, Isabelle Ling; Kirsch, Bodo; Morandi, Eolo; van Eickels, Martin; Cohen, Ariel

    2015-04-01

    There are still many unresolved issues concerning patient outcomes and prognostic factors in patients with atrial fibrillation (AF) and left atrial/left atrial appendage (LA/LAA) thrombi. Rivaroxaban (Xarelto®), a potent and highly selective oral, direct factor Xa inhibitor, is a new therapeutic option in this setting. The planned study program will consist of a prospective interventional study (X-TRA) and a retrospective observational registry (CLOT-AF). The primary objective of the X-TRA study is to explore the efficacy of rivaroxaban in the treatment of LA/LAA thrombi in patients with nonvalvular AF or atrial flutter, scheduled to undergo cardioversion or AF ablation, in whom an LA/LAA thrombus has been found on transesophageal echocardiography (TEE) before the procedure. The primary end point is the complete LA/LAA thrombus resolution rate at 6 weeks of end of treatment confirmed by TEE. The secondary objectives are to describe categories of thrombus outcome in patients (resolved, reduced, unchanged, larger, or new) confirmed on TEE at the end of treatment (after 6 weeks of treatment), incidence of the composite of stroke and noncentral nervous system systemic embolism at the end of treatment and during follow-up, and incidence of all bleeding at the end of treatment and during follow-up. The objective of the CLOT-AF registry is to provide retrospective thrombus-related patient outcome data after standard-of-care anticoagulant treatment in patients with nonvalvular AF or atrial flutter, who have TEE-documented LA/LAA thrombi. The data will be used as a reference for the prospective X-TRA study. In conclusion, X-TRA and CLOT-AF will provide some answers to the many unresolved issues concerning patient outcomes and prognostic factors in patients with AF and LAA thrombi. Results from this study program would provide the first prospective interventional study (X-TRA) and a large international retrospective observational registry (CLOT-AF) on the prevalence and

  2. Acute thrombosis during left main stenting using tap technique in a patient presenting with non-ST-segment elevation acute coronary syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Natarajan, Deepak, E-mail: deepaknatarajan@me.com

    2015-06-15

    This case reports the sudden development of large burden of thrombi in the left anterior descending coronary artery immediately following distal left main stenting using TAP technique in a middle aged man who presented with non ST-segment elevation acute coronary syndrome despite having been administered 7,500 units of unfractionated heparin and being given 325 mg of aspirin and 60 mg of prasugrel prior to the procedure. The thrombi were managed effectively by giving an intra-coronary high bolus dose of tirofiban (25 mcg/kg) without the need for catheter thrombus extraction. Tirofiban intra-venous infusion was maintained for 18 hours, and the patient was discharged in stable condition on the third day. Importantly there is no controlled study on upstream administration of glycoprotein IIb/IIIa inhibitors in addition to the newer more potent anti-platelet agents in patients with unprotected distal left main disease presenting with non ST-segment elevation acute coronary syndrome, nor is there any data on safety and efficacy of mandatory usage of injectable anti-platelet agents at the start of a procedure in a catheterization laboratory in such a setting.

  3. Left Ventricular Aneurysm: Sudden Unexpected Deaths in a 29-Year-Old Man.

    Science.gov (United States)

    Srettabunjong, Supawon

    2017-08-02

    Left ventricular aneurysm (LVA) is an abnormal dilated heart structure, either congenital or acquired. LVA is a rare cardiac condition with no symptoms in most cases, thus occasionally diagnosed during investigations of other diseases. Its association with certain cardiac complications and sudden cardiac deaths has been reported. However, its role as a cause of sudden unexpected death is rare. The author reported a sudden cardiac death in a 29-year-old man with LVA. Without a significant coronary artery disease and known etiologies of LVA, such an abnormal heart structure in the present case was considered congenital LVA. As no other possible mechanisms of death could be identified other than LVA with its associated pathologic lesions, mural thrombi, and dilated cardiomegaly, his death was attributable to fatal cardiac arrhythmia (most commonly ventricular tachycardia) secondary to LVA. © 2017 American Academy of Forensic Sciences.

  4. Left atrial volume index

    DEFF Research Database (Denmark)

    Poulsen, Mikael K; Dahl, Jordi S; Henriksen, Jan Erik;

    2013-01-01

    To determine the prognostic importance of left atrial (LA) dilatation in patients with type 2 diabetes (T2DM) and no history of cardiovascular disease.......To determine the prognostic importance of left atrial (LA) dilatation in patients with type 2 diabetes (T2DM) and no history of cardiovascular disease....

  5. Left heart catheterization

    Science.gov (United States)

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

  6. Left Ventricular Hypertrophy

    Science.gov (United States)

    ... the chamber itself also increases. The enlarged heart muscle loses elasticity and eventually may fail to pump with as much force as needed. Left ventricular hypertrophy is more common in people who have uncontrolled ...

  7. Left-Handed Connections.

    Science.gov (United States)

    Lipson, Alice M.

    1984-01-01

    The following aspects of left-handedness are discussed: etiology and associated learning and developmental disorders; right-brain dominance and how to detect it; adaptations to the physical learning environment; behavior patterns; and teaching techniques. (JW)

  8. Left atrial appendage closure devices for cardiovascular risk reduction in atrial fibrillation patients

    Directory of Open Access Journals (Sweden)

    Cruz-Gonzalez I

    2015-05-01

    Full Text Available Ignacio Cruz-Gonzalez,* Juan Carlos Rama-Merchan,* Javier Rodriguez-Collado, Javier Martin-Moreiras, Alejandro Diego-Nieto, Antonio Arribas-Jimenez, Pedro Luís SanchezDepartment of Cardiology, University Hospital of Cardiology and IBSAL, Salamanca, Spain *Ignacio Cruz-Gonzalez and Juan Carlos Rama-Merchan have contributed equally to this work and should be considered co-first authors Abstract: Atrial fibrillation (AF is the most common sustained arrhythmia in clinical practice. AF is associated with a 4–5-fold increased risk of stroke and systemic embolism. Oral anticoagulant is the first-line therapy for this purpose, but it has various limitations and is often contraindicated or underutilized. Autopsy and surgical data have suggested that 90% of atrial thrombi in nonvalvular AF patients originate from the left atrial appendage, leading to the development of percutaneous closure for thromboembolic prevention. This paper examines the current evidence on left atrial appendage closure devices for cardiovascular risk reduction in AF patients. Keywords: atrial fibrillation, left atrial appendage, stroke, oral anticoagulant, percutaneous closure, thromboembolic prevention

  9. Left Atrial Appendage: Physiology, Pathology, and Role as a Therapeutic Target

    Directory of Open Access Journals (Sweden)

    Damiano Regazzoli

    2015-01-01

    Full Text Available Atrial fibrillation (AF is the most common clinically relevant cardiac arrhythmia. AF poses patients at increased risk of thromboembolism, in particular ischemic stroke. The CHADS2 and CHA2DS2-VASc scores are useful in the assessment of thromboembolic risk in nonvalvular AF and are utilized in decision-making about treatment with oral anticoagulation (OAC. However, OAC is underutilized due to poor patient compliance and contraindications, especially major bleedings. The Virchow triad synthesizes the pathogenesis of thrombogenesis in AF: endocardial dysfunction, abnormal blood stasis, and altered hemostasis. This is especially prominent in the left atrial appendage (LAA, where the low flow reaches its minimum. The LAA is the remnant of the embryonic left atrium, with a complex and variable morphology predisposing to stasis, especially during AF. In patients with nonvalvular AF, 90% of thrombi are located in the LAA. So, left atrial appendage occlusion could be an interesting and effective procedure in thromboembolism prevention in AF. After exclusion of LAA as an embolic source, the remaining risk of thromboembolism does not longer justify the use of oral anticoagulants. Various surgical and catheter-based methods have been developed to exclude the LAA. This paper reviews the physiological and pathophysiological role of the LAA and catheter-based methods of LAA exclusion.

  10. Hypoplastic left heart syndrome (image)

    Science.gov (United States)

    Hypoplastic left heart syndrome is a congenital heart condition that occurs during the development of the heart in the ... womb. During the heart's development, parts of the left side of the heart (mitral valve, left ventricle ...

  11. Artificial Left Ventricle

    CERN Document Server

    Ranjbar, Saeed; Meybodi, Mahmood Emami

    2014-01-01

    This Artificial left ventricle is based on a simple conic assumption shape for left ventricle where its motion is made by attached compressed elastic tubes to its walls which are regarded to electrical points at each nodal .This compressed tubes are playing the role of myofibers in the myocardium of the left ventricle. These elastic tubes have helical shapes and are transacting on these helical bands dynamically. At this invention we give an algorithm of this artificial left ventricle construction that of course the effect of the blood flow in LV is observed with making beneficiary used of sensors to obtain this effecting, something like to lifegates problem. The main problem is to evaluate powers that are interacted between elastic body (left ventricle) and fluid (blood). The main goal of this invention is to show that artificial heart is not just a pump, but mechanical modeling of LV wall and its interaction with blood in it (blood movement modeling) can introduce an artificial heart closed to natural heart...

  12. PERSISTENT LEFT SUPERIOR VENACAVA

    Directory of Open Access Journals (Sweden)

    Devinder Singh

    2014-05-01

    Full Text Available A Persistent Left Superior Venacava (PLSVC is the most common variation of the thoracic venous system and rare congenital vascular anomaly and is prevalent in 0.3% of the population. It may be associated with other cardiovascular abnormalities including atrial septal defect, bicuspid aortic valve, coarctation of aorta, coronary sinus ostial atresia, and cor triatriatum. Incidental rotation of a dilated coronary sinus on echocardiography should raise the suspicion of PLSVC. The diagnosis should be confirmed by saline contrast echocardiography. Condition is usually asymptomatic. Here we present a rare case of persistent left superior vena cava presented in OPD with dyspnoea & palpitations.

  13. 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.

  14. Left or Right

    Institute of Scientific and Technical Information of China (English)

    常厚飞

    2007-01-01

    In Europe people hold the fork in the left hand and the knife in the right throughout the meal, a system that is generally agreed to be more efficient than the American zigzag method. Americans hold both the fork and the knife in their right hands throughout the meal,

  15. 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

  16. Dual-enhancement cardiac computed tomography for assessing left atrial thrombus and pulmonary veins before radiofrequency catheter ablation for atrial fibrillation.

    Science.gov (United States)

    Hur, Jin; Pak, Hui-Nam; Kim, Young Jin; Lee, Hye-Jeong; Chang, Hyuk-Jae; Hong, Yoo Jin; Choi, Byoung Wook

    2013-07-15

    Noninvasive imaging that provides anatomic information while excluding intracardiac thrombus would be of significant clinical value for patients referred for catheter ablation of atrial fibrillation (AF). This study assessed the diagnostic performance of a dual-enhancement single-phase cardiac computed tomography (CT) protocol for thrombus and circulatory stasis detection in AF patients before catheter ablation. We studied 101 consecutive symptomatic AF patients (71 men and 30 women; mean age, 61.8 years) who were scheduled to have catheter ablation. All patients had undergone pre-AF ablation CT imaging and transesophageal echocardiography on the same day. CT was performed with prospective electrocardiographic gating, and scanning began 180 seconds after the test bolus. Mean left atrial appendage (LAA)/ascending aorta Hounsfield unit (HU) ratios were measured on CT images. Among the 101 patients, 9 thrombi and 18 spontaneous echo contrasts were detected by transesophageal echocardiography. The overall sensitivity, specificity, positive predictive value, and negative predictive value of CT for the detection of thrombi in the LAA were 89%, 100%, 100%, and 99%, respectively. The mean LAA/ascending aorta HU ratios were significantly different between thrombus and circulatory stasis (0.17 vs 0.33, p = 0.002). Dual-enhancement single-scan cardiac CT is a sensitive modality for detecting and differentiating LAA thrombus and circulatory stasis.

  17. Left musculus sternalis.

    Science.gov (United States)

    Arráez-Aybar, L A; Sobrado-Perez, J; Merida-Velasco, J R

    2003-07-01

    During routine dissection in the Morphological Sciences Department II of the Universidad Complutense de Madrid, the presence of a sternalis muscle was observed in the left hemithorax of a 70-year-old male cadaver. We report on its position, relationships, and innervation, as well as its clinical relevance, indicating some guidelines for its physical examination. We also present a brief overview of the existing literature regarding the nomenclature, historical reports, and incidence of this muscle.

  18. Feasibility of transapical aortic valve replacement through a left ventricular apical diverticulum

    Directory of Open Access Journals (Sweden)

    Ferrari Enrico

    2013-01-01

    Full Text Available Abstract Transapical aortic valve replacement is an established technique performed in high-risk patients with symptomatic aortic valve stenosis and vascular disease contraindicating trans-vascular and trans-aortic procedures. The presence of a left ventricular apical diverticulum is a rare event and the treatment depends on dimensions and estimated risk of embolisation, rupture, or onset of ventricular arrhythmias. The diagnosis is based on standard cardiac imaging and symptoms are very rare. In this case report we illustrate our experience with a 81 years old female patient suffering from symptomatic aortic valve stenosis, respiratory disease, chronic renal failure and severe peripheral vascular disease (logistic euroscore: 42%, who successfully underwent a transapical 23 mm balloon-expandable stent-valve implantation through an apical diverticulum of the left ventricle. Intra-luminal thrombi were absent and during the same procedure were able to treat the valve disease and to successfully exclude the apical diverticulum without complications and through a mini thoracotomy. To the best of our knowledge, this is the first time that a transapical procedure is successfully performed through an apical diverticulum.

  19. Percutaneous left atrial appendage closure devices: safety, efficacy, and clinical utility

    Directory of Open Access Journals (Sweden)

    Swaans MJ

    2016-09-01

    Full Text Available Martin J Swaans, Lisette IS Wintgens, Arash Alipour,  Benno JWM Rensing, Lucas VA Boersma Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands Abstract: Atrial fibrillation (AF is the most common arrhythmia treated in the clinical practice. One of the major complications of AF is a thromboembolic cerebral ischemic event. Up to 20% of all strokes are caused by AF. Thromboembolic cerebral ischemic event in patients with AF occurs due to atrial thrombi, mainly from the left atrial appendage (LAA. Prevention of clot formation with antiplatelet agents and especially oral anticoagulants (­vitamin K antagonists or newer oral anticoagulants has been shown to be effective in reducing the stroke risk in patients with AF but has several drawbacks with (major bleedings as the most important disadvantage. Therefore, physical elimination of the LAA, which excludes the site of clot formation by surgical or percutaneous techniques, might be a good alternative. In this review, we discuss the safety, efficacy, and clinical utility of the Watchman™ LAA closure device. Keywords: stroke, left atrial appendage, prevention, atrial fibrillation

  20. 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.

  1. Your left-handed brain

    OpenAIRE

    2014-01-01

    While most people prefer to use their right hand to brush their teeth, throw a ball, or hold a tennis racket, left-handers prefer to use their left hand. This is the case for around 10% of all people. There was a time (not so long ago) when left-handers were stigmatized (see Glossary) in Western (and other) communities: it was considered a bad sign if you were left-handed, and left-handed children were often forced to write with their right hand. This is nonsensical: there is nothing wrong wi...

  2. Left Artinian Algebraic Algebras

    Institute of Scientific and Technical Information of China (English)

    S. Akbari; M. Arian-Nejad

    2001-01-01

    Let R be a left artinian central F-algebra, T(R) = J(R) + [R, R],and U(R) the group of units of R. As one of our results, we show that, if R is algebraic and char F = 0, then the number of simple components of -R = R/J(R)is greater than or equal to dimF R/T(R). We show that, when char F = 0 or F is uncountable, R is algebraic over F if and only if [R, R] is algebraic over F. As another approach, we prove that R is algebraic over F if and only if the derived subgroup of U(R) is algebraic over F. Also, we present an elementary proof for a special case of an old question due to Jacobson.

  3. Left ventricular apical diseases.

    Science.gov (United States)

    Cisneros, Silvia; Duarte, Ricardo; Fernandez-Perez, Gabriel C; Castellon, Daniel; Calatayud, Julia; Lecumberri, Iñigo; Larrazabal, Eneritz; Ruiz, Berta Irene

    2011-08-01

    There are many disorders that may involve the left ventricular (LV) apex; however, they are sometimes difficult to differentiate. In this setting cardiac imaging methods can provide the clue to obtaining the diagnosis. The purpose of this review is to illustrate the spectrum of diseases that most frequently affect the apex of the LV including Tako-Tsubo cardiomyopathy, LV aneurysms and pseudoaneurysms, apical diverticula, apical ventricular remodelling, apical hypertrophic cardiomyopathy, LV non-compaction, arrhythmogenic right ventricular dysplasia with LV involvement and LV false tendons, with an emphasis on the diagnostic criteria and imaging features. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s13244-011-0091-6) contains supplementary material, which is available to authorized users.

  4. [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.

  5. Retroaortic left renal vein joining the left common iliac vein

    Energy Technology Data Exchange (ETDEWEB)

    Brancatelli, G.; Galia, M.; Finazzo, M.; Sparacia, G.; Pardo, S.; Lagalla, R. [Dept. of Radiology ' ' P. Cignolini' ' , Univ. of Palermo (Italy)

    2000-11-01

    Retroaortic left renal vein joining the left common iliac vein is a rare congenital anomaly in the development of the inferior vena cava. To our knowledge, only one case has been reported in the literature; however, its imaging features have never been described. A 27-year-old male presented with a 1-year history of recurrent right flank pain, dysuria, hematuria, and fever (39 C). Computed tomography and MR venography showed a retroaortic left renal vein joining the left common iliac vein. We present the CT and MR venography findings and discuss their feasibility in showing this congenital anomaly. (orig.)

  6. Neovascularization in Left Atrial Myxoma

    Science.gov (United States)

    Dubey, Laxman; Chaurasia, Amit Kumar

    2012-01-01

    Abstract We report a case with a left atrial mass who underwent coronary angiography to rule out coronary artery disease. Coronary angiography revealed an anomalous tortuous vascular structure originating from the left circumflex coronary artery to the left atrial tumor suggestive of neovascularization. Preoperative coronary angiography is useful for coronary artery evaluation and also provides additional information regarding the feeding vessel supplying the mass. PMID:24757609

  7. Left ventricle to left atrium shunt via a paravalvular abscess.

    Science.gov (United States)

    Gasparovic, H; Smalcelj, A; Brida, M

    2009-10-01

    Intracardiac fistulas are rare complications of infective endocarditis that contribute to the complexity of surgical management, and impose an additional hemodynamic burden on the already challenged heart. We report on a case of successful surgical management of a paravalvular communication between the left ventricle and the left atrium via an abscess cavity. Georg Thieme Verlag KG Stuttgart. New York.

  8. Case report series of left atrial thrombus formation in patients on dabigatran therapy.

    Science.gov (United States)

    Sharma, Sanjiv; Singh, Sarabjeet; Sandhu, Rasham; Monterroso, Mark; Bhambi, Neil; Sharma, Rohan

    2014-01-01

    Dabigatran etexilate mesylate, a direct thrombin inhibitor, has been approved in the United States as an alternative to warfarin for the prevention of stroke and systemic thromboembolism in patients with nonvalvular atrial fibrillation. The authors report 2 cases of development of large left atrial thrombi and unfortunate occurrence of thromboembolic events in patients with chronic atrial fibrillation, despite these patients being compliant with recommended dabigatran therapy. The authors postulate that certain unique pharmacologic characteristics of the drug may be disadvantageous toward providing a therapeutic level of anticoagulation in all patients and may provide an explanation of occurrence of these thrombotic events, namely, (1) a competitive, reversible, and incomplete inhibition of only one coagulation factor (thrombin), as opposed to warfarin that leads to noncompetitive inhibition of multiple coagulation factors, (2) a short half-life (12-17 hours) and linear pharmacodynamics related to drug levels that conceivably causes an hourly variation of the level of anticoagulation, (3) a much lower incidence of supratherapeutic anticoagulation ("overshoot") with dabigatran as compared with warfarin, and (4) a reported increase in the coagulation factors that follows long-term use of dabigatran. Also, the absence of routine monitoring to test the therapeutic efficacy of the drug prevents diagnosis of cases where anticoagulation remains subtherapeutic. These factors could explain occurrence of the thrombotic and thromboembolic events in our cases.

  9. Left atrial appendage closure for prevention of death, stroke, and bleeding in patients with nonvalvular atrial fibrillation.

    Science.gov (United States)

    Gloekler, Steffen; Saw, Jacqueline; Koskinas, Konstantinos C; Kleinecke, Caroline; Jung, Werner; Nietlispach, Fabian; Meier, Bernhard

    2017-08-26

    Nonvalvular atrial fibrillation (AF) is the most frequent arrhythmia with a prevalence of 1%-2% in the general population. Its prevalence increases with age and its diagnosis benefits of improvement and simplification of technologies for its detection. Today, AF affects approximately 7% of individuals age>65years and 15%-20% of octogenarians. Due to stasis and activation of coagulation in a fibrillating atrium, patients are at increased risk of thromboembolism, in particular ischemic stroke, with an overall stroke risk of 5% per year. Since the left atrium itself is round and smooth-walled, thrombi typically do not form there, but almost exclusively in the left atrial appendage (LAA), a blind sac-like heterogeneous structure trabeculated by pectinate muscles. In the past five decades, oral anticoagulation (OAC) with vitamin K antagonists (VKA) has been the state-of-the art treatment to prevent stroke and systemic embolism from thrombi in AF. In the last decade, nonvitamin K dependant oral anticoagulants (NOAC) have been shown to be overall superior to VKA with respect to efficacy and safety in large trials and registries. Given the safety issues of indefinite OAC with either VKA or NOAC, it is plausible to consider left atrial appendage closure (LAAC) as an alternative strategy for prevention of all three catastrophes for patients with AF on anticoagulation: death, stroke or other systemic embolization, and bleeding. In the past years, LAAC has been compared to VKA in prospective randomized trials, yielding superior results regarding efficacy and non-inferiority regarding safety in the mid-term. Today, the decision to provide the most appropriate treatment for a patient with AF (OAC, NOAC, or LAAC) is complex and needs to be individualized. This review provides a comprehensive update on the current state of LAAC in the field of prevention of death, stroke and bleedings in patients suffering from nonvalvular AF. We describe the pathophysiology of the LAA with regard

  10. Principally Left Hereditary and Principally Left Strong Radicals

    Institute of Scientific and Technical Information of China (English)

    S. Tumurbat; R. Wiegandt

    2001-01-01

    A radical γ is normal if and only if γ is principally left hereditary and principally left strong (i.e., γ(L) = L e A and Lz ∈γ for all z ∈ L imply L γ(A)). Let a radical γ satisfy that A°∈γ and S° A° imply S°∈γ.Then γ is a hereditary normal radical if and only if γ is principally left strong and γ {A | (A, +,◇a) ∈γ a ∈ A}, where the multiplication ◇a is defined by x ◇a y = xay. The Behrens radical class B is the largest principally left hereditary subclass of the Brown-McCoy radical class G. Neither3 nor G is principally left strong.

  11. The Left-Handed Writer.

    Science.gov (United States)

    Bloodsworth, James Gaston

    Contrary to the beliefs of many, right-handedness is not a single factor existing in almost all people, with a few exceptions termed left-handed: neither extreme exists independently of the other. During the first 4 years of life there is a period of fluctuation between right and left-handed dominance. Statistics and findings vary in determining…

  12. 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. .

  13. Left ventricular wall stress compendium.

    Science.gov (United States)

    Zhong, L; Ghista, D N; Tan, R S

    2012-01-01

    Left ventricular (LV) wall stress has intrigued scientists and cardiologists since the time of Lame and Laplace in 1800s. The left ventricle is an intriguing organ structure, whose intrinsic design enables it to fill and contract. The development of wall stress is intriguing to cardiologists and biomedical engineers. The role of left ventricle wall stress in cardiac perfusion and pumping as well as in cardiac pathophysiology is a relatively unexplored phenomenon. But even for us to assess this role, we first need accurate determination of in vivo wall stress. However, at this point, 150 years after Lame estimated left ventricle wall stress using the elasticity theory, we are still in the exploratory stage of (i) developing left ventricle models that properly represent left ventricle anatomy and physiology and (ii) obtaining data on left ventricle dynamics. In this paper, we are responding to the need for a comprehensive survey of left ventricle wall stress models, their mechanics, stress computation and results. We have provided herein a compendium of major type of wall stress models: thin-wall models based on the Laplace law, thick-wall shell models, elasticity theory model, thick-wall large deformation models and finite element models. We have compared the mean stress values of these models as well as the variation of stress across the wall. All of the thin-wall and thick-wall shell models are based on idealised ellipsoidal and spherical geometries. However, the elasticity model's shape can vary through the cycle, to simulate the more ellipsoidal shape of the left ventricle in the systolic phase. The finite element models have more representative geometries, but are generally based on animal data, which limits their medical relevance. This paper can enable readers to obtain a comprehensive perspective of left ventricle wall stress models, of how to employ them to determine wall stresses, and be cognizant of the assumptions involved in the use of specific models.

  14. Failure to lyse venous thrombi because of elevated plasminogen activator Inhibitor 1 (PAI-1) and 4G polymorphism of its promotor genome (The PAI-1/4G Syndrome).

    Science.gov (United States)

    Bern, Murray M; McCarthy, Nancy

    2010-10-01

    Plasminogen activator Inhibitor 1 (PAI-1) inhibits plasminogen activators leading to decreased fibrinolysis and increased risk of thromboembolic disease (TED). Shifts in PAI-1 promoter genome from normal 5G>5G to 4G>5G or 4G>4G alleles are associated with overexpression of PAI-1. In this study patients with residual venous thrombi were observed to have increased PAI-1 levels and more frequent shifts to 4G alleles. Of the 26, 20 (76.9%) patients with unresolved thrombus had elevated PAI-1 values. 4G genomic shifts were found in 92.9% patients studied. Normal PAI-1 levels were found in 5 patients with 4G polymorphisms. Thus, PAI-1 is often elevated among patients with residual thrombus, with an unexpectedly high prevalence of the 4G polymorphism of the promoter genome. Patients with persistent thrombus should be considered at risk of having constituently increased PAI-1 due to genomic changes in the PAI-1 promoter genome. Hypotheses are proposed to explain those with normal PAI-1, despite having 4G polymorphisms.

  15. Prevalence and Aetiology of Left Ventricular Thrombus in Patients Undergoing Transthoracic Echocardiography at the University of Maiduguri Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Mohammed Abdullahi Talle

    2014-01-01

    Full Text Available Objectives. We sought to determine the prevalence and aetiology of LVT among patients undergoing echocardiography. Methods. We reviewed case notes and echocardiographic data of patient diagnosed with LVT using noncontrast transthoracic echocardiography. Definition of various conditions was made using standard guidelines. Mean ± SD were derived for continuous variables and comparison was made using Student’s t-test. Results. Total of 1302 transthoracic echocardiograms were performed out of which 949 adult echocardiograms were considered eligible. Mean age of all subjects with abnormal echocardiograms was 44.73 (16.73 years. Abnormalities associated with LVT were observed in 782/949 (82.40% subjects among whom 84/782 (8.85% had LVT. The highest prevalence of 39.29% (33/84 was observed in patients with dilated cardiomyopathy, followed by myocardial infarction with a prevalence of 29.76% (25/84. Peripartum cardiomyopathy accounted for 18/84 (21.43% cases with some having multiple thrombi, whereas hypertensive heart disease was responsible for 6/84 (7.14% cases. The lowest prevalence of 2.38% (2/84 was observed in those with rheumatic heart disease. Left ventricular EF of <35% was recorded in 55/84 (65.48%. Conclusions. Left ventricular thrombus is common among patients undergoing echo, with dilated cardiomyopathy being the most common underlying aetiology followed by myocardial infarction. Multiple LVTs were documented in peripartum cardiomyopathy.

  16. 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...

  17. 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...

  18. 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

  19. To the Left or the Right?

    Institute of Scientific and Technical Information of China (English)

    ZHANGZHAOHUI

    2004-01-01

    THE Left Bank Gallery in the Zhongguancun area of Beijing's Haidian District unveiled “The Left-Wing” in late December 2003. The gallery housed the exhibit two huge concrete floors within a commercialreal estate project called Left Bank.

  20. [Left pulmonary agenesis diagnosed late].

    Science.gov (United States)

    Deleanu, Oana; Pătraşcu, Natalia; Nebunoiu, Ana-Maria; Vintilă, V; Ulmeanu, Ruxandra; Mihălţan, F D

    2010-01-01

    We present the case of a 51 years old female-patient, with severe dextroscoliosis, having like unique symptom progressive dyspnea. The blood samples reveals polycythemia, the radiological exam shows the opacification of 2/3 of the left thorax, the absence of the lung structure in the other 1/3, the deviation of the mediastinum, and dextroscoliosis; the computed tomography reveals the absence of the left lung artery and the left airways, compensatory hyperinflation of the right lung and dilatation of the trunk and right pulmonary artery; the bronchoscopy does not visualize the carina or the left main bronchus, typical for pulmonary agenesis. Echocardiography confirmed the absence of left pulmonary artery and shows mild pulmonary hypertension (systolic pressure in the pulmonary artery of 33 mmHg) with dilatation of the right cavities, but good cinetics. We face a case of pulmonary agenesis lately diagnosed, with modest functional cardiologic implications, limited therapeutic options and good survival, justified by the late appearance of the pulmonary hypertension of low severity and without worsening in time.

  1. Producing The New Regressive Left

    DEFF Research Database (Denmark)

    Crone, Christine

    to be a committed artist, and how that translates into supporting al-Assad’s rule in Syria; the Ramadan programme Harrir Aqlak’s attempt to relaunch an intellectual renaissance and to promote religious pluralism; and finally, al-Mayadeen’s cooperation with the pan-Latin American TV station TeleSur and its ambitions...... 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...... coalition (Iran, Hizbollah, Syria), capitalises on a series of factors that bring them together in spite of their otherwise diverse worldviews and agendas. The New Regressive Left is united by resistance against the growing influence of Saudi Arabia in the religious, cultural, political, economic...

  2. Left atrial thrombus resolution in atrial fibrillation or flutter: Results of a prospective study with rivaroxaban (X-TRA) and a retrospective observational registry providing baseline data (CLOT-AF).

    Science.gov (United States)

    Lip, Gregory Y H; Hammerstingl, Christoph; Marin, Francisco; Cappato, Riccardo; Meng, Isabelle Ling; Kirsch, Bodo; van Eickels, Martin; Cohen, Ariel

    2016-08-01

    Data on left atrial/left atrial appendage (LA/LAA) thrombus resolution after non-vitamin K antagonist (VKA) oral anticoagulant treatment are scarce. The primary objective of X-TRA was to explore the use of rivaroxaban for the resolution of LA/LAA thrombi in patients with nonvalvular atrial fibrillation (AF) or atrial flutter, with the CLOT-AF registry providing retrospective data after standard-of-care therapy in this setting. X-TRA was a prospective, single-arm, open-label, multicenter study that investigated rivaroxaban treatment for 6 weeks for LA/LAA thrombus resolution in patients with nonvalvular AF or atrial flutter and LA/LAA thrombus confirmed at baseline on a transesophageal echocardiogram (TEE). CLOT-AF retrospectively collected thrombus-related patient outcome data after standard-of-care anticoagulant treatment for 3 to 12 weeks in patients with nonvalvular AF or atrial flutter who had LA/LAA thrombi on TEE recorded in their medical file. In X-TRA, patients were predominantly (95.0%) from Eastern European countries. The adjudicated thrombus resolution rate was 41.5% (22/53 modified intention-to-treat [mITT] patients, 95% CI 28.1%-55.9%) based on central TEE assessments. Resolved or reduced thrombus was evident in 60.4% (32/53 mITT patients, 95% CI 46.0%-73.6%) of patients. In CLOT-AF, the reported thrombus resolution rate was 62.5% (60/96 mITT patients, 95% CI 52.0%-72.2%) and appeared better in Western European countries (34/50; 68.0%) than in Eastern European countries (26/46; 56.5%). X-TRA is the first prospective, multicenter study examining LA/LAA thrombus resolution with a non-VKA oral anticoagulant in VKA-naïve patients or in patients with suboptimal VKA therapy. Rivaroxaban could be a potential option for the treatment of LA/LAA thrombi. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  3. Lower Body Weight in Men, an Epidemiological Predictor of Enlarged Left Atrium in Sinus Rhythm Patients with Dilated Heart

    Science.gov (United States)

    Bakalli, Aurora; Georgievska-Ismail, Ljubica; Musliu, Nebi; Koçinaj, Dardan

    2016-01-01

    Background/Aims: The source of thrombi in patients with dilated cardiomyopathy is not necessarily from the dilated left ventricle. Left atrium (LA) and left atrial appendage (LAA) might be in charge for relatively high rate of systemic embolizations in these patients. The main aim of our study was to identify epidemiological predictors in sinus rhythm patients with dilated heart for LA and LAA dilation and/or dysfunction. Patients and Methods: This was a prospective cross-sectional study conducted from 2009 to 2014 in 101 sinus rhythm patients with dilated heart. We excluded patients with swallowing problems, acute myocardial infarction, atrial fibrillation/flutter, severe systolic dysfunction, mechanical valves, oral anticoagulation therapy, and/or patients with a history of stroke/systemic thromboembolic event. Results: Mean patient age was 58.13 ± 12.66 years and 69.3% were men. Hypertension was encountered in 51% of our patients, 56% of them had a history of coronary artery disease, 30% had diabetes, 25% had dyslipidemia, 30% were smokers, whereas 10% were alcoholics. Mean LA dimensions resulted higher than reference values, whereas 86% of our patients had LAA dysfunction. Male gender was an independent predictor for LA diameter dilation (95% confidence interval [CI]: 1.765–9.078, P = 0.005), while lower body weight was a predictor for enlargement of LA area (95% CI: 0.044–0.351, P = 0.014) and LA volume (95% CI: 0.160–2.067, P = 0.024). Conclusion: Male patients with dilated cardiomyopathy at sinus rhythm with lower body weight tend to have larger LA and consequently might be at higher risk of developing atrial thrombus and its subsequent consequences. PMID:28465968

  4. Percutaneous left atrial appendage occlusion - treatment outcomes and 6 months of follow-up - a single-center experience.

    Science.gov (United States)

    Karczewski, Michał; Woźniak, Sebastian; Skowronek, Radomir; Burysz, Marian; Fischer, Marcin; Anisimowicz, Lech; Demkow, Marcin; Konka, Marek; Ogorzeja, Wojciech

    2016-06-01

    To present the results of treatment and evaluate 6 months of follow-up in a group of patients with non-valvular atrial fibrillation, who underwent the procedure of percutaneous left atrial appendage occlusion (PLAAO). Percutaneous left atrial appendage occlusion was performed in 34 patients with non-valvular atrial fibrillation and contraindications for oral anticoagulation therapy. The risk of thromboembolic and bleeding complications was determined based on the CHA2DS2VASc and HAS-BLED scales. The Amplatzer Amulet system from St. Jude Medical was used. On the first postoperative day, all patients were started on double antiplatelet therapy with 75 mg/day of acetylsalicylic acid (ASA) and 75 mg/day of clopidogrel (CLO). On the 30(th) postoperative day, the efficacy of the antiplatelet therapy was assessed with impedance aggregometry using a Multiplate analyzer (Roche). Echocardiographic examinations were performed intraoperatively and on the first postoperative day; subsequently, follow-up examinations were conducted 1 and 6 months after the implantation. In all patients, proper occluder position was observed throughout the follow-up. No leakage or thrombi around the implants were found. No strokes or bleeding complications associated with the antiplatelet therapy were observed. Multiplate assessment of platelet activity was conducted in 20 out of 34 patients. The efficacy of ASA treatment was demonstrated in all patients; no response to clopidogrel treatment was observed in 5 out of 20 patients. One patient suffered from cardiac tamponade, which required the performance of full sternotomy. Local complications (hematomas of the inguinal region) were observed in 3 patients. One of the patients died for reasons unrelated to the procedure. Percutaneous left atrial appendage occlusion is an effective procedure in patients with non-valvular atrial fibrillation and contraindications for chronic anticoagulation therapy. Further observation is necessary to evaluate the

  5. Mitochondria and left ventricular hypertrophy

    Institute of Scientific and Technical Information of China (English)

    Haiyan Zhu; Shiwen Wang

    2008-01-01

    @@ Introduction Left ventricular hypertrophy (LVH) is one of the vicious organ damages of essential hypertension.It contributes a lot to high mortality of essential hypertension due to sudden cardiac death,ventricular arrhythmia and heart failure.Many factors involve in the pathogenesis of hypertension-induced LVH including inherited variants as well as environmental factors.

  6. Low scale left-right-right-left symmetry

    CERN Document Server

    Abbas, Gauhar

    2016-01-01

    We propose an effective left-right-right-left model with a parity breaking scale around a few TeV. One of the main achievements of the model is that the mirror fermions as well as the mirror gauge sector simultaneously could be at TeV scale. It is shown that the most dangerous quadratic divergence of the SM Higgs boson involving the top quark in the loop is naturally suppressed atleast up to approximately $10$ TeV. This could lead to a sufficient parameter space in the scalar potential to make the SM Higgs mass natural even up to the Planck scale. An elegant symmetry breaking pattern is also proposed.

  7. What Research Tells Us About Left Handedness.

    Science.gov (United States)

    Arnold, Rita

    Left handed people have had bad publicity throughout history, and the resulting myths and disadvantages of left handedness have often not been properly dealt with in the classroom. Our language itself maintains a bias against the left, and many other cultures have defined the left as disreputable. Today's life style also provides many physical…

  8. The New 3D Printed Left Atrial Appendage Closure with a Novel Holdfast Device: A Pre-Clinical Feasibility Animal Study.

    Directory of Open Access Journals (Sweden)

    M Brzeziński

    Full Text Available Many patients undergoing cardiac surgery have risk factors for both atrial fibrillation (AF and stroke. The left atrial appendage (LAA is the primary site for thrombi formation. The most severe complication of emboli derived from LAA is stroke, which is associated with a 12-month mortality rate of 38% and a 12-month recurrence rate of 17%. The most common form of treatment for atrial fibrillation and stroke prevention is the pharmacological therapy with anticoagulants. Nonetheless this form of therapy is associated with high risk of major bleeding. Therefore LAA occlusion devices should be tested for their ability to reduce future cerebral ischemic events in patients with high-risk of haemorrhage.The aim of this study was to evaluate the safety and feasibility of a novel left atrial appendage exclusion device with a minimally invasive introducer in a swine model.A completely novel LAA device, which is composed of two tubes connected together using a specially created bail, was designed using finite element modelling (FEM to obtain an optimal support force of 36 N at the closure line. The monolithic form of the occluder was obtained by using additive manufacturing of granular PA2200 powder with the technology of selective laser sintering (SLS. Fifteen swine were included in the feasibility tests, with 10 animals undergoing fourteen days of follow-up and 5 animals undergoing long-term observation of 3 months. For one animal, the follow-up was further prolonged to 6 months. The device was placed via minithoracotomy. After the observation period, all of the animals were euthanized, and their hearts were tested for LAA closure and local inflammatory and tissue response.After the defined observation period, all fifteen hearts were explanted. In all cases the full closure of the LAA was achieved. The macroscopic and microscopic evaluation of the explanted hearts showed that all devices were securely integrated in the surrounding tissues. No

  9. Right Heart Thrombi Accompained with Pulmonary Embolism

    Directory of Open Access Journals (Sweden)

    Mustafa Çörtük

    2015-10-01

    Full Text Available Aim: Right sided heart thrombus (RSHT is rarely seen. It is generally detected during transthoracic echocardiographic (TTE examination or multislice thoracic computed tomographic scanning for pulmonary embolism (PE. Although RSHT and PE secondary to this situation is rare, mortality during the course of process is very high. We aim to aproach right cardiac trombus and determine the results of treatment. Method: In this study 25 patients hospital records were investigated retrospectively. The data obtained consisted of diagnostic methods, presence of shock state, treatments applied and results were assessed. Results: Th present study revealed that the 32% of patients had been admitted to hospital in shock state, hospital mortality rate was 24%, and this mortality rate was not affected by different treatment choices. Conclusion: The exact incidence of RSHT is unknown. It is reported that the probability of seeing a case suffering from RSHT during echocardiographic examination performed to diagnose the PE is 9%. RSHT may cause PE anytime and requires urgent treatment. In our study, we determined that the hospital mortaliy did not change with the type of given treatment and overall mortality was determined as 24%. There are no sufficient studies searching large series on RSHT in literature. Therefore, there is no agreement on treatment tecniques.

  10. Right-handed and left-landed

    Institute of Scientific and Technical Information of China (English)

    李悦

    2005-01-01

    Today about 15% of the number of people is left-handed.But why are people left-handed? The answer is the way the brain (大脑) works.The brain has two halves——the right half and the left half.The right half controls (控制)the left side of the body,and the left controls the right side of the body.

  11. Twelve-month follow-up of left atrial appendage occlusion with Amplatzer Amulet.

    Science.gov (United States)

    Kleinecke, Caroline; Park, Jai-Wun; Gödde, Martin; Zintl, Konstantin; Schnupp, Steffen; Brachmann, Johannes

    2017-01-01

    The Amplatzer Amulet (St. Jude Medical, Minneapolis, MN, USA) is a second gen-eration Amplatzer device for left atrial appendage (LAA) occlusion (LAAO) for stroke prophylaxis in patients with atrial fibrillation. This research sought to assess the clinical performance of the Amplatzer Amulet device and in follow up for 12 months. In this single-center registry patients with atrial fibrillation and contraindication to oral anticoagulation underwent LAAO with the Amplatzer Amulet device. Follow-up was performed before discharge, by transesophageal echocardiography (TEE) after 6 weeks and telephone interview after 3, 6 and 12 months. Between October 2014 and August 2015 50 patients (76.1 ± 8.3 years; 30 male) were en-rolled. Procedural success was achieved in 49 (98%) patients. Major periprocedural adverse events were observed in 4 (8%) of patients: 1 device embolization, 2 pericardial effusions requiring pericardiocente-sis and 1 prolonged hospital stay due to retropharyngeal hematoma from the TEE probe. Follow-up TEE was available in 38 of 50 patients showing complete LAA sealing in all. 2 device-related thrombi were also documented. At 12-month follow-up 7 patients had died unrelated to the device. Ischemic stroke occurred in 3 patients. According to neurological examination two were classified as microangiopathic and not cardio-embolic. The other one could not be classified. Bleeding complications (5 minor, 3 major) were documented in 8 patients. Although minimizing procedure-related complications remains challenging, LAAO with the Amplatzer Amulet device showed high procedural success and excellent LAA sealing. (Cardiol J 2017; 24, 2: 131-138).

  12. 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 dilatatio...

  13. 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

  14. Automated left ventricular capture management.

    Science.gov (United States)

    Crossley, George H; Mead, Hardwin; Kleckner, Karen; Sheldon, Todd; Davenport, Lynn; Harsch, Manya R; Parikh, Purvee; Ramza, Brian; Fishel, Robert; Bailey, J Russell

    2007-10-01

    The stimulation thresholds of left ventricular (LV) leads tend to be less reliable than conventional leads. Cardiac resynchronization therapy (CRT) requires continuous capture of both ventricles. The purpose of this study is to evaluate a novel algorithm for the automatic measurement of the stimulation threshold of LV leads in cardiac resynchronization systems. We enrolled 134 patients from 18 centers who had existing CRT-D systems. Software capable of automatically executing LV threshold measurements was downloaded into the random access memory (RAM) of the device. The threshold was measured by pacing in the left ventricle and analyzing the interventricular conduction sensed in the right ventricle. Automatic LV threshold measurements were collected and compared with manual LV threshold tests at each follow-up visit and using a Holter monitor system that recorded both the surface electrocardiograph (ECG) and continuous telemetry from the device. The proportion of Left Ventricular Capture Management (LVCM) in-office threshold tests within one programming step of the manual threshold test was 99.7% (306/307) with a two-sided 95% confidence interval of (98.2%, 100.0%). The algorithm measured the threshold successfully in 96% and 97% of patients after 1 and 3 months respectively. Holter monitor analysis in a subset of patients revealed accurate performance of the algorithm. This study demonstrated that the LVCM algorithm is safe, accurate, and highly reliable. LVCM worked with different types of leads and different lead locations. LVCM was demonstrated to be clinically equivalent to the manual LV threshold test. LVCM offers automatic measurement, output adaptation, and trends of the LV threshold and should result in improved ability to maintain LV capture without sacrificing device longevity.

  15. Left Supraclavicular Spindle Cell Lipoma

    OpenAIRE

    Oladejo Olaleye; Bertram Fu; Ram Moorthy; Charles Lawson; Myles Black; David Mitchell

    2010-01-01

    Background. Spindle cell lipoma (SCL) is a benign lipomatous tumour, typically occurring in the posterior neck, shoulder or upper back of elderly males. They compose of fat, CD34 positive spindle cells, and ropey collagen on a myxoid matrix. This case highlights a rare presentation of SCL and the need for pre-operative diagnosis. Case Report. A 63-year-old gentleman presented with a pre-existing left supraclavicular mass that had recently increased in size. FNA and CT Scans were performed and...

  16. Left atrial ball valve thrombus

    Directory of Open Access Journals (Sweden)

    R. Balaji

    2013-10-01

    Full Text Available "Ball valve thrombus" which is a spherical free floating clot in left atrium is an often quoted, but uncommonly encountered complication in patients with severe mitral stenosis of rheumatic origin, who are in atrial fibrillation. We describe the case of a 31-year-old lady with rheumatic heart disease, severe mitral stenosis and moderately severe aortic stenosis who had undergone closed mitral valvotomy 13 years ago. The patient presented with an episode of non-exertional syncope and breathlessness on exertion of 6 months duration and was in normal sinus rhythm. Echocardiography facilitated ante-mortem diagnosis and prompt institution of surgery was life saving.

  17. Facts about Hypoplastic Left Heart Syndrome

    Science.gov (United States)

    ... left and right sides of the heart: the patent ductus arteriosus and the patent foramen ovale . Normally, these openings ... functioning left side of the heart through the patent ductus arteriosus and the patent foramen ovale. The right side ...

  18. The Semigroup Structure of Left Clifford Semirings

    Institute of Scientific and Technical Information of China (English)

    Yu Qi GUO; Kar Ping SHUM; M. K. SEN

    2003-01-01

    In this paper, we generalize Clifford semirings to left Clifford semirings by means of theso-called band semirings. We also discuss a special case of this kind of semirings, that is, strongdistributive lattices of left rings.

  19. Left supraclavicular spindle cell lipoma.

    Science.gov (United States)

    Olaleye, Oladejo; Fu, Bertram; Moorthy, Ram; Lawson, Charles; Black, Myles; Mitchell, David

    2010-01-01

    Background. Spindle cell lipoma (SCL) is a benign lipomatous tumour, typically occurring in the posterior neck, shoulder or upper back of elderly males. They compose of fat, CD34 positive spindle cells, and ropey collagen on a myxoid matrix. This case highlights a rare presentation of SCL and the need for pre-operative diagnosis. Case Report. A 63-year-old gentleman presented with a pre-existing left supraclavicular mass that had recently increased in size. FNA and CT Scans were performed and results discussed in the mutidisciplinary team meeting. Excisional biopsy was recommended. Radiology. CT neck showed a left supraclavicular mass of fatty density with fine internal septations. A low-grade liposarcoma could not be excluded. Histopathology. FNA was indeterminate. Histology of specimen showed bland spindle cells with no evidence of malignancy. Immuno-histochemistry showed SCL with CD34 positivity and negative staining on CDK4 and p16. Management. Excision biopsy of the mass was performed which was technically difficult as the mass invaginated around the brachial plexus. The patient recovered well post-operatively with no neurological deficits. Conclusion. Spindle cell lipoma is a rare benign tumour and a pre-operative diagnosis based on the clinical context, imaging and immuno-histochemistry is crucial to management.

  20. Left Supraclavicular Spindle Cell Lipoma

    Directory of Open Access Journals (Sweden)

    Oladejo Olaleye

    2010-01-01

    This case highlights a rare presentation of SCL and the need for pre-operative diagnosis. Case Report. A 63-year-old gentleman presented with a pre-existing left supraclavicular mass that had recently increased in size. FNA and CT Scans were performed and results discussed in the mutidisciplinary team meeting. Excisional biopsy was recommended. Radiology. CT neck showed a left supraclavicular mass of fatty density with fine internal septations. A low-grade liposarcoma could not be excluded. Histopathology. FNA was indeterminate. Histology of specimen showed bland spindle cells with no evidence of malignancy. Immuno-histochemistry showed SCL with CD34 positivity and negative staining on CDK4 and p16. Management. Excision biopsy of the mass was performed which was technically difficult as the mass invaginated around the brachial plexus. The patient recovered well post-operatively with no neurological deficits. Conclusion. Spindle cell lipoma is a rare benign tumour and a pre-operative diagnosis based on the clinical context, imaging and immuno-histochemistry is crucial to management.

  1. [Pulmonary hypertension caused by left heart disease].

    Science.gov (United States)

    Erer, Betül; Eren, Mehmet

    2010-09-01

    Increased resistance to pulmonary venous drainage is the main mechanism in pulmonary hypertension (PH) developing due to left heart disease. This condition may occur as a result of various diseases affecting left ventricle, left atrium, mitral or aortic valves. Pulmonary hypertension is the common and well-recognized complication of left ventricular systolic dysfunction and pulmonary arterial hypertension accompanying chronic heart failure is related to increased mortality. Treatment should be tailored according to the underlying disease.

  2. Transcortical mixed aphasia with left frontoparietal lesions.

    Science.gov (United States)

    Maeshima, S; Uematsu, Y; Terada, T; Nakai, K; Itakura, T; Komai, N

    1996-05-01

    We present a case of transcortical mixed aphasia following a left frontoparietal infarct caused by vasospasm after subarachnoid haemorrhage. Although CT showed low-density areas in the left frontal lobe and basal ganglia, single photon emission CT revealed a wider area of low perfusion over the entire left hemisphere, except for the left perisylvian speech areas. Hence, transcortical mixed aphasia may be caused by the isolation of perisylvian speech areas due to disconnection from surrounding areas.

  3. Split Left GC-Lpp Semigroups

    Institute of Scientific and Technical Information of China (English)

    Zhen Zhen LI; Xiao Jiang GUO; Zhi Qing FU

    2012-01-01

    A left GC-lpp semigroup S is called split if the natural homomorphism γb of S onto S/γ induced by γ is split.It is proved that a left GC-lpp semigroup is split if and only if it has a left adequate transversal.In particular,a construction theorem for split left GC-lpp semigroups is established.

  4. Bicyclic semigroups of left I-quotients

    CERN Document Server

    Ghroda, Nassraddin

    2011-01-01

    In this article we study left I-orders in the bicyclic monoid $\\mathcal{B}$. We give necessary and sufficient conditions for a subsemigroup of $\\mathcal{B}$ to be a left I-oreder in $\\mathcal{B}$. We then prove that any left I-order in $\\mathcal{B}$ is straight.

  5. The Left-Handed: "Their Sinister" History.

    Science.gov (United States)

    Costas, Elaine Fowler

    The history of left-handedness can provide teachers and parents a better understanding of left-handed children and give those children more pride in their difference. No child should be made to feel that he or she is abnormal because of using the left hand, although some specific instruction for these students is necessary in handwriting. Many…

  6. Left-handed Children in Singapore.

    Science.gov (United States)

    Gan, Linda

    1998-01-01

    Used teacher questionnaires to examine incidence of left-handedness in nearly 2,800 Singaporean children, racial differences in this left-handed population, and educational provisions in preschool and primary school. Findings indicated that 7.5% of preschoolers and 6.3% of primary children were left-handed, with a higher proportion being Chinese…

  7. Left-handed wrestlers are more successful.

    Science.gov (United States)

    Ziyagil, Mehmet Akif; Gursoy, Recep; Dane, Senol; Yuksel, Ramazan

    2010-08-01

    It has been reported that there is a high proportion of left-handers among top athletes in different sports. In this study, the goal was to examine the rate of left-handedness in the top wrestlers at the world championships for achievement by left-handed wrestlers. The rate of left-handedness was higher in wrestlers with medal honors compared to wrestlers without medals for both men and women. The winning numbers and match degrees were higher in the left-handed wrestlers than in both right- and mixed-handed wrestlers among top international wrestlers.

  8. Giant and thrombosed left ventricular aneurysm

    Institute of Scientific and Technical Information of China (English)

    Jose; Alberto; de; Agustin; Jose; Juan; Gomez; de; Diego; Pedro; Marcos-Alberca; Jose; Luis; Rodrigo; Carlos; Almeria; Patricia; Mahia; Maria; Luaces; Miguel; Angel; Garcia-Fernandez; Carlos; Macaya; Leopoldo; Perez; de; Isla

    2015-01-01

    Left ventricular aneurysms are a frequent complication of acute extensive myocardial infarction and are most commonly located at the ventricular apex. A timely diagnosis is vital due to the serious complications that can occur,including heart failure,thromboembolism,or tachyarrhythmias. We report the case of a 78-yearold male with history of previous anterior myocardial infarction and currently under evaluation by chronic heart failure. Transthoracic echocardiogram revealed a huge thrombosed and calcified anteroapical left ventricular aneurysm. Coronary angiography demonstrated that the left anterior descending artery was chronically occluded,and revealed a big and spherical mass with calcified borders in the left hemithorax. Left ventriculogram confirmed that this spherical mass was a giant calcified left ventricular aneurysm,causing very severe left ventricular systolic dysfunction. The patient underwent cardioverter-defibrillator implantation for primary prevention.

  9. Giant and thrombosed left ventricular aneurysm.

    Science.gov (United States)

    de Agustin, Jose Alberto; de Diego, Jose Juan Gomez; Marcos-Alberca, Pedro; Rodrigo, Jose Luis; Almeria, Carlos; Mahia, Patricia; Luaces, Maria; Garcia-Fernandez, Miguel Angel; Macaya, Carlos; de Isla, Leopoldo Perez

    2015-07-26

    Left ventricular aneurysms are a frequent complication of acute extensive myocardial infarction and are most commonly located at the ventricular apex. A timely diagnosis is vital due to the serious complications that can occur, including heart failure, thromboembolism, or tachyarrhythmias. We report the case of a 78-year-old male with history of previous anterior myocardial infarction and currently under evaluation by chronic heart failure. Transthoracic echocardiogram revealed a huge thrombosed and calcified anteroapical left ventricular aneurysm. Coronary angiography demonstrated that the left anterior descending artery was chronically occluded, and revealed a big and spherical mass with calcified borders in the left hemithorax. Left ventriculogram confirmed that this spherical mass was a giant calcified left ventricular aneurysm, causing very severe left ventricular systolic dysfunction. The patient underwent cardioverter-defibrillator implantation for primary prevention.

  10. Asymptomatic post-rheumatic giant left atrium.

    Science.gov (United States)

    Özkartal, Tardu; Tanner, Felix C; Niemann, Markus

    2016-06-26

    A 78-year-old asymptomatic woman was referred to our clinic for a second opinion regarding indication for mitral valve surgery. An echocardiogram showed a moderate mitral stenosis with a concomitant severe regurgitation. The most striking feature, however, was a giant left atrium with a parasternal anteroposterior diameter of 79 mm and a left atrial volume index of 364 mL/m². There are various echocardiographic definitions of a giant left atrium, which are mainly based on measurements of the anteroposterior diameter of the left atrium using M-mode in the parasternal long axis view. Since the commonly accepted method for echocardiographic evaluation of left atrial size is left atrial volume index, we propose a cut-off value of 140 mL/m(2) for the definition of a "giant left atrium".

  11. Effect of Metabolic Syndrome on Risk Stratification for Left Atrial or Left Atrial Appendage Thrombus Formation in Patients with Nonvalvular Atrial Fibrillation

    Science.gov (United States)

    Chen, Yu-Yang; Liu, Qi; Liu, Li; Shu, Xiao-Rong; Su, Zi-Zhuo; Zhang, Hai-Feng; Nie, Ru-Qiong; Wang, Jing-Feng; Xie, Shuang-Lun

    2016-01-01

    Background: Metabolic syndrome (MS) is a risk factor for stroke and thromboembolism event. Left atrial or LA appendage (LA/LAA) thrombus is a surrogate of potential stroke. The relationship between MS and atrial thrombus remains unclear. In this study, we sought to investigate the effect of MS on risk stratification of LA/LAA thrombus formation in patients with nonvalvular atrial fibrillation (NVAF). Methods: This cross-sectional study enrolled 294 consecutive NVAF patients without prior anticoagulant and lipid-lowering therapies. LA/LAA thrombus was determined by transesophageal echocardiography. Risk assessment of LA/LAA thrombus was performed using the CHADS2, CHA2DS2-VASc, MS, CHADS2-MS, and CHA2DS2-VASc-MS scores. Logistic regression analyses were performed to determine which factors were significantly related to LA/LAA thrombus. Odds ratio (OR) including 95% confidence interval was also calculated. The predictive powers of different scores for the risk of LA/LAA thrombus were represented by C-statistics and compared by receiver operating characteristic (ROC) analysis. Results: LA/LAA thrombi were identified in 56 patients (19.0%). Logistic analysis showed that MS was the strongest risk factor for LA/LAA thrombus in NVAF patients (OR = 14.698, P < 0.001). ROC curve analyses revealed that the C-statistics of CHADS2-MS and CHA2DS2-VASc-MS was significantly higher than those of CHADS2 and CHA2DS2-VASc scores (CHADS2-MS vs. CHADS2, 0.807 vs. 0.726, P = 0.0019). Furthermore, MS was helpful for identifying individuals with a high risk of LA/LAA thrombus in the population with a low risk of stroke (CHADS2 or CHA2DS2-VASc score = 0). Conclusions: MS is associated with LA/LAA thrombus risk in patients with NVAF. In addition to the CHADS2 and CHA2DS2-VASc scores, the CHADS2-MS and CHA2DS2-VASc-MS scores provide additional information on stroke risk assessment. PMID:27748329

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

    OpenAIRE

    2016-01-01

    Background 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. Methods For this study, 54 (27 left handed and 27 right handed) first year medical students were selected. They were trained for different ...

  13. Percutaneous left atrial appendage occlusion – treatment outcomes and 6 months of follow-up – a single-center experience

    Science.gov (United States)

    Karczewski, Michał; Skowronek, Radomir; Burysz, Marian; Fischer, Marcin; Anisimowicz, Lech; Demkow, Marcin; Konka, Marek; Ogorzeja, Wojciech

    2016-01-01

    Aim To present the results of treatment and evaluate 6 months of follow-up in a group of patients with non-valvular atrial fibrillation, who underwent the procedure of percutaneous left atrial appendage occlusion (PLAAO). Material and methods Percutaneous left atrial appendage occlusion was performed in 34 patients with non-valvular atrial fibrillation and contraindications for oral anticoagulation therapy. The risk of thromboembolic and bleeding complications was determined based on the CHA2DS2VASc and HAS-BLED scales. The Amplatzer Amulet system from St. Jude Medical was used. On the first postoperative day, all patients were started on double antiplatelet therapy with 75 mg/day of acetylsalicylic acid (ASA) and 75 mg/day of clopidogrel (CLO). On the 30th postoperative day, the efficacy of the antiplatelet therapy was assessed with impedance aggregometry using a Multiplate analyzer (Roche). Echocardiographic examinations were performed intraoperatively and on the first postoperative day; subsequently, follow-up examinations were conducted 1 and 6 months after the implantation. Results In all patients, proper occluder position was observed throughout the follow-up. No leakage or thrombi around the implants were found. No strokes or bleeding complications associated with the antiplatelet therapy were observed. Multiplate assessment of platelet activity was conducted in 20 out of 34 patients. The efficacy of ASA treatment was demonstrated in all patients; no response to clopidogrel treatment was observed in 5 out of 20 patients. One patient suffered from cardiac tamponade, which required the performance of full sternotomy. Local complications (hematomas of the inguinal region) were observed in 3 patients. One of the patients died for reasons unrelated to the procedure. Conclusions Percutaneous left atrial appendage occlusion is an effective procedure in patients with non-valvular atrial fibrillation and contraindications for chronic anticoagulation therapy. Further

  14. Photonic crystal with left-handed components

    CERN Document Server

    Markos, Peter

    2015-01-01

    We show that the periodic array of left-handed cylinders possesses a rich spectrum of guided modes when the negative permeability of cylinders equals exactly to minus value of permeability of embedding media. These resonances strongly influences propagation of electromagnetic waves through photonic structures made from left-handed materials. A series of Fano resonances excited by incident wave destroys the band frequency spectrum of square array of left-handed cylinders and increases considerably the absorption of transmitted waves.

  15. Left handedness and Leadership in Interactive Contests

    CERN Document Server

    Mukherjee, Satyam

    2013-01-01

    Left-handedness is known to provide an advantage at top level at many sports involving interactive contests. Earlier studies revealed that this is because of the innate superiority of left-handed contestants. Again, most of the renowned leaders of the world are known to have been left-handed. We analyze the data of batting and bowling performance in Cricket and verify the advantage of left-handedness for batsmen. For bowlers, left-handedness provide no advantage. Leadership play an important role in politics, sports and mentorship. In this paper we show that Cricket captains who bat left-handed have a strategic advantage over the right-handed captains in Test cricket. Our results demonstrate that critical importance of left-handedness and successful leadership. Our study shows that left-handed captains lead in more number of games and are significantly more successful than right-handed captains . Interestingly left-handed captains have a higher batting average than the right-handed counterparts, perhaps indic...

  16. Anarchy, socialism and a Darwinian left.

    Science.gov (United States)

    Clarke, Ellen

    2006-03-01

    In A Darwinian left Peter Singer aims to reconcile Darwinian theory with left wing politics, using evolutionary game theory and in particular a model proposed by Robert Axelrod, which shows that cooperation can be an evolutionarily successful strategy. In this paper I will show that whilst Axelrod's model can give support to a kind of left wing politics, it is not the kind that Singer himself envisages. In fact, it is shown that there are insurmountable problems for the idea of increasing Axelrodian cooperation within a welfare state. My surprising conclusion will be that a Darwinian left worthy of the name would be anarchistic.

  17. Left-sided omental torsion: CT appearance

    Energy Technology Data Exchange (ETDEWEB)

    Aoun, N.; Haddad-Zebouni, S.; Slaba, S.; Ghossain, M. [Hotel-Dieu de France Hospital, Beirut (Lebanon). Dept. of Radiology; Noun, R. [Hotel-Dieu de France Hospital, Beirut (Lebanon). Dept. of General Surgery

    2001-01-01

    A 34-year-old male presented with exquisite left flank pain. Computed tomography showed a hyperdense vascular structure surrounded by whirling linear streaks situated in the greater omentum under the splenic flexure of the colon. Omental stranding extended caudally into the pelvis where part of the inflamed omentum entered a left inguinal hernia sac. Surgery revealed left-sided torsion of the greater omentum. Left-sided omental torsion is infrequent and pre-operative diagnosis is rarely established. The CT findings of an omental fatty mass with a whirling pattern is characteristic of omental torsion. Preoperative diagnosis is important because conservative management has been suggested. (orig.)

  18. Cilia in vertebrate left-right patterning.

    Science.gov (United States)

    Dasgupta, Agnik; Amack, Jeffrey D

    2016-12-19

    Understanding how left-right (LR) asymmetry is generated in vertebrate embryos is an important problem in developmental biology. In humans, a failure to align the left and right sides of cardiovascular and/or gastrointestinal systems often results in birth defects. Evidence from patients and animal models has implicated cilia in the process of left-right patterning. Here, we review the proposed functions for cilia in establishing LR asymmetry, which include creating transient leftward fluid flows in an embryonic 'left-right organizer'. These flows direct asymmetric activation of a conserved Nodal (TGFβ) signalling pathway that guides asymmetric morphogenesis of developing organs. We discuss the leading hypotheses for how cilia-generated asymmetric fluid flows are translated into asymmetric molecular signals. We also discuss emerging mechanisms that control the subcellular positioning of cilia and the cellular architecture of the left-right organizer, both of which are critical for effective cilia function during left-right patterning. Finally, using mosaic cell-labelling and time-lapse imaging in the zebrafish embryo, we provide new evidence that precursor cells maintain their relative positions as they give rise to the ciliated left-right organizer. This suggests the possibility that these cells acquire left-right positional information prior to the appearance of cilia.This article is part of the themed issue 'Provocative questions in left-right asymmetry'. © 2016 The Author(s).

  19. Application of persistent methylene blue dyeing method for anatomic hepatotectomy of hepatocellular carcinoma with bile duct tumor thrombi%持久亚甲蓝染色法在肝细胞癌合并胆管癌栓解剖性肝切除术中的应用

    Institute of Scientific and Technical Information of China (English)

    蔡守旺; 吕文平; 杨世忠; 曾建平; 徐立宁; 张文智; 董家鸿

    2012-01-01

    Objective To evaluate the role of anantomic hepatotectomy of hepatocellular carcinoma with bile duct tumor thrombi by application of persistent methylene blue dyeing method.Methods From January 2009 to February 2011,11 hepatocellular carcinoma patients with bile duct tumor thrombi underwent anantomic hepatotectomy with removal of the biliary tumor thrombus.There were 10 male and 1 female patients.The average age was 49 years ( ranging from 31 to 67 years).The initial symptom of 9 out of the 11 patients was jaundice. After anatomy and ligation of Glissonean pedicle of pre-resection segment,methylene blue was injected into its far-end portal vein in order to dye the segment,Results Persistent methylene blue dyeing method was successful in all patients. Primary foci were found in all patients.Hepatotectomy were performed,including 4 patients of segmentectomy,3 patients of subsegmentectomy,2 patients of hemihepatectomy,and 2 patients of hepatic sectorectomy.The mean operation time and blood loss was 137 minutes and 246 ml respectively.Severe complications such as liver function failure and sub-diaphragm abscess was avoided in all patients.No perioperative death.Post-operation radiotherapy was performed on 2 patients.Over a mean follow-up time of 14.6 months,liver cancer recurrence occured in 2 patients,abdomen seeding metastasis in 1 patient,bile duct tumor thrombi recurrence in 1 case,and 2 patients died.Conclusions Anantomic hepatotectomy of hepatocellular carcinoma with bile duct tumor thrombi by application of persistent methylene blue dyeing method can make resection more precise and improve curative effect.%目的 探讨持久亚甲蓝染色法在肝细胞癌合并胆管癌栓患者的解剖性肝切除术中的应用价值.方法 2009年1月至2011年2月对11例肝细胞癌合并胆管癌栓患者实施解剖性肝切除术和胆管取癌栓术.其中男性10例,女性1例;年龄31~67岁,平均年龄49岁.9例以黄疸为首

  20. Detection of left atrial thrombus in patients with mitral stenosis and atrial fibrillation: retrospective comparison of two-phase computed tomography, transoesophageal echocardiography and surgical findings

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Bo Hwa; Ko, Sung Min [Konkuk University Medical Center, Konkuk University School of Medicine, Department of Radiology, Research Institute of Medical Science, Seoul (Korea, Republic of); Hwang, Hweung Kon [Konkuk University Medical Center, Konkuk University School of Medicine, Department of Cardiology, Seoul (Korea, Republic of); Song, Meong Gun; Shin, Je Kyoun [Konkuk University Medical Center, Konkuk University School of Medicine, Department of Thoracic surgery, Seoul (Korea, Republic of); Kang, Woon Seok; Kim, Tae-Yop [Konkuk University Medical Center, Konkuk University School of Medicine, Department of Anesthesiology, Seoul (Korea, Republic of)

    2013-11-15

    This retrospective study aims to assess the accuracy of two-phase computed tomography (CT) and transoesophageal echocardiography (TEE) for the detection of left atrial (LA) thrombus in patients with mitral stenosis (MS) and atrial fibrillation (AF), by using intraoperative findings as the reference standard. Preoperative two-phase CT and intraoperative TEE were performed in 106 patients with MS and AF. The ratio (LAA/AA{sub L}) of Hounsfield units (HU) in the LA appendage (LAA) to the ascending aorta (AA) was calculated on the late-phase CT image. LA echodense masses on TEE and LA filling defects on two-phase CT were observed in 29 and 39 patients, respectively. Thirty-five LA thrombi were identified at surgery in 27 patients. Compared with the intraoperative findings, per-patient sensitivity, specificity, positive and negative predictive values of two-phase CT were 100 %, 85 %, 69 % and 100 %, and those by using TEE were 93 %, 95 %, 86 % and 97 % in detecting LAA thrombus. After adopting the cut-off value of 0.5 for the LAA/AA{sub L} HU ratio, the specificity and positive predictive value of two-phase CT were increased to 96 % and 90 %, respectively. Two-phase CT with a cut-off value of LAA/AA{sub L} HU ratio of 0.5 provides high performance for the detection of LAA thrombus. (orig.)

  1. 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

    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......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...... with larger left ventricular diameter and higher left ventricular mass index (both P ventricular hypertrophy was greater (84 vs. 64%; P

  2. Left-Handers and Cognitive Proficiency.

    Science.gov (United States)

    Wellman, Mary M.

    In this research report, the influences of handedness, hand position while writing, and familial sinistrality (presence of left-handed relatives) on children's intellectual, reading, and visual-motor performance were investigated. Forty left- and right-handed children between the ages of 7 and 10 served as subjects. To assess hand positions, an…

  3. A Note on Left Regular Semiring

    Directory of Open Access Journals (Sweden)

    N. Sulochana

    2016-08-01

    Full Text Available In this paper we have focused on the additive and multiplicative identity „e‟ and determine the additive and multiplicative semigroups. Here we established that, A semiring S in which (S, + and (S, • are left singular semigroups, then S is a left regular semiring. We have framed an example for this proposition by considering a two element set

  4. 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 arrangspan>ed 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…

  5. 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…

  6. 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...

  7. Variant course of left gonadal artery

    Directory of Open Access Journals (Sweden)

    Mamatha Y

    2010-08-01

    Full Text Available The variations of the arteries that develop from the mesonephric arteries, including renal, gonadal and suprarenal arteries are common. Variations in the anatomical relationship of the gonadal arteries to the renal vessels are frequently reported. We here present a case of an unusual origin and course of a left testicular artery arching over left renal vein. The arching of the left testicular artery over the left renal vein could be a possible cause of the left renal vein compression. Therefore, knowledge of the possible existence of arching gonadal vessels in relation to the renal vein could be of paramount importance to vascular surgeons and urologists during surgery in the retroperitoneal region.

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

    Directory of Open Access Journals (Sweden)

    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

  9. A giant left main trunk and left circumflex artery-to-right ventricle fistula

    Directory of Open Access Journals (Sweden)

    Zhao-hui Peng

    2014-01-01

    Full Text Available Coronary artery fistula including the left trunk and left circumflex is uncommon. We present a 24-year-old male patient with a giant left main trunk and left circumflex artery to right ventricle fistula, which is diagnosed by transthoracic echocardiography and coronary computed tomography angiography. In this paper, the case report is to provide a better understanding of clinical characteristics for this disease.

  10. 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…

  11. Changes of Left Ventricular Geometry Shape and Left Ventricular Regional Function in Patients With Dilated Cardiomyopathy

    Institute of Scientific and Technical Information of China (English)

    Liang-yu WANG; Ming-xing XIE; Qing-bo LI; Ping CHEN; Zhi-xiong CAI; Zhi-dan ZHU

    2009-01-01

    Objectives To assess the left ventricle regional systolic and diastolic function, left ventricle geometry and left venti-tie sphericity indexes in patients with dilated cardiomyopathy (DCM) by quantitative tissue velocity imaging (QTVI). Methods Thirty normal subjects and 52 DCM patients underwent QTVI and colour Doppler flow imaging study in or-der to measure the left ventricular regional function along left ventricle apical long-axis view and the left ventricle geom-etry. Peak tissue velocities of left venticle regional muscular tissue during systole (Vs), systolic acceleration (a), ear-ly diastole(Ve) and left atrium contraction(Va) along left venticle apical long axis view were measured. The indexes of left ventdcular regional systolic and diastolic function were mearsured at the same time. The left ventricle geometry shape was reflected from the systolic and diastolic sphericity index (Sis and Sid), the left ventricular ejection fraction (LVEF) and D wave/A wave (PVd/Pva) of pulmonary veins flowing spectrum reflected the global left ventricular systolic and diastolic function. The Vs, Ve, Va, a, PVd/Pva ratio, LVEF, Sis, Sid and their correlations between normal subjects and patients with DCM were compared and analyzed. Results Vs, Ve, Va, a, PVd/Pva, Sis and Sid in patients with DCM were lower than those in normal persons. There were significant relations between Sis and a (r=0.6142, P<0.05), Ve/Va and Sid (r=0.6271, P<0.05). Conclusions QTVI offer a newer method which has a higher sensitivity and accuracy in evaluating the left venticle regional systolic and diastolic function in DCM patients. There was significant relation between regional cardiac function and left venticle sphericity.

  12. [Social aspects of left-handedness].

    Science.gov (United States)

    Milenković, Sanja; Belojević, Goran; Kocijancić, Radojka

    2010-01-01

    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 behavioural patterns appear in these people. This was a sort of provoked behaviour 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.

  13. 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.

  14. Surgical Treatment of Left Ventricular Pseudoaneurysm

    Science.gov (United States)

    Mujanovic, Emir; Bergsland, Jacob; Avdic, Sevleta; Stanimirovic-Mujanovic, Sanja; Kovacevic-Preradovic, Tamara; Kabil, Emir

    2014-01-01

    Introduction: Left ventricular pseudoaneurysm is a rare condition because in most instances ventricular free-wall rupture leads to fatal pericardial tamponade. Rupture of the free wall of the left ventricle is a cata­strophic complication of myocardial infarction, occurring in approximately 4% of pa­tients with infarcts, resulting in immediate collapse of the patient and electromechanical dissociation. In rare cases the rupture is contained by pericardial and fibrous tissue, and the result is a pseudoaneurysm. The left ventricular pseudoaneurysm contains only pericardial and fibrous elements in its wall-no myocardial tissue. Because such aneurysms have a strong tendency to rupture, this disorder may lead to death if it is left surgically untreated. Case report: In this case report, we present a patient who underwent successful repair of a left ventricular pseudoaneurysm, which followed a myocardial infarction that was caused by occlusion of the left circumflex coronary artery. Although repair of left ventricular pseudoaneurysm is still a surgical challenge, it can be performed with acceptable results in most patients. PMID:25568538

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

    National Research Council Canada - National Science Library

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

    2016-01-01

    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...

  16. Anomalous Feeding of the Left Upper Lobe.

    Science.gov (United States)

    Hazzard, Christopher; Itagaki, Shinobu; Lajam, Fouad; Flores, Raja M

    2016-09-01

    We report the case of a 53-year-old woman who presented with massive hemoptysis. Computed tomographic angiography revealed an anomalous vessel arising from the abdominal aorta, coursing anteriorly and through the diaphragm, and feeding the left upper lobe. At operation the vessel was found to anastomose to the left upper lobe lingula, which contained multiple vascular abnormalities and arteriovenous fistulas. The vessel was ligated, and the affected portion of the left upper lobe was resected. Anomalous systemic arterial supply of an upper lobe is an especially rare form of a Pryce type 1 abnormality. Recognition of these unusual anatomic variants is crucial to successful treatment and avoidance of adverse events.

  17. Leptogenesis in left-right symmetric theories

    CERN Document Server

    Joshipura, A S; Rodejohann, W

    2001-01-01

    The masses and mixing of the light left-handed neutrinos can be related to those of the heavy right-handed neutrinos in left-right symmetric theories. Properties of the light neutrinos are measured in terrestrial experiments and the CP-violating decays of their heavy counterparts produce a baryon asymmetry via the well-known leptogenesis mechanism. The left-handed Higgs triplet, present in left-right symmetric theories, modifies the usual see-saw formula. It is possible to relate the lepton asymmetry to the light neutrino parameters when the triplet and the top quark through the usual see-saw mechanism give dominant contribution to the neutrino mass matrix. We find that in this situation the small angle MSW and vacuum solutions produce reasonable asymmetry, whereas the large angle MSW case requires extreme fine-tuning of the three phases in the mixing matrix.

  18. Leptogenesis in left-right symmetric theories

    Energy Technology Data Exchange (ETDEWEB)

    Joshipura, Anjan S. E-mail: anjan@prl.ernet.in; Paschos, Emmanuel A. E-mail: paschos@physik.uni-dortmund.de; Rodejohann, Werner E-mail: rodejoha@xena.physik.uni-dortmund.de

    2001-09-17

    The masses and mixing of the light left-handed neutrinos can be related to those of the heavy right-handed neutrinos in left-right symmetric theories. Properties of the light neutrinos are measured in terrestrial experiments and the CP-violating decays of their heavy counterparts produce a baryon asymmetry via the well-known leptogenesis mechanism. The left-handed Higgs triplet, present in left-right symmetric theories, modifies the usual see-saw formula. It is possible to relate the lepton asymmetry to the light neutrino parameters when the triplet and the top quark through the usual see-saw mechanism give the dominant contribution to the neutrino mass matrix. We find that in this situation the small angle MSW and vacuum solutions produce reasonable asymmetry, whereas the large angle MSW case requires extreme fine-tuning of the three phases in the mixing matrix.

  19. Left-right symmetry and neutrino stability

    Energy Technology Data Exchange (ETDEWEB)

    Akhmedov, E.K. [Valencia Univ. (Spain). Dept. de Fisica Teorica; Joshipura, A.S. [Valencia Univ. (Spain). Dept. de Fisica Teorica; Ranfone, S. [Valencia Univ. (Spain). Dept. de Fisica Teorica; Valle, J.W.F. [Valencia Univ. (Spain). Dept. de Fisica Teorica

    1995-05-08

    We consider a left-right symmetric model in which neutrinos acquire mass due to the spontaneous violation of both the gauged B-L and a global U(1) symmetry broken by the vacuum expectation value (VEV) of a gauge singlet scalar boson left angle {sigma} right angle . For suitable choices of left angle {sigma} right angle consistent with all laboratory and astrophysical observations neutrinos will be unstable against majoron emission. All neutrino masses in the keV to MeV range are possible, since the expected neutrino decay lifetimes can be short enough to dilute their relic density below the cosmologically required level. A wide variety of possible new phenomena, associated to the presence of left-right symmetry and/or the global symmetry at the TeV scale, could therefore be observable, without conflict with cosmology. The latter includes the possibility of invisibly decaying higgs bosons, which can be searched at LEP, NLC and LHC. ((orig.)).

  20. Case series: Congenital left ventricular diverticulum

    Directory of Open Access Journals (Sweden)

    Shah Dharita

    2010-01-01

    Full Text Available Congenital left ventricular diverticulum is a rare cardiac malformation characterized by a localized outpouching from the cardiac chamber. The patient is usually asymptomatic. However, complications like embolism, infective endocarditis, arrhythmia and, rarely, rupture can be the initial presentation. Diagnosis can be established by USG, echocardiography, CT angiography, and MRI. We report here two neonates with congenital left ventricular apical diverticulum associated with epigastric hernia.

  1. Laparoscopic vs open left hepatectomy for hepatolithiasis

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM: To explore the feasibility and therapeutic effect of total laparoscopic left hepatectomy (LLH) for hepatolithiasis. METHODS: From June 2006 to October 2009, 61 consecutive patients with hepatolithiasis who met the inclusion criteria for LLH were treated in our institute. Of the 61 patients with hepatolithiasis, 28 underwent LLH (LLH group) and 33 underwent open left hepatectomy (OLH group). Clinical data including operation time, intraoperative blood loss, postoperative complication rate, postoperative...

  2. Aneurysm of the left main coronary artery

    Directory of Open Access Journals (Sweden)

    Ênio E. Guérios

    2000-12-01

    Full Text Available Aneurysm of the left main coronary artery is a rare angiographic finding, with few cases described in the international literature. We report the case of a 42-year-old male with a previous history of acute myocardial infarction, whose coronariography indicated triple vessel coronary disease and an aneurysm of the left main coronary artery. A review of the etiology, clinical aspects, and surgical management of coronary arterial aneurysm is presented.

  3. Congenital left atrial appendage aneurysm: Atypical presentation

    Directory of Open Access Journals (Sweden)

    Mehdi Bamous

    2017-01-01

    Full Text Available Congenital left atrial appendage aneurysm is a rare condition caused by dysplasia of the atrial muscles. We report a case of a 14-year-old boy, with a 5-month history of cough and in sinus rhythm. Transthoracic echocardiography and computerized tomographic angiography confirmed the aneurysm of the left atrial appendage which was resected through median sternotomy on cardiopulmonary bypass. This case is presented not only for its rarity but also for its atypical clinical presentation.

  4. Thoracoscopic Left Splanchnicectomy: Two Trocar Technique

    OpenAIRE

    George Jinescu; Ion Lica; Septimiu Andrei; Cornelia Chidiosan; Mihnea Dinu

    2014-01-01

    Background: Abdominal hyperalgic syndrome in unresectable pancreatic cancer worsens the quality of patients' life. The goal of this article is to evaluate the feasibility of performing the left splanchnicectomy using a two trocar thoracoscopic approach. Material and Methods: One patient suffering from intractable pain due to unresectable pancreatic cancer (stage IV) with liver metastasis underwent thoracoscopic unilateral left splanchnicectomy. The procedure was performed using only two troca...

  5. Left △-Product Structure of Left C-Wrpp Semigroups%左G-Wrpp半群的左△-积

    Institute of Scientific and Technical Information of China (English)

    张晓敏

    2009-01-01

    We study another structure of so-called left C-wrpp semigroups.In particular,the concept of left △-product is extended and enriched.The aim of this paper is to give a construction of left C-wrpp semigroups by a left regular band and a strong semilattice of left-R cancellative monoids.Properties of left C-wrpp semigroups endowed with left △-products are particularly investigated.

  6. Left ventricular performance during triggered left ventricular pacing in patients with cardiac resynchronization therapy and left bundle branch block

    DEFF Research Database (Denmark)

    Witt, Christoffer Tobias; Kronborg, Mads Brix; Nohr, Ellen Aagaard;

    2016-01-01

    PURPOSE: To assess the acute effect of triggered left ventricular pacing (tLVp) on left ventricular performance and contraction pattern in patients with heart failure, left bundle branch block (LBBB), and cardiac resynchronization therapy (CRT). METHODS: Twenty-three patients with pre-implant QRS...... conduction, tLVp, and BiV pacing and compared as paired data. Echocardiographic analysis was done blinded with respect to pacing mode. RESULTS: LVEF was significantly higher during BiV pacing (47 ± 11 %) compared with intrinsic conduction (43 ± 13 %, P = 0.001) and tLVp (44 ± 13 %, P = 0.001), while......V pacing. CONCLUSIONS: The acute effect of tLVp on LV systolic function and contraction pattern is significantly lower than the effect of BiV pacing and not different from intrinsic conduction in patients with LBBB and CRT....

  7. 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...

  8. [Left predominance of varices: myth or reality?].

    Science.gov (United States)

    Cornu-Thénard, A; Maraval, M; Boivin, P; Parpex, P

    1986-01-01

    The study of 843 legs operated for major varices shows that they are equally distributed between the two lower limbs (48.6% on the right, 51.4% on the left). There is little sex-determined variation in this distribution (410 women - 184 men), the main difference being that found in men: +4.6% on the left. Other studies carried out in Europe come to much the same conclusion. Two of these studies do, however, note a much clearer predominance of left-leg varices in men (+10%). For some studies, the lack of information about the type of varices being considered has proved troublesome (for example the many isolated telangiectasis and varices) and means that it is impossible to come to any exact conclusion. Clinical quantification is therefore desirable: at least it takes into account the diameter of the varices studied.

  9. 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.

  10. Probabilistic Parsing Using Left Corner Language Models

    CERN Document Server

    Manning, C D; Manning, Christopher D.; Carpenter, Bob

    1997-01-01

    We introduce a novel parser based on a probabilistic version of a left-corner parser. The left-corner strategy is attractive because rule probabilities can be conditioned on both top-down goals and bottom-up derivations. We develop the underlying theory and explain how a grammar can be induced from analyzed data. We show that the left-corner approach provides an advantage over simple top-down probabilistic context-free grammars in parsing the Wall Street Journal using a grammar induced from the Penn Treebank. We also conclude that the Penn Treebank provides a fairly weak testbed due to the flatness of its bracketings and to the obvious overgeneration and undergeneration of its induced grammar.

  11. Contrasting Assessments of the Latin American Left

    Directory of Open Access Journals (Sweden)

    Paul Lawrence Haber

    2011-01-01

    Full Text Available The ability of the Latin American electoral left to make substantial progress on the social justice agenda while in office is much disputed. Two significant schools of thought are identified: one generally sympathetic and the other critical. This essay explores this argument with reference to Brazil, El Salvador, and Bolivia. At the heart of the debate is the relationship between social movements and political parties of the left. Should social movements collaborate with political parties of the left? While the critics raise important questions and concerns that are useful to illuminate the limitations of gradualism they do not present a viable strategy forward. The article concludes with the observation that the nature of this collaboration is a worthy subject of serious debate and reform proposals.

  12. Gelastic seizures involving the left parietal lobe.

    Science.gov (United States)

    Machado, René Andrade; Astencio, Adriana Goicoechea

    2012-01-01

    Gelastic seizures have been described in various epilepsies arising from the temporal or frontal lobes, although the most commonly encountered form is related to the presence of a hypothalamic hamartoma. We describe a patient with gelastic seizures involving the left parietal lobe. Our patient, an 8-year-old girl, underwent interictal video/EEG monitoring and MRI. The seizures consisted of brief staring followed by smiling and laughing. Electroencephalography during the gelastic seizures showed rhythmic spikes and waves in the left parietal lobe. MRI revealed the characteristic features of focal cortical dysplasia. Our findings suggest that the left parietal lobe may actively participate in the particular epileptogenic network generating gelastic seizures. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Lone, Mobile Left Atrial Hydatid Cyst

    Science.gov (United States)

    Ugurlu, Mehmet; Baktir, Ahmet Oguz; Tekin, Ali Ihsan; Tok, Ahmet; Yagmur, Bayram

    2016-01-01

    Echinococcosis is endemic in various regions of Turkey. Cardiac involvement in echinococcosis is rare, and lone cardiac hydatid cysts are even more unusual. Because cardiac hydatid disease can be fatal, even asymptomatic patients are optimally referred for surgical treatment. We present a rare case of a lone, primary, mobile hydatid cyst in the left atrium of a 62-year-old woman. The cyst caused dyspnea from left ventricular inflow obstruction. In addition to reporting the patient's fatal case, we discuss cardiac hydatid cysts in terms of the scant medical literature. PMID:27303247

  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. Left paraduodenal hernias; Hernias paraduodenales izquierdas

    Energy Technology Data Exchange (ETDEWEB)

    Lopez-Negrete, L.; Garcia-Lozano, J.; Sanchez, J. L.; Tejeiro, A.; Sala, J. [Hospital Valle del Nalon. Riano-Sama. Asturias (Spain)

    2002-07-01

    We report two cases of left paraduodenal internal hernias located in the fossa of Landzert that were diagnosed by CT. Internal hernias are an infrequent cause of acute abdomen, due to the intestinal sub occlusion they produce. Left paraduodenal hernias are responsible for about 50% of internal hernias. CT makes it possible to demonstrate the group of herniated loops between the stomach, fourth segment of the duodenum, descending colon, and tail of the pancreas. The identification of the loops in an atypical position together with displaced blood vessels (mesenteric vessels) and colon gives concerns on them a typical radiological semiology that makes them easily identifiable. (Author) 9 refs.

  16. 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.

  17. Correlation of Left Atrial Diameter by Echocardiography and Left Atrial Volume by Computed Tomography

    NARCIS (Netherlands)

    Hof, Irene; Arbab-Zadeh, Armin; Scherr, Daniel; Chilukuri, Karuna; Dalal, Darshan; Abraham, Theodore; Lima, Joao; Calkins, Hugh

    2009-01-01

    Computed Tomography. Introduction: For patients undergoing catheter ablation of atrial fibrillation (AF), left atrial size is a predictor of recurrence of AF during follow-up. For this reason, major clinical trials have used a left atrial diameter (LAD) of more than 5.0 or 5.5 cm, assessed by echoca

  18. Left common basal pyramid torsion following left upper lobectomy/segmentectomy.

    Science.gov (United States)

    Wang, Wei-Li; Cheng, Yen-Po; Cheng, Ching-Yuan; Wang, Bing-Yen

    2015-05-01

    Lobar or segmental lung torsion is a severe complication of lung resection. To the best of our knowledge, common basal pyramid torsion has never been reported. We describe a case of left basal pyramid torsion after left upper lobectomy and superior segmentectomy, which was successfully treated by thoracoscopic surgery.

  19. Left Pulmonary Artery Thrombosis in a Neonate with Left Lung Hypoplasia

    Directory of Open Access Journals (Sweden)

    Matthias P. van Schendel

    2012-01-01

    Full Text Available Thrombotic events in neonates may origin from fetal life. A 4-day-old newborn infant with a family history of heterozygous type 1 protein C deficiency was diagnosed with left lung hypoplasia and left pulmonary artery thrombosis. Its source was prenatally closed ductus arteriosus. Surgical removal of the thrombus was performed.

  20. Postoperative normalization of left ventricular noncompaction and new echocardiographic signs in aorta to left ventricular tunnel.

    Science.gov (United States)

    Malakan Rad, Elaheh; Zeinaloo, Ali Akbar

    2013-04-01

    We report postoperative normalization of left ventricular noncompaction in a neonate undergoing successful neonatal surgery for type II aorta to left ventricular tunnel (ALVT) associated with a large patent ductus arteriosus, floppy and extremely redundant anterior mitral leaflet, right coronary artery arising directly from the tunnel, and severe left ventricular noncompaction. We also described 2 novel echocardiographic findings in ALVT including "triple wavy line sign" on M-mode echocardiography which disappeared 1 month after operation and "abnormally increased left ventricular posterior wall motion" on M-mode of standard parasternal long-axis view on color tissue Doppler imaging (TDI) that also normalized postoperatively. We showed that proper definition of endocardial border is extremely important in strain and strain rate imaging in the context of left ventricular noncompaction. Preoperative longitudinal strain and strain rate were significantly decreased in comparison to radial strain and strain rate. Circumferential strain and strain rate were normal. © 2013, Wiley Periodicals, Inc.

  1. Diastolic Left Ventricular Dysfunction : A Clinical Appraisal

    NARCIS (Netherlands)

    Bronzwaer, J.G.F.

    2003-01-01

    Diastolic left ventricular (LV) distensibility is determined by the material properties of the LV wall and by LV geometry (i.e., LV shape, LV volume and LV wall thickness). These material properties are influenced both by the physical structure of the LV myocardium and by the dynamic process of myoc

  2. Left ventricular hypertrophy : virtuous intentions, malign consequences

    NARCIS (Netherlands)

    Pokharel, S; Sharma, UC; Pinto, YM

    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 Ca2+ homeostasis, there ar

  3. Topologically Left Invariant Means on Semigroup Algebras

    Indian Academy of Sciences (India)

    Ali Ghaffari

    2005-11-01

    Let $M(S)$ be the Banach algebra of all bounded regular Borel measures on a locally compact Hausdorff semitopological semigroup with variation norm and convolution as multiplication. We obtain necessary and sufficient conditions for $M(S)^∗$ to have a topologically left invariant mean.

  4. Giant melanoma of the left thumb

    NARCIS (Netherlands)

    Zeebregts, CJAM; Schraffordt Koops, H.

    2000-01-01

    A 74-year-old female patient is described with a giant melanoma of the left thenar and concomitant bilateral pulmonary metastases. Palliative treatment consisted of a two-staged procedure in order to save the limb from amputation. Firstly, perfusion with gamma-interferon, tumour necrosis factor-alph

  5. Left-right model for dark matter

    CERN Document Server

    Dong, P V

    2016-01-01

    We argue that dark matter can automatically arise from a gauge theory that possesses a non-minimal left-right gauge symmetry, SU(3)_C \\otimes SU(M)_L \\otimes SU(N)_R \\otimes U(1)_X, for (M,N) = (2,3), (3,2), (3,3), \\cdots, and (5,5).

  6. Congestive cardiomyopathy and left ventricular thrombus.

    Science.gov (United States)

    Gould, L; Gopalaswamy, C; Chandy, F; Kim, B S

    1983-07-01

    A left ventricular thrombus was detected by echocardiography in a 54-year-old man with congestive cardiomyopathy. With the use of anticoagulants, the thrombus completely disappeared. Patients with congestive cardiomyopathy who are at high risk for thrombus formation should be screened with two-dimensional echocardiography. If a thrombus is recognized, anticoagulation therapy can then be instituted.

  7. Pathological Left-Handedness: An Explanatory Model.

    Science.gov (United States)

    Satz, Paul

    Reported was an explanatory conceptual model for pathological left-handedness (PLH) and related hypotheses, some of which could not be tested empirically due to lack of information. The model was reported to provide an explanation for the relationship between handedness and specific learning disability, and handedness and cerebral dominance for…

  8. [Congenital left sinus of Valsalva aneurysm].

    Science.gov (United States)

    Simões, M V; Figueira, R R; Barbato, D; Miziara, H L

    1991-01-01

    Two cases of left sinus of Valsalva congenital aneurysm (SVCA), incidentally found are described. The authors call attention on rarity of them, and present new concepts about their morphogenesis and incidence. They also suggested a higher incidence of asymptomatic and undiagnosed cases of SVCA should be considered.

  9. Liponeurocytoma of the Left Lateral Ventricle

    Directory of Open Access Journals (Sweden)

    Ahmet BEKAR

    2009-09-01

    Full Text Available Liponeurocytoma has been recognized recently as a distinct clinicopathological entity by the World Health Organization. Although there are few cases described in the literature it has been accepted as a benign lesion. Here we present a 55-year-old woman with a supratentorial intraventricular liponeurocytoma of the left lateral ventricle.

  10. Laparoscopic versus open left lateral segmentectomy

    Directory of Open Access Journals (Sweden)

    Rela Mohamed

    2009-09-01

    Full Text Available Abstract Background Laparoscopic liver surgery is becoming increasingly common. This cohort study was designed to directly compare perioperative outcomes of the left lateral segmentectomy via laparoscopic and open approach. Methods Between 2002 and 2006 43 left lateral segmentectomies were performed at King's College Hospital. Those excluded from analysis included previous liver resections, polycystic liver disease, liver cirrhosis and synchronous operations. Of 20 patients analysed, laparoscopic (n = 10 were compared with open left lateral segmentectomy (n = 10. Both groups had similar patient characteristics. Results Morbidity rates were similar with no wound or chest infection in either group. The conversion rate was 10% (1/10. There was no difference in operating time between the groups (median time 220 minutes versus 179 minutes, p = 0.315. Surgical margins for all lesions were clear. Less postoperative opiate analgesics were required in the laparoscopic group (median 2 days versus 5 days, p = 0.005. The median postoperative in-hospital stay was less in the laparoscopic group (6 days vs 9 days, p = 0.005. There was no mortality. Conclusion Laparoscopic left lateral segmentectomy is safe and feasible. Laparoscopic patients may benefit from requiring less postoperative opiate analgesia and a shorter post-operative in-hospital stay.

  11. Diastolic Left Ventricular Dysfunction : A Clinical Appraisal

    NARCIS (Netherlands)

    Bronzwaer, J.G.F.

    2003-01-01

    Diastolic left ventricular (LV) distensibility is determined by the material properties of the LV wall and by LV geometry (i.e., LV shape, LV volume and LV wall thickness). These material properties are influenced both by the physical structure of the LV myocardium and by the dynamic process of

  12. The Rings Characterized by Minimal Left Ideals

    Institute of Scientific and Technical Information of China (English)

    Jun Chao WEI

    2005-01-01

    We study these rings with every minimal left ideal being a projective, direct summand and a p-injective module, respectively. Some characterizations of these rings are given, and the relations among them are obtained. With these rings, we characterize semisimple rings. Finally, we introduce MC2 rings, and give some characterizations of MC2 rings.

  13. Nonlinear dynamics of the left ventricle.

    Science.gov (United States)

    Munteanu, Ligia; Chiroiu, Calin; Chiroiu, Veturia

    2002-05-01

    The cnoidal method is applied to solve the set of nonlinear dynamic equations of the left ventricle. By using the theta-function representation of the solutions and a genetic algorithm, the ventricular motion can be described as a linear superposition of cnoidal pulses and additional terms, which include nonlinear interactions among them.

  14. Artificial, parallel, left-handed DNA helices.

    Science.gov (United States)

    Tian, Cheng; Zhang, Chuan; Li, Xiang; Li, Yingmei; Wang, Guansong; Mao, Chengde

    2012-12-19

    This communication reports an engineered DNA architecture. It contains multiple domains of half-turn-long, standard B-DNA duplexes. While each helical domain is right-handed and its two component strands are antiparallel, the global architecture is left-handed and the two component DNA strands are oriented parallel to each other.

  15. Some Characterizations of Left Weakly Regular Ordered Semigroups

    Institute of Scientific and Technical Information of China (English)

    TANC JIAN; XIE XIANG-YUN

    2011-01-01

    In this paper,the notion of left weakly regular ordered semigroups is introduced.Furthermore,left weakly regular ordered semigroups are characterized by the properties of their left ideals,right ideals and (generalized) bi-ideals,and also by the properties of their fuzzy left ideals,fuzzy right ideals and fuzzy (generalized) bi-ideals.

  16. 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.

  17. 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.

  18. 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.

  19. Reconstruction of the left-sided brachiocephalic trunk after vascular ring operation in left-handed child with Kommerell's diverticulum.

    Science.gov (United States)

    Haponiuk, Ireneusz; Paczkowski, Konrad; Chojnicki, Maciej; Jaworski, Radosław; Steffens, Mariusz; Szofer-Sendrowska, Aneta; Kwaśniak, Ewelina; Zieliński, Jacek; Gierat-Haponiuk, Katarzyna

    2013-01-01

    We report a case of a 2-year-old girl with prenatal diagnosis of vascular ring composed of a right-sided aortic arch, a left ligamentum arteriosum, and a left subclavian artery (arteria lusoria sin) originating from a retroesophageal Kommerell's diverticulum, who was referred for surgery with symptoms related to local compression - severe dysphagia and respiratory disorders. Through the left posterolateral thoracotomy, a ligamentum arteriosum between the Kommerell's diverticulum and the left pulmonary artery was divided and because of left-handedness of the child a brachiocephalic trunk was reconstructed in the fashion of anastomosis of the left subclavian artery and the left common carotid artery, originating from the ascending aorta.

  20. A constrained supersymmetric left-right model

    CERN Document Server

    Hirsch, Martin; Opferkuch, Toby; Porod, Werner; Staub, Florian

    2016-01-01

    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.

  1. Left Realism and Social Democratic Renewal

    Directory of Open Access Journals (Sweden)

    Russell Hogg

    2016-09-01

    Full Text Available At its inception Left Realism argued the need to develop a radical social democratic approach to crime. I argue that its contribution and continuing relevance primarily lies in this political project, the need for which has not dissipated. But this can only be advanced as an integral component of a more general renewal of social democratic ideas and politics that challenges the hegemony of neo-liberalism. This is far from guaranteed. The possibilities and challenges after the global financial crisis are considered. I argue for a rethinking of some core themes from early Left Realism to (as I see it better complement the task of social democratic renewal in the present.

  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-right symmetry and neutrino stability

    CERN Document Server

    Akhmedov, E K; Ranfone, S; Valle, José W F; Joshipura, A S; Ranfone, S; Valle, J W F

    1995-01-01

    We consider a left-right symmetric model in which neutrinos acquire mass due to the spontaneous violation of both the gauged B-L and a global U(1) symmetry broken by the vacuum expectation value (VEV) of a gauge singlet scalar boson \\VEV{\\sigma}. For suitable choices of \\VEV{\\sigma} consistent with all laboratory and astrophysical observations neutrinos will be unstable against majoron emission. All neutrino masses in the keV to MeV range are possible, since the expected neutrino decay lifetimes can be short enough to dilute their relic density below the cosmologically required level. A wide variety of possible new phenomena, associated to the presence of left-right symmetry and/or the global symmetry at the TeV scale, could therefore be observable, without conflict with cosmology. The latter includes the possibility of invisibly decaying higgs bosons, which can be searched at LEP, NLC and LHC.

  4. Minimal Left-Right Dark Matter

    CERN Document Server

    Heeck, Julian

    2015-01-01

    We show that left-right-symmetric models can easily accommodate stable TeV-scale dark matter particles. The stability of a newly introduced multiplet arises either accidentally as in the Minimal Dark Matter framework or comes courtesy of the remaining unbroken $\\mathbb{Z}_2$ subgroup of $B-L$. As a minimal example 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 $SU(2)\\times SU(2)\\times U(1)$ models that explain the recent diboson excess at ATLAS in terms of a new charged gauge boson of mass 2 TeV.

  5. [Myocardial revascularization surgery via a left minithoracotomy].

    Science.gov (United States)

    da Silveira, W L; Leite, A F; Artiaga, E P; Queiroz, F C; Ferreira, K A; de Carvalho, M C; da Silva, M A; Abdulmassih del Papa, M; Costa, L H; da Cunha, O M; Nazzeta, H; de Oliveira, V G

    1998-12-01

    There is, today, a global tendency towards a surgical approach privileging very small incisions, the so-called minimally invasive intervention, which results in a less aggressive action. The introduction of this new technique makes it possible to dissect the left internal thoracic artery (LITA) and to perform in the anastomosis with the anterior interventricular artery (AIA) through a left minithoracotomy. From May of 1996 to october of 1997, 11 patients with ischemic heart disease and a single proximal lesion of the AIA were submitted to a myocardial revascularization (MR). The surgical approach consisted of a left anterolateral thoracotomy through the 4th left intercostal space, of approximately 10 cm, and in the last 6 cases, resection of part of the cartilage of the 4th and 5th ribs, dissection of the LITA, as well as opening and repair of the pericardium adjacent to the AIA was done. All patients received a single bypass to the AIA with a graft of the LITA, without extracorporeal circulation. The patients' age varied between 46 and 76 years (mean = 58.55). Ten patients (90.90%) were males and 1 (9.09%) was a female. Hospital stay ranged from 4 to 8 days, with the average of 5.2 days. None of the patients presented any electrocardiographic change in the immediate post-operatory period. During the control period one patient developed a clot in the distal LITA, with important compromise of the flow. In another patient the stenosis was at the level of the anastomosis. Both were successfully submitted to angioplasty. There were no deaths in the groups studied. The absence of deaths suggests to us that MR surgery carried out with this minimally invasive technique, in selected groups and is an excellent alternative to the revascularization of the AIA.

  6. Is Left-Right Symmetry the Key?

    CERN Document Server

    Senjanovic, Goran

    2016-01-01

    Abdus Salam challenged the chiral gauge nature of the Standard Model by paving the road towards the Left-Right symmetric electro-weak theory. I describe here the logical and historical construction of this theory, by emphasising the pioneering and key role it played for neutrino mass. I show that it is a self-contained and predictive model with the Higgs origin of Majorana neutrino mass, in complete analogy with the SM situation regarding charged fermions.

  7. 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.

  8. Diastolic Left Ventricular Dysfunction : A Clinical Appraisal

    OpenAIRE

    Bronzwaer, J.G.F.

    2003-01-01

    Diastolic left ventricular (LV) distensibility is determined by the material properties of the LV wall and by LV geometry (i.e., LV shape, LV volume and LV wall thickness). These material properties are influenced both by the physical structure of the LV myocardium and by the dynamic process of myocardial relaxation. The material properties of the myocardium dictate the strain that follows a given stress, and determine position and shape of the myocardial stress-strain relationship. The mater...

  9. Left Atrial Ablation for Atrial Fibrillation

    Science.gov (United States)

    Sternik, Leonid; Schaff, Hartzel V.; Luria, David; Glikson, Michael; Kogan, Alexander; Malachy, Ateret; First, Maya; Raanani, Ehud

    2011-01-01

    The maze procedure is the gold standard for the ablation of atrial fibrillation, and the “box lesion” around the pulmonary veins is the most important part of this procedure. We have created this lesion with a bipolar radiofrequency ablator, abandoning the usual use of this device (to achieve bilateral epicardial isolation of the pulmonary veins). From March 2004 through the end of May 2010, we performed surgical ablation of atrial fibrillation in 240 patients. Of this number, 205 underwent operation by a hybrid maze technique and the remaining 35 (our study cohort) underwent the creation of a box lesion around the pulmonary veins by means of a bipolar radiofrequency device. Ablation lines were created by connecting the left atriotomy to the amputated left atrial appendage, with 2 ablation lines made with a bipolar radiofrequency device above and below the pulmonary veins. Lesions were made along the transverse and oblique sinuses by epicardial and endocardial application of a bipolar device. The left atrial isthmus was ablated by bipolar radiofrequency and cryoprobe. No complications were associated with the box lesion: 90% and 89% of patients were in sinus rhythm at 3 and 6 months of follow-up, respectively. By creating a box lesion around the pulmonary veins, we expect to improve transmurality by means of epicardial and endocardial ablation of 1 rather than 2 layers of atrial wall, as in epicardial pulmonary vein isolation. Isolation of the entire posterior wall of the left atrium is better electrophysiologically and renders dissection around the pulmonary veins unnecessary. PMID:21494518

  10. 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...... are investigated via simulation studies, and the suggested estimators are used in a study of prostate cancer based on the Finnish twin cohort where a twin pair is included only if both twins were alive in 1974....

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

    Science.gov (United States)

    Luauté, Jacques; Jacquin-Courtois, Sophie; O'Shea, Jacinta; Christophe, Laure; Rode, Gilles; Boisson, Dominique; Rossetti, Yves

    2012-01-01

    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. PMID:23050168

  12. 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.

  13. Anomalous Origin of Left Circumflex Artery

    Science.gov (United States)

    Çitaku, Hajdin; Kamberi, Lulzim; Gorani, Daut; Koçinaj, Dardan; Krasniqi, Xhevdet

    2015-01-01

    Introduction: The coronary anatomic variation of the left circumflex artery (LCx) is considered as the most common anatomic variation with a separate ostium from the right sinus, and very unusual variation as a proximal branch of right coronary artery (RCA). Case report: We report two cases, the first case is a 64-year-old man with chest pain and with history of hypertension, obesity, dyslipidemia and current smoker, and the second case is a 67-year-old who presented to the emergency department with chest pain and with a past medical history of arterial hypertension and type 2 diabetes mellitus. In the coronarography of the first case is detected an ectopic left circumflex coronary artery from the right coronary sinus with stenotic changes in RCA and LCx. The second case in the coronary angiography revealed an ectopic left circumflex coronary artery from the proximal part of the right coronary artery with stenotic changes in LAD, RCA and LCx. Based on guidelines for revascularization our patients successfully underwent treatment procedures. We present two cases that because of the atherosclerotic coronary artery disease leads to the need of coronarography find out the presence of coronary artery anomalies. Conclusion: During the coronarography we should think about coronary artery anomaly or missing artery knowing that type of these anomalies, considering that may be a contributing factor in the development of the atherosclerosis determines the method of the treatment. PMID:26843740

  14. Hypersexuality from resection of left occipital arteriovenous malformation.

    Science.gov (United States)

    Cao, Yong; Zhu, Zhaohui; Wang, Rong; Wang, Shuo; Zhao, Jizong

    2010-01-01

    The authors report their experience on one patient with hypersexuality from resection of left occipital arteriovenous malformation. To the best of our knowledge, this is the first case reported in the literature. A 35-year-old right-handed female farmer suffered a sudden left occipital hemorrhage with subarachnoid and subdural hemorrhages of the left hemisphere. Transient left uncal herniation occurred at the onset and was released by conservative treatment. Digital subtraction angiography showed a brain left occipital arteriovenous malformation. After microsurgical resection of the arteriovenous malformation, the patient developed hypersexual behavior. Positron emission tomography showed hypermetabolism in the left frontal region and left posterior hippocampal gyrus and hypometabolism in the left anterior hippocampal gyrus and the left occipital surgical area. Theories concerning normal pressure perfusion breakthrough and specific areas in the brain responsible for the human sexual response are discussed.

  15. Off-pump anastomosis of the left internal mammary artery to the left anterior descending coronary artery through a left inferior J-hemisternotomy

    DEFF Research Database (Denmark)

    Modrau, Ivy; Nielsen, Per Hostrup; Nielsen, Dorthe Viemose

    2016-01-01

    Since the 1990s, a large body of literature has been published regarding minimally invasive coronary artery bypass grafting. Varying techniques, complexity of the procedures and the necessity of patient selection have led to its inconsistent application. We describe the standardized technique...... of left internal mammary artery grafting to the left anterior descending coronary artery, off-pump through a left inferior J-hemisternotomy (JOPCAB). This approach is straightforward, safe, effective, and replicable in virtually all patients. JOPCAB requires no patient selection or other prerequisite than...... experience in standard off-pump technique. The left internal mammary artery is harvested under direct vision through a left inferior J-hemisternotomy. The left anterior descending coronary artery is exposed with left-sided pericardial stitches. The off-pump anastomosis is performed with the aid of a suction...

  16. 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.

  17. The Maximal Graded Left Quotient Algebra of a Graded Algebra

    Institute of Scientific and Technical Information of China (English)

    Gonzalo ARANDA PINO; Mercedes SILES MOLINA

    2006-01-01

    We construct the maximal graded left quotient algebra of every graded algebra A without homogeneous total right zero divisors as the direct limit of graded homomorphisms (of left A-modules)from graded dense left ideals of A into a graded left quotient algebra of A. In the case of a superalgebra,and with some extra hypothesis, we prove that the component in the neutral element of the group of the maximal graded left quotient algebra coincides with the maximal left quotient algebra of the component in the neutral element of the group of the superalgebra.

  18. Correlation between hand preference and intraocular pressure from right- and left-eyes in right- and left-handers.

    Science.gov (United States)

    Dane, Senol; Gümüştekin, Kenan; Yazici, Ahmet Taylan; Baykal, Orhan

    2003-02-01

    To test whether there is a relationship between handedness and the intraocular pressure and there is a lateralization in the intraocular pressure, the intraocular pressures of the right- and left-eyes were compared in right- and left-handed students. The intraocular pressures were higher in the right-eye than in the left-eye in men, right-handers, and right-eyed subjects; there was no right-left difference in females, left-handers, left-eyed, and both-eyed subjects. The intraocular pressure of right- and left-eyes was higher in left-handers than right-handers. And there were significant negative correlations between hand preference and the intraocular pressure of both right- and left-eyes. We have concluded that the dominant eye has higher intraocular pressure compared to the nondominant one, and there is a relationship between hand preference and the intraocular pressure.

  19. Radiographic and echocardiographic assessment of left atrial size in 100 cats with acute left-sided congestive heart failure.

    Science.gov (United States)

    Schober, Karsten E; Wetli, Ellen; Drost, Wm Tod

    2014-01-01

    The aims of this study were to evaluate left atrial size in cats with acute left-sided congestive heart failure. We hypothesized that left atrial size as determined by thoracic radiography can be normal in cats with acute left-sided congestive heart failure. One hundred cats with acute left-sided congestive heart failure in which thoracic radiography and echocardiography were performed within 12 h were identified. Left atrial size was evaluated using right lateral and ventrodorsal radiographs. Measurements were compared to two-dimensional echocardiographic variables of left atrial size and left ventricular size. On echocardiography, left atrial enlargement was observed in 96% cats (subjective assessment) whereas maximum left atrial dimension was increased (>15.7 mm) in 93% cats. On radiographs left atrial enlargement (subjective assessment) was found in 48% (lateral view), 53% (ventrodorsal view), and 64% (any view) of cats whereas left atrial enlargement was absent in 36% of cats in both views. Agreement between both methods of left atrial size estimation was poor (Cohen's kappa 0.17). Receiver operating characteristic curve analysis identified a maximum echocardiographic left atrial dimension of approximately 20 mm as the best compromise (Youden index) between sensitivity and specificity in the prediction of radiographic left atrial enlargement. Left atrial enlargement as assessed by thoracic radiography may be absent in a clinically relevant number of cats with congestive heart failure. Therefore, normal left atrial size on thoracic radiographs does not rule out presence of left-sided congestive heart failure in cats with clinical signs of respiratory distress.

  20. 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

    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. Left atrium segmentation for atrial fibrillation ablation

    Science.gov (United States)

    Karim, R.; Mohiaddin, R.; Rueckert, D.

    2008-03-01

    Segmentation of the left atrium is vital for pre-operative assessment of its anatomy in radio-frequency catheter ablation (RFCA) surgery. RFCA is commonly used for treating atrial fibrillation. In this paper we present an semi-automatic approach for segmenting the left atrium and the pulmonary veins from MR angiography (MRA) data sets. We also present an automatic approach for further subdividing the segmented atrium into the atrium body and the pulmonary veins. The segmentation algorithm is based on the notion that in MRA the atrium becomes connected to surrounding structures via partial volume affected voxels and narrow vessels, the atrium can be separated if these regions are characterized and identified. The blood pool, obtained by subtracting the pre- and post-contrast scans, is first segmented using a region-growing approach. The segmented blood pool is then subdivided into disjoint subdivisions based on its Euclidean distance transform. These subdivisions are then merged automatically starting from a seed point and stopping at points where the atrium leaks into a neighbouring structure. The resulting merged subdivisions produce the segmented atrium. Measuring the size of the pulmonary vein ostium is vital for selecting the optimal Lasso catheter diameter. We present a second technique for automatically identifying the atrium body from segmented left atrium images. The separating surface between the atrium body and the pulmonary veins gives the ostia locations and can play an important role in measuring their diameters. The technique relies on evolving interfaces modelled using level sets. Results have been presented on 20 patient MRA datasets.

  2. Silent giant left atrium. A case report.

    Science.gov (United States)

    Badui, E; Delgado, C; Enciso, R; Graef, A; Solorio, S; Madrid, R; Cruz, H

    1995-05-01

    A sixty-two-year-old white woman with a 14.5 cm (145 mm) silent giant left atrial enlargement secondary probably to rheumatic heart disease is presented. Aside from mild progressive shortness of breath during the past year, the patient had been asymptomatic all her life. Her clinical picture was manifested for the first time by syncope secondary to slow atrial fibrillation, for which a permanent pacemaker was required. The correct diagnosis of the enlarged chamber was not possible through the routine chest roentgenogram. In this case, the echocardiogram, nuclear angiogram, and computed tomography were the pertinent studies needed to reach the diagnosis.

  3. Between Right and Left Handed Media

    CERN Document Server

    Ingrey, P C; Jakeman, E; French, O E

    2008-01-01

    We report analytical calculations for the propagation of electromagnetic radiation through an inhomogeneous layer whose refractive index varies in one dimension situated between bulk right- and left-handed media. Significant field localization is generated in the layer that is caused by the coherent superposition of evanescent waves. The strength of the field localization and the transmission properties of the layer are investigated as a function of the layer width, losses and defects in the refractive index; the former two being modelled by continuous changes, and the latter by discontinuous changes, in the index profile.

  4. Dual (type IV left anterior descending artery

    Directory of Open Access Journals (Sweden)

    Ozdil Baskan

    2013-11-01

    Full Text Available Congenital coronary artery anomalies are uncommon. Dual left anterior descending coronary artery (LAD is defined as the presence of two LADs within the anterior interventricular sulcus (AIVS, and is classified into four types. Type IV is a rarely reported subtype and differs from the others, with a long LAD originating from the right coronary artery (RCA. Dual LAD is a benign coronary artery anomaly, but should be recognised especially before interventional procedures. With the increasing use of multidedector computed tomography (MDCT, it is essential for radiologists to be aware of this entity and the cross-sectional findings.

  5. Degenerate Neutrinos in Left Right Symmetric Theory

    OpenAIRE

    Joshipura, Anjan S.

    1994-01-01

    Various hints on the neutrino masses namely, ({\\em i}) the solar neutrino deficit ({\\em ii}) the atmospheric neutrino deficit ({\\em iii}) the need for the dark matter and/or ({\\em iv}) the non-zero neutrinoless double beta decay collectively imply that all the three neutrinos must be nearlty degenerate. This feature can be understood in the left right symmetric theory. We present a model based on the group $SU(2)_{L}\\times SU(2)_R\\times U(1)_{B-L}\\times SU(2)_H$ which can explain the required...

  6. 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.

  7. Shared Frailty Model for Left-Truncated Multivariate Survival Data

    DEFF Research Database (Denmark)

    Jensen, Henrik; Brookmeyer, Ron; Aaby, Peter;

    multivariate survival data, left truncation, multiplicative hazard model, shared gamma frailty, conditional model, piecewise exponential model, childhood survival......multivariate survival data, left truncation, multiplicative hazard model, shared gamma frailty, conditional model, piecewise exponential model, childhood survival...

  8. Endoventriculoplasty using autologous endocardium for anterior left ventricular aneurysms

    NARCIS (Netherlands)

    Grandjean, JG; Mariani, MA; D'Alfonso, A; Musazzi, A; Boonstra, PW

    Background: There is currently consensus that endoventriculoplasty is the treatment of choice for an anterior left ventricular aneurysm. We describe here a new technique of endoventriculoplasty using autologous endocardium for left ventricular anterior aneurysm. Method: From 1990 until 2003, 49

  9. Surgical Management of Intramyocardial Left Anterior Descending Artery.

    Science.gov (United States)

    De Salvatore, Sergio; Segreto, Antonio; Chiusaroli, Alessandro; Congiu, Stefano; Bizzarri, Federico

    2015-11-01

    An intramyocardial left anterior descending artery can be found in up to 30% of patients undergoing coronary artery bypass graft procedures. We review the various techniques available to identify an intramyocardial left anterior descending artery.

  10. 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.

  11. Pulmonary hypertension due to left heart diseases.

    Science.gov (United States)

    Vachiéry, Jean-Luc; Adir, Yochai; Barberà, Joan Albert; Champion, Hunter; Coghlan, John Gerard; Cottin, Vincent; De Marco, Teresa; Galiè, Nazzareno; Ghio, Stefano; Gibbs, J Simon R; Martinez, Fernando; Semigran, Marc; Simonneau, Gerald; Wells, Athol; Seeger, Werner

    2013-12-24

    Pulmonary hypertension (PH), a common complication of left heart diseases (LHD), negatively impacts symptoms, exercise capacity, and outcome. Although the true prevalence of PH-LHD is unknown, a subset of patients might present significant PH that cannot be explained by a passive increase in left-sided filling pressures. The term "out-of-proportion" PH has been used to identify that population without a clear definition, which has been found less than ideal and created confusion. We propose a change in terminology and a new definition of PH due to LHD. We suggest to abandon "out-of-proportion" PH and to distinguish "isolated post-capillary PH" from "post-capillary PH with a pre-capillary component" on the basis of the pressure difference between diastolic pulmonary artery pressure and pulmonary artery wedge pressure. Although there is no validated treatment for PH-LHD, we provide insights into management and discuss completed and randomized trials in this condition. Finally, we provide recommendations for future clinical trials to establish safety and efficacy of novel compounds to target this area of unmet medical need. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  12. [Hypoplastic left heart syndrome (general review)].

    Science.gov (United States)

    Tláskal, T; Povýsilová, V; Vondrys, D; Skovránek, J

    1999-05-01

    The hypoplastic left heart syndrome (HLHS) is a critical congenital heart lesion with a small left ventricle in combination with stenosis or atresia of the aortic and the mitral valve. This heart disease is associated with a nearly 100% mortality at neonatal age. Until recently, this heart lesion was considered inoperable because of extremely unfavourable morphology. Introduction of the Norwood three-step reconstructive operation on one hand, and heart transplantation in neonates, on the other hand, improved the prognosis of patients with this complex heart lesion. In our country, however, this heart disease, if found during the first months of pregnancy, represents an indication for its termination, and neonates with HLHS are offered only symptomatic medical treatment. On basis of good experience from several most experienced cardiac centres we believe that it is necessary to reassess the statement considering HLHS as an inoperable disease. The main change from this aspect necessitates, however, a detailed analysis of the whole problem not only from the morphological, clinical and surgical point of view but also from philosophical, psychological, socio-economic and health care organisation aspects.

  13. Endometrial Adenocarcinoma with Concomitant Left Atrial Myxoma

    Directory of Open Access Journals (Sweden)

    Lisa N. Abaid

    2009-08-01

    Full Text Available Background: Atrial myxomas are the most common primary heart tumors and predominantly considered to be benign lesions. Case Study: We report a case involving a 77-year-old woman who presented with a pelvic mass. She was found to have a primary endometrial cancer and primary lung cancer with concomitant metastatic adrenal gland and mesenteric lesions. Her prior medical history also included an untreated 4.0 × 2.0-cm left atrial myxoma which was identified on CT scan during the workup of her pelvic mass. Results: A clinical decision was made to proceed with surgery for the pelvic mass with a subsequent recommendation for left atrial mass resection. Currently, the patient is scheduled to begin chemotherapy for primary lung cancer. Conclusion: The reported incidence of uterine cancer and a concurrent atrial myxoma is very rare. Consequently, the manner and timing in which treatment should be provided is imprecise. In the present case, the risk for cardiac complications was high, but given the presence of a partial bowel obstruction and the need to diagnose the primary site of her metastatic malignancy, the decision was made to proceed with exploratory abdominal surgery.

  14. Tamponade by an expanding left ventricular pseudoaneurysm: A unique presentation.

    Science.gov (United States)

    Mahesh, Balakrishnan; Ong, Ping; Kutty, Ramesh; Abu-Omar, Yasir

    2015-10-01

    Left ventricular free wall rupture secondary to myocardial infarction is an uncommon but catastrophic event requiring emergency surgery. We describe a unique presentation of left ventricular free wall rupture as delayed tamponade caused by a gradually expanding pseudoaneurysm compressing the left atrium, leading to pulmonary congestion that required increasing respiratory support to maintain oxygenation, and necessitated emergency surgery. We discuss the options available to treat pseudoaneurysms due to left ventricular free wall rupture.

  15. Isolated Left Pulmonary Artery Agenesis: A Case Report

    OpenAIRE

    Tansel Ansal Balcı; Zehra Pınar Koç; Gamze Kırkıl; Ahmet Kürşad Poyraz

    2012-01-01

    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 w...

  16. 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

    applying new strict ECG criteria subsequent rates of response in DCM were 18/19 (95%) and in IHD of 18/23 (78%) respectively, p... 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.... CONCLUSION: Interventricular electrical delay predicts left ventricular remodeling after CRT and new, strict ECG criteria of LBBB are superior in predicting remodeling....

  17. Left coronary artery stenosis causing left ventricular dysfunction in two children with supravalvular aortic stenosis.

    Science.gov (United States)

    Yildiz, Okan; Altin, Firat H; Kaya, Mehmet; Ozyılmaz, Isa; Guzeltas, Alper; Erek, Ersin

    2015-04-01

    Congenital supravalvar aortic stenosis (SVAS) is an arteriopathy associated with Williams-Beuren syndrome (WBS) and other isolated elastin gene deletions. Cardiovascular manifestations associated with WBS are characterized by obstructive arterial lesions such as SVAS and pulmonary artery stenosis in addition to bicuspid aortic valve and mitral valve prolapse. However, coronary artery ostial stenosis may be associated with SVAS, and it increases the risk of sudden death and may complicate surgical management. In this report, we present our experience with two patients having SVAS and left coronary artery ostial stenosis with associated left ventricular dysfunction. © The Author(s) 2014.

  18. Left ventricular thrombus formation after repair of anomalous left coronary artery from the pulmonary artery.

    Science.gov (United States)

    Freud, Lindsay R; Koenig, Peter R; Russell, Hyde M; Patel, Angira

    2014-04-01

    Although thrombus formation following myocardial infarction in adults is well known, intracardiac thrombosis in children is uncommon. We report the case of a large left ventricular thrombus in an infant with ischemic cardiomyopathy secondary to anomalous origin of the left coronary artery from the pulmonary artery. Given its mobility and protrusion across the aortic valve, the patient underwent urgent thrombus removal through a transaortic approach. There were no embolic or neurologic complications. This case highlights that thrombectomy may be performed safely and successfully in critically ill pediatric patients.

  19. Left Ventricular Thrombus Formation After Repair of Anomalous Left Coronary Artery From the Pulmonary Artery

    Science.gov (United States)

    Freud, Lindsay R.; Koenig, Peter R.; Russell, Hyde M.; Patel, Angira

    2014-01-01

    Although thrombus formation following myocardial infarction in adults is well known, intracardiac thrombosis in children is uncommon. We report the case of a large left ventricular thrombus in an infant with ischemic cardiomyopathy secondary to anomalous origin of the left coronary artery from the pulmonary artery. Given its mobility and protrusion across the aortic valve, the patient underwent urgent thrombus removal through a transaortic approach. There were no embolic or neurologic complications. This case highlights that thrombectomy may be performed safely and successfully in critically ill pediatric patients. PMID:24668990

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Spatial Deficit in Familial Left-Handed Children.

    Science.gov (United States)

    And Others; Eme, Robert

    1978-01-01

    The study evaluated the hypothesis that familial left-handed children, who presumably have bilateral representation of language ability, should show an impairment in spatial abiblity on 44 children (22 right handed, 11 familial left handed, and 11 nonfamilial left handed) whose average age was 8 years old. (Author/PHR)

  2. Left-Handed Children--Are They Losing Out?

    Science.gov (United States)

    Milsom, Lauren

    1995-01-01

    Discusses difficulties faced by left-handed children in everyday schoolwork. Highlights include right-handed bias of toys, clothing, and tools; the need for guidance in handwriting; problem areas including domestic science, arts and crafts, and metal and woodwork; left-hand advantages in sports and creative arts; and the European Left-Handers Club…

  3. Learning Conflict Among Mixed-Dominance Left-Handed Individuals.

    Science.gov (United States)

    Blai, Boris, Jr.

    This study investigates the hypothesis that it is mixed-dominance among left handers (i.e. left handedness and right eye and/or foot dominance), that is related to academic learning difficulties among such individuals, rather than the generally held notion that their difficulties stem from the fact that they are left handers in a "right handed…

  4. Left-Handed Students: A Forgotten Minority. Fastback 399.

    Science.gov (United States)

    Kelly, Evelyn B.

    This fastback, a booklet bound "left-handed," is designed to help educators become aware of the problems faced by left-handed students in school and to suggest ways that many of the problems might be solved. Following an introduction discussing a personal experience with left-handedness, the booklet continues with a brief history of the treatment…

  5. 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

  6. 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.

  7. Related anomalies of origin of left vertebral and left inferior thyroid arteries

    Energy Technology Data Exchange (ETDEWEB)

    Sartor, K.; Freckmann, N.; Boeker, D.K.

    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.

  8. Rare Anomalous Origin of Superior Left Pulmonary Artery from Left Subclavian Vein

    Energy Technology Data Exchange (ETDEWEB)

    Lv, Tian-shi, E-mail: TerrenceLv@126.com; Wang, Chao, E-mail: wangchaoxs@163.com; Song, Li, E-mail: song9981@163.com; Lv, Yong-xing, E-mail: lyongxing@msn.com; Zou, Ying-hua, E-mail: yinghzou@139.com [Peking University First Hospital, Department of Interventional Radiology and Vascular Surgery (China)

    2013-10-15

    We report for the first time an extremely rare anomalous origin of the superior left pulmonary artery in a 60 year-old man. Although it was occult in clinical indications, such a malformation still ought to be considered, especially during endovascular procedures.

  9. 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…

  10. Left Inferior Frontal Cortex and Syntax: Function, Structure and Behaviour in Patients with Left Hemisphere Damage

    Science.gov (United States)

    Tyler, Lorraine K.; Marslen-Wilson, William D.; Randall, Billi; Wright, Paul; Devereux, Barry J.; Zhuang, Jie; Papoutsi, Marina; Stamatakis, Emmanuel A.

    2011-01-01

    For the past 150 years, neurobiological models of language have debated the role of key brain regions in language function. One consistently debated set of issues concern the role of the left inferior frontal gyrus in syntactic processing. Here we combine measures of functional activity, grey matter integrity and performance in patients with left…

  11. Beta blockers & left ventricular hypertrophy regression.

    Science.gov (United States)

    George, Thomas; Ajit, Mullasari S; Abraham, Georgi

    2010-01-01

    Left ventricular hypertrophy (LVH) particularly in hypertensive patients is a strong predictor of adverse cardiovascular events. Identifying LVH not only helps in the prognostication but also in the choice of therapeutic drugs. The prevalence of LVH is age linked and has a direct correlation to the severity of hypertension. Adequate control of blood pressure, most importantly central aortic pressure and blocking the effects of cardiomyocyte stimulatory growth factors like Angiotensin II helps in regression of LVH. Among the various antihypertensives ACE-inhibitors and angiotensin receptor blockers are more potent than other drugs in regressing LVH. Beta blockers especially the newer cardio selective ones do still have a role in regressing LVH albeit a minor one. A meta-analysis of various studies on LVH regression shows many lacunae. There have been no consistent criteria for defining LVH and documenting LVH regression. This article reviews current evidence on the role of Beta Blockers in LVH regression.

  12. 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 .

  13. Psychotic Symptoms Associated with Left Caudate Infarction

    Directory of Open Access Journals (Sweden)

    Ying-Chih Cheng

    2015-09-01

    Full Text Available Psychotic symptoms following acquired brain lesion are relatively rare, and thus, the specific association linking such symptoms to the distinct brain structure remains unclear. The frontal–subcortical circuits are thought to modulate motor activity and human behavior, and have been reported to be associated with many neuropsychiatric symptoms. We herein report the case of a 77-year-old man without previous psychiatric disorder who developed a new onset of psychotic symptoms following left caudate infarction. The presented case supports the fact that psychosis might arise from alteration of the distinct brain structure. The functional impairment of the frontal–subcortical circuits may be a critical factor linking the pathogenesis of psychosis associated with acquired brain lesion.

  14. Degenerate Neutrinos in Left Right Symmetric Theory

    CERN Document Server

    Joshipura, A S

    1995-01-01

    Various hints on the neutrino masses namely, ({\\em i}) the solar neutrino deficit ({\\em ii}) the atmospheric neutrino deficit ({\\em iii}) the need for the dark matter and/or ({\\em iv}) the non-zero neutrinoless double beta decay collectively imply that all the three neutrinos must be nearlty degenerate. This feature can be understood in the left right symmetric theory. We present a model based on the group $SU(2)_{L}\\times SU(2)_R\\times U(1)_{B-L}\\times SU(2)_H$ which can explain the required departures from degeneracy in neutrino masses and large mixing among them without assuming any of the mixing in the quark or charged lepton sector to be large as would be expected in a typical $SO(10)$ model.

  15. Heredity in fundamental left complemented algebras

    Directory of Open Access Journals (Sweden)

    Marina Haralampidou

    2016-06-01

    Full Text Available In the present paper, we introduce the notion of a fundamental complemented linear space, through continuous projections. This notion is hereditary. Relative to this, we prove that if a certain topological algebra is fundamental, then a concrete subspace is fundamental too. For a fundamental complemented linear space, we define the notion of continuity of the complementor. In some cases, we employ a generalized notion of complementation, that of (left precomplementation. In our main result, the continuity of the complementor for a certain fundamental complemented (topological algebra is inherited to the induced vector complementor of the underlying linear space of a certain right ideal. Weakly fundamental algebras are also considered in the context of locally convex ones.

  16. Left Ventricle Diverticulum with Partial Cantrell's Syndrome

    Directory of Open Access Journals (Sweden)

    Mustapha El Kouache

    2012-01-01

    Full Text Available Cantrell syndrome is a very rare congenital disease associating five features: a midline, upper abdominal wall disorder, lower sternal abnormality, anterior diaphragmatic defect, diaphragmatic pericardial abnormality, and congenital abnormalities of the heart. In this paper, we report a case of partial Cantrell's syndrome with left ventricular diverticulum, triatrial situs solitus, ventricular septal defect, dextrorotation of the heart, an anterior pericardial diaphragmatic defect, and a midline supraumbilical abdominal wall defect with umbilical hernia. The 5-month-old patient underwent a successful cardiac surgical procedure. A PTFE membrane was placed on the apex of the heart to facilitate reopening of the patient’s chest. Postoperative course was uneventful. The patient was discharged with good clinical condition and with a normal cardiac function.

  17. Retrieval of embolized left atrial appendage devices.

    Science.gov (United States)

    Fahmy, Peter; Eng, Lim; Saw, Jacqueline

    2016-09-28

    Percutaneous left atrial appendage (LAA) closure is gaining interest as an alternative option for prevention of strokes in patients with Atrial Fibrillation (AF), especially for those with contraindications to anticoagulation. Complications from these procedures are well described in the medical literature. LAA closures may lead to pericardial effusion, device-associated thrombus, and device embolization. Understanding the reasons for embolization, strategies to avoid embolization, and the techniques for retrieval of LAA devices (ACP/AMULET and WATCHMAN) should be appreciated by endovascular implanters. We describe two cases of LAA device embolization that were both successfully retrieved percutaneously and other percutaneous techniques to safely retrieve embolized LAA devices. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  18. Amplitudes for left-handed strings

    CERN Document Server

    Siegel, W

    2015-01-01

    We consider a class of string-like models introduced previously where all modes are left-handed, all states are massless, T-duality is manifest, and only a finite number of orders in the string tension can appear. These theories arise from standard string theories by a singular gauge limit and associated change in worldsheet boundary conditions. In this paper we show how to calculate amplitudes by using the gauge parameter as an infrared regulator. The amplitudes produce the Cachazo-He-Yuan delta-functions after some modular integration; the Mason-Skinner string-like action and amplitudes arise from the zero-tension (infinite-slope) limit. However, without the limit the amplitudes have the same problems as found in the Mason-Skinner formalism.

  19. A two phase harmonic model for left ventricular function

    CERN Document Server

    Dubi, S; Dubi, Y

    2006-01-01

    A minimal model for mechanical motion of the left ventricle is proposed. The model assumes the left ventricle to be a harmonic oscillator with two distinct phases, simulating the systolic and diastolic phases, at which both the amplitude and the elastic constant of the oscillator are different. Taking into account the pressure within the left ventricle, the model shows qualitative agreement with functional parameters of the left ventricle. The model allows for a natural explanation of heart failure with preserved systolic left ventricular function, also termed diastolic heart failure. Specifically, the rise in left ventricular filling pressures following increased left-ventricular wall stiffness is attributed to a mechanism aimed at preserving heart rate and cardiac output.

  20. A Class of Left E-adequate Semigroups

    Institute of Scientific and Technical Information of China (English)

    LI YONG-HUA; HE YONG

    2010-01-01

    In this paper we establish a construction of a class of left E-adequate semigroups by using semilattices of cancellative monoids and fundamental left E-adequate semigroups. We first introduce concepts of type μ+ (μ*, μ) abundant semigroups and type μ+ left E-adequate semigroups. In fact, regular semigroups are type μ+ abundant semigroups and inverse semigroups are type μ+ left E-adequate semigroups. Next, we construct a special kind of algebras called E+-product. It is proved that every E+-product is a type μ+ left E-adequate semigroup, and every type μ+ left E-adequate semigroup is isomorphic to an E+-product of a semilattice of cancellative monoids with a fundamental left E-adequate semigroup. Finally, as a corollary of the main result, it is deduced that every inverse semigroup is isomorphic to an E+-product of a Clifford semigroup by a fundamental inverse semigroup.

  1. Proprioceptive target matching asymmetries in left-handed individuals.

    Science.gov (United States)

    Goble, Daniel J; Noble, Brittany C; Brown, Susan H

    2009-08-01

    In right-handers, the ability to reproduce proprioceptive targets has been shown to be asymmetric, favoring the non-preferred left arm. The present study sought to determine whether a similar arm/hemisphere asymmetry exists for left-handers. Ten strong left-handed adults used the left or right arm to perform proprioceptive target matching tasks that varied in processing demands (i.e., need for memory, interhemispheric transfer) and target amplitude (20, 40 degrees). Similar to right-handers, left-handed individuals had smaller total errors when matching with the non-preferred arm. This asymmetry was greatest in conditions with increased processing demands and larger amplitude targets. These results provide the first evidence to date of right arm/left hemisphere dominance for proprioceptive target matching in left-handers that is the "mirror image" of right-handers.

  2. Left Atrial Tachycardia After Pulmonary Vein Isolation for Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Kenichi Hashimoto, MD

    2005-01-01

    Full Text Available Left atrial tachycardia (AT has been reported to occur after pulmonary vein isolation (PVI for the treatment of atrial fibrillation (AF. We treated 3 patients who developed AT of different mechanisms following PVI. In case 1, focal AT originating at the ostium of the left superior PV was demonstrated and focal radiofrequency ablation was performed at the breakthrough point at the ostium of the left superior PV terminated the AT. In case 2, AT was shown to be counterclockwise macroreentrant AT around the left inferior PV through the conduction gap of the left sided posterior wall for which linear ablation was performed between left superior and inferior PVs. Focal ablation at the conduction gap terminated the AT. In case 3, a macroreentrant AT propagating around the mitral annulus was demonstrated and linear ablation between left inferior pulmonary vein and mitral annulus (mitral isthmus terminated the AT.

  3. Pedestrian safety under permissive left-turn signal control

    Directory of Open Access Journals (Sweden)

    Yi Qi

    2017-06-01

    Full Text Available At intersections with permissive only signal control, pedestrians will move at the phase with the parallel through vehicular movement and the permissive left-turn movement. The left-turn vehicles have to yield to both opposing vehicles and pedestrians at the crosswalk. Under such complicated driving conditions, collision risks rise if left-turn vehicles make misjudgments and fail to yield to the pedestrians. In this research, driving-simulation based experiments were conducted for identifying and assessing the impacts of the factors that contribute to the collision between the left-turn vehicles and the pedestrians during the permissive left-turn phase. The results of this study showed that the percentage of left-turn trucks and the pedestrian volume has significant impacts on the pedestrian safety under permissive left-turn signal control.

  4. Relationship of left heart size and left ventricular mass with exercise capacity in chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    SHEN Yu-qin; WANG Le-min; CHE Lin; SONG Hao-ming; ZHANG Qi-ping

    2011-01-01

    Background Impaired exercise capacity is one of the most common clinical manifestations in patients with chronic heart failure (CHF). The severity of reduced exercise capacity is an indicator of disease prognosis. The aim of the current study was to investigate the association between left heart size and mass with exercise capacity.Methods A total of 74 patients were enrolled in the study, with 37 having congestive heart failure (left ventricular ejection fraction (LVEF) <0.45) and the other 37 with coronary heart disease (by coronary angiography) serving as the control group (LVEF >0.55). Echocardiography and cardiopulmonary exercise test were performed. The multiply linear regression model was used to evaluate the association between echocardiogrphic indices and exercise capacities.Results The study showed that left ventricular end diastolic / systolic diameter (LVEDD/LVESD), left atrial diameter (LAD) and left ventricular mass index (LVMI) were significantly enlarged in patients with chronic heart failure compared with controls (P <0.01). The VO2AT, Peak VO2, Load AT, and Load Peak in chronic heart failure patients were also significantly reduced compared with controls (P <0.05), VE/VCO2 slope was increased in patients with chronic heart failure (P <0.01). Multivariate linear regression analysis indicated that the patients' exercise capacity was significantly associated with the left heart size and mass, however, the direction and/or strength of the associations sometimes varied in chronic heart failure patients and controls. Load AT correlated negatively with LVEDD in chronic heart failure patients (P=0.012), while Load AT correlated positively with LVEDD in control patients (P=0.006). VE/VCO2 slope correlated positively with LAD (B=0.477, P <0.0001) in chronic heart failure patients, while the VE/VCO2 slope correlated negatively with LAD in control patients (P=0.009).Conclusion The study indicates that the size of LVEDD and LAD are important

  5. Novel parameter for assessment of left atrial size in patients with hypertension: ratio of left atrial volume to left ventricular volume

    Institute of Scientific and Technical Information of China (English)

    LI Yue; CHAI Liang; ZHANG Yun; LI Lei

    2009-01-01

    Background Left atrial enlargement has been suggested as a more robust marker of diastolic dysfunction. We hypothesize that the ratio of left atrial volume to left ventricular volume (LAV/LVV) may be more reasonable to reflect left atrial enlargement in the patients with hypertension, because hypertensive patients have a characteristic of concentric remodeling of the left ventricle which is often accompanied with diastolic dysfunction. The aim of this study was to determine if the LAV/LVV can be used as a new parameter to assess left atrial size in hypertensive patients and the relationship between the LAV/LVV and diastolic dysfunction.Methods Ninety-one patients with hypertension and forty-three normal controls were studied. The hypertensive patients were assigned to the normal wall (NW) and hypertrophic wall (HW) groups. The left atrial diameter (LAD), LAV, left atrial volume index (LAVi), LVV and LAV/LVV were measured and calculated by 2-dimensional echocardiography and real time 3-dimensional echocardiography. All of the above parameters were used to evaluate the size of the left atrium. The ratio of peak E velocity of mitral valve inflow to peak E' velocity of lateral mitral annulus (E/E') was measured by pulse Doppler and tissue Doppler. This parameter was used to evaluate diastolic function. Results The LAD, LAV, LAVi, LAV/LVV and E/E' in hypertensive groups were significantly higher than those in the normal group (P <0.05 or 0.01), and those in the HW group were significantly higher than those in the NW group (P <0.05 or 0.01). The E/E' had a positive correlation with LAV, LAVi and LAV/LVV. The correlation coefficient between E/E' and LAV/LVV was relatively higher than that between E/E' and LAD or LAVi.Conclusion LAV/LVV may be used as a new index to evaluate left atrial size in hypertensive patients with diastolic dysfunction.

  6. Evaluation of left renal vein entrapment using multidetector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Poyraz, Ahmet K.; Onur, Mehmet R. [Dept. of Radiology, Firat Univ. School of Medicine, Elazig (Turkey)], e-mail: akursadpoyraz@yahoo.com.tr; Firdolas, Fatih [Dept. of Urology, Firat Univ. School of Medicine, Elazig (Turkey); Kocakoc, Ercan [Dept. of Radiology, Bezmialem Vakif Univ., School of Medicine, Istanbul (Turkey)

    2013-03-15

    Background: Nutcracker syndrome, also called left renal vein entrapment syndrome, is a cause of non-glomerular hematuria with difficulties in diagnosis. Multidetector computed tomography (MDCT) is a powerful tool to prevent unnecessary diagnostic procedures. Purpose: To retrospectively determine the prevalence of nutcracker phenomenon and nutcracker syndrome seen in MDCT in consecutive patients. Material and Methods: The institutional review board approved the study and waived the requirement for informed consent. Abdominal contrast-enhanced MDCT scans were reviewed from 1000 consecutive patients. MDCT scan assessment included renal vein diameter measurements and evaluation for the presence of anterior or posterior left renal vein entrapment. Electronic medical records and urine analysis reports of patients with left renal vein entrapment were reviewed. Student's t test was used to assess differences in renal vein diameter in patients with left renal vein entrapment. Results: Left renal vein entrapment was observed in 10.9% (109), retroaortic left renal vein in 6.5% (65), entrapment of left renal vein between superior mesenteric artery and aorta in 4.1% (41), and circumaortic left renal vein in 0.3% (3) of patients. Mean diameters of right (8.8 {+-} 1.9 mm) and unentrapped left (8.9 {+-} 1.8 mm) renal veins were not significantly different (P = 0.1). The mean diameter of anterior entrapped left renal veins (10.3 {+-} 2 mm) was significantly greater (P = 0.04) than contralateral renal veins (8.6 {+-} 2.1 mm) in their widest portion. In 8.8% of patients with the left renal vein entrapment, urine analysis showed isomorphic hematuria or proteinuria with no other known cause. Varicocele and pelvic congestion were seen in 5.5% of patients with the left renal vein entrapment. Conclusion: Left renal vein entrapment is not a rare entity and renal nutcracker phenomenon might be underdiagnosed.

  7. Left Ventricular Hypertrophy Evaluation in Obese Hypertensive Patients: Effect of Left Ventricular Mass Index Criteria

    Directory of Open Access Journals (Sweden)

    Eduardo Cantoni Rosa

    2002-04-01

    Full Text Available PURPOSE: To evaluate left ventricular mass (LVM index in hypertensive and normotensive obese individuals. METHODS: Using M mode echocardiography, 544 essential hypertensive and 106 normotensive patients were evaluated, and LVM was indexed for body surface area (LVM/BSA and for height² (LVM/h². The 2 indexes were then compared in both populations, in subgroups stratified according to body mass index (BMI: or = 30kg/m². RESULTS: The BSA index does not allow identification of significant differences between BMI subgroups. Indexing by height² provides significantly increased values for high BMI subgroups in normotensive and hypertensive populations. CONCLUSION: Left ventricular hypertrophy (LVH has been underestimated in the obese with the use of LVM/BSA because this index considers obesity as a physiological variable. Indexing by height² allows differences between BMI subgroups to become apparent and seems to be more appropriate for detecting LVH in obese populations.

  8. Congenital left ventricular aneurysm coexisting with left ventricular non-compaction in a newborn.

    Science.gov (United States)

    Ootani, Katsuki; Shimada, Jun; Kitagawa, Yosuke; Konno, Yuki; Miura, Fumitake; Takahashi, Toru; Ito, Etsuro; Ichinose, Kouta; Yonesaka, Susumu

    2014-10-01

    Described herein is the case of a rare combination of congenital left ventricular (LV) aneurysm and left ventricular non-compaction (LVNC) in a newborn. The patient developed refractory heart failure soon after birth and died at 5 months of age. The etiology of both congenital LV aneurysm and LVNC seems to be maldevelopment of the ventricular myocardium during early fetal life. Treatment should be individually tailored depending on clinical severity, and treatment options are limited. Given that this combination of congenital LV aneurysm and LVNC is significantly associated with poor prognosis, it appears that patients with congenital LV aneurysm and LVNC are candidates for early, aggressive intervention, including surgical aneurysmectomy and evaluation for transplantation. It is important to be aware of this combination of congenital LV aneurysm and LVNC, and to make earlier decisions on therapeutic strategy.

  9. A neonate with left pulmonary artery thrombosis and left lung hypoplasia: a case report

    Directory of Open Access Journals (Sweden)

    ElHassan Nahed O

    2010-08-01

    Full Text Available Abstract Introduction Spontaneous intrauterine arterial thrombosis and congenital pulmonary hypoplasia are rare conditions and have not been reported to occur together. The literature rather includes two reports of babies with neonatal pulmonary artery occlusion and post-infarction cysts of the lungs. Case presentation We report a case of a live Caucasian male newborn with left lung hypoplasia that occurred in association with left pulmonary artery thrombosis. Despite a critical neonatal course, including extracorporeal membrane oxygenation, this infant is alive and well at 18 months of age without any neurodevelopmental sequelae or reactive airway disease. Conclusion This association suggests the possibility of an intrauterine vascular event between the fifth and eighth weeks of gestation during early pulmonary artery and lung development.

  10. TOOL USE DISORDERS AFTER LEFT BRAIN DAMAGE

    Directory of Open Access Journals (Sweden)

    Josselin eBaumard

    2014-05-01

    Full Text Available In this paper we review studies that investigated tool use disorders in left-brain damaged (LBD patients over the last thirty years. Four tasks are classically used in the field of apraxia: Pantomime of tool use, single tool use, real tool use and mechanical problem solving. Our aim was to address two issues, namely, (1 the role of mechanical knowledge in real tool use and (2 the cognitive mechanisms underlying pantomime of tool use, a task widely employed by clinicians and researchers. To do so, we extracted data from 36 papers and computed the difference between healthy subjects and LBD patients. On the whole, pantomime of tool use is the most difficult task and real tool use is the easiest one. Moreover, associations seem to appear between pantomime of tool use, real tool use and mechanical problem solving. These results suggest that the loss of mechanical knowledge is critical in LBD patients, even if all of those tasks (and particularly pantomime of tool use might put differential demands on semantic memory and working memory.

  11. What's 'left' in the 'Garden of Sweden'?

    Science.gov (United States)

    Olsen, Gregg M

    2013-01-01

    Liberalization, restructuring, and retrenchment have been underway in Sweden for more than two decades and have rapidly accelerated under the current non-socialist coalition government. It is uncertain how much of the Swedish social policy model is "left" now, in terms of both what remains of it and its political character. A cross-temporal look at developments within Sweden reveals striking and continual rollbacks and marketization since the 1990s. However, this view must be qualified, both because Sweden's undisputed descent is from a comparatively lofty position and because there have been some noteworthy, but often ignored, gains even amidst marked decline over the past few decades. A cross-national examination indicates that, despite rapidly rising rates of income and wealth inequality, Sweden remains an egalitarian leader in several respects. This view must be qualified, too, because, while it continues to routinely out-perform Anglo nations such as Canada, the United Kingdom, and the United States, Sweden is less often, and less notably, distinct from several of its continental counterparts in Europe now. Moreover, the foundation of the model, labor strength, has been significantly undermined.

  12. ECG manifestations of left ventricular electrical remodeling.

    Science.gov (United States)

    Estes, E Harvey

    2012-01-01

    Research and thinking about the electrocardiographic manifestations of left ventricular hypertrophy has been constrained by a limited conceptual model of the process: heart disease produces chamber enlargement (increased mass), which in turn produces an altered electrocardiogram. The process is much more complex than can be represented in this simple model. A more robust and intricate model is proposed, in which heart (and vascular) disease causes structural changes, electrical changes, biochemical changes, and others, all of which interact to produce electrical remodeling of ventricular myocardium. This electrical remodeling results in a variety of ECG changes. All of these changes interact, leading to an altered clinical course, and to premature death. It is suggested that research, based on this model, can provide new clues to the processes involved, and improve the prediction of clinical outcomes. New directions in research, in recording equipment, and in organizational activities are suggested to test this new model, and to improve the usefulness of the electrocardiogram as a research and diagnostic tool.

  13. 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.

  14. 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

  15. Arterial baroreflex function and left ventricular hypertrophy

    Institute of Scientific and Technical Information of China (English)

    MIAO Chao-Yu; SU Ding-Feng

    2004-01-01

    It is well known that the arterial baroreflex(ABR)plays a key role in the regulation of heart rate and stabilization of blood pressure.Currently,it appears that ABR dysfunction is involved in the pathophysiology of cardiovascular disease states.Since the mid-1990s,a number of studies have been carried out in our laboratory to explore the pathological significance of ABR function in cardiovascular damage.This minireview summarizes our research work on the topic of ABR and left ventricular hypertrophy(LVH).On the basis of discussion concerning the importance of ABR dysfunction in hypertensive LVH and sinoaortic denervation-induced LVH,we advance a new strategy for reversal of LVH,that is,restoration of impaired ABR function.We tested this hypothesis in animal models with ABR deficiency.It was found that improvement of impaird ABR function with long-term treatment of ketanserin or candesartan was accompanied by reversal of LVH.The preliminary results indicate that it is feasible to target ABR for treatment of LVH.

  16. Fourier coefficient description of left ventricular shape.

    Science.gov (United States)

    Round, W H; Bates, R H; Ikram, H

    1991-12-01

    A method of quantifying the shape of the left ventricle of the heart as seen in 2D echocardiograms was developed. It is based on describing the shape in terms of the coefficients a fifth-order trigonometric Fourier series. Such a series has eleven Fourier coefficients which is too large a number for clinical application so pairs of coefficients are combined to give six coefficients (alpha 0, alpha 1, ... , alpha 5). A trial was conducted to test the ability of the coefficient description to classify subjects as having normal right ventricles or ventricles with an apical abnormality. The tests showed that one of the coefficients (alpha 2) was higher for the subjects with an apical abnormality and that this difference increased with exercise. This is as was expected. However, it was found to be difficult to get a reliable estimate of alpha 2 from a single scan of a patient and that it is therefore probably necessary to average data from several scans to obtain a reliable alpha 2 value for a single patient.

  17. Left Atrial Appendage Occlusion for Stroke Prevention.

    Science.gov (United States)

    Chanda, Arijit; Reilly, John P

    More than 2.3 million adults in the United States have atrial fibrillation (AF), which exposes them to a 5-fold increased risk of stroke. The left atrial appendage (LAA) appears to be the source of thrombus formation in the vast majority of these patients. Anticoagulation significantly reduces the risk of stroke, but often we encounter patients who have absolute or relative contraindication to anticoagulation. Percutaneous LAA exclusion offers an alternative to anticoagulation to decrease the risk of stroke. Three device systems are currently available in the United States. The WATCHMAN® device is the most studied and approved by Food and Drug Administration (FDA) to be used in patients with AF unsuitable for anticoagulation who are at a high risk of stroke. The Amulet® device is currently being used as part of the AMPLATZER® Amulet® LAA Occluder trial, which is a non-inferiority randomized trial comparing the Amulet® to the WATCHMAN® device. The third device in use is the LARIAT®, which is an FDA approved snare and pre-tied stich system. It is used to approximate soft tissue which in this case is the LAA. It is a hybrid system and requires both epicardial and endocardial access. The main obstacle to percutaneous LAA closure is procedural related complications, which can be minimized with optimum operator experience. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Hemodynamic forces in a model left ventricle

    Science.gov (United States)

    Domenichini, Federico; Pedrizzetti, Gianni

    2016-12-01

    Intraventricular pressure gradients were clinically demonstrated to represent one useful indicator of the left ventricle (LV) function during the development of heart failure. We analyze the fluid dynamics inside a model LV to improve the understanding of the development of hemodynamic forces (i.e., mean pressure gradient) in normal conditions and their modification in the presence of alterations of LV tissue motion. To this aim, the problem is solved numerically and the global force exchanged between blood flow and LV boundaries is computed by volume integration. We also introduce a simplified analytical model, based on global conservation laws, to estimate hemodynamic forces from the knowledge of LV tissue information commonly available in cardiac imaging. Numerical results show that the normal intraventricular gradients feature a deep brief suction at early diastolic filling and a persistent thrust during systolic ejection. In presence of abnormalities of the wall motion, the loss of time synchrony is more relevant than the loss of spatial uniformity in modifying the normal pressure gradient spatiotemporal pattern. The main findings are reproduced in the integral model, which represents a possible easy approach for integrating fluid dynamics evaluations in the clinical examination.

  19. 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

  20. Atypical interhemispheric communication in left-handed individuals.

    Science.gov (United States)

    Iwabuchi, Sarina J; Kirk, Ian J

    2009-01-28

    The relative latencies of evoked electroencephalogram potentials to lateralized visual stimuli were used to calculate the interhemispheric transfer time (IHTT) in right-handed and left-handed males. We confirmed earlier observations of a directional asymmetry in right-handed males. That is, IHTT from the right to the left hemisphere is significantly shorter than from the left to the right. We showed for the first time, however, that this directional asymmetry is not seen in left-handed males. It is suggested that differences in the cytoarchitechtonics of the right and left hemisphere (differences that may result in lateralization of function per se) underlie the asymmetric IHTT in right handers, and that these differences are less pronounced in left handers.

  1. Stopband Phenomena in the Passband of Left-Handed Metamaterials

    Institute of Scientific and Technical Information of China (English)

    ZHAO Xiao-Peng; ZHAO Qian; ZHANG Fu-Li; ZHAO Wei; LIU Ya-Hong

    2006-01-01

    Stopband phenomena are reported in the passband of left-handed metamaterials. The samples with linear defect are designed by removing one layer of split ring resonators (SRRs). It is shown that the left-handed transmission peaks have a distinct transform with the relative deviation of the SRRs centre from the wire centre δ, from a single left-handed peak, double left-handed peaks with different magnitude to no transmission peak, i.e. left-handed properties of metamaterials disappear. Numerical simulation shows that the change of δ makes the effective permeability shift at a frequency range, where stopband occurs. It is thought that the stopband in left-handed passband is due to the symmetry breaking between SRRs and wires in the metamaterials.

  2. Cervical origin of left subclavian artery: A rare anomaly

    Directory of Open Access Journals (Sweden)

    Ponnusamy Shunmuga Sundaram

    2014-01-01

    Full Text Available A 22-year-old lady was referred to our institute for the management of pulmonary atresia with hypoplastic pulmonary arteries. Computed tomographic Angiography (CTA showed right aortic arch with left brachicephalic artery as the first branch, which trifurcated into internal carotid, external carotid and subclavian artery high up in the neck at the level of third cervical vertebra. The left subclavian artery then travelled back caudally and entered into the arm after giving rise to a large collateral artery. This is the first ever-reported case of cervical origin of left subclavian artery (COLSA in the literature. This anomaly can be explained by the absence of left fourth aortic arch with left subclavian artery arising from the left third aortic arch.

  3. Crab scars reveal survival advantage of left-handed snails

    OpenAIRE

    Dietl, Gregory P.; Hendricks, Jonathan R.

    2006-01-01

    Biological asymmetries are important elements of the structure and function of many living organisms. Using the Plio–Pleistocene fossil record of crab predation on morphologically similar pairs of right- and left-handed snail species, we show here for the first time, contrary to traditional wisdom, that rare left-handed coiling promotes survival from attacks by right-handed crabs. This frequency-dependent result influences the balance of selection processes that maintain left-handedness at th...

  4. [Vertigo induced by noise or pressure to the left ear].

    Science.gov (United States)

    Seidel, D U; Dülks, A; Remmert, S

    2011-06-01

    A 49-year-old male patient presented with recently acquired vertigo induced by noise or pressure to the left ear. With appropriate stimulation, oscillopsia with a rotatory component could be reproduced in videooculography. Cervical vestibular evoked myogenic potentials (VEMP) showed increased amplitudes and a lowered threshold on the left side. CT of the petrous bone showed a bony dehiscence of the left superior semicircular canal. Conservative therapy was initiated as a first step.

  5. Left-handed surgical instruments - a guide for cardiac surgeons.

    Science.gov (United States)

    Burdett, Clare; Theakston, Maureen; Dunning, Joel; Goodwin, Andrew; Kendall, Simon William Henry

    2016-08-19

    For ease of use and to aid precision, left-handed instruments are invaluable to the left-handed surgeon. Although they exist, they are not available in many surgical centres. As a result, most operating theatre staff (including many left-handers) have little knowledge of their value or even application. With specific reference to cardiac surgery, this article addresses the ways in which they differ, why they are needed and what is required - with tips on use.

  6. Anatomical variation of the origin of the left vertebral artery

    OpenAIRE

    Patasi B; Yeung A; Goodwin S; Jalali A

    2009-01-01

    This paper presents and describes the anatomical variation of the left vertebral artery originating from the arch of aorta as a case report. This variation was found in one of the cadavers at the Division of Clinical and Functional Anatomy, Faculty of Medicine, University of Ottawa. During routine dissection of a male cadaver, in the superior mediastinum and the neck we observed an atypical origin of the left vertebral artery. Atypical origin was compared to the typical origin of the left ver...

  7. 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.

  8. Intravascular ultrasound for angiographically indeterminant left main coronary artery disease.

    Science.gov (United States)

    Parashara, D K; Jacobs, L E; Ledley, G S; Yazdanfar, S; Oline, J; Kotler, M N

    1994-01-01

    The precise diagnosis of the presence of significant left main coronary artery disease has profound prognostic and therapeutic implications. Coronary cineangiography has shown to be imprecise and inaccurate to determine the percent stenosis of the left main coronary artery. We report a case with significant left main coronary artery disease in whom coronary cineangiography was in discordance with the clinical data and intravascular ultrasonography. Based on the intravascular ultrasound findings, the patient underwent coronary artery bypass graft surgery. Therefore, the intravascular ultrasonography may be the procedure of choice for assessing indeterminant left main coronary artery lesions by coronary angiography.

  9. Symptomatic Type IV Dual Left Anterior Descending Coronary Artery

    Directory of Open Access Journals (Sweden)

    Kyriacos Papadopoulos MD

    2016-12-01

    Full Text Available Dual left anterior descending coronary artery is a rare congenital anomaly with 4 subtypes. Double left anterior descending coronary artery originating from the left main stem and the right coronary artery (type IV dual left anterior descending artery has been reported to occur in 0.01% to 0.7% of patients undergoing cardiac catheterization. We report a case of a 49-year-old woman who was found to have this anomaly during coronary angiography. The patient had been complaining of chest pain that mimics angina pectoris and exercise tolerance test was positive for myocardial ischemia.

  10. What’s on the left?

    Directory of Open Access Journals (Sweden)

    Paul Isambert

    2011-07-01

    Full Text Available Discourse structure is investigated from the point of view of topic shifts. The paper focuses on the French adverb autrement, an important tool in such operations. It requires an antecedent, the topic to be shifted, which it generally finds among salient elements such as topicalized noun phrases or frames. However, since there might be several such elements in the left context, other devices are used to ensure that interlocutors clearly understand which topic is being shifted, i.e. what the antecedent of autrement is. These devices are mostly: stating the new topic, which is similar in many respects (syntax, semantics to the previous one; the repetition of an overarching topic is also an important way to clarify discourse structure. In cases where such markers are absent, it is hypothesized that topics exist at least covertly. On the whole, discourse structure, and especially the left context, must be highly organized if autrement is to work properly. Thus, the study of autrement offers an interesting perspective on discourse structure as a whole, including the Right Frontier constraint: not only does autrement find its antecedent on the Right Frontier, it also shapes it by closing topics and modifying the availability of discourse referents.Cet article étudie la structure du discours du point de vue des changements de topiques, et plus précisément en se concentrant sur l’adverbe autrement et son rôle central dans une telle opération. Ce marqueur nécessite un antécédent, le topique qu’il ferme, qu’il trouve généralement parmi les éléments saillants du discours tels que les groupes nominaux topicalisés et les cadratifs. Cependant, comme il peut y avoir plusieurs éléments de cette sorte dans le contexte gauche, d’autres procédés sont aussi employés pour s’assurer que les interlocuteurs comprennent clairement quel topique est fermé, c’est-à-dire quel élément est l’antécédent d’autrement. Ces procédés sont

  11. Left ventricular biomechanics in professional football players.

    Science.gov (United States)

    von Lueder, T G; Hodt, A; Gjerdalen, G F; Steine, K

    2017-04-04

    Chronic exercise induces adaptive changes of left ventricular (LV) ejection and filling capacities which may be detected by novel speckle-tracking echocardiography (STE) and tissue Doppler imaging (TDI)-based techniques. A total of 103 consecutive male elite Norwegian soccer players and 46 age-matched healthy controls underwent echocardiography at rest. STE was used to assess LV torsional mechanics and LV systolic longitudinal strain (LS). Diastolic function was evaluated by trans-mitral blood flow, mitral annular velocities by TDI, and LV inflow propagation velocity by color M-mode. Despite similar global LS, players displayed lower basal wall and higher apical wall LS values vs controls, resulting in an incremental base-to-apex gradient of LS. Color M-mode and TDI-derived data were similar in both groups. Peak systolic twist rate (TWR) was significantly lower in players (86.4±2.8 vs controls 101.9±5.2 deg/s, Pplayers (-124.5±4.2 vs -106.9±6.7 deg/s) and peaked earlier during the cardiac cycle (112.7±0.8 vs 117.4±2.4% of systole duration, both Pplayers. Augmented diastolic wall strain (DWS), a novel measure of LV compliance in players, was associated with improved myocardial mechanical efficiency. The described myocardial biomechanics may underlie augmented exertional cardiac function in athletes and may have a potential role to characterize athlete's heart by itself or to distinguish it from hypertensive or hypertrophic cardiomyopathy. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Stenting for left main stenosis in a child with anomalous origin of left coronary artery: case report

    Institute of Scientific and Technical Information of China (English)

    CHEN Ming; HONG Tao; HUO Yong

    2005-01-01

    @@ Anomalous left coronary artery (LCA) arising from right cusp is an uncommon condition. Clinical evidence has shown that this coronary anomaly is consistently related to sudden death. Current treatment options include modification of behaviour, medicine or surgery. Stents have been successfully applied for left main stenosis for a decade. We report a case of LCA arising from right cusp with left main stenosis treated with coronary stent in a child patient.

  13. Osteopathic treatment in a patient with left-ventricular assist device with left brachialgia: a case report

    Science.gov (United States)

    Bordoni, Bruno; Marelli, Fabiola; Morabito, Bruno; Sacconi, Beatrice

    2017-01-01

    This study deals with an osteopathic approach used for a patient with left-ventricular assist device (L-VAD) affected by left brachialgia. Clinical examination revealed the presence of thoracic outlet syndrome and pectoralis minor syndrome, with compression of the left proximal ulnar nerve, related to the surgical sternotomy performed. The osteopathic techniques used can be classified as indirect and direct, addressed to the pectoralis minor and the first left rib, respectively. To our knowledge, this is the first text in literature with an osteopathic treatment in a patient with L-VAD. PMID:28144166

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  15. Nipro extra-corporeal left ventricular assist device fitting after left ventricular reconstruction with mitral valve plasty.

    Science.gov (United States)

    Arakawa, Mamoru; Yamaguchi, Atsushi; Nishimura, Takashi; Itoh, Satoshi; Yuri, Koichi; Kyo, Shunei; Adachi, Hideo

    2015-12-01

    Both left ventricular assist device and left ventricular reconstruction are treatment choices for severe heart failure conditions. Our institution performed a left ventricular assist device installation following a left ventricular reconstruction procedure on a 42-year-old male patient who presented with dilated cardiomyopathy and low cardiac output syndrome. A mitral valve plasty was used to correct the acute mitral valve regurgitation and we performed a Nipro extra-corporeal left ventricular assist device installation on post-operative day 14. Due to the left ventricular reconstruction that the patient had in a previous operation, we needed to attach an apical cuff on posterior apex, insert the inflow cannula with a large curve, and shift the skin insertion site laterally to the left. We assessed the angle between the cardiac longitudinal axis and the inflow cannula using computed tomography. The patient did not complain of any subjective symptoms of heart failure. Although Nipro extra-corporeal left ventricular assist device installation after left ventricular reconstruction has several difficulties historically, we have experienced a successful case.

  16. 'Sorry, I meant the patient's left side': impact of distraction on left-right discrimination.

    Science.gov (United States)

    McKinley, John; Dempster, Martin; Gormley, Gerard J

    2015-04-01

    Medical students can have difficulty in distinguishing left from right. Many infamous medical errors have occurred when a procedure has been performed on the wrong side, such as in the removal of the wrong kidney. Clinicians encounter many distractions during their work. There is limited information on how these affect performance. Using a neuropsychological paradigm, we aim to elucidate the impacts of different types of distraction on left-right (LR) discrimination ability. Medical students were recruited to a study with four arms: (i) control arm (no distraction); (ii) auditory distraction arm (continuous ambient ward noise); (iii) cognitive distraction arm (interruptions with clinical cognitive tasks), and (iv) auditory and cognitive distraction arm. Participants' LR discrimination ability was measured using the validated Bergen Left-Right Discrimination Test (BLRDT). Multivariate analysis of variance was used to analyse the impacts of the different forms of distraction on participants' performance on the BLRDT. Additional analyses looked at effects of demographics on performance and correlated participants' self-perceived LR discrimination ability and their actual performance. A total of 234 students were recruited. Cognitive distraction had a greater negative impact on BLRDT performance than auditory distraction. Combined auditory and cognitive distraction had a negative impact on performance, but only in the most difficult LR task was this negative impact found to be significantly greater than that of cognitive distraction alone. There was a significant medium-sized correlation between perceived LR discrimination ability and actual overall BLRDT performance. Distraction has a significant impact on performance and multifaceted approaches are required to reduce LR errors. Educationally, greater emphasis on the linking of theory and clinical application is required to support patient safety and human factor training in medical school curricula. Distraction has

  17. 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.

  18. Laparoscopic features and repair of a combined left Spigelian hernia and left Morgagni diaphragmatic hernia.

    Science.gov (United States)

    Chamary, S L; Chamary, V L

    2015-03-01

    Both Spigelian and Morgagni hernias cause serious morbidity so early diagnosis and timely treatment are necessary. These two types of hernia are more commonly found on the right side of patients. They are rare individually in adults and even rarer in combination. So far, an association between the two hernias has only been reported on the right. We describe the first case of a Spigelian hernia and a Morgagni hernia in a 62-year-old woman, both occurring on the left side. Our accompanying video describes several laparoscopic features that will help lead to early detection and diagnosis.

  19. Percutaneous closure of the left atrial appendage for prevention of thromboembolism in atrial fibrillation for patients with contraindication to or failure of oral anticoagulation: a single-center experience.

    Science.gov (United States)

    Faustino, Ana; Paiva, Luís; Providência, Rui; Trigo, Joana; Botelho, Ana; Costa, Marco; Leitão-Marques, António

    2013-06-01

    In non-valvular atrial fibrillation 90% of thrombi originate in the left atrial appendage (LAA). Percutaneous LAA closure has been shown to be non-inferior to warfarin for prevention of thromboembolism. To evaluate the initial experience of a single center in percutaneous LAA closure in patients with high thromboembolic risk and in whom oral anticoagulation was impractical or contraindicated or had failed. Patients with non-valvular atrial fibrillation and CHADS2 score ≥2 in whom oral anticoagulation was impractical or contraindicated or had failed underwent percutaneous LAA closure according to the standard technique. After the procedure, dual antiplatelet therapy was maintained for one month, followed by single antiplatelet therapy indefinitely. Patients were followed by clinical assessment and transthoracic and transesophageal echocardiography. The procedure was performed in 22 of the 23 selected patients (95.7%), mean age 70±9 years, CHADS2 score 3.2±0.9 and CHA2DS2-VASC score 4.7±1.4. Intraprocedural device replacement was necessary only in the first patient, due to oversizing. The following periprocedural complications were observed: one femoral pseudoaneurysm, three femoral hematomas and two minor oropharyngeal bleeds, resolved by local hemostatic measures. During a 12±8 month follow-up a mild peri-device flow and a thrombus adhering to the device, resolved under with enoxaparin therapy, were identified. The rate of transient ischemic attack (TIA)/stroke was lower than expected according to the CHADS2 score (0 vs. 6.7±2.2%). In our initial experience, this procedure proved to be a feasible, safe and effective alternative for atrial fibrillation patients in whom oral anticoagulation is not an option. Only relatively minor complications were observed, with a lower than expected TIA/stroke rate. Copyright © 2012 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  20. Why are some people left-handed? An evolutionary perspective.

    Science.gov (United States)

    Llaurens, V; Raymond, M; Faurie, C

    2009-04-12

    Since prehistoric times, left-handed individuals have been ubiquitous in human populations, exhibiting geographical frequency variations. Evolutionary explanations have been proposed for the persistence of the handedness polymorphism. Left-handedness could be favoured by negative frequency-dependent selection. Data have suggested that left-handedness, as the rare hand preference, could represent an important strategic advantage in fighting interactions. However, the fact that left-handedness occurs at a low frequency indicates that some evolutionary costs could be associated with left-handedness. Overall, the evolutionary dynamics of this polymorphism are not fully understood. Here, we review the abundant literature available regarding the possible mechanisms and consequences of left-handedness. We point out that hand preference is heritable, and report how hand preference is influenced by genetic, hormonal, developmental and cultural factors. We review the available information on potential fitness costs and benefits acting as selective forces on the proportion of left-handers. Thus, evolutionary perspectives on the persistence of this polymorphism in humans are gathered for the first time, highlighting the necessity for an assessment of fitness differences between right- and left-handers.

  1. Why are there (almost) no left-handers in China?

    Science.gov (United States)

    Kushner, Howard I

    2013-06-01

    Surveys of Chinese students since the 1980s report that less than 1% are left-handed. This is an extraordinarily low number given the generally accepted view that between 10 and 12% of humans are left-handed. Are there actually very few left-handers in China and, if so, why? A number of sometimes overlapping reasons have shaped Chinese attitudes toward left-handedness. Some of these reflect the transcendent human reactions to biological laterality. Others have been shaped by Chinese historical and cultural experience. What is true in China can be identified in other societies: attitudes and practices toward left-handers have been and continue to be shaped by over-determined forces, which at the same time transcend specific cultures, while they respond to historical and cultural pressures. Like the Chinese, many North and East African peoples attempt to 'cure' left-handedness by a combination of restraints and severe punishments. Religion has often reinforced these practices. In China, we can see how a combination of traditional values and practical considerations seems to have merged to reduce both the actual and reported prevalence of left-handedness. When we add in the population of India, and much of the remaining Islamic world, we can conclude that for two-thirds of the world's population, being born left-handed exposes one to discrimination and stigma.

  2. 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.

  3. 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.

  4. Cortical Reorganization of Language Functioning Following Perinatal Left MCA Stroke

    Science.gov (United States)

    Tillema, Jan-Mendelt; Byars, Anna W.; Jacola, Lisa M.; Schapiro, Mark B.; Schmithorst, Vince J.; Szaflarski, Jerzy P.; Holland, Scott K.

    2008-01-01

    Objective: Functional MRI was used to determine differences in patterns of cortical activation between children who suffered perinatal left middle cerebral artery (MCA) stroke and healthy children performing a silent verb generation task. Methods: Ten children with prior perinatal left MCA stroke (age 6-16 years) and ten healthy age matched…

  5. 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

  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. Pulmonary inflammatory myofibroblastic tumor invading the left atrium.

    Science.gov (United States)

    Berman, Marius; Georghiou, Georgios P; Schonfeld, Tommy; Feinmesser, Meora; Horev, Gadi; Vidne, Bernardo A; Saute, Milton

    2003-08-01

    Inflammatory myofibroblastic tumor is a rare solid tumor that most often affects children and young adults. Although benign, the tumor may be very aggressive locally. We describe a 9-year-old boy with primary inflammatory myofibroblastic tumor of the left upper lobe involving the left atrium.

  8. 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

  9. An exceptional cause of left lower quadrant abdominal pain

    Institute of Scientific and Technical Information of China (English)

    Bassam Abboud; Ronald Daher

    2009-01-01

    Acute appendicitis is an exceptional cause of left lower quadrant abdominal pain. Computed tomography scan is the key to its diagnosis and helps to establish its early treatment. We present a case of a 35-year-old male patient who presented acute appendicitis with redundant and loosely attached cecum which was diagnosed based on his left lower quadrant abdominal pain.

  10. 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.

  11. On Functional Inequalities Originating from Module Jordan Left Derivations

    Directory of Open Access Journals (Sweden)

    Ick-Soon Chang

    2008-06-01

    Full Text Available 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.

  12. Pseudoaneurysm of the left atrium following infective endocarditis

    Science.gov (United States)

    Manuel, Devi A; Sahayo, Bino John; Thomson, Viji Samuel; Jose, Jacob

    2017-01-01

    Transthoracic echocardiogram of a 3-year-old child showed a hypoechoic cavity in the posterior wall of the left atrium communicating with the left ventricle through an orifice in the mitral annulus, suggestive of pseudoaneurysm (Ps), probably the result of infective endocarditis. Three-dimensional echocardiography was helpful to confirm the diagnosis and assess the anatomical relationship of the Ps. PMID:28163437

  13. Enantioselective targeting left-handed Z-G-quadruplex.

    Science.gov (United States)

    Zhao, Andong; Zhao, Chuanqi; Ren, Jinsong; Qu, Xiaogang

    2016-01-25

    Herein, we report the first example where an M-enantiomer of a chiral metal complex can selectively stabilize a left-handed G-quadruplex, but its P-enantiomer cannot. The interactions between the chiral metal complexes and the left-handed G-quadruplex were evaluated by UV melting, circular dichroism, isothermal titration calorimetry, gel electrophoresis and NMR titrations.

  14. Left-Handed Preschool Children with Orthopedic Disabilities.

    Science.gov (United States)

    Banham, Katharine M.

    1983-01-01

    The mental development of 332 preschool-age children with orthopedic disabilities was assessed at a children's hospital over a 10-year period, and comparisons were made for right-handed and left-handed. The left-handed children were slower than right-handed children in learning speech and language skills (Author/SEW)

  15. Fountain-Gould Left Orders for Associative Pairs

    Institute of Scientific and Technical Information of China (English)

    José A. ANQUELA; Teresa CORT(E)S; Miguel G(O)MEZ LOZANO; Mercedes SILES MOLINA

    2006-01-01

    In this paper, we introduce a notion of weak Fountain-Gould left order for associative pairs and give a Goldie-like theory of associative pairs which are weak Fountain-Gould left orders in semiprime pairs coinciding with their socles.

  16. 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 h...

  17. 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...

  18. Appropriate Education, Juvenile Corrections, and No Child Left Behind

    Science.gov (United States)

    Leone, Peter E.; Cutting, Candace A.

    2004-01-01

    The No Child Left Behind (NCLB) Act of 2001 promotes high-quality educational services for all children and youths, regardless of race, gender, ethnicity, disability, income, or background. Despite the law's laudable goals, one group continues to be left behind: youths who are incarcerated in juvenile correctional facilities. These…

  19. Left ventricular metastasis from a primary lung carcinoma

    Institute of Scientific and Technical Information of China (English)

    CHE Guo-wei; LIU Lun-xu; ZHANG Er-yong; ZHOU Qing-hua

    2007-01-01

    @@ The most common tumors associated with cardiac metastases are lung carcinoma and melanoma.1 Although the cardiac involvement of lung cancer is common(lung cancer usually directly invades into the pericardium and/or left/right atrium),the primary lung cancer accompanied with metastasis to the left ventricle is extremely rare.

  20. Persistent Left Unilateral Mirror Writing: A Neuropsychological Case Study

    Science.gov (United States)

    Angelillo, Valentina G.; De Lucia, Natascia; Trojano, Luigi; Grossi, Dario

    2010-01-01

    Mirror writing (MW) is a rare disorder in which a script runs in direction opposite to normal and individual letters are reversed. The disorder generally occurs after left-hemisphere lesions, is transient and is observed on the left hand, whereas usually motor impairments prevent assessment of direction of right handwriting. We describe a…

  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. Left testicular artery arching over the ipsilateral renal vein

    Institute of Scientific and Technical Information of China (English)

    Munekazu Naito; Hayato Terayama; Yoichi Nakamura; Shogo Hayashi; Takayoshi Miyaki; Masahiro Itoh

    2006-01-01

    Aim: To report two cases of the left testicular artery arching over the left renal vein (LRV) before running downward to the testis. Methods: The subjects were obtained from two Japanese cadavers. During the student course of gross-anatomical dissection, the anatomical relationship between the testicular vessels and the renal vein was specifically observed. Results: The arching left testicular artery arose from the aorta below the LRV and made a loop around the LRV, which appeared to be mildly compressed between the arching artery and the psoas major muscle.Conclusion: Clinically, compression of the LRV between the abdominal aorta and the superior mesenteric artery occasionally induces LRV hypertension, resulting in varicocele, orthostatic protenuria and hematuria. Considering that the incidence of a left arching testicular artery is higher than that of a right one, an arching left artery could be an additional cause of LRV hypertension.

  3. Left-sided omental torsion with inguinal hernia

    Institute of Scientific and Technical Information of China (English)

    Yasumitsu Hirano; Kaeko Oyama; Hiroshi Nozawa; Takuo Hara; Koichi Nakada; Masahiro Hada; Takeshi Takagi; Makoto Hirano

    2006-01-01

    We report a case of surgically proved left-sided torsion of the greater omentum that caused secondary by untreated inguinal hernia. Case A 36-year-old man presented to our hospital with abdominal pain. He had been diagnosed with a left inguinal hernia, but he had not received any treatments. Contrast-enhanced computed tomography (CT) of the abdomen showed a large fat density mass below the Sigmoid colon and left inguinal hernia with incarcerated fat. Exploratory laparotomy revealed torsion of the greater omentum with small bloody ascites. The greater omentum was twisted into one and a half circles and entered into a left inguinal hernia. An omentectomy with a repair of left inguinal hernia was performed. A resected omentum was submitted for pathological examination, which showed hemorrhagic infarction. Omental torsion is a rare cause of acute abdominal pain but should be included in the differential diagnoses of acute abdomen, especially in patients with untreated inguinal hernia.

  4. Impaired speech repetition and left parietal lobe damage.

    Science.gov (United States)

    Fridriksson, Julius; Kjartansson, Olafur; Morgan, Paul S; Hjaltason, Haukur; Magnusdottir, Sigridur; Bonilha, Leonardo; Rorden, Christopher

    2010-08-18

    Patients with left hemisphere damage and concomitant aphasia usually have difficulty repeating others' speech. Although impaired speech repetition, the primary symptom of conduction aphasia, has been associated with involvement of the left arcuate fasciculus, its specific lesion correlate remains elusive. This research examined speech repetition among 45 stroke patients who underwent aphasia testing and MRI examination. Based on lesion-behavior mapping, the primary structural damage most closely associated with impaired speech repetition was found in the posterior portion of the left arcuate fasciculus. However, perfusion-weighted MRI revealed that tissue dysfunction, in the form of either frank damage or hypoperfusion, to the left inferior parietal lobe, rather than the underlying white matter, was associated with impaired speech repetition. This latter result suggests that integrity of the left inferior parietal lobe is important for speech repetition and, as importantly, highlights the importance of examining cerebral perfusion for the purpose of lesion-behavior mapping in acute stroke.

  5. CABG surgery in a patient with left iliac artery occlusion

    Directory of Open Access Journals (Sweden)

    Oscar F. De La Peña Brush

    2015-09-01

    Full Text Available We present the case of an 82 years old male with Congestive Heart Failure (Left Ventricle Ejection Fraction: 20% and Acute Pulmonary Edema secondary to Acute Myocardial Infarction that required Coronary Artery Bypass Graft (CABG surgery. Past Medical History included Aortoiliac Occlusive Ddisease with total occlusion of the Left Iliac Artery and collateral circulation to the left inferior limb through the Left Internal Mammary Artery (LIMA. CABG was perfomed without harvesting the LIMA due to high risk of leg ischemia. An attempt to revascularize the left limb previous to the cardiac surgery in other to do so. Would have been too risky in this case. After 2 months follow up, patient showed good clinical outcomes.

  6. 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.

  7. Isolated Hypoplasia of Left Pulmonary Artery with Agenesis of Left Lobe of Thyroid: A Case Report.

    Science.gov (United States)

    Khadir, Mohammed Abdul; Narayana, Ganesh; Ramagopal, Ganavi; Nayar, Pradeep G

    2016-12-01

    Isolated Unilateral hypoplasia or agenesis of a branch of pulmonary artery is very rare. It is usually seen associated with congenital heart diseases such as tetralogy of Fallot, atrial septal defect, coarctation of the aorta, right aortic arch, truncus arteriosus, patent ductus arteriosus and pulmonary atresia. It occurs as a result of lack of embryological development of either the left or right sixth aortic arch and has been found to present itself with various clinical manifestations as during childhood it presents as contralateral pulmonary hypertension and in adults as haemoptysis. Early diagnosis and early surgical indication avoids the evolution of pulmonary hypertension to unfavourble state of more severe and progressive degrees and also prevents the development of pulmonary systemic collateral circulation, which is mainly responsible for subsequent haemoptysis in the adulthood. We hereby, report the case of an infant who presented with features of lower respiratory tract infection and later diagnosed as isolated congenital hypoplasia of left pulmonary artery and hence planned for proper follow-up for early surgery thereby preventing complications in the future.

  8. Surgical Left Atrial Appendage Exclusion Does Not Impair Left Atrial Contraction Function: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Gijs E. De Maat

    2015-01-01

    Full Text Available Background. In order to reduce stroke risk, left atrial appendage amputation (LAAA is widely adopted in recent years. The effect of LAAA on left atrial (LA function remains unknown. The objective of present study was to assess the effect of LAAA on LA function. Methods. Sixteen patients with paroxysmal AF underwent thoracoscopic, surgical PVI with LAAA (LAAA group, and were retrospectively matched with 16 patients who underwent the same procedure without LAA amputation (non-LAAA group. To objectify LA function, transthoracic echocardiography with 2D Speckle Tracking was performed before surgery and at 12 months follow-up. Results. Mean age was 57 ± 9 years, 84% were male. Baseline characteristics did not differ significantly except for systolic blood pressure (p=0.005. In both groups, the contractile LA function and LA ejection fraction were not significantly reduced. However, the conduit and reservoir function were significantly decreased at follow-up, compared to baseline. The reduction of strain and strain rate was not significantly different between groups. Conclusions. In this retrospective, observational matched group comparison with a convenience sample size of 16 patients, findings suggest that LAAA does not impair the contractile LA function when compared to patients in which the appendage was unaddressed. However, the LA conduit and reservoir function are reduced in both the LAAA and non-LAAA group. Our data suggest that the LAA can be removed without late LA functional consequences.

  9. Left-handedness in professional and amateur tennis.

    Directory of Open Access Journals (Sweden)

    Florian Loffing

    Full Text Available Negative frequency-dependent effects rather than innate predispositions may provide left-handers with an advantage in one-on-one fighting situations. Support mainly comes from cross-sectional studies which found significantly enhanced left-hander frequencies among elite athletes exclusively in interactive sports such as baseball, cricket, fencing and tennis. Since professional athletes' training regimes continuously improve, however, an important unsolved question is whether the left-handers' advantage in individual sports like tennis persists over time. To this end, we longitudinally tracked left-hander frequencies in year-end world rankings (men: 1973-2011, ladies: 1975-2011 and at Grand Slam tournaments (1968-2011 in male and female tennis professionals. Here we show that the positive impact of left-handed performance on high achievement in elite tennis was moderate and decreased in male professionals over time and was almost absent in female professionals. For both sexes, left-hander frequencies among year-end top 10 players linearly decreased over the period considered. Moreover, left-handedness was, however, no longer seems associated with higher probability of attaining high year-end world ranking position in male professionals. In contrast, cross-sectional data on left-hander frequencies in male and female amateur players suggest that a left-handers' advantage may still occur on lower performance levels. Collectively, our data is in accordance with the frequency-dependent hypothesis since reduced experience with left-handers in tennis is likely to be compensated by players' professionalism.

  10. Left-handedness in professional and amateur tennis.

    Science.gov (United States)

    Loffing, Florian; Hagemann, Norbert; Strauss, Bernd

    2012-01-01

    Negative frequency-dependent effects rather than innate predispositions may provide left-handers with an advantage in one-on-one fighting situations. Support mainly comes from cross-sectional studies which found significantly enhanced left-hander frequencies among elite athletes exclusively in interactive sports such as baseball, cricket, fencing and tennis. Since professional athletes' training regimes continuously improve, however, an important unsolved question is whether the left-handers' advantage in individual sports like tennis persists over time. To this end, we longitudinally tracked left-hander frequencies in year-end world rankings (men: 1973-2011, ladies: 1975-2011) and at Grand Slam tournaments (1968-2011) in male and female tennis professionals. Here we show that the positive impact of left-handed performance on high achievement in elite tennis was moderate and decreased in male professionals over time and was almost absent in female professionals. For both sexes, left-hander frequencies among year-end top 10 players linearly decreased over the period considered. Moreover, left-handedness was, however, no longer seems associated with higher probability of attaining high year-end world ranking position in male professionals. In contrast, cross-sectional data on left-hander frequencies in male and female amateur players suggest that a left-handers' advantage may still occur on lower performance levels. Collectively, our data is in accordance with the frequency-dependent hypothesis since reduced experience with left-handers in tennis is likely to be compensated by players' professionalism.

  11. Left and right ventricular diastolic function in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Rudhani Ibrahim

    2010-01-01

    Full Text Available The aim of this prospective study was the assessment of left ventricular and right ventricular diastolic function in patients on hemodialysis (HD and the correlation of this func-tion with the duration of HD. The study included 42 patients (22 females and 20 males with chro-nic renal failure (CRF, treated with HD, and 40 healthy subjects (24 females and 16 males with no history of cardiovascular disease and with normal renal function, who constituted the control group. The groups were matched for age and sex. All study patients and control subjects under-went detailed history taking and physical examination. They also underwent electrocardiogram, echocardiography and biochemical and hematological blood analyses. Significant differences were noted between the two groups in the two-dimensional and M-mode echocardiography findings concerning aortic root dimension, transverse diameter of the left atrium, thickness of the inter-ventricular septum, thickness of the left ventricular posterior wall, left ventricular diastolic diameter, left ventricular systolic diameter, shortening fraction, ejection fraction as well as findings from the pulse Doppler study, including E wave, A wave, E/A ratio, deceleration time of E wave (DT-E, acceleration time of E wave (AT-E, tricuspid E and A waves (E tr and A tr and E tr /A tr , ratio. There were significant changes in HD patients without arterial hypertension as well in the control group subjects. Our study suggests that the left ventricular and left atrial dimensions as well as the left ventricular wall thickness are augmented in patients with CRF treated with HD compared with the control group. Additionally, the left and right ventricular diastolic function is also reduced in these patients. These differences were also noted in patients with CRF without arterial hypertension. Left ventricular diastolic dysfunction had no correlation with the duration of HD.

  12. Left and right ventricular diastolic function in hemodialysis patients.

    Science.gov (United States)

    Rudhani, Ibrahim Destan; Bajraktari, Gani; Kryziu, Emrush; Zylfiu, Bejtush; Sadiku, Shemsedin; Elezi, Ymer; Rexhepaj, Nehat; Vitia, Arber; Emini, Merita; Abazi, Murat; Berbatovci-Ukimeraj, M; Kryeziu, Kaltrina; Hsanagjekaj, Venera; Korca, Hajrije; Ukimeri, Aferdita

    2010-11-01

    The aim of this prospective study was the assessment of left ventricular and right ventricular diastolic function in patients on hemodialysis (HD) and the correlation of this function with the duration of HD. The study included 42 patients (22 females and 20 males) with chronic renal failure (CRF), treated with HD, and 40 healthy subjects (24 females and 16 males) with no history of cardiovascular disease and with normal renal function, who constituted the control group. The groups were matched for age and sex. All study patients and control subjects underwent detailed history taking and physical examination. They also underwent electrocardiogram, echocardiography and biochemical and hematological blood analyses. Significant differences were noted between the two groups in the two-dimensional and M-mode echocardiography findings concerning aortic root dimension, transverse diameter of the left atrium, thickness of the interventricular septum, thickness of the left ventricular posterior wall, left ventricular diastolic diameter, left ventricular systolic diameter, shortening fraction, ejection fraction as well as findings from the pulse Doppler study, including E wave, A wave, E/A ratio, deceleration time of E wave (DT-E), acceleration time of E wave (AT-E), tricuspid E and A waves (E tr and A tr ) and E tr /A tr , ratio. There were significant changes in HD patients without arterial hypertension as well in the control group subjects. Our study suggests that the left ventricular and left atrial dimensions as well as the left ventricular wall thickness are augmented in patients with CRF treated with HD compared with the control group. Additionally, the left and right ventricular diastolic function is also reduced in these patients. These differences were also noted in patients with CRF without arterial hypertension. Left ventricular diastolic dysfunction had no correlation with the duration of HD.

  13. 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.

  14. Efficacy and Safety of the WATCHMAN Left Atrial Appendage System for Stroke Prevention in Chinese Patients with Nonvalvular Atrial Fibrillation: A Single-center, Prospective, Observational Study

    Science.gov (United States)

    Huang, Wei-Ping; Zhang, Yong-Hua; He, Lei; Su, Xi; Yang, Xin-Wei; Guo, Zai-Xiong

    2017-01-01

    Background: In patients with nonvalvular atrial fibrillation (NVAF), embolic stroke is thought to be associated with left atrial appendage (LAA) thrombi. The WATCHMAN LAA Occlusion Device has been shown to be noninferior to conventional oral anticoagulation with warfarin for stroke prevention in patients with NVAF. This study aimed to evaluate the procedural feasibility, safety and 12-month outcomes of the WATCHMAN LAA Occlusion Device in NVAF patients with high risk for stroke in China. Methods: The clinical data of 106 NVAF patients, who were consecutively underwent LAA closure with the WATCHMAN Device between April 2014 and May 2015, were collected. Patients were followed up at 1, 3, 6, and 12 months after discharge. A transesophageal echocardiograph was performed at 45 days after implantation and repeated in case of an unexpected event during the follow-up period. Results: This study included 106 NVAF patients with a mean age of 64.2 ± 8.6 years (ranging from 50 to 88 years), and the mean CHA2DS2-VASc score of all patients was 3.6 ± 1.6 (ranging from 2 to 9). Among those 106 NVAF patients, 100 (94.3%) patients were implanted with the device successfully. The procedural success rate was 94.3% (100/106), and the occlusion rate was 100.0% (100/100). There were one tamponade, one ischemic stroke, and eight minor pericardial effusions during hospitalization. During 12-month follow-up period, two patients developed a thrombus layer on the device that resolved with additional anticoagulation: one with visible device-thrombus experienced transient ischemic stroke, and one had a hemorrhagic stroke. There were no deaths in this study. The overall survival rate was 100.0%, and nonmajor adverse event rate was 95.0% (95/100). In this study, the expected annual rate of ischemic stroke risk in these patients according to the CHA2DS2-VASc score was 4.0%, while the observed ischemic stroke rate was 2.0% per year. Conclusions: LAA closure with the WATCHMAN Device was feasible

  15. Left medial parietal lobe and receptive language functions: mixed transcortical aphasia after left anterior cerebral artery infarction.

    Science.gov (United States)

    Ross, E D

    1980-02-01

    Three aphasic patients with infarctions involving the left anterior cerebral artery have been studied. Two had trancortical motor aphasia, and one had mixed transcortical (or isolation) aphasia. Based on computerized tomography in two patients and whole-brain sections in one, the patient with mixed transcortical aphasia had a lesion that went beyond the rolandic fissure to involve the anterior precuneus lobule of the left medial parietal lobe. In the patients with transcortical motor aphasia, the lesion was confined to the frontal lobe. From these cases and other data, it seems likely that the left medial parietal lobe has receptive language functions analogous to the motor language functions of the left medial frontal lobe, thus accounting for the mixed transcortical aphasia observed in the patient whose left anterior cerebral artery infarction involved both the medial parietal and medial frontal lobes.

  16. Horseshoe lung associated with left-lung hypoplasia, left pulmonary artery sling and bilateral agenesis of upper lobe bronchi.

    Science.gov (United States)

    Oguz, Berna; Alan, Serdar; Ozcelik, Ugur; Haliloglu, Mithat

    2009-09-01

    Horseshoe lung, a rare congenital anomaly, is almost always associated with unilateral (usually right-sided) lung hypoplasia, and, in most cases, in conjunction with the scimitar syndrome. We present an 8-month-old boy with horseshoe lung associated with left-lung hypoplasia, left pulmonary artery sling and bilateral agenesis of the upper lobe bronchi, diagnosed by multidetector CT (MDCT) imaging. The study also revealed an anomalous origin of the left vertebral artery as the last branch of the aortic arch, distal to the left subclavian artery, and an anomalous origin of the left common carotid artery from the brachiocephalic trunk. A hemivertebral anomaly of the seventh cervical vertebra was incidentally detected. MDCT with high-quality multiplanar and three-dimensional reconstructions is a noninvasive and rapid technique for detecting the complex combination of vascular, tracheobronchial and parenchymal anomalies, and any potential bone anomalies, in one imaging study.

  17. Effects of Substrates with Different Dielectric Parameters on Left-Handed Frequency of Left-Handed Materials

    Institute of Scientific and Technical Information of China (English)

    QUAN Bao-Gang; LI Chao; SUI Qiang; LI Jun-Jie; LIU Wu-Ming; LI Fang; GU Chang-Zhi

    2005-01-01

    @@ Wedge-shaped left-handed materials (LHMs) with split ring resonators and wires structures are fabricated by photolithography and lift-off techniques, and the variation of left-handed frequency induced by substrates with different dielectric parameters is investigated. The Snell refraction experiments of the LHM samples are carried out on an angular resoled microwave spectrometer, and the results indicate that the left-handed frequencies of the LHMs shifted downward from 10.57 GHz to 9.74 GHz when the dielectric parameters of the LHM substrates increase from 3.7 to 4.8. Moreover, the finite difference time domain method is used to simulate the microwave transmission properties of the left-handed materials with different substrates, and the experimental results are in agreement with the numerical simulation results. In addition, the reason for the shifting of the left-handedfrequency of the LHMs is discussed theoretically.

  18. Horseshoe lung associated with left-lung hypoplasia, left pulmonary artery sling and bilateral agenesis of upper lobe bronchi

    Energy Technology Data Exchange (ETDEWEB)

    Oguz, Berna; Haliloglu, Mithat [Hacettepe University Faculty of Medicine, Department of Radiology, Ankara (Turkey); Alan, Serdar; Ozcelik, Ugur [Hacettepe University Faculty of Medicine, Department of Pediatrics, Ankara (Turkey)

    2009-09-15

    Horseshoe lung, a rare congenital anomaly, is almost always associated with unilateral (usually right-sided) lung hypoplasia, and, in most cases, in conjunction with the scimitar syndrome. We present an 8-month-old boy with horseshoe lung associated with left-lung hypoplasia, left pulmonary artery sling and bilateral agenesis of the upper lobe bronchi, diagnosed by multidetector CT (MDCT) imaging. The study also revealed an anomalous origin of the left vertebral artery as the last branch of the aortic arch, distal to the left subclavian artery, and an anomalous origin of the left common carotid artery from the brachiocephalic trunk. A hemivertebral anomaly of the seventh cervical vertebra was incidentally detected. MDCT with high-quality multiplanar and three-dimensional reconstructions is a noninvasive and rapid technique for detecting the complex combination of vascular, tracheobronchial and parenchymal anomalies, and any potential bone anomalies, in one imaging study. (orig.)

  19. Association of arterial stiffness and electrocardiography-determined left ventricular hypertrophy with left ventricular diastolic dysfunction.

    Directory of Open Access Journals (Sweden)

    Po-Chao Hsu

    Full Text Available OBJECTIVES: Increased arterial stiffness is associated with left ventricular diastolic dysfunction (LVDD, but this association may be influenced by left ventricular (LV performance. Left ventricular hypertrophy (LVH is not only a significant determinant of LV performance, but is also correlated with LVDD. This study is designed to compare LV diastolic function among patients divided by brachial-ankle pulse wave velocity (baPWV and electrocardiography (ECG-determined LVH and to assess whether increased baPWV and ECG-determined LVH are independently associated with LVDD. METHODS: This cross-sectional study enrolled 270 patients and classified them into four groups according to the median value of baPWV and with/without ECG-determined LVH. The baPWV was measured using an ABI-form device. ECG-determined LVH was defined by Sokolow-Lyon criterion. LVDD was defined as impaired relaxation, pseudonormal, and restrictive mitral inflow patterns. Groups 1, 2, 3, and 4 were patients with lower baPWV and without ECG-determined LVH, lower baPWV but with ECG-determined LVH, higher baPWV but without ECG-determined LVH, and higher baPWV and with ECG-determined LVH respectively. RESULTS: Early diastolic mitral velocity (Ea was gradually decreased from group 1 to group 4 (p≦0.027. Patients in group 4 had the highest prevalence of LVDD (all p<0.001. After multivariate analysis, both baPWV and ECG-determined LVH were independent determinants of Ea (β = -0.02, P<0.001; β = -1.77, P<0.001 respectively and LVDD (odds ratio = 1.02, P = 0.011 and odds ratio = 3.53, P = 0.013 respectively. CONCLUSION: Our study showed the group with higher baPWV and ECG-determined LVH had the lowest Ea and highest prevalence of LVDD. In addition, both baPWV and ECG-determined LVH were independently associated with Ea and LVDD. Hence, assessment of arterial stiffness by baPWV and LVH by ECG may be useful in identifying the high risk group of LVDD.

  20. Left-handedness and achievements in foreign language studies.

    Science.gov (United States)

    Lamm, O; Epstein, R

    1999-12-01

    Studies of brain lateralization lend support to the hypothesis that language-motor functions in left-handers are differently organized from those in right-handers. However, the implications of these differences regarding cognitive functioning are as yet subject to controversy. This concerns all hypotheses raised and empirical data collected over the years. Although it was suggested that left-handers are at higher risk of having language and reading deficits, empirical data from clinical and nonclinical populations are inconclusive at the present time. No effort, however, has been invested in examining possible differences in academic studies of foreign languages according to handedness. Here we report data indicating inferior achievements of left-handed native Hebrew speakers in studies of English as a foreign language. Left-handed pupils significantly more than right-handers were placed in lower level English classes and had more difficulties in applying orthographic-phonological mapping rules in reading English words and pseudowords. However, left-handers' difficulties in this task were not correlated with their performance in a word recognition task. It is thus suggested that the "common symptom" of poor word reading in left-handers indicates different processing failures in different left-handers, some of which impede the buildup of an internal representational system of mapping orthography to phonology and some of which concern mainly the precision of word production.

  1. Salt and left ventricular hypertrophy: what are the links?

    Science.gov (United States)

    Langenfeld, M R; Schmieder, R E

    1995-11-01

    Left ventricular hypertrophy is a frequent and prognostically unfavourable finding in patients with essential hypertension and has been found to be a predictor for the development of essential hypertension in normotensive subjects. Among various genetic, haemodynamic and humoral determinants, dietary salt intake has been demonstrated to influence left ventricular mass in hypertensive disease. Several cross-sectional studies have shown a close relation between dietary salt intake and parameters of left ventricular hypertrophy. Moreover, reduction of dietary sodium intake was associated with a decrease of left ventricular mass in a prospective study. The underlying mechanism of how salt intake modulates myocardial structure has not been explained yet. Three possible explanations are discussed: (1) sodium influences left ventricular mass via raised preload, (2) the sympathetic nervous system acts as a mediator, and (3) the renin-angiotensin-aldosterone system is the responsible link. Recent animal experiments and clinical studies suggest that the renin-angiotensin-aldosterone system may mediate both the cardiotrophic and the blood pressure raising effects of salt. However, not all individuals have a similar high susceptibility to blood pressure elevation develop left ventricular hypertrophy when exposed to high salt intake. We suggest that the underlying mechanism is a dysregulation of the renin-angiotensin-aldosterone system. Some individuals may have an impaired downregulation of angiotensin II synthesis when challenged with high salt intake. Accordingly, we found that relatively too high levels of angiotensin II in relation to urinary sodium excretion were associated with left ventricular hypertrophy in these individuals on high salt intake.

  2. The role of the left putamen in multilingual language production.

    Science.gov (United States)

    Abutalebi, Jubin; Della Rosa, Pasquale Anthony; Gonzaga, Anna Kaarina Castro; Keim, Roland; Costa, Albert; Perani, Daniela

    2013-06-01

    Subcortical structures are a key component of bilingual language processing. For instance, there is now evidence that the head of the left caudate is involved in controlling languages in bilingual individuals. On the other hand, the left putamen is hypothesized to be involved in articulatory processes but little is known on its engagement in bilingual language processing. Here, our hypothesis was that the left putamen of multilinguals is engaged when producing words in the less proficient language. We investigated this issue with event-related functional Magnetic Resonance (er-fMRI) in a group of multilinguals (n = 14) and in monolinguals (n = 14) during a picture-naming task. Further, we hypothesized increased grey matter density in the left putamen as an effect of experience since multilinguals constantly face a major articulatory load (i.e., speaking multiple languages) during life. To test these hypotheses we measured structural differences between multilinguals and monolinguals using voxel-based morphometry (VBM). Our results indicate that multilinguals have increased activation in the left putamen for a non-native language, but only if they are not highly proficient in that language. In addition, we found increased grey matter density in the left putamen of multilinguals compared to monolinguals. These findings highlight that the multilingual brain handles a complex articulatory repertoire (i.e., dealing with multiple languages) by inducing structural plasticity in the left putamen.

  3. Biomechanical differences between left- and right-handed baseball pitchers.

    Science.gov (United States)

    Solomito, Matthew J; Ferreria, Joel V; Nissen, Carl W

    2016-06-02

    Left-handed baseball pitchers are thought to have a number of theoretical advantages compared to right-handed pitchers; however, there is limited scientific research detailing differences in the pitching mechanics of right- and left-handed pitchers. Therefore, this study sought to understand whether any kinematic and kinetic differences existed between right- and left-handed baseball pitchers. A total of 52 collegiate pitchers were included in this study; 26 left-handed pitchers were compared to 26 age-, height-, weight- and ball velocity-matched right-handed pitchers. Demographic information, passive shoulder range of motion and kinematic and kinetic data were obtained for each pitcher participating in the study. Results indicated that left-handed pitchers did not have a glenohumeral internal rotation deficit as compared to right-handed pitchers. Kinematic analysis indicated that elbow flexion, horizontal glenohumeral abduction and wrist coronal plane motion were significantly different between the two study cohorts. It was also noted that left-handed pitchers had increased elbow varus moments. The findings of this study suggest that pitching coaches should be aware that there are biomechanical differences between left- and right-handed pitchers.

  4. When left is "right". Motor fluency shapes abstract concepts.

    Science.gov (United States)

    Casasanto, Daniel; Chrysikou, Evangelia G

    2011-04-01

    Right- and left-handers implicitly associate positive ideas like "goodness" and "honesty" more strongly with their dominant side of space, the side on which they can act more fluently, and negative ideas more strongly with their nondominant side. Here we show that right-handers' tendency to associate "good" with "right" and "bad" with "left" can be reversed as a result of both long- and short-term changes in motor fluency. Among patients who were right-handed prior to unilateral stroke, those with disabled left hands associated "good" with "right," but those with disabled right hands associated "good" with "left," as natural left-handers do. A similar pattern was found in healthy right-handers whose right or left hand was temporarily handicapped in the laboratory. Even a few minutes of acting more fluently with the left hand can change right-handers' implicit associations between space and emotional valence, causing a reversal of their usual judgments. Motor experience plays a causal role in shaping abstract thought.

  5. Left-sided gallbladder: Its clinical significance and imaging presentations

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To assess the importance of preoperative diagnosis and presentation of left-sided gallbladder using ultrasound (US), CT and angiography.METHODS: Retrospective review of 1482 patients who underwent enhanced CT scanning was performed. Left-sided gallbladder was diagnosed if a right-sided ligamentum teres was present. The image presentations on US, CT and angiography were also reviewed.RESULTS: Left-sided gallbladder was diagnosed in nine patients. The associated abnormalities on CT imaging included portal vein anomalies, absence of umbilical portion of the portal vein in the left lobe of the liver,club-shaped portal vein in the right lobe of the liver, and difficulty in identifying segment Ⅳ. Angiography in six of nine patients demonstrated abnormal portal venous system (trifurcation type in four of six patients). The main hepatic arteries followed the portal veins in all six patients. The segment Ⅳ artery was identified in four of six patients using angiography, although segment Ⅳ was difficult to define on CT imaging. Hepatectomy was performed in three patients with concomitant liver tumor and the diagnosis of left-sided gallbladder was confirmed intraoperatively.CONCLUSION: Left-sided gallbladder is an important clinical entity in hepatectomy due to its associated portal venous and biliary anomalies. It should be considered in US, CT and angiography images that demonstrate no definite segment IV, absence of umbilical portion of the portal vein in the left lobe, and club-shaped right anterior portal vein.

  6. Parcellation of left parietal tool representations by functional connectivity

    Science.gov (United States)

    Garcea, Frank E.; Z. Mahon, Bradford

    2014-01-01

    Manipulating a tool according to its function requires the integration of visual, conceptual, and motor information, a process subserved in part by left parietal cortex. How these different types of information are integrated and how their integration is reflected in neural responses in the parietal lobule remains an open question. Here, participants viewed images of tools and animals during functional magnetic resonance imaging (fMRI). K-means clustering over time series data was used to parcellate left parietal cortex into subregions based on functional connectivity to a whole brain network of regions involved in tool processing. One cluster, in the inferior parietal cortex, expressed privileged functional connectivity to the left ventral premotor cortex. A second cluster, in the vicinity of the anterior intraparietal sulcus, expressed privileged functional connectivity with the left medial fusiform gyrus. A third cluster in the superior parietal lobe expressed privileged functional connectivity with dorsal occipital cortex. Control analyses using Monte Carlo style permutation tests demonstrated that the clustering solutions were outside the range of what would be observed based on chance ‘lumpiness’ in random data, or mere anatomical proximity. Finally, hierarchical clustering analyses were used to formally relate the resulting parcellation scheme of left parietal tool representations to previous work that has parcellated the left parietal lobule on purely anatomical grounds. These findings demonstrate significant heterogeneity in the functional organization of manipulable object representations in left parietal cortex, and outline a framework that generates novel predictions about the causes of some forms of upper limb apraxia. PMID:24892224

  7. 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.

  8. Crab scars reveal survival advantage of left-handed snails.

    Science.gov (United States)

    Dietl, Gregory P; Hendricks, Jonathan R

    2006-09-22

    Biological asymmetries are important elements of the structure and function of many living organisms. Using the Plio-Pleistocene fossil record of crab predation on morphologically similar pairs of right- and left-handed snail species, we show here for the first time, contrary to traditional wisdom, that rare left-handed coiling promotes survival from attacks by right-handed crabs. This frequency-dependent result influences the balance of selection processes that maintain left-handedness at the species level and parallels some social interactions in human cultures, such as sports that involve dual contests between opponents of opposite handedness.

  9. Bottom-Left Placement Theorem for Rectangle Packing

    CERN Document Server

    Huang, Wenqi; Chen, Duanbing

    2011-01-01

    This paper proves a bottom-left placement theorem for the rectangle packing problem, stating that if it is possible to orthogonally place n arbitrarily given rectangles into a rectangular container without overlapping, then we can achieve a feasible packing by successively placing a rectangle onto a bottom-left corner in the container. This theorem shows that even for the real-parameter rectangle packing problem, we can solve it after finite times of bottom-left placement actions. Based on this theorem, we might develop efficient heuristic algorithms for solving the rectangle packing problem.

  10. Dark Matter in Lepto-Baryonic Left-Right Theories

    CERN Document Server

    Patra, Sudhanwa

    2015-01-01

    A Lepto-Baryonic Left-Right symmetric theory is considered where leptons and baryons are local gauge symmetries. These theories are generally anomalous and the possible gauge anomaly free solutions for these theories are presented here. This paper also shows different ways in which Lepto-Baryonic Left-Right theories are broken down to Standard Model gauge group which further breaks down to low energy by SM Higgs boson. It is found that the neutral component of fermion triplets can be a viable dark matter candidate originally introduced for gauge anomaly cancellation. The other dark matter possibilities within this Lepto-Baryonic Left-Right symmetric theories are also presented.

  11. Right Handed Quark Mixing in Left-Right Symmetric Theory

    CERN Document Server

    Senjanović, Goran

    2014-01-01

    We give exact formulas for the right-handed analog of the CKM matrix in the minimal Left-Right symmetric theory, for the case when the Left-Right symmetry is generalised Parity as in the original version of the theory. We derive its explicit form and give a physical reason for the known and surprising fact that the right-handed mixing angles are close to the CKM ones, in spite of the Left-Right symmetry being badly broken in nature.

  12. Right Handed Quark Mixing in Left-Right Symmetric Theory

    OpenAIRE

    Senjanović, Goran; Tello, Vladimir

    2014-01-01

    We give exact formulas for the right-handed analog of the CKM matrix in the minimal Left-Right symmetric theory, for the case when the Left-Right symmetry is generalized Parity as in the original version of the theory. We derive its explicit form and give a physical reason for the known and surprising fact that the right-handed mixing angles are close in value to the CKM ones, in spite of the Left-Right symmetry being badly broken in nature. We exemplify our results on the production of the r...

  13. 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)

  14. 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.

  15. Total occlusion of left main coronary artery without angina pectoris.

    Science.gov (United States)

    DePace, N L; Kimbiris, D; Iskandrian, A S; Bemis, C E; Segal, B L

    1983-05-01

    A patient had total occlusion of the left main coronary artery that was proved by coronary arteriography. The patient was initially seen with clinical signs of congestive heart failure but without symptoms of angina pectoris or ECG evidence of myocardial infarction. The patient's extensive right-to-left coronary artery collaterals may have contributed to the absence of chest pain. Because of the severe left ventricular dysfunction and the absence of chest pain, the patient was treated with medical therapy. Six months after the cardiac catheterization, he was alive and well under New York Heart Association functional classification II.

  16. Anomalous Positive Refraction in an Anisotropic Left-Handed Medium

    Institute of Scientific and Technical Information of China (English)

    HU Wei; LUO Hai-Lu; CAO Jing-Xiao

    2005-01-01

    @@ We investigate the refraction phenomena of extraordinary light at a planar interface associated with a uniaxial left-handed medium. It is found that the anomalous positive refraction can occur at the interface from anisotropic right-handed medium to a uniaxially anisotropic left-handed medium. When the optical axis of a uniaxial left-handed medium is not normal or parallel to the interface, the refraction of the Poynting vector for the extraordinary waves can be either positive or negative depending on the incident angles, while the refraction of the wave vector is always negative. The physical essential of the anomalous positive refraction results from the anisotropy of uniaxial crystals.

  17. Radionuclide assessment of left ventricular function following cardiac surgery

    Energy Technology Data Exchange (ETDEWEB)

    Howe, W.R.; Jones, R.H.; Sabiston, D.C. Jr.

    1976-01-01

    Use of a high count-rate gamma scintillation camera permits the noninvasive assessment of left ventricular function by nuclear angiocardiography. Counts recorded from the region of the left ventricle at 50- or 100-msec intervals during the first transit of an intravenously administered bolus of radioisotope produce a high-fidelity indicator-dilution curve. Count fluctuations reflect left ventricular volume changes during the cardiac cycle and permit measurement of dv/dt, ejection fraction, mean transit time, and wall motion of this chamber. The present study evaluates (1) the accuracy of this technique compared to standard biplane cineangiography and (2) its usefulness in evaluating patients after cardiac surgery.

  18. Left-handedness in blind and sighted children.

    Science.gov (United States)

    Caliskan, Erkan; Dane, Senol

    2009-03-01

    Rates of left-handedness were compared in 1387 blind and 831 sighted children. The rate in male blind children was higher than in female blind children. The incidence of left-handedness was significantly higher in blind than in sighted children in both boys and girls. The percentages of left-handedness were 18.23% and 17.02% in male and female blind children, and 11.02% and 7.52% in male and female sighted children, respectively. It can be stated that sighting is important in the development of normal typical cerebral lateralisation or hand preference.

  19. Semigroups and their topologies arising from Green's left quasiorder

    Directory of Open Access Journals (Sweden)

    Bettina Richmond

    2008-10-01

    Full Text Available Given a semigroup (S, ·, Green’s left quasiorder on S is given by a ≤ b if a = u · b for some u ϵ S1. We determine which topological spaces with five or fewer elements arise as the specialization topology from Green’s left quasiorder for an appropriate semigroup structure on the set. In the process, we exhibit semigroup structures that yield general classes of finite topological spaces, as well as general classes of topological spaces which cannot be derived from semigroup structures via Green’s left quasiorder.

  20. One-Stage Angioplasty and Stenting of Ostium of Left Common Carotid Artery and Stenting of Left Internal Carotid Artery

    Directory of Open Access Journals (Sweden)

    Massoud Ghasemi

    2017-02-01

    Full Text Available Our aim was to report techniques and our experience in One-stage angioplasty and stenting of ostium of left common carotid and left internal carotid arteries in an octogenarian man with transient ischemic attack, who was completely recovered from neurologic insults short time after the procedure. An 81-year-old man presented with a transient ischemic attack. Neurologic examination showed left side transient visual obscuration or amaurosis fugax and right hemiparesis. Carotid duplex imaging revealed an 80% stenosis of the left internal carotid artery (LICA and 95 % of the ostium of left common carotid artery (left CCA. Immediate brain MRI wasn’t possible. Angioplasty and stenting of both lesions (left CCA and LICA was performed successfully without complications in one session. Stenting of common carotid artery ostial lesion and internal carotid artery (due to significant lesion in one session could be done even in acute neurologic phase and also in very old patients, provided that, considering technical ways for neuroprotection and avoidance of other complications.

  1. Overlay Technique for Transcatheter Left Atrial Appendage Closure.

    Science.gov (United States)

    Li, Shuang; Zhu, Mengyun; Lu, Yunlan; Tang, Kai; Zhao, Dongdong; Chen, Wei; Xu, Yawei

    2015-08-01

    The Overlay technique is popular in peripheral artery interventions, but not in coronary or cardiac structural procedures. We present an initial experience using three-episode overlays during a transcatheter left atrial appendage closure. The first overlay was applied to facilitate advancement of the delivery sheath into left atrium. The second overlay was used to navigate the advancement of prepped delivery system containing the compressed occluder into its optimal position in the left atrium. The third overlay facilitated the real-time deployment of the closure device. This case report demonstrates the effectiveness of the overlay technique in facilitating each step of the transcatheter left atrial appendage closure. Copyright © 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  2. 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 for in...

  3. 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.

  4. Left atrial size: physiologic determinants and clinical applications

    National Research Council Canada - National Science Library

    Abhayaratna, Walter P; Seward, James B; Appleton, Christopher P; Douglas, Pamela S; Oh, Jae K; Tajik, A Jamil; Tsang, Teresa S M

    2006-01-01

    .... In this review, we discuss the normal size and phasic function of the left atrium. Further, we outline the clinically important aspects and pitfalls of evaluating LA size, and the methods for assessing LA function using echocardiography...

  5. Anatomical variation of the origin of the left vertebral artery

    Directory of Open Access Journals (Sweden)

    Patasi B

    2009-08-01

    Full Text Available This paper presents and describes the anatomical variation of the left vertebral artery originating from the arch of aorta as a case report. This variation was found in one of the cadavers at the Division of Clinical and Functional Anatomy, Faculty of Medicine, University of Ottawa. During routine dissection of a male cadaver, in the superior mediastinum and the neck we observed an atypical origin of the left vertebral artery. Atypical origin was compared to the typical origin of the left vertebral artery in the anatomical literature. We compared our findings with different possible variations of the origin of the left vertebral artery reported in the literature. The clinical importance of the variation is discussed.

  6. [Keratoacanthoma on the left cheek of Galileo Galilei].

    Science.gov (United States)

    Roth, W

    1986-09-01

    In an oil painting from the School of Sustermans, which can be seen in the Palazzo Pitti in Florence, we diagnosed the alterations typical of a keratoacanthoma in the left cheek-bone area of the portrayed Galileo Galilei.

  7. left ventricular hypertrophy in renal failure a review

    African Journals Online (AJOL)

    Key words: Left Ventricular hypertrophy (LVH), Renal failure; cardiovascular. INTRODUCTION. Chronic ... of anaemia; age, disturbed elasticity of the central arteries with elevated ..... Arodiwe E. B. Prevalence of and factors associated with LVH ...

  8. Characteristics of surface waves in anisotropic left-handed materials

    Institute of Scientific and Technical Information of China (English)

    Jiang Yong-Yuan; Shi Hong-Yan; Zhang Yong-Qiang; Hou Chun-Feng; Sun Xiu-Dong

    2007-01-01

    We report the coexistence of TE and TM surface modes in certain same frequency domain at the interface between one isotropic regular medium and another biaxially anistotropic left-handed medium. The conditions for the existence of TE and TM polarized surface waves in biaxially anisotropic left-handed materials are identified, respectively.The Poynting vector and the energy density associated with surface modes are calculated. Depending on the system parameters, either TE or TM surface modes can have the time averaged Poynting vector directed to or opposite to the mode phase velocity. It is seen that the characteristics of surface waves in biaxially anisotropic left-handed media are significantly different from that in isotropic left-handed media.

  9. Left-handed sperm removal by male Calopteryx damselflies (Odonata).

    Science.gov (United States)

    Tsuchiya, Kaori; Hayashi, Fumio

    2014-01-01

    Male genitalia in several insect species are asymmetry in right and left shape. However, the function of such asymmetric male genitalia is still unclear. We found that the male genitalia of the damselfly Calopteryx cornelia (Odonata: Calopterygidae) are morphologically symmetric just after emergence but asymmetric after reproductive maturation. Males remove rival sperm stored in the female bursa copulatrix (single spherical sac) and the following spermatheca (Y-shaped tubular sac) prior to their own ejaculation to prevent sperm competition. Males possess the aedeagus with a recurved head to remove bursal sperm and a pair of spiny lateral processes to remove spermathecal sperm. The right lateral process is less developed than the left, and sperm stored in the right spermathecal tube are rarely removed. Experiments involving surgical cutting of each lateral process demonstrated that only the left process functions in spermathecal sperm removal. Thus, males of C. cornelia are left-handed in their sperm removal behaviour at copulation.

  10. Stochastic left-right neuronal asymmetry in Caenorhabditis elegans.

    Science.gov (United States)

    Alqadah, Amel; Hsieh, Yi-Wen; Xiong, Rui; Chuang, Chiou-Fen

    2016-12-19

    Left-right asymmetry in the nervous system is observed across species. Defects in left-right cerebral asymmetry are linked to several neurological diseases, but the molecular mechanisms underlying brain asymmetry in vertebrates are still not very well understood. The Caenorhabditis elegans left and right amphid wing 'C' (AWC) olfactory neurons communicate through intercellular calcium signalling in a transient embryonic gap junction neural network to specify two asymmetric subtypes, AWC(OFF) (default) and AWC(ON) (induced), in a stochastic manner. Here, we highlight the molecular mechanisms that establish and maintain stochastic AWC asymmetry. As the components of the AWC asymmetry pathway are highly conserved, insights from the model organism C. elegans may provide a window onto how brain asymmetry develops in humans.This article is part of the themed issue 'Provocative questions in left-right asymmetry'.

  11. Delusional misidentifications and duplications: right brain lesions, left brain delusions.

    Science.gov (United States)

    Devinsky, Orrin

    2009-01-01

    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.

  12. Autosomal dominant inheritance of left ventricular outflow tract obstruction

    NARCIS (Netherlands)

    Wessels, Marjolein; Berger, Rudolphus; Frohn-Mulder, Ingrid M E; Roos-Hesselink, Jolien W; Hoogeboom, Jeanette J M; Mancini, Grazia S; Bartelings, Margot M; Krijger, Ronald de; Wladimiroff, Jury W; Niermeijer, Martinus F; Grossfeld, Paul; Willems, Patrick J

    2005-01-01

    Most nonsyndromic congenital heart malformations (CHMs) in humans are multifactorial in origin, although an increasing number of monogenic cases have been reported recently. We describe here four new families with presumed autosomal dominant inheritance of left ventricular outflow tract obstruction

  13. Right-left and the scrotum in Greek sculpture.

    Science.gov (United States)

    McManus, I C

    2004-04-01

    The scrotum in humans is asymmetric, the right testicle being visibly higher than the left in most men. Paradoxically, it is also the case that the right testicle is somewhat larger, rather than smaller, as might be expected. Greek classical and pre-classical art, which took great care in its attention to anatomical detail, correctly portrayed the right testicle as the higher, but then incorrectly portrayed the left testicle as visibly larger. The implication is that the Greeks used a simple mechanical theory, the left testicle being thought to be lower because it was larger and hence more subject to the pull of gravity. The present study examines data on scrotal asymmetry in more detail, and puts them in the context of Greek theories of functional differences between the right side and the left side.

  14. Impaired speech repetition and left parietal lobe damage

    National Research Council Canada - National Science Library

    Fridriksson, Julius; Kjartansson, Olafur; Morgan, Paul S; Hjaltason, Haukur; Magnusdottir, Sigridur; Bonilha, Leonardo; Rorden, Christopher

    2010-01-01

    .... However, perfusion-weighted MRI revealed that tissue dysfunction, in the form of either frank damage or hypoperfusion, to the left inferior parietal lobe, rather than the underlying white matter...

  15. Left ventricular to right atrial shunt resulting from infective endocarditis.

    Science.gov (United States)

    Ellis, C J; Gray, K E; Ainscow, D A

    1975-02-01

    A unique case is described in which infective endocarditis of the aortic valve led to intractable heart failure and necropsy examination showed that the patient had developed a communication between the left ventricle and right atrium.

  16. A Case Report of Left-Sided Headache with Rhinocleisis

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ Case Report A patient, with a complaint of a left-sided headache plus a rhinocleisis for a month, was admitted to our hospital. The clinical diagnosis showed that it was a primary adenoid cystic carcinoma (ACC) of the nasopharynx.

  17. Left Ventricular Function After Prolonged Exercise in Equine Endurance Athletes

    DEFF Research Database (Denmark)

    Flethøj, M.; Schwarzwald, C. C.; Haugaard, M. M.;

    2016-01-01

    Background: Prolonged exercise in human athletes is associated with transient impairment of left ventricular (LV) function, known as cardiac fatigue. Cardiac effects of prolonged exercise in horses remain unknown. Objectives :To investigate the effects of prolonged exercise on LV systolic...

  18. Hypoxia Caused by Persistent Left Superior Vena Cava Connecting to the Left Atrium A Rare Clinical Entity

    Science.gov (United States)

    Freeman, Andrew M.; Fenster, Brett E.; Weinberger, Howard D.; Buckner, J. Kern; Lynch, David

    2012-01-01

    We relate the case of a 40-year-old man with a history of premature birth and dextroposition of the heart who presented for an evaluation of persistent hypoxia. An unrevealing pulmonary evaluation and agitated-saline echocardiogram led to cardiac magnetic resonance imaging. This revealed a very unusual finding: a persistent left superior vena cava with insertion into the left atrium and a small connecting vein between the right and left superior venae cavae. The implications, embryology, and pathogenesis of this rare condition are discussed. PMID:23109762

  19. Comparative response of right and left ventricles to volume overload.

    Science.gov (United States)

    Mathew, R; Thilenius, O G; Arcilla, R A

    1976-08-01

    The cardiac volume data of 49 normal children were compared with those of 23 with secundum atrial septal defect and 24 with patent ductus arteriosus. Significantly smaller ventricular end-diastolic volumes were observed in the normal infants than in older children (right ventricle 53.9 versus 75.5 cm3/m2; left ventricle 46.7 versus 63.6 cm3/m2). "Distensibility" of the right ventricle (DRV), left ventricle (DLV) and left atrium increased normally with age. DRV and DLV were similar shortly after birth; thereafter, DRV increased more rapidly than DLV (mean DRV 12.7; mean DLV 7.8 cm3/m2 per mm Hg, P less than 0.001). In both atrial septal defect and patent ductus arteriosus, the ipsilateral (involved) ventricles had increased volume, increased output, normal ejection fraction and increased distensibility. The contralateral (left) ventricle in atrial septal defect was smaller than normal (39.6 versus 49.7 cm3, P less than 0.001), and had a smaller ejection fraction (0.63 versus 0.71, P less than 0.01) and output (3.70 versus 4.57 liters/min per m2, P less than 0.005). In contrast, the contralateral (right) ventricle in patent ductus arteriosus remained normal. Left atrial maximal volume was larger than normal in atrial septal defect (46.6 versus 35.9 cm3/m2, P less than 0.001). The left atrial and left ventricular volumes in patent ductus arteriosus were, respectively, 152 and 142 percent of normal, indicating comparable response to the volume load. The left head changes in atrial septal defect may be related both to a functionally restrictive defect and to the difference in distensibility of the ventricles.

  20. My Left Foot——The Lettet “A”

    Institute of Scientific and Technical Information of China (English)

    ChristyBrown; 许洪武

    2004-01-01

    Christy Brown, the celebrated painter and writer,overcame the difficulties of being born with cerebral palsy by using his left foot,the only part of his body which he could use with real control.In this story you will be comparing the opening of Christy's autobiographical novel with a scene from the successful film of his early life, “My Left Foot”.

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    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. Scattering Forces within a Left-Handed Photonic Crystal.

    Science.gov (United States)

    Ang, Angeleene S; Sukhov, Sergey V; Dogariu, Aristide; Shalin, Alexander S

    2017-01-23

    Electromagnetic waves are known to exert optical forces on particles through radiation pressure. It was hypothesized previously that electromagnetic waves inside left-handed metamaterials produce negative radiation pressure. Here we numerically examine optical forces inside left-handed photonic crystals demonstrating negative refraction and reversed phase propagation. We demonstrate that even though the direction of force might not follow the flow of energy, the positive radiation pressure is maintained inside photonic crystals.

  4. Congenital complete and partial absence of the left pericardium.

    Science.gov (United States)

    Jurko, Alexander; Minarik, Milan; Cisarikova, Viera; Polacek, Hubert; Schusterova, Ingrid

    2013-09-01

    Congenital absence of pericardium is a rare malformation. We report 2 young patients with a diagnosis of congenital absence of the pericardium. The posteroanterior view of the chest X-ray showed displacement of the left cardiac border into the left hemithorax. Unusual acoustical windows and abnormal cardiac and septal motion during echocardiography suggested the diagnosis of congenital absence of pericardium. Magnetic resonance imaging definitive confirmed diagnosis of congenital absence of pericardium.

  5. Regional renal venous hypertension and left-sided varicocele

    OpenAIRE

    O. B. Zhukov; A. V. Verzin; P. L. Penkov

    2014-01-01

    One of the most frequent correctable causes of male infertility is a varicocele. The etiology and pathogenesis of varicocele to date is a matter of debate. The aim of our study was to determine the causes and incidence of regional renal hypertension in patients with leftsided varicocele. The study involved 110 patients with left-sided varicocele in age from 18 to 35 years. Algorithm for evaluation of patients with left-sided varicocele included: physical examination, ultrasound with Doppler k...

  6. Left wind forward in football (soccer). Khinanthropometry and footprint analysis

    OpenAIRE

    Herrero de Lucas, A.; Cabañas Armesilla, M.D.; Maestre López, I.

    2004-01-01

    Kinanthropometry is the study of size, shape, proportionality, body composition, biological maturation and body function with the objective of understanding the process of growth, exercise, sport performance and nutrition. It has been accepted measurements in the right side of the subject as equivalent of the overall sportsman. Right and left side variations therefore have not been sufficiently studied, particularly in left handed football players. Materials and Methods: Analysis ...

  7. Left-right asymmetry: lessons from Cancún

    OpenAIRE

    Burdine, Rebecca D.; Caspary, Tamara

    2013-01-01

    The satellite symposium on ‘Making and breaking the left-right axis: implications of laterality in development and disease’ was held in June 2013 in conjunction with the 17th International Society for Developmental Biology meeting in Cancún, Mexico. As we summarize here, leaders in the field gathered at the symposium to discuss recent advances in understanding how left-right asymmetry is generated and utilized across the animal kingdom.

  8. Preterm Delivery in the Setting of Left Calyceal Rupture

    OpenAIRE

    2015-01-01

    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 de...

  9. Left hand dominance affects supra-second time processing

    Directory of Open Access Journals (Sweden)

    Carmelo Mario Vicario

    2011-10-01

    Full Text Available Previous works exploring the brain functions of left-handed and right-handed people have shown variances in spatial and motor abilities that might be explained according to consistent structural and functional differences. Given the role of both spatial and motor information in the processing temporal intervals, we designed a study investigating timing abilities in left-handed subjects. To this purpose left-handed and right-handed subjects were asked to perform a time reproduction of sub-second vs. supra-second time intervals with their left and right hand.Our results show that left-handed participants sub-estimated the processing of the supra-second intervals, independently of the hand used to perform the task, while no differences were reported for the sub-second intervals. These results are discussed according to recent advances on suprasecond motor timing research as well as emerging evidences which suggest a linear representation of time with a left-to-right displacing.

  10. 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.

  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. 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.

  13. Concentric left ventricular morphology in aerobically trained kayak canoeists.

    Science.gov (United States)

    Gates, Phillip E; Campbell, Ian G; George, Keith P

    2004-09-01

    The aim of the present study was to test the hypothesis that upper body aerobically trained athletes (kayak canoeists) would have greater left ventricular wall thickness, but similar left ventricular diastolic chamber dimensions, compared with recreationally active and sedentary men. Ultrasound echocardiography was used to determine cardiac structure and function in highly trained kayak canoeists (n = 10), moderately active (n = 10) and sedentary men (n = 10). The septal and posterior left ventricular walls were approximately 0.2 cm thicker in kayak canoeists (P kayak canoeists had a concentric pattern of left ventricular adaptation to aerobic upper body training. Scaling the data to body composition indices had no effect on the outcome of the statistical analysis. There were no differences in resting Doppler left ventricular diastolic or systolic function among the groups. Ejection fraction was lower in the kayak canoeists, but the magnitude of the difference was within the normal variability for this measurement. Thus aerobically upper body trained athletes demonstrated a concentric pattern of cardiac enlargement, but resting left ventricle function was not different between athletes, moderately active and sedentary individuals.

  14. Right-left discrimination: effects of handedness and educational background.

    Science.gov (United States)

    Ofte, Sonja H

    2002-07-01

    The present study investigated right left discrimination, with a paper-and-pen test with cartoon figures. The test consisted of line drawings of a person with no, one, or both arms crossing the vertical axis of the body in the figure. The subjects' task was to mark with a pencil, as fast as possible, which was the right or left hand in the figure. The line drawings were viewed from the back, from the front, or randomly alternating between the back and front views. Two studies were conducted. The first consisted of 393 adults: 153 males and 240 females; 338 right-handers and 55 left-handers. The results showed that the males performed better than the females. The left-handers and the right-handers performed equally well. However, the left-handed males performed better than the right-handed males. There was no difference in performance between the right-handed and the left-handed females. The second study consisted of 175 right-handed college students: 63 psychology students. 54 medical students, and 58 law students. The main finding was that the medical students performed better than the psychology students for all figure orientation subtests and for all arm positions. In comparison with the law students, the medical students performed at the same level on the back view subtest, but they performed better on the front view subtest and on two out of three arm positions on the alternating view subtest.

  15. 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, Pskin 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.

  16. Left ventricular diastolic function in patients with advanced cystic fibrosis.

    Science.gov (United States)

    Koelling, Todd M; Dec, G William; Ginns, Leo C; Semigran, Marc J

    2003-05-01

    To assess left ventricular systolic and diastolic function in adult patients with cystic fibrosis using radionuclide ventriculography. Although myocardial fibrosis has been described in autopsy specimens of patients with cystic fibrosis, the possibility that myocardial dysfunction may occur during life in adult patients with cystic fibrosis has not been explored. To assess the possibility of cardiac dysfunction occurring in cystic fibrosis, we studied 40 patients with advanced cystic fibrosis with first-pass radionuclide ventriculography and compared them to 9 patients with advanced bronchiectasis and 18 normal control subjects. Indexes of right ventricular systolic function were similarly impaired in patients with cystic fibrosis and patients with bronchiectasis. Left ventricular ejection fraction of patients with cystic fibrosis, patients with bronchiectasis, and normal control subjects did not differ. Fractional left ventricular filling at 50% of diastole, an index of diastolic function, was significantly lower in patients with cystic fibrosis (54 +/- 13%, mean +/- SD) in comparison to patients with bronchiectasis (66 +/- 4%, p = 0.009) or normal control subjects (69 +/- 14, p = 0.0002). The contribution of atrial systole to total diastolic left ventricular filling was greater in patients with cystic fibrosis (38 +/- 18%) than in patients with bronchiectasis (21 +/- 4%, p = 0.01) or normal control subjects (25 +/- 12%, p = 0.01). Patients with advanced cystic fibrosis demonstrate impaired left ventricular distensibility when compared to normal control subjects and patients with bronchiectasis. Patients with cystic fibrosis may be at risk of heart failure due to right ventricular dysfunction or left ventricular diastolic dysfunction.

  17. 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.

  18. Preterm Delivery in the Setting of Left Calyceal Rupture

    Science.gov (United States)

    Hanson, Brent; Tabbarah, Rami

    2015-01-01

    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. PMID:26483981

  19. 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.

  20. 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.

  1. 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.

  2. 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

    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 of PALS and ...

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

    DEFF Research Database (Denmark)

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

    2008-01-01

    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...

  4. Preoperative left hepatic lobe devascularisation to minimize perioperative bleeding in a Jehovah’s Witness undergoing left hepatectomy

    Directory of Open Access Journals (Sweden)

    Laurence Weinberg

    2017-01-01

    Conclusion: Combination of portal vein embolization and hepatic lobe devascularisation to produce total vascular occlusion of inflow to the left lobe radiologically allowed a near bloodless surgical field during major liver resection in a Jehovah’s Witness patient.

  5. 'Left behind' but not left alone: parental migration & the psychosocial health of children in Moldova.

    Science.gov (United States)

    Vanore, Michaella; Mazzucato, Valentina; Siegel, Melissa

    2015-05-01

    In Moldova, large-scale and rapidly feminised migration flows have inspired a wave of qualitative reports on children "left behind". Despite this recent interest, few studies have empirically evaluated the effects of parental migration on the psychosocial health of such children. Using data collected from a nationally-representative household survey conducted in Moldova between September 2011 and February 2012, this paper analyses the psychosocial health outcomes of children of migrant parents by comparing them with children without migrant parents (n = 1979). Child psychosocial health is measured through caregiver-reported Strengths and Difficulties Questionnaire (SDQ) scores. Multivariate regression analyses show that parental migration seldom corresponds to worse emotional symptoms outcomes but does correspond to increased conduct problems. Separate analyses for male and female children show significant gendered differences. The results partially contest the negative results that have been the subject of qualitative reports and, in particular, demonstrate that the migration of mothers infrequently results in worse psychosocial outcomes for children-contrary to what has been assumed in the discourse about parental migration in Moldova.

  6. Left ventricular ejection fraction and left ventricular end-diastolic volume in patients with diastolic dysfunction.

    Science.gov (United States)

    Jovin, Ion S; Ebisu, Keita; Liu, Yi-Hwa; Finta, Laurie A; Oprea, Adriana D; Brandt, Cynthia A; Dziura, James; Wackers, Frans J

    2013-01-01

    Diastolic dysfunction can be diagnosed on equilibrium radionuclide angiocardiography (ERNA) by a low peak filling rate (PFR) in the setting of a normal left ventricular ejection fraction (LVEF). The authors evaluated the relationship between diastolic dysfunction, LVEF, and end-diastolic volume (EDV). A total of 408 predominantly asymptomatic patients with an LVEF ≥50% by ERNA were studied. LVEF of patients with a low PFR was compared with the LVEF of patients with a normal PFR. Correlation analyses to evaluate the association between PFR and EDV were also performed. The LVEF of patients with a low PFR was lower than the LVEF of patients with normal PFR (59±7 vs 63%±7%; PPFR (r=-0.04; P=.32). The results did not change when the EDV indices were used. In patients who had repeat scans, there was no correlation between the change in EDV and the change in PFR (r=0.16; P=.2). In asymptomatic patients undergoing ERNA who have normal systolic function, a low PFR can be associated with a lower LVEF, but it is not associated with changes in EDV. This suggests that diastolic dysfunction is associated with mild systolic dysfunction.

  7. 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.

  8. Persistent left cranial vena cava draining into the left atrium associated with pulmonary stenosis in a French bulldog.

    Science.gov (United States)

    Zani, Alessandro; Becchetti, Elisa; Leonardi, Paola; Sinatra, Alessandro

    2014-06-01

    A 5-month-old female French bulldog was evaluated for the presence of a heart murmur. Through clinical and echocardiographic evaluations, a severe Type A pulmonary stenosis was diagnosed. Angiography during right ventricular catheterization for valvuloplasty revealed drainage from a persistent left cranial vena cava (PLCVC) into the left atrium; this was confirmed later by contrast echocardiography. This report is the first to describe this anatomical variant of a PLCVC in a dog.

  9. 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.

  10. A survey of left-handed helices in protein structures.

    Science.gov (United States)

    Novotny, Marian; Kleywegt, Gerard J

    2005-03-25

    All naturally occurring amino acids with the exception of glycine contain one or more chiral carbon atoms and can therefore occur in two different configurations, L (levo, left-handed) and D (dextro, right-handed). Proteins are almost exclusively built from L-amino acids. The stereochemical bias of nature is further reflected at the secondary structure level where right-handed helices are strongly preferred over left-handed helices. The handedness of helices has not received much attention in the past and is often overlooked during the analysis, description and deposition of experimentally solved protein structures. Therefore, an extensive survey of left-handed helices in the Protein Data Bank (PDB) was undertaken to analyse their frequency of occurrence, length, amino acid composition, conservation and possible structural or functional role. All left-handed helices (of four or more residues) in a non-redundant subset of the PDB, were identified using hydrogen-bonding analysis, comparison of related structures, and experimental electron density assessment to filter out likely spurious and artefactual hits. This analysis yielded 31 verified left-handed helices in a set of 7284 proteins. The phi angles of the residues in the left-handed helices lie between 30 degrees and 130 degrees and the psi angles lie between -50 degrees and 100 degrees . Most of the helices are short (four residues) and for 87% of them, it was possible to determine that they are important for the stability of the protein, for ligand binding, or as part of the active site. This suggests that, even though left-handed helices are rare, when they do occur, they are structurally or functionally significant. Four secondary structure assignment programs were tested for their ability to identify the handedness of the helices. Of these programs, only DSSP correctly assigns the handedness.

  11. Right versus left stapes surgery: is there a difference?

    Science.gov (United States)

    Karkas, Alexandre; Chahine, Karim; Righini, Christian Adrien; Khirnetkina, Ayuna; Schmerber, Sébastien

    2009-12-01

    To search for a statistically significant difference in auditory results between right and left ears after surgery for otosclerosis. Retrospective case-review study. Academic tertiary referral center. Eight hundred ninety-four cases of stapes surgery were reviewed. Patients were divided into 2 groups: right ear (474 cases) and left ear (420 cases). There were 4 classes in each group depending on the preoperative air-bone gap (ABG). Each class was divided into 3 subclasses depending on the preoperative bone conduction (BC). Two parameters were analyzed: ABG and BC. The parameters compared between right and left ears were 1) the difference between mean preoperative and 4-month postoperative ABG (DeltaABG) and 2) the difference between mean preoperative and 4-month postoperative BC (DeltaBC). We used the analysis of variance statistical test. Furthermore, we calculated the number of patients who have had postoperative sensorineural hearing loss at 4 months defined as a fall in BC of more than 10 dB and compared the results between right and left ears using chi test. There was no statistically significant difference in the DeltaABG and the DeltaBC between the right and left ear (p = 0.742 and 0.426, respectively) taking into consideration all classes and subclasses. We found 19 cases of postoperative sensorineural hearing loss, among which are 10 right ears and 9 left ears. The difference was not statistically significant (p = 0.973). There is no functional difference between stapes surgery performed in the right ear as compared with that performed in the left ear.

  12. Regional renal venous hypertension and left-sided varicocele

    Directory of Open Access Journals (Sweden)

    O. B. Zhukov

    2013-01-01

    Full Text Available One of the most frequent correctable causes of male infertility is a varicocele. The etiology and pathogenesis of varicocele to date is a matter of debate. The aim of our study was to determine the causes and incidence of regional renal hypertension in patients with leftsided varicocele. The study involved 110 patients with left-sided varicocele in age from 18 to 35 years. Algorithm for evaluation of patients with left-sided varicocele included: physical examination, ultrasound with Doppler kidney, basin area left renal vein, aorto-mesenteric portion; the scrotum with a sample Trombetta, phlebography аnd phlebotonometry basin left renal vein and the common iliac vein. Renospermatic reflux was detected in 89 (81 %, ileospermatic 12 (11 % and mixed 9 (8 % patients. Patients with reflux ileospermatic excluded from the study. The 96 patients with left-sided varicocele underwent venography and phlebotonometry in 37 (38.5 % were renal venous hypertension, with 35 of them that it was due to aorto-mesenteric compression, and in 2 cases an anomaly development – annular renal vein. Our data are comparable with the results of other authors. Patients with mesenteric compressed statistically significant reduction in the diameter of renal veins in the aorto-mesenteric portion and increased blood flow in this region, and expand prestenosis left renal vein and reduce flow velocity in this region compared with the group without renal phlebohypertension. Patients with renal phlebohypertension subsequently held shunt types of operations performed in patients with normotension occlusive types of operations. An integrated assessment of patients with left-side allows to make a holistic understanding of the basic mechanisms of disease etiology and select the appropriate type of surgery.

  13. Establishment of a chronic left ventricular aneurysm model in rabbit

    Institute of Scientific and Technical Information of China (English)

    Cang-Song XIAO; Chang-Qing GAO; Li-Bing LI; Yao WANG; Tao ZHAO; Wei-Hua YE; Chong-Lei REN; Zhi-Yong LIU; Yang WU

    2014-01-01

    Objectives To establish a cost-effective and reproducible procedure for induction of chronic left ventricular aneurysm (LVA) in rabbits. Methods Acute myocardial infarction (AMI) was induced in 35 rabbits via concomitant ligation of the left anterior descending (LAD) coronary artery and the circumflex (Cx) branch at the middle portion. Development of AMI was co n-firmed by ST segment elevation and akinesis of the occluded area. Echocardiography, pathological evaluation, and agar i n-tra-chamber casting were utilized to validate the formation of LVA four weeks after the surgery. Left ventricular end systolic pressure (LVESP) and diastolic pressure (LVEDP) were measured before, immediately after and four weeks after ligation. D i-mensions of the ventricular chamber, thickness of the interventricular septum (IVS) and the left ventricular posterior wall (LVPW) left ventricular end diastolic volume (LVEDV) and systolic volume (LVESV), and ejection fraction (EF) were recorded by echo-cardiography. Results Thirty one (88.6%) rabbits survived myocardial infarction and 26 of them developed aneurysm (83.9%). The mean area of aneurysm was 33.4% ± 2.4% of the left ventricle. LVEF markedly decreased after LVA formation, whereas LVEDV, LVESV and the thickness of IVS as well as the dimension of ventricular chamber from apex to mitral valve annulus significantly increased. LVESP immediately dropped after ligation and recovered to a small extent after LVA formation. LVEDP progressively increased after ligation till LVA formation. Areas in the left ventricle (LV) that underwent fibrosis included the apex, anterior wall and lateral wall but not IVS. Agar intra-chamber cast showed that the bulging of LV wall was prominent in the area of aneurysm. Conclusions Ligation of LAD and Cx at the middle portion could induce develo pment of LVA at a mean area ratio of 33.4%±2.4%which involves the apex, anterior wall and lateral wall of the LV.

  14. 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.

  15. Social stereotyping of left-handers in Serbia.

    Science.gov (United States)

    Dragović, Milan; Badcock, Johanna C; Sanja, Milenković; Gregurović, Margareta; Šram, Zlatko

    2013-01-01

    Social tolerance towards left-handed people is commonly accepted in the twenty-first century, though not universal. However, at the level of social cognition a subtle bias against this visible minority group might not have disappeared. To investigate this possibility we adopted the theoretical framework of the stereotype content model (SCM) whereby two fundamental dimensions (warmth and competence) are sufficient to explain group differences in stereotype content. We examined how a large sample of medical students (N=300) perceived nine social groups (seven with various physical, social, or mental handicaps, and the two target groups of left- and right-handers), and four "anchor" groups comprising educated people, pensioners, drug addicts, and rich people) which are considered as prototypical in terms of the SCM. Hierarchical cluster analysis was performed to determine similarity of groups in the warmth × competence two-dimensional space. Four clusters were identified, with left- and right-handers located in the same cluster together with educated people. This cluster had higher ratings on both warmth and competence (i.e., more positive stereotype) compared with all other groups. However, within-cluster analysis showed that the left-handed group was perceived as lower on both dimensions compared to the right-handed group. This statistically significant difference suggests that implicit bias against left-handed individuals has not vanished despite pervasive social tolerance. Possible mechanisms that may explain this subtle and subliminal stereotyping are discussed.

  16. Alexia without agraphia following biopsy of a left thalamic tumor.

    Science.gov (United States)

    Tamhankar, Madhura A; Coslett, Harry B; Fisher, Michael J; Sutton, Leslie N; Liu, Grant T

    2004-02-01

    Alexia without agraphia is a rare disconnection syndrome characterized by the loss of reading ability with retention of writing and verbal comprehension. We report a patient who developed alexia without agraphia after undergoing a biopsy for a malignant glioma involving the left thalamus. A 15-year-old right-handed male presented with 3 days of severe headache, and vomiting, and 1 month of blurry vision in his right visual field. Magnetic resonance imaging of the brain disclosed a large exophytic mass originating in the left thalamus, with mass effect and hydrocephalus. The patient underwent biopsy of the left thalamic mass via a transcallosal approach. Postoperatively, the patient complained of inability to read or identify letters. Examination revealed alexia without agraphia. The syndrome of alexia without agraphia can be rarely caused after surgery. A transcallosal procedure through the splenium of the corpus callosum may disrupt the visual association fibers traveling from the right occipital cortex to the left angular gyrus. In our case the syndrome occurred because of a preexisting right homonymous hemianopia resulting from a left thalamic tumor.

  17. [Heart failure with preserved left ventricular ejection fraction].

    Science.gov (United States)

    Maeder, Micha T; Rickli, Hans

    2013-10-16

    Heart failure with preserved left ventricular ejection fraction (LVEF; HFpEF) is a common type of heart failure in the elderly, and it typically represents advanced hypertensive heart disease. The left ventricle in patients with HFpEF is characterized by concentric remodeling, normal LVEF, but reduced left longitudinal shortening, and importantly diastolic dysfunction. Dyspnoe and fatigue in patients with HFpEF are due to impaired left ventricular filling with a rapid increase in filling pressures and the lack of an increase in stroke volume during exercise. The diagnosis of HFpEF requires the careful exclusion of non-cardiac causes of dyspnoe as well as cardiac causes of dyspnoe associated with preserved LVEF other than HFpEF, primarily coronary artery disease and valve disease. Then, the following findings are required to make a diagnosis of HFpEF: a non-dilated left ventricle with an LVEF >50% and the presence of a significant diastolic impairment, which can be assessed using invasive haemodynamics, echocardiography, natriuretic peptides, or a combination of these tools. In contrast to patients with heart failure and reduced LVEF there is still no established treatment for patients with HFpEF, which prolongs survival or reduces the rate of hospitalizations for heart failure. There is currently however intense research going on in this field, and results from large trials evaluating the effects of various interventions on clinical endpoints are expected within the next years.

  18. 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.

  19. 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.

  20. 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.

  1. Left and right in the Bible from a neuropsychological perspective.

    Science.gov (United States)

    Fabbro, F

    1994-03-01

    Although in several neuropsychological works dealing with hemispheric specializations a few passages of the Bible referring to the left and the right have been mentioned now and then, a systematical study with a neuropsychological approach to this topic was still a missing link. By using concordance texts from the Bible books of the Hebrew Canon (Old Testament, OT) and from the New Testament (NT), all the verses containing any reference to the left and the right (OT = 151, NT = 49 verses) have been identified and classified into 10 groups: (1) references to space, (2) symmetric sayings, (3) the right hand is the favorite hand, (4) right eye preference, (5) God's right hand, (6) the right side is more prestigious, (7) the right side in liturgy, (8) left hand preference, (9) fatal left-hand shots, and (10) on the left side. Some statistical considerations have been put forward and a neuropsychological, anthropological approach has been suggested for the purpose of interpreting the most interesting verses. According to the author of the present paper, it would be worthwhile commenting on some texts of ancient and modern literature not only from a linguistic, historical, religious and theological point of view, but also by means of a neuropsychological approach.

  2. The halting arrival of left-handed Z-DNA.

    Science.gov (United States)

    Gagna, C E; Lambert, W C

    2003-03-01

    Forty-nine years ago Watson and Crick proposed a double-stranded (ds-) model for DNA. This double helix has become an icon of molecular biology. Twenty-six years later, Rich accidently discovered Z-DNA, an exotic left-handed nucleic acid. For many years thereafter, this left-handed DNA was thought to be an artifact. DNA is no longer looked upon as a static molecule but rather an extremely dynamic structure in which different conformations are in equilibrium with each other. Many researchers have spent the last two decades characterizing this novel left-handed DNA structure. Now many investigators are beginning to accept the possibility that this novel ds-DNA conformation may play a significant in vivo role within eukaryotic and prokaryotic cells. However, more research needs to be performed before it is absolutely accepted by all in the scientific community.

  3. Left Atrial Reverse Remodeling: Mechanisms, Evaluation, and Clinical Significance.

    Science.gov (United States)

    Thomas, Liza; Abhayaratna, Walter P

    2017-01-01

    The left atrium is considered a biomarker for adverse cardiovascular outcomes, particularly in patients with left ventricular diastolic dysfunction and atrial fibrillation in whom left atrial (LA) enlargement is of prognostic importance. LA enlargement with a consequent decrease in LA function represents maladaptive structural and functional "remodeling" that in turn promotes electrical remodeling and a milieu conducive for incident atrial fibrillation. Medical and nonmedical interventions may arrest this pathophysiologic process to the extent that subsequent reverse remodeling results in a reduction in LA size and improvement in LA function. This review examines cellular and basic mechanisms involved in LA remodeling, evaluates the noninvasive techniques that can assess these changes, and examines potential mechanisms that may initiate reverse remodeling.

  4. 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.

  5. Left-Handed W Bosons at the LHC

    CERN Document Server

    Bern, Z; Dixon, L J; Cordero, F Febres; Forde, D; Gleisberg, T; Hoeche, S; Ita, H; Kosower, D A; Maitre, D; Ozeren, K

    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.

  6. Implantation of left ventricular assist device complicated by undiagnosed thrombophilia.

    Science.gov (United States)

    Szarszoi, Ondrej; Maly, Jiri; Turek, Daniel; Urban, Marian; Skalsky, Ivo; Riha, Hynek; Maluskova, Jana; Pirk, Jan; Netuka, Ivan

    2012-01-01

    A patient with dilated cardiomyopathy and no history of thromboembolic events received a surgically implanted axial-flow left ventricular assist device. After implantation, transesophageal echocardiography revealed a giant thrombus on the lateral and anterior aspects of the left ventricle. The inflow cannula inserted through the apex of the left ventricle was not obstructed, and the device generated satisfactory blood flow. Laboratory screening for thrombophilia showed protein S deficiency, heterozygous factor V Leiden mutation, and heterozygous MTHFR C667T mutation. During the entire duration of circulatory support, no significant suction events were detected, and the patient was listed for heart transplantation. Ventricular assist device implantation can unmask previously undiagnosed thrombophilia; therefore, it should be necessary to identify thrombophilic patients before cardiac support implantation.

  7. 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.

  8. Early verb constructions in French: adjacency on the left edge.

    Science.gov (United States)

    Veneziano, Edy; Clark, Eve V

    2016-11-01

    Children acquiring French elaborate their early verb constructions by adding adjacent morphemes incrementally at the left edge of core verbs. This hypothesis was tested with 2657 verb uses from four children between 1;3 and 2;7. Consistent with the Adjacency Hypothesis, children added clitic subjects first only to present tense forms (as in il saute 'he jumps'); modals to infinitives (as in faut sauter 'has to jump'); and auxiliaries to past participles (as in a sauté 'has jumped'). Only after this did the children add subjects to the left of a modal or auxiliary, as in elle veut sauter 'she wants to jump', or elle a sauté 'she has jumped'. The order in which these elements were added, and the development in the frequencies of the constructions, all support the predictions of the Adjacency Hypothesis for left edge development in early verb constructions.

  9. 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.

  10. Universal Features of Left-Right Entanglement Entropy.

    Science.gov (United States)

    Das, Diptarka; Datta, Shouvik

    2015-09-25

    We show the presence of universal features in the entanglement entropy of regularized boundary states for (1+1)D conformal field theories on a circle when the reduced density matrix is obtained by tracing over right- or left-moving modes. We derive a general formula for the left-right entanglement entropy in terms of the central charge and the modular S matrix of the theory. When the state is chosen to be an Ishibashi state, this measure of entanglement is shown to precisely reproduce the spatial entanglement entropy of a (2+1)D topological quantum field theory. We explicitly evaluate the left-right entanglement entropies for the Ising model, the tricritical Ising model and the su[over ^](2)_{k} Wess-Zumino-Witten model as examples.

  11. A strategic approach for cardiac MR left ventricle segmentation.

    Science.gov (United States)

    Dakua, Sarada Prasad; Sahambi, J S

    2010-09-01

    Quantitative evaluation of cardiac function from cardiac magnetic resonance (CMR) images requires the identification of the myocardial walls. This generally requires the clinician to view the image and interactively trace the contours. Especially, detection of myocardial walls of left ventricle is a difficult task in CMR images that are obtained from subjects having serious diseases. An approach to automated outlining the left ventricular contour is proposed. In order to segment the left ventricle, in this paper, a combination of two approaches is suggested. Difference of Gaussian weighting function (DoG) is newly introduced in random walk approach for blood pool (inner contour) extraction. The myocardial wall (outer contour) is segmented out by a modified active contour method that takes blood pool boundary as the initial contour. Promising experimental results in CMR images demonstrate the potentials of our approach.

  12. Using mathematical morphology to determine left ventricular contours

    Energy Technology Data Exchange (ETDEWEB)

    Pladellorens, J. (Universitat Politecnica de Catalunya (Spain). Dept. d' Optica i Optometria); Serrat, J. (Universitat Autonoma de Barcelona (Spain). Dept. d' Informatica); Castell, A. (Hospital de la Vall d' Hebro, Barcelona (Spain). Dept. de Medicina Nuclear); Yzuel, M.J. (Universitat Autonoma de Barcelona (Spain). Dept. de Fisica)

    1993-12-01

    Mathematical morphology is used for the determination of left ventricular contours in scintigraphic images using multigated radionuclide angiography. The authors developed a completely automatic method that first restores the image with a Wiener filter, then finds the region where the left ventricle is contained, and finally segments the left ventricle contour and a background zone. The contours depend on the values of the parameters that appear in the mathematical morphology method, which are related to the height and the slope of the count distribution. Results obtained with this method are compared with the contours and the background zones outlined by experts on the basis of the number of counts, and the authors study the values of the parameters with which optimum correlation is obtained. (author).

  13. Left-Right Entanglement Entropy of Dp-branes

    CERN Document Server

    Zayas, Leopoldo A Pando

    2016-01-01

    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. 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.

  14. Perturbativity and mass scales of Left-Right Higgs bosons

    CERN Document Server

    Maiezza, Alessio; Nesti, Fabrizio

    2016-01-01

    The scalar sector of the minimal Left-Right model at TeV scale is revisited in light of the large quartic coupling needed for a heavy flavor-changing scalar. The stability and perturbativity of the effective potential is discussed and merged with constraints from low-energy processes. Thus the perturbative level of the Left-Right scale is sharpened. Lower limits on the triplet scalars are also derived: the left-handed triplet is bounded by oblique parameters, while the doubly-charged right-handed component is limited by the $h \\to \\gamma \\gamma, Z \\gamma$ decays. Current constraints disfavor their detection as long as $W_R$ is within the reach of the LHC.

  15. Simultaneous normal and parallel incidence planar left-handed metamaterial.

    Science.gov (United States)

    Lv, Jianhong; Yan, Baorong; Liu, Minghai; Hu, Xiwei

    2009-08-01

    We investigate numerically the negative refraction of a simultaneous normal and parallel incidence planar left-handed metamaterial (LHM) in this paper. This LHM is comprised of fourfold C-shaped rings, which are printed on both sides of the substrates symmetrically, and it can exhibit left-handed properties with electromagnetic wave incident in three different directions. The retrieved result and the simulated result verify the left-handed properties of the fourfold C-shaped metamaterial very well. Then the different electric responses of the normal and parallel incidence cases to the incident electromagnetic wave are discussed, and it is due to the different distribution of the induced currents in the metallic wires.

  16. 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)

    Ersboll, M; Andersen, Mads Jønsson; Valeur, N.

    2013-01-01

    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...... atrium volumes, and PALS within 48 hours of admission. PALS was related to a composite outcome of death and heart failure hospitalization. Reduced PALS was associated with hypertension, diabetes mellitus, and Killip class >1 (P...

  17. Huge Left Atrium Accompanied by Normally Functioning Prosthetic Valve.

    Science.gov (United States)

    Sabzi, Feridoun

    2015-01-01

    Giant left atria are defined as those measuring larger than 8 cm and are typically found in patients who have rheumatic mitral valve disease with severe regurgitation. Enlargement of the left atrium may create compression of the surrounding structures such as the esophagus, pulmonary veins, respiratory tract, lung, inferior vena cava, recurrent laryngeal nerve, and thoracic vertebrae and lead to dysphagia, respiratory dysfunction, peripheral edema, hoarse voice, or back pain. However, a huge left atrium is usually associated with rheumatic mitral valve disease but is very rare in a normally functioning prosthetic mitral valve, as was the case in our patient. A 46-year-old woman with a past medical history of mitral valve replacement and chronic atrial fibrillation was admitted to our hospital with a chief complaint of cough and shortness of breath, worsened in the last month. Physical examination showed elevated jugular venous pressure, respiratory distress, cardiac cachexia, heart failure, hepatomegaly, and severe edema in the legs. Chest radiography revealed an inconceivably huge cardiac sell-out. Transthoracic echocardiography demonstrated a huge left atrium, associated with thrombosis, and normal function of the prosthetic mitral valve. Cardiac surgery with left atrial exploration for the extraction of the huge thrombosis and De Vega annuloplasty for tricuspid regurgitation were carried out. The postoperative course was eventful due to right ventricular failure and low cardiac output syndrome; and after two days, the patient expired with multiple organ failure. Thorough literature review showed that our case was the largest left atrium (20 × 22 cm) reported thus far in adults with a normal prosthetic mitral valve function.

  18. Left hippocampus sparing whole brain radiotherapy (WBRT): A planning study.

    Science.gov (United States)

    Kazda, Tomas; Vrzal, Miroslav; Prochazka, Tomas; Dvoracek, Petr; Burkon, Petr; Pospisil, Petr; Dziacky, Adam; Nikl, Tomas; Jancalek, Radim; Slampa, Pavel; Lakomy, Radek

    2017-07-20

    Unilateral sparing of the dominant (left) hippocampus during whole brain radiotherapy (WBRT) could mitigate cognitive decline, especially verbal memory, similar to the widely investigated bilateral hippocampus avoidance (HA-WBRT). The aim of this planning study is dosimetrical comparison of HA-WBRT with only left hippocampus sparing (LHA-WBRT) plans. HA-WBRT plans for 10 patients were prepared in accordance with RTOG 0933 trial and served as baseline for comparisons with several LHA-WBRT plans prepared with an effort: 1) to maintain the same left hippocampus dosimetry ("BEST PTV") and 2) to maintain same dosimetry in planning target volume as in HA-WBRT ("BEST LH"). All HA-WBRT plans met RTOG 0933 protocol criteria with a mean Conformity index 1.09 and mean Homogeneity index (HI) 0.21. Mean right and left hippocampal D100 % was 7.8 Gy and 8.5 Gy and mean Dmax 14.0 Gy and 13.8 Gy, respectively. "BEST PTV" plans reduced HI by 31.2 % (P=0.005) which is mirrored by lower PTV_D2% (-0.8 Gy, P=0.005) and higher PTV_D98% (+1.3 Gy, P=0.005) as well as decreased optic pathway's Dmax by 1 Gy. In "BEST LH", mean D100% and Dmax for the left hippocampus were significantly reduced by 11.2 % (P=0.005) and 10.9 % (P=0.005) respectively. LHA-WBRT could improve target coverage and/or further decrease in dose to spared hippocampus. Future clinical trials must confirm whether statistically significant reduction in left hippocampal dose is also clinically significant.

  19. Huge Left Atrium Accompanied by Normally Function- ing Prosthetic Valve

    Directory of Open Access Journals (Sweden)

    Feridoun Sabzi

    2015-10-01

    Full Text Available Giant left atria are defined as those measuring larger than 8 cm and are typically found in patients who have rheumatic mitral valve disease with severe regurgitation. Enlargement of the left atrium may create compression of the surrounding structures such as the esophagus, pulmonary veins, respiratory tract, lung, inferior vena cava, recurrent laryngeal nerve, and thoracic vertebrae and lead to dysphagia, respiratory dysfunction, peripheral edema, hoarse voice, or back pain. However, a huge left atrium is usually associated with rheumatic mitral valve disease but is very rare in a normally functioning prosthetic mitral valve, as was the case in our patient. A 46-year-old woman with a past medical history of mitral valve replacement and chronic atrial fibrillation was admitted to our hospital with a chief complaint of cough and shortness of breath, worsened in the last month. Physical examination showed elevated jugular venous pressure, respiratory distress, cardiac cachexia, heart failure, hepatomegaly, and severe edema in the legs. Chest radiography revealed an inconceivably huge cardiac sell-out. Transthoracic echocardiography demonstrated a huge left atrium, associated with thrombosis, and normal function of the prosthetic mitral valve. Cardiac surgery with left atrial exploration for the extraction of the huge thrombosis and De Vega annuloplasty for tricuspid regurgitation were carried out. The postoperative course was eventful due to right ventricular failure and low cardiac output syndrome; and after two days, the patient expired with multiple organ failure. Thorough literature review showed that our case was the largest left atrium (20 × 22 cm reported thus far in adults with a normal prosthetic mitral valve function.

  20. Hemodynamic effects of left atrial or left ventricular cannulation for acute circulatory support in a bovine model of left heart injury.

    Science.gov (United States)

    Kapur, Navin K; Paruchuri, Vikram; Pham, Duc Thinh; Reyelt, Lara; Murphy, Barbara; Beale, Corinna; Bogins, Courtney; Wiener, Daniel; Nilson, James; Esposito, Michele; Perkins, Scott; Perides, George; Karas, Richard H

    2015-01-01

    Our objective was to examine the hemodynamic effects of a trans-aortic axial flow catheter (Impella CP) in the left ventricle (LV) versus left atrial (LA) to femoral artery bypass using a centrifugal pump (TandemHeart: TH) in a bovine model of acute LV injury. In three male calves, we performed sequential activation of a CP then TH device in each animal. After 60 minutes of left anterior descending artery ligation, a CP was activated at maximal power. The CP was then removed and the TH activated at 5,500 then a maximum of 7,500 rotations per minute (RPM). The CP generated a maximum 3.1 ± 0.2 L/minute (LPM) of flow, whereas the TH at 5,500 and 7,500 RPM generated 3.1 ± 0.4 and 4.4 ± 0.3 LPM. At 3.1 LPM, the CP and TH reduced LV stroke work (LVSW) similarly. The TH reduced stroke volume, whereas the CP did not. The CP reduced end-systolic pressure, whereas the TH did not. At a maximum flow of 4.4 LPM, the TH provided a greater reduction in LVSW than maximal CP activation. This is the first report to compare the hemodynamic effects of trans-aortic LV unloading versus LA-to-femoral artery (FA) bypass.

  1. Frequency of left-handedness among the Andhra Pradesh people.

    Science.gov (United States)

    Dronamraju, K R

    1975-01-01

    The percentages of left-handed people among the males and females of Andhra Pradesh tribals in India were found to be 15.49 and 7.79, and in Hindus 6.9 and 4.65. The difference between the sexes among tribals is significant. The tribal people studied were Koya Doras, Sugalis (or Lambadis), and Konda Reddis. It is suggested that similar quantitative studies of left-handedness should be made in other tribal and aboriginal populations before they are culturally comditioned to right-handedness.

  2. Determination of left ventricular mass through SPECT imaging

    Science.gov (United States)

    Zárate-Morales, A.; Rodríguez-Villafuerte, M.; Martínez-Rodríguez, F.; Arévila-Ceballos, N.

    1998-08-01

    An edge detection algorithm has been applied to estimate left ventricular (LV) mass from single photon emission computed tomography (SPECT) thallium-201 images. The algorithm was validated using SPECT images of a phantom. The algorithm was applied to 20 patient studies from the Hospital de Cardiologia, Centro Médico Nacional Siglo XXI. Left ventricular masses derived from the stress and redistribution studies were highly correlated (r=0.96). The average LV masses obtained were 162±37 g and 169±34 g in the redistribution and stress studies, respectively.

  3. Warm Dark Matter in Low Scale Left-Right Theory

    OpenAIRE

    Nemevsek, Miha; Senjanovic, Goran; Zhang, Yue

    2012-01-01

    We investigate the viability of having dark matter in the minimal left-right symmetric theory. We find the lightest right-handed neutrino with a mass around keV as the only viable candidate consistent with a TeV scale of left-right symmetry. In order to account for the correct relic density with such low scales, the thermal overproduction of the dark matter in the early universe is compensated by a sufficient late entropy production due to late decay of heavier right-handed neutrinos. We poin...

  4. Matching models of left ventricle and systemic artery

    Institute of Scientific and Technical Information of China (English)

    柳兆荣; 吴驰

    1997-01-01

    To reveal how the matching models of the left ventricle and its afterload affect the pressure and flow in the aortic root, the differences between the measured pressure and flow waveforms and those determined by three kinds of matching model were compared. The results showed that, compared with the results by both matching models 1 and 2, the pressure and flow waveforms determined by matching model 3 established in this work were in the closest agreement with the corresponding experimental waveforms, therefore indicating that matching model 3 was a matching model that closely and rationally characterized the match between the left ventricle and the systemic artery.

  5. Ebstein's Anomaly, Left Ventricular Noncompaction, and Sudden Cardiac Death

    Science.gov (United States)

    McGee, Michael; Warner, Luke; Collins, Nicholas

    2015-01-01

    Ebstein's anomaly is a congenital disorder characterized by apical displacement of the septal leaflet of the tricuspid valve. Ebstein's anomaly may be seen in association with other cardiac conditions, including patent foramen ovale, atrial septal defect, and left ventricular noncompaction (LVNC). LVNC is characterized by increased trabeculation within the left ventricular apex. Echocardiography is often used to diagnose LVNC; however, magnetic resonance (MR) imaging offers superior characterization of the myocardium. We report a case of sudden cardiac death in a patient with Ebstein's anomaly with unrecognized LVNC noted on post mortem examination with screening documenting the presence of LVNC in one of the patient's twin sons. PMID:26240764

  6. Absence of left circumflex with superdominant right coronary artery

    Science.gov (United States)

    Quijada-Fumero, Alejandro; Pimienta-González, Raquel; Rodriguez-Esteban, Marcos

    2014-01-01

    Congenital anomalies of coronary arteries are a group of diseases that are infrequently found. Their prevalence has been reported from 0.6% to 1.3%. Most clinical manifestations are benign and asymptomatic. Congenital absence of the left circumflex artery is a very rare congenital anomaly of the coronary circulation, and only a few cases have been reported in the literature. We report a case of a 51-year-old man who underwent a cardiac catheterisation. Coronary angiography showed a left anterior descending coronary artery with no circumflex and a dominant right coronary artery. PMID:25535241

  7. Left hand tactile agnosia after posterior callosal lesion.

    Science.gov (United States)

    Balsamo, Maddalena; Trojano, Luigi; Giamundo, Arcangelo; Grossi, Dario

    2008-09-01

    We report a patient with a hemorrhagic lesion encroaching upon the posterior third of the corpus callosum but sparing the splenium. She showed marked difficulties in recognizing objects and shapes perceived through her left hand, while she could appreciate elementary sensorial features of items tactually presented to the same hand flawlessly. This picture, corresponding to classical descriptions of unilateral associative tactile agnosia, was associated with finger agnosia of the left hand. This very unusual case report can be interpreted as an instance of disconnection syndrome, and allows a discussion of mechanisms involved in tactile object recognition.

  8. Tunable left-handed metamaterial based on electrorheological fluids

    Institute of Scientific and Technical Information of China (English)

    Yong Huang; Xiaopeng Zhao; Liansheng Wang; Chunrong Luo

    2008-01-01

    A tunable left-handed metamaterial consisting of a periodic array of the left-handed dendritic structure units infiltrated with electro-rheological fluids is demonstrated. Experimental results show that the passband can move from the original 8.50-10.60 GHz to 7.16-8.39 GHz after electrorheological fluids are infused. When adc (direct current) electric field of 666 V/mm is applied, the passband moves toward lower frequency of within 7.08-8.30 GHz. This method provides one convenient way to design adaptive metamaterials.

  9. Left-handed materials in magnetized metallic magnetic thin films

    Institute of Scientific and Technical Information of China (English)

    WU Rui-xin; XIAO John Q.

    2006-01-01

    The authors' theoretical investigation on the high-frequency response of magnetized metallic magnetic films showed that magnetic films may become left-handed materials (LHMs) near the ferromagnetic resonance frequency of incident waves with right-handed circular polarization (RCP) and linear polarization (LP). The frequency range where LHM exists depends on the waves polarization, the magnetic damping coefficient, and the ferromagnetic characteristic frequency ωm of the film. There also exists a critical damping coefficient αc, above which the left-handed properties disappear completely.

  10. Left bundle branch block: a rare ECG manifestation of hyperkalemia

    Directory of Open Access Journals (Sweden)

    Venkata Madhav M

    2015-04-01

    Full Text Available A 20-year-old female patient with chronic kidney disease was brought to our emergency medical department with symptoms of pain in chest and abdomen, vomitings. Laboratory testing revealed serum potassium 7.7 mEq/L, serum creatinine 9.1 mg/dL. Electrocardiogram (ECG showed left bundle branch block (LBBB pattern with left axis deviation, tall T waves and ST elevation. Among ECG alterations in hyperkalemia, LBBB is rare and is being reported in our case.

  11. A successful team treatment for left main shock syndrome

    Institute of Scientific and Technical Information of China (English)

    Bin Que; Yu-Tong Cheng; Hai Gao; Xiao-Tong Hou; Ran Dong; Nan Li; Shao-Ping Nie

    2013-01-01

    Acute myocardial infarction complicated by cardiogenic shock and left main coronary artery disease is called left main shock syndrome. It is reported that the morbility and mortality of the syndrome is approximately 0.46%and 55%-80%, respectively. However, the best treat-ment strategy in these cases is unknown. In this article, we present a patient with LMSS who successively underwent emergency percutane-ous coronary intervention and coronary artery bypass grafting with hemodynamic support within 5 days. The patient is now on his three month uneventful out-patient follow-up.

  12. Left Posteroventral Pallidotomy Results in a Deficit in Verbal Memory

    Directory of Open Access Journals (Sweden)

    S. F. Crowe

    1998-01-01

    Full Text Available Whilst pallidotomy is emerging as a popular approach to the treatment to Parkinson’s disease, little is yet known about the cognitive effects of this procedure. This study presents 19 patients (6 right, 13 left who were assessed both before and after the procedure on a battery of cognitive tests. The results indicate that subjects with left-sided lesions display significant decline in verbal memory between one and three months following the procedure. The results are consistent with the notion of either a classic amnesic syndrome or a deficit in striato-frontal working memory.

  13. What's to the left of the indefinite article?

    DEFF Research Database (Denmark)

    Wood, Johanna; Vikner, Sten

    2013-01-01

    One approach to research into the syntax of nominals focuses on parallels between nominals and clauses. Within the generative tradition, the structure of the left periphery of the clause has been well documented as a position for e.g. wh-words and topic and focus (see e.g Rizzi 1997), whereas...... the left periphery of the nominal has received much less attention. One of the more challenging areas of research within the nominal is the analysis of elements that can occur before the indefinite article, e.g. "such (a book)" and "so interesting (a book)". Another recently studied phenomenon, often taken...

  14. Magnetotunable left-handed FeSiB ferromagnetic microwires.

    Science.gov (United States)

    Labrador, Alberto; Gómez-Polo, Cristina; Pérez-Landazábal, José Ignacio; Zablotskii, Vitalii; Ederra, Iñigo; Gonzalo, Ramón; Badini-Confalonieri, Giovanni; Vázquez, Manuel

    2010-07-01

    The magnetotunable left-handed characteristics of Fe(77.5)Si(12.5)B(10) glass-coated ferromagnetic microwires are analyzed in array and single microwire configuration, employing a rectangular waveguide working in X band. While the negative permeability is ascribed to the natural ferromagnetic resonance (NFMR) of the highly and positive magnetostrictive microwire, the negative permittivity features of the medium are attributed to the interaction of the microwires with the metallic rectangular waveguide. The dependence of the NFMR frequency on the applied external magnetic field enables the design of magnetotunable left-handed systems with wide-frequency band.

  15. Safety of the Las Vegas left-turn display.

    Science.gov (United States)

    Ozmen, Ozlem; Tian, Zong Z; Gibby, A Reed

    2014-01-01

    This paper provides a safety evaluation of a special protected/permitted left turn signal control (Las Vegas LT Display) that has been implemented in the urbanized area of Las Vegas, Nevada. The Las Vegas LT Display eliminates the yellow trap condition for leading approach in lead/lag operation. It provides protected only left turns during certain times of day by suppressing the permitted green ball and yellow ball displays. Before and after studies were conducted using the crash data from 10 intersections. Results from the analyses indicated that no obvious safety concerns due to use of the special display. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. An Endomyocardial Biopsy of the Left Ventricle in an Anorexia Nervosa Patient with Sinus Bradycardia and Left Ventricular Systolic Dysfunction

    Directory of Open Access Journals (Sweden)

    Satoshi Takahashi

    2016-01-01

    Full Text Available Anorexia nervosa (AN is an eating disorder characterized by an abnormally low body weight, an intense fear of gaining weight, and a distorted perception of body weight. AN is a life-threatening condition that significantly increases the risk of death due to cardiac complications, such that at least one-third of all deaths in patients with AN are associated with cardiac causes including sudden death. In many reports, sudden death has been linked to reduced left ventricular function, structural changes, and QT abnormalities. However, the mechanistic details connecting AN to cardiac abnormalities remain unknown. Here we present an endomyocardial biopsy of the left ventricle in a case of AN with a reversible left ventricular systolic dysfunction.

  17. Prognostic significance of left ventricular diastolic dysfunction in patients with left ventricular hypertrophy and systemic hypertension (the LIFE Study)

    DEFF Research Database (Denmark)

    Wachtell, Kristian; Palmieri, Vittorio; Gerdts, Eva;

    2010-01-01

    Patients with hypertension and left ventricular (LV) hypertrophy commonly have impaired diastolic filling. However, it remains unknown whether changes in LV diastolic filling variables are associated with cardiovascular morbidity and mortality. In this study, 778 patients with hypertension...... valve flow pattern, this was not associated with reduced cardiovascular morbidity and mortality when adjusting for blood pressure, left atrial diameter, LV mass index, and treatment in time-varying Cox analyses. In contrast, lower in-treatment E/A ratios and shorter mitral valve deceleration times were...... associated with less risk for heart failure. Similarly, normal in-treatment transmitral flow pattern was strongly associated with less risk for heart failure (hazard ratio 0.22, 95% confidence interval 0.05 to 0.98, p = 0.048), even when taking in-treatment left atrial diameter and blood pressure...

  18. Obstructive left heart disease in neonates with a "borderline" left ventricle: diagnostic challenges to choosing the best outcome.

    Science.gov (United States)

    Tuo, Giulia; Khambadkone, Sachin; Tann, Oliver; Kostolny, Martin; Derrick, Graham; Tsang, Victor; Sullivan, Ian; Marek, Jan

    2013-10-01

    In most newborns with left heart obstruction, the choice between a single-ventricle or biventricular management pathway is clear. However, in some neonates with a "borderline" left ventricle, this decision is difficult. Existing criteria do not reliably identify neonates who will have a good long-term outlook after biventricular repair (BVR). The objective of this study was prospective assessment of the outcome after BVR for newborns in whom the left ventricle (LV) was considered "borderline" by an expert group. This study was a prospective follow-up evaluation of neonates with obstructive left heart disease related to a "borderline" LV who underwent biventricular management between January 2005 and April 2011. Of 154 neonates who required intervention for left heart obstruction, 13 (7.8 %) met the echocardiographic (echo) inclusion criteria. At the first and last echo, the z-scores were respectively -1.76 ± 1.37 and -0.66 ± 1.47 (p = 0.013) for the mitral valve, -1.02 ± 1.57 and -0.23 ± 1.78 (p = 0.056) for the aortic valve, and 13.77 ± 5.8 and 20.85 ± 8.9 ml/m(2) (p = 0.006) for the LV end-diastolic volume. At this writing, all 12 survivors are clinically well. However, LV diastolic dysfunction and pulmonary artery hypertension was present in 5 (36 %) of 12 patients. Endocardial fibroelastosis (EFE) was detected in five patients at the last follow-up echo, but only in two patients preoperatively. Cardiac magnetic resonance imaging did not confirm EFE in any of assessed patients. The study authors could not reliably predict the outcome after BVR for neonates with left heart obstruction and a "borderline" LV. The presence of EFE with consequent diastolic dysfunction is more important than LV volume in determining the outcome. Prospective identification of EFE remains challenging.

  19. 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...... or regression of ECG LVH in 427 patients and persistence or development of new LVH in 298 patients. At baseline, although there were no significant differences in the mean values of MWS and scMWS, patients with persistence or development of ECG LVH at year 3 had significantly higher baseline prevalences...

  20. Non-invasive measurement of stroke volume and left ventricular ejection fraction. Radionuclide cardiography compared with left ventricular cardioangiography

    DEFF Research Database (Denmark)

    Kelbaek, H; Svendsen, Jesper Hastrup; Aldershvile, J;

    2011-01-01

    The stroke volume (SV) was determined by first passage radionuclide cardiography and the left ventricular ejection fraction (LVEF) by multigated radionuclide cardiography in 20 patients with ischemic heart disease. The results were evaluated against those obtained by the invasive dye dilution...... or thermodilution and left ventricular cardioangiographic techniques. In a paired comparison the mean difference between the invasive and radionuclide SV was -1 ml (SED 3.1) with a correlation coefficient of 0.83 (p less than 0.01). Radionuclide LVEF values also correlated well with cardioangiographic measurements...

  1. Laparoscopic repair of diaphragmatic hernia after left ventricular assist device.

    Science.gov (United States)

    Farma, Jeffrey; Leeser, David; Furukawa, Satoshi; Dempsey, Daniel T

    2003-06-01

    This case report describes a patient with a symptomatic diaphragmatic hernia that developed after orthotopic heart transplantation and explantation of a left ventricular assist device. The hernia was repaired laparoscopically, and at 6-month follow-up, she is without evidence of recurrence.

  2. Occlusion of left atrial appendage in patients with atrial fibrillation

    Directory of Open Access Journals (Sweden)

    О. Н. Ганеева

    2015-10-01

    Full Text Available The article reviews a new method of prophylaxis of thromboembolitic complications, specifically occlusion of left atrial appendage, in patients with atrial fibrillation. Indications and contraindications for the procedure, as well as a step-by-step process of the intervention itself are described. Special emphasis is placed on the up-to-date evidence and the review of clinical trials.

  3. Quantitative assessment of regional left ventricular motion using endocardial landmarks

    NARCIS (Netherlands)

    C.J. Slager (Cornelis); T.E.H. Hooghoudt (Ton); P.W.J.C. Serruys (Patrick); J.C.H. Schuurbiers (Johan); J.H.C. Reiber (Johan); G.T. Meester (Geert); P.D. Verdouw (Pieter); P.G. Hugenholtz (Paul)

    1986-01-01

    textabstractIn this study the hypothesis is tested that the motion pattern of small anatomic landmarks, recognizable at the left ventricular endocardial border in the contrast angiocardiogram, reflects the motion of the endocardial wall. To verify this, minute metal markers were inserted in the endo

  4. An ectopic hamartomatous thymoma compressing left jugular vein

    African Journals Online (AJOL)

    2014-05-07

    May 7, 2014 ... neck (frequently on the left) and does not usually impact adjacent ... manifests distinct pathological features, the lesion is either ... After the diagnosis and treatment of this patient, we believe that EHT or ... Department of Thoracic Surgery, School of Medicine, .... without postoperative pathology and IHC.

  5. Gold Olive Branch Left on the Moon by Neil Armstrong

    Science.gov (United States)

    1971-01-01

    This is the gold replica of an olive branch, the traditional symbol of peace, left on the Moon's surface by Apollo 11 crewmembers. Astronaut Neil A. Armstrong, commander, placed the small replica (less than half a foot in length) on the Moon. The gesture represented a wish for peace for all mankind.

  6. Transesophageal echocardiography assessment of severe ostial left main coronary stenosis

    Science.gov (United States)

    Firstenberg, M. S.; Greenberg, N. L.; Lin, S. S.; Garcia, M. J.; Alexander, L. A.; Thomas, J. D.

    2000-01-01

    Doppler echocardiography is commonly used in the assessment of stenotic valvular orifices. We describe the application of transesophageal echocardiography for the detection of a critical ostial left main coronary stenosis. Because preoperative coronary angiography often is not routinely performed in young patients undergoing valve surgery, application of Doppler echocardiography can potentially prevent catastrophic complications, particularly in atypical cases.

  7. Left ventricular cardiac myxoma and sudden death in a dog

    NARCIS (Netherlands)

    de Nijs, M.I.|info:eu-repo/dai/nl/412015625; Vink, Aryan; Bergmann, W.|info:eu-repo/dai/nl/36275585X; Szatmári, V.|info:eu-repo/dai/nl/272734497

    2016-01-01

    Background: Myxoma is a very rare benign cardiac tumor in dogs. This is the first description of a cardiac myxoma originating from the left ventricular outflow tract, presumably causing sudden death. Case presentation: A previously healthy 12-year-old male West Highland white terrier was found dead

  8. Left ventricular cardiac myxoma and sudden death in a dog

    NARCIS (Netherlands)

    de Nijs, Maria Irene; Vink, Aryan; Bergmann, Wilhelmina; Szatmári, Viktor

    2016-01-01

    BACKGROUND: Myxoma is a very rare benign cardiac tumor in dogs. This is the first description of a cardiac myxoma originating from the left ventricular outflow tract, presumably causing sudden death. CASE PRESENTATION: A previously healthy 12-year-old male West Highland white terrier was found dead

  9. Thinking left and right : neurocognitive studies on spatial relation processing

    NARCIS (Netherlands)

    Van der Ham, C.J.M.

    2010-01-01

    In many of our interactions with our environment, we make use of spatial relations. These spatial relations can be either categorical or coordinate. Categorical spatial relations concern abstract relations like “left of” and “above”, whereas coordinate spatial relations are metric in nature and conc

  10. [A case of alexia with agraphia following left occipital lobe].

    Science.gov (United States)

    Sato, M; Yamamoto, Y; Shimazaki, S; Watanabe, K

    1987-03-01

    Since Dejerine reported cases of alexia with agraphia in 1891 and of pure alexia in 1892, it is generally said that the former may occur due to the lesion of the left angular gyrus and the latter due to that of the medial inferior area of the left occipital lobe. In this article, we reported a case of alexia with agraphia who had the main lesion in the medial inferior area of the occipital lobe of the left hemisphere. A 62-year-old right-handed male showed alexia with agraphia. CT scan and single photon emission CT revealed the main lesion in the medial occipital area on the left side. Alexia with agraphia of the patient was characterized as follows: with regard to reading, though his recognition of forms as letter was nearly spared, he could neither read letters or words nor differentiate Kana- from Kanji-letters. Paralexic errors included confusion of Kana and Kanji. He manifested no kinesthetic facilitation in reading. Regarding writing, his disturbances were more severe in Kanji-writing, but there were paragraphia and difficulty of letter-form evocation even in Kana-writing. He could not write spontaneously or to dictation. His copying of letters was also disturbed. Since it is said that there is no difference between Kana- and Kanji-disturbance in Japanese pure alexics, an aspect of alexia of the patient may be common to pure alexia.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. The Crisis of the Left in Contemporary South Africa

    Directory of Open Access Journals (Sweden)

    Dale T. McKinley

    2008-01-01

    Full Text Available The left in South Africa, fourteen years into the post-apartheid era, needs to face harsh realities: despite a long and often courageous left history, there does not exist an anti-capitalist and socialist vision that has the potential to challenge fundamentally, and to change, South African capitalism and to unite left forces. The practical result is a strategic crisis in which an unnecessary dichotomy has been erected between anti-capitalist mass struggle and action, and the need for a socialist organizational form to give politically strategic expression to such struggles. Dale McKinley argues that it is the left’s responsibility to work towards a political alternative that emanates from, and is grounded in, the ongoing and linked struggles of the mass of organized workers and poor against the impact and consequences of neoliberalism. Not to undertake this task is to condemn class struggle and left politics in South Africa to the realm of cyclical mitigation and crisis.

  12. Left atrial appendage occlusion with the AMPLATZER Amulet device

    DEFF Research Database (Denmark)

    Tzikas, Apostolos; Gafoor, Sameer; Meerkin, David

    2016-01-01

    anatomies like "chicken wing" left atrial appendage. Finally, for operators who are switching from AMPLATZER Cardiac Plug to Amulet, the main differences between the two devices with respect to implantation technique are presented. CONCLUSIONS: In conclusion, this document reflects a consensus approach...

  13. Hypertrophic cardiomyopathy with apical left ventricular aneurysm: a case report

    Institute of Scientific and Technical Information of China (English)

    江腾勇; 韩智红; 王京; 吕强; 吴学思

    2002-01-01

    @@ Morphological diversity is one characteristic of hypertrophic cardi omyopathy (HCM), but it is not common that HCM is associated with apical left ve ntricular aneurysm (LVA) without evidence of a coronary artery lesion. We repor t on such a case and review the pathogenesis, manifestations and diagnostic meth ods by collecting the few available papers published on this topic.

  14. No Child Left Behind as an Anti-Poverty Measure

    Science.gov (United States)

    Anyon, Jean; Greene, Kiersten

    2007-01-01

    This article argues that, although No Child Left Behind (NCLB) is not presented as a jobs policy, the Act does function as a substitute for the creation of decently paying jobs for those who need them. Aimed particularly at the minority poor like its 1965 predecessor, the Elementary and Secondary Education Act, NCLB acts as an anti-poverty program…

  15. Echocardiographic evaluation of left ventricular function in ischemic heart disease

    NARCIS (Netherlands)

    Mollema, Sjoerd Adriaan

    2010-01-01

    The presence of a decreased left ventricular (LV) function after myocardial infarction has demonstrated to be of considerable clinical importance. In this thesis, the role of 2D echocardiography to evaluate LV function in ischemic heart disease was investigated. In the first part of the thesis, rece

  16. intraoperative colonic irrigation in the management of left sided ...

    African Journals Online (AJOL)

    hi-tech

    2000-11-01

    Nov 1, 2000 ... Surgery, Jos University Teaching Hospital, P.M.B. 2076, Jos, Plateau State, Nigeria. ... Conclusion: The results of this study suggest that intraoperative colonic lavage is an effective ..... Hawley P. J., Hunt K. H. and Dunply J. E. Aetiology of colonic ... Thow G. Emergency left colon resection with primary.

  17. Apraxia and spatial inattention dissociate in left hemisphere stroke.

    Science.gov (United States)

    Timpert, David C; Weiss, Peter H; Vossel, Simone; Dovern, Anna; Fink, Gereon R

    2015-10-01

    Theories of lateralized cognitive functions propose a dominance of the left hemisphere for motor control and of the right hemisphere for spatial attention. Accordingly, spatial attention deficits (e.g., neglect) are more frequently observed after right-hemispheric stroke, whereas apraxia is a common consequence of left-hemispheric stroke. Clinical reports of spatial attentional deficits after left hemisphere (LH) stroke also exist, but are often neglected. By applying parallel analysis (PA) and voxel-based lesion-symptom mapping (VLSM) to data from a comprehensive neuropsychological assessment of 74 LH stroke patients, we here systematically investigate the relationship between spatial inattention and apraxia and their neural bases. PA revealed that apraxic (and language comprehension) deficits loaded on one common component, while deficits in attention tests were explained by another independent component. Statistical lesion analyses with the individual component scores showed that apraxic (and language comprehension) deficits were significantly associated with lesions of the left superior longitudinal fascicle (SLF). Data suggest that in LH stroke spatial attention deficits dissociate from apraxic (and language comprehension) deficits. These findings contribute to models of lateralised cognitive functions in the human brain. Moreover, our findings strongly suggest that LH stroke patients should be assessed systematically for spatial attention deficits so that these can be included in their rehabilitation regime.

  18. Roseomonas infection associated with a left ventricular assist device.

    Science.gov (United States)

    Singal, Amit; Malani, Preeti N; Day, Larry J; Pagani, Francis D; Clark, Nina M

    2003-12-01

    Roseomonas species have been increasingly noted as causes of human infection. We present what we believe is the first case of left ventricular assist device (LVAD) infection secondary to Roseomonas. The clinical characteristics of Roseomonas infection and the pertinent features of LVAD infection are reviewed.

  19. Eccentric pericardial effusion after radiation therapy of left breast carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Green, B.; Zornoza, J.; Ricks, J.P.

    1977-01-01

    Pericardial damage is one of the consequences of cardiac radiation and may lead to chronic pericarditis and/or tamponade. In three patients treated with radiation for carcinoma of the left breast, the effusions were loculated on the right side of the pericardium resulting in a peculiar cardiac silhouette. The importance of recognizing this entity and possible treatment is stressed.

  20. POINTWISE SIMULTANEOUS APPROXIMATION BY LEFT GAMMA QUASI-INTERPOLANTS

    Institute of Scientific and Technical Information of China (English)

    Hongbiao Jiang

    2008-01-01

    Recently some classical operator quasi-interpolants were introduced to obtain much faster convergence.We consider left Gamma quasi-interpolants and give a pointwise simultaneous approximation equivalence theorem with ω2r(4)λ(f,f)∞ by means of unified the classical modulus and Ditzian-Totick modulus.