WorldWideScience

Sample records for left main lm

  1. Left main percutaneous coronary intervention.

    Science.gov (United States)

    Teirstein, Paul S; Price, Matthew J

    2012-10-23

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

  2. Left Main Coronary Artery Aneurysm

    Directory of Open Access Journals (Sweden)

    Hossein Doustkami

    2016-07-01

    Full Text Available Aneurysms of the left main coronary artery are exceedingly rare clinical entities, encountered incidentally in approximately 0.1% of patients who undergo routine angiography. The most common cause of coronary artery aneurysms is atherosclerosis. Angiography is the gold standard for diagnosis and treatment. Depending on the severity of the coexisting coronary stenosis, patients with left main coronary artery aneurysms can be effectively managed either surgically or pharmacologically. We herein report a case of left main coronary artery aneurysm in a 72-year-old man with a prior history of hypertension presenting to our hospital because of unstable angina. The electrocardiogram showed ST-segment depression and T-wave inversion in the precordial leads. All the data of blood chemistry were normal. Echocardiography showed akinetic anterior wall, septum, and apex, mild mitral regurgitation and ejection fraction of 45%. Coronary angiography revealed a saccular aneurysm of the left main coronary artery with significant stenosis in the left anterior descending, left circumflex, and right coronary artery. The patient immediately underwent coronary artery bypass grafting and ligation of the aneurysm. At six months’ follow-up, he remained asymptomatic.

  3. Reduced duration of dual antiplatelet therapy using an improved drug-eluting stent for percutaneous coronary intervention of the left main artery in a real-world, all-comer population: Rationale and study design of the prospective randomized multicenter IDEAL-LM trial.

    Science.gov (United States)

    Lemmert, Miguel E; Oldroyd, Keith; Barragan, Paul; Lesiak, Maciej; Byrne, Robert A; Merkulov, Evgeny; Daemen, Joost; Onuma, Yoshinobu; Witberg, Karen; van Geuns, Robert-Jan

    2017-05-01

    Continuous improvements in stent technology make percutaneous coronary intervention (PCI) a potential alternative to surgery in selected patients with unprotected left main coronary artery (uLMCA) disease. The optimal duration of dual antiplatelet therapy (DAPT) in these patients remains undetermined, and in addition, new stent designs using a bioabsorbable polymer might allow shorter duration of DAPT. IDEAL-LM is a prospective, randomized, multicenter study that will enroll 818 patients undergoing uLMCA PCI. Patients will be randomized in a 1:1 fashion to intravascular ultrasound-guided PCI with the novel everolimus-eluting platinum-chromium Synergy stent with a biodegradable polymer (Boston Scientific, Natick, MA) followed by 4 months of DAPT or the everolimus-eluting cobalt-chromium Xience stent (Abbott Vascular, Santa Clara, CA) followed by 12 months of DAPT. The total follow-up period will be 5 years. A subset of 100 patients will undergo optical coherence tomography at 3 months. The primary end point will be major adverse cardiovascular events (composite of all-cause mortality, myocardial infarction, and ischemia-driven target vessel revascularization) at 2 years. Secondary end points will consist of the individual components of the primary end point, procedural success, a device-oriented composite end point, stent thrombosis as per Academic Research Consortium criteria, and bleeding as per Bleeding Academic Research Consortium criteria. IDEAL-LM is designed to assess the safety and efficacy of the novel Synergy stent followed by 4 months of DAPT vs the Xience stent followed by 12 months of DAPT in patients undergoing uLMCA PCI. The study will provide novel insights regarding optimal treatment strategy for patients undergoing PCI of uLMCA disease (www.clinicaltrials.gov, NCT 02303717). Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  4. Reduced duration of dual antiplatelet therapy using an improved drug-eluting stent for percutaneous coronary intervention of the left main artery in a real-world, all-comer population: Rationale and study design of the prospective randomized multicenter IDEAL-LM trial

    NARCIS (Netherlands)

    Lemmert, M.E.; Oldroyd, K.; Barragan, P.; Lesiak, M.; Byrne, R.A.; Merkulov, E.; Daemen, J.; Onuma, Y.; Witberg, K.; Geuns, R.J.M. van

    2017-01-01

    BACKGROUND: Continuous improvements in stent technology make percutaneous coronary intervention (PCI) a potential alternative to surgery in selected patients with unprotected left main coronary artery (uLMCA) disease. The optimal duration of dual antiplatelet therapy (DAPT) in these patients remains

  5. Coronary Anomalies: Left Main Coronary Artery Aneurysm

    OpenAIRE

    Varda, Rajsekhar; Chitimilla, Santosh Kumar; Lalani, Aslam

    2012-01-01

    Coronary artery aneurysm is one of the rarest anomalies that we see in our medical practice and they are mostly associated with obstructive lesions due to atherosclerotic changes. Management of these aneurysm patients (conservative or surgical repair) usually depends on obstructive lesions and associated symptoms. We are presenting a case of left main aneurysm measuring around 1 4 × 2 8  mm with other obstructive leisons. It was treated with surgical repair in view of obstructive lesions and ...

  6. Coronary Anomalies: Left Main Coronary Artery Aneurysm

    Directory of Open Access Journals (Sweden)

    Rajsekhar Varda

    2012-01-01

    Full Text Available Coronary artery aneurysm is one of the rarest anomalies that we see in our medical practice and they are mostly associated with obstructive lesions due to atherosclerotic changes. Management of these aneurysm patients (conservative or surgical repair usually depends on obstructive lesions and associated symptoms. We are presenting a case of left main aneurysm measuring around 14×28 mm with other obstructive leisons. It was treated with surgical repair in view of obstructive lesions and symptoms.

  7. Angiographically borderline left main coronary artery lesions: correlation of transthoracic doppler echocardiography and intravascular ultrasound: a pilot study

    Directory of Open Access Journals (Sweden)

    Varga Albert

    2011-06-01

    Full Text Available Abstract Background the clinical decision making could be difficult in patients with borderline lesions (visually assessed stenosis severity of 30 to 50% of the left main coronary artery (LM. The aim of the study was to evaluate the relationship between transthoracic Doppler (TTDE peak diastolic flow velocity (PDV and intravascular ultrasound (IVUS measurements in the assessment of angiographically borderline LM lesions. Methods 27 patients (mean age 64 ± 8 years, 21 males with borderline LM stenosis referred for IVUS examination were included in the study. We performed standard IVUS with minimal lumen area (MLA and plaque burden (PB measurement and routine quantitative coronary angiography (QCA with diameter stenosis (%DS and area stenosis (%AS assessment in all. During TTDE, resting PDV was measured in the LM. Results interpretable Doppler signal could be obtained in 24 patients (88% feasibility; therefore these patients entered the final analysis. MLA was 7.1 ± 2.7 mm2. TTDE measured PDV correlated significantly with IVUS-derived MLA (r = -0.46, p 2 LM stenosis. Conclusion In angiographically borderline LM disease, resting PDV from transthoracic echocardiography is increased in presence of increased plaque burden by IVUS. TTDE evaluation might be a useful adjunct to other invasive and non-invasive methods in the assessment of borderline LM lesions. Further, large scale studies are needed to establish the exact cut-off value of PDV for routine clinical application.

  8. Exercise thallium-201 myocardial scintigraphy in left main coronary artery disease

    International Nuclear Information System (INIS)

    Kihara, Koichi; Nishimura, Tsunehiko; Uehara, Toshiisa; Hayashida, Kohei; Sumiyoshi, Tetsuya; Saito, Muneyasu

    1987-01-01

    To detect left main (LM) coronary artery disease (CAD), exercise thallium-201 myocardial scintigraphy was analyzed in 24 patients (LM stenosis > 50 %) without myocardial infarction and 10 normal controls. A high risk myocardial scintigraphy was defined as follows; (1) a LMCAD scintigraphic pattern reported by Dash, (2) nonuniform diffuse slow washout, (3) increased lung thallium uptake on the initial anterior image. Twenty-three (96 %) patients had an abnormal scintigraphic findings. The LMCAD scintigraphic pattern was found in seven (29 %) patients, all of whom had LM stenosis more than 90 %. Remaining 17 patients with LM stenosis less than 90 % didn't show this pattern. In the 10 LMCAD patients without right coronary artery (RCA) lesion, four (40 %) patients showed this pattern. But in the 14 LMCAD patients with RCA lesion, three (21 %) patients showed this pattern. In this study, a high risk exercise electrocardiography was also defined as follows; (1) > 2 mm ST depression, (2) appearance of ST depression at 50 watt or less exercise load, (3) 10 mmHg or more decrease in systolic blood pressure during exercise. Detection of high risk CAD with exercise electrocardiography, exercise thallium scintigraphy and either were 46, 67, 83 %, respectively. (author)

  9. 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.

  10. Diagnostic performance of computed tomography coronary angiography to detect and exclude left main and/or three-vessel coronary artery disease

    DEFF Research Database (Denmark)

    Dharampal, Anoeshka S; Papadopoulou, Stella L; Rossi, Alexia

    2013-01-01

    To determine the diagnostic performance of CT coronary angiography (CTCA) in detecting and excluding left main (LM) and/or three-vessel CAD ("high-risk" CAD) in symptomatic patients and to compare its discriminatory value with the Duke risk score and calcium score.......To determine the diagnostic performance of CT coronary angiography (CTCA) in detecting and excluding left main (LM) and/or three-vessel CAD ("high-risk" CAD) in symptomatic patients and to compare its discriminatory value with the Duke risk score and calcium score....

  11. The left main facts: faced, spun, but alas too few.

    Science.gov (United States)

    Brinker, Jeff

    2008-03-04

    Bypass surgery has been shown to prolong life in patients with significant left main stenosis compared with medical therapy and is the current standard of care. Recent registry data suggest that stenting may offer intermediate-term results similar to surgery, although with a greater need for repeat revascularization. Drug-eluting stents appear to improve the outcomes of stenting. Over 20% of patients with left main disease currently receive stents, and there is need for ongoing randomized controlled trials to validate this approach. It is essential that such patients receive balanced counseling as to revascularization options.

  12. Important parameters in the detection of left main trunk disease using stress myocardial perfusion imaging

    International Nuclear Information System (INIS)

    Shiba, Chie; Chikamori, Taishiro; Hida, Satoshi

    2009-01-01

    We sought noninvasively to diagnose left main trunk (LMT) disease using myocardial perfusion imaging (MPI). Five hundred and eight patients with suspected coronary artery disease (CAD) underwent both stress MPI and coronary angiography. The extent and severity of perfusion abnormalities were assessed using a 20-segment model. In addition, perfusion defects in both left anterior descending and left circumflex arterial territories were defined as a left main (LM) pattern defect, and those in 3-coronary arterial territories as a 3-vessel pattern defect. In 42 patients with LMT disease, a summed stress score (19.4±10.0 vs. 13.5±10.0; p<0.0001) and a summed rest score (12.1±9.7 vs. 7.0±7.8; p=0.002) were greater than in 466 patients without LMT disease, while a summed difference score was similar (7.3±7.7 vs. 6.5±6.1; p=NS). The prevalence of an LM-pattern defect was low in both groups (12% vs. 8%; p=NS). However, a 3-vessel pattern defect (33% vs. 7%; p<0.0001), lung uptake of radiotracers (38% vs. 11%; p<0.0001), and transient ischemic dilation (31% vs. 13%; p=0.003) were more frequently observed in patients with LMT disease than in those without. Logistic regression analysis showed that a 3-vessel pattern defect (odds ratio (OR)=3.5, 95% confidence interval (CI)=1.4-8.8; p=0.007), lung uptake of radiotracers (OR=2.5, 95% CI=1.1-5.7; p=0.03), and previous myocardial infarction (MI) (OR=2.4, 95% CI=1.0-5.7; p=0.05) were the most important parameters to detect LMT disease. After excluding 163 patients with previous MI, a repeat analysis revealed that lung uptake of radiotracers (OR=8.2, 95% CI=2.3-29.2; p=0.001) and an LM-pattern defect (OR=6.3, 95% CI=1.4-27.2; p<0.02) were independent predictors for LMT disease. In the identification of LMT disease, lung uptake of radiotracers was a single best parameter, which was independent of the presence or absence of previous MI. (author)

  13. Clinical outcomes after PCI for acute coronary syndrome in unprotected left main coronary artery disease: insights from the Swiss Acute Left Main Coronary Vessel Percutaneous Management (SALVage) study.

    Science.gov (United States)

    Puricel, Serban; Adorjan, Patrick; Oberhänsli, Markus; Stauffer, Jean-Christophe; Moschovitis, Aris; Vogel, Rolf; Goy, Jean-Jacques; Müller, Olivier; Eeckhout, Eric; Togni, Mario; Wenaweser, Peter; Meier, Bernhard; Windecker, Stephan; Cook, Stéphane

    2011-10-30

    Unprotected left main (ULM) coronary artery disease is encountered in 3%-10% of coronary angiograms and is associated with high mortality. The survival of patients with ULM disease presenting with acute coronary syndromes (ACS) depends on different variables and is lowest in those with cardiogenic shock (CS). The aim of the present study was to estimate the impact of baseline characteristics on the subsequent clinical outcome in patients treated by percutaneous coronary intervention (PCI) of ULM for ACS. One hundred and thirty-four patients were retrieved from our database and followed by phone or physician visit. Patients were classified into two groups according to their presentation (CS/STEMI group: patients presenting with CS or ST-elevation myocardial infarction; NSTEMI/UA group: patients with non-STEMI or unstable angina). Data collected were baseline characteristics, procedural information, and clinical outcome. The primary endpoint was all-cause mortality at 6-month follow-up. The secondary end point was a composite of cardiac death, myocardial infarction, and any repeat revascularisation, i.e., major adverse cardiac events (MACE). Kaplan-Meier curves were computed for survival. Logistic regression determined that hypercholesterolaemia (OR 6.22, p=0.03), high pre-procedural TIMI score (OR 3.89, p=0.01), preserved left ventricular ejection fraction (OR 1.07, p=0.01) and LM as culprit lesion (OR 8.57, p=0.01) protected against development of CS. Primary outcome occurred in 44% of patients in the CS/STEMI group compared to 6% in the NSTEMI/UA group (p<0.001). MACE were observed in 30 patients (48%) of the CS/STEMI group and in 12 patients (19%) of the NSTEMI/UA group (p=0.001). Acute coronary syndrome due to critical ULM stenosis is associated with high mortality even after successful PCI. Patients presenting with CS or STEMI are at particular risk.

  14. Recurrent Syncope Attributed to Left Main Coronary Artery Severe Stenosis

    Directory of Open Access Journals (Sweden)

    Min Li

    2015-01-01

    Full Text Available Patients with acute coronary syndrome (ACS rarely manifest as recurrent syncope due to malignant ventricular arrhythmia. We report a case of a 56-year-old Chinese male with complaints of paroxysmal chest burning sensation and distress for 2 weeks as well as loss of consciousness for 3 days. The electrocardiogram (ECG revealed paroxysmal multimorphologic ventricular tachycardia during attack and normal heart rhythm during intervals. Coronary angiograph showed 90% stenosis in left main coronary artery and 80% stenosis in anterior descending artery. Two stents sized 4.0*18 mm and 2.75*18 mm were placed at left main coronary artery and anterior descending artery, respectively, during percutaneous coronary intervention (PCI. The patient was discharged and never had ventricular arrhythmia again during a 3-month follow-up since the PCI. This indicated that ventricular tachycardia was correlated with persistent severe myocardial ischemia. Coronary vasospasm was highly suspected to be the reason of the sudden attack and acute exacerbation. PCI is recommended in patients with both severe coronary artery stenosis and ventricular arrhythmia. Removing myocardial ischemia may stop or relieve ventricular arrhythmia and prevent cardiac arrest.

  15. Unruptured aneurysm of the left sinus of Valsalva compressing the left main coronary artery: successful percutaneous treatment.

    Science.gov (United States)

    Hausinger, P; Sasi, V; Volford, G; Bitay, M; Bogáts, G; Thury, A; Palkó, A; Forster, T; Nemes, A

    2014-09-01

    Aneurysm of the left sinus of Valsalva is an extremely rare entity. It may be asymptomatic and incidentally discovered, or may be symptomatic and manifest acutely with compression of adjacent cardiac structures. Encasement of the left main coronary artery by such an aneurysm is a recognized but infrequent complication that can lead to severe coronary insufficiency. Surgical decompression of the left main coronary artery is the standard treatment for such conditions. We describe a patient presenting with extrinsic compression of the left main coronary artery by a large unruptured aneurysm of the left sinus of Valsalva occurring 4 months after unsuccessful surgical repair. Since reoperation was considered high-risk for the patient, successful fractional flow reserve- and intravascular ultrasound-guided percutaneous treatment of the left main coronary artery was performed with implantation of one bare-metal stent.

  16. Exercise thallium-201 myocardial imaging in left main coronary artery disease: sensitive but not specific

    International Nuclear Information System (INIS)

    Rehn, T.; Griffith, L.S.; Achuff, S.C.; Bailey, I.K.; Bulkley, B.H.; Burow, R.; Pitt, B.; Becker, L.C.

    1981-01-01

    To determine the usefulness of thallium-201 scintigraphy for identifying left main coronary artery disease, the results of scintigraphy at rest and during exercise were compared in 24 patients with 50 percent or greater narrowing of the left main coronary artery and 80 patients with 50 percent or greater narrowing of one or more of the major coronary arteries but without left main coronary involvement. By segmental analysis of the scintigrams, perfusion defects were assigned to the left anterior descending, left circumflex or right coronary artery, singly or in combination, and the pattern of simultaneous left anterior descending and circumflex arterial defects was used to identify left main coronary artery disease. Of the 24 patients with left main coronary artery disease, 22 (92 percent) had abnormal exercise scintigrams. Despite this high sensitivity, the pattern of perfusion defects was not specific; the ''left main pattern'' was found in 3 patients (13 percent) with left main coronary artery disease but also in 3 (33 percent) of 9 patients with combined left anterior descending and left circumflex arterial disease, 4 (19 percent) of 21 patients with three vessel disease and 3 (6 percent) of 50 patients with one or two vessel disease but excluding the group with left anterior descending plus left circumflex arterial disease. The pattern of perfusion defects in the patients with left main coronary artery disease was determined by the location and severity of narrowings in the coronary arteries downstream from the left main arterial lesion. Concomitant lesions in other arteries were found in all patients with left main coronary disease (one vessel in 1 patient, two vessels in 7 patients and three vessels in 16). For this reason, it is unlikely that even with improvements in radiopharmaceutical agents and imaging techniques, myocardial perfusion scintigraphy will be sufficiently specific for definitive identification of left main coronary artery disease

  17. Outcome in high risk patients with unprotected left main coronary artery stenosis treated with percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Kaltoft, Anne; Thayssen, Per

    2010-01-01

    ) non-STEMI (NSTEMI) or unstable angina, and (3) stable angina. All patients were followed up for 18 months. RESULTS: A total of 344 patients were treated with LM PCI (STEMI: 71, NSTEMI/unstable angina: 157, and stable angina: 116). In STEMI patients, the median logistic EuroSCORE was 22.......5 (interquartile range 12.5-39.5), in non-STEMI (NSTEMI)/unstable angina patients 13.8 (4.8-23.9), and in stable angina patients 4.8 (2.2-10.4). Mortality after 18 months 38.0, 18.5, and 11.2% (P unstable angina, and stable angina, respectively. MI after 18 months was 9.9, 6...... with NSTEMI and stable angina pectoris is comparable with other high surgical risk patients with unprotected left main lesion. Further, TLR rates and risk of stent thrombosis were low....

  18. Simultaneous kissing stents for the treatment of left main stenosis in cardiogenic shock

    International Nuclear Information System (INIS)

    Rahman, N.; Dhakam, S.; Nadeem, N.

    2007-01-01

    Significant narrowing of the left main coronary artery puts the patient at high risk, since occlusion of this vessel, if unprotected by collateral flow or a patent bypass graft to either the left anterior descending or circumflex artery, compromises flow to approximately 75% of the left ventricle. Percutaneous coronary intervention of left main coronary artery may be the only life saving procedure. There are limited data on the general use of percutaneous intervention (PCI) in patients with acute myocardial infarction (MI) due to left main disease. Small series have noted in-hospital mortality rates of 30 to 35 percent following PCI with or without stenting. Moreover, cardiogenic shock secondary to acute MI, in patients with left main coronary artery disease, carries a very high mortality. Treatment options are limited especially when emergent coronary artery bypass surgery is not an option. We report a case of emergency angioplasty of left main coronary artery with simultaneous kissing stent technique in cardiogenic shock. (author)

  19. Percutaneous Coronary Intervention of Left Main Disease: Pre- and Post-EXCEL (Evaluation of XIENCE Everolimus Eluting Stent Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization) and NOBLE (Nordic-Baltic-British Left Main Revascularization Study) Era.

    Science.gov (United States)

    Park, Duk-Woo; Park, Seung-Jung

    2017-06-01

    For nearly half a century, coronary artery bypass grafting has been the standard treatment for patients with obstructive left main coronary artery (LMCA) disease. However, there has been considerable evolution in the field of percutaneous coronary intervention, and especially, percutaneous coronary intervention for LMCA disease has been rapidly expanded with adoption of drug-eluting stents. Some, but not all randomized trials, have shown that percutaneous coronary intervention with drug-eluting stents might be a suitable alternative for selected patients with LMCA disease instead of bypass surgery. However, none of previous trials involving early-generation drug-eluting stents was sufficiently powered and comparative trials using contemporary drug-eluting stents were limited. Recently, primary results of 2 new trials of EXCEL (Evaluation of XIENCE Everolimus Eluting Stent Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization) and NOBLE (Nordic-Baltic-British Left Main Revascularization Study) were reported. However, these trials showed conflicting results, which might pose uncertainty on the optimal revascularization strategy for LMCA disease. In this article, with the incorporation of a key review on evolution of LMCA treatment, we summarize the similarity or disparity of the EXCEL and NOBLE trials, focus on how they relate to previous trials in the field, and finally speculate on how the treatment strategy may be changed or recommended for LMCA treatment. © 2017 American Heart Association, Inc.

  20. Percutaneous Coronary Intervention versus Coronary Artery Bypass Grafting in Patients with Diabetic Nephropathy and Left Main Coronary Artery Disease.

    Science.gov (United States)

    Li, Hsin-Ru; Hsu, Chiao-Po; Sung, Shih-Hsien; Shih, Chun-Che; Lin, Shing-Jong; Chan, Wan-Leong; Wu, Cheng-Hsueh; Lu, Tse-Min

    2017-03-01

    Patients with diabetic nephropathy and unprotected left main (LM) coronary artery disease suffer from high cardiovascular morbidity and mortality. Although surgical revascularization is currently recommended in this special patient population, the optimal revascularization method for this distinct patient group has remained unclear. We collected 99 consecutive patients with unprotected LM disease and diabetic nephropathy, including 46 patients who had undergone percutaneous coronary intervention (PCI), and 53 who had coronary artery bypass grafting (CABG), with a mean age of 72 ± 10; with 80.8% male. Diabetic nephropathy was defined as overt proteinuria (proteinuria > 500 mg/day) and estimated glomerular filtration rate (eGFR) by the modified Modification of Diet in Renal Disease (MDRD) equation of less than 60 mL/min/1.73 m 2 . The baseline characteristics, angiographic results and long-term clinical outcomes were retrospectively analyzed. The baseline characteristic of all patients were similar except for smokers, low density lipoprotein (LDL) level and extension of coronary artery disease involvement. The median follow-up period was 3.8 years. There were 73 patients (74%) considered as high risk with additive European System for Cardiac Operative Risk Evaluation (EuroSCORE) ≥ 6. During follow-up period, the long term rate of all-cause death (PCI vs. CABG: 45.7% vs. 58.5%, p = 0.20) and all-cause death/myocardial infarction (MI)/stroke (PCI vs. CABG: 52.2% vs. 60.4%, p = 0.41) were comparable between the PCI and CABG group, whereas the repeat revascularization rate was significantly higher in the PCI group (PCI vs. CABG: 32.6% vs. 9.4%, p patients with unprotected LM disease and diabetic nephropathy, we found that PCI was a comparable alternative to CABG in terms of long-term risks of all-cause death/MI/stroke, with significantly higher repeat revascularization rate. Given the small patient number and retrospective nature, our findings should be validated by

  1. Stenting of Anomalous Left Main Coronary Artery Stenosis in an Adult with a Retroaortic Course

    Directory of Open Access Journals (Sweden)

    Lanjewar Charan

    2011-01-01

    Full Text Available Coronary bypass graft has been the conventional treatment of choice in anomalous left man coronary artery stenosis. We are reporting an interesting case with anomalous left main coronary artery originating from right aortic sinus having retroaortic course complicated by significant atherosclerotic narrowing of the vessel and its percutaneous management.

  2. Thirty Years Later: Evolution of Treatment for Acute Left Main Coronary Artery Occlusion

    Directory of Open Access Journals (Sweden)

    Moshe Y. Flugelman

    2016-01-01

    Full Text Available Acute occlusion of left main coronary artery is a catastrophic event. We describe two patients with acute occlusion of the left main coronary artery treated thirty years apart. The first patient was treated in 1982 and survived the event without revascularization but developed severe heart failure. His survival was so unusual that it merited a case report at that time. The second patient was treated at the end of 2015. Early revascularization resulted in myocardial reperfusion and near normal left ventricular function. These patients exemplify the progress in therapeutic cardiology over the last 30 years.

  3. An Unusual Case of Spontaneous Left Main Coronary Dissection in A Young Pregnant Woman Treated with Percutaneous Intervention

    Directory of Open Access Journals (Sweden)

    Jayme Ferro

    2017-12-01

    Full Text Available Spontaneous coronary artery dissection (SCAD is the spontaneous separation of the coronary artery wall, not iatrogenic or related to trauma. SCAD is an uncommon disease in which the left main coronary involvement is rare. SCAD is commonly nonatherosclerotic, according to predisposing factors (fibromuscular dysplasia, female gender, pregnancy, ecc and precipating factors (intense exercise/emotional stress, vigorous Valsalva type activities, abuse of recreational drugs, ecc. Diagnosis of SCAD is first based on clinical grounds and then confirmed with imaging. Access to different imaging techniques, in particular coronary angiography (CA and intravascular ultrasound (IVUS, is crucial to recognize and manage SCAD in acute care settings. We report an unusual case of high risk acute coronary syndrome due to the left main coronary dissection in a 33 year-old pregnant woman at 19th week of gestation. According to coronary angiography and clinical unstable conditions, LM was successfully treated with a provisional stenting technique. Intra-procedural IVUS was helpful to obtain good stent apposition and confirm the underlying intramural hematoma. Before invasive strategy, the cooperation of the heart team was crucial because we not only considered some protocols to reduce radiation and contrast agent exposure, but also planned a follow up in order to organize the delivery and minimize potential stress conditions and bleeding risk to the fetus. SCAD should not be underestimated when associated to ACS and pregnancy: urgent coronary angiography and bail-out adjunctive imaging are crucial. Improvements in materials and techniques together with a protocol for radiation/contrast media exposure and for antithrombotics drugs administration could make percutaneous interventions feasible and safe in these scenarios.

  4. Long-term prognostic value of risk scores after drug-eluting stent implantation for unprotected left main coronary artery: A pooled analysis of the ISAR-LEFT-MAIN and ISAR-LEFT-MAIN 2 randomized clinical trials.

    Science.gov (United States)

    Xhepa, Erion; Tada, Tomohisa; Kufner, Sebastian; Ndrepepa, Gjin; Byrne, Robert A; Kreutzer, Johanna; Ibrahim, Tareq; Tiroch, Klaus; Valgimigli, Marco; Tölg, Ralf; Cassese, Salvatore; Fusaro, Massimiliano; Schunkert, Heribert; Laugwitz, Karl L; Mehilli, Julinda; Kastrati, Adnan

    2017-01-01

    To evaluate the long-term prognostic value of risk scores in the setting of drug-eluting stent (DES) implantation for uLMCA. Data on the prognostic value of novel risk scores developed to select the most appropriate revascularization strategy in patients undergoing DES implantation for uLMCA disease are relatively limited. The study represents a patient-level pooled analysis of the ISAR-LEFT-MAIN (607 patients randomized to paclitaxel-eluting or sirolimus-eluting stents) and the ISAR-LEFT-MAIN-2 (650 patients randomized to everolimus-eluting or zotarolimus-eluting stents) randomized trials. The Syntax Score (SxScore) as well the Syntax Score II (SS-II), the EuroSCORE and the Global Risk Classification (GRC) were calculated. The primary outcome was all-cause mortality. At a mean follow-up of 3 years there were 160 deaths (12.7%). The death-incidence was significantly higher in the upper tertiles than in the intermediate or lower ones for all risk scores (log-rank test P risk scores were able to stratify the mortality risk at long-term follow-up. EuroSCORE was the only risk score that significantly improved the discriminatory power of a multivariable model to predict long-term mortality. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  5. An unusual case of left main coronary artery aneurysm with right ventricle fistula

    Directory of Open Access Journals (Sweden)

    Shweta Nathani

    2012-01-01

    Full Text Available A 4-year-old boy presented with repeated respiratory tract infections. Echocardiography showed dilation of the left main coronary artery with flow into the Right Ventricular Outflow Tract (RVOT. Diagnosis of Left Coronary Artery Aneurysm (LMCA with RVOT fistula was made. A surgical repair of LMCA aneurysm by two-patch technique was performed. The patient had an excellent outcome postoperatively and is asymptomatic on follow-up.

  6. Left-main restenosis in the DES era-a call for action.

    Science.gov (United States)

    di Palma, Gaetano; Cortese, Bernardo

    2017-11-10

    Percutaneous treatment of the unprotected left main trunk (ULM), defined as a vessel without patent bypass graft either to the left circumflex (LCX) or left anterior descending (LAD) artery, has gained a precise role thanks to recent scientific evidence. Although new generation drug-eluting stents have already proven to be safer, there is still a consistent risk of restenosis and late adverse events. The optimal management of a ULM restenosis is still debated. Here we aim at presenting a review of the available data in literature and show our choice for treating it. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. LM6000 update program

    Energy Technology Data Exchange (ETDEWEB)

    Westerkamp, D.F.

    1995-12-31

    In October 1992, the first LM6000 industrial gas turbine entered commercial service. Two years later, a new dry low emission combustion system went into operation in Ghent, Belgium, followed shortly by the two units at Orange Cogen in Bartow, Florida. Additional planned modifications to achieve even lower emission levels and further improve the thermodynamic performance of this equipment are planned for late 1997. This paper presents the current status of the LM6000 program, including reliability and availability trends, and describes the product development program GE is currently implementing on the LM6000. The design changes required to increase the output and efficiency, as well as improve emissions capability, are discussed in some detail. The impact that these improvements have on project economics is also reviewed.

  8. A practical tip to engage the left main coronary artery in patients presenting with aortic aneurysms

    Directory of Open Access Journals (Sweden)

    Kudret Keskin

    2017-09-01

    Full Text Available Coronary angiography in patients presenting with ascending aortic aneurysms can be challenging since standard catheters may fail to reach the left main coronary artery. A widely accepted approach is the mother-in-child catheter technique whereby a catheter with a smaller diameter is telescoped through one with a bigger diameter, a procedure that helps to lengthen the catheter. However, this technique is associated with several disadvantages such as thrombus formation within the catheters, inadvertent damage to the left main ostium, and the necessity of manipulation, which the operator may not be familiar with. Therefore, in our case we present a method, which involves the application of a regular Judkins Right 4 catheter for left main engagement. We propose that this method can be safely attempted prior to using telescoping techniques.

  9. Left main disease management strategy: indications and revascularization methods in particular groups of subjects.

    Science.gov (United States)

    Krzych, Łukasz J; Bochenek-Klimczyk, Krystyna; Wasiak, Michał; Białek, Krzysztof; Bolkowski, Maciej; Gierek, Danuta; Bochenek, Andrzej

    2012-01-01

    Surgical revascularization with coronary artery by-pass grafting is still recommended in vast majority of patients with unprotected left main disease. The aim of the paper was to analyze optimal treatment of left main disease in selected groups of patients, on the basis of current guidelines and information gained from literature data. We focused on data in relation to treatment of elderly patients, diabetics and those hemodynamically unstable. Additionally we discussed the issue of anti-platelet therapy and informed consent. As far as efficacy of treatment is concerned, not only method of revascularization but also general condition of the patient, the factors influencing peri-operative risk and optimal pharmacotherapy should be taken into account. Therefore establishment of the heart team is crucial when choosing the most suitable method of invasive treatment of left main disease.

  10. Unprotected Left Main Coronary Artery Disease: Management in the Post NOBLE and EXCEL Era.

    Science.gov (United States)

    Borges, Nyal; Kapadia, Samir R; Ellis, Stephen G

    2017-09-01

    The optimal management of unprotected left main coronary artery (ULMCA) disease is currently a debated topic. Percutaneous coronary intervention (PCI) has seen an increased adoption for the management of ULMCA disease after numerous small-scale randomised trials and cohort studies showed equipoise with coronary artery bypass grafting (CABG) for low complexity lesions. The recently published NOBLE and EXCEL trials are two of the largest international randomised clinical trials comparing PCI and CABG in patients with ULMCA disease. In lieu of all the available evidence, PCI appears to be equivalent to CABG in regard to mortality in patients with ULMCA disease. In non-diabetic patients with low complexity coronary disease (SYNTAX score ≤32), PCI appears to be a reasonable alternative to CABG, especially for ostial and midshaft left main coronary lesions. CABG is preferable in the presence of diabetes, multivessel coronary disease in addition to ULMCA or complex coronary lesions (SYNTAX score >33) including distal left main lesions.

  11. The EXCEL and NOBLE trials: similarities, contrasts and future perspectives for left main revascularisation.

    Science.gov (United States)

    Campos, Carlos M; Christiansen, Evald H; Stone, Gregg W; Serruys, Patrick W

    2015-01-01

    Unprotected left main coronary artery (ULMCA) stenosis has relatively high prevalence and exposes patients to a high risk for adverse cardiovascular events. The optimal revascularisation strategy (coronary artery bypass surgery [CABG] or percutaneous coronary intervention [PCI]) for patients with complex coronary artery disease is a topic of continuing debate. The introduction of the newer-generation drug-eluting stents (DES) -with documented improvements in both safety and efficacy- has prompted the interventional community to design two new dedicated randomised trials comparing CABG and PCI: the NOBLE (Coronary Artery Bypass Grafting Vs Drug Eluting Stent Percutaneous Coronary Angioplasty in the Treatment of Unprotected Left Main Stenosis) and EXCEL (Evaluation of XIENCE Everolimus Eluting Stent Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization) trials. The aims of the present review are to describe the similarities and contrasts between these two trials as well to explore their future implications in ULMCA treatment.

  12. Left main coronary artery atresia and associated cardiac defects: report on concomitant surgical treatment.

    Science.gov (United States)

    Jatene, Marcelo; Juaneda, Ignacio; Miranda, Rogerio Dos Anjos; Gato, Rafaella; Marcial, Miguel Lorenzo Barbero

    2011-10-01

    A 9-year-old boy with congenital atresia of the left main coronary artery underwent myocardial revascularization. Coarctation of the aorta and ventricular septal defect were diagnosed at the age of 1 year. At age 7 years, the child presented with syncope while exercising. Preoperative evaluation included cardiac catheterization which revealed the unexpected finding of congenital atresia of the left main coronary artery with origin of the circumflex artery from the right coronary artery. Surgical correction included myocardial revascularization by means of left internal mammary artery graft to the anterior descending coronary artery, coarctation resection, and ventricular septal defect repair. The patient recovered uneventfully. We report the details of this extremely rare case with successful concomitant surgical management of the congenital coronary artery anomaly and the associated structural heart disease.

  13. Outcomes After Percutaneous Coronary Intervention or Bypass Surgery in Patients With Unprotected Left Main Disease

    NARCIS (Netherlands)

    Cavalcante, Rafael; Sotomi, Yohei; Lee, Cheol W.; Ahn, Jung-Min; Farooq, Vasim; Tateishi, Hiroki; Tenekecioglu, Erhan; Zeng, Yaping; Suwannasom, Pannipa; Collet, Carlos; Albuquerque, Felipe N.; Onuma, Yoshinobu; Park, Seung-Jung; Serruys, Patrick W.

    2016-01-01

    Currently available randomized data on the comparison between percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) for the treatment of unprotected left main coronary disease (LMD) lacks statistical power due to low numbers of patients enrolled. This study assessed

  14. Abolished ventilation and perfusion of lung caused by blood clot in the left main bronchus

    DEFF Research Database (Denmark)

    Afzelius, P; Bergmann, A; Henriksen, J H

    2015-01-01

    /Q) scintigraphy with single-photon emission CT (SPECT)/CT. V/Q SPECT/CT demonstrated abolished ventilation due to obstruction of the left main bronchus and markedly reduced perfusion of the entire left lung, a condition that was completely reversed after removal of a blood clot. We present the first pictorially......It is generally assumed that the lungs possess arterial autoregulation associated with bronchial obstruction. A patient with pneumonia and congestive heart failure unexpectedly developed frequent haemoptysis. High-resolution CT and diagnostic CT were performed as well as ventilation/perfusion (V...

  15. Perspectives on Imaging the Left Main Coronary Artery Using Intravascular Ultrasound and Optical Coherence Tomography

    Directory of Open Access Journals (Sweden)

    Harry C Lowe

    2015-01-01

    Full Text Available Percutaneous Coronary Intervention (PCI for significant left main coronary artery (LMCA stenosis is increasingly being viewed as a viable alternative to Coronary Artery Bypass Grafting (CABG (1. This is leading to an expectation of increasing numbers of such procedures, with a consequent focus on both the ability to image both lesion severity, and assess more accurately the results of PCI. While there have been advances in physiologic assessment of left main severity using fractional flow reserve (FFR, imaging of the LMCA using Intravascular Ultrasound (IVUS and more recently Optical Coherence Tomography (OCT has the specific advantage of being able to provide detailed anatomical information both pre and post PCI, such that it is timely to review briefly the current status of these two imaging technologies in the context of LMCA intervention.

  16. Missing left main ostio-proximal coronary artery disease during angiography using tiger catheter

    Directory of Open Access Journals (Sweden)

    Biswajit Majumder

    2016-01-01

    Full Text Available Coronary angiography by right radial artery route using Optitorque Tiger catheter is on the rise given the low rate of local complications and feasibility to perform it as a day-care procedure. We report here a case of coronary angiography performed using Optitorque Tiger catheter (5-French which resulted in a diagnostic error, missing the ostio-proximal left main coronary artery disease which was later detected using EBU 3.5 guide catheter (7-French while performing angioplasty.

  17. Comparative study of limited intentional normovolaemic haemodilution in patients with left main coronary artery stenosis.

    Science.gov (United States)

    Herregods, L; Foubert, L; Moerman, A; François, K; Rolly, G

    1995-11-01

    Intentional normovolaemic haemodilution is a blood saving technique which can be performed when major blood loss is expected. Severe coronary artery disease and particularly left main stenosis are considered a contraindication for intentional normovolaemic haemodilution. The effects and complications of limited intentional normovolaemic haemodilution in patients with left main coronary artery stenosis scheduled for coronary artery bypass grafting were evaluated. Patients were randomly allocated to two groups: group A (n = 15) underwent limited intentional normovolaemic haemodilution to a haematocrit of 34%; group B (n = 15), no intentional normovolaemic haemodilution was performed. In both groups succinyl-linked gelatin was used to maintain normovolaemia. Haemodynamic parameters were kept as constant as possible. In group A, a mean (SD) volume of 785 (250) ml of blood was withdrawn [range 500-1200 ml]. ST segment changes occurred on the ECG in three patients in each group. There were no statistically significant differences for frequency, maximum deflection and duration of ST-segment changes. Limited intentional normovolaemic haemodilution can be performed safely in patients with left main coronary artery stenosis. In this study it was not associated with increased frequency, severity or duration of ST-segment changes, or with arrhythmias or haemodynamic instability.

  18. Transverse partial stent ablation with rotational atherectomy for suboptimal culotte technique in left main stem bifurcation.

    Science.gov (United States)

    De Maria, Giovanni Luigi; Kharbanda, Rajesh; Banning, Adrian P

    2017-11-06

    Longitudinal rotational atherectomy of metal struts is well described as bail-out strategy to treat undilatable instent restenosis. Ablation of metal stent struts jailing the ostium of a major side branch in a coronary bifurcation is not described. In the current report, we describe a case of "transverse" rotational atherectomy to treat a failure of culotte stenting in a left main stem bifurcation. We document for the first time in vivo and in man the effect of this strategy using optical coherence tomography. © 2017 Wiley Periodicals, Inc.

  19. Fractured Tracheostomy Tube in Left Main Bronchus with No Mouth Opening: An Anaesthetic Challenge

    Directory of Open Access Journals (Sweden)

    Arghya Mukherjee

    2014-10-01

    Full Text Available Foreign body aspiration is a serious medical condition that demands prompt diagnosis and treatment to prevent fatal complications. This is a case report of a 42 year male with history of surgery for carcinoma tongue, hemiglossectomy and tracheostomy. He presented with dislodged fractured metallic tracheostomy tube in left main bronchus. Patient was breathing through stenosed tracheostomy stoma with bilateral normal air entry in chest. He was haemodynamically stable. Rigid bronchoscopic removal was impossible due to no mouth opening. After securing airway, general anaesthesia was induced and thoracotomy was performed to remove dislodged tube. Proper planning and coordinated team work resulted in good outcome.

  20. Percutaneous coronary angioplasty versus coronary artery bypass grafting in treatment of unprotected left main stenosis (NOBLE)

    DEFF Research Database (Denmark)

    Makikallio, T.; Holm, Niels R.; Lindsay, Gail M.

    2016-01-01

    coronary artery disease. Methods In this prospective, randomised, open-label, non-inferiority trial, patients with left main coronary artery disease were enrolled in 36 centres in northern Europe and randomised 1: 1 to treatment with PCI or CABG. Eligible patients had stable angina pectoris, unstable...... angina pectoris, or non-ST-elevation myocardial infarction. Exclusion criteria were ST-elevation myocardial infarction within 24 h, being considered too high risk for CABG or PCI, or expected survival of less than 1 year. The primary endpoint was major adverse cardiac or cerebrovascular events (MACCE...

  1. Dissection of the left main coronary artery after blunt thoracic trauma: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Beilman Greg

    2010-07-01

    Full Text Available Abstract Blunt chest trauma is commonly encountered by surgeons and is rarely associated with cardiac injuries. The incidence of cardiac injury is rare but can be rapidly fatal, requiring prompt recognition and treatment. We review the case of a 37 year-old male who was involved in a head-on motor vehicle collision at highway speed and was found to have an isolated left main coronary artery dissection. We then review the supporting literature for evaluation of blunt cardiac injuries and the treatment options for traumatic coronary dissection.

  2. Mediastinal radiotherapy and ostial lesion of the left main coronary artery

    International Nuclear Information System (INIS)

    Victor, Edgar Guimaraes; Parente, Giordano Bruno de Oliveira

    2004-01-01

    Ischemic cardiac disease is a rare complication and, only recently recognized, of mediastinal irradiation for neoplasms in this region. A case of a 51 years old woman with angina pectoris, rapidly progressive is related, where the angiographic finding was represented by ostial sub occlusive lesion of the left coronary body. The previous story showed the use of radiotherapy for mediastinal Hodgkin lymphoma treatment, with close relation to right ventricle, removed by surgery and afterwards treated with irradiation and chemotherapy two years ago. The coronary stenosis induction in these patients can be dependent or not of the focal arteriosclerosis and is mediated, mainly, by intimal thickness due to tissular fibrosis without alteration in the medium layer and with inclination for the ostial portions of the main arteries. The recognition of this condition (thorax radiotherapy), as an isolated and independent factor for the coronary disease, should be considered in the acting plan for prevention, detection and previous therapy

  3. Use of Intravascular Ultrasound Imaging in Percutaneous Coronary Intervention to Treat Left Main Coronary Artery Disease.

    Science.gov (United States)

    De Maria, Giovanni Luigi; Banning, Adrian P

    2017-05-01

    Due to its potential prognostic implications and technical complexity, revascularisation of left main coronary artery (LMCA) disease requires careful consideration. Since publication of the results of the SYNTAX study, and more recently the EXCEL and NOBLE trials, there has been particular interest in percutaneous revascularisation of the LMCA. It is becoming clear that percutaneous revascularisation of LMCA disease requires appropriate lesion preparation and carefully optimised stenting in order to offer patients a treatment option as effective as coronary artery bypass grafting. For this reason intravascular imaging, and especially intravascular ultrasound, is becoming a key procedural step in LMCA percutaneous coronary intervention. In the current review paper we analyse the role of intravascular imaging with intravascular ultrasound in LMCA percutaneous coronary intervention, focusing on the main applications in this context from lesion assessment to stent sizing and optimisation.

  4. Total occlusion of the left main and proximal right coronary artery: case report and review of the literature.

    Science.gov (United States)

    Leon, M N; Abu-Halawa, S; Ramanna, N; Kokotsakis, J N; Treistman, B; Anderson, H V

    1996-11-01

    Chronic total left main coronary artery occlusion at angiography is very rare, and there are only four cases reported with concomitant total right coronary artery occlusion. We describe a case of total left main and proximal right coronary artery occlusion and review the clinical and angiographic characteristics of this condition which represents the most severe from of coronary artery disease compatible with life.

  5. Left main coronary artery obstruction by dislodged native-valve calculus after transcatheter aortic valve replacement.

    Science.gov (United States)

    Durmaz, Tahir; Ayhan, Huseyin; Keles, Telat; Aslan, Abdullah Nabi; Erdogan, Kemal Esref; Sari, Cenk; Bilen, Emine; Akcay, Murat; Bozkurt, Engin

    2014-08-01

    Transcatheter aortic valve replacement can be an effective, reliable treatment for severe aortic stenosis in surgically high-risk or ineligible patients. However, various sequelae like coronary artery obstruction can occur, not only in the long term, but also immediately after the procedure. We present the case of a 78-year-old woman whose left main coronary artery became obstructed with calculus 2 hours after the transfemoral implantation of an Edwards Sapien XT aortic valve. Despite percutaneous coronary intervention in that artery, the patient died. This case reminds us that early recognition of acute coronary obstruction and prompt intervention are crucial in patients with aortic stenosis who have undergone transcatheter aortic valve replacement.

  6. Stent implantation of left main coronary artery stenosis in an infant: Effective long-term treatment?

    Directory of Open Access Journals (Sweden)

    Christian Paech

    2015-01-01

    Full Text Available Coronary artery stenosis is a rare phenomenon in children. Coronary stent implantation is generally not considered a standard treatment option due to technical difficulties and potential complications in this group of patients. Nevertheless, several pediatric cases reporting successful implantation with acceptable short-term experiences have been described. The following case presents a successful stent implantation for left main coronary artery (LMCA stenosis early after surgery for anomalous left coronary artery from pulmonary artery (ALCAPA at the age of 6 months. The excellent mid-term results and notably the procedure′s potential as a long-term treatment in small children are highlighted. A 6-month-old infant underwent surgery for ALCAPA. Due to sudden postoperative deterioration, cardiac catheterization was performed. Coronary angiography revealed severe (90% ostial LMCA stenosis. A PROMUS drug-eluting stent (Promus Element AL3.0 Χ 8 mm, Boston Scientific, Natick, Massachusetts, USA was implanted. The procedure was performed without complications. Antiplatelet therapy with acetylsalicylic acid and clopidogrel was initiated. Subsequently, cardiac function improved slowly. Cardiac catheterization 3 years 8 months after stent implantation showed no restenosis with a proximal LMCA diameter still at the 50 th percentile for age. Neither were signs of heart failure reported at the last follow-up at 7 years of age. Presupposing normal growth, the implanted stent would thus provide sufficient myocardial perfusion with a LMCA lumen at the 40 th percentile at the age of 16 years. In selected cases, coronary stent implantation may be an effective mid- to long-term treatment of coronary artery stenosis even in very young children.

  7. Subacute narrowing of the left main coronary artery following directional atherectomy for proximal obstructive coronary artery disease

    NARCIS (Netherlands)

    Piek, J. J.; Koch, K. T.; van der Wal, A. C.; Becker, A. E.

    1997-01-01

    Directional atherectomy is an alternative device for treatment of highly eccentric or proximal coronary lesions considered less suitable for balloon angioplasty. We report a patient with exuberant neointimal proliferation, extending into the left main coronary artery, following directional

  8. Surgical repair of an aneurysm-like fistula connecting the left main coronary artery with the right atrium.

    Science.gov (United States)

    Tong, Guang; Sun, Zhongchan; Zhang, Weida

    2016-08-01

    Coronary fistula is defined as an anomalous connection between a coronary artery and any of the four chambers of the heart or any of its great vessels. A coronary fistula connecting the left main coronary artery to the right atrium is the most uncommon. In the present study, we report the surgical management of a very uncommon case of an aneurysm-like fistula connecting the left main coronary artery to the right atrium in a 2-year-old boy.

  9. Successful surgical osteoplasty of the left main coronary artery with concomitant mitral valve replacement and tricuspid annuloplasty

    Directory of Open Access Journals (Sweden)

    Ujjwal Kumar Chowdhury

    2017-01-01

    Full Text Available A 50-year-old woman with rheumatic heart disease, mitral stenosis, and critical isolated left main ostial stenosis was successfully treated by mitral valve replacement, tricuspid annuloplasty, and surgery of left main osteoplasty and is reported for its rarity. Notable clinical findings included an intermittently irregular pulse, blood pressure of 100/70 mmHg, cardiomegaly, a diastolic precordial thrill, a mid-diastolic murmur without presystolic accentuation that was loudest at the mitral area. Chest radiograph revealed cardiomegaly with a cardiothoracic ratio of 0.7 due to enlarged right atrium, right ventricle with a straightened left heart border and evidence of pulmonary hypertension. The investigation shows that surgical reconstruction of the left main coronary artery is safe and effective for the treatment.

  10. How should I treat a coronary "traffic jam"? A triple kissing balloon in distal left main trifurcation.

    Science.gov (United States)

    Testa, Luca; Bedogni, Francesco

    2011-03-01

    A 60-year-old man with relapsing unstable angina a year aftger an anterior acute myocardial infarction treated with PCI to proximal left anterior descending (LAD) and proximal intermediate branch (IB), resulting in a severely impaired LV function. Physical examination, laboratorytest, transthoracic echocardiogram, rest ECG, coronary angiography. Severe in-stent restenosis to IB, with a bulky plaque involving distal left main, obtuse marginal and proximal circumflex. Percutaneous coronary intervention/coronary artery bypass grafting.

  11. Novel Echocardiographic Indices for Assessing the Left Main Coronary Artery in Children With Kawasaki Disease.

    Science.gov (United States)

    Malakan Rad, Elaheh; Malekzadeh, Iran; Ziaee, Vahid; Rajabi, Raheleh; Shahabi, Zohreh

    2016-08-01

    Kawasaki disease (KD) is the most common cause of acquired myocardial infarction in children. Coronary artery involvement is the most serious feature of this vasculitis syndrome. Timely diagnosis of coronary artery involvement is of utmost importance since it can prevent long-term morbidity and mortality. The current methods for the diagnosis of coronary artery dilation in KD are inconsistent and are also not capable of detecting all the abnormal coronary arteries or the so-called occult dilations present. The aim of this study was to determine the sensitivity and specificity of three novel allometric indices for the diagnosis of left main coronary artery (LMCA) involvement in KD. We performed a prospective case-control study in 69 children (38 with KD and 31 healthy children). All the followed up patients underwent two complete echocardiographic examinations at the time of admission and 4 - 6 weeks later. We measured the size of the LMCA, coronary sinus (CS) and aorta (A) and calculated the LMCA/CS, LMCA/A and LMCA/CS/A ratios. We also calculated the cut-off scores for each index using receiver operating characteristic curves both in the acute phase and 4 - 6 weeks later. In the acute phase, the cut-off scores for the LMCA/A ratio was > 0.23; LMCA/CS, > 0.44; and LMCA/CS/A, > 0.03. This implied 60% sensitivity and 80% specificity for the detection of abnormal LMCA in KD. Four to six weeks after the acute phase, the LMCA/A cut-off score was > 0.23; LMCA/CS, > 0.73; and LMCA/CS/A, > 0.73. This implied 100% sensitivity and 100% specificity for the detection of abnormal LMCA. There was a significant decrease in the size of the CS in comparison with the control group (1.92 ± 0.363 mm; P = 0.007 and 0.023). The LMCA/A, LMCA/CS and LMCA/CS/A ratios seem to provide simple and patient-specific indices for the detection of abnormal LMCA in KD, both in the acute and subacute phase. Further, a decrease in the size of the CS may imply a decrease in coronary artery flow in the

  12. [Percutaneous approach for the treatment of unprotected left main coronary stenosis. New perspectives with the use of coronary stents].

    Science.gov (United States)

    Pessanha, A V; Rodrigues, C; Fuks, V; Murad, H; Murad, M

    1997-03-01

    We describe a case of coronary stenosis located in an unprotected left main coronary artery, treated primarily and electively with the placement of a coronary stent. As a function of the large mass of myocardium involved, this patient would be considered a classical candidate for direct surgery, because the inherent risk involved with conventional balloon angioplasty, mainly due to the eventual occurrence of acute closure during the procedure. Since the previsibility of the immediate results with the use of coronary stents was significantly improved, we propose this new therapeutic approach for this traditionally surgical case, that has been performed with success and without any complication. This strategy for the treatment of unprotected left main lesions with the elective placement of Palmaz-Schatz stents, has not yet been proposed or applied in our country, and may represent a new universe of indication of percutaneous treatment of coronary artery disease, no longer approaching the left main stem only in special or emergency situations, usually a result of complications of left main manipulation during angioplasty of the coronary system. The patient involved in this case did not show any contraindication for the treatment with conventional open heart surgery.

  13. Contemporary percutaneous treatment of unprotected left main coronary stenoses: initial results from a multicenter registry analysis 1994-1996.

    NARCIS (Netherlands)

    S.G. Ellis (Stephen); H. Tamai (Hideo); K. Kosuga; A. Colombo (Antonio); D.R. Holmes Jr (David); C.M. Miguel (Carlos); C.L. Grines; P.L. Whitlow (Patrick); H.J. White; J. Moses; P.S. Teirstein (Paul); P.W.J.C. Serruys (Patrick); J.A. Bittl; M.R. Mooney; T.M. Shimshak; P.C. Block (Peter); R. Erbel (Raimund); M. Nobuyoshi (Masakiyo)

    1997-01-01

    textabstractBACKGROUND: Coronary artery bypass surgery (CABG) has been considered the therapy of choice for patients with unprotected left main (ULMT) coronary stenoses. Selected single-center reports suggest that the results of percutaneous intervention may now approach those of CABG. METHODS AND

  14. Three-Year Major Clinical Outcomes of Angiography-Guided Single Stenting Technique in Non-Complex Left Main Coronary Artery Diseases.

    Science.gov (United States)

    Kim, Yong Hoon; Her, Ae-Young; Rha, Seung-Woon; Choi, Byoung Geol; Shim, Minsuk; Choi, Se Yeon; Byun, Jae Kyeong; Li, Hu; Kim, Woohyeun; Kang, Jun Hyuk; Choi, Jah Yeon; Park, Eun Jin; Park, Sung Hun; Lee, Sunki; Na, Jin Oh; Choi, Cheol Ung; Lim, Hong Euy; Kim, Eung Ju; Park, Chang Gyu; Seo, Hong Seog; Oh, Dong Joo

    2017-10-12

    There is limited long-term comparative clinical outcome data concerning angiography- versus intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) in non-complex left main coronary artery (LMCA) disease treated with the single stenting technique in the drug-eluting stent (DES) era.The aim of this study was to investigate whether angiography-guided stenting is comparable to IVUS-guided stenting during 3-year clinical follow-up periods in patients with non-complex LM disease treated with the single stenting technique.A total of 196 patients treated with either angiography-guided (n = 74) or IVUS-guided (n = 122) PCI were included. The primary outcome was the occurrence of major adverse cardiac events (MACE) defined as total death, non-fatal myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), and non-target vessel revascularization (Non-TVR). To adjust for any potential confounders, propensity score (PS) adjusted analysis was performed.During 3-year follow-up, the PS adjusted Cox-proportional hazard ratio (HR) was not significantly different between the two groups for total death, cardiac death, and MI. Also, TLR and the combined rates of TVR and non-TVR were not significantly different. Finally, MACE was not significantly different between the two groups (HR: 0.63, 95% Confidence interval (CI): 0.33-1.17; P = 0.149).Angiography-guided PCI for non-complex LMCA diseases treated with the single stenting technique showed comparable results compared with IVUS-guided PCI in reducing clinical events during 3-year clinical follow-up in the DES era. Although IVUS guided PCI is the ideal strategy, angiography-guided PCI can be an option for LMCA PCI in some selected cases.

  15. Chylous ascites as the main manifestation of left ventricular dysfunction: a case report

    Directory of Open Access Journals (Sweden)

    Mandó Oscar G

    2005-08-01

    Full Text Available Abstract Background Ascites is one of the most common complications of liver diseases, even though in 15% of the cases it is related to extrahepatic diseases; 3% are of cardiac nature and they appear associated with signs and symptoms of heart failure. Case presentation A 70 year old man was admitted with more than one year history of abdominal distension and a weight gain of 10 kilograms. He is asymptomatic and walks 2000–3000 meters a day without angor or dyspnea. The physical examination shows moderate abdominal distension, with no hepatosplenomegaly or edema, and there is mild jugular vein distension. The studies performed (complete laboratory work up, paracentesis, liver biopsy, echocardiogram, intrahepatic pressure measurements, etc. showed a chylous ascites related to portal hypertension, and left ventricular dysfunction was the only probable cause found. Conclusion Asymptomatic heart dysfunction can mimic liver disease and should be kept in mind as a cause of chylous ascites.

  16. Optimal Revascularization Strategy on Medina 0,1,0 Left Main Bifurcation Lesions in Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Xuwei Zheng

    2016-01-01

    Full Text Available Aim. Diabetes mellitus (DM is a major risk factor for cardiovascular disease. The implications of a diagnosis of DM are as severe as the diagnosis of coronary artery disease. For many patients with complex coronary artery disease, optimal revascularization strategy selection and optimal medical therapy are equally important. In this study, we compared the hemodynamic results of different stenting techniques for Medina 0,1,0 left main bifurcation lesions. Methods. We use idealized left main bifurcation models and computational fluid dynamics analysis to evaluate hemodynamic parameters which are known to affect the risk of restenosis and thrombosis at stented bifurcation. The surface integrals of time-averaged wall shear stress (TAWSS and oscillatory shear index (OSI at bifurcation site were quantified. Results. Crossover stenting without final kissing balloon angioplasty provided the most favorable hemodynamic results (integrated values of TAWSS = 2.96 × 10−4 N, OSI = 4.75 × 10−6 m2 with bifurcation area subjected to OSI values >0.25, >0.35, and >0.45 calculated as 0.39 mm2, 0.06 mm2, and 0 mm2, respectively. Conclusion. Crossover stenting only offers hemodynamic advantages over other stenting techniques for Medina 0,1,0 left main bifurcation lesions and large bifurcation angle is associated with unfavorable flow profiles.

  17. LM6000 gas turbine plant; LM6000 gas turbine plant

    Energy Technology Data Exchange (ETDEWEB)

    Nozaki, N.; Sato, T. [Ishikawajima-Harima Heavy Industries Co. Ltd., Tokyo (Japan)

    1998-09-01

    The LM6000 gas turbine is a most advanced industrial gas turbine derived from an aero-engine. The gas turbine has a power output of 45 MW with over 42% thermal efficiency, and such features as high efficiency, compactness, and easy maintenance. The gas turbine is used widely for electric power generation, marine propulsion and mechanical drive applications, particularly frequently for medium-capacity power plants because of its high efficiency. This paper summarizes the newest form of this LM6000 gas turbine, and introduces as its application example to power plants two examples of practical use in combined cycle power generation which is anticipated of increased use in the future. A combined cycle power plant for a paper mill in Indonesia is characterized by the gas turbine being a back-pressure turbine, where low pressure steam after having been used for power generation is fed to the paper mill. A combined cycle power plant for the Xinzhu scientific and industrial complex in Taiwan is characterized by adoption of a sucked air cooling device, which cools gas turbine sucked air temperature down to 7.2 deg C, and the gas turbine power generator being operated upto its maximum output of 45 MW. 7 figs., 1 tab.

  18. Two congenital coronary abnormalities affecting heart function: anomalous origin of the left coronary artery from the pulmonary artery and congenital left main coronary artery atresia.

    Science.gov (United States)

    Xiao, Yanyan; Jin, Mei; Han, Ling; Ding, Wenhong; Zheng, Jianyong; Sun, Chufan; Lyu, Zhenyu

    2014-01-01

    The anomalous origin of the left coronary artery (LCA) from the pulmonary artery (ALCAPA) and congenital left main coronary artery atresia (CLMCA-A) are two kinds of very rare coronary heart diseases which affect heart function profoundly. This study aimed to retrospectively illustrate the clinical features and therapy experience of ALCAPA and CLMCA-A patients. From April 1984 to July 2012, in Beijing Anzhen Hospital, 23 patients were diagnosed with ALCAPA and 4 patients with CLMCA-A. We summarized the clinical data of the 27 cases and retrospectively analyzed the clinical manifestation, diagnosis, and treatments of these two kinds of congenital coronary abnormalities. The 23 patients (13 males and 10 females, aged ranging from 2.5 months to 65 years) identified with ALCAPA were classified into infantile type (age of onset younger than 12 months, 16 cases) and adult type (age of onset older than 12 months, 7 cases). Four patients were diagnosed with CLMCA-A (three males and one female, aged ranging from 3 months to 2 years). The main clinical manifestations of infantile-type ALCAPA and CLMCA-A include repeated respiratory tract infection, heart failure, dyspnea, feeding intolerance, diaphoresis, and failure to thrive. And these two congenital coronary abnormalities might be misdiagnosed as endocardial fibroelastosis, dilated cardiomyopathy, and acute myocardial infarction. As for the adult-type ALCAPA, cardiac murmurs and discomfort of the precordial area are the most common presentations and might be misdiagnosed as coronary heart disease, myocarditis, or patent ductus arteriosus. In ECG examination: Infantile-type ALCAPA and CLMCA-A showed abnormal Q waves with T wave inversion in leads I, avL, and V4-V6, especially in lead avL. However, ECG of adult-type ALCAPA lacked distinct features. In chest radiography: pulmonary congestion and cardiomegaly were the most common findings in infantile-type ALCAPA and CLMCA-A, while pulmonary artery segment dilation was more

  19. ST Segment Elevation Myocardial Infarction Due to Severe Ostial Left Main Stem Stenosis in a Patient with Syphilitic Aortitis.

    Science.gov (United States)

    Predescu, L M; Zarma, L; Platon, P; Postu, M; Bucsa, A; Croitoru, M; Prodan, B; Chioncel, O; Deleanu, D

    2016-01-01

    Cardiovascular manifestations of tertiary syphilis infections are uncommon, but represent an important cause of mortality and morbidity. Syphilitic aortitis is characterized by aortic regurgitation, dilatation of ascending aorta and ostial coronary artery lesions. We report a case of 36 years old man admitted to our hospital for acute anterior ST segment elevation myocardial infarction complicated with cardiogenic shock (hypotension 75/50 mmHg). Transthoracic echocardiography revealed a dilated left ventricle with severe systolic dysfunction (ejection fraction = 25%), severe mitral regurgitation, moderate aortic regurgitation and mildly dilated ascending aorta. Coronary angiography showed a severe ostial lesion of left main coronary artery which was treated by urgent stent implantation and an intra-aortic contrapulsation balloon was implanted. Blood tests for syphilitic infection were positive. The patient was discharged with treatment including benzathine penicillin. In our case, we present an acute manifestation of a syphilitic ostial left main stenosis treated by primary percutaneous coronary intervention in acute myocardial infarction. Long term follow-up of the patient is crucial as a result of potential rapid in-stent restenosis caused by continuous infection of the ascending aorta. This case is particular because it shows that syphilitic aortitis can be diagnosed in acute settings, like ST segment elevation myocardial infarction.

  20. New-Onset Atrial Fibrillation After PCI or CABG for Left Main Disease: The EXCEL Trial.

    Science.gov (United States)

    Kosmidou, Ioanna; Chen, Shmuel; Kappetein, A Pieter; Serruys, Patrick W; Gersh, Bernard J; Puskas, John D; Kandzari, David E; Taggart, David P; Morice, Marie-Claude; Buszman, Paweł E; Bochenek, Andrzej; Schampaert, Erick; Pagé, Pierre; Sabik, Joseph F; McAndrew, Thomas; Redfors, Björn; Ben-Yehuda, Ori; Stone, Gregg W

    2018-02-20

    There is limited information on the incidence and prognostic impact of new-onset atrial fibrillation (NOAF) following percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for left main coronary artery disease (LMCAD). This study sought to determine the incidence of NOAF following PCI and CABG for LMCAD and its effect on 3-year cardiovascular outcomes. In the EXCEL (Evaluation of XIENCE Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization) trial, 1,905 patients with LMCAD and low or intermediate SYNTAX scores were randomized to PCI with everolimus-eluting stents versus CABG. Outcomes were analyzed according to the development of NOAF during the initial hospitalization following revascularization. Among 1,812 patients without atrial fibrillation on presentation, NOAF developed at a mean of 2.7 ± 2.5 days after revascularization in 162 patients (8.9%), including 161 of 893 (18.0%) CABG-treated patients and 1 of 919 (0.1%) PCI-treated patients (p EXCEL trial, NOAF was common after CABG but extremely rare after PCI. The development of NOAF was strongly associated with subsequent death and stroke in CABG-treated patients. Further studies are warranted to determine whether prophylactic strategies to prevent or treat atrial fibrillation may improve prognosis in patients with LMCAD who are undergoing CABG. (Evaluation of XIENCE Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization [EXCEL]; NCT01205776). Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  1. Progression of left main coronary artery disease 3 years after Bentall operation in a young female with Marfan syndrome.

    Science.gov (United States)

    Nishino, Tomohiro; Ehara, Natsuhiko; Kim, Kitae; Yamamuro, Atsushi; Kitai, Takeshi; Kobori, Atsushi; Kinoshita, Makoto; Kaji, Shuichiro; Tani, Tomoko; Okada, Yukikatsu; Furukawa, Yutaka

    2013-04-01

    A 39-year-old woman with Marfan syndrome presented to our hospital with chest oppression on effort. She underwent aortic root remodeling combined with aortic valve replacement 14 years ago and Bentall operation for enlargement of remaining native Valsalva sinus 3 years ago. A coronary computed tomography and a coronary angiography showed left main coronary artery stenosis, which was subsequently treated with percutaneous coronary intervention using a bare-metal stent. Follow-up coronary angiography performed 1 year after stenting revealed no restenosis.

  2. Isolated huge aneurysm of the left main coronary artery in a 22-year-old patient with type 1 neurofibromatosis.

    Science.gov (United States)

    Pontailler, Margaux; Vilarem, Didier; Paul, Jean-François; Deleuze, Philippe H

    2015-03-01

    A 22-year-old patient with neurofibromatosis type 1 presented with acute chest pain. A computed tomography scan and coronary angiography revealed a partially thrombosed huge aneurysm of the left main coronary artery. Despite medical treatment, the patient's angina recurred. The patient underwent a coronary bypass grafting operation and surgical exclusion of the aneurysm. Postoperative imaging disclosed good permeability of the 3 coronary artery bypass grafts and complete thrombosis of the excluded aneurysm. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  3. [Surgical Treatment of Left Main Trunk Coronary Artery Aneurysm with Asymptomatic Myocardial Ischemia;Report of a Case].

    Science.gov (United States)

    Okugi, Satoshi; Saito, Hiroyuki; Umeda, Etsuji; Takiguchi, Yoji

    2017-05-01

    Coronary artery aneurysm is rare, and there is no established protocol for surgical indication. On preoperative examination of orthopedic surgery, a 76-year-old male was found with asymptomatic myocardial ischemia. Radiological examinations revealed triple vessel disease and a coronary artery aneurysm, 10 mm in size, at the bifurcation of the left main trunk. Combined with quintuple coronary artery bypass grafting, surgical repair of the aneurysm was peformed under cardiopulmonary bypass on beating heart. Epicardial echocardiography was used to detect the site and the blood flow on the aneurysm. Postoperative course was uneventful. Epicardial echocardiography was useful for detecting the coronary artery aneurysm in the myocardium and the residual aneurysmal blood flow.

  4. Branching patterns of the left main coronary artery in the dog demonstrated by the use of corrosion casting technique.

    Science.gov (United States)

    Noestelthaller, A; Probst, A; König, H E

    2007-02-01

    As many investigators use dogs as experimental models in catheterization-, ligation-, and collateral flow studies, knowledge and awareness of the canine left coronary artery anatomical variation is vital for differentiation between canine and human coronary arterial patterns and canine and human coronary congenital anomalies with or without circulatory importance. The present study was performed to examine and review the various principal subdivisions of the canine left main coronary artery (LMCA) in vascular casts of 20 hearts obtained from cadavers of clinically normal dogs of various ages, breeds and of either sex. A corrosion casting technique using an acrylic resin called Tensol Cement No. 70 and a lower-viscosity acrylic resin called Mercox were used to produce a three-dimensional model of the canine coronary arteries. In our study, all dog hearts were left preponderant and the patterns of the principal subdivisions of the LMCA were grouped into three types: Type 1 occurred in seven of the 20 dogs (35%), Type 2 in 12 of 20 dogs (60%) and Type 3 in one instance (5%). A comparison between the canine divisional patterns of the LMCA in the vascular casts and those reported in the literature showed major agreement.

  5. String-sign in left internal thoracic artery is associated with regression in left main trunk stenosis after coronary artery bypass.

    Science.gov (United States)

    Yokoyama, Ken; Miyauchi, Katsumi; Kawamura, Masaki; Kajimoto, Kan; Dohi, Tomotaka; Yamagami, Shinichiro; Kano, Tatsuzi; Amano, Atsushi; Hosoda, Yasuyuki; Daida, Hiroyuki

    2011-01-01

    The left internal thoracic artery (LITA) is the conduit of choice for coronary artery bypass (CABG) due to favorable long-term patency. Uncommonly, diffuse narrowing like a string without significant stenosis of an anastomosis is observed in the LITA graft (called "string sign"). Isolated left main trunk (LMT) diseases were reported to regress in some cases. However, the relationship between "string sign" and the regression of solitary LMT disease remains unknown.We retrospectively studied 40 consecutive patients with isolated LMT stenosis who underwent CABG using LITA and who underwent angiography before and after operation (31 males, 9 females, mean age, 65.0 years). The patients were divided into 2 groups according to the postoperative angiographic outcomes of the LITA graft: one group included patients with "string sign" (6 patients), the other group consisted of patients with a patent LITA graft (34 patients).There were no significant differences in clinical backgrounds between the two groups. The 2 groups showed similar quantitative % coronary artery stenosis of the LMT before operation (77.5% versus 76.8%) and the observation period was similar in both groups. Coronary angiography after CABG revealed that % stenosis of the LMT in patients with "string sign" was significantly less than that in patients with a patent LITA graft (41.7 ± 26% versus 82.5 ± 11%, P string sign group". Furthermore, ostial stenosis was more frequent in patients with "string sign". "String phenomenon" of the LITA graft is one of the signs related to the regression of LMT stenosis, and especially in ostial stenosis of the LMT.

  6. Successful treatment of cardiogenic shock by stenting of the left main coronary artery in acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Knežević Božidarka

    2008-01-01

    Full Text Available Introduction. Patients with non-ST elevation acute coronary syndromes (NSTE-ACS are sometimes severely hemodynamicly compromised. Urgent coronary angiography should be performed in these patients in percutaneous coronary intervention (PCI centers according to the ESC NSTE-ACS guidelines to determine suitabilty for percutaneous or surgical revascularization. Case report. We reported a 62-year-old male with chest pain admitted to the Coronary Care Unit. ST segment depression of 2 mm in leads I, L and V4-6 was revealed at electrocardiogram. After following 6 hours the patient had chest pain and signs of cardiogenic shock despite of the therapy. Chest x-ray showed pulmonary edema. Echocardiographic examination showed dyskinetic medium and apical segments of septum. The patient underwent coronary angiography immediately which revealed 75% stenosis of the left main coronary artery with thrombus. The use of a GPIIb/III inhibitor-tirofiban and stent implantation resulted in TIMI III flow. After that the patient had no chest pain and acute heart failure subsided in the following days Echocardiography done at the fourth day from PCI showed only hypokinesis medium and apical segment of septum. The patient was discharged at day 11 from admission in a stable condition. Conclusion. Stenting of left main coronary artery stenosis in patients with cardiogenic shock and non- ST segment elevation acute coronary syndromes may be a life saving procedure.

  7. Extracorporeal cardiopulmonary resuscitation for breath-holding spells followed by cardiac arrest due to left main coronary artery stenosis.

    Science.gov (United States)

    Ozyilmaz, Isa; Altin, Husnu Fırat; Yildiz, Okan; Erek, Ersin; Ergul, Yakup; Guzeltas, Alper

    2015-06-01

    Non-syndromic congenital supravalvular aortic stenosis (SVAS) leads to ventricular hypertrophy and increased oxygen consumption, and when combined with other factors reduces coronary blood flow, potentially resulting in myocardial ischemia and sudden cardiac death. While the anatomic obstruction of coronary circulation is as common in non-syndromic SVAS as in Williams syndrome, it often remains unacknowledged. Extracorporeal membrane oxygenation (ECMO) is an elective procedure that can be used to support patients with cardiac arrest during diagnosis as a way to reduce cardiopulmonary load in preparation for surgery or further treatment. In this report, we describe the rare case of an infant with severe SVAS and mild valvular pulmonary and left main coronary artery stenosis, as well as breath-holding spells. After multiple cardiac arrests, the infant underwent diagnostic catheter angiography on ECMO and had the pathology surgically corrected. © 2015 Japan Pediatric Society.

  8. A Late Sequela of the David Procedure: Left Main Coronary Artery Compression and Myocardial Infarction due to Pseudoaneurysm Formation.

    Science.gov (United States)

    Karatas, Mehmet Baran; Tuygun, Abdullah Kemal; Gungor, Baris; Sisman, Seviye Bora; Sahin, Sinan; Bolca, Osman

    2016-02-01

    Valve-sparing root replacement (the David procedure) is a valuable alternative to conventional aortic root replacement with a composite graft, especially in patients whose aortic valve leaflets have not been altered. However, reintervention rates are higher than are those associated with composite graft implantation. In this report, we present the case of a patient who had undergone valve-sparing root replacement 2 years earlier and was admitted to our hospital with myocardial infarction and cardiogenic shock secondary to coronary ostial button dissection, aortic pseudoaneurysm formation, and severe left main coronary artery compression. To our knowledge, this case is exceedingly rare. Rather than attempt local reconstruction of the mouth of the pseudoaneurysm, we excised the lesion, the aortic valve, and the graft, and we successfully implanted a composite aortic graft with a mechanical aortic valve.

  9. Spontaneous left main coronary artery dissection complicated by pseudoaneurysm formation in pregnancy: role of CT coronary angiography

    Directory of Open Access Journals (Sweden)

    Weintraub Nealw F

    2009-04-01

    Full Text Available Abstract We report a case of a 26-year-old female, who presented at 34 weeks of an uncomplicated pregnancy with an acute ST elevation anterior wall myocardial infarction. Cardiac catheterization suggested a left main coronary artery dissection with pseudoaneurysm formation. The patient's course was complicated by congestive heart failure. She was initially managed conservatively by a multidisciplinary team including heart failure specialists, obstetricians, and cardiovascular surgeons. 4 days after admission, her LMC was imaged by dual-source 64 slice Cardiac computed tomography, coronary dissection was identified extending to the lumen, and the presence of pseudoaneurysm was confirmed. She underwent subsequently a staged procedure, which included placement of an intra-aortic balloon pump, cesarean section, and coronary artery bypass grafting. This case illustrates the utility of coronary artery CT imaging to assess the complexity and stability of coronary artery dissections, thereby helping to determine the need for, and timing of revascularization procedures.

  10. Generalizability of EXCEL and NOBLE results to a large registry population with unprotected left main coronary artery disease.

    Science.gov (United States)

    Lee, Pil Hyung; Kang, Se Hun; Han, Seungbong; Ahn, Jung-Min; Bae, Jae Seok; Lee, Cheol Hyun; Kang, Soo-Jin; Lee, Seung-Whan; Kim, Young-Hak; Lee, Cheol Whan; Park, Seong-Wook; Park, Duk-Woo; Park, Seung-Jung

    2017-12-01

    The aim of this study was to determine how trial-based findings of EXCEL and NOBLE might be interpreted and generalizable in 'real-world' settings with comparison of data from the large-scaled, all-comer Interventional Research Incorporation Society-Left MAIN Revascularization (IRIS-MAIN) registry. We compared baseline clinical and procedural characteristics and also determined how the relative treatment effect of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) was different in EXCEL and NOBLE, compared with those of the multicenter, IRIS-MAIN registry (n=2481). The primary outcome for between-study comparison was a composite of death, myocardial infarction (MI), or stroke. There were between-study differences in patient risk profiles (age, BMI, diabetes, and clinical presentation), lesion complexities, and procedural characteristics (stent type, the use of off-pump surgery, and radial artery); the proportion of diabetes and acute coronary syndrome was particularly lower in NOBLE than in other studies. Although there was interstudy heterogeneity for the protocol definition of MI, the risks for serious composite outcome of death, MI, or stroke were similar between PCI and CABG in EXCEL [hazard ratio (HR): 1.00; 95% confidence interval (CI): 0.79-1.26; P=0.98] and in the matched cohort of IRIS-MAIN (HR: 1.08; 95%CI: 0.85-1.38; P=0.53), whereas it was significantly higher after PCI than after CABG in NOBLE (HR: 1.47; 95%CI: 1.06-2.05; P=0.02), which was driven by more common MI and stroke after PCI. In the comparison of a large-sized, all-comer registry, the EXCEL trial might represent better generalizability with respect to baseline characteristics and observed clinical outcomes compared with the NOBLE trial.

  11. Long-term clinical results of acute myocardial infarction at the left main trunk requiring percutaneous cardiopulmonary support.

    Science.gov (United States)

    Yamauchi, Takashi; Masai, Takafumi; Fujii, Kenji; Sawa, Yoshiki; Shirai, Shinya; Kamigaki, Mitsunori; Itou, Naofumi

    2017-12-01

    The clinical results of patients with acute myocardial infarction (AMI) at the left main trunk (LMT) remain unclear, especially in cases requiring percutaneous cardiopulmonary support (PCPS). Twenty seven cases of AMI at the LMT requiring emergent PCPS were retrospectively investigated. These 27 patients were aged 44-83 years (65.6 ± 8.6 years) and 20 (81.5%) were men. Peak creatine kinase (CK) leakage ranged from 538 to 34,010 IU/l (13,553 ± 7656 IU/l). Eight (29.6%) patients were discharged without mechanical support. Ten (37.0%) patients underwent left ventricular assist device (LVAD) implantation, five of whom with preoperative organ failure could not survive more than 6 months after implantation. The other nine (33.3%) patients died of low output syndrome or brain damage. The overall survival rates were 53.7, 41.3, 33.0, and 28.3% at 3 months, 6 months, 1 year, and 2 years, respectively. Multivariate analysis showed that Killip class 3/4 at hospital arrival was an independent risk factor for hospital mortality (odds ratio 20.4). Patients with more than 5 days of PCPS support period (n = 6), ≥ 4 h to revascularization (n = 6) or maximum CK leakage ≥20,000 IU/dl (n = 3) were not associated with successful PCPS or IABP weaning. The long-term clinical outcomes of patients with LMT disease requiring PCPS is devastating. Rapid cardiopulmonary resuscitation and coronary revascularization and timely insertion of LVAD before the onset of complications might lead to better survival.

  12. Three Year Follow-Up of a Vein Patch Repair for a Coronary Artery Saccular Aneurysm of the Left Main Bifurcation.

    Science.gov (United States)

    Kawase, Yasuhiro; Ishii, Yosuke; Yoshio, Takahide; Nishina, Dai; Bessho, Ryuzo; Nitta, Takashi

    2017-04-20

    This report describes a case of surgical treatment for a coronary artery saccular aneurysm of the left main bifurcation. A coronary artery saccular aneurysm (7 mm × 10 mm) and three vessel disease, including the left main trunk, were diagnosed by coronary angiography. A surgical resection and saphenous vein patch repair of the left main coronary artery aneurysm was performed concomitantly with coronary artery bypass grafting. The pathological findings of the aneurysm clarified that the aneurysm wall was atrophic and extremely thin because of a collapsed trilaminar arterial structure due to atherosclerosis. A coronary computed tomographic scan revealed no aneurysmal formation in the patent left main trunk and patent grafts 3 years after surgery.

  13. Assessing the left main stem in the cardiac catheterization laboratory. What is "significant"? Function, imaging or both?

    Science.gov (United States)

    Kassimis, George; de Maria, Giovanni Luigi; Patel, Niket; Raina, Tushar; Scott, Peter; Kharbanda, Rajesh K; Banning, Adrian P

    2018-01-01

    Revascularization of significant Left Main Stem (LMS) disease improves clinical outcomes. This can be achieved through either Coronary Artery Bypass Grafting or Percutaneous coronary intervention. Defining a significant stenosis of the LMS can be challenging and debatable, as most data have been derived using angiographic assessment alone, with a threshold of 50% luminal stenosis used as a marker of functional significance. The use of adjunctive technologies like Intravascular Ultrasound and Fractional Flow Reserve has improved our ability to accurately assess the anatomical severity and physiological significance of coronary artery stenoses, much more so, than can be achieved through conventional angiography alone. An improved assessment of LMS disease through these adjunctive techniques offers procedural and clinical benefits. Rather than focus on the preferred methods of revascularisation, this article aims to highlight the common pitfalls and misconceptions in the assessment of LMS stenoses. We also propose a simple algorithm for the assessment of LMS disease to help guide revascularisation decisions. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Comparison of a Simple Angiographic Approach With a Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery Score-Based Approach for Left Main Coronary Artery Stenting: A Pooled Analysis of Serial PRECOMBAT (Premier of Randomized Comparison of Bypass Surgery Versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease) Studies.

    Science.gov (United States)

    Lee, Pil Hyung; Lee, Jong-Young; Lee, Cheol Whan; Kim, Seon-Ok; Ahn, Jung-Min; Park, Duk-Woo; Kang, Soo-Jin; Lee, Seung-Whan; Kim, Young-Hak; Park, Seong-Wook; Park, Seung-Jung

    2018-01-01

    The applicability of Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery scores to left main coronary artery disease (CAD) has been questioned. A simplified alternative is needed for guiding decision making. We evaluated the prognostic value of a simplified angiographic classification in comparison with a Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery score-based approach for patients with left main CAD undergoing drug-eluting stent implantation. The proposed approach classified left main CAD as either extensive (n=819), defined as left main bifurcation lesions with an involvement of ostial left circumflex artery or as any left main lesion plus multivessel CAD, or limited (n=453), defined as ostial/midshaft lesions or left main bifurcation lesions without an involvement of ostium of left circumflex artery, alone or plus 1-vessel disease. The databases from 4 prospective Premier of Randomized Comparison of Bypass Surgery versus Angioplasty Using Sirolimus-Eluting Stent in Patients with Left Main Coronary Artery Disease studies were pooled, and the primary outcome was a major adverse cardiac event, defined as death, myocardial infarction, or repeat revascularization. During follow-up (median 38 months; interquartile range, 36-61 months), the risk for major adverse cardiac event was significantly higher with extensive than with limited left main CAD (adjusted hazard ratio, 2.13; 95% confidence interval, 1.54-2.94; P Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery score tertiles did not effectively stratify these 2 outcome measures. Compared with Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery scores, the simpler angiographic approach provided better discrimination for future cardiovascular events in patients with left main CAD undergoing drug-eluting stent implantation. © 2018 American Heart Association, Inc.

  15. Learning LM Specificity for Ganglion Cells

    Science.gov (United States)

    Ahumada, Albert J.

    2015-01-01

    Unsupervised learning models have been proposed based on experience (Ahumada and Mulligan, 1990;Wachtler, Doi, Lee and Sejnowski, 2007) that allow the cortex to develop units with LM specific color opponent receptive fields like the blob cells reported by Hubel and Wiesel on the basis of visual experience. These models used ganglion cells with LM indiscriminate wiring as inputs to the learning mechanism, which was presumed to occur at the cortical level.

  16. Frequency of significant three vessel coronary artery disease and left main stem disease in acute coronary syndrome patients having high LDL cholesterol level

    International Nuclear Information System (INIS)

    Zeb, S.; Achakzai, A.S.; Zeb, J.; Zeb, R.; Adil, M.; Jan, H.

    2017-01-01

    Objective: To calculate the frequency of significant three-vessel coronary artery and left main stem disease in patients presenting with acute coronary syndrome having high LDL cholesterol level. Methodology: This observational study was performed in Lady Reading Hospital, Peshawar, Pakistan from June 1, 2013 to December 31, 2013. All consecutive patients undergoing coronary angiography admitted with acute coronary syndrome within past 30 days and having LDL cholesterol more than 130mg/dl were included in the study. Demographic data was noted. The data was analyzed by using software SPSS version 16. Results: A total number of 206 patients were included in the study. Mean age was 51.25+-8.4 years. Of them, 139(67.5%) were male and 67(32.5%) female. Hypertension was found in 87(42.2%) patients, diabetes was found in 71(34.5%) patients, 56(27.2%) were smokers, family history of CAD was present in 39(18.9%) patients. The incidence of significant three vessel coronary artery disease was 52(25.2%) and left main stem disease were present in 15(7.2%). Out of 67(32.4%) with severe triple vessel and Left main stem disease, males were 51(76.1%) and females were 16(23.9%). Patients with significant three vessel and left main stem disease were more frequently males and younger. Conclusion: Patients having acute coronary syndrome with High LDL levels are more frequently have significant three vessel and Left main stem disease.

  17. Electrocardiographic characteristics associated with in-hospital outcome in patients with left main acute coronary syndrome: For contriving a new risk stratification score.

    Science.gov (United States)

    Iida, Takayuki; Tanimura, Fumito; Takahashi, Kyoko; Nakamura, Hideki; Nakajima, Satoshi; Nakamura, Motoyuki; Morino, Yoshihiro; Itoh, Tomonori

    2016-12-01

    The aim of this study was to evaluate electrocardiographic characteristics associated with in-hospital prognosis in patients with left main acute coronary syndrome. A total of 89 left main acute coronary syndrome subjects were selected from 3357 consecutive acute coronary syndrome patients (2.7%). Patients of this study were divided into two groups; those who survived and those who died. Patients' characteristics and electrocardiogram on admission were then retrospectively analyzed between the two groups. In-hospital mortality was 28.1%. The prevalence and degree of ST-segment elevation at lead aVL were significantly higher in the deceased group than in the survival group ( psyndrome. Electrocardiographic characteristics should be assessed in addition to the established risk score in patients with left main acute coronary syndrome.

  18. LM2500+ Brush Seal Case Study

    Science.gov (United States)

    Haaser, Fred G.

    2006-01-01

    The LM2500+ industrial aeroderivative gas turbine, a 25% enhanced power derivative of the LM2500 gas turbine, recently completed its development test program during the period 5/96 - 10/96. Early in the engine program a Quality Function Deployment (QFD) process was used to determine customer needs for this project.The feedback obtained from the QFD process showed without doubt that gas turbine customers now emphasize product reliability and availability at the top of their needs. One area of development on the LM2500+ was to investigate the use of a brush seal as a means to reduce undesirable turbine cooling leakages within the turbine mid frame in order to enhance part life. This presentation presents a case study on the factors that went into evaluating a brush seal during engine test, test results, and the ultimate decision not to implement the brush seal for cost and other reasons.

  19. Predictors of long-term outcomes after bypass grafting versus drug-eluting stent implantation for left main or multivessel coronary artery disease

    NARCIS (Netherlands)

    Chang, Mineok; Lee, Cheol Whan; Ahn, Jung-Min; Cavalcante, Rafael; Sotomi, Yohei; Onuma, Yoshinobu; Han, Minkyu; Park, Seong-Wook; Serruys, Patrick W.; Park, Seung-Jung

    2017-01-01

    Background: We assessed predictors of long-term outcomes after coronary artery bypass grafting (CABG) versus those after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) in 3,230 patients with left main or multivessel coronary artery disease (CAD). Methods and Results: Data

  20. Intraoperative Use of the Ventrain for Single Lung Ventilation After Iatrogenic Trauma to the Left Main Bronchus During Thoracoscopy: A Case Report

    NARCIS (Netherlands)

    Evers, Veronika M.; Immink, Rogier V.; van Boven, Willem J. P.; van Berge Henegouwen, Mark I.; Hollmann, Markus W.; Veelo, Denise P.

    2017-01-01

    In a patient undergoing thoracoscopic esophagectomy and concomitant wedge resection, an iatrogenic lesion in the left main bronchus was observed following deflation of the right lung. Because the bronchial cuff of the double-lumen tube was visible through the lesion, repair was only possible after

  1. Hospital patterns of medical management strategy use for patients with non-ST-elevation myocardial infarction and 3-vessel or left main coronary artery disease

    NARCIS (Netherlands)

    Harskamp, Ralf E.; Wang, Tracy Y.; Bhatt, Deepak L.; Wiviott, Stephen D.; Amsterdam, Ezra A.; Li, Shuang; Thomas, Laine; de Winter, Robbert J.; Roe, Matthew T.

    2014-01-01

    Patients with non-ST-elevation myocardial infarction (NSTEMI) and three-vessel or left main coronary disease (3VD/LMD) have a high risk of long-term mortality when treated with a medical management strategy (MMS) compared with revascularization. We evaluated patterns of use and patient features

  2. Left main bronchus compression as a result of tuberculous lymphnode compression of the right-sided airways with right lung volume loss in children.

    Science.gov (United States)

    Andronikou, S; Van Wyk, M J; Goussard, P; Gie, R P

    2014-03-01

    The superior mediastinal space is confined by the sterno-manubrium anteriorly and the vertebral column posterior. An abnormal relationship between the superior mediastinal structures may result in compression of the left main bronchus. In patients with right-sided pneumonectomy an exaggerated compensatory response may lead to stretching and compression of the remainder of the intra-thoracic airway. Lymphobronchial TB mimics pneumonectomy when it causes compression of the bronchus intermedius, between nodal lymphnode groups with resultant volume loss in the right lung and displacement of the mediastinum to the right. The left main bronchus may be at risk of compression due to rotation and displacement of the major vessels. To report pediatric cases of right-sided lymphobronchial TB with volume loss, demonstrate the use of angle measurements to quantify mediastinal dynamics and support a pathogenetic theory for left main bronchus compression. CT scans in children with TB and right lung volume loss, were compared retrospectively with controls using angle measurements based on descriptions of the aorta-carinal syndrome and the post-pneumonectomy syndrome. The Mann-Whitney U-test was used to compare groups. The "Pulmonary bifurcation angle" between the main pulmonary arteries reached statistical significance (P = 0.025). The "Pulmonary outflow tract rotation" angle (pulmonary trunk with the mid sagittal plane) approached statistical significance (P = 0.078). The left main bronchus ranged from complete obliteration in two patients to 0.7 cm. In 16 of 30 patients the size was reduced to less than 75% of expected. In children with right lung volume loss from TB, the compression of the contralateral bronchus is due to narrowing of the pulmonary artery bifurcation angle as the main trunk rotates towards the midline. This is comparable to the post-pneumonectomy syndrome. © 2012 Wiley Periodicals, Inc.

  3. A fleet leader experience with dry low emissions aeroderivative gas turbines (LM6000PB and PD)

    Energy Technology Data Exchange (ETDEWEB)

    Vandesteene, J.L.; De Witte, M.

    1998-07-01

    In January 1995, the world's first LM6000 dry low emissions (DLE) aeroderivative gas turbine supplied by GE M and I was successfully started up at Gent power plant. In November 1997, the world's first uprated LM6000, also equipped with the DLE combustion system, began commercial operation at Geel cogeneration facility. TEE handled the engineering, procurement, construction and commissioning of these projects as well as for several other repowering and cogeneration facilities based on high efficiency DLE aeroderivative gas turbines. By mid 1998, seven LM6000 DLE and one LM2500 DLE will be in commercial operation at several cogeneration and power plants in Belgium. The results of three years of experience with the LM engines are presented: the reasons why the LM engines were selected, the history of the different units, the maintenance organization, the fleet fired hours and availability, and the main technical issues like DLE combustor, LPT5 failures. The conclusion is that after having experienced several serious problems, the LM6000 and the DLE combustion system have matured and now seem sufficiently reliable. The actual performance data of the uprated engine are significantly better than initially expected.

  4. Prediction of left main or 3-vessel disease using myocardial perfusion reserve on dynamic thallium-201 single-photon emission computed tomography with a semiconductor gamma camera.

    Science.gov (United States)

    Shiraishi, Shinya; Sakamoto, Fumi; Tsuda, Noriko; Yoshida, Morikatsu; Tomiguchi, Seiji; Utsunomiya, Daisuke; Ogawa, Hisao; Yamashita, Yasuyuki

    2015-01-01

    Myocardial perfusion imaging (MPI) may fail to detect balanced ischemia. We evaluated myocardial perfusion reserve (MPR) using Tl dynamic single-photon emission computed tomography (SPECT) and a novel cadmium zinc telluride (CZT) camera for predicting 3-vessel or left main coronary artery disease (CAD). METHODS AND RESULTS: A total of 55 consecutive patients with suspected CAD underwent SPECT-MPI and coronary angiography. The MPR index was calculated using the standard 2-compartment kinetic model. We analyzed the utility of MPR index, other SPECT findings, and various clinical variables. On multivariate analysis, MPR index and history of previous myocardial infarction (MI) predicted left main and 3-vessel disease. The area under the receiver operating characteristic curve was 0.81 for MPR index, 0.699 for history of previous MI, and 0.86 for MPR index plus history of previous MI. MPR index ≤1.5 yielded the highest diagnostic accuracy. Sensitivity, specificity, and accuracy were 86%, 78%, and 80%, respectively, for MPR index, 64%, 76%, 73% for previous MI, and 57%, 93%, and 84% for MPR index plus history of previous MI. Quantification of MPR using dynamic SPECT and a novel CZT camera may identify balanced ischemia in patients with left main or 3-vessel disease.

  5. 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.

  6. [Simultaneous endovascular aortic aneurysm repair and coronary artery bypass grafting in a patient with abdominal aortic aneurysm and left main trunk lesion].

    Science.gov (United States)

    Nakao, Yoshihisa; Mitsuoka, Hiroshi; Masuda, Mikio; Shintani, Tsunehiro; Higashi, Shigeki

    2010-10-01

    To patients with severe coronary artery disease (CAD) and expanding large abdominal aortic aneurysm (AAA), simultaneous coronary artery bypass grafting (CABG) and AAA repair has been recommended. A 68-year-old woman had a CAD and an AAA 71 mm in diameter which was enlarging. Coronary angiography showed severe stenoses in the left main trunk (LMT), the left anterior descending artery and the circumflex artery. On-pump beating CABG and AAA repair with endovascular aneurysm repair (EVAR) were performed simultaneously, because intraaortic balloon pumping (IABP) might be needed due to severe stenoses of LMT. Just after EAVR, on-pump beating CABG was performed. The patient was discharged 15 days after the operation. It was suggested that a simultaneous operation of CABG and EVAR might be safe and effective for high risk patients with CAD and AAA.

  7. Left Main Coronary Artery Compression following Melody Pulmonary Valve Implantation: Use of Impella Support as Rescue Therapy and Perioperative Challenges with ECMO

    Directory of Open Access Journals (Sweden)

    Erica D. Wittwer

    2014-01-01

    Full Text Available The purpose of this case is to describe the complex perioperative management of a 30-year-old woman with congenital heart disease and multiple resternotomies presenting with pulmonary homograft dysfunction and evaluation for percutaneous pulmonary valve replacement. Transvenous, transcatheter Melody valve placement caused left main coronary artery occlusion and cardiogenic shock. An Impella ventricular assist device (VAD provided rescue therapy during operating room transport for valve removal and pulmonary homograft replacement. ECMO support was required following surgery. Several days later during an attempted ECMO wean, her hemodynamics deteriorated abruptly. Transesophageal and epicardial echocardiography identified pulmonary graft obstruction, requiring homograft revision due to large thrombosis. This case illustrates a role for Impella VAD as bridge to definitive procedure after left coronary occlusion and describes management of complex perioperative ECMO support challenges.

  8. Wind Tunnel Measurements at LM Wind Power

    DEFF Research Database (Denmark)

    Bertagnolio, Franck

    2012-01-01

    This section presents the results obtained during the experimental campaign that was conducted in the wind tunnel at LM Wind Power in Lunderskov from August 16th to 26th, 2010. The goal of this study is to validate the so-called TNO trailing edge noise model through measurements of the boundary...... layer turbulence characteristics and the far-field noise generated by the acoustic scattering of the turbulent boundary layer vorticies as they convect past the trailing edge. This campaign was conducted with a NACA0015 airfoil section that was placed in the wind tunnel section. It is equipped with high...

  9. SPRINT spray intercooling augments LM6000 output

    Energy Technology Data Exchange (ETDEWEB)

    Smith, David

    1998-09-01

    By injecting water between the low pressure and high pressure compressors of an aeroderivative gas turbine, GE-IAD engineers have demonstrated that a 9 per cent increase in output accompanied by reduced life cycle costs can be achieved. Designated the SPRINT system, uprated LM 6000 units with augmented efficiency have been introduced to the market. The first two production units, both supplied to Southern Electric Power Generation in England for mid-merit independent power generation plants at Chickerell in Dorset and Burghfield in Berkshire, have each clocked in excess of 500 operating hours since start-up in early April 1998. MPS visited the Chickerell installation in late July 1998. (UK)

  10. Uprated LM6000s repower Belgian plants

    Energy Technology Data Exchange (ETDEWEB)

    Marque, A. [Ge Marine & Industrial Engines, Cincinnati, OH (United States)

    1998-04-01

    Two coal-fired power stations in Belgium - Langerlo and Ruien - are currently being repowered and will use GE`s uprated LM6000 PD aeroderivative gas turbines. The conversion of these plants, which will use Dry Low Emission (DLE) equipped gas turbines, is expected to increase power by about 25%, improve overall efficiency by 2% and decrease emissions by 20% at each facility. These repowerings were developed by Brussels-based Tractebel Energy Engineering for the private utility, Electrabel. 2 figs., 1 tab.

  11. Exploration the extrudability of aluminum matrix composite (LM6/TIC ...

    African Journals Online (AJOL)

    Aluminum matrix composites (LM6/TiC) is a mix of excellent properties of aluminum casting alloy (LM6), and particles of (TiC) which make it the first choice in many applications like airplane and marine industries. During this research the extrudability and mechanical specifications of this composite (LM6/TiC) are ...

  12. LM6000 engine testing : a unique concept

    Energy Technology Data Exchange (ETDEWEB)

    Goehring, D. [TransCanada Turbines Ltd., Calgary, AB (Canada)

    2004-07-01

    This presentation describes a project undertaken by TransCanada Turbines to test overhauled General Electric LM6000 industrial gas turbine engines. Most mainstream aero-derivative gas turbine testing takes place in specially designed, and expensive test cells. In an attempt to reduce testing costs, TransCanada Turbines modified an existing General Electric Stewart and Stevenson LM6000 PC package into a quick change-out test cell east of Strathmore, Alberta at the EnCana Cavalier Power Station. This paper describes the skid mounted engine design, the quick change-out concept and the modification to the control system to enable engine testing. Engine testing involved disconnecting and removing the engine from the generator package, installing and running a test engine, and then reinstalling the EnCana engine within a short time span. Both engines required a quick disconnect connection. Yanos Aerospace developed a data acquisition system for post processing of the test data. The several benefits associated with the testing package were presented along with environmental benefits. 15 figs.

  13. Neodymium-140 DOTA-LM3

    DEFF Research Database (Denmark)

    Severin, Gregory; Kristensen, Lotte K.; Nielsen, Carsten H.

    2017-01-01

    analogue, DOTA-LM3 (1,4,7,10- tetraazacyclododecane, 1,4,7- tri acetic acid, 10- acetamide N - p-Cl-Phecyclo(D-Cys-Tyr-d-4-amino-Phe(carbamoyl)-Lys-Thr-Cys)D-Tyr-NH2) and injected into H727 xenograft bearing mice. Comparative pre- and post-mortem PET imaging at 16 h postinjection was used to quantify......140Nd (t1/2 = 3.4 days), owing to its short-lived positron emitting daughter 140Pr (t1/2 = 3.4 min), has promise as an in vivo generator for positron emission tomography (PET). However, the electron capture decay of 140Nd is chemically disruptive to macrocycle-based radiolabeling, meaning...... the in vivo redistribution of 140Pr following 140Nd decay. The somatostatin receptor-positive pancreas exhibited the highest tissue accumulation of 140Nd-DOTA-LM3 (13% ID/g at 16 h) coupled with the largest observed redistribution rate, where 56 ± 7% (n = 4, mean ± SD) of the in situ produced 140Pr washed out...

  14. Transesophageal echocardiography in surgical management of pseudoaneurysm of mitral-aortic intervalvular fibrosa with aneurysms of right sinus of Valsalva and left main coronary artery

    Directory of Open Access Journals (Sweden)

    Shreedhar S Joshi

    2013-01-01

    Full Text Available Pseudoaneurysm of mitral-aortic intervalvular fibrosa (MAIVF is a rare complication associated with aortic and/or mitral valve surgery complicated by infective endocarditis. We report pseudoaneurysm of MAIVF in a young adult without overt cardiac disease or previous cardiac surgery. The patient had a rare combination of pseudoaneurysm of MAIVF impinging on anterior mitral leaflet causing moderate mitral regurgitation, right sinus of Valsalva aneurysm extending into interventricular septum, and left main coronary artery aneurysm. Transesophageal echocardiography helped in confirming the lesions, delineating the anatomy of all the lesions, and assessing the adequacy of surgical repair.

  15. Mediastinal radiotherapy and ostial lesion of the left main coronary artery; Radioterapia mediastinica e lesao ostial de tronco de coronaria esquerda

    Energy Technology Data Exchange (ETDEWEB)

    Victor, Edgar Guimaraes; Parente, Giordano Bruno de Oliveira [Pernambuco Univ., Recife, PE (Brazil). Hospital das Clinicas]. E-mail: evictor@truenet.com.br

    2004-03-01

    Ischemic cardiac disease is a rare complication and, only recently recognized, of mediastinal irradiation for neoplasms in this region. A case of a 51 years old woman with angina pectoris, rapidly progressive is related, where the angiographic finding was represented by ostial sub occlusive lesion of the left coronary body. The previous story showed the use of radiotherapy for mediastinal Hodgkin lymphoma treatment, with close relation to right ventricle, removed by surgery and afterwards treated with irradiation and chemotherapy two years ago. The coronary stenosis induction in these patients can be dependent or not of the focal arteriosclerosis and is mediated, mainly, by intimal thickness due to tissular fibrosis without alteration in the medium layer and with inclination for the ostial portions of the main arteries. The recognition of this condition (thorax radiotherapy), as an isolated and independent factor for the coronary disease, should be considered in the acting plan for prevention, detection and previous therapy.

  16. Unexpected evolution of a non-stenotic lesion in the left main coronary artery of a patient with non-ST-segment elevation myocardial infarction.

    Science.gov (United States)

    Ispas, Alexandru Florin; Mangin, Lionel; Paziuc, Alexandru; Belle, Loic

    2017-06-01

    A 72-year-old man was referred to our catheterization laboratory 48 hours after a non-ST-segment elevation myocardial infarction. His medical history included coronary artery disease (CAD) (percutaneous coronary intervention of the right coronary artery and chronic total occlusion of the circumflex artery), atrial fibrillation (AF), and chronic kidney disease. An electrocardiogram showed a pre-existent left bundle-branch block and the patient's maximum cardiac troponin concentration was 8.64 µg/L (upper limit of normal: 0.003 µg/L). The coronary angiogram revealed an ulcerated plaque of the left main coronary artery (LMCA) and moderate stenosis of the left anterior descending (LAD) coronary artery. A non-interventional approach to treatment was chosen. One month later, a control angiography showed a giant distal aneurysm complicating the lesion; the fractional flow reserve (FFR) value in the LAD was 0.74. The heart team discussed the case and concluded that the aneurysm was inaccessible via surgery. To protect the LAD from possible covered stent thrombosis or restenosis, coronary artery bypass grafting of the LAD was performed prior to percutaneous coronary intervention (PCI). Five days later, we proceeded with percutaneous exclusion of the aneurysm. We combined coil embolization of three Interlock™ two-dimensional detachable coils with stenting of the LMCA, using a PK Papyrus™ covered stent. Effective angiographic exclusion was achieved. The patient was discharged on warfarin, aspirin, and clopidogrel for 1 month, followed by long-term aspirin and oral anticoagulation. A 6-month follow-up angiography demonstrated a completely sealed aneurysm and optical coherence tomography (OCT) confirmed the successful endothelialization of the covered stent.

  17. Quality-of-Life After Everolimus-Eluting Stents or Bypass Surgery for Left-Main Disease: Results From the EXCEL Trial.

    Science.gov (United States)

    Baron, Suzanne J; Chinnakondepalli, Khaja; Magnuson, Elizabeth A; Kandzari, David E; Puskas, John D; Ben-Yehuda, Ori; van Es, Gerrit-Anne; Taggart, David P; Morice, Marie-Claude; Lembo, Nicholas J; Brown, W Morris; Banning, Adrian; Simonton, Charles A; Kappetein, A Pieter; Sabik, Joseph F; Serruys, Patrick W; Stone, Gregg W; Cohen, David J

    2017-12-26

    The EXCEL (Evaluation of Xience Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization) trial compared outcomes in patients with unprotected left main coronary artery disease (LMCAD) treated with coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI) using everolimus-eluting stents. Whereas rates of death, stroke, and myocardial infarction were similar at 36 months, event timing and repeat revascularization rates differed by treatment group. To understand the effects of revascularization strategy from the patient's perspective, a prospective quality of life (QoL) substudy was performed alongside the EXCEL trial. Between September 2010 and March 2014, 1,905 patients with LMCAD were randomized to undergo CABG or PCI, of whom 1,788 participated in the QoL substudy. QoL was assessed at baseline and 1, 12, and 36 months using the Seattle Angina Questionnaire, the 12-Item Short Form Health Survey, the Rose Dyspnea Scale, the Patient Health Questionnaire-8, and the EQ-5D. Differences between PCI and CABG were assessed using longitudinal random-effect growth curve models. Over 36 months, both PCI and CABG were associated with significant improvements in QoL compared with baseline. At 1 month, PCI was associated with better QoL than CABG. By 12 months though, these differences were largely attenuated, and by 36 months, there were no significant QoL differences between PCI and CABG. Among selected patients with LMCAD, both PCI and CABG result in similar QoL improvement through 36 months, although a greater early benefit is seen with PCI. Taken together with the 3-year clinical results of EXCEL, these findings suggest that PCI and CABG provide similar intermediate-term outcomes for patients with LMCAD. (Evaluation of Xience Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization [EXCEL]; NCT01205776). Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier

  18. Pseudo-aneurisma post-traumático de tronco de arteria coronaria izquierda Post-traumatic false (pseudo aneurysm of the left main coronary artery

    Directory of Open Access Journals (Sweden)

    Melina M. Gallo

    2011-08-01

    Full Text Available El pseudo-aneurisma de arteria coronaria es extremadamente raro. Su historia natural es poco conocida y su tratamiento discutido. Se presenta el caso de un paciente con pseudo-aneurisma de tronco de la coronaria izquierda e infarto antero-apical del ventrículo izquierdo cinco años después de un paro cardíaco secundario a un traumatismo no penetrante de tórax. Se consideró entonces que la lesión no era pasible de corrección percutánea o quirúrgica por lo que se optó por tratamiento médico conservador. Una angiografía coronaria por tomografía computarizada multicorte realizada 10 años después del evento inicial mostró ausencia de progresión de la lesión.Coronary pseudo-aneurysm is an extremely rare entity. Its natural history is scarcely known and its treatment is controversial. We report a case of pseudo-aneurysm of the left main coronary artery associated with an antero-apical infarct of the left ventricle diagnosed five years after a cardiac arrest following a non-penetrating thoracic trauma. The patient was treated conservatively because percutaneous or surgical correction were not considered suitable for this lesion. A multidetector computed tomography coronary angiogram performed 10 years after the initial event showed no evidence of progression.

  19. Benefits of maintenance agreements for GE`s LM2500 and LM6000 gas turbines

    Energy Technology Data Exchange (ETDEWEB)

    Brown, F.G. [Northland Power Inc., Toronto, ON (Canada)

    1997-12-31

    The six-year gas turbine maintenance agreement that Northland Power has signed with General Electric Marine and Industrial Engines for the Cochrane, Kirkland Lake and Iroquois Falls plants was discussed. Power at the plants is generated by one GE LM2500PH, three LM2500PE and two LM6000PA aeroderivative gas turbines. For each of the three plants, Northland considered the benefits and limitations of aeroderivative gas turbines versus industrial gas turbines. Aeroderivatives could have higher capital costs per MWh, higher operating and maintenance cost per MWh and irregular maintenance costs. However, they also offer significant benefits such as short delivery, installation and commissioning, greater peaking capacity and accommodation of starts and stops, suitable size for mechanical drive and many cogeneration projects, higher efficiency, and rapid changeouts. The outsourcing of the contract has been very beneficial to stockholders because Northland has reduced the risk in its gas turbine maintenance projections by up to 20 per cent and is able to focus more on its core business of power plant development, operations and general maintenance. Northland management is strongly convinced that gas turbine agreements form an integral component of the aeroderivative gas turbine solution.4 tabs., 4 figs.

  20. [Percutaneous coronary intervention of unprotected left main coronary compared with coronary artery bypass grafting; 3 years of experience in the National Institute of Cardiology, Mexico].

    Science.gov (United States)

    López-Aguilar, Carlos; Abundes-Velasco, Arturo; Eid-Lidt, Guering; Piña-Reyna, Yigal; Gaspar-Hernández, Jorge

    The best revascularisation method of the unprotected left main artery is a current and evolving topic. A total of 2439 percutaneous coronary interventions (PCI) were registered during a 3-year period. The study included all the patients with PCI of the unprotected left main coronary (n=48) and matched with patients who underwent coronary artery bypass graft (CABG) (n=50). Major adverse cerebral and cardiac events (MACCE) were assessed within the hospital and in outpatients during a 16 month follow up. The cardiovascular risk was greater in the PCI group; logEuroSCORE 16±21 vs. 5±6, P=.001; clinical Syntax 77±74 vs 53±39, P=.04. On admission, the PCI group of patients had a higher frequency of ST segment elevation myocardial infarction (STEMI) and cardiogenic shock. The MACCE were similar in both groups (14% vs. 18%, P=.64). STEMI was less frequent in the PCI group (0% vs. 10%, P=.03). Cardiovascular events were lower in the PCI group (2.3% vs. 18%, P=.01), and there was a decrease in general and cardiac mortality (2.3% vs. 12%, P=.08 y 2.3% vs. 8%, P=.24), on excluding the patients with cardiogenic shock as a presentation. MACCE were similar in both groups in the out-patient phase (15% vs. 12%, P=.46). Survival without MACCE, general and cardiac death were comparable between groups (log rank, P=.38, P=.44 and P=.16, respectively). Even though the clinical and peri-procedural risk profile of the PCI patients were higher, the in-hospital and out-hospital efficacy and safety were comparable with CABG. Copyright © 2016 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

  1. Impact of final kissing balloon inflation after simple stent implantation for the treatment of non-left main true coronary bifurcation lesions in patients with acute coronary syndrome.

    Science.gov (United States)

    Kim, Tae-Hoon; Lee, Hyun Jong; Jang, Ho-Jun; Kim, Je Sang; Park, Jin Sik; Choi, Rak Kyeong; Choi, Young Jin; Shim, Won-Heum; Ro, Young Moo; Yu, Cheol Woong; Kwon, Sung Woo

    2014-12-20

    We sought to evaluate the impact of final kissing balloon inflation (FKBI) after simple stent implantation for the treatment of non-left main true coronary bifurcation lesions in patients with acute coronary syndrome (ACS). Whether FKBI should be mandatory after simple stent implantation for the treatment of coronary bifurcation lesion is controversial. Besides, ACS patients who have undergone bifurcation percutaneous coronary intervention with simple stent implantation may experience worse prognosis compared to stable angina pectoris patients. Two hundred and fifty one eligible patients (67.7% male, mean age 61.7 ± 10.4 years) were enrolled. The study population was divided into two groups according to the performance of FKBI. The primary end points were major adverse cardiac event (MACE); target lesion revascularization (TLR), non-fatal myocardial infarction (MI) and cardiac death during the follow-up period. Over a mean follow-up period of 3.0 ± 1.9 years, there were 29 MACEs (10 TLR, 6 non-fatal MI, and 13 cardiac deaths), representing an event rate of 11.6%. Kaplan-Meier survival analysis revealed that FBKI group had favorable outcome compared to non-FKBI group with regard to hard events (p = 0.010) as well as composite MACEs (p = 0.008). In multivariable analysis, FKBI was a significant predictor of composite MACEs [hazard ratio 0.398 (95% confidence interval 0.190-0.836, p = 0.015)] and hard events [hazard ratio 0.325 (95% confidence interval 0.130-0.811, p = 0.016)]. In terms of prognosis, performing FKBI after simple stent implantation for the treatment of non-left main true coronary bifurcation lesions may be mandatory in ACS patients. Copyright © 2014. Published by Elsevier Ireland Ltd.

  2. Provisional versus elective two-stent strategy for unprotected true left main bifurcation lesions: Insights from a FAILS-2 sub-study.

    Science.gov (United States)

    Kawamoto, Hiroyoshi; Chieffo, Alaide; D'Ascenzo, Fabrizio; Jabbour, Richard J; Naganuma, Toru; Cerrato, Enrico; Ugo, Fabrizio; Pavani, Marco; Varbella, Ferdinando; Boccuzzi, Giacomo; Pennone, Mauro; Garbo, Roberto; Conrotto, Federico; Biondi-Zoccai, Giuseppe; D'Amico, Maurizio; Moretti, Claudio; Escaned, Javier; Gaita, Fiorenzo; Nakamura, Sunao; Colombo, Antonio

    2018-01-01

    This study sought to investigate the optimal percutaneous coronary intervention (PCI) strategy for true unprotected left main coronary artery (ULMCA) bifurcations. The FAILS-2 was a retrospective multi-center study including patients with ULMCA disease treated with second-generation drug-eluting stents. Of these, we compared clinical outcomes of a provisional strategy (PS; n=216) versus an elective two-stent strategy (E2S; n=161) for true ULMCA bifurcations. The primary endpoint was the incidence of major adverse cardiac events (MACEs) at 3-years. We further performed propensity-score adjustment for clinical outcomes. There were no significant differences between the groups in terms of patient and lesion characteristics. 9.7% of patients in the PS group crossed over to a provisional two-stent strategy. MACEs were not significantly different between groups (MACE at 3-year; PS 28.1% vs. E2S 28.9%, adjusted p=0.99). The rates of target lesion revascularization (TLR) on the circumflex artery (LCX) were numerically high in the E2S group (LCX-TLR at 3-years; PS 11.8% vs. E2S 16.6%, adjusted p=0.51). E2S was associated with a comparable MACE rate to PS for true ULMCA bifurcations. The rates of LCX-TLR tended to be higher in the E2S group although there was no statistical significance. This study sought to compare the clinical outcomes of a provisional strategy (PS) with an elective two-stent strategy (E2S) for the treatment of true unprotected left main coronary artery bifurcations. 377 Patients (PS 216 vs. E2S 161 patients) were evaluated, and 9.7% in the PS group crossed over to a two-stent strategy. E2S was associated with a similar major adverse cardiac event rate at 3-years when compared to the PS strategy (PS 28.1% vs. E2S 28.9%, p=0.99). However, the left circumflex artery TLR rate at 3-year tended to be higher in the E2S group (PS 11.8% vs. E2S 16.6%, p=0.51). Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Neodymium-140 DOTA-LM3

    DEFF Research Database (Denmark)

    Severin, Gregory; Kristensen, Lotte K.; Nielsen, Carsten H.

    2017-01-01

    140Nd (t1/2 = 3.4 days), owing to its short-lived positron emitting daughter 140Pr (t1/2 = 3.4 min), has promise as an in vivo generator for positron emission tomography (PET). However, the electron capture decay of 140Nd is chemically disruptive to macrocycle-based radiolabeling, meaning...... that an in vivo redistribution of the daughter 140Pr is expected before positron emission. The purpose of this study was to determine how the delayed positron from the de-labeled 140Pr affects preclinical imaging with 140Nd. To explore the effect, 140Nd was produced at CERN-ISOLDE, reacted with the somatostatin...... analogue, DOTA-LM3 (1,4,7,10- tetraazacyclododecane, 1,4,7- tri acetic acid, 10- acetamide N - p-Cl-Phecyclo(D-Cys-Tyr-d-4-amino-Phe(carbamoyl)-Lys-Thr-Cys)D-Tyr-NH2) and injected into H727 xenograft bearing mice. Comparative pre- and post-mortem PET imaging at 16 h postinjection was used to quantify...

  4. ANGIOPLASTIA PERCUTÁNEA CON STENT EN EL TRONCO PRINCIPAL DE LA ARTERIA CORONARIA IZQUIERDA / Percutaneous angioplasty with stent in the left main coronary artery

    Directory of Open Access Journals (Sweden)

    Javier Almeida Gómez

    2012-10-01

    Full Text Available ResumenIntroducción y objetivos: La afectación significativa del tronco común izquierdo, es la más letal de las presentaciones de la enfermedad arterial coronaria. El tratamiento de elección, es la cirugía de derivación aorto-coronaria. En varios estudios multicéntricos, se sugiere la posibilidad de tratar la enfermedad de tronco mediante el intervencionismo coronario percutáneo con implantación de prótesis endoluminal o stent. El objetivo de esta investigación fue caracterizar la angioplastia percutánea con stent en el tronco principal de la arteria coronaria izquierda. Método: Se realizó un estudio observacional, descriptivo y transversal en 21 pacientes con angioplastia percutánea con stent en el tronco principal de la arteria coronaria izquierda, realizadas en el laboratorio de Hemodinámica y Cardiología Intervencionista del Hospital "Hermanos Ameijeiras", entre enero 2010 y julio 2011. Resultados: No existió diferencia significativa en el sexo. Predominó el grupo de edad entre 50-64 años (47,6 % y el color de la piel blanca (76,19 %. El factor de riesgo cardiovascular más encontrado fue la HTA (85,71 %, seguido de dislipidemia (47,61 %. El diagnóstico más observado fue la angina de esfuerzo estable, 14 casos (66,66 %. La lesión en el cuerpo del tronco (12 pacientes, 57,1 %, fue la más encontrada, seguida de la ostial (8 casos. El tipo de stent más utilizado fue el liberador de fármacos (61,9 %, y solamente 4 pacientes presentaban troncos protegidos quirúrgicamente. Conclusiones: La mayor cantidad de casos fueron electivos, con predominio de los troncos no protegidos. El factor de riesgo coronario más encontrado fue la HTA. Se encontró asociación significativa entre la diabetes mellitus y la localización ostial de la lesión tratada. / AbstractIntroduction and Objectives: Significant impairment of the left main coronary artery is the most lethal presentation of coronary artery disease. The treatment of choice

  5. Limited intentional normovolemic hemodilution: ST-segment changes and use of homologous blood products in patients with left main coronary artery stenosis.

    Science.gov (United States)

    Herregods, L; Moerman, A; Foubert, L; Den Blauwen, N; Mortier, E; Poelaert, J; Struys, M

    1997-02-01

    To assess and compare the effects of limited intentional normovolemic hemodilution (LINH) on ST-segment changes and to evaluate the need for homologous blood products. Prospective, randomized study. University hospital. Seventy-one patients with left main stenosis scheduled for semi-urgent coronary artery bypass grafting. Patients in group A (n = 39) underwent LINH during the prebypass period until a hematocrit of 34% was obtained. Simultaneously, succinyl-linked gelatin was infused. In group B (n = 32), no hemodilution was performed. Mean arterial pressure and central venous pressure were kept as constant as possible. During the postbypass period, autologous blood was retransfused. The need for homologous blood products was noted intraoperatively and postoperatively. ST-segment analysis of lead II and chest lead was continuously performed in all patients. An ST-segment change was defined as a decrease from baseline of 1.0 mm (-0.1 mV). The appearance and degree of ST-segment depression were comparable in both groups (group A: 7 patients -0.1 mV, 1 patient -0.2 mV; group B: 5 patients -0.1 mV; 3 patients -0.2 mV). In group A, ST-segment depression occurred during and after the blood exchange. However, the mean duration of the ST-segment depression (group A: 33 +/- 18 minutes; group B: 20 +/- 10 minutes) was comparable between groups. In group A, a mean of 750 mL +/- 245 mL of blood was obtained. Total blood loss was significantly higher in group B (p < 0.052); 25 patients in group A (64%) and 12 patients in group B (38%) did not require homologous blood products (p < 0.03). Intraoperatively, only the need for packed red cells was greater in group B (p < 0.04). Postoperatively, the use of homologous blood products is higher than intraoperatively (p < 0.02). LINH performed in patients with left main stenosis, scheduled for semi-urgent coronary bypass, is not associated with increases in frequency, degree, or duration of ST-segment changes. This procedure allowed a

  6. Loop facility for LM-MHD study

    International Nuclear Information System (INIS)

    Pan Chuanjie; Xu Zengyu; Zhao Li; Zhang Xiujie

    2007-01-01

    A loop facility, namely, New Liquid Metal Experimental Loop (NLMEL), was built in 2007 in SWIP, Which can be used to carry out the experimental investigation on the liquid metal (LM) MHD effects, such as MHD effects of liquid divertor and liquid blanket. The working fluid in the loop is Ga 68 In 20 Sn 12 alloy, which the melting point is 10.7 degree C, the density 6363 kg/m 3 , the electrical resistivity 3.3074 x 10 6 Ω·m -1 , the surface tension 0.353 N·m -1 , the dynamical viscosity 4.0 x 10 -7 m 2 /s at 20 degree C, and its chemical properties is not active. The loop facility consists of two three-phase alternating current(AC) electromagnetic (EM) pumps, dump tank, pump tank, expansion tank, calibrated flowmeter tank, EM flowmeter, electromagnet, MHD test section and its auxiliary system. Two experimental loops, namely, free surface jet flow and duct flow, were designed and installed at the experimental region of the uniform magnetic field in loop facility. The MHD experiment of liquid divertor can be carried out in free surface jet flow loop, and the MHD experimental for liquid blanket, such as MHD effect experiment in rectangular duct with FCI, can be carried out in duct flow loop. The rated voltage of two EM pumps is 380 V, the work temperature less than 500 degree C, electric current 14 and 6 A, fluid flux 11 and 4.7 m 3 /h, outlet pressure less than 6 x 10 5 and 5 x 10 5 Pa, respectively. A 12-ton electromagnet can provide the transverse magnetic field from 0 to 2.0 Tesla, and the uniform magnetic field space of 700 x 140 x 80. Total resistance of electromagnet coils is 1.5 Ω at 20 degree C. High-quality Direct Current (DC) Power supply can provide 0-200 A DC, and 0-60 kW power, the stability of current less than 1%, AC ripple factor less than 1%. Auxiliary systems include: oil cooling loop for cooling electromagnet and two EM pumps, and high purity argon device for protect gas of loop, and pumping vacuum device for loop devices, and electric device

  7. CABG Surgery Remains the best Option for Patients with Left Main Coronary Disease in Comparison with PCI-DES: Meta-Analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Sá, Michel Pompeu Barros Oliveira; Soares, Artur Freire; Miranda, Rodrigo Gusmão Albuquerque; Araújo, Mayara Lopes; Menezes, Alexandre Motta; Silva, Frederico Pires Vasconcelos; Lima, Ricardo Carvalho

    2017-01-01

    To compare the safety and efficacy of coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) using drug-eluting stents (DES) in patients with unprotected left main coronary artery (ULMCA) disease. MEDLINE, EMBASE, CENTRAL/CCTR, SciELO, LILACS, Google Scholar and reference lists of relevant articles were searched for clinical studies that reported outcomes at 1-year follow-up after PCI with DES and CABG for the treatment of ULMCA stenosis. Five studies fulfilled our eligibility criteria and they included a total of 4.595 patients (2.298 for CABG and 2.297 for PCI with DES). At 1-year follow-up, there was no significant difference between CABG and DES groups concerning the risk for death (risk ratio [RR] 0.973, P=0.830), myocardial infarction (RR 0.694, P=0.148), stroke (RR 1.224, P=0.598), and major adverse cerebrovascular and cardiovascular events (RR 0.948, P=0.680). The risk for target vessel revascularization (TVR) was significantly lower in the CABG group compared to the DES group (RR 0.583, Pmeta-regression, there was evidence that the factor "female gender" modulated the effect regarding myocardial infarction rates, favoring the CABG strategy. CABG surgery remains the best option of treatment for patients with ULMCA disease, with lower TVR rates.

  8. Noninvasive identification of left main and triple vessel coronary artery disease: improved accuracy using quantitative analysis of regional myocardial stress distribution and washout of thallium-201

    International Nuclear Information System (INIS)

    Maddahi, J.; Abdulla, A.; Garcia, E.V.; Swan, H.J.; Berman, D.S.

    1986-01-01

    The capabilities of visual and quantitative analysis of stress redistribution thallium-201 scintigrams, exercise electrocardiography and exercise blood pressure response were compared for correct identification of extensive coronary disease, defined as left main or triple vessel coronary artery disease, or both (50% or more luminal diameter coronary narrowing), in 105 consecutive patients with suspected coronary artery disease. Extensive disease was present in 56 patients and the remaining 49 had either less extensive coronary artery disease (n = 34) or normal coronary arteriograms (n = 15). Although exercise blood pressure response, exercise electrocardiography and visual thallium-201 analysis were highly specific (98, 88 and 96%, respectively), they were insensitive for identification of patients with extensive disease (14, 45 and 16%, respectively). Quantitative thallium-201 analysis significantly improved the sensitivity of visual thallium-201 analysis for identification of patients with extensive disease (from 16 to 63%, p less than 0.001) without a significant loss of specificity (96 versus 86%, p = NS). Eighteen (64%) of the 28 patients who were misclassified by visual analysis as having less extensive disease were correctly classified as having extensive disease by virtue of quantitative analysis of regional myocardial thallium-201 washout. When the results of quantitative thallium-201 analysis were combined with those of blood pressure and electrocardiographic response to exercise, the sensitivity and specificity for identification of patients with extensive disease was 86 and 76%, respectively, and the highest overall accuracy (0.82) was obtained

  9. Meta-Analysis of Drug-Eluting Stents Versus Coronary Artery Bypass Grafting in Unprotected Left Main Coronary Narrowing.

    Science.gov (United States)

    Sardar, Partha; Giri, Jay; Elmariah, Sammy; Chatterjee, Saurav; Kolte, Dhaval; Kundu, Amartya; Nairooz, Ramez; Aronow, Wilbert S; Owan, Theophilus; Mukherjee, Debabrata; Feldman, Dmitriy N; Abbott, J Dawn

    2017-06-01

    Patients with unprotected left main coronary artery (ULMCA) disease are increasingly treated with percutaneous coronary intervention (PCI) using new-generation drug-eluting stents (DES); however, the benefits of DES compared with coronary artery bypass grafting (CABG) in ULMCA remain controversial. This meta-analysis evaluated the effects of PCI with DES compared with CABG for the treatment of ULMCA stenosis. Databases were searched through November 30, 2016. Randomized controlled trials (RCTs) comparing DES with PCI versus CABG for ULMCA stenosis were identified. We calculated summary odds ratios (ORs) and 95% CIs with the random-effects model. The primary outcome was major adverse cardiovascular events, defined as a composite of death from any cause, stroke, or myocardial infarction (MI). The analysis included 4,612 patients from 5 RCTs. Compared with CABG, patients assigned to PCI had a similar rate of major adverse cardiovascular events (OR 1.06, 95% CI 0.79 to 1.43), all-cause mortality (OR 1.03, 95% CI 0.79 to 1.35), cardiovascular death (OR 1.03, 95% CI 0.73 to 1.45), stroke (OR 0.81, 95% CI 0.38 to 1.76), and MI (OR 1.47, 95% CI 0.87 to 2.47). The risk of any repeat revascularization was significantly greater in the PCI group than that in the CABG group (OR 1.85, 95% CI 1.53 to 2.24). In conclusion, our meta-analysis of RCTs suggest that PCI with DES results in comparable mortality, stroke, and MI compared with CABG for revascularization of ULMCA stenosis, with PCI associated with higher rates of repeat revascularization. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Meta-Analysis of Randomized Control Trials Comparing Drug-Eluting Stents Versus Coronary Artery Bypass Grafting for Significant Left Main Coronary Narrowing.

    Science.gov (United States)

    Qian, Cheng; Feng, Hong; Cao, Jianlei; Wei, Baozhu; Wang, Yanggan

    2017-05-01

    Previous meta-analyses showed that drug-eluting stent (DES) implantation may serve as an alternative to coronary artery bypass grafting (CABG) for unprotected left main coronary artery (ULMCA) stenosis, largely driven by data from registries. Hence, we performed a meta-analysis of randomized controlled trials (RCTs) to overcome this limitation. PubMed, the Cochrane Library, and Scopus were systematically searched through October 2016 to identify eligible RCTs. The primary outcomes were major adverse cardiac and cerebrovascular events (MACCE) at 1-year and long-term (≥3 years) follow-ups. This meta-analysis included 5 RCTs, totaling 4,595 patients with ULMCA disease. Compared with CABG, DES showed similar 1-year rates of MACCE (risk ratio [RR] 1.14, 95% confidence interval [CI] 0.91-1.42), all-cause death, and myocardial infarction, with a higher incidence of revascularization (RR 1.68, 95% CI 1.24-2.27) and lower incidence of stoke (RR 0.43, 95% CI 0.23-0.78). At long-term follow-up, DES placement was inferior to CABG in terms of MACCE (RR 1.27, 95% CI 1.13-1.43) and revascularization (RR 1.70, 95% CI 1.43-2.01). There was no difference in long-term risk of other outcomes between these 2 strategies. In conclusion, DES stenting and CABG for ULMCA disease yield comparable rates of MACCE at 1-year follow-up; however, CABG is associated with a decreased risk of long-term MACCE compared with DES, exclusively driven by the considerable reduction in revascularization events. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. CABG Surgery Remains the best Option for Patients with Left Main Coronary Disease in Comparison with PCI-DES: Meta-Analysis of Randomized Controlled Trials

    Science.gov (United States)

    Sá, Michel Pompeu Barros Oliveira; Soares, Artur Freire; Miranda, Rodrigo Gusmão Albuquerque; Araújo, Mayara Lopes; Menezes, Alexandre Motta; Silva, Frederico Pires Vasconcelos; Lima, Ricardo Carvalho

    2017-01-01

    Objective To compare the safety and efficacy of coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) using drug-eluting stents (DES) in patients with unprotected left main coronary artery (ULMCA) disease. Methods MEDLINE, EMBASE, CENTRAL/CCTR, SciELO, LILACS, Google Scholar and reference lists of relevant articles were searched for clinical studies that reported outcomes at 1-year follow-up after PCI with DES and CABG for the treatment of ULMCA stenosis. Five studies fulfilled our eligibility criteria and they included a total of 4.595 patients (2.298 for CABG and 2.297 for PCI with DES). Results At 1-year follow-up, there was no significant difference between CABG and DES groups concerning the risk for death (risk ratio [RR] 0.973, P=0.830), myocardial infarction (RR 0.694, P=0.148), stroke (RR 1.224, P=0.598), and major adverse cerebrovascular and cardiovascular events (RR 0.948, P=0.680). The risk for target vessel revascularization (TVR) was significantly lower in the CABG group compared to the DES group (RR 0.583, P<0.001). It was observed no publication bias regarding the outcomes, but only the outcome TVR was free from substantial statistical heterogeneity of the effects. In the meta-regression, there was evidence that the factor "female gender" modulated the effect regarding myocardial infarction rates, favoring the CABG strategy. Conclusion CABG surgery remains the best option of treatment for patients with ULMCA disease, with lower TVR rates. PMID:29211222

  12. Apollo 11 Astronaut Aldrin Next to Lunar Module (LM)

    Science.gov (United States)

    1969-01-01

    The first manned lunar landing mission, Apollo 11, launched from the Kennedy Space Center (KSC) in Florida via the Marshall Space Flight Center (MSFC) developed Saturn V launch vehicle on July 16, 1969 and safely returned to Earth on July 24, 1969. Aboard the space craft were astronauts Neil A. Armstrong, commander; Michael Collins, Command Module (CM) pilot; and Edwin E. (Buzz) Aldrin Jr., Lunar Module (LM) pilot. The CM, piloted by Michael Collins, remained in a parking orbit around the Moon while the LM, named 'Eagle'', carrying astronauts Armstrong and Aldrin, landed on the Moon in the Sea of Tranquility. The LM was a two part spacecraft. Its lower or descent stage had the landing gear, engines, and fuel needed for the landing. When the LM blasted off the Moon, the descent stage served as the launching pad for its companion ascent stage, which was also home for the two astronauts on the surface of the Moon. The LM was full of gear with which to communicate, navigate, and rendezvous. It also had its own propulsion system, and an engine to lift it off the Moon and send it on a course toward the orbiting CM. Aldrin is pictured here next to the LM on the lunar surface.

  13. Geographical Difference of the Interaction of Sex With Treatment Strategy in Patients With Multivessel Disease and Left Main Disease: A Meta-Analysis From SYNTAX (Synergy Between PCI With Taxus and Cardiac Surgery), PRECOMBAT (Bypass Surgery Versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease), and BEST (Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment of Patients With Multivessel Coronary Artery Disease) Randomized Controlled Trials

    NARCIS (Netherlands)

    Sotomi, Yohei; Onuma, Yoshinobu; Cavalcante, Rafael; Ahn, Jung-Min; Lee, Cheol Whan; van Klaveren, David; de Winter, Robbert J.; Wykrzykowska, Joanna J.; Farooq, Vasim; Morice, Marie-Claude; Steyerberg, Ewout W.; Park, Seung-Jung; Serruys, Patrick W.

    2017-01-01

    The impact of sex on clinical outcomes of percutaneous coronary intervention and coronary artery bypass graft for patients with multivessel coronary disease and unprotected left main disease could be dissimilar between Western and Asian populations. 2=58%). The present meta-analysis suggested the

  14. LM6000s bring fast track power to Tanzania

    Energy Technology Data Exchange (ETDEWEB)

    Lukas, R. [Stone and Webster Canada Ltd., Toronto, ON (Canada); Sutcliffe, K. [Stewart and Stevenson Services, Houston, TX (United States); Oosthuizen, P. [Roshcon, Johannesburg (South Africa)

    1996-06-01

    Like many developing countries, Tanzania is in urgent need of power. To ease the situation, the Tanzanian government utility, Tanzania Electric Supply Company (Tanesco) recently began operating a power plant using two LM6000 aeroderivative gas turbines at a facility in Ubungo. The plant began operation just 165 days after the order was placed. (author)

  15. Daphnetin inhibits invasion and migration of LM8 murine osteosarcoma cells by decreasing RhoA and Cdc42 expression

    International Nuclear Information System (INIS)

    Fukuda, Hiroki; Nakamura, Seikou; Chisaki, Yugo; Takada, Tetsuya; Toda, Yuki; Murata, Hiroaki; Itoh, Kazuyuki; Yano, Yoshitaka; Takata, Kazuyuki; Ashihara, Eishi

    2016-01-01

    Daphnetin, 7,8-dihydroxycoumarin, present in main constituents of Daphne odora var. marginatai, has multiple pharmacological activities including anti-proliferative effects in cancer cells. In this study, using a Transwell system, we showed that daphnetin inhibited invasion and migration of highly metastatic murine osteosarcoma LM8 cells in a dose-dependent manner. Following treatment by daphnetin, cells that penetrated the Transwell membrane were rounder than non-treated cells. Immunofluorescence analysis revealed that daphnetin decreased the numbers of intracellular stress fibers and filopodia. Moreover, daphnetin treatment dramatically decreased the expression levels of RhoA and Cdc42. In summary, the dihydroxycoumarin derivative daphnetin inhibits the invasion and migration of LM8 cells, and therefore represents a promising agent for use against metastatic cancer. - Highlights: • Daphnetin, a coumarin-derivative, inhibited invasion and migration of LM8 cells. • Stress fibers and filopodia were decreased by daphnetin treatment. • Daphnetin decreased RhoA and Cdc42 protein expression.

  16. Daphnetin inhibits invasion and migration of LM8 murine osteosarcoma cells by decreasing RhoA and Cdc42 expression

    Energy Technology Data Exchange (ETDEWEB)

    Fukuda, Hiroki [Department of Clinical and Translational Physiology, Kyoto Pharmaceutical University, Kyoto (Japan); Nakamura, Seikou [Department of Pharmacognosy, Kyoto Pharmaceutical University, Kyoto (Japan); Chisaki, Yugo [Education and Research Center for Clinical Pharmacy, Kyoto Pharmaceutical University, Kyoto (Japan); Takada, Tetsuya [Department of Clinical and Translational Physiology, Kyoto Pharmaceutical University, Kyoto (Japan); Toda, Yuki [Department of Medicinal Chemistry, Kyoto Pharmaceutical University, Kyoto (Japan); Murata, Hiroaki [Department of Orthopedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto (Japan); Department of Orthopedic Surgery, Matsushita Memorial Hospital, Osaka (Japan); Itoh, Kazuyuki [Department of Biology, Osaka Medical Center of Cancer and Cardiovascular Diseases, Osaka (Japan); Yano, Yoshitaka [Education and Research Center for Clinical Pharmacy, Kyoto Pharmaceutical University, Kyoto (Japan); Takata, Kazuyuki [Department of Clinical and Translational Physiology, Kyoto Pharmaceutical University, Kyoto (Japan); Ashihara, Eishi, E-mail: ash@mb.kyoto-phu.ac.jp [Department of Clinical and Translational Physiology, Kyoto Pharmaceutical University, Kyoto (Japan)

    2016-02-26

    Daphnetin, 7,8-dihydroxycoumarin, present in main constituents of Daphne odora var. marginatai, has multiple pharmacological activities including anti-proliferative effects in cancer cells. In this study, using a Transwell system, we showed that daphnetin inhibited invasion and migration of highly metastatic murine osteosarcoma LM8 cells in a dose-dependent manner. Following treatment by daphnetin, cells that penetrated the Transwell membrane were rounder than non-treated cells. Immunofluorescence analysis revealed that daphnetin decreased the numbers of intracellular stress fibers and filopodia. Moreover, daphnetin treatment dramatically decreased the expression levels of RhoA and Cdc42. In summary, the dihydroxycoumarin derivative daphnetin inhibits the invasion and migration of LM8 cells, and therefore represents a promising agent for use against metastatic cancer. - Highlights: • Daphnetin, a coumarin-derivative, inhibited invasion and migration of LM8 cells. • Stress fibers and filopodia were decreased by daphnetin treatment. • Daphnetin decreased RhoA and Cdc42 protein expression.

  17. Validating the EXCEL hypothesis: a propensity score matched 3-year comparison of percutaneous coronary intervention versus coronary artery bypass graft in left main patients with SYNTAX score ≤32.

    Science.gov (United States)

    Capodanno, Davide; Caggegi, Anna; Capranzano, Piera; Cincotta, Glauco; Miano, Marco; Barrano, Gionbattista; Monaco, Sergio; Calvo, Francesco; Tamburino, Corrado

    2011-06-01

    The aim of this study is to verify the study hypothesis of the EXCEL trial by comparing percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) in an EXCEL-like population of patients. The upcoming EXCEL trial will test the hypothesis that left main patients with SYNTAX score ≤ 32 experience similar rates of 3-year death, myocardial infarction (MI), or cerebrovascular accidents (CVA) following revascularization by PCI or CABG. We compared the 3-year rates of death/MI/CVA and death/MI/CVA/target vessel revascularization (MACCE) in 556 patients with left main disease and SYNTAX score ≤ 32 undergoing PCI (n = 285) or CABG (n = 271). To account for confounders, outcome parameters underwent extensive statistical adjustment. The unadjusted incidence of death/MI/CVA was similar between PCI and CABG (12.7% vs. 8.4%, P = 0.892), while MACCE were higher in the PCI group compared to the CABG group (27.0% vs. 11.8%, P EXCEL-like cohort of patients with left main disease, there seems to be a clinical equipoise between PCI and CABG in terms of death/MI/CVA. However, even in patients with SYNTAX score ≤ 32, CABG is superior to PCI when target vessel revascularization is included in the combined endpoint. Copyright © 2011 Wiley-Liss, Inc.

  18. Fluctuations in a mixed IS-LM business cycle model

    Directory of Open Access Journals (Sweden)

    Hamad Talibi Alaoui

    2008-09-01

    Full Text Available In the present paper, we extend a delayed IS-LM business cycle model by introducing an additional advance (anticipated capital stock in the investment function. The resulting model is represented in terms of mixed differential equations. For the deviating argument $au$ (advance and delay being a bifurcation parameter we investigate the local stability and the local Hopf bifurcation. Also some numerical simulations are given to support the theoretical analysis.

  19. Late stroke: comparison of percutaneous coronary intervention versus coronary artery bypass grafting in patients with multivessel disease and unprotected left main disease: a meta-analysis and review of literature.

    Science.gov (United States)

    Athappan, Ganesh; Chacko, Paul; Patvardhan, Eshan; Gajulapalli, Rama Dilip; Tuzcu, Emin Murat; Kapadia, Samir R

    2014-01-01

    Studies have suggested that the early excess risk of stroke in coronary artery bypass grafting (CABG) may be compensated for by a slow but progressive catch-up phenomenon in patients undergoing percutaneous coronary intervention (PCI). We therefore undertook this analysis to compare the temporal stroke risk between PCI and CABG in patients with unprotected left main stenosis and multivessel coronary artery disease. Studies of PCI versus CABG for unprotected left main stenosis and multivessel disease published between January 1994 (stent era) and July 2013 were identified using an electronic search and reviewed using meta-analytic techniques. We selected 57 reports for the meta-analysis by applying the inclusion and exclusion criteria. The analysis was performed on 80,314 patient records. There was a significantly lower risk of cumulative stroke in patients undergoing PCI with stenting at 1 year (odds ratio [OR], 0.55; 95% confidence interval [CI], 0.42-0.71), 2 years (OR, 0.78; 95% CI, 0.66-0.92), 3 years (OR, 0.79; 95% CI, 0.67-0.92), 4 years (OR, 0.74; 95% CI, 0.56-0.97), and 5 years (OR, 0.79; 95% CI, 0.69-0.91). There was no significant difference in the incidence of stroke because of the small sample size (OR, 0.71; 95% CI, 0.46-1.08) at >5 years between PCI and CABG. Similar results were observed on subgroup analysis (multi-vessel coronary artery disease, unprotected left main, diabetics, and randomized trials) and for stroke within 30 days. Late stroke (stroke>30 days) was similar between the 2 groups. There is a significantly lower risk of stroke within 30 days and cumulative stroke with PCI as compared with CABG up to year 5. There is no late catch up of stroke in the PCI arm. The risk of stroke should be weighed in deciding between revascularization strategies.

  20. Development of fi lm forming formulation and technology of polymeric fi lm coating on Indotril tablets

    Directory of Open Access Journals (Sweden)

    L. I. Kucherenko

    2013-09-01

    Full Text Available Introduction. In previous researches we grounded expedience of «Indotril» tablets development; formulation and technology of "Indotril" tablet cores were developed. Received tablet cores should be covered by protective polymeric film with the purpose of unpleasant taste elimination, increase of tablets expiration date. Objective. The aim of our investigation was to develop the film forming composition and technology of polymeric film coating on «Indotril» tablets in pseudo-fluidized layer. Materials and Methods. As “Indotril” tablets cores should be covered by protective polymeric film we performed research designed to select efficient film forming solution. Thus modern filming agents were studied, besides such factors were investigated: concentration of film forming suspension, increase of tablet coat in mass, air temperature under gas distribution grid. Obtained tablets were checked according to pharmacopeia methods. Results and discussion. First we studied tablet compression force influence on main parameters of «Indotril» cores tablets: on crushing strength, abrasion in pseudo-fluidized layer unit and disintegration. Then for further investigation we chose «Indotril» cores tablets with crushing strength near 70 H, abrasion - up to 0,5% and disintegration time - not more than 10 minutes. We performed research to select film forming solution for covering “Indotril” tablets in pseudo-fluidized layer unit. As filming agents we used different samples of hydroxypropyl methylcellulose (HPMC by Japan company Shin-Etsu Chemical Co and English company Colorcon. Water HPMC solutions were prepared which contained plasticizer (propylene glycol, pigment (titanium IV dioxide and dye (tartrazine. Coating process of “Indotril” tablets was performed in laboratory pseudo-fluidized layer unit with the air temperature 75ºC under gas distribution grid. Variance analysis of experimental data on quality of coat surface showed insignificance as

  1. Long-term forecasting and comparison of mortality in the Evaluation of the Xience Everolimus Eluting Stent vs. Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization (EXCEL) trial: prospective validation of the SYNTAX Score II.

    Science.gov (United States)

    Campos, Carlos M; van Klaveren, David; Farooq, Vasim; Simonton, Charles A; Kappetein, Arie-Pieter; Sabik, Joseph F; Steyerberg, Ewout W; Stone, Gregg W; Serruys, Patrick W

    2015-05-21

    To prospectively validate the SYNTAX Score II and forecast the outcomes of the randomized Evaluation of the Xience Everolimus-Eluting Stent Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization (EXCEL) Trial. Evaluation of the Xience Everolimus Eluting Stent vs. Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization is a prospective, randomized multicenter trial designed to establish the efficacy and safety of percutaneous coronary intervention (PCI) with the everolimus-eluting stent compared with coronary artery bypass graft (CABG) surgery in subjects with unprotected left-main coronary artery (ULMCA) disease and low-intermediate anatomical SYNTAX scores (EXCEL, the SYNTAX Score II was prospectively applied to predict 4-year mortality in the CABG and PCI arms. The 95% prediction intervals (PIs) for mortality were computed using simulation with bootstrap resampling (10 000 times). For the entire study cohort, the 4-year predicted mortalities were 8.5 and 10.5% in the PCI and CABG arms, respectively [odds ratios (OR) 0.79; 95% PI 0.43-1.50). In subjects with low (≤22) anatomical SYNTAX scores, the predicted OR was 0.69 (95% PI 0.34-1.45); in intermediate anatomical SYNTAX scores (23-32), the predicted OR was 0.93 (95% PI 0.53-1.62). Based on 4-year mortality predictions in EXCEL, clinical characteristics shifted long-term mortality predictions either in favour of PCI (older age, male gender and COPD) or CABG (younger age, lower creatinine clearance, female gender, reduced left ventricular ejection fraction). The SYNTAX Score II indicates at least an equipoise for long-term mortality between CABG and PCI in subjects with ULMCA disease up to an intermediate anatomical complexity. Both anatomical and clinical characteristics had a clear impact on long-term mortality predictions and decision making between CABG and PCI. Published on behalf of the European Society of Cardiology. All rights reserved. © The

  2. Design and rationale for a randomised comparison of everolimus-eluting stents and coronary artery bypass graft surgery in selected patients with left main coronary artery disease: the EXCEL trial.

    Science.gov (United States)

    Kappetein, Arie Pieter; Serruys, Patrick W; Sabik, Joseph F; Leon, Martin B; Taggart, David P; Morice, Marie-Claude; Gersh, Bernard J; Pocock, Stuart J; Cohen, David J; Wallentin, Lars; Ben-Yehuda, Ori; van Es, Gerrit-Anne; Simonton, Charles A; Stone, Gregg W

    2016-09-18

    Coronary artery bypass graft (CABG) surgery is the standard of care for revascularisation of patients with left main coronary artery disease (LMCAD). Recent studies have suggested that percutaneous coronary intervention (PCI) with drug-eluting stents (DES) may provide comparable outcomes in selected patients with LMCAD without extensive CAD. We therefore designed a trial to investigate whether PCI with XIENCE cobalt-chromium everolimus-eluting stents (CoCr-EES) would result in non-inferior or superior clinical outcomes to CABG in selected patients with LMCAD. The Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization (EXCEL) trial is a prospective, open-label, multicentre, international study of 1,900 randomised subjects. Patients with significant LMCAD with a SYNTAX score ≤32 and local Heart Team consensus that the subject is appropriate for revascularisation by both PCI and CABG are consented and randomised 1:1 to undergo PCI using CoCr-EES or CABG. All patients undergo follow-up for five years. The primary endpoint is the three-year composite rate of death, stroke or myocardial infarction, assessed at a median follow-up of at least three years (with at least two-year follow-up in all patients), powered for sequential non-inferiority and superiority testing. The EXCEL study will define the contemporary roles of CABG and PCI using XIENCE CoCr-EES in patients with LMCAD disease with low and intermediate SYNTAX scores.

  3. Spontaneous left main coronary artery dissection

    Directory of Open Access Journals (Sweden)

    Alptug Tokatli

    2016-03-01

    Full Text Available Spontaneous coronary artery dissection (SCAD is a very rare clinical condition. Physiopathology of SCAD is still mostly unclear. Clinical presentation of SCAD ranges from atypical symptoms to sudden cardiac death. The diagnosis of dissection is generally made by using conventional coronary angiography. Invasive or conservative treatment is reasonable.

  4. Accelerated fatigue testing of LM 19.1 blades

    DEFF Research Database (Denmark)

    Kristensen, Ole Jesper Dahl; Jørgensen, E.

    2003-01-01

    material. In addition to the thermal imaging surveillance the blades were instrumented with strain gauges. This report presents the temperature duringtest, calibration test results, moment range measurements, strain statistics, thermal imaging registrations and a determination of the size and cause......A series of 19.1 metre wind turbine blades manufactured by LM Glasfiber A/S of Lunderskov, Denmark were subjected to a series of flapwise fatigue tests. The object of these fatigue tests is to evaluate the impact of an increased load on the blade in afatigue test and to give information...... if it is possible to increase the load in fatigue test to shorten test time. The tests were carried out as a part of a project financed by the Danish Energy Agency. During the fatigue tests the blades have beensurveyed with thermal imaging equipment to determine how an increase in fatigue load affects the blade...

  5. LM-research opportunities and activities at Beer-Sheva

    International Nuclear Information System (INIS)

    Lesin, S.

    1996-01-01

    Energy conversion concepts based on liquid metal (LM) magnetohydrodynamic (MHD) technology was intensively investigated at the Center for MHD Studies (CMHDS), in the Ben-Gurion University of the Negev in Israel. LMMHD energy conversion systems operate in a closed cycle as follows: heat intended for conversion into electricity is added to a liquid metal contained in a closed loop of pipes. The liquid metal is mixed with vapor or gas introduced from outside so that a two-phase mixture is formed. The gaseous phase performs a thermodynamic cycle, converting a certain amount of heat into mechanical energy of the liquid metal. This energy is converted into electrical power as the metal flows across a magnetic field in the MHD channel. Those systems where the expanding thermodynamic fluid performs work against gravitational forces (natural circulation loops) and using heavy liquid metals are named ETGAR systems. A number of different heavy-metal facilities have been specially constructed and tested with fluid combinations of mercury and steam, mercury and nitrogen, mercury and freon, lead-bismuth and steam, and lead and steam. Since the experimental investigation of such flows is a very difficult task and all the known measurment methods are incomplete and not fully reliable, a variety of experimental approaches have been developed. In most experiments, instantaneous pressure distribution along the height of the upcomer were measured and the average void fraction was calculated numerically using the one-dimensional equation for the two-phase flow. The research carried out at the CMHDS led to significant improvements in the characterization of the two-phase phenomena expected in the riser of ETGAR systems. One of the most important outcomes is the development of a new empirical correlation which enables the reliable prediction of the velocity ratio between the LM and the steam (slip), the friction factor, as well as of the steam void fraction distribution along the riser

  6. Outcomes of coronary artery bypass grafting versus percutaneous coronary intervention with second-generation drug-eluting stents for patients with multivessel and unprotected left main coronary artery disease

    Directory of Open Access Journals (Sweden)

    Kyriacos Papadopoulos

    2017-01-01

    Full Text Available Objectives: To compare the efficacy and safety of percutaneous coronary intervention using second-generation drug-eluting stents with those of coronary artery bypass grafting among patients with multivessel disease and/or unprotected left main coronary artery disease in terms of mortality, myocardial infarction, repeat revascularization, and angina. Background: Although coronary artery disease is a leading cause of death in the Western world and in many developing countries, its optimal treatment is still a matter of controversy. Several studies have examined the clinical safety and efficacy of percutaneous coronary intervention using first-generation drug-eluting stents over coronary artery bypass grafting in patients with multivessel disease and/or unprotected left main coronary artery disease. However, this study compared the efficacy of percutaneous coronary intervention using second-generation drug-eluting stents to that of coronary artery bypass grafting for multivessel disease and/or unprotected left main coronary artery disease. Methods: This was a prospective single-center cohort study conducted from September 2012 to November 2014 at the Nicosia General Hospital. In total, 140 patients (94% men and 6% women with chronic coronary artery disease undergoing revascularization with either percutaneous coronary intervention using second-generation drug-eluting stents or coronary artery bypass grafting were evaluated. We examined the differences in clinical outcomes between coronary artery bypass grafting and percutaneous coronary intervention at 1-year follow-up. Results: Percutaneous coronary intervention with second-generation drug-eluting stents as opposed to coronary artery bypass grafting resulted in similar rates of mortality (5.7% vs 11.4%, respectively; p = 0.135, myocardial infarction (0% vs 4.3%, respectively, repeat revascularization (4.3% vs 8.6%, respectively; p = 0.115 and angina (10% vs 18.6%, respectively; p = 0

  7. Geographical Difference of the Interaction of Sex With Treatment Strategy in Patients With Multivessel Disease and Left Main Disease: A Meta-Analysis From SYNTAX (Synergy Between PCI With Taxus and Cardiac Surgery), PRECOMBAT (Bypass Surgery Versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease), and BEST (Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment of Patients With Multivessel Coronary Artery Disease) Randomized Controlled Trials.

    Science.gov (United States)

    Sotomi, Yohei; Onuma, Yoshinobu; Cavalcante, Rafael; Ahn, Jung-Min; Lee, Cheol Whan; van Klaveren, David; de Winter, Robbert J; Wykrzykowska, Joanna J; Farooq, Vasim; Morice, Marie-Claude; Steyerberg, Ewout W; Park, Seung-Jung; Serruys, Patrick W

    2017-05-01

    The impact of sex on clinical outcomes of percutaneous coronary intervention and coronary artery bypass graft for patients with multivessel coronary disease and unprotected left main disease could be dissimilar between Western and Asian populations. To assess clinical outcomes after percutaneous coronary intervention or coronary artery bypass graft in women and men with multivessel coronary disease and unprotected left main disease, a pooled analysis (n=3280) was performed using the patient-level data from 3 large randomized trials: SYNTAX (Synergy between PCI with Taxus and Cardiac Surgery), PRECOMBAT (Bypass Surgery Versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease), and BEST (Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment of Patients with Multivessel Coronary Artery Disease) trials. The primary end point was all-cause death. Of 3280 patients, 794 patients (24.2%) were women. The median follow-up period was 1806 days (1611-1837 days). In women, a high heterogeneity of the treatment effect among the 3 trials was found for all-cause death ( I 2 >50%), whereas in men, it was consistent across the 3 trials. In the Western trial (SYNTAX), female sex favored coronary artery bypass graft compared with percutaneous coronary intervention (hazard ratio (percutaneous coronary intervention) 2.213; 95% confidence interval, 1.242-3.943; P =0.007), whereas in the Asian women (PRECOMBAT and BEST), the treatment effect was neutral between both strategies. Sex interaction with treatment strategy was evident in the Western trial ( P interaction =0.019) but not in the Asian trials (PRECOMBAT P interaction =0.469 and BEST P interaction =0.472; I 2 =58%). The present meta-analysis suggested the presence of the heterogeneous sex-treatment interaction across Asian and Western trials. Considering the ongoing globalization of our medical practice, the heterogeneity of the sex-treatment interaction needs to be

  8. A dynamic IS-LM model with delayed taxation revenues

    International Nuclear Information System (INIS)

    De Cesare, Luigi; Sportelli, Mario

    2005-01-01

    Some recent contributions to Economic Dynamics have shown a new interest for delay differential equations. In line with these approaches, we re-proposed the problem of the existence of a finite lag between the accrual and the payment of taxes in a framework where never this type of lag has been considered: the well known IS-LM model. The qualitative study of the system of functional (delay) differential equations shows that the finite lag may give rise to a wide variety of dynamic behaviours. Specifically, varying the length of the lag and applying the 'stability switch criteria', we prove that the equilibrium point may lose or gain its local stability, so that a sequence of alternated stability/instability regions can be observed if some conditions hold. An important scenario arising from the analysis is the existence of limit cycles generated by sub-critical and supercritical Hopf bifurcations. As numerical simulations confirm, if multiple cycles exist, the so called 'crater bifurcation' can also be detected. Economic considerations about a stylized policy analysis stand by qualitative and numerical results in the paper

  9. Isolated flavonoids against mammary tumour cells LM2.

    Science.gov (United States)

    Carli, Camila B de A; de Matos, Djamile C; Lopes, Flávia C M; Maia, Danielle C G; Dias, Maristela B; Sannomiya, Miriam; Rodrigues, Clenilson M; Andreo, Marcio A; Vilegas, Wagner; Colombo, Lucas L; Carlos, Iracilda Z

    2009-01-01

    The purpose of the present study was to investigate antitumour and anti-inflammatory activities of flavonoids isolated from Byrsonima crassa, Davilla elliptica and Mouriri pusa. The antitumour activity was measured by the MTT assay in murine mammary tumour cells (LM2) and the IC50 values of the flavonoids tested ranged from (31.5 +/- 2.97) to (203.1 +/- 5.9) microg/ml. The flavonoids 1 (myricetin-3-O-alpha-L-rhamnopyranoside) and 3 (quercetin-3-O-galactopyranoside) from D. elliptica were the most active ones against the tumour cells. The same samples were tested to determine the inhibition of the release of nitric oxide (NO) and of the tumour necrosis factor-alpha (TNF-alpha) in murine macrophages by the Griess and ELISA sandwich assay, respectively. Almost all the samples showed inhibitory activity to the release of NO but not of TNF-alpha. Of all substances tested, flavonoids 2 (quercetin) and 6 (myricetin) may show promising activity in the treatment of murine breast cancer by immunomodulatory and antiproliferative activities.

  10. Design and Simulation of a PIC16F877A and LM35 Based ...

    African Journals Online (AJOL)

    This paper describes the design and simulation of a temperature virtual monitoring system using proteus (Labcenter electronics). The device makes use of the PIC16F877A, LM35, 2x16 LCD and other discrete components. The lm35 serve as the temperature sensor, whose output is fed into the PIC16F877A for further ...

  11. Genome sequence of Lactobacillus mucosae LM1, isolated from piglet feces.

    Science.gov (United States)

    Lee, Je Hee; Valeriano, Valerie Diane; Shin, Yu-Ri; Chae, Jong Pyo; Kim, Geun-Bae; Ham, Jun-Sang; Chun, Jongsik; Kang, Dae-Kyung

    2012-09-01

    Lactobacillus mucosae LM1, isolated from stool samples of a healthy piglet, displays good in vitro mucin adhesion and antimicrobial activity against pathogenic bacteria. To elucidate its antimicrobial effects and to find its epithelial cell and mucin adhesion genes, the genomic sequence of L. mucosae LM1 was investigated.

  12. Long-term outcomes following mini-crush versus culotte stenting for the treatment of unprotected left main disease: Insights from the milan and New-Tokyo (MITO) registry.

    Science.gov (United States)

    Kawamoto, Hiroyoshi; Takagi, Kensuke; Chieffo, Alaide; Ruparelia, Neil; Yusuke Fujino; Yabushita, Hiroto; Watanabe, Yusuke; Latib, Azeem; Carlino, Mauro; Montorfano, Matteo; Nakamura, Sunao; Colombo, Antonio

    2017-01-01

    This study aimed to investigate the long-term outcomes following mini-crush versus culotte stenting with drug-eluting stents (DES) for the treatment of unprotected left main coronary artery (LMCA) disease. Both mini-crush and culotte stenting are considered efficacious treatment options when a planned 2-stent strategy is deemed necessary for unprotected LMCA disease. However, there are limited data available with regard to the long-term clinical outcomes of each strategy in this setting. Between July 2002 and November 2013, 225 patients were identified. 135 patients were treated with the mini-crush technique, and 90 patients with culotte stenting. The median follow-up period was 1,263 (IQR 820-1,847) days. The mini-crush group had worse lesion and procedural characteristics when compared to the culotte group. There were no significant differences in major adverse cardiac events (MACE) at 5 years (mini-crush 36.0% vs. culotte 41.4%, P = 0.57). Myocardial infarction (MI) and definite stent thrombosis (ST) occurred significantly higher (MI; 0 vs. 11.3%, log-rank P = 0.003, and definite ST; 0 vs. 6.3%, log-rank P = 0.02, respectively) in the culotte group. Cox regression analysis indicated that full stent coverage of the LMCA and SYNTAX score were independent predictors for MACE. The incidence of MACE and overall TLR were comparable between groups. However, the rates of MI and definite ST were significantly higher in the culotte group. Full stent coverage of the LMCA may reduce the incidence of MACE when a two-stent strategy is used for the treatment of unprotected LMCA disease. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  13. Long term outcomes of new generation drug eluting stents versus coronary artery bypass grafting for multivessel and/or left main coronary artery disease. A Bayesian network meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Mina, George S; Watti, Hussam; Soliman, Demiana; Shewale, Anand; Atkins, Jessica; Reddy, Pratap; Dominic, Paari

    2018-01-05

    Most data guiding revascularization of multivessel disease (MVD) and/or left main disease (LMD) favor coronary artery bypass grafting (CABG) over percutaneous coronary intervention (PCI). However, those data are based on trials comparing CABG to bare metal stents (BMS) or old generation drug eluting stents (OG-DES). Hence, it is essential to outcomes of CABG to those of new generation drug eluting stents (NG-DES). We searched PUBMED and Cochrane database for trials evaluating revascularization of MVD and/or LMD with CABG and/or PCI. A Bayesian network meta-analysis was performed to calculate odds ratios (OR) and 95% credible intervals (CrI). Primary outcome was major adverse cardiovascular events (MACE) at 3-5 years. Secondary outcomes were mortality, cerebrovascular accidents (CVA), myocardial infarction (MI) and repeat revascularization. We included 10 trials with a total of 9287 patients. CABG was associated with lower MACE when compared to BMS or OG-DES. However, MACE was not significantly different between CABG and NG-DES (OR 0.79, CrI 0.45-1.40). Moreover, there were no significant differences between CABG and NG-DES in mortality (OR 0.78, CrI 0.45-1.37), CVA (OR 0.93 CrI 0.35-2.2) or MI (OR 0.6, CrI 0.17-2.0). On the other hand, CABG was associated with lower repeat revascularization (OR 0.55, CrI 0.36-0.84). Our study suggests that NG-DES is an acceptable alternative to CABG in patients with MVD and/or LMD. However, repeat revascularization remains to be lower with CABG than with PCI. Copyright © 2018. Published by Elsevier Inc.

  14. Spherical Harmonics Ylm(θ,ϕ: Positive and Negative Integer Representations of su(1,1 for l-m and l+m

    Directory of Open Access Journals (Sweden)

    H. Fakhri

    2016-01-01

    Full Text Available The azimuthal and magnetic quantum numbers of spherical harmonics Ylm(θ,ϕ describe quantization corresponding to the magnitude and z-component of angular momentum operator in the framework of realization of su(2 Lie algebra symmetry. The azimuthal quantum number l allocates to itself an additional ladder symmetry by the operators which are written in terms of l. Here, it is shown that simultaneous realization of both symmetries inherits the positive and negative (l-m- and (l+m-integer discrete irreducible representations for su(1,1 Lie algebra via the spherical harmonics on the sphere as a compact manifold. So, in addition to realizing the unitary irreducible representation of su(2 compact Lie algebra via the Ylm(θ,ϕ’s for a given l, we can also represent su(1,1 noncompact Lie algebra by spherical harmonics for given values of l-m and l+m.

  15. Correlation between Biosurfactants and Antifungal Activity of a Biocontrol Bacterium, Bacillus amyloliquefaciens LM11

    Directory of Open Access Journals (Sweden)

    Beom Ryong Kang

    2017-06-01

    Full Text Available Bacillus amyloliquefaciens LM11 was isolated from the feces of larvae of the rhino beetle and showed strong antifungal activities against various phytopathogenic fungi by producing biosurfactants. In this study, our overall goal was to determine relationship between biosurfactants produced from the LM11 strain and its role in growth inhibition of phytopathogenic fungi. Production and expression levels of B. amyloliquefaciens LM11 biosurfactants were significantly differed depending on growth phases. Transcriptional and biochemical analysis indicated that the biosurfactants of the LM11 strain were greatly enhanced in late log-phase to stationary phase. Inhibitions of phytopathogenic mycelial growth and spore germination were directly correlated (P<0.001, R=0.761 with concentrations of the LM11 cell-free culture filtrates. The minimum inhibitory surface tension of the culture filtrate of the B. amyloliquefaciens LM11 grown in stationary phase to inhibit mycelial growth of the phytopathogenic fungi was 38.5 mN/m (P<0.001, R=0.951–0.977. Our results indicated that the biosurfactants of B. amyloliquefaciens LM11 act as key antifungal metabolites in biocontrol of plant diseases, and measuring surface tension of the cell-free culture fluids can be used as an easy indicator for optimal usage of the biocontrol agents.

  16. Possibilities and testing of CPRNG in block cipher mode of operation PM-DC-LM

    Energy Technology Data Exchange (ETDEWEB)

    Zacek, Petr; Jasek, Roman; Malanik, David [Faculty of applied Informatics, Tomas Bata University in Zlin, Zlin, Czech Republic zacek@fai.utb.cz, jasek@fai.utb.cz, dmalanik@fai.utb.cz (Czech Republic)

    2016-06-08

    This paper discusses the chaotic pseudo-random number generator (CPRNG), which is used in block cipher mode of operation called PM-DC-LM. PM-DC-LM is one of possible subversions of general PM mode. In this paper is not discussed the design of PM-DC-LM, but only CPRNG as a part of it because designing is written in other papers. Possibilities, how to change or to improve CPRNG are mentioned. The final part is devoted for a little testing of CPRNG and some testing data are shown.

  17. Possibilities and testing of CPRNG in block cipher mode of operation PM-DC-LM

    Science.gov (United States)

    Zacek, Petr; Jasek, Roman; Malanik, David

    2016-06-01

    This paper discusses the chaotic pseudo-random number generator (CPRNG), which is used in block cipher mode of operation called PM-DC-LM. PM-DC-LM is one of possible subversions of general PM mode. In this paper is not discussed the design of PM-DC-LM, but only CPRNG as a part of it because designing is written in other papers. Possibilities, how to change or to improve CPRNG are mentioned. The final part is devoted for a little testing of CPRNG and some testing data are shown.

  18. Possibilities and testing of CPRNG in block cipher mode of operation PM-DC-LM

    International Nuclear Information System (INIS)

    Zacek, Petr; Jasek, Roman; Malanik, David

    2016-01-01

    This paper discusses the chaotic pseudo-random number generator (CPRNG), which is used in block cipher mode of operation called PM-DC-LM. PM-DC-LM is one of possible subversions of general PM mode. In this paper is not discussed the design of PM-DC-LM, but only CPRNG as a part of it because designing is written in other papers. Possibilities, how to change or to improve CPRNG are mentioned. The final part is devoted for a little testing of CPRNG and some testing data are shown.

  19. LM6000s the answer to Western Mining`s energy strategy

    Energy Technology Data Exchange (ETDEWEB)

    Fludder, S. [GE Marine & Industrial Engines, Jakarta (Indonesia); Smith, N. [Stewart & Stevenson International, Inc., Perth (Australia)

    1996-11-01

    Western Mining Corporation Ltd of Australia installed Stewart & Stevenson power generation packages with GE LM6000 gas turbines to reduce energy costs. The four LM6000 gas turbine-generator sets were sold by Stewart & Stevenson International, Inc of Houston, Texas, USA, and the LM6000 gas turbines were manufactured by GE Marine & Industrial Engines, Evendale, Ohio. These applications mark the first sale of Stewart & Stevenson gas turbine-generator packages in Australia, and one of the first uses of the LM6000 on this continent. WMC uses the equipment for cogeneration at three of the sites, with a percentage of the gas turbine exhaust energy used in the ore drying process or for low-grade steam production. 3 figs., 1 tab.

  20. 77 FR 17568 - Notice of Receipt of Petition for Decision That Nonconforming 2005 Ifor Williams LM85G Trailers...

    Science.gov (United States)

    2012-03-26

    ...-0030, Notice 1] Notice of Receipt of Petition for Decision That Nonconforming 2005 Ifor Williams LM85G... Safety Administration (NHTSA) of a petition for a decision that 2005 Ifor Williams LM85G trailers that... whether nonconforming 2005 Ifor Williams LM85G trailers are eligible for importation into the United...

  1. Studies on the concentration dependence of specific rotation of Alpha lactose monohydrate (α-LM) aqueous solutions and growth of α-LM single crystals

    Science.gov (United States)

    Vinodhini, K.; Divya Bharathi, R.; Srinivasan, K.

    2018-02-01

    Lactose is an optically active substance. As it is one of the reducing sugars, exhibits mutarotation in solution when it dissolves in any solvent. In solution, lactose exists in two isomeric forms, alpha-Lactose (α-L) and beta-lactose (β-L) through the mutarotation reaction. Mutarotation produces a dynamic equilibrium between two isomers in a solution and kinetics of this process determines the growth rate of alpha lactose monohydrate (α-LM) crystals. Since no data were available on the specific rotation of aqueous α-LM solutions at different concentrations at 33 °C, the initial experiments were carried out on the specific rotation of aqueous α-LM solutions at different concentrations at 33 °C. The specific rotations of the solutions were decreased with increasing time through the mutarotation reaction. The initial and final (equilibrium) specific rotations of the solutions were determined by using automatic digital polarimeter. The compositions of α and β-L in all prepared solutions were calculated from initial and final optical rotations by the method of Sharp and Doob. The composition of α-L decreased whereas, the composition of β-L increased in solutions with increasing concentration of α-LM at 33 °C. Experimental results revealed that this method could be easily and safely employed to study the dependence of specific rotation of solutions on their concentration. The effect of β-lactose on the morphology of nucleated α-LM single crystals has been studied at different experimental conditions.

  2. The Bmp signaling pathway regulates development of left-right asymmetry in amphioxus

    Czech Academy of Sciences Publication Activity Database

    Soukup, Vladimír; Kozmik, Zbyněk

    2018-01-01

    Roč. 143, č. 1 (2018), s. 164-174 R&D Projects: GA ČR(CZ) GP14-20839P; GA MŠk LH12047; GA MŠk(CZ) LM2015062; GA MŠk LO1419; GA MŠk(CZ) LM2015040 Institutional support: RVO:68378050 Keywords : Bmp signaling * Nodal pathway * Amphioxus * Left-right asymmetry Subject RIV: EB - Genetics ; Molecular Biology

  3. CloudLM: a Cloud-based Language Model for Machine Translation

    Directory of Open Access Journals (Sweden)

    Ferrández-Tordera Jorge

    2016-04-01

    Full Text Available Language models (LMs are an essential element in statistical approaches to natural language processing for tasks such as speech recognition and machine translation (MT. The advent of big data leads to the availability of massive amounts of data to build LMs, and in fact, for the most prominent languages, using current techniques and hardware, it is not feasible to train LMs with all the data available nowadays. At the same time, it has been shown that the more data is used for a LM the better the performance, e.g. for MT, without any indication yet of reaching a plateau. This paper presents CloudLM, an open-source cloud-based LM intended for MT, which allows to query distributed LMs. CloudLM relies on Apache Solr and provides the functionality of state-of-the-art language modelling (it builds upon KenLM, while allowing to query massive LMs (as the use of local memory is drastically reduced, at the expense of slower decoding speed.

  4. Optimization of Squeeze Casting Process Parameters Using Taguchi in LM13 Matrix B4C Reinforced Composites

    Science.gov (United States)

    Akhil, K. T.; Arul, Sanjivi

    2018-02-01

    Aluminium metal matrix composite has widely used in aerospace and automobile industry due to its high strength to weight ratio. Aluminium LM13 matrix B4C reinforced composites are mainly manufactured by Squeeze casting process. The present work optimizes squeeze casting process parameters using Taguchi method. The control factors used for the experiments were Squeeze Pressure, Die Preheat Temperature and weight percentage of Boron Carbide (B4C) along with multiple performance characteristic of Hardness, Ultimate Tensile Strength (UTS) and Yield Strength (YS). The L27 orthogonal array was used for experimental design. Analysis of variance (ANOVA) is used to determine the significant factor and found out that Squeeze pressure is the most significant factor followed by percentage of B4C.

  5. Evaluation of Teaching the IS-LM Model through a Simulation Program

    Science.gov (United States)

    Pablo-Romero, Maria del Populo; Pozo-Barajas, Rafael; Gomez-Calero, Maria de la Palma

    2012-01-01

    The IS-ML model is a basic tool used in the teaching of short-term macroeconomics. Teaching is essentially done through the use of graphs. However, the way these graphs are traditionally taught does not allow the learner to easily visualise changes in the curves. The IS-LM simulation program overcomes difficulties encountered in understanding the…

  6. A study on lead myristate (LM) soap film crystal by positron annihilation life spectroscopy

    International Nuclear Information System (INIS)

    Shi Zikang; Yu xianchun

    1992-01-01

    The quality of the LM soap film crystal is determined by means of the positron annihilation life spectroscopy. It is found that the technology to be used to make soap film will influence the film quality and the film quality can be improved by a reasonable heat treatment

  7. HUMAN CAPSULE EPITHELIAL-CELL DEGENERATION A LM, SEM AND TEM INVESTIGATION

    NARCIS (Netherlands)

    JONGEBLOED, WL; KALICHARAN, D; WORST, JGF

    1993-01-01

    The degeneration of the capsule epithelium of cataractous lenses has been studied with LM, SEM on TEM with emphases on TEM. The observed degeneration of the epithelial cells can be described as follows: The cell nucleus becomes picnotic and desintegrates as result of change of the chromatin.

  8. Hot Wire Anemometer Turbulence Measurements in the wind Tunnel of LM Wind Power

    DEFF Research Database (Denmark)

    Fischer, Andreas

    Flow measurements were carried out in the wind tunnel of LM Wind Power A/S with a Dantec Streamline CTA system to characterize the flow turbulence. Besides the free tunnel flow with empty test section we also investigated the tunnel flow when two grids with different mesh size were introduced dow...

  9. Evolutionary renovation of L/M opsin polymorphism confers a fruit discrimination advantage to ateline New World monkeys

    OpenAIRE

    Matsumoto, Yoshifumi; Hiramatsu, Chihiro; Matsushita, Yuka; Ozawa, Norihiro; Ashino, Ryuichi; Nakata, Makiko; Kasagi, Satoshi; Di Fiore, Anthony; Schaffner, Colleen M; Aureli, Filippo; Melin, Amanda D; Kawamura, Shoji

    2014-01-01

    New World monkeys exhibit prominent colour vision variation due to allelic polymorphism of the long-to-middle wavelength (L/M) opsin gene. The known spectral variation of L/M opsins in primates is broadly determined by amino acid composition at three sites: 180, 277 and 285 (the ‘three-sites’ rule). However, two L/M opsin alleles found in the black-handed spider monkeys (Ateles geoffroyi) are known exceptions, presumably due to novel mutations. The spectral separation of the two L/M photopigm...

  10. Uranium-Bearing Evaporite Mineralization Influencing Plume Persistence. Literature Review and DOE-LM Site Surveys

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2016-05-01

    This report on evaporite mineralization was completed as an Ancillary Work Plan for the Applied Studies and Technology program under the U.S. Department of Energy (DOE) Office of Legacy Management (LM). This study reviews all LM sites under Title I and Title II of the Uranium Mill Tailings Radiation Control Act (UMTRCA) and one Decontamination and Decommissioning site to provide (1) a summary of which sites have evaporite deposits, (2) any available quantitative geochemical and mineralogical analyses, and (3) references to relevant reports. In this study, “evaporite” refers to any secondary mineral precipitate that occurs due to a loss of water through evaporative processes. This includes efflorescent salt crusts, where this term refers to a migration of dissolved constituents to the surface with a resulting salt crust, where “salt” can refer to any secondary precipitate, regardless of constituents. The potential for the formation of evaporites at LM sites has been identified, and may have relevance to plume persistence issues. Evaporite deposits have the potential to concentrate and store contaminants at LM sites that could later be re-released. These deposits can also provide a temporary storage mechanism for carbonate, chloride, and sulfate salts along with uranium and other contaminants of concern (COCs). Identification of sites with evaporites will be used in a new technical task plan (TTP), Persistent Secondary Contaminant Sources (PeSCS), for any proposed additional sampling and analyses. This additional study is currently under development and will focus on determining if the dissolution of evaporites has the potential to hinder natural flushing strategies and impact plume persistence. This report provides an initial literature review on evaporites followed by details for each site with identified evaporites. The final summary includes a table listing of all relevant LM sites regardless of evaporite identification.

  11. Uranium-Bearing Evaporite Mineralization Influencing Plume Persistence. Literature Review and DOE-LM Site Surveys

    International Nuclear Information System (INIS)

    2016-01-01

    This report on evaporite mineralization was completed as an Ancillary Work Plan for the Applied Studies and Technology program under the U.S. Department of Energy (DOE) Office of Legacy Management (LM). This study reviews all LM sites under Title I and Title II of the Uranium Mill Tailings Radiation Control Act (UMTRCA) and one Decontamination and Decommissioning site to provide (1) a summary of which sites have evaporite deposits, (2) any available quantitative geochemical and mineralogical analyses, and (3) references to relevant reports. In this study, 'evaporite' refers to any secondary mineral precipitate that occurs due to a loss of water through evaporative processes. This includes efflorescent salt crusts, where this term refers to a migration of dissolved constituents to the surface with a resulting salt crust, where 'salt' can refer to any secondary precipitate, regardless of constituents. The potential for the formation of evaporites at LM sites has been identified, and may have relevance to plume persistence issues. Evaporite deposits have the potential to concentrate and store contaminants at LM sites that could later be re-released. These deposits can also provide a temporary storage mechanism for carbonate, chloride, and sulfate salts along with uranium and other contaminants of concern (COCs). Identification of sites with evaporites will be used in a new technical task plan (TTP), Persistent Secondary Contaminant Sources (PeSCS), for any proposed additional sampling and analyses. This additional study is currently under development and will focus on determining if the dissolution of evaporites has the potential to hinder natural flushing strategies and impact plume persistence. This report provides an initial literature review on evaporites followed by details for each site with identified evaporites. The final summary includes a table listing of all relevant LM sites regardless of evaporite identification.

  12. Main Memory

    NARCIS (Netherlands)

    P.A. Boncz (Peter); L. Liu (Lei); M. Tamer Özsu

    2008-01-01

    htmlabstractPrimary storage, presently known as main memory, is the largest memory directly accessible to the CPU in the prevalent Von Neumann model and stores both data and instructions (program code). The CPU continuously reads instructions stored there and executes them. It is also called Random

  13. ultraLM and miniLM: Locator tools for smart tracking of fluorescent cells in correlative light and electron microscopy.

    Science.gov (United States)

    Brama, Elisabeth; Peddie, Christopher J; Wilkes, Gary; Gu, Yan; Collinson, Lucy M; Jones, Martin L

    2016-12-13

    In-resin fluorescence (IRF) protocols preserve fluorescent proteins in resin-embedded cells and tissues for correlative light and electron microscopy, aiding interpretation of macromolecular function within the complex cellular landscape. Dual-contrast IRF samples can be imaged in separate fluorescence and electron microscopes, or in dual-modality integrated microscopes for high resolution correlation of fluorophore to organelle. IRF samples also offer a unique opportunity to automate correlative imaging workflows. Here we present two new locator tools for finding and following fluorescent cells in IRF blocks, enabling future automation of correlative imaging. The ultraLM is a fluorescence microscope that integrates with an ultramicrotome, which enables 'smart collection' of ultrathin sections containing fluorescent cells or tissues for subsequent transmission electron microscopy or array tomography. The miniLM is a fluorescence microscope that integrates with serial block face scanning electron microscopes, which enables 'smart tracking' of fluorescent structures during automated serial electron image acquisition from large cell and tissue volumes.

  14. Elicitation of Both Anti HIV-1 Env Humoral and Cellular Immunities by Replicating Vaccinia Prime Sendai Virus Boost Regimen and Boosting by CD40Lm

    Science.gov (United States)

    Zhang, Xianfeng; Sobue, Tomoyoshi; Isshiki, Mao; Makino, Shun-ichi; Inoue, Makoto; Kato, Kazunori; Shioda, Tatsuo; Ohashi, Takashi; Sato, Hirotaka; Komano, Jun; Hanabusa, Hideji; Shida, Hisatoshi

    2012-01-01

    For protection from HIV-1 infection, a vaccine should elicit both humoral and cell-mediated immune responses. A novel vaccine regimen and adjuvant that induce high levels of HIV-1 Env-specific T cell and antibody (Ab) responses was developed in this study. The prime-boost regimen that used combinations of replication-competent vaccinia LC16m8Δ (m8Δ) and Sendai virus (SeV) vectors expressing HIV-1 Env efficiently produced both Env-specific CD8+ T cells and anti-Env antibodies, including neutralizing antibodies (nAbs). These results sharply contrast with vaccine regimens that prime with an Env expressing plasmid and boost with the m8Δ or SeV vector that mainly elicited cellular immunities. Moreover, co-priming with combinations of m8Δs expressing Env or a membrane-bound human CD40 ligand mutant (CD40Lm) enhanced Env-specific CD8+ T cell production, but not anti-Env antibody production. In contrast, priming with an m8Δ that coexpresses CD40Lm and Env elicited more anti-Env Abs with higher avidity, but did not promote T cell responses. These results suggest that the m8Δ prime/SeV boost regimen in conjunction with CD40Lm expression could be used as an immunization platform for driving both potent cellular and humoral immunities against pathogens such as HIV-1. PMID:23236521

  15. 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.

  16. Advantages of air conditioning and supercharging an LM6000 gas turbine inlet

    Energy Technology Data Exchange (ETDEWEB)

    Kolp, D.A. [Kolp Engineering, Avon, CT (United States); Flye, W.M. [Stewart and Stevenson, Houston, TX (United States); Guidotti, H.A. [Energy Services, Inc., Framington, CT (United States)

    1995-07-01

    Of all the external factors affecting a gas turbine, inlet pressure and temperature have the greatest impact on performance. The effect of inlet temperature variations is especially pronounced in the new generation of high-efficiency gas turbines typified by the 40 MW GE LM6000. A reduction of 50 F (28 C) in inlet temperature can result in a 30 percent increase in power and a 4.5 percent improvement in heat rate. An elevation increase to 5,000 ft (1,524 m) above sea level decreases turbine output 17 percent; conversely supercharging can increase output more than 20 percent. This paper addresses various means of heating, cooling and supercharging LM6000 inlet air. An economic model is developed and sample cases are cited to illustrate the optimization of gas turbine inlet systems, taking into account site conditions, incremental equipment cost and subsequent performance enhancement.

  17. A Learning Model for L/M Specificity in Ganglion Cells

    Science.gov (United States)

    Ahumada, Albert J.

    2016-01-01

    An unsupervised learning model for developing LM specific wiring at the ganglion cell level would support the research indicating LM specific wiring at the ganglion cell level (Reid and Shapley, 2002). Removing the contributions to the surround from cells of the same cone type improves the signal-to-noise ratio of the chromatic signals. The unsupervised learning model used is Hebbian associative learning, which strengthens the surround input connections according to the correlation of the output with the input. Since the surround units of the same cone type as the center are redundant with the center, their weights end up disappearing. This process can be thought of as a general mechanism for eliminating unnecessary cells in the nervous system.

  18. Power management implementation in FreeRTOS on LM3S3748

    Directory of Open Access Journals (Sweden)

    Simonović Mirela

    2013-01-01

    Full Text Available Power consumption has become a major concern of embedded systems today. With the aim to reduce power consumption during the runtime, operating systems are dealing with power management. In this work, the FreeRTOS port is extended with power management features on LM3S3748 microcontroller. Tickless idle technique is implemented to provide more powersaving during the processor idle periods.

  19. Bisphenol A Inhibits Cell Proliferation and Reduces the Motile Potential of Murine LM8 Osteosarcoma Cells.

    Science.gov (United States)

    Kidani, Teruki; Yasuda, Rie; Miyawaki, Joji; Oshima, Yusuke; Miura, Hiromasa; Masuno, Hiroshi

    2017-04-01

    The aim of this study was to examine the effect of bisphenol A (BPA) on the proliferation and motility potential of murine LM8 osteosarcoma cells. LM8 cells were treated for 3 days with or without 80 μM BPA. The effect of BPA on cell proliferation was determined by DNA measurement in the cultures and 5-bromo-2'-deoxyuridine (BrdU) incorporation study. Ethanol-fixed cells were stained with hematoxylin-eosin (H&E) to visualize cell morphology. Cell motility was assayed using inserts with uncoated membranes in invasion chambers. Expression of cell division cycle 42 (CDC42) was determined by immunofluorescence staining and western blotting. BPA reduced the DNA content of cultures and the number of BrdU-positive cells. BPA induced a change in morphology from cuboidal with multiple filopodia on the cell surface to spindle-shaped with a smooth cell surface. BPA-treated cells expressed less CDC42 and were less motile than untreated cells. BPA inhibited DNA replication and cell proliferation. BPA inhibited filopodia formation and motile potential by inhibiting CDC42 expression in LM8 cells. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  20. Quantitative Proteogenomics and the Reconstruction of the Metabolic Pathway in Lactobacillus mucosae LM1.

    Science.gov (United States)

    Pajarillo, Edward Alain B; Kim, Sang Hoon; Lee, Ji-Yoon; Valeriano, Valerie Diane V; Kang, Dae-Kyung

    2015-01-01

    Lactobacillus mucosae is a natural resident of the gastrointestinal tract of humans and animals and a potential probiotic bacterium. To understand the global protein expression profile and metabolic features of L. mucosae LM1 in the early stationary phase, the QExactive(TM) Hybrid Quadrupole-Orbitrap Mass Spectrometer was used. Characterization of the intracellular proteome identified 842 proteins, accounting for approximately 35% of the 2,404 protein-coding sequences in the complete genome of L. mucosae LM1. Proteome quantification using QExactive(TM) Orbitrap MS detected 19 highly abundant proteins (> 1.0% of the intracellular proteome), including CysK (cysteine synthase, 5.41%) and EF-Tu (elongation factor Tu, 4.91%), which are involved in cell survival against environmental stresses. Metabolic pathway annotation of LM1 proteome using the Kyoto Encyclopedia of Genes and Genomes (KEGG) database showed that half of the proteins expressed are important for basic metabolic and biosynthetic processes, and the other half might be structurally important or involved in basic cellular processes. In addition, glycogen biosynthesis was activated in the early stationary phase, which is important for energy storage and maintenance. The proteogenomic data presented in this study provide a suitable reference to understand the protein expression pattern of lactobacilli in standard conditions.

  1. Context-aware adaptive and personalized mobile learning delivery supported by UoLmP

    Directory of Open Access Journals (Sweden)

    Sergio Gómez

    2014-01-01

    Full Text Available Over the last decade, several research initiatives have investigated the potentials of the educational paradigm shift from the traditional one-size-fits-all teaching approaches to adaptive and personalized learning. On the other hand, mobile devices are recognized as an emerging technology to facilitate teaching and learning strategies that exploit individual learners’ context. This has led to an increased interest on context-aware adaptive and personalized mobile learning systems aiming to provide learning experiences delivered via mobile devices and tailored to learner’s personal characteristics and situation. To this end, in this paper we present a context-aware adaptive and personalized mobile learning system, namely the Units of Learning mobile Player (UoLmP, which aims to support semi-automatic adaptation of learning activities, that is: (a adaptations to the interconnection of the learning activities (namely, the learning flow and (b adaptations to the educational resources, tools and services that support the learning activities. Initial evaluation results from the use of UoLmP provide evidence that UoLmP can successfully adapt the learning flow of an educational scenario and the delivery of educational resources, tools and services that support the learning activities. Finally, these adaptations can facilitate students to complete successfully the learning activities of an educational scenario.

  2. Expression of Leishmania major LmSTI1 in Yeast Pichia Pastoris

    Directory of Open Access Journals (Sweden)

    Mehdi Shokri

    2017-01-01

    Full Text Available Background: Leishmania major LmSTI1 is a conserved protein among different species of leishmania, and expressed in both amastigote and promastigote forms of L. major life cycle. It has previously been expressed in bacterial systems.Materials and Methods: To express LmSTI1 in the methylotrophic yeast         Pichia pastoris (P. pastoris, the shuttle vector pPICZA containing gene lmsti1 was constructed under the control of the AOX1 promoter. The recombinant vector was electro-transformed into P. pastoris, and induced by 0.5% methanol in the buffered medium. The expression of the LmSTI1 protein was visualized in the total soluble protein of P. pastoris by 12% SDS-PAGE, and further confirmed by Western blotting with L.major-infected mouse sera and HRP-conjugated goat anti-mouse IgG as the first and secondary antibodies, respectively.Results: The expression level was 0.2% of total soluble proteins.Conclusion: It might be possible to use this formulation as a whole yeast candidate vaccine against cutaneous leishmanization.

  3. Main findings

    International Nuclear Information System (INIS)

    2014-01-01

    Licensing regimes vary from country to country. When the license regime involves several regulators and several licenses, this may lead to complex situations. Identifying a leading organisation in charge of overall coordination including preparation of the licensing decision is a useful practice. Also, if a stepwise licensing process is implemented, it is important to fix in legislation decisions and/or time points and to identify the relevant actors. There is considerable experience in civil and mining engineering that can be applied when constructing a deep geological disposal facility. Specific challenges are, however, the minimization of disturbances to the host rock and the understanding of its long-term behavior. Construction activities may affect the geo-hydraulic and geochemical properties of the various system components which are important safety features of the repository system. Clearly defined technical specifications and an effective quality management plan are important in ensuring successful repository implementation which is consistent with safety requirements. Monitoring plan should also be defined in advance. The regulatory organization should prepare itself to the licensing review before construction by allocating sufficient resources. It should increase its competence, e.g., by interacting early with the implementer and through its own R and D. This will allow the regulator to define appropriate technical conditions associated to the construction license and to elaborate a relevant inspection plan of the construction work. After construction, obtaining the operational license is the most important and crucial step. Main challenges include (a) establishing sufficient confidence so that the methods for closing the individual disposal units comply with the safety objectives and (b) addressing the issue of ageing of materials during a 50-100 years operational period. This latter challenge is amplified when reversibility/retrievability is required

  4. Reduced Latency in the Metastatic Niche Contributes to the More Aggressive Phenotype of LM8 Compared to Dunn Osteosarcoma Cells

    Directory of Open Access Journals (Sweden)

    Matthias J. E. Arlt

    2013-01-01

    Full Text Available Metastasis is the major cause of death of osteosarcoma patients and its diagnosis remains difficult. In preclinical studies, however, forced expression of reporter genes in osteosarcoma cells has remarkably improved the detection of micrometastases and, consequently, the quality of the studies. We recently showed that Dunn cells equipped with a lacZ reporter gene disseminated from subcutaneous primary tumors as frequently as their highly metastatic subline LM8, but only LM8 cells grew to macrometastases. In the present time-course study, tail-vein-injected Dunn and LM8 cells settled within 24 h at the same frequency in the lung, liver, and kidney of mice. Furthermore, Dunn cells also grew to macrometastases, but, compared to LM8, with a delay of two weeks in lung and one week in liver and kidney tissue, consistent with prolonged survival of the mice. Dunn- and LM8-cell-derived ovary and spine metastases occurred less frequently. In vitro, Dunn cells showed less invasiveness and stronger contact inhibition and intercellular adhesion than LM8 cells and several cancer- and dormancy-related genes were differentially expressed. In conclusion, Dunn cells, compared to LM8, have a similar capability but a longer latency to form macrometastases and provide an interesting new experimental system to study tumor cell dormancy.

  5. Non-stick properties of thin-film coatings on dental-restorative instruments

    OpenAIRE

    Leppäniemi, Jarmo; Hoshian, Sasha; Suomalainen, Kimmo; Luoto, Toni; Jokinen, Ville; Koskinen, Jari

    2017-01-01

    Molemmat tiedostot Word-muodossa. Pitää muuttaa pdf:ksi tai eivät siirry Aaltodociin. The non-stick properties of thin-film coatings on dental-restorative instruments were investigated by static contact-angle measurement using dental filler resin as well as by scanning electron microscopy of the amount of sticking dental restorative material. Furthermore, using a customized dipping measurement set-up, non-stick properties were evaluated by measuring force-by-time when the instrument was pull...

  6. Use of the LM-OSL technique for the detection of partial bleaching in quartz

    DEFF Research Database (Denmark)

    Larsen, N.A.; Bulur, E.; Bøtter-Jensen, L.

    2000-01-01

    is known as linear modulation OSL (LM-OSL). In controlled laboratory conditions, this technique has been employed to study the ease-of-bleaching of the trapped charge in quartz by comparing the OSL curves of quartz aliquots which have been either: (1) fully bleached, followed by a laboratory dose of beta...... -irradiation, or (2) partially bleached, followed by the laboratory beta -dose. The ratio of the OSL signals due to the beta -dose from the partly and fully bleached aliquots is illustrated to be a potential indicator of the degree of optical resetting of the OSL signal in dating material. The key parameter...

  7. [Identification of elephantopi herba and its adulterants by LM/SEM observation and TLC scanning].

    Science.gov (United States)

    Cao, Hui; Li, Yao-Lan; Ye, Wen-Cai; Li, Yong-Xue; But, Pui-Hay; Shaw, Pang-Chui

    2013-08-01

    To provide identification basis for distinguishing Elephantopi Herba and its adulterants. Light microscopy (LM), scanning electron microscopy (SEM) and thin layer chromatography scanning (TLCS) methods were used to identify Didancao (Elephantopus scaber) and its adulterants Baihuadidancao (Elephantopus mollis) and Jiadidancao (Pseudelephantopus spicatus). Based on the microscopic features and TLC profiles, the commercial Didancao samples retailed in mainland China, Taiwan, Hong Kong and Macau markets were identified as Elephantopus scaber. These methods are accurate and reliable, which can be used for identification of Elephantopi Herba and its adulterants.

  8. Vegetative propagation of malay apple [Syzygium malaccense (L.) Merr. & LM Perry

    OpenAIRE

    de Almeida, Eduardo Jose [UNESP; Torrecillas Scaloppi, Eliana Mayra [UNESP; de Jesus, Natanael; Benassi, Antonio Carlos; Devos Ganga, Rita Maria; Geraldo Martins, Antonio Baldo [UNESP

    2010-01-01

    O jambeiro vermelho [Syzygium malaccense (L.) Merr. & L.M. Perry] se apresenta como opção ao fruticultor por apresentar frutos atrativos e bem aceitos pelo consumidor. A dificuldade de cultivo dessa espécie reside no fato de que a planta possui um porte demasiadamente alto e longo período juvenil quando propagada por semente, com isso, é desejável sua multiplicação vegetativa visando a antecipar o período produtivo e diminuir seu porte. Foi estudada a possibilidade de clonagem dessa espécie p...

  9. Numerical study of hydrogen absorption in a LM-Ni5 hybride reactor

    International Nuclear Information System (INIS)

    Altinisik, K.; Tekin, M.; Mat, M. D.; Altinisik, A.; Veziroglu, T. N.

    2007-01-01

    Metal hydride formation in an Lm-Ni5 storage tank is numerically studied with a continuum mathematical model. The model considers complex heat, and mass transfer and chemical reaction in the reaction bed. It is found that hydride formation enhances at regions with lower equilibrium pressure. Absorbed hydrogen mass increases exponentially at earlier times of hydriding process and slow down after temperature of reaction bed increases due to the heat of reaction. Numerical results agree satisfactorily with the experimental data in the literature

  10. ISR main control room

    CERN Multimedia

    CERN PhotoLab

    1970-01-01

    The ISR main control room (SRC) on the night of 20 October when beam was first successfully injected into Ring I. The panels along the left contain controls and observational information about the beam-transfer system and injection. Along the right are recorders showing beam intensity (in the centre) and controls for currents in the main magnets, the pole face windings, and auxiliary magnets, and the magnetic field display panel (further for the rear). At the far back are controls and observations for the r.f. system and the betatron-frequency meter. Also at the far back (in the centre) are oscilloscopes for looking at signals from the pick-up electrodes.

  11. A mercury transport and fate model (LM2-mercury) for mass budget assessment of mercury cycling in Lake Michigan

    Science.gov (United States)

    LM2-Mercury, a mercury mass balance model, was developed to simulate and evaluate the transport, fate, and biogeochemical transformations of mercury in Lake Michigan. The model simulates total suspended solids (TSS), disolved organic carbon (DOC), and total, elemental, divalent, ...

  12. Characterization of antimicrobial lipopeptides produced by Bacillus sp. LM7 isolated from chungkookjang, a Korean traditional fermented soybean food.

    Science.gov (United States)

    Lee, Mi-Hwa; Lee, Jiyeon; Nam, Young-Do; Lee, Jong Suk; Seo, Myung-Ji; Yi, Sung-Hun

    2016-03-16

    A wild-type microorganism exhibiting antimicrobial activities was isolated from the Korean traditional fermented soybean food Chungkookjang and identified as Bacillus sp. LM7. During its stationary growth phase, the microorganism secreted an antimicrobial substance, which we partially purified using a simple two-step procedure involving ammonium sulfate precipitation and heat treatment. The partially purified antimicrobial substance, Anti-LM7, was stable over a broad pH range (4.0-9.0) and at temperatures up to 80 °C for 30 min, and was resistant to most proteolytic enzymes and maintained its activity in 30% (v/v) organic solvents. Anti-LM7 inhibited the growth of a broad range of Gram-positive bacteria, including Bacillus cereus and Listeria monocytogenes, but it did not inhibit lactic acid bacteria such as Lactobacillus plantarum and Lactococcus lactis subsp. Lactis. Moreover, unlike commercially available nisin and polymyxin B, Anti-LM7 inhibited certain fungal strains. Lastly, liquid chromatography-mass spectrometry analysis of Anti-LM7 revealed that it contained eight lipopeptides belonging to two families: four bacillomycin D and four surfactin analogs. These Bacillus sp. LM7-produced heterogeneous lipopeptides exhibiting extremely high stability and a broad antimicrobial spectrum are likely to be closely related to the antimicrobial activity of Chungkookjang, and their identification presents an opportunity for application of the peptides in environmental bioremediation, pharmaceutical, cosmetic, and food industries. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. COMPARATIVE ANALYSIS OF MODELS OF RAILWAY LOADS C14 AND LM71 FOR GIRDER BRIDGES

    Directory of Open Access Journals (Sweden)

    V. Artomov

    2014-01-01

    Full Text Available Purpose. The article analyzes the railway load LM71 for the purpose of its application in national design projects of the railway girder bridges. Purpose of the article is harmonization of national design codes of enginnering structures with the European standards (Eurocodes. Methodology. Analytical calculation methods (influence lines, the matrix analysis and computer programming are used in the article. Findings. Deflected mode parameters of the railway bridges under the influence of loads C14 and LM71 have certain differences. The extent of these differences depends on length, material of drift structures and also on dynamic coefficients. These dependences should be considered in national design codes and in harmonized with Eurocodes standards. In the further researches relationships between load C14 and models SW, HSLM taking into account various dynamic effects and trains speedis planned to determine. Originality. The presented results, in particular deflected mode parameters (including loads with dynamic coefficients, obtained for the first time. Practical value. Results of research are used in National Annex to the National Standard of Ukraine NSTU-N B EN 1991-2:2010. Eurocode 1. Actions on structures. Part 2. Traffic loads on bridges (EN 1991-2:2003.

  14. Microstructural characteristics of spray formed zircon sand reinforced LM13 composite

    Energy Technology Data Exchange (ETDEWEB)

    Kaur, Kamalpreet [School of Physics and Materials Science, Thapar University, Patiala, Punjab 147 004 (India); Pandey, O.P., E-mail: oppandey@thapar.ed [School of Physics and Materials Science, Thapar University, Patiala, Punjab 147 004 (India)

    2010-08-06

    Aluminum metal matrix composites (MMC) are one of the attractive light weight substance which find their application in automotive and aerospace industries. In the present work spray forming technique has been used to prepare zircon sand reinforced LM13 alloy. The spray formed composite and base alloy were characterized using optical and scanning electron microscopes. The thermal analysis of the base alloy, zircon sand particles and reinforced composite has been done with differential thermal analyzer and dilatometer to see its applicability at high temperature. The microstructural features and hardness of spray formed LM13/zircon sand composite revealed equiaxed morphology with nearly uniform distribution of zircon sand particles in the middle of preform as well as good particle/matrix interfacial bonding. The linear expansion coefficient of base alloy is found to be 8.67 x 10{sup -6} K{sup -1} and for spray formed composite is 8.38 x 10{sup -6} K{sup -1} (5% V{sub f} of zircon sand) and 9.11 x 10{sup -6} K{sup -1} (15% V{sub f} of zircon sand) in 25-465 {sup o}C temperature limit, which is quite comparable indicating good interfacial bonding.

  15. In vitro evaluation of the mucin-adhesion ability and probiotic potential of Lactobacillus mucosae LM1.

    Science.gov (United States)

    Valeriano, V D; Parungao-Balolong, M M; Kang, D-K

    2014-08-01

    In this report, we characterized the probiotic potential of Lactobacillus mucosae LM1, focusing on its in vitro mucin-adhesion abilities. Screening assays were used to evaluate LM1. Previous studies on Lact. mucosae species have been performed, but few have examined the ability of this species to adhere to and colonize the intestinal mucosa. Thus, adhesion, aggregation and pathogen inhibition assays of LM1 along with microbial adhesion to solvents (MATS) assay were carried out in comparison with another putative probiotic, Lactobacillus johnsonii PF01, and the commercial strain, Lactobacillus rhamnosus GG. Based on MATS assay, the cell surfaces of the lactobacilli strains were found to be hydrophobic and highly electron-donating, but the average hydropathy (GRAVY) index of predicted surface-exposed proteins in the LM1 genome indicated that most were hydrophilic. LM1 showed the highest adhesion, aggregation and hydrophobicity among the strains tested and significantly inhibited the adhesion of Escherichia coli K88 and Salmonella enterica serovar Typhimurium KCCM 40253. Correlations among adhesion, aggregation and hydrophobicity, as well as between coaggregation and displacement of E. coli, were observed. Increased adhesion may not always correlate with increased pathogen inhibition due to various strain-specific mechanisms. Nevertheless, LM1 has promising probiotic properties that can be explored further using a genomics approach. Our data on adhesion of LM1 strain showed a significant correlation between adhesion, hydrophobicity of cell surface and autoaggregation. This study gives basic knowledge for the elucidation of the adhesion mechanism of Lactobacillus sp. and prediction of its adherence in specific host models. © 2014 The Society for Applied Microbiology.

  16. Evaluation of the Common Land Model (CoLM from the Perspective of Water and Energy Budget Simulation: Towards Inclusion in CMIP6

    Directory of Open Access Journals (Sweden)

    Chengwei Li

    2017-07-01

    Full Text Available Land surface models (LSMs are important tools for simulating energy, water and momentum transfer across the land–atmosphere interface. Many LSMs have been developed over the past 50 years, including the Common Land Model (CoLM, a LSM that has primarily been developed and maintained by Chinese researchers. CoLM has been adopted by several Chinese Earth System Models (GCMs that will participate in the Coupled Model Intercomparison Project Phase 6 (CMIP6. In this study, we evaluate the performance of CoLM with respect to simulating the water and energy budgets. We compare simulations using the latest version of CoLM (CoLM2014, the previous version of CoLM (CoLM2005 that was used in the Beijing Normal University Earth System Model (BNU-GCM for CMIP5, and the Community Land Model version 4.5 (CLM4.5 against global diagnostic data and observations. Our results demonstrate that CLM4.5 outperforms CoLM2005 and CoLM2014 in simulating runoff (R, although all three models overestimate runoff in northern Europe and underestimate runoff in North America and East Asia. Simulations of runoff and snow depth (SNDP are substantially improved in CoLM2014 relative to CoLM2005, particularly in the Northern Hemisphere. The simulated global energy budget is also substantially improved in CoLM2014 relative to CoLM2005. Simulations of sensible heat (SH based on CoLM2014 compare favorably to those based on CLM4.5, while root-mean-square errors (RMSEs in net surface radiation indicate that CoLM2014 (RMSE = 16.02 W m−2 outperforms both CoLM2005 (17.41 W m−2 and CLM4.5 (23.73 W m−2. Comparisons at regional scales show that all three models perform poorly in the Amazon region but perform relatively well over the central United States, Siberia and the Tibetan Plateau. Overall, CoLM2014 is improved relative to CoLM2005, and is comparable to CLM4.5 with respect to many aspects of the energy and water budgets. Our evaluation confirms CoLM2014 is suitable for inclusion in

  17. Process-oriented statistical-dynamical evaluation of LM precipitation forecasts

    Directory of Open Access Journals (Sweden)

    A. Claußnitzer

    2008-04-01

    Full Text Available The objective of this study is the scale dependent evaluation of precipitation forecasts of the Lokal-Modell (LM from the German Weather Service in relation to dynamical and cloud parameters. For this purpose the newly designed Dynamic State Index (DSI is correlated with clouds and precipitation. The DSI quantitatively describes the deviation and relative distance from a stationary and adiabatic solution of the primitive equations. A case study and statistical analysis of clouds and precipitation demonstrates the availability of the DSI as a dynamical threshold parameter. This confirms the importance of imbalances of the atmospheric flow field, which dynamically induce the generation of rainfall.

  18. Le marquage de l’aspect en chinois LM et LE

    OpenAIRE

    Jin, Limin; Hendriks, Henriette

    2009-01-01

    Au cours de ces vingt-cinq dernières années, les travaux acquisitionnels en langue maternelle et en langue seconde ont montré que la morphologie flexionnelle émerge dans une configuration qui s’écarte de celle de la langue cible (Andersen & Shirai, 1994, 1996 ; Bardovi-Harlig, 1999, 2000 pour un bilan exhaustif de ces études). La découverte de ce type de régularités a conduit à formuler l’Hypothèse de l’Aspect, selon laquelle les apprenants en LM et en LE initialement « influencés par les pro...

  19. The theory of endogenous money and the LM schedule: prelude to a reconstruction of ISLM

    Directory of Open Access Journals (Sweden)

    THOMAS I. PALLEY

    Full Text Available ABSTRACT Money is at the center of macroeconomics, which makes understanding the money supply central for macroeconomic theory. This paper presents the Post Keynesian theory of endogenous money supply and shows how it is fundamentally different from the conventional money supply theory. The conventional approach relies on the money multiplier and bank lending is invisible. Post Keynesian theory discards the money multiplier and focuses on bank lending which drives money creation. The paper emphasizes the structuralist version of Post Keynesian theory which retains Keynes’ liquidity preference theory of long term interest rates and also recognizes banks are subject to financial constraints that limit their lending activities. The paper then shows how to derive the LM schedule in an endogenous money economy, which is a necessary prelude to reconstructing the ISLM model.

  20. Development of LM10-MIRA LOX/LNG expander cycle demonstrator engine

    Science.gov (United States)

    Rudnykh, Mikhail; Carapellese, Stefano; Liuzzi, Daniele; Arione, Luigi; Caggiano, Giuseppe; Bellomi, Paolo; D'Aversa, Emanuela; Pellegrini, Rocco; Lobov, S. D.; Gurtovoy, A. A.; Rachuk, V. S.

    2016-09-01

    This article contains results of joint works by Konstruktorskoe Buro Khimavtomatiki (KBKhA, Russia) and AVIO Company (Italy) on creation of the LM10-MIRA liquid-propellant rocket demonstrator engine for the third stage of the upgraded "Vega" launcher.Scientific and research activities conducted by KBKhA and AVIO in 2007-2014 in the frame of the LYRA Program, funded by the Italian Space Agency, with ELV as Prime contractor, and under dedicated ASI-Roscosmos inter-agencies agreement, were aimed at development and testing of a 7.5 t thrust expander cycle demonstrator engine propelled by oxygen and liquid natural gas (further referred to as LNG).

  1. Poisoning effect of bismuth on modification behaviour of strontium in LM25 alloy

    International Nuclear Information System (INIS)

    Farahany, S.; Ourdjini, A.; Idris, M.H.; Thai, L.T.

    2011-01-01

    Nucleation and growth, temperature measurements and microstructure observations of silicon phase are presented for strontium modified Al-7% Si (LM25) cast alloy treated with bismuth. The results show that addition of bismuth in strontium modified alloys may have a poisoning effect resulting in lost modification of the silicon phase. With increasing Bi/Sr ratio, thermal analysis measurements showed that the eutectic growth temperature increased remarkably to 573 deg C and recalescence decreased to 0.2 deg C and the morphology of silicon displayed the same flake-like structure as in the unmodified alloys. Microstructural observation showed that a minimum Bi/Sr ratio of 1.2 which is equivalent to a Sr/Bi ratio of 0.43 is required for effective strontium modification and neutralization of the poisoning effect of bismuth. (author)

  2. 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

  3. LM lightning protection and evolutions for larger wind turbine rotor blades

    Energy Technology Data Exchange (ETDEWEB)

    Mortensen, I. [LM Glasfiber Group, Lunderskov (Denmark)

    2005-07-01

    Over 2000 thunder storms are active throughout the world at any given moment, producing approximately 100 flashes of lightning per second. Non-conducting wind turbine blades without conducting components are often struck by lightning and suffer major damage. Statistics have shown that lightning causes 4 to 8 faults per 100 turbines per year in northern Europe, and that 7 to 10 per cent of all lightning damages involve wind turbine blades, which are the most expensive components to repair. There is also an increased risk of inboard puncture for lightning strikes of lower currents. Various lightning protection systems were presented in this paper, as well as optimization methods for different types of wind turbine blades. Multi-receptors, drain receptors, conductive cables and diverter strips were evaluated. Testing procedures for lightning protection components were reviewed. An outline of the Hige voltage test was presented. It was noted that pollution promotes the capture capabilities of wind turbine blades. Extensive high-voltage impact tests have shown that the semi-conductive carbon fibre is struck by lightning as often as the actual lightning receptors. Details of the LM DiverterStrip were presented. The strip captures the lightning strike and guides the way to the receptor. The strip is low maintenance and designed to last for 20 years, with a minimal influence on air flow. In addition, the current travelling in an ionized path above the segments of the LM strip makes a smooth transfer to the receptor. A recent year-long field tests has shown good results, without any wear or lightning damage to the strips. It was concluded that lightning protection reduces insurance costs, and that standard lightning protection systems used for fibre glass blades do not provide sufficient lightning protection for carbon fibre blades. refs., tabs., figs.

  4. Rancang Bangun Alat Ukur Kelajuan Udara Tipe Thermal Terintegrasi Termometer Udara Berbasis Sensor LM35 dan PT100

    Directory of Open Access Journals (Sweden)

    Laila Katriani

    2017-11-01

    INTEGRATED WITH AIR THERMOMETER USING  LM35 SENSOR AND PT100 SENSOR This research aimed to design a thermal type anemometer integrated with air thermometer using Lm35 sensor and PT100 sensor. The study began in Mei until Oktober 2016. The study was conducted at the Laboratory of Electronics and Instrumentation, Department of Physics Education, State University of Yogyakarta. The design of the thermal type anemometer consists of two stages, namely, the design of the hardware and software design. Hardware design consists of a sensor system design (LM35 and PT100,  LM317 design, system design for data processing and display. Software design using C language. Based on the results of tests that had been done, shows that the sensor output LM35, whic is voltage is proportional to temperature changes, which had a sensitivity of 0.009 volts / ºC and initial output voltage of the sensor when the temperature reach 0 °C is 0,041 volts. PT100 sensor output, which is resistance is proportional to temperature changes, which had sensitivity of 0.391 Ω/oC and initial output resistance of the sensor when temperature reach 28 °C is 100,8 Ω. Error percent of thermal-type air speed measuring instrument testing is 4%.

  5. Evaluation of Pre- and Post- Redevelopment Groundwater Chemical Analyses from LM Monitoring Wells

    Energy Technology Data Exchange (ETDEWEB)

    Kamp, Susan [Navarro Reserch and Engineering, Oak Ridge, TN (United States); Dayvault, Jalena [US Department of Energy, Washington, DC (United States). Office of Legacy Management

    2016-05-01

    This report documents the efforts and analyses conducted for the Applied Studies and Technology (AS&T) Ancillary Work Plan (AWP) project titled Evaluation of Pre- and Post- Redevelopment Groundwater Sample Laboratory Analyses from Selected LM Groundwater Monitoring Wells. This effort entailed compiling an inventory of nearly 500 previous well redevelopment events at 16 U.S. Department of Energy Office of Legacy Management (LM) sites, searching the literature for impacts of well redevelopment on groundwater sample quality, and—the focus of this report—evaluating the impacts of well redevelopment on field measurements and sample analytical results. Study Catalyst Monitoring well redevelopment, the surging or high-volume pumping of a well to loosen and remove accumulated sediment and biological build-up from a well, is considered an element of monitoring well maintenance that is implemented periodically during the lifetime of the well to mitigate its gradual deterioration. Well redevelopment has been conducted fairly routinely at a few LM sites in the western United States (e.g., the Grand Junction office site and the Gunnison processing site in Colorado), but at most other sites in this region it is not a routine practice. Also, until recently (2014–2015), there had been no specific criteria for implementing well redevelopment, and documentation of redevelopment events has been inconsistent. A catalyst for this evaluation was the self-identification of these inconsistencies by the Legacy Management Support contractor. As a result, in early 2015 Environmental Monitoring Operations (EMO) staff began collecting and documenting additional field measurements during well redevelopment events. In late 2015, AS&T staff undertook an independent internal evaluation of EMO's well redevelopment records and corresponding pre- and post-well-redevelopment groundwater analytical results. Study Findings Although literature discussions parallel the prevailing industry

  6. Complexity dynamics and Hopf bifurcation analysis based on the first Lyapunov coefficient about 3D IS-LM macroeconomics system

    Science.gov (United States)

    Ma, Junhai; Ren, Wenbo; Zhan, Xueli

    2017-04-01

    Based on the study of scholars at home and abroad, this paper improves the three-dimensional IS-LM model in macroeconomics, analyzes the equilibrium point of the system and stability conditions, focuses on the parameters and complex dynamic characteristics when Hopf bifurcation occurs in the three-dimensional IS-LM macroeconomics system. In order to analyze the stability of limit cycles when Hopf bifurcation occurs, this paper further introduces the first Lyapunov coefficient to judge the limit cycles, i.e. from a practical view of the business cycle. Numerical simulation results show that within the range of most of the parameters, the limit cycle of 3D IS-LM macroeconomics is stable, that is, the business cycle is stable; with the increase of the parameters, limit cycles becomes unstable, and the value range of the parameters in this situation is small. The research results of this paper have good guide significance for the analysis of macroeconomics system.

  7. pK(a) modelling and prediction of drug molecules through GA-KPLS and L-M ANN.

    Science.gov (United States)

    Noorizadeh, H; Farmany, A; Noorizadeh, M

    2013-02-01

    Genetic algorithm and partial least square (GA-PLS), kernel PLS (GA-KPLS) and Levenberg- Marquardt artificial neural network (L-M ANN) techniques were used to investigate the correlation between dissociation constant (pK(a) ) and descriptors for 60 drug compounds. The applied internal (leave-group-out cross validation (LGO-CV)) and external (test set) validation methods were used for the predictive power of models. Descriptors of GA-KPLS model were selected as inputs in L-M ANN model. The results indicate that L-M ANN can be used as an alternative modeling tool for quantitative structure-property relationship (QSPR) studies. Copyright © 2011 John Wiley & Sons, Ltd.

  8. LM-OSL signals from some insulators: an analysis of the dependency of the detrapping probability on stimulation light intensity

    DEFF Research Database (Denmark)

    Bulur, E.; Bøtter-Jensen, L.; Murray, A.S.

    2001-01-01

    Optically stimulated luminescence (OSL) signals from various insulators including quartz, Al2O3 : C, BeO and NaCl have been studied using the linear modulation OSL (LM-OSL) technique. LM-OSL is based on the linear increase of the stimulation light power from zero to a maximum during the measurement...... is not always correct. The initial decay rates of the blue (similar to 470 nm) light stimulated constant power OSL decay curves were examined to test the relation between the detrapping rates and the stimulation light intensity. In SiO2, Al2O3 : C and BeO a linear relation between the detrapping rates....... The resultant OSL curve initially increases and then decays after reaching a maximum, The analysis of LM-OSL data usually assumes a linear relationship between the detrapping rate and the stimulation light intensity. However, experiments carried out using various insulators have shown that this assumption...

  9. Evolutionary renovation of L/M opsin polymorphism confers a fruit discrimination advantage to ateline New World monkeys.

    Science.gov (United States)

    Matsumoto, Yoshifumi; Hiramatsu, Chihiro; Matsushita, Yuka; Ozawa, Norihiro; Ashino, Ryuichi; Nakata, Makiko; Kasagi, Satoshi; Di Fiore, Anthony; Schaffner, Colleen M; Aureli, Filippo; Melin, Amanda D; Kawamura, Shoji

    2014-04-01

    New World monkeys exhibit prominent colour vision variation due to allelic polymorphism of the long-to-middle wavelength (L/M) opsin gene. The known spectral variation of L/M opsins in primates is broadly determined by amino acid composition at three sites: 180, 277 and 285 (the 'three-sites' rule). However, two L/M opsin alleles found in the black-handed spider monkeys (Ateles geoffroyi) are known exceptions, presumably due to novel mutations. The spectral separation of the two L/M photopigments is 1.5 times greater than expected based on the 'three-sites' rule. Yet the consequence of this for the visual ecology of the species is unknown, as is the evolutionary mechanism by which spectral shift was achieved. In this study, we first examine L/M opsins of two other Atelinae species, the long-haired spider monkeys (A. belzebuth) and the common woolly monkeys (Lagothrix lagotricha). By a series of site-directed mutagenesis, we show that a mutation Y213D (tyrosine to aspartic acid at site 213) in the ancestral opsin of the two alleles enabled N294K, which occurred in one allele of the ateline ancestor and increased the spectral separation between the two alleles. Second, by modelling the chromaticity of dietary fruits and background leaves in a natural habitat of spider monkeys, we demonstrate that chromatic discrimination of fruit from leaves is significantly enhanced by these mutations. This evolutionary renovation of L/M opsin polymorphism in atelines illustrates a previously unappreciated dynamism of opsin genes in shaping primate colour vision. © 2014 The Authors. Molecular Ecology Published by John Wiley & Sons Ltd.

  10. Genetics of leaf rust-resistant mutant WH 147-LM-1 in hexaploid wheat variety WH 147

    International Nuclear Information System (INIS)

    Reddy, V.R.K.; Viswanathan, P.

    1999-01-01

    By applying gamma rays, EMS and their combination in hexaploid wheat variety WH 147, a total of 20 mutants (0.0226%) exhibiting complete leaf rust resistance were isolated from segregating M2 rows.When one of the rust-resistant mutants, WH 147-LM-1 was crossed with the universally susceptible, suggesting that the mutant character is controlled by one dominant gene and one recessive gene.The F2 plants derived by crossing the mutant WH 147-LM with seven near-isogenic wheat lines showed segregation for susceptibility, indicating that the mutant character was indeed generated through induced mutations

  11. Branching patterns of left coronary artery among North Indians ...

    African Journals Online (AJOL)

    The left coronary artery displays variations in pattern, number and distribution of its branches. These variations influence the manifestation and extent of the coronary artery disease affecting the left main branch. A total of 100 North Indian cadaveric hearts were dissected to observe the main trunk of the left coronary artery.

  12. Performance of High Temperature Operational Amplifier, Type LM2904WH, under Extreme Temperatures

    Science.gov (United States)

    Patterson, Richard; Hammoud, Ahmad; Elbuluk, Malik

    2008-01-01

    Operation of electronic parts and circuits under extreme temperatures is anticipated in NASA space exploration missions as well as terrestrial applications. Exposure of electronics to extreme temperatures and wide-range thermal swings greatly affects their performance via induced changes in the semiconductor material properties, packaging and interconnects, or due to incompatibility issues between interfaces that result from thermal expansion/contraction mismatch. Electronics that are designed to withstand operation and perform efficiently in extreme temperatures would mitigate risks for failure due to thermal stresses and, therefore, improve system reliability. In addition, they contribute to reducing system size and weight, simplifying its design, and reducing development cost through the elimination of otherwise required thermal control elements for proper ambient operation. A large DC voltage gain (100 dB) operational amplifier with a maximum junction temperature of 150 C was recently introduced by STMicroelectronics [1]. This LM2904WH chip comes in a plastic package and is designed specifically for automotive and industrial control systems. It operates from a single power supply over a wide range of voltages, and it consists of two independent, high gain, internally frequency compensated operational amplifiers. Table I shows some of the device manufacturer s specifications.

  13. Optimization of the Machining parameter of LM6 Alminium alloy in CNC Turning using Taguchi method

    Science.gov (United States)

    Arunkumar, S.; Muthuraman, V.; Baskaralal, V. P. M.

    2017-03-01

    Due to widespread use of highly automated machine tools in the industry, manufacturing requires reliable models and methods for the prediction of output performance of machining process. In machining of parts, surface quality is one of the most specified customer requirements. In order for manufactures to maximize their gains from utilizing CNC turning, accurate predictive models for surface roughness must be constructed. The prediction of optimum machining conditions for good surface finish plays an important role in process planning. This work deals with the study and development of a surface roughness prediction model for machining LM6 aluminum alloy. Two important tools used in parameter design are Taguchi orthogonal arrays and signal to noise ratio (S/N). Speed, feed, depth of cut and coolant are taken as process parameter at three levels. Taguchi’s parameters design is employed here to perform the experiments based on the various level of the chosen parameter. The statistical analysis results in optimum parameter combination of speed, feed, depth of cut and coolant as the best for obtaining good roughness for the cylindrical components. The result obtained through Taguchi is confirmed with real time experimental work.

  14. Investigations on LM6 Metal Matrix Composite with borosilicate Glass Reinforcement for Aerospace applications

    Science.gov (United States)

    Rathnaraj, J. David; Sathish, S.

    2017-10-01

    The recycling of glass wastes from the industries and society holds a threat to the environment and leads to the need for new applications. While producing a metal matrix composite production cost is an important factor which decides the suitable application. So, while developing a new material with this low - cost has great importance in this competitive world. In this study, an metal-matrix composite fabricated from an aluminum alloy (LM6) and Borosilicate glass powder particles with % addition of 2.5%, 5%, 7.5%, and 10% were produced by liquid Processing (stir casting) technique. The variations in the mechanical properties like toughness, compressive strength, hardness, and tensile were examined. The microstructures of the fabricated metal matrix composite have been obtained by using Metallographic microscope. The addition of the borosilicate glass indicated an improved behavior in the hardness and toughness properties. The Rockwell hardness value of fabricated metal matrix composite increases with the increase in % of reinforcement. The compressive and tensile strength of the fabricated MMC increases until reinforcement reaches a maximum of 7.5%. The microstructure of the fabricated MMC shows that the reinforcements were homogeneously distributed in the fabricated metal matrix composite.

  15. Symbol error rate performance evaluation of the LM37 multimegabit telemetry modulator-demodulator unit

    Science.gov (United States)

    Malek, H.

    1981-01-01

    The LM37 multimegabit telemetry modulator-demodulator unit was tested for evaluation of its symbol error rate (SER) performance. Using an automated test setup, the SER tests were carried out at various symbol rates and signal-to-noise ratios (SNR), ranging from +10 to -10 dB. With the aid of a specially designed error detector and a stabilized signal and noise summation unit, measurement of the SER at low SNR was possible. The results of the tests show that at symbol rates below 20 megasymbols per second (MS)s) and input SNR above -6 dB, the SER performance of the modem is within the specified 0.65 to 1.5 dB of the theoretical error curve. At symbol rates above 20 MS/s, the specification is met at SNR's down to -2 dB. The results of the SER tests are presented with the description of the test setup and the measurement procedure.

  16. Comparative genomic analysis of Lactobacillus mucosae LM1 identifies potential niche-specific genes and pathways for gastrointestinal adaptation.

    Science.gov (United States)

    Valeriano, Valerie Diane V; Oh, Ju Kyoung; Bagon, Bernadette B; Kim, Heebal; Kang, Dae-Kyung

    2017-12-23

    Lactobacillus mucosae is currently of interest as putative probiotics due to their metabolic capabilities and ability to colonize host mucosal niches. L. mucosae LM1 has been studied in its functions in cell adhesion and pathogen inhibition, etc. It demonstrated unique abilities to use energy from carbohydrate and non-carbohydrate sources. Due to these functions, we report the first complete genome sequence of an L. mucosae strain, L. mucosae LM1. Analysis of the pan-genome in comparison with closely-related Lactobacillus species identified a complete glycogen metabolism pathway, as well as folate biosynthesis, complementing previous proteomic data on the LM1 strain. It also revealed common and unique niche-adaptation genes among the various L. mucosae strains. The aim of this study was to derive genomic information that would reveal the probable mechanisms underlying the probiotic effect of L. mucosae LM1, and provide a better understanding of the nature of L. mucosae sp. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Characterization of the LM5 pectic galactan epitope with synthetic analogues of β-1,4-d-galactotetraose

    DEFF Research Database (Denmark)

    Andersen, Mathias Christian Franch; Boos, Irene; Marcus, Susan E.

    2016-01-01

    .g. Immunofluorescent microscopy. Here, we describe the detailed epitope mapping of the mab LM5 that is shown to bind to a minimum of three sugar residues at the non-reducing end of linear beta-1,4-linked galactan. The study uses de novo synthetic analogs of galactans combined with carbohydrate microarray...

  18. Radiative Auger effect in the K-LM and K-MM transitions in argon, kripton and xenon

    International Nuclear Information System (INIS)

    Muehleisen, Arthur

    1996-01-01

    The radiative Auger (RA) effect in the K-LM and K-MM transitions in Ar, Kr and Xe is studied. The measurements were performed at the University of Fribourg in Switzerland, except for one of the Ar K-LM measurements that was done at the PSI, Villingen, Switzerland. Johann type spectrometer was used for that measurement, while for the same K-LM measurement in Fribourg von Hamos spectrometer was employed. The measurements on Kr and Xe were performed with transmission type spectrometer with a curved crystal. The transitions were photoinduced by an X-ray tube. Ar K-LM yield was determined to be 0.18±0.04 % relatively to the K α1,2 yield. For Kr, the K-LM and K-MM yields, relatively to the K α1,2 respectively K α1,3 line, were found to be 0.15 % ±0.04 % and 0.77 % ±0.2 %, respectively. For Xe , only an upper limit of 0.008 % relatively to the K α1,2 line could be deduced for the K-LM yield, whereas the total relative intensity of the unresolved K - M 4,5 M 4,5 and K - M 1 N 1 RA transitions was found to be 0.06 % ± 0.02 % relatively to the Kβ 1,3 . In addition, the Xe K - M 2,3 N 1 , K - M 1 N 4,5 and K - M 1 N 2,3 transitions were also observed with a total relative intensity of 0.05 % ± 0.02 %. The experimental values were compared with known experimental and theoretical data. The RA intensity calculations were performed within the radiative field model (Ar and Kr K - MM) and within the shake model (Ar and Kr K - LM and K - MM). The calculated results show satisfactory agreement with our experimental data and other available data. Strong dependence of the calculated RA yield on the atomic potential used was observed. 53 refs., [sl

  19. 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....

  20. Uso rutinario del balón de contra-pulsación aórtica preoperatorio en pacientes con enfermedad del tronco común izquierdo sometidos a cirugía de revascularización coronaria Routine use of preoperative intra-aortic balloon pump counterpulsation (IABP implantation in patients with left main coronary artery disease undergoing coronary revascularization surgery

    Directory of Open Access Journals (Sweden)

    Andrés Fernández

    2008-08-01

    cuidados intensivos se infectaron 6,5% de los pacientes con balón y 3% del grupo sin balón (p=0,49 y hubo sepsis en 4,3% del grupo con balón y en ninguno del grupo restante (p=0,23. La letalidad en la unidad de cuidados intensivos se presentó en 2,2% del grupo de balón y en 3% del otro grupo (p=0,06. No ocurrió mortalidad intrahospitalaria fuera de la unidad de cuidados intensivos como tampoco mortalidad a 30 días después del alta. El tiempo de estancia en la misma unidad fue de 4,13 días en el grupo de balón y 2,7 días en el grupo sin balón, sin diferencia estadísticamente significativa entre éstos (p=0,154. El tiempo de ventilación mecánica en el grupo de balón fue de 1,96 días mientras que en el otro grupo fue de 1,18 días sin diferencia estadísticamente significativa (p=0,288. Con respecto a los pacientes que recibieron balón de contra pulsación intra-aórtico, el promedio de uso de balón fue de 1,32 días y no se presentaron complicaciones vasculares relacionadas con su uso. Conclusiones: este estudio sugiere que con el uso rutinario del balón de contra pulsación aórtica previo a la cirugía electiva de revascularización coronaria en pacientes cuya única indicación sea la lesión severa del tronco común izquierdo, no se obtiene beneficio en cuanto a letalidad y tiempo de estancia en la unidad de cuidados intensivos, ni con respecto al tiempo de ventilación mecánica. Tampoco se encontró mayor riesgo de desarrollar infección o sepsis en la misma unidad.Background: Left main coronary artery disease as the only criterion for intra-aortic balloon counterpulsation implantation is an indication which evidence is limited to experts’ recommendations; therefore, studies that may give a higher level of evidence are required. For this reason, we developed in our institution a study that evaluated the experience in the use of IABP in patients with left main coronary artery disease undergoing coronary revascularization surgery. Objective

  1. A large family of AvrLm6-like genes in the apple and pear scab pathogens, Venturia inaequalis and Venturia pirina

    Directory of Open Access Journals (Sweden)

    Jason eShiller

    2015-11-01

    Full Text Available Venturia inaequalis and V. pirina are Dothideomycete fungi that cause apple scab and pear scab disease respectively. Whole genome sequencing of V. inaequalis and V. pirina isolates has revealed predicted proteins with sequence similarity to AvrLm6, a Leptosphaeria maculans effector that triggers a resistance response in Brassica napus and Brassica juncea carrying the resistance gene, Rlm6. AvrLm6-like genes are present as large families (> 16 members in all sequenced strains of V. inaequalis and V. pirina, while in L. maculans, only AvrLm6 and a single paralogue have been identified. The Venturia AvrLm6-like genes are located in gene poor regions of the genomes, and mostly in close proximity to transposable elements which may explain the expansion of these gene families. An AvrLm6-like gene from V. inaequalis with the highest sequence identity to AvrLm6 was unable to trigger a resistance response in Rlm6 carrying Brassica juncea. RNA-seq and qRT-PCR gene expression analyses, of in planta and in vitro grown V. inaequalis, has revealed that many of the AvrLm6-like genes are expressed during infection. An AvrLm6 homologue from V. inaequalis that is up-regulated during infection was shown (using a YFP-fusion protein construct to be localized to the sub-cuticular stroma during infection of apple hypocotyls.

  2. Examining Ecological and Ecosystem Level Impacts of Aquatic Invasive Species in Lake Michigan Using An Ecosystem Productivity Model, LM-Eco

    Science.gov (United States)

    Ecological and ecosystem-level impacts of aquatic invasive species in Lake Michigan were examined using the Lake Michigan Ecosystem Model (LM-Eco). The LM-Eco model includes a detailed description of trophic levels and their interactions within the lower food web of Lake Michiga...

  3. Parameter study of LM 9. 7 m wind turbine blades. Measurement of efficiency curves and breaking proficiency of an LM 9. 7 m wind turbine blade mounted on a WM 20 S wind turbine produced by Wind Matic. Parameterstudium af LM 9. 7 m vinge. Maaling af effektkurver og bremseevne for LM 9. 7 m vinge monteret paa WM 20 S vindmoelle fra Wind Matic

    Energy Technology Data Exchange (ETDEWEB)

    Gjerding, J.B.

    1988-08-15

    Measurements of performance and breaking efficiency of a LM 9.7 m wind turbine blade mounted on a WM 20 S wind turbine produced by the firm Wind Matic in Denmark. Measurements were made, taking account of wind speed and direction, electric power production, the number of rotations, air pressure and temperature with a scanning frequency of 17 Hz, nacelle orientation and using a mean period of one minute. (AB).

  4. The Effects of Low Dose-Rate Ionizing Radiation on the Shapes of Transients in the LM124 Operational Amplifier

    Science.gov (United States)

    Buchner, Stephen; McMorrow, Dale; Roche, Nicholas; Dusseau, Laurent; Pease, Ron L.

    2008-01-01

    Shapes of single event transients (SETs) in a linear bipolar circuit (LM124) change with exposure to total ionizing dose (TID) radiation. SETs shape changes are a direct consequence of TID-induced degradation of bipolar transistor gain. A reduction in transistor gain causes a reduction in the drive current of the current sources in the circuit, and it is the lower drive current that most affects the shapes of large amplitude SETs.

  5. Crystallization and preliminary crystallographic characterization of LmACR2, an arsenate/antimonate reductase from Leishmania major

    Energy Technology Data Exchange (ETDEWEB)

    Bisacchi, Davide [Bioinformatics and Structural Proteomics, IST-National Cancer Research Institute, Genova (Italy); Zhou, Yao; Rosen, Barry P.; Mukhopadhyay, Rita [Department of Biochemistry and Molecular Biology, Wayne State University School of Medicine, Detroit, Michigan (United States); Bordo, Domenico, E-mail: domenico.bordo@istge.it [Bioinformatics and Structural Proteomics, IST-National Cancer Research Institute, Genova (Italy)

    2006-10-01

    LmACR2 from L. major is the first rhodanese-like enzyme directly involved in the reduction of arsenate and antimonate to be crystallized. Diffraction data have been collected to 1.99 Å resolution using synchrotron X-rays. Arsenic is present in the biosphere owing either to the presence of pesticides and herbicides used in agricultural and industrial activities or to leaching from geological formations. The health effects of prolonged exposure to arsenic can be devastating and may lead to various forms of cancer. Antimony(V), which is chemically very similar to arsenic, is used instead in the treatment of leishmaniasis, an infection caused by the protozoan parasite Leishmania sp.; the reduction of pentavalent antimony contained in the drug Pentostam to the active trivalent form arises from the presence in the Leishmania genome of a gene, LmACR2, coding for the protein LmACR2 (14.5 kDa, 127 amino acids) that displays weak but significant sequence similarity to the catalytic domain of Cdc25 phosphatase and to rhodanese enzymes. For structural characterization, LmACR2 was overexpressed, purified to homogeneity and crystallized in a trigonal space group (P321 or P3{sub 1}21/P3{sub 2}21). The protein crystallized in two distinct trigonal crystal forms, with unit-cell parameters a = b = 111.0, c = 86.1 Å and a = b = 111.0, c = 175.6 Å, respectively. At a synchrotron beamline, the diffraction pattern extended to a resolution limit of 1.99 Å.

  6. Multi-Scale Parameter Identification of Lithium-Ion Battery Electric Models Using a PSO-LM Algorithm

    Directory of Open Access Journals (Sweden)

    Wen-Jing Shen

    2017-03-01

    Full Text Available This paper proposes a multi-scale parameter identification algorithm for the lithium-ion battery (LIB electric model by using a combination of particle swarm optimization (PSO and Levenberg-Marquardt (LM algorithms. Two-dimensional Poisson equations with unknown parameters are used to describe the potential and current density distribution (PDD of the positive and negative electrodes in the LIB electric model. The model parameters are difficult to determine in the simulation due to the nonlinear complexity of the model. In the proposed identification algorithm, PSO is used for the coarse-scale parameter identification and the LM algorithm is applied for the fine-scale parameter identification. The experiment results show that the multi-scale identification not only improves the convergence rate and effectively escapes from the stagnation of PSO, but also overcomes the local minimum entrapment drawback of the LM algorithm. The terminal voltage curves from the PDD model with the identified parameter values are in good agreement with those from the experiments at different discharge/charge rates.

  7. Left heart catheterization

    Science.gov (United States)

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

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

    Science.gov (United States)

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

    2017-07-01

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

  9. Derivatives of Dictyostelium differentiation-inducing factors inhibit lysophosphatidic acid–stimulated migration of murine osteosarcoma LM8 cells

    Energy Technology Data Exchange (ETDEWEB)

    Kubohara, Yuzuru, E-mail: ykuboha@juntendo.ac.jp [Department of Molecular and Cellular Biology, Institute for Molecular and Cellular Regulation (IMCR), Gunma University, Maebashi 371-8512 (Japan); Department of Health Science, Juntendo University Graduate School of Health and Sports Science, Inzai 270-1695 (Japan); Komachi, Mayumi [Department of Molecular and Cellular Biology, Institute for Molecular and Cellular Regulation (IMCR), Gunma University, Maebashi 371-8512 (Japan); Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi 371-8511 (Japan); Homma, Yoshimi [Department of Biomolecular Science, Institute of Biomedical Sciences, Fukushima Medical University School of Medicine, Fukushima 960-1295 (Japan); Kikuchi, Haruhisa; Oshima, Yoshiteru [Laboratory of Natural Product Chemistry, Tohoku University Graduate School of Pharmaceutical Sciences, Aoba-yama, Aoba-ku, Sendai 980-8578 (Japan)

    2015-08-07

    Osteosarcoma is a common metastatic bone cancer that predominantly develops in children and adolescents. Metastatic osteosarcoma remains associated with a poor prognosis; therefore, more effective anti-metastatic drugs are needed. Differentiation-inducing factor-1 (DIF-1), −2, and −3 are novel lead anti-tumor agents that were originally isolated from the cellular slime mold Dictyostelium discoideum. Here we investigated the effects of a panel of DIF derivatives on lysophosphatidic acid (LPA)-induced migration of mouse osteosarcoma LM8 cells by using a Boyden chamber assay. Some DIF derivatives such as Br-DIF-1, DIF-3(+2), and Bu-DIF-3 (5–20 μM) dose-dependently suppressed LPA-induced cell migration with associated IC{sub 50} values of 5.5, 4.6, and 4.2 μM, respectively. On the other hand, the IC{sub 50} values of Br-DIF-1, DIF-3(+2), and Bu-DIF-3 versus cell proliferation were 18.5, 7.2, and 2.0 μM, respectively, in LM8 cells, and >20, 14.8, and 4.3 μM, respectively, in mouse 3T3-L1 fibroblasts (non-transformed). Together, our results demonstrate that Br-DIF-1 in particular may be a valuable tool for the analysis of cancer cell migration, and that DIF derivatives such as DIF-3(+2) and Bu-DIF-3 are promising lead anti-tumor agents for the development of therapies that suppress osteosarcoma cell proliferation, migration, and metastasis. - Highlights: • LPA induces cell migration (invasion) in murine osteosarcoma LM8 cells. • DIFs are novel lead anti-tumor agents found in Dictyostelium discoideum. • We examined the effects of DIF derivatives on LPA-induced LM8 cell migration in vitro. • Some of the DIF derivatives inhibited LPA-induced LM8 cell migration.

  10. Derivatives of Dictyostelium differentiation-inducing factors inhibit lysophosphatidic acid–stimulated migration of murine osteosarcoma LM8 cells

    International Nuclear Information System (INIS)

    Kubohara, Yuzuru; Komachi, Mayumi; Homma, Yoshimi; Kikuchi, Haruhisa; Oshima, Yoshiteru

    2015-01-01

    Osteosarcoma is a common metastatic bone cancer that predominantly develops in children and adolescents. Metastatic osteosarcoma remains associated with a poor prognosis; therefore, more effective anti-metastatic drugs are needed. Differentiation-inducing factor-1 (DIF-1), −2, and −3 are novel lead anti-tumor agents that were originally isolated from the cellular slime mold Dictyostelium discoideum. Here we investigated the effects of a panel of DIF derivatives on lysophosphatidic acid (LPA)-induced migration of mouse osteosarcoma LM8 cells by using a Boyden chamber assay. Some DIF derivatives such as Br-DIF-1, DIF-3(+2), and Bu-DIF-3 (5–20 μM) dose-dependently suppressed LPA-induced cell migration with associated IC 50 values of 5.5, 4.6, and 4.2 μM, respectively. On the other hand, the IC 50 values of Br-DIF-1, DIF-3(+2), and Bu-DIF-3 versus cell proliferation were 18.5, 7.2, and 2.0 μM, respectively, in LM8 cells, and >20, 14.8, and 4.3 μM, respectively, in mouse 3T3-L1 fibroblasts (non-transformed). Together, our results demonstrate that Br-DIF-1 in particular may be a valuable tool for the analysis of cancer cell migration, and that DIF derivatives such as DIF-3(+2) and Bu-DIF-3 are promising lead anti-tumor agents for the development of therapies that suppress osteosarcoma cell proliferation, migration, and metastasis. - Highlights: • LPA induces cell migration (invasion) in murine osteosarcoma LM8 cells. • DIFs are novel lead anti-tumor agents found in Dictyostelium discoideum. • We examined the effects of DIF derivatives on LPA-induced LM8 cell migration in vitro. • Some of the DIF derivatives inhibited LPA-induced LM8 cell migration

  11. The receptor-like kinase SOBIR1 interacts with Brassica napus LepR3 and is required for Leptosphaeria maculans AvrLm1-triggered immunity

    Directory of Open Access Journals (Sweden)

    Lisong eMa

    2015-10-01

    Full Text Available AbstractThe fungus Leptosphaeria maculans (L. maculans is the causal agent of blackleg disease of canola/oilseed rape (Brassica napus worldwide. We previously reported cloning of the B. napus blackleg resistance gene, LepR3, which encodes a receptor-like protein. LepR3 triggers localised cell death upon recognition of its cognate Avr protein, AvrLm1. Here, we exploited the Nicotiana benthamiana model plant to investigate the recognition mechanism of AvrLm1 by LepR3. Co-expression of the LepR3/AvrLm1 gene pair in N. benthamiana resulted in development of a hypersensitive response (HR. However, a truncated AvrLm1 lacking its indigenous signal peptide was compromised in its ability to induce LepR3-mediated HR, indicating that AvrLm1 is perceived by LepR3 extracellularly. Structure-function analysis of the AvrLm1 protein revealed that the C-terminal region of AvrLm1 was required for LepR3-mediated HR in N. benthamiana and for resistance to L. maculans in B. napus. LepR3 was shown to be physically interacting with the B. napus receptor like kinase, SOBIR1 (BnSOBIR1. Silencing of NbSOBIR1 or NbSERK3 (BAK1 compromised LepR3-AvrLm1-dependent HR in N. benthamiana, suggesting that LepR3-mediated resistance to L. maculans in B. napus requires SOBIR1 and BAK1/SERK3. Using this model system, we determined that BnSOBIR1 and SERK3/BAK1 are essential partners in the LepR3 signalling complex and were able to define the AvrLm1 effector domain.

  12. Réalisation d'un support expérimental de recherche pour le projet robotique PANDORE : définition et implantation du langage LM

    OpenAIRE

    Mazer, Emmanuel

    1981-01-01

    Detailed presentation of the place of this work within the framework of the PANDORE project, of the definition of the LM language for the description of manipulation and assembly tasks, of a functional analysis of this language, of the equipment used, of the current implantation of LM in this equipment, and of the testing done on this equipment by means of the software implanted.; Présentation détaillée de la place de ce travail dans le cadre du projet PANDORE, de la définition du langage LM ...

  13. [Recurrent left atrial myxoma].

    Science.gov (United States)

    Moreno Martínez, Francisco L; Lagomasino Hidalgo, Alvaro; Mirabal Rodríguez, Roger; López Bermúdez, Félix H; López Bernal, Omaida J

    2003-01-01

    Primary cardiac tumors are rare. Mixomas are the most common among them; 75% are located in the left atrium, 20% in the right atrium, and the rest in the ventricles. The seldom appear in atrio-ventricular valves. Recidivant mixoma are also rare, appearing in 1-5% of all patients that have undergone surgical treatment of a mixoma. In this paper we present our experience with a female patient, who 8 years after having been operated of a left atrial mixoma, began with symptoms of mild heart failure. Transthoracic echocardiography revealed recurrence of the tumor, and was therefore subjected to a second open-heart surgery from which she recovered without complications.

  14. Modelling and multi objective optimization of LM13 aluminium alloy squeeze cast process parameters using taguchi and genetic algorithm

    Directory of Open Access Journals (Sweden)

    S. Vellingiri

    2018-01-01

    Full Text Available This present investigation deals with squeeze casting process in order to produce a component with good mechanical properties such as micro-hardness(VH, tensile strength(Rm, and density(ρ on LM13 by varying squeeze pressure(P, molten temperature(Tm and die temperature(Td. Taguchi experimental design L9 orthogonal array was used to determine the signal to noise ratio. The results specified that the squeeze pressure and die preheat temperature are the most influencing parameters for mechanical properties improvement. Genetic algorithm (GA has been applied to optimize the casting parameters that simultaneously maximize the responses.

  15. Propagação vegetativa de jambeiro vermelho [Syzygium malaccense (L.) Merr. & L.M. Perry

    OpenAIRE

    Almeida,Eduardo José de; Scaloppi,Eliana Mayra Torrecillas; Jesus,Natanael de; Benassi,Antonio Carlos; Ganga,Rita Maria Devós; Martins,Antonio Baldo Geraldo

    2010-01-01

    O jambeiro vermelho [Syzygium malaccense (L.) Merr. & L.M. Perry] se apresenta como opção ao fruticultor por apresentar frutos atrativos e bem aceitos pelo consumidor. A dificuldade de cultivo dessa espécie reside no fato de que a planta possui um porte demasiadamente alto e longo período juvenil quando propagada por semente, com isso, é desejável sua multiplicação vegetativa visando a antecipar o período produtivo e diminuir seu porte. Foi estudada a possibilidade de clonagem dessa espéc...

  16. 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.

  17. ultraLM and miniLM: Locator tools for smart tracking of fluorescent cells in correlative light and electron microscopy [version 1; referees: 2 approved, 1 approved with reservations

    Directory of Open Access Journals (Sweden)

    Elisabeth Brama

    2016-12-01

    Full Text Available In-resin fluorescence (IRF protocols preserve fluorescent proteins in resin-embedded cells and tissues for correlative light and electron microscopy, aiding interpretation of macromolecular function within the complex cellular landscape. Dual-contrast IRF samples can be imaged in separate fluorescence and electron microscopes, or in dual-modality integrated microscopes for high resolution correlation of fluorophore to organelle. IRF samples also offer a unique opportunity to automate correlative imaging workflows. Here we present two new locator tools for finding and following fluorescent cells in IRF blocks, enabling future automation of correlative imaging. The ultraLM is a fluorescence microscope that integrates with an ultramicrotome, which enables ‘smart collection’ of ultrathin sections containing fluorescent cells or tissues for subsequent transmission electron microscopy or array tomography. The miniLM is a fluorescence microscope that integrates with serial block face scanning electron microscopes, which enables ‘smart tracking’ of fluorescent structures during automated serial electron image acquisition from large cell and tissue volumes.

  18. 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

  19. Helicoidal Organization of Chitin in the Cuticle of the Migratory Locust Requires the Function of the Chitin Deacetylase2 Enzyme (LmCDA2)*

    Science.gov (United States)

    Yu, Rongrong; Liu, Weimin; Li, Daqi; Zhao, Xiaoming; Ding, Guowei; Zhang, Min; Ma, Enbo; Zhu, KunYan; Li, Sheng; Moussian, Bernard; Zhang, Jianzhen

    2016-01-01

    In the three-dimensional extracellular matrix of the insect cuticle, horizontally aligned microfibrils composed of the polysaccharide chitin and associated proteins are stacked either parallel to each other or helicoidally. The underlying molecular mechanisms that implement differential chitin organization are largely unknown. To learn more about cuticle organization, we sought to study the role of chitin deacetylases (CDA) in this process. In the body cuticle of nymphs of the migratory locust Locusta migratoria, helicoidal chitin organization is changed to an organization with unidirectional microfibril orientation when LmCDA2 expression is knocked down by RNA interference. In addition, the LmCDA2-deficient cuticle is less compact suggesting that LmCDA2 is needed for chitin packaging. Animals with reduced LmCDA2 activity die at molting, underlining that correct chitin organization is essential for survival. Interestingly, we find that LmCDA2 localizes only to the initially produced chitin microfibrils that constitute the apical site of the chitin stack. Based on our data, we hypothesize that LmCDA2-mediated chitin deacetylation at the beginning of chitin production is a decisive reaction that triggers helicoidal arrangement of subsequently assembled chitin-protein microfibrils. PMID:27637332

  20. Helicoidal Organization of Chitin in the Cuticle of the Migratory Locust Requires the Function of the Chitin Deacetylase2 Enzyme (LmCDA2).

    Science.gov (United States)

    Yu, Rongrong; Liu, Weimin; Li, Daqi; Zhao, Xiaoming; Ding, Guowei; Zhang, Min; Ma, Enbo; Zhu, KunYan; Li, Sheng; Moussian, Bernard; Zhang, Jianzhen

    2016-11-18

    In the three-dimensional extracellular matrix of the insect cuticle, horizontally aligned microfibrils composed of the polysaccharide chitin and associated proteins are stacked either parallel to each other or helicoidally. The underlying molecular mechanisms that implement differential chitin organization are largely unknown. To learn more about cuticle organization, we sought to study the role of chitin deacetylases (CDA) in this process. In the body cuticle of nymphs of the migratory locust Locusta migratoria, helicoidal chitin organization is changed to an organization with unidirectional microfibril orientation when LmCDA2 expression is knocked down by RNA interference. In addition, the LmCDA2-deficient cuticle is less compact suggesting that LmCDA2 is needed for chitin packaging. Animals with reduced LmCDA2 activity die at molting, underlining that correct chitin organization is essential for survival. Interestingly, we find that LmCDA2 localizes only to the initially produced chitin microfibrils that constitute the apical site of the chitin stack. Based on our data, we hypothesize that LmCDA2-mediated chitin deacetylation at the beginning of chitin production is a decisive reaction that triggers helicoidal arrangement of subsequently assembled chitin-protein microfibrils. © 2016 by The American Society for Biochemistry and Molecular Biology, Inc.

  1. Sistem Pengendali Peralatan Elektronik dalam Rumah secara Otomatis Menggunakan Sensor PIR, Sensor LM35, dan Sensor LDR

    Directory of Open Access Journals (Sweden)

    Eka Desyantoro

    2015-08-01

    Full Text Available Listrik merupakan hal yang sangat penting di kehidupan kita. Setiap pekerjaan kita pasti dibantu dengan adanya listrik. Mulai dari penerangan hingga pengaturan suhu ruangan pun semuanya dibantu oleh listrik. Ketergantungan manusia terhadap listrik ini menimbulkan kebiasaan buruk. Banyak orang yang terkadang membiarkan suatu peralatan elektronik hidup pada saat tidak dibutuhkan. Terjadi suatu permasalahan untuk menciptakan suatu desain sistem embedded untuk mengendalikan peralatan elektronik dalam rumah secara otomatis. Makalah ini membahas tentang perancangan sistem pengendali peralatan elektronik dalam rumah secara otomatis. Sistem terdiri dari sensor PIR yang berfungsi untuk mendeteksi objek bergerak (manusia, sensor LM35 yang berfungsi untuk mendeteksi suhu, dan sensor LDR berfungsi sebagai sensor cahaya. Mikrokontroller ATMega16 sebagai pengendali jalannya sistem dari pembacaan sensor, menampilkan data sensor pada LCD dan mengatur kontak relay untuk menghidup dan mematikan listrik. Sistem pengendali peralatan elektronik dalam rumah secara otomatis menunjukan sensor LDR dapat membedakan gelap dan terang, sensor suhu LM35 dapat mendeteksi suhu dalam ruangan dengan toleransi kesalahan pembacaan kurang lebih 2o Celcius, dan sensor PIR dapat mendeteksi pergerakan manusia sejauh 5 meter.

  2. Palyno-morphological characteristics of gymnosperm flora of pakistan and its taxonomic implications with LM and SEM methods.

    Science.gov (United States)

    Khan, Raees; Ul Abidin, Sheikh Zain; Ahmad, Mushtaq; Zafar, Muhammad; Liu, Jie; Amina, Hafiza

    2018-01-01

    The present study is intended to assess gymnosperms pollen flora of Pakistan using Light Microscope (LM) and Scanning Electron Microscopy (SEM) for its taxonomic significance in identification of gymnosperms. Pollens of 35 gymnosperm species (12 genera and five families) were collected from its various distributional sites of gymnosperms in Pakistan. LM and SEM were used to investigate different palyno-morphological characteristics. Five pollen types (i.e., Inaperturate, Monolete, Monoporate, Vesiculate-bisaccate and Polyplicate) were observed. Six In equatorial view seven types of pollens were observed, in which ten species were sub-angular, nine species were Traingular, six species were Perprolate, three species were Rhomboidal, three species were semi-angular, two species were rectangular and two species were prolate. While five types of pollen were observed in polar view, in which ten species were Spheroidal, nine species were Angular, eight were Interlobate, six species were Circular, two species were Elliptic. Eighteen species has rugulate and 17 species has faveolate ornamentation. Eighteen species has verrucate and 17 have gemmate type sculpturing. The data was analysed through cluster analysis. The study showed that these palyno-morphological features have significance value in classification and identification of gymnosperms. Based on these different palyno-morphological features, a taxonomic key was proposed for the accurate and fast identifications of gymnosperms from Pakistan. © 2017 Wiley Periodicals, Inc.

  3. Influence of CNTRENE® C100LM carbon nanotube material on the growth and regulation of Escherichia coli

    Directory of Open Access Journals (Sweden)

    Brittany Twibell

    2017-08-01

    Full Text Available The growing use of carbon nanotubes (CNTs in industrial and consumer products raises important questions about their environmental fate and impact on prokaryotes. In the environment, CNTs are exposed to a variety of conditions (e.g., UV light that could lead to decomposition and changes in their chemical properties. Therefore, the potential cytotoxic effect of both pristine and artificially aged carboxyl functionalized CNTRENE® C100LM CNTmaterial at neutral and acidic conditions on Escherichia coli K12 was analyzed using a minimal inhibitory concentration (MIC assay, which also allowed monitoring of non-lethal growth effects. However, there were no observable MIC or significant changes in growth behavior in E. coli K12 when exposed to pristine or aged CNTs. Exposure to pristine CNTRENE® C100LM CNT material did not appear to influence cell morphology or damage the cells when examined by electron microscopy. In addition, RNA sequencing revealed no observable regulatory changes in typical stress response pathways. This is surprising considering that previous studies have claimed high cytotoxicity of CNTs, including carboxyl functionalized single-walled CNTs, and suggest that other factors such as trace heavy metals or other impurities are likely responsible for many of the previously reported cytotoxicity in E. coli and possibly other microorganisms.

  4. Investigation of Mechanical and Wear Properties of LM24/Silicate/Fly Ash Hybrid Composite Using Vortex Technique

    Directory of Open Access Journals (Sweden)

    B. R. Senthil Kumar

    2016-01-01

    Full Text Available This work has investigated to find the influence of silicate on the wear behavior of LM 24/4 wt.% fly ash hybrid composite. The investigation reveals the effectiveness of incorporation of silicate in the composite for gaining wear reduction. Silicate particles with fly ash materials were incorporated into aluminum alloy matrix to accomplish reduction in wear resistance and improve the mechanical properties. The LM24/silicate/fly ash hybrid composite was prepared with 4 wt.% fly ash particles with 4, 8, 12, 16, 20, and 24 wt.% of silicate using vortex technique. Tribological properties were evaluated under different load (15, 30, 45, 60, and 75 N; sliding velocity (0.75, 1.5, 2.25, and 3 m/sec condition using pin on disc apparatus and mechanical properties like density, hardness, impact strength, and tensile strength of composites were investigated. In addition, the machining of the aluminum hybrid composite was studied using Taguchi L9 orthogonal array with analysis of variance. The properties of the hybrid composites containing 24 wt.% silicates exhibit the superior wear resistance and mechanical properties.

  5. Left Ventricular Assist Devices

    Directory of Open Access Journals (Sweden)

    Khuansiri Narajeenron

    2017-04-01

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

  6. Fabrication of Fucoxanthin-Loaded Microsphere(F-LM) By Two Steps Double-Emulsion Solvent Evaporation Method and Characterization of Fucoxanthin before and after Microencapsulation.

    Science.gov (United States)

    Noviendri, Dedi; Jaswir, Irwandi; Taher, Muhammad; Mohamed, Farahidah; Salleh, Hamzah Mohd; Noorbatcha, Ibrahim Ali; Octavianti, Fitri; Lestari, Widya; Hendri, Ridar; Ahmad, Hasna; Miyashita, Kazuo; Abdullah, Alias

    2016-08-01

    Microencapsulation is a promising approach in drug delivery to protect the drug from degradation and allow controlled release of the drug in the body. Fucoxanthin-loaded microsphere (F-LM) was fabricated by two step w/o/w double emulsion solvent evaporation method with poly (L-lactic-coglycolic acid) (PLGA) as carrier. The effect of four types of surfactants (PVA, Tween-20, Span-20 and SDS), homogenization speed, and concentration of PLGA polymer and surfactant (PVA), respectively, on particle size and morphology of F-LM were investigated. Among the surfactants tested, PVA showed the best results with smallest particle size (9.18 µm) and a smooth spherical surface. Increasing the homogenization speed resulted in a smaller mean F-LM particle size [d(0.50)] from 17.12 to 9.18 µm. Best particle size results and good morphology were attained at homogenization speed of 20 500 rpm. Meanwhile, increased PLGA concentration from 1.5 to 11.0 (% w/v) resulted in increased F-LM particle size. The mean particle size [d(0.5)] of F-LM increased from 3.93 to 11.88 µm. At 6.0 (% w/v) PLGA, F-LM showed the best structure and external morphology. Finally, increasing PVA concentration from 0.5 to 3.5 (% w/v) resulted in decreased particle size from 9.18 to 4.86 µm. Fucoxanthin characterization before and after microencapsulation was carried out to assess the success of the microencapsulation procedure. Thermo gravimetry analysis (TGA), glass transition (Tg) temperature of F-LM and fucoxanthin measured using DSC, ATR-FTIR and XRD indicated that fucoxanthin was successfully encapsulated into the PLGA matrix, while maintaining the structural and chemical integrity of fucoxanthin.

  7. Optimal artificial neural network architecture selection for performance prediction of compact heat exchanger with the EBaLM-OTR technique

    International Nuclear Information System (INIS)

    Wijayasekara, Dumidu; Manic, Milos; Sabharwall, Piyush; Utgikar, Vivek

    2011-01-01

    Highlights: → Performance prediction of PCHE using artificial neural networks. → Evaluating artificial neural network performance for PCHE modeling. → Selection of over-training resilient artificial neural networks. → Artificial neural network architecture selection for modeling problems with small data sets. - Abstract: Artificial Neural Networks (ANN) have been used in the past to predict the performance of printed circuit heat exchangers (PCHE) with satisfactory accuracy. Typically published literature has focused on optimizing ANN using a training dataset to train the network and a testing dataset to evaluate it. Although this may produce outputs that agree with experimental results, there is a risk of over-training or over-learning the network rather than generalizing it, which should be the ultimate goal. An over-trained network is able to produce good results with the training dataset but fails when new datasets with subtle changes are introduced. In this paper we present EBaLM-OTR (error back propagation and Levenberg-Marquardt algorithms for over training resilience) technique, which is based on a previously discussed method of selecting neural network architecture that uses a separate validation set to evaluate different network architectures based on mean square error (MSE), and standard deviation of MSE. The method uses k-fold cross validation. Therefore in order to select the optimal architecture for the problem, the dataset is divided into three parts which are used to train, validate and test each network architecture. Then each architecture is evaluated according to their generalization capability and capability to conform to original data. The method proved to be a comprehensive tool in identifying the weaknesses and advantages of different network architectures. The method also highlighted the fact that the architecture with the lowest training error is not always the most generalized and therefore not the optimal. Using the method the

  8. Genistein inhibits cell invasion and motility by inducing cell differentiation in murine osteosarcoma cell line LM8

    Directory of Open Access Journals (Sweden)

    Nakamura Atsushi

    2012-09-01

    Full Text Available Abstract Background One of the problems associated with osteosarcoma is the frequent formation of micrometastases in the lung prior to diagnosis because the development of metastatic lesions often causes a fatal outcome. Therefore, the prevention of pulmonary metastases during the early stage of tumor development is critical for the improvement of the prognosis of osteosarcoma patients. In Japan, soy is consumed in a wide variety of forms, such as miso soup and soy sauce. The purpose of this study is to investigate the effect of genistein, an isoflavone found in soy, on the invasive and motile potential of osteosarcoma cells. Methods LM8 cells were treated for 3 days with various concentrations of genistein. The effect of genistein on cell proliferation was determined by DNA measurement in the cultures and 5-bromo-2’-deoxyuridine (BrdU incorporation study. The assays of cell invasion and motility were performed using the cell culture inserts with either matrigel-coated membranes or uncoated membranes in the invasion chambers. The expression and secretion of MMP-2 were determined by immunohistochemistry and gelatin zymography. The subcellular localization and cellular level of β-catenin were determined by immunofluorescence and Western blot. For examining cell morphology, the ethanol-fixed cells were stained with hematoxylin-eosin (H&E. The expression of osteocalcin mRNA was determined by reverse transcription-polymerase chain reaction (RT-PCR. Results Genistein dose-dependently inhibits cell proliferation. Genistein-treated cells were less invasive and less motile than untreated cells. The expression and secretion of MMP-2 were lower in the genistein-treated cultures than in the untreated cultures. β-Catenin in untreated cells was located in the cytoplasm and/or nucleus, while in genistein-treated cells it was translocated near to the plasma membrane. The level of β-catenin was higher in genistein-treated cells than in untreated cells

  9. Effect of troglitazone on tumor growth and pulmonary metastasis development of the mouse osteosarcoma cell line LM8

    International Nuclear Information System (INIS)

    Aizawa, Junichi; Sakayama, Kenshi; Kamei, Setsuya; Kidani, Teruki; Yamamoto, Haruyasu; Norimatsu, Yoshiaki; Masuno, Hiroshi

    2010-01-01

    Osteosarcoma often develops micrometastases in the lung prior to diagnosis, causing a fatal outcome. Therefore, the prevention of pulmonary metastases is critical for the improvement of the prognosis of patients with osteosarcoma. The purpose of this study was to investigate whether troglitazone (TGZ) is considered as possible therapeutics in the treatment of growth and metastasis of osteosarcoma. LM8 cells were treated for 3 days with various concentrations of TGZ. The effect of TGZ on cell proliferation was determined by DNA measurement in the cultures and 5-bromo-2'-deoxyuridine incorporation study. The assay of cell invasion and motility was performed using either the Matrigel-coated cell culture inserts or the uncoated cell culture inserts in the invasion chambers. The effect of TGZ on Akt signaling was assessed by Western blot analysis of Akt and p-Akt. The effects of oral administration of either TGZ (TGZ group) or ethanol (control group) on the growth of primary tumor and the development of pulmonary metastasis were examined in nude mice implanted with LM8 cells on their backs. The expression and activity of matrix metalloproteinase 2 (MMP-2) within the tumor were determined by immunohistochemistry and zymography. The microvessel density (MVD) within the tumor was determined by immunohistochemistry for CD34. TGZ dose-dependently inhibits cell proliferation. TGZ-treated cells were less invasive and less motile than untreated cells. The activity of MMP-2 secreted by TGZ-treated cells was lower than that secreted by untreated cells. TGZ decreased the level of p-Akt. The primary tumor mass was smaller in the TGZ group than in the control group. The TGZ group had less metastatic tumors in the lung compared with the control group. The expression and activity of MMP-2 within the tumor of the TGZ group were lower than those of the control group. The MVD within the tumor of the TGZ group was lower than that of the control group. Inhibition of Akt signaling by

  10. Repowering of lenenergo severnaya TETS-21 with lm6000 gas turbine. Export trade information

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-11-01

    The study, conducted by Joseph Technology Corporation, was funded by the U.S. Trade and Development Agency. The report shows the results of a feasibility study done for the proposed repowering of the Severnaya TETS-21 power plant. The study includes various alternatives for the repowering, as well as an assessment of existing equipment and performance specifications needed to complete the project. The report is divided into the following sections: Executive Summary (1) Introduction; (2) Assessment of Existing Equipment; (3) Combined Cycle Evaluation; (4) Economic Analysis; (5) Impact of Environment. Appendices 1-4 follows the main body of the report. The study contains a second portion which is the Russian translation of the report.

  11. Left Ventricular Pseudoaneurysm Perceived as a Left Lung Mass

    Directory of Open Access Journals (Sweden)

    Ugur Gocen

    2013-02-01

    Full Text Available Left ventricular pseudo-aneurysm is a rare complication of aneurysmectomy. We present a case of surgically-treated left ventricular pseudo-aneurysm which was diagnosed three years after coronary artery bypass grafting and left ventricular aneurysmectomy. The presenting symptoms, diagnostic evaluation and surgical repair are described. [Cukurova Med J 2013; 38(1.000: 123-125

  12. Modeling and experimental investigation of LM26 pressure die cast process parameters using multi objective genetic algorithm (MOGA

    Directory of Open Access Journals (Sweden)

    N. Zeelanbasha

    2017-01-01

    Full Text Available This present investigation deals with pressure die casting process to produce an automotive valve closer component with better mechanical properties such as micro-hardness(HV, surface roughness (μm and porosity (% on LM26 by varying intensification pressure (α Kgf/cm2, shot velocity (β m/s and pouring temperature (γ °C. Using response surface methodology (RSM, the optimal parametric combination is found to be α (186,68 Kgf/cm2, β (0,599 m/s and γ (662,93 °C for multi responses (121,18 HV, (0,93 μm and 0,017 % can be achieved corresponding to highest desirability of 0,73. The optimized results were obtained by the Pareto-optimal solutions using multi objective genetic algorithm (MOGA provides flexibility to select the best setting depending on suitable applications.

  13. Machinability and Tribological Properties of Stir Cast LM6/SiC/GR Hybrid Metal Matrix Composite

    Directory of Open Access Journals (Sweden)

    Tahat Montasser S.

    2016-01-01

    Full Text Available Analysis on machining characteristics in turning of LM6/SiC/Gr hybrid metal matrix composites is made of (Al-11.8%Si/SiC/Gr hybrid metal matrix composites. The process performances such as porosity, wear rate of the composites, tool wear, tool life, specific modulus, surface roughness and material removal rate with equal weight fraction of SiC and Gr particulates of 3%, 7%, 10% and 13% reinforcement are investigated. This experimental analysis and test results on the machinability of Al/SiCMMC will provide essential guidelines to the manufacturers. Hybird metal matrix composites reinforced with graphite particles posses better machinability and tribological properties.

  14. Will initiatives to promote hydroelectricity consumption be effective? Evidence from univariate and panel LM unit root tests with structural breaks

    International Nuclear Information System (INIS)

    Lean, Hooi Hooi; Smyth, Russell

    2014-01-01

    This paper examines whether initiatives to promote hydroelectricity consumption are likely to be effective by applying univariate and panel Lagrange Multiplier (LM) unit root tests to hydroelectricity consumption in 55 countries over the period 1965–2011. We find that for the panel, as well as about four-fifths of individual countries, that hydroelectricity consumption is stationary. This result implies that shocks to hydroelectricity consumption in most countries will only result in temporary deviations from the long-run growth path. An important consequence of this finding is that initiatives designed to have permanent positive effects on hydroelectricity consumption, such as large-scale dam construction, are unlikely to be effective in increasing the share of hydroelectricity, relative to consumption of fossil fuels. - Highlights: • Applies unit root tests to hydroelectricity consumption. • Hydroelectricity consumption is stationary. • Shocks to hydroelectricity consumption result in temporary deviations from the long-run growth path

  15. Derivation of airfoil characteristics for the LM 19.1 blade based on 3D CFD rotor calculations

    Energy Technology Data Exchange (ETDEWEB)

    Bak, C.; Soerensen, N.N.; Madsen, H.A. [Risoe National Lab., Roskilde (Denmark)

    1999-03-01

    Airfoil characteristics for the LM 19.1 blade are derived from 3D CFD computations on a full-scale 41-m rotor. Based on 3D CFD the force distributions on the blades are determined, from which airfoil characteristics are derived using the momentum theory. The final airfoil characteristics are constructed using both wind tunnel measurements and 3D CFD. Compared to 2D wind tunnel measurements they show a low lift in stall for the airfoil sections at the tip. At the airfoil sections at the inner part of the blade, they show a high lift in stall. At about 60% radius the lift agrees well to 2D wind tunnel measurements. Aero-elastic calculations using the final airfoil characteristics show good agreement to measured power and flap moments. Furthermore, a fatigue load analysis shows a reduction of up to 15% of the load compared to commonly used data. (au)

  16. Comparative SEM and LM foliar epidermal and palyno-morphological studies of Amaranthaceae and its taxonomic implications.

    Science.gov (United States)

    Hussain, Amara Noor; Zafar, Muhammad; Ahmad, Mushtaq; Khan, Raees; Yaseen, Ghulam; Khan, Muhammad Saleem; Nazir, Abdul; Khan, Amir Muhammad; Shaheen, Shabnum

    2018-02-27

    Palynological features as well as comparative foliar epidermal using light and scanning electron microscope (SEM) of 17 species (10genera) of Amaranthaceae have been studied for its taxonomic significance. Different foliar and palynological micro-morphological characters were examined to explain their value in resolving the difficulty in identification. All species were amphistomatic but stomata on abaxial surface were more abundant. Taxonomically significant epidermal character including stomata type, trichomes (unicellular, multicellular, and capitate) and epidermal cells shapes (polygonal and irregular) were also observed. Pollens of this family are Polypantoporate, pores large, spheroidal, mesoporous region is sparsely to scabrate, densely psilate, and spinulose. All these characters can be active at species level for identification purpose. This study indicates that at different taxonomic levels, LM and SEM pollen and epidermal morphology is explanatory and significant to identify species and genera. © 2018 Wiley Periodicals, Inc.

  17. Optical design of 200-lm/W phosphorescent green light emitting devices based on the high refractive index substrate

    Energy Technology Data Exchange (ETDEWEB)

    Mikami, Akiyoshi [Department of Electrical Engineering, Kanazawa Institute of Technology, Nonoichimachi, Ishikawa 921-8501 (Japan)

    2011-09-15

    Light extraction efficiency has been successfully enhanced by using high refractive index substrate coupled with micro-lens array and weak micro-cavity structure. Optical energy intensity including waveguide, substrate and external modes was analyzed based on wave optics. It was shown that most of the waveguide mode is turned to the substrate mode by the effect of high index refraction substrate. About a half of the light can be extracted from the substrate by the assistance of surface textured structure. An external quantum efficiency of 57% and a power efficiency of over 200-lm/W were obtained in a green phosphorescent device. (copyright 2011 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim) (orig.)

  18. Dendritic distributions of Ih channels in experimentally-derived multi-compartment models of oriens-lacunosum/moleculare (O-LM hippocampal interneurons

    Directory of Open Access Journals (Sweden)

    Vladislav eSekulic

    2015-02-01

    Full Text Available The O-LM cell type mediates feedback inhibition onto hippocampal pyramidal cells and gates information flow in the CA1. Its functions depend on the presence of voltage-gated channels (VGCs, which affect its integrative properties and response to synaptic input. Given the challenges associated with determining densities and distributions of VGCs on interneuron dendrites, we take advantage of computational modeling to consider different possibilities. In this work, we focus on hyperpolarization-activated channels (h-channels in O-LM cells. While h-channels are known to be present in O-LM cells, it is unknown whether they are present on their dendrites. In previous work, we used ensemble modeling techniques with experimental data to obtain insights into potentially important conductance balances. We found that the best O-LM models that included uniformly distributed h-channels in the dendrites could not fully capture the sag response. This led us to examine activation kinetics and non-uniform distributions of h-channels in the present work. In tuning our models, we found that different kinetics and non-uniform distributions could better reproduce experimental O-LM cell responses. In contrast to CA1 pyramidal cells where higher conductance densities of h-channels occur in more distal dendrites, decreasing conductance densities of h-channels away from the soma were observed in O-LM models. Via an illustrative scenario, we showed that having dendritic h-channels clearly speeds up back-propagating action potentials in O-LM cells, unlike when h-channels are present only in the soma. Although the present results were morphology-dependent, our work shows that it should be possible to determine the distributions and characteristics of O-LM cells with recordings and morphologies from the same cell. We hypothesize that h-channels are distributed in O-LM cell dendrites and endow them with particular synaptic integration properties that shape information flow

  19. Preliminary neutronics design studies for a 400 MWt STAR-LM

    International Nuclear Information System (INIS)

    Aliberti, G.; Yang, W. S.; Stillman, J. A.; Hill, R. N.

    2004-01-01

    Neutronics design studies for a 400 MWt high temperature fast reactor are being performed, utilizing lead coolant, transuranic (TRU) nitride fuel, and HT-9 structural material. Under the main design constraints of long fuel lifetime, natural convection heat transport, semi-autonomous control, and small unit size, parametric studies were performed to maximize the discharge burnup and minimize the burnup reactivity swing. Based on the results of these parametric studies, two point designs were developed for a single-batch once-through fuel cycle; one is a 15 full power year cycle design with core volume of 9.5 cubic meters, and the other is a 12 full power year cycle design with core volume of 7.4 cubic meters. For these two point designs, fuel cycle analyses and reactivity feedback coefficients calculations were performed. The 9.5 cubic meter design achieved an average discharge burnup of 83 MWd/kg with a maximum reactivity change over the lifetime of 0.6%. The peak fast fluence was well within the fast fluence limit of HT9, and both average and peak power densities were well below the estimated limit for natural circulation. The performances of the 7.4 cubic meter design were slightly inferior to this design. To enhance the passive safety characteristics, however, further design improvements need to be made to reduce the coolant density coefficient and to increase the radial expansion coefficient. (authors)

  20. Maine's Employability Skills Program

    Science.gov (United States)

    McMahon, John M.; Wolffe, Karen E.; Wolfe, Judy; Brooker, Carrie

    2013-01-01

    This Practice Report describes the development and implementation of the "Maine Employability Skills Program," a model employment program developed by the Maine Division for the Blind and Visually Impaired (DBVI). The program was designed to support the efforts of the chronically unemployed or underemployed. These consumers were either…

  1. Three dimensional computations of the flow around a LM19 rotor

    Energy Technology Data Exchange (ETDEWEB)

    Hambraeus, T. [FFA, Bromma (Sweden)

    1997-12-31

    To achieve insight in the flow phenomenon occurring in wind power engineering modeling of the flow through the basic governing equations, Navier-Stokes and Euler, can be a great complement to experiments and other computational methods such as the BEM (Blade Element Momentum). Navier-Stokes methods is regularly used in prediction of air-foil flows but then mostly under attached flow conditions. One of the main differences between air-foil computations for aircraft industry and computations for wind turbine applications is that the former is not very interested in separated flow while for the latter case this is part of the operating conditions. It has been noted that separated flow poses problems since the most popular turbulence models such as Baldwin-Lomax and the {kappa}-{epsilon} model seems to over estimate the amount of turbulent viscosity produced and thus suppressing the separation. The work with finding better turbulence models is presently an area with large amount of research offering improved models. However, in the present report only the two mentioned turbulence models have been used. The present report shows computational results obtained with the Navier-Stokes solver EU-RANUS. First the results from a two-dimensional verification cases are shown to verify that the solver produces results comparable with other solvers. The flow computed is attached flow and slightly separated flow over the so called Profile-A. Secondly three dimensional computations of the flow over a full three dimensional rotor at attached and stalled conditions is shown. The computed results are compared with measured power data from field experiments. (EG)

  2. MRI rare finding: Absence of the left liver lobe

    Directory of Open Access Journals (Sweden)

    Isabella Ceravolo

    Full Text Available We report a rare case of left liver lobe absence in an 80-year-old male patient discovered during an MRI scan. The main imaging features of this condition are briefly reviewed, together with its pathogenesis and the most common associations and differential diagnoses. Keywords: Left liver lobe, Liver abnormalities, Liver magnetic resonance imaging

  3. Turbine main engines

    CERN Document Server

    Main, John B; Herbert, C W; Bennett, A J S

    1965-01-01

    Turbine Main Engines deals with the principle of operation of turbine main engines. Topics covered include practical considerations that affect turbine design and efficiency; steam turbine rotors, blades, nozzles, and diaphragms; lubricating oil systems; and gas turbines for use with nuclear reactors. Gas turbines for naval boost propulsion, merchant ship propulsion, and naval main propulsion are also considered. This book is divided into three parts and begins with an overview of the basic mode of operation of the steam turbine engine and how it converts the pressure energy of the ingoing ste

  4. Complete genome sequence of Bacillus velezensis LM2303, a biocontrol strain isolated from the dung of wild yak inhabited Qinghai-Tibet plateau.

    Science.gov (United States)

    Chen, Liang

    2017-06-10

    Bacillus velezensis LM2303 is a biocontrol strain with a broad inhibitory spectrum against plant pathogens, isolated from the dung of wild yak inhabited Qinghai-Tibet plateau, China. Here we present its complete genome sequence, which consists of a single, circular chromosome of 3,989,393bp with a 46.68% G+C content. Genome analysis revealed genes encoding specialized functions for the biosynthesis of antifungal metabolites and antibacterial metabolites, the promotion of plant growth, the alleviation of oxidative stress and nutrient utilization. And the biosynthesis of antimicrobial metabolites in strain LM2303 was confirmed by biochemical analysis, while its plant growth promoting traits were confirmed by inoculation tests. Our results will establish a better foundation for further studies and biocontrol application of B. velezensis LM2303. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Why Dora Left

    DEFF Research Database (Denmark)

    Gammelgård, Judy

    2017-01-01

    The question of why Dora left her treatment before it was brought to a satisfactory end and the equally important question of why Freud chose to publish this problematic and fragmentary story have both been dealt with at great length by Freud’s successors. Dora has been read by analysts, literary...... critics, and not least by feminists. The aim of this paper is to point out the position Freud took toward his patient. Dora stands out as the one case among Freud’s 5 great case stories that has a female protagonist, and reading the case it becomes clear that Freud stumbled because of an unresolved...... problem toward femininity, both Dora’s and his own. In Dora, it is argued, Freud took a new stance toward the object of his investigation, speaking from the position of the master. Freud presents himself as the one who knows, in great contrast to the position he takes when unraveling the dream. Here he...

  6. Maine highway safety plan

    Science.gov (United States)

    2010-01-01

    Each September 1, the MeBHS must provide NHTSA a comprehensive plan to reduce : traffic crashes and resulting deaths, injuries and property damage. The Highway Safety : Plan (HSP) serves as Maines application for available federal funds for these ...

  7. Maine Field Station

    Data.gov (United States)

    Federal Laboratory Consortium — In 2000 NOAA's National Marine Fisheries Service established the Maine Field Station in Orono, ME to have more direct involvement in the conservation of the living...

  8. Maine's forests 2008

    Science.gov (United States)

    George L. McCaskill; William H. McWilliams; Charles J. Barnett; Brett J. Butler; Mark A. Hatfield; Cassandra M. Kurtz; Randall S. Morin; W. Keith Moser; Charles H. Perry; Christopher W. Woodall

    2011-01-01

    The second annual inventory of Maine's forests was completed in 2008 after more than 3,160 forested plots were measured. Forest land occupies almost 17.7 million acres, which represents 82 percent of the total land area of Maine. The dominant forest-type groups are maple/beech/yellow birch, spruce/fir, white/red/jack pine, and aspen/white birch. Statewide volume...

  9. Maine Forests 2013

    Science.gov (United States)

    George L. McCaskill; Thomas Albright; Charles J. Barnett; Brett J. Butler; Susan J. Crocker; Cassandra M. Kurtz; William H. McWilliams; Patrick D. Miles; Randall S. Morin; Mark D. Nelson; Richard H. Widmann; Christopher W. Woodall

    2016-01-01

    The third 5-year annualized inventory of Maine's forests was completed in 2013 after more than 3170 forested plots were measured. Maine contains more than 17.6 million acres of forest land, an area that has been quite stable since 1960, covering more than 82 percent of the total land area. The number of live trees greater than 1 inch in diameter are approaching 24...

  10. Expression, characterization, and site-directed mutation of a multiple herbicide-resistant acetohydroxyacid synthase (rAHAS) from Pseudomonas sp. Lm10.

    Science.gov (United States)

    Lang, Zhi-Fei; Shen, Jing-Jing; Cai, Shu; Zhang, Jun; He, Jian; Li, Shun-Peng

    2011-08-01

    A multiple herbicide-resistant acetohydroxyacid synthase (rAHAS) gene was cloned from Pseudomonas sp. Lm10. Sequence analysis showed that the rAHAS regulatory subunit was identical to that of Pseudomonas putida KT2440 (sensitive AHAS, sAHAS), whereas six different sites [H134→N (rAHAS→sAHAS), A135→P, S136→T, I210→V, F264→Y, and S486→W] were found in the catalytic subunit. The rAHAS and sAHAS were over expressed, purified and characterized. rAHAS showed higher resistance to four kinds of AHAS-inhibitor herbicides than sAHAS. The resistance factor of rAHAS was 56.0-fold, 12.6-fold, 6.5-fold, and 9.2-fold as compared with sAHAS when metsulfuron-methyl, imazethapyr, flumetsulam, and pyriminobac-methyl used as inhibitor, respectively. The specific activity of rAHAS was lower than that of sAHAS and the K (m) value of rAHAS for pyruvate was approximately onefold higher than the corresponding value for sAHAS. Data from site-directed mutagenesis demonstrated that alteration at A135, F264, and S486 resulted in resistance reduction, while the mutation at H134, S136, and I210 has little effect on the resistance. A135 was mainly responsible for resistance to imidazolinone; F264 conferred resistance to sulfonylurea and triazolopyrimidine sulfonamide; and S486 showed multiple herbicides resistance to the four herbicides.

  11. 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.

  12. Non-compact left ventricle/hypertrabeculated left ventricle

    International Nuclear Information System (INIS)

    Restrepo, Gustavo; Castano, Rafael; Marmol, Alejandro

    2005-01-01

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

  13. Mechanical discordance between left atrium and left atrial appendage

    Directory of Open Access Journals (Sweden)

    Arash Khamooshian

    2018-01-01

    Full Text Available During standard transesophageal echocardiographic examinations in sinus rhythm (SR patients, the left atrial appendage (LAA is not routinely assessed with Doppler. Despite having a SR, it is still possible to have irregular activity in the LAA. This situation is even more important for SR patients where assessment of the left atrium is often foregone. We describe a case where we encountered this situation and briefly review how to assess the left atrium and its appendage in such a case scenario.

  14. Neodymium-140 DOTA-LM3: Evaluation of an In Vivo Generator for PET with a Non-Internalizing Vector

    Science.gov (United States)

    Severin, Gregory W.; Kristensen, Lotte K.; Nielsen, Carsten H.; Fonslet, Jesper; Jensen, Andreas I.; Frellsen, Anders F.; Jensen, K. M.; Elema, Dennis R.; Maecke, Helmut; Kjær, Andreas; Johnston, Karl; Köster, Ulli

    2017-01-01

    140Nd (t1/2 = 3.4 days), owing to its short-lived positron emitting daughter 140Pr (t1/2 = 3.4 min), has promise as an in vivo generator for positron emission tomography (PET). However, the electron capture decay of 140Nd is chemically disruptive to macrocycle-based radiolabeling, meaning that an in vivo redistribution of the daughter 140Pr is expected before positron emission. The purpose of this study was to determine how the delayed positron from the de-labeled 140Pr affects preclinical imaging with 140Nd. To explore the effect, 140Nd was produced at CERN-ISOLDE, reacted with the somatostatin analogue, DOTA-LM3 (1,4,7,10- tetraazacyclododecane, 1,4,7- tri acetic acid, 10- acetamide N - p-Cl-Phecyclo(d-Cys-Tyr-d-4-amino-Phe(carbamoyl)-Lys-Thr-Cys)d-Tyr-NH2) and injected into H727 xenograft bearing mice. Comparative pre- and post-mortem PET imaging at 16 h postinjection was used to quantify the in vivo redistribution of 140Pr following 140Nd decay. The somatostatin receptor-positive pancreas exhibited the highest tissue accumulation of 140Nd-DOTA-LM3 (13% ID/g at 16 h) coupled with the largest observed redistribution rate, where 56 ± 7% (n = 4, mean ± SD) of the in situ produced 140Pr washed out of the pancreas before decay. Contrastingly, the liver, spleen, and lungs acted as strong sink organs for free 140Pr3+. Based upon these results, we conclude that 140Nd imaging with a non-internalizing vector convolutes the biodistribution of the tracer with the accumulation pattern of free 140Pr. This redistribution phenomenon may show promise as a probe of the cellular interaction with the vector, such as in determining tissue dependent internalization behavior. PMID:28748183

  15. Neodymium-140 DOTA-LM3: Evaluation of an In Vivo Generator for PET with a Non-Internalizing Vector

    Directory of Open Access Journals (Sweden)

    Gregory W. Severin

    2017-07-01

    Full Text Available 140Nd (t1/2 = 3.4 days, owing to its short-lived positron emitting daughter 140Pr (t1/2 = 3.4 min, has promise as an in vivo generator for positron emission tomography (PET. However, the electron capture decay of 140Nd is chemically disruptive to macrocycle-based radiolabeling, meaning that an in vivo redistribution of the daughter 140Pr is expected before positron emission. The purpose of this study was to determine how the delayed positron from the de-labeled 140Pr affects preclinical imaging with 140Nd. To explore the effect, 140Nd was produced at CERN-ISOLDE, reacted with the somatostatin analogue, DOTA-LM3 (1,4,7,10- tetraazacyclododecane, 1,4,7- tri acetic acid, 10- acetamide N - p-Cl-Phecyclo(d-Cys-Tyr-d-4-amino-Phe(carbamoyl-Lys-Thr-Cysd-Tyr-NH2 and injected into H727 xenograft bearing mice. Comparative pre- and post-mortem PET imaging at 16 h postinjection was used to quantify the in vivo redistribution of 140Pr following 140Nd decay. The somatostatin receptor-positive pancreas exhibited the highest tissue accumulation of 140Nd-DOTA-LM3 (13% ID/g at 16 h coupled with the largest observed redistribution rate, where 56 ± 7% (n = 4, mean ± SD of the in situ produced 140Pr washed out of the pancreas before decay. Contrastingly, the liver, spleen, and lungs acted as strong sink organs for free 140Pr3+. Based upon these results, we conclude that 140Nd imaging with a non-internalizing vector convolutes the biodistribution of the tracer with the accumulation pattern of free 140Pr. This redistribution phenomenon may show promise as a probe of the cellular interaction with the vector, such as in determining tissue dependent internalization behavior.

  16. The main cubioid

    International Nuclear Information System (INIS)

    Blokh, Alexander; Oversteegen, Lex; Ptacek, Ross; Timorin, Vladlen

    2014-01-01

    The connectedness locus in the parameter space of quadratic polynomials is called the Mandelbrot set. A good combinatorial model of this set is due to Thurston. By definition, the principal hyperbolic domain of the Mandelbrot set consists of parameter values, for which the corresponding quadratic polynomials have an attracting fixed point. The closure of the principal hyperbolic domain of the Mandelbrot set is called the main cardioid. Its topology is completely described by Thurston's model. Less is known about the connectedness locus in the parameter space of cubic polynomials. In this paper, we discuss cubic analogues of the main cardioid and establish relationships between them. (paper)

  17. [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.

  18. 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

  19. Ladybugs of Maine

    Science.gov (United States)

    Color images are presented for the 57 species of Coccinellidae, commonly known as ladybugs, that are documented from Maine. Images are displayed in taxonomic order. Information on each species includes its genus-species name, length, and an actual-size silhouette beside a grid matched to the scale...

  20. Main designations and attributions

    International Nuclear Information System (INIS)

    2010-01-01

    The chapter presents the main designations and attributions of the LNMRI - Brazilian National Laboratory of Metrology of Ionizing Radiation, the Cooperative Center in Radiation Protection and Medical Preparations for Accidents with Radiation; the Treaty for fully banning of nuclear tests and the Regional Center for Training of IAEA

  1. Main facts 1995

    International Nuclear Information System (INIS)

    1996-01-01

    This report presents the main facts of the studies carried out by the Direction des Etudes et Recherches (DER) of Electricite de France: new applications of electricity, classical and nuclear thermal power plants, electrical equipment, environment protection, monitoring and plants operations

  2. Main facts 1993

    International Nuclear Information System (INIS)

    1994-01-01

    This report presents the main facts of the studies carried out by the Direction des Etudes et Recherches (DER) of Electricite de France: new applications of electricity, classical and nuclear thermal power plants, electrical equipment, environment protection, network analysis, information and informatic equipment

  3. Complexity and Hopf Bifurcation Analysis on a Kind of Fractional-Order IS-LM Macroeconomic System

    Science.gov (United States)

    Ma, Junhai; Ren, Wenbo

    On the basis of our previous research, we deepen and complete a kind of macroeconomics IS-LM model with fractional-order calculus theory, which is a good reflection on the memory characteristics of economic variables, we also focus on the influence of the variables on the real system, and improve the analysis capabilities of the traditional economic models to suit the actual macroeconomic environment. The conditions of Hopf bifurcation in fractional-order system models are briefly demonstrated, and the fractional order when Hopf bifurcation occurs is calculated, showing the inherent complex dynamic characteristics of the system. With numerical simulation, bifurcation, strange attractor, limit cycle, waveform and other complex dynamic characteristics are given; and the order condition is obtained with respect to time. We find that the system order has an important influence on the running state of the system. The system has a periodic motion when the order meets the conditions of Hopf bifurcation; the fractional-order system gradually stabilizes with the change of the order and parameters while the corresponding integer-order system diverges. This study has certain significance to policy-making about macroeconomic regulation and control.

  4. The relationship of PON1 QR 192 and LM 55 polymorphisms with serum paraoxonase activities of Turkish diabetic patients.

    Science.gov (United States)

    Altuner, Durdu; Ates, Ilker; Suzen, Sinan H; Koc, Gonul Varan; Aral, Yalcin; Karakaya, Asuman

    2011-11-01

    Paraoxonase (PON1) is a serum esterase responsible for the protection against xenobiotics toxicity such as paraoxon. Alterations in PON1 concentrations have been reported in a variety of diseases including diabetes mellitus (DM). It has been shown that the serum PON1 concentration and activity are decreased in patients with both type 1 and type 2 DM. This study aimed to investigate the lipid profiles and the relationship between PON1 activity and PON1, QR192 and LM55 polymorphisms in Turkish type 2 diabetic patients and non-diabetic control subjects. According to our results, RR variant had significantly higher PON activity than QQ and QR variants (p < 0.01) and LL variant had significantly higher PON activity than MM variant in both control and patient groups (p < 0.05). In conclusion, we found that PON1 192RR and 55LL genotypes are associated with higher PON activity than QQ and MM genotypes. This may be more protective to lipid peroxidation.

  5. Morpho-palynological study of Cyperaceae from wetlands of Azad Jammu and Kashmir using SEM and LM.

    Science.gov (United States)

    Butt, Maryam Akram; Zafar, Muhammad; Ahmad, Mushtaq; Sultana, Shazia; Ullah, Fazal; Jan, Gul; Irfan, Ali; Naqvi, Syeda Andleeb Zahra

    2018-01-31

    In this study 12 species of Cyperaceae have been studied for quantitative and qualitative observation of pollen grains through Light and scanning electron microscopy. Pollens of 12 species of Cyperaceae from different wetlands of Azad Jammu and Kashmir were collected. Morphological characters of pollen grains were then investigated under the Light and Scanning electron microscope. Two pollen types have been observed apolar and heteropolar. Shape of pollens was prolate (4 spp), sub-spheroidal (7 spp), and oblate (1 spp). Variation observed in exine sculpturing granular (4 spp), reticulate (1 spp), areolate-punctate (3 spp), and psilate (2 spp). Polar to equatorial ratio and fertility percentage of the pollens were also studied. Based on these micromorphlogical characters of pollens taxonomic keys have been made for the accurate identification of the members of Cyperaceae. The characteristics studied in present research work are very much valuable taxonomically and phytochemically for the identification of species of family Cyperaceae. Light microscope (LM) and Scanning electron microscope (SEM) were used for pollen observation, which play vital role in the taxonomical identification of species and provide sufficient information for taxonomist. © 2018 Wiley Periodicals, Inc.

  6. Analysis of Tribological Behaviour of Functionally Graded LM13 Aluminium/TiS2 Composite Using Design of Experiments

    Directory of Open Access Journals (Sweden)

    N. Radhika

    2016-09-01

    Full Text Available Functionally graded LM13 aluminium/10wt% TiS2 composite was fabricated by centrifugal casting method and hollow cylindrical part has the dimension of 150x150x20 mm was obtained. The microstructural evaluation and vicker’s micro-hardness test was carried out on the surfaces at the distance of 1, 6, 12 and 18 mm from the outer surface of functionally graded composites. The microstructural investigation reveals that the TiS2 reinforcement particles concentrated more on the outer periphery and less at the inner periphery of the composite. The hardness of the composite surface increases at the particle rich region of outer periphery and decreases towards inner region. The dry sliding wear experiments were conducted on the composite specimens as per plan of Taguchi’s L16 orthogonal array design. The parameters considered were load, sliding velocity, sliding distance and distance from outer periphery of the composite, varied for four levels. Signal- to- Noise ratio and Analysis of Variance were carried out and the significance test revealed that distance from outer periphery had major impact (43.11 % followed by sliding distance (31.19 %, load (16.59 %, and sliding velocity (7.33 %. Adequacy of model was predicted through regression equation and the error was found to be less than 8 %. The scanning electron microscope analysis carried out for the worn-out surfaces showed maximum wear resistance of the functionally graded composite at outer periphery.

  7. Leptosphaeria maculans effector AvrLm4-7 affects salicylic acid (SA) and ethylene (ET) signalling and hydrogen peroxide (H2O2) accumulation in Brassica napus

    Czech Academy of Sciences Publication Activity Database

    Nováková, Miroslava; Šašek, Vladimír; Trdá, Lucie; Krutinová, Hana; Mongin, T.; Valentová, O.; Balesdent, M.H.; Rouxel, T.; Burketová, Lenka

    2016-01-01

    Roč. 17, č. 6 (2016), s. 818-831 ISSN 1464-6722 R&D Projects: GA ČR GA13-26798S Institutional support: RVO:61389030 Keywords : AvrLm4-7 * Brassica napus * effector Subject RIV: GF - Plant Pathology, Vermin, Weed, Plant Protection Impact factor: 4.697, year: 2016

  8. Primary structure of a 14 kDa basic structural protein (Lm-76) from the cuticle of the migratory locust, Locusta migratoria

    DEFF Research Database (Denmark)

    Andersen, Jens S.; Andersen, S O; Højrup, P

    1993-01-01

    The complete amino acid sequence of a 14 kDa structural protein (LM-76) isolated from pharate cuticle of the locust, Locusta migratoria, was determined by Edman degradation of the intact protein and enzymatically derived peptides. Plasma desorption and electrospray mass spectrometry was used as a...

  9. Renovating the Main Building

    CERN Multimedia

    CERN Bulletin

    2010-01-01

    CERN's "Main Building" is exactly that. The Organization's central hub, with hundreds of staff and visitors passing through its doors every day, will soon be getting a well-earned facelift. Refurbishment work will proceed in phases, starting with the Salle des Pas Perdus, the concourse between the Council Chamber and the Main Auditorium. By the end of August, informal seating areas will be installed, electronic display panels will provide practical information and improved sound insulation will enhance conditions in the auditoria and surrounding meeting rooms.   In light green the area that will undergo the facelift. Work will start in July. The ground floor is home to the entrance to Restaurant No. 1, the bank, the post office, the travel agent, the Users Office, the Staff Association, the notice boards etc. Step up to the first floor to access CERN's largest lecture theatre, the Council Chamber and its "Pas Perdus" lobby. Everyone who works at or visits CERN i...

  10. Main applications of superconductors

    International Nuclear Information System (INIS)

    Tixador, P.; Brunet, Y.

    2007-01-01

    In 2004, the world market of superconductivity reached 3.65 billion euros and was mainly concerning the NbTi-type superconductors. The high critical temperature superconductors (HCTS) have not reached the industrial maturity yet, both in terms of efficiency and cost, but this situation may change at medium term. Superconductors are mainly used in the industry today to create moderated to high inductions (1.5 to more than 20 T) inside volumes up to several hundreds of m 3 . This article treats of the present day industrial applications of NbTi and Nb 3 Sn superconductors: 1 - specificities of superconductors: persisting mode, AC losses, protection of a superconducting magnet, dimensioning of a superconducting coil; 2 -industrial magnets: NMR imaging, spectroscopy, proton cyclotron; 3 - magnets for research: high energy physics (accelerators-colliders, detectors), fusion facilities (reaction, magnetic confinement, tokamak, ITER), laboratory magnets; 4 - magnets for specific applications: magnetic separation, magnetic levitated train, MHD. (J.S.)

  11. Characterization and Genetic Analysis of a Novel Light-Dependent Lesion Mimic Mutant, lm3, Showing Adult-Plant Resistance to Powdery Mildew in Common Wheat.

    Directory of Open Access Journals (Sweden)

    Fang Wang

    Full Text Available Lesion mimics (LMs that exhibit spontaneous disease-like lesions in the absence of pathogen attack might confer enhanced plant disease resistance to a wide range of pathogens. The LM mutant, lm3 was derived from a single naturally mutated individual in the F1 population of a 3-1/Jing411 cross, backcrossed six times with 3-1 as the recurrent parent and subsequently self-pollinated twice. The leaves of young seedlings of the lm3 mutant exhibited small, discrete white lesions under natural field conditions. The lesions first appeared at the leaf tips and subsequently expanded throughout the entire leaf blade to the leaf sheath. The lesions were initiated through light intensity and day length. Histochemical staining revealed that lesion formation might reflect programmed cell death (PCD and abnormal accumulation of reactive oxygen species (ROS. The chlorophyll content in the mutant was significantly lower than that in wildtype, and the ratio of chlorophyll a/b was increased significantly in the mutant compared with wildtype, indicating that lm3 showed impairment of the biosynthesis or degradation of chlorophyll, and that Chlorophyll b was prone to damage during lesion formation. The lm3 mutant exhibited enhanced resistance to wheat powdery mildew fungus (Blumeria graminis f. sp. tritici; Bgt infection, which was consistent with the increased expression of seven pathogenesis-related (PR and two wheat chemically induced (WCI genes involved in the defense-related reaction. Genetic analysis showed that the mutation was controlled through a single partially dominant gene, which was closely linked to Xbarc203 on chromosome 3BL; this gene was delimited to a 40 Mb region between SSR3B450.37 and SSR3B492.6 using a large derived segregating population and the available Chinese Spring chromosome 3B genome sequence. Taken together, our results provide information regarding the identification of a novel wheat LM gene, which will facilitate the additional fine

  12. Project evaluation: main characteristics

    OpenAIRE

    Moutinho, Nuno

    2010-01-01

    — The evaluation process of real investment projects must consider not only the traditional financial approach, but also non-financial aspects. Non financial analysis can provide additional relevant information about projects. We investigate financial and non-financial areas most relevant in project appraisal. We present main critical success factors and areas of analysis that lead to the perception of project success. Finally, companies are segmented to verify its financial and non-financial...

  13. Maine coast winds

    Energy Technology Data Exchange (ETDEWEB)

    Avery, Richard

    2000-01-28

    The Maine Coast Winds Project was proposed for four possible turbine locations. Significant progress has been made at the prime location, with a lease-power purchase contract for ten years for the installation of turbine equipment having been obtained. Most of the site planning and permitting have been completed. It is expect that the turbine will be installed in early May. The other three locations are less suitable for the project, and new locations are being considered.

  14. Propagação vegetativa de jambeiro vermelho [Syzygium malaccense (L. Merr. & L.M. Perry] Vegetative propagation of malay apple [Syzygium malaccense (L. Merr. & L.M. Perry

    Directory of Open Access Journals (Sweden)

    Eduardo José de Almeida

    2010-12-01

    Full Text Available O jambeiro vermelho [Syzygium malaccense (L. Merr. & L.M. Perry] se apresenta como opção ao fruticultor por apresentar frutos atrativos e bem aceitos pelo consumidor. A dificuldade de cultivo dessa espécie reside no fato de que a planta possui um porte demasiadamente alto e longo período juvenil quando propagada por semente, com isso, é desejável sua multiplicação vegetativa visando a antecipar o período produtivo e diminuir seu porte. Foi estudada a possibilidade de clonagem dessa espécie pelas técnicas de estaquia, alporquia e enxertia. No experimento por estaquia, testaram-se três doses de ácido indolbutírico (AIB (0, 1.000 3.000 e 5.000 mg L-1 em dois comprimentos de estacas herbáceas (15 e 25 cm. No experimento de alporquia, avaliaram-se duas épocas de realização do alporque (verão e outono e quatro doses de AIB (0, 1.000, 4.000, 7.000 e 10.000 mg kg-1. Na enxertia, analisou-se a compatibilidade do jambeiro vermelho (S. malaccense sobre o jambeiro rosa [Syzygium jambos (L. Alston] com dois diâmetros de porta-enxertos (0,5 e 0,8 cm em duas épocas (inverno e verão, pelo método de enxertia de topo em fenda cheia. A estaquia obteve até 20% de enraizamento, independentemente da dose de AIB, exceto na dose de 5.000 mg L-1, que apresentou efeito negativo ao enraizamento entre estacas de 15 cm; não houve sucesso para alporquia e enxertia, nas condições estudadas.The Malay Apple [Syzygium malaccense (L. Merr. & L.M. Perry] is an option for the producer as its fruits are attractive and well accepted by the consumer. The difficulty of culture of this species is that the plant is very tall and has a long juvenile period when propagated by seed, making its vegetative propagation necessary to anticipate the productive period and decrease its size. The possibility of vegetative propagation of this species was studied by cutting, layering, and grafting. In the cutting experiment, three doses of indolbutyric acid (IBA (0, 1,000, 3

  15. Myxoma of the Left Ventricle

    Science.gov (United States)

    Novoa, José; Delgado, Antonio; Alonso, Ana

    2014-01-01

    This report concerns a 69-year-old woman who presented with an asymptomatic myxoma in the left ventricle. The tumor was successfully excised. We provide a very brief review of 72 other published cases of surgically treated left ventricular myxoma. PMID:25120392

  16. Left ventricular hypertrophy in athletes.

    Science.gov (United States)

    Douglas, P S; O'Toole, M L; Katz, S E; Ginsburg, G S; Hiller, W D; Laird, R H

    1997-11-15

    Left ventricular wall thickness >1.3 cm, septal-to-posterior wall ratios > 1.5, diastolic left ventricular size >6.0 cm, and eccentric or concentric remodeling are rare in athletes. Values outside of these cutoffs in an athlete of any age probably represent a pathologic state.

  17. 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…

  18. Two Lefts in Latin America?

    DEFF Research Database (Denmark)

    Christensen, Steen Fryba

    In this working paper I list five researchers' categorizations of the Latin American left in power (april 2006) in a schematic form. The most important criteria for the categorizations are given.......In this working paper I list five researchers' categorizations of the Latin American left in power (april 2006) in a schematic form. The most important criteria for the categorizations are given....

  19. A Giant Left Atrial Myxoma

    Directory of Open Access Journals (Sweden)

    Medhat F. Zaher

    2014-01-01

    Full Text Available Atrial myxomas are the most common primary cardiac tumors. Patients with left atrial myxomas generally present with mechanical obstruction of blood flow, systemic embolization, and constitutional symptoms. We present a case of an unusually large left atrial myxoma discovered incidentally in a patient with longstanding dyspnea being managed as bronchial asthma.

  20. Summary of main points

    International Nuclear Information System (INIS)

    2006-01-01

    In conjunction with its 6. annual meeting, the WPDD in close co-operation with the FSC held a Topical session on 'Stakeholder Involvement in Decommissioning' on November 14, 2005. The session was attended by 36 participants totally representing 14 NEA member countries and 2 international organisations. Two keynote addresses were given at the Topical Session. The first one treated of what is needed for robust decisions and how to bring all stakeholders into the debate. In the second keynote address a summary was made on what have been said on stakeholder involvement in decommissioning during earlier meetings of the WPDD. The main part of the session was then devoted to views from different stakeholders regarding their role and their involvement. This part contained viewpoints from local communities (Kaevlinge in Sweden and Port Hope in Canada), authorities (Scottish Executive and CSNC) and operators (EDF from France and EWN from Germany). Case studies from the decommissioning of Dounrey in the UK and from Trojan and Main Yankee in the USA were presented in the end part of the Topical session followed by a summary and lessons learnt report by the Rapporteur. A detailed programme of the Topical session can be seen in Appendix 1

  1. 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. .

  2. 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.

  3. Experimental Investigation of Process Parameters in Drilling LM25 Composites Coated with Multi Wall Carbon Nano Tubes Using Sonication Process

    Directory of Open Access Journals (Sweden)

    Sangeetha M.

    2017-09-01

    Full Text Available Aluminium based metal matrix composites are widely used in automobile components such as cardan shaft of Chevrolet corvette, disc brake and engine push rod. In this experiment a Hybrid Metal Matrix Composites (HMMC are fabricated and drilled. Drilling is the process of making slots in disc brake and thread in the engine parts. The surface quality of the drilled specimen depends on the speed, feed, drill type and the thrust force. Thrust force plays the major role in drilling the specimen. In this experiment HMMCs are fabricated using two processes-called, sonication and casting. Sonication is the process of coating the carbon nanotubes over the silicon carbide particles (SiCp. Semisolid stir casting is used to reinforce the coated SiCp in the LM 25 alloy. A drilling process is performed on HMMC to analyse the extent to which the input parameters influence the thrust force and Ovality. The tools used for drilling are solid carbide tools of three different diameters. Taguchi’s experimental design is adopted for the drilling operation. A mathematical model is used to determine the influence of input parameters on the outputs thrust force and ovality. This paper proves the combination of N3, f1 and d1 of the carbide tool results in the lowest value of thrust force and ovality while drilling HMMCs. In this work the HMMC is prepared by coating the abrasive nature, silicon carbide particle and there is a good interfacial bonding between the reinforced particle and matrix and the drilling process becomes smoother. The new being of this article is the treated ceramics, SiCp with carbon nanotubes. This HMMC shows the improved mechanical properties compared to other metal matrix composites surveyed in the literatures.

  4. Autosynchronized systolic unloading during left ventricular assist with a centrifugal pump.

    Science.gov (United States)

    Kono, Satoshi; Nishimura, Kazunobu; Nishina, Takeshi; Yuasa, Sadatoshi; Ueyama, Koji; Hamada, Chikuma; Akamatsu, Teruaki; Komeda, Masashi

    2003-02-01

    The purpose of this study was to investigate how the inflow cannulation site of the left ventricular assist system with a centrifugal pump would influence cardiac function on failing heart models. In 10 sheep, a left ventricular assist system was instituted by an outflow cannula in the descending aorta, two inflow cannulas in the left atrium and the left ventricle, and connecting those cannulas to a magnetically suspended centrifugal pump. A conductance catheter and a tipped micromanometer for monitoring the pressure-volume loop were also inserted into the left ventricle. Myocardial oxygen consumption was directly measured. Heart failure was induced by injection of microspheres into the left main coronary artery. The assist rate was varied from 0% to 100% at each inflow cannulation site. The pump flow with left ventricular cannulation increased during the systolic phase and decreased during the diastolic phase, whereas it was constant with left atrial cannulation. Ejection fraction with left atrial cannulation decreased as the assist rate increased, whereas that with left ventricular cannulation was maintained up to 75% assist. The external work with left atrial cannulation decreased gradually as the assist rate increased, whereas the external work with left ventricular cannulation did not decrease until the assist rate reached 75%. The myocardial oxygen consumption in both cannulations decreased proportionally as the assist rate increased; they were significantly less with left ventricular cannulation at the 100% assist rate than with left atrial cannulation. Left ventricular cannulation during left ventricular assistance maintains ejection fraction and effectively reduces oxygen consumption.

  5. Mustafa Bin Bâlî ve İlm-i Firâset’i Mustafa Bin Bâlî And İlm-i Firâset

    Directory of Open Access Journals (Sweden)

    Ramazan SARIÇİÇEK

    2012-12-01

    alışma niteliğindedir. Yalnızca Fahreddin Razi ve Muhyiddin-i Arabî değil Hamdullah Hamdi’den İbni Sina’ya kadar daha birçok ilim adamının eserlerinden de yararlanılmıştır. Bu yönüyle alanında tektir diyebiliriz. Zira bu alanda yazılan eserler genellikle firâset ilminin uygulaması üzerinedir. Yani bu ilmin temel kıstasları üzerinde durmak yerine sonuçları üzerinde dururlar. Halbuki bu eser bütün olarak firâset üzerine yapılmış derli toplu bir çalışmadır. Diğer eserlerde bilgiler bölük pörçük ve dağınık iken bu eser firâsetle ilgili bilgileri bir akademisyen titizliğiyle derleyip bir araya getirmiştir.Ayrıca eser mensur olmasına rağmen içinde Arapça, Farsça ve Türkçe olmak üzere çeşitli manzumeler de bulunmaktadır. Dil bakımından ise Eski Anadolu Türkçesine ait dil malzemeleri içermektedir.

  6. 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...

  7. Dabigatran for left ventricular thrombus

    Directory of Open Access Journals (Sweden)

    Satishkumar Kolekar

    2015-09-01

    Dabigatran is a reversible direct thrombin inhibitor and currently approved for the prevention of thromboembolic episodes in non-valvar atrial fibrillation. This case demonstrates possible thrombolytic properties of dabigatran in resolution of left ventricular thrombus.

  8. Left ventricular apical ballooning syndrome

    International Nuclear Information System (INIS)

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

    2007-01-01

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

  9. Characterization of Sinorhizobium sp. LM21 Prophages and Virus-Encoded DNA Methyltransferases in the Light of Comparative Genomic Analyses of the Sinorhizobial Virome

    Directory of Open Access Journals (Sweden)

    Przemyslaw Decewicz

    2017-06-01

    Full Text Available The genus Sinorhizobium/Ensifer mostly groups nitrogen-fixing bacteria that create root or stem nodules on leguminous plants and transform atmospheric nitrogen into ammonia, which improves the productivity of the plants. Although these biotechnologically-important bacteria are commonly found in various soil environments, little is known about their phages. In this study, the genome of Sinorhizobium sp. LM21 isolated from a heavy-metal-contaminated copper mine in Poland was investigated for the presence of prophages and DNA methyltransferase-encoding genes. In addition to the previously identified temperate phage, ΦLM21, and the phage-plasmid, pLM21S1, the analysis revealed the presence of three prophage regions. Moreover, four novel phage-encoded DNA methyltransferase (MTase genes were identified and the enzymes were characterized. It was shown that two of the identified viral MTases methylated the same target sequence (GANTC as cell cycle-regulated methyltransferase (CcrM of the bacterial host strain, LM21. This discovery was recognized as an example of the evolutionary convergence between enzymes of sinorhizobial viruses and their host, which may play an important role in virus cycle. In the last part of the study, thorough comparative analyses of 31 sinorhizobial (prophages (including active sinorhizobial phages and novel putative prophages retrieved and manually re-annotated from Sinorhizobium spp. genomes were performed. The networking analysis revealed the presence of highly conserved proteins (e.g., holins and endolysins and a high diversity of viral integrases. The analysis also revealed a large number of viral DNA MTases, whose genes were frequently located within the predicted replication modules of analyzed prophages, which may suggest their important regulatory role. Summarizing, complex analysis of the phage protein similarity network enabled a new insight into overall sinorhizobial virome diversity.

  10. Right colon cancer: Left behind.

    Science.gov (United States)

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

    2016-09-01

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

  11. Comparison of bacterial quantities in left and right colon biopsies and faeces.

    Science.gov (United States)

    Lyra, Anna; Forssten, Sofia; Rolny, Peter; Wettergren, Yvonne; Lahtinen, Sampo J; Salli, Krista; Cedgård, Lennart; Odin, Elisabeth; Gustavsson, Bengt; Ouwehand, Arthur C

    2012-08-28

    To compare quantities of predominant and pathogenic bacteria in mucosal and faecal samples. Twenty patients undergoing diagnostic colonoscopy with endoscopically and histologically normal mucosa were recruited to the study, 14 subjects of which also supplied faecal (F) samples between 15 d to 105 d post colonoscopy. Mucosal biopsies were taken from each subject from the midportion of the ascending colon (right side samples, RM) and the sigmoid (left side samples, LM). Predominant intestinal and mucosal bacteria including clostridial 16S rRNA gene clusters IV and XIVab, Bacteroidetes, Enterobacteriaceae, Bifidobacterium spp., Akkermansia muciniphila (A. muciniphila), Veillonella spp., Collinsella spp., Faecalibacterium prausnitzii (F. prausnitzii) and putative pathogens such as Escherichia coli (E. coli), Clostridium difficile (C. difficile), Helicobacter pylori (H. pylori) and Staphylococcus aureus (S. aureus) were analysed by quantitative polymerase chain reaction (qPCR). Host DNA was quantified from the mucosal samples with human glyceraldehyde 3-phosphate dehydrogenase gene targeting qPCR. Paired t tests and the Pearson correlation were applied for statistical analysis. The most prominent bacterial groups were clostridial groups IV and XIVa+b and Bacteroidetes and bacterial species F. prausnitzii in both sample types. H. pylori and S. aureus were not detected and C. difficile was detected in only one mucosal sample and three faecal samples. E. coli was detected in less than half of the mucosal samples at both sites, but was present in all faecal samples. All detected bacteria, except Enterobacteriaceae, were present at higher levels in the faeces than in the mucosa, but the different locations in the colon presented comparable quantities (RM, LM and F followed by P(1) for RM vs F, P(2) for LM vs F and P(3) for RM vs LM: 4.17 ± 0.60 log(10)/g, 4.16 ± 0.56 log(10)/g, 5.88 ± 1.92 log(10)/g, P(1) = 0.011, P(2) = 0.0069, P(3) = 0.9778 for A. muciniphila; 6.25 ± 1

  12. Doubling left syntactic positions in Danish

    DEFF Research Database (Denmark)

    Jørgensen, Henrik

    2016-01-01

    This paper deals with the doubling of left syntactic positions in Danish. Such doublings consist of a referential element: a NP or a clause, and an anaphoric element, an unstressed personal pronoun or an unstressed resumptive adverb. In main clauses, the CP-spec position may double in this way, w...... in the analysis of a broadcasted public speech (sect. 5). In earlier versions of Danish, as shown in sect. 4, the construction is both more frequent in writing and also seems almost obligatory....

  13. Aphasia following left thalamic hemorrhage

    International Nuclear Information System (INIS)

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

    1984-01-01

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

  14. Left neglect dyslexia: Perseveration and reading error types.

    Science.gov (United States)

    Ronchi, Roberta; Algeri, Lorella; Chiapella, Laura; Gallucci, Marcello; Spada, Maria Simonetta; Vallar, Giuseppe

    2016-08-01

    Right-brain-damaged patients may show a reading disorder termed neglect dyslexia. Patients with left neglect dyslexia omit letters on the left-hand-side (the beginning, when reading left-to-right) part of the letter string, substitute them with other letters, and add letters to the left of the string. The aim of this study was to investigate the pattern of association, if any, between error types in patients with left neglect dyslexia and recurrent perseveration (a productive visuo-motor deficit characterized by addition of marks) in target cancellation. Specifically, we aimed at assessing whether different productive symptoms (relative to the reading and the visuo-motor domains) could be associated in patients with left spatial neglect. Fifty-four right-brain-damaged patients took part in the study: 50 out of the 54 patients showed left spatial neglect, with 27 of them also exhibiting left neglect dyslexia. Neglect dyslexic patients who showed perseveration produced mainly substitution neglect errors in reading. Conversely, omissions were the prevailing reading error pattern in neglect dyslexic patients without perseveration. Addition reading errors were much infrequent. Different functional pathological mechanisms may underlie omission and substitution reading errors committed by right-brain-damaged patients with left neglect dyslexia. One such mechanism, involving the defective stopping of inappropriate responses, may contribute to both recurrent perseveration in target cancellation, and substitution errors in reading. Productive pathological phenomena, together with deficits of spatial attention to events taking place on the left-hand-side of space, shape the manifestations of neglect dyslexia, and, more generally, of spatial neglect. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. 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.

  16. Intravascular ultrasound-guided stenting of left main stem dissection after medtronic corevalve implantation

    NARCIS (Netherlands)

    N.M. van Mieghem (Nicolas); P.P.T. de Jaegere (Peter)

    2013-01-01

    textabstractTranscatheter aortic valve implantation (TAVI) implies the introduction, positioning, and deployment of a stented bioprosthesis in the (calcified) native aortic valve. We report an at first glance uneventful TAVI with the Medtronic Corevalve System, which was followed by transient

  17. Novel Echocardiographic Indices for Assessing the Left Main Coronary Artery in Children With Kawasaki Disease

    OpenAIRE

    Elaheh Malakan Rad; Iran Malekzadeh; Vahid Ziaee; Raheleh Rajabi; Zohreh Shahabi

    2016-01-01

    Background Kawasaki disease (KD) is the most common cause of acquired myocardial infarction in children. Coronary artery involvement is the most serious feature of this vasculitis syndrome. Timely diagnosis of coronary artery involvement is of utmost importance since it can prevent long-term morbidity and mortality. The current methods for the diagnosis of coronary artery dilation in KD are inconsistent and are also not capable of detecting all the abnormal coronary arteries or t...

  18. 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.

  19. Detailed anatomy of a left accessory aberrant colic artery.

    Science.gov (United States)

    Rusu, M C; Vlad, M; Voinea, L M; Curcă, G C; Sişu, A M

    2008-10-01

    In an aged human female cadaver a left accessory aberrant colic artery (LAACA) was observed and studied. It originated from the superior mesenteric artery at 3 cm proximal to the middle colic artery, at the inferior border of pancreas, passing over Treitz's muscle and continued covered by the superior duodenal fold where it crossed the inferior mesenteric vein. Further, it continued with a satellite vein anterior to the left renal vein and the anterior branch of the renal artery. The LAACA divided into an ascending branch and a descending one, anastomosed with the middle colic and proper left colic arteries; between its two primary branches and the splenic flexure of colon, a hypovascular area was observed. The surgical relevance of the LAACA detailed anatomy mainly relates to specific procedures performed in left colectomies and nephrectomies.

  20. Why Are the Right and Left Hemisphere Conceptual Representations Different?

    Directory of Open Access Journals (Sweden)

    Guido Gainotti

    2014-01-01

    Full Text Available The present survey develops a previous position paper, in which I suggested that the multimodal semantic impairment observed in advanced stages of semantic dementia is due to the joint disruption of pictorial and verbal representations, subtended by the right and left anterior temporal lobes, rather than to the loss of a unitary, amodal semantic system. The main goals of the present review are (a to survey a larger set of data, in order to confirm the differences in conceptual representations at the level of the right and left hemispheres, (b to examine if language-mediated information plays a greater role in left hemisphere semantic knowledge than sensory-motor information in right hemisphere conceptual knowledge, and (c to discuss the models that could explain both the differences in conceptual representations at the hemispheric level and the prevalence of the left hemisphere language-mediated semantic knowledge over the right hemisphere perceptually based conceptual representations.

  1. Left coronary arterial blood flow: Noninvasive detection by Doppler US

    International Nuclear Information System (INIS)

    Gramiak, R.; Holen, J.; Moss, A.J.; Gutierrez, O.H.; Picone, A.L.; Roe, S.A.

    1986-01-01

    Continuous wave (CW) and pulsed Doppler ultrasound studies with spectral analysis were used to detect the left coronary arterial blood flow in patients who were undergoing routine echocardiography. The pulmonary artery is a stable ultrasonic landmark from which detection of the blood flow can be effected. The left coronary artery can be distinguished by its blood flow toward the cardiac apex and by specific, functional flow features. Flow patterns vary among the left main, circumflex, and anterior descending arteries; patterns also vary with respiration cycles. In the present study, coronary arterial blood flow was detected in 58 of 70 patients (83%). Findings were validated by selectively injecting an agitated saline contrast medium into the left coronary artery and, in another study, by comparing human Doppler phasic flow waveforms with electromagnetic flowmeter recordings obtained in dogs

  2. Left Activism, Succour and Selfhood

    DEFF Research Database (Denmark)

    Hughes, Celia Penelope

    2014-01-01

    an interchange of motherhood, domesticity, far-left politics, and close female friendship. The article will show how the women's epistolary friendship offers intimate insight into female self-fashioning at a breakthrough social and political moment in 1970s Britain. As they reflected on some of the key political...

  3. Genomic and structural characterization of Kunitz-type peptide LmKTT-1a highlights diversity and evolution of scorpion potassium channel toxins.

    Directory of Open Access Journals (Sweden)

    Zongyun Chen

    Full Text Available BACKGROUND: Recently, a new subfamily of long-chain toxins with a Kunitz-type fold was found in scorpion venom glands. Functionally, these toxins inhibit protease activity and block potassium channels. However, the genomic organization and three-dimensional (3-D structure of this kind of scorpion toxin has not been reported. PRINCIPAL FINDINGS: Here, we characterized the genomic organization and 3-D nuclear magnetic resonance structure of the scorpion Kunitz-type toxin, LmKTT-1a, which has a unique cysteine pattern. The LmKTT-1a gene contained three exons, which were interrupted by two introns located in the mature peptide region. Despite little similarity to other Kunitz-type toxins and a unique pattern of disulfide bridges, LmKTT-1a possessed a conserved Kunitz-type structural fold with one α-helix and two β-sheets. Comparison of the genomic organization, 3-D structure, and functional data of known toxins from the α-KTx, β-KTx, γ-KTx, and κ-KTx subfamily suggested that scorpion Kunitz-type potassium channel toxins might have evolved from a new ancestor that is completely different from the common ancestor of scorpion toxins with a CSα/β fold. Thus, these analyses provide evidence of a new scorpion potassium channel toxin subfamily, which we have named δ-KTx. CONCLUSIONS/SIGNIFICANCE: Our results highlight the genomic, structural, and evolutionary diversity of scorpion potassium channel toxins. These findings may accelerate the design and development of diagnostic and therapeutic peptide agents for human potassium channelopathies.

  4. Innovation Developments of Coal Chemistry Science in L.M. Litvinenko Institute of Physical-Organic Chemistry and Coal Chemistry of NAS of Ukraine

    Directory of Open Access Journals (Sweden)

    Shendrik, T.G.

    2015-11-01

    Full Text Available The article presents short historical review and innovation developments of Coal Chemistry Department of L.M. Litvinenko Institute, NAS of Ukraine connected with coal mine exploitation problems, search for decisions toward prevention of spontaneous combustion, dust control in mines, establishing structural chemical features of coal with different genesis and stages of metamorphism with the aim to develop new methods of their modification and rational use. The methods of obtaining inexpensive sorbents from Ukrainian raw materials (including carbon containing waste are proposed. The problems of modern coal chemistry science in IPOCC of NAS of Ukraine are outlined.

  5. Left ventricular diastolic performance of left ventricular hypertrophy

    Energy Technology Data Exchange (ETDEWEB)

    Ikezono, Tohru; Ozaki, Masaharu; Yamagishi, Takashi; Shimizu, Tatsuro; Furutani, Yuji; Kusukawa, Reizo

    1987-02-01

    To study left ventricular diastolic performance in different forms of left ventricular hypertrophy, ECG gated cardiac blood pool scan was performed in 11 patients with hypertrophic nonobstructive cardiomyopathy (HCM) and in 19 patients with hypertension (HT), and left ventricular volume curve (LVVC) was analyzed and compared with those of 13 normal subjects (N). Ejection fraction (EF) and early filling volume ratio (the ratio of volume increment of 100 msec later than the zero point in the first derivative of LVVC to the end diastolic volume) (%EFV) were computed from LVVC. Peak ejection rate (PER) and peak filling rate (PFR) were obtained from the first derivative of LVVC. Peak ejection acceleration (PEA) and peak filling acceleration (PFA) were calculated from the second derivative of LVVC. EF, PER and PEA did not show any difference between these 3 groups. PFR was lower in HT (2.6 +- 0.5) compared with those in HCM (3.0 +- 0.5) (p < 0.05) and in N (3.4 +- 0.5) (p < 0.001), but the %EFV in HCM (4.9 +- 1.8) was lower than those in HT (6.9 +- 1.9) (p < 0.01) and in N (11.4 +- 1.4) (p < 0.001). Moreover, PFA in HCM (27.9 +- 7.2) was increased than those in HT (20.2 +- 5.4) (p < 0.01) with no differences between HCM and N (29.4 +- 8.1). Significant correlation was observed between PFR and PFA (Y = 0.06X + 1.4. r = 0.856. p < 0.001). These result indicate that, in HCM, reduced increase in early left ventricular volume is compensated by a greater filling acceleration. In contrast, there is no compensation by filling acceleration in HT.

  6. Producing The New Regressive Left

    DEFF Research Database (Denmark)

    Crone, Christine

    This thesis is the first comprehensive research work conducted on the Beirut based TV station, an important representative of the post-2011 generation of Arab satellite news media. The launch of al-Mayadeen in June 2012 was closely linked to the political developments across the Arab world...... members, this thesis investigates a growing political trend and ideological discourse in the Arab world that I have called The New Regressive Left. On the premise that a media outlet can function as a forum for ideology production, the thesis argues that an analysis of this material can help to trace...... the contexture of The New Regressive Left. If the first part of the thesis lays out the theoretical approach and draws the contextual framework, through an exploration of the surrounding Arab media-and ideoscapes, the second part is an analytical investigation of the discourse that permeates the programmes aired...

  7. The resurrection of Jesus: What's left to say? | Schutte | HTS ...

    African Journals Online (AJOL)

    The resurrection of Jesus: What's left to say? P J W (Flip) Schutte. Abstract. The resurrection of Jesus is one of the most discussed topics in the current theological debate. It divides the theologians involved into either liberal or orthodox. Those who enter the debate are labeled. The main issue centers around the arguments: ...

  8. Left Dislocation in Arabic: The complexity of form and meaning ...

    African Journals Online (AJOL)

    This paper studies the complexity of L(eft) D(islocation). It demonstrates that the function that is crosslinguistically associated with LD is conveyed in Arabic by a set of LD constructions. In the analyzed corpus, these constructions belong to two main types: Clitic LD and Subject LD. Some LD constructions formally and/or ...

  9. PhyLM: A Mission Design Concept for an Optical/Lidar Instrument to Measure Ocean Productivity and Aerosols from Space

    Science.gov (United States)

    Gervin, Janette C.; Behrenfeld, Michael; McClain, Charles R.; Spinhirne, James; Purves, Lloyd; Wood, H. John; Roberto, Michael R.

    2004-01-01

    The Physiology Lidar-Multispectral Mission (PhyLM) is intended to explore the complex ecosystems of our global oceans. New "inversion" methods and improved understanding of marine optics have opened the door to quantifying a range of critical ocean properties. This new information could revolutionize our understanding of global ocean processes, such as phytoplankton growth, harmful algal blooms, carbon fluxes between major pools and the productivity equation. The new science requires new measurements not addressed by currently planned space missions. PhyLM will combine active and advanced passive remote sensing technologies to quantify standing stocks and fluxes of climate-critical components of the Ocean carbon cycle to meet these science providing multispectral bands from the far UV through the near infrared (340 - 1250 nm) at a ground resolution of 250 m. Improved detectors, filters, mirrors, digitization and focal plane design will offer an overall higher-quality data product. The unprecedented accuracy and precision of the absolute water-leaving radiances will support inversion- based quantification of an expanded set of ocean carbon cycle components. The dual- wavelength (532 & 1064 nm) Nd:Yag Lidar will enhance the accuracy and precision of the passive data by providing aerosol profiles for atmospheric correction and coincident active measurements of backscattering. The Lidar will also examine dark-side fluorescence as an additional approach to quantifying phytoplankton biomass in highly productive regions.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    Left ventricular hypertrophy [LVH, high left ventricular mass (LVM)] is traditionally classified as concentric or eccentric based on left ventricular relative wall thickness. We evaluated left ventricular systolic function in a new four-group LVH classification based on left ventricular dilatation...

  11. PS main supply: motor-generator set.

    CERN Multimedia

    Maximilien Brice

    2002-01-01

    In picture 04 the motor is on the right in the background and the main view is of the generator. The peak power in each PS cycle drawn from the generator, up to 96 MW, is taken from the rotational kinetic energy of the rotor (a heavy-weight of 80 tons), which makes the rotational speed drop by only a few percent. The motor replenishes the average power of 2 to 4 MW. Photo 05: The motor-generator set is serviced every year and, in particular, bearings and slip-rings are carefully checked. To the left is the motor with its slip-rings visible. It has been detached from the axle and moved to the side, so that the rotor can be removed from the huge generator, looming at the right.

  12. Five-year outcomes following PCI with DES versus CABG for unprotected LM coronary lesions: meta-analysis and meta-regression of 2914 patients.

    Science.gov (United States)

    Sá, Michel Pompeu Barros de Oliveira; Ferraz, Paulo Ernando; Escobar, Rodrigo Renda; Nunes, Eliobas Oliveira; Soares, Alexandre Magno Macário Nunes; Araújo e Sá, Frederico Browne Correia de; Vasconcelos, Frederico Pires; Lima, Ricardo Carvalho

    2013-03-01

    To compare the safety and efficacy at long-term follow-up of coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) using drug-eluting stents (DES) in patients with unprotected left main coronary artery (ULMCA) disease. MEDLINE, EMBASE, CENTRAL/CCTR, SciELO, LILACS, Google Scholar and reference lists of relevant articles were searched for clinical studies that reported outcomes at 5-year follow-up after PCI with DES and CABG for the treatment of ULMCA stenosis. Five studies (1 randomized controlled trial and 4 observational studies) were identified and included a total of 2914 patients (1300 for CABG and 1614 for PCI with DES). At 5-year follow-up, there was no significant difference between the CABG and PCI-DES groups in the risk for death (odds ratio [OR] 1.159, P=0.168 for random effect) or the composite endpoint of death, myocardial infarction, or stroke (OR 1.214, P=0.083). The risk for target vessel revascularization (TVR) was significantly lower in the CABG group compared to the PCI-DES group (OR 0.212, PDES group (OR 0.526, P<0.001). It was observed no publication bias about outcomes and considerably heterogeneity effect about MACCE. CABG surgery remains the best option of treatment for patients with ULMCA disease, with less need of TVR and MACCE rates at long-term follow-up.

  13. Homeostatic Left Heart integration and disintegration links atrio-ventricular covariation's dyshomeostasis in Hypertrophic Cardiomyopathy.

    Science.gov (United States)

    Piras, Paolo; Torromeo, Concetta; Evangelista, Antonietta; Gabriele, Stefano; Esposito, Giuseppe; Nardinocchi, Paola; Teresi, Luciano; Madeo, Andrea; Schiariti, Michele; Varano, Valerio; Puddu, Paolo Emilio

    2017-07-24

    Left ventricle and left atrium are and have been practically always analyzed separately in common clinically and non-clinically oriented cardiovascular investigations. Both classic and speckle tracking echocardiographic data contributed to the knowledge about deformational impairments occurring in systo-diastolic differences. Recently new trajectory based approaches allowed a greater awareness about the entire left ventricle or left atrium revolution and on their deficiencies that take place in presence of hypertrophic cardiomyopathy. However, surprisingly, the concomitant function of the two left heart chambers has not been analyzed for their geometrical/mechanical relationship. For the first time we study here, by acquiring left ventricle and left atrial geometries on the same heartbeat, the trajectory attributes of the entire left heart treated as a whole shape and the shape covariation of its two subunits. We contrasted healthy subjects with patients affected by hypertrophic cardiomyopathy. We found impaired left heart trajectory mainly in terms of orientation and size. More importantly, we found profound differences in the direction of morphological covariation of left ventricle and left atrium. These findings open to new perspectives in pathophysiological evaluation of different diseases by allowing the appreciation of concomitant functioning of both left heart whole geometry and of its two chambers.

  14. 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

  15. A Left-Sided Prevalence of Lentigo Maligna: A UK Based Observational Study and Review of the Evidence

    Directory of Open Access Journals (Sweden)

    Mark Gorman

    2015-01-01

    Full Text Available Skin cancer has been shown to present asymmetrically, prevalent on the left side of the body, more so in subtypes of cutaneous melanoma such as lentigo maligna. Biases have been linked to cumulative UV light exposure and automobile driving patterns. Though left-right ratios have previously correlated with the side men or women tend to position themselves or countries drive on, more recent trends indicate a consistent left-sided bias. To clarify reasons for changing trends, a review of the evidence base and LM’s laterality in a UK cohort (99 cases 2000–2011 was conducted for the first time. The strong correlation of left-sided excess, found in both genders (ratios 1.381–1.5, P<0.05  X2 0.841, is congruent with more recent findings. Though evidence indicates that driving position is no longer a risk factor for LM, due most likely to improved car window UV protection, it remains the most commonly attributed cause. Understanding phenomena such as UV lights “scatter effect” or that cumulative exposure may not be a significant risk factor helps rationalize older conclusions that would otherwise appear contradictory. The reasons for left-sided excess remain unclear but may be due to factors requiring further research such as the body’s anatomical/embryological asymmetry.

  16. Capturing interactions between nitrogen and hydrological cycles under historical climate and land use: Susquehanna watershed analysis with the GFDL land model LM3-TAN

    Science.gov (United States)

    Lee, M.; Malyshev, S.; Shevliakova, E.; Milly, Paul C. D.; Jaffé, P. R.

    2014-01-01

    We developed a process model LM3-TAN to assess the combined effects of direct human influences and climate change on terrestrial and aquatic nitrogen (TAN) cycling. The model was developed by expanding NOAA's Geophysical Fluid Dynamics Laboratory land model LM3V-N of coupled terrestrial carbon and nitrogen (C-N) cycling and including new N cycling processes and inputs such as a soil denitrification, point N sources to streams (i.e., sewage), and stream transport and microbial processes. Because the model integrates ecological, hydrological, and biogeochemical processes, it captures key controls of the transport and fate of N in the vegetation–soil–river system in a comprehensive and consistent framework which is responsive to climatic variations and land-use changes. We applied the model at 1/8° resolution for a study of the Susquehanna River Basin. We simulated with LM3-TAN stream dissolved organic-N, ammonium-N, and nitrate-N loads throughout the river network, and we evaluated the modeled loads for 1986–2005 using data from 16 monitoring stations as well as a reported budget for the entire basin. By accounting for interannual hydrologic variability, the model was able to capture interannual variations of stream N loadings. While the model was calibrated with the stream N loads only at the last downstream Susquehanna River Basin Commission station Marietta (40°02' N, 76°32' W), it captured the N loads well at multiple locations within the basin with different climate regimes, land-use types, and associated N sources and transformations in the sub-basins. Furthermore, the calculated and previously reported N budgets agreed well at the level of the whole Susquehanna watershed. Here we illustrate how point and non-point N sources contributing to the various ecosystems are stored, lost, and exported via the river. Local analysis of six sub-basins showed combined effects of land use and climate on soil denitrification rates, with the highest rates in the

  17. Development and Molecular Cytogenetic Identification of a Novel Wheat-Leymus mollis Lm#7Ns (7D Disomic Substitution Line with Stripe Rust Resistance.

    Directory of Open Access Journals (Sweden)

    Xiaofei Yang

    Full Text Available Leymus mollis (2n = 4x = 28, NsNsXmXm possesses novel and important genes for resistance against multi-fungal diseases. The development of new wheat-L. mollis introgression lines is of great significance for wheat disease resistance breeding. M11003-3-1-15-8, a novel disomic substitution line of common wheat cv. 7182 -L. mollis, developed and selected from the BC1F5 progeny between wheat cv. 7182 and octoploid Tritileymus M47 (2n = 8x = 56, AABBDDNsNs, was characterized by morphological and cytogenetic identification, analysis of functional molecular markers, genomic in situ hybridization (GISH, sequential fluorescence in situ hybridization (FISH-genomic in situ hybridization (GISH and disease resistance evaluation. Cytological observations suggested that M11003-3-1-15-8 contained 42 chromosomes and formed 21 bivalents at meiotic metaphase I. The GISH investigations showed that line contained 40 wheat chromosomes and a pair of L. mollis chromosomes. EST-STS multiple loci markers and PLUG (PCR-based Landmark Unique Gene markers confirmed that the introduced L. mollis chromosomes belonged to homoeologous group 7, it was designated as Lm#7Ns. While nulli-tetrasomic and sequential FISH-GISH analysis using the oligonucleotide Oligo-pSc119.2 and Oligo-pTa535 as probes revealed that the wheat 7D chromosomes were absent in M11003-3-1-15-8. Therefore, it was deduced that M11003-3-1-15-8 was a wheat-L. mollis Lm#7Ns (7D disomic substitution line. Field disease resistance demonstrated that the introduced L. mollis chromosomes Lm#7Ns were responsible for the stripe rust resistance at the adult stage. Moreover, M11003-3-1-15-8 had a superior numbers of florets. The novel disomic substitution line M11003-3-1-15-8, could be exploited as an important genetic material in wheat resistance breeding programs and genetic resources.

  18. In-hospital outcomes of a minimally invasive off-pump left thoracotomy approach using a centrifugal continuous-flow left ventricular assist device.

    Science.gov (United States)

    Sileshi, Bantayehu; Haglund, Nicholas A; Davis, Mary E; Tricarico, Nicole M; Stulak, John M; Khalpey, Zain; Danter, Matthew R; Deegan, Robert; Kennedy, Jason; Keebler, Mary E; Maltais, Simon

    2015-01-01

    Minimally invasive left thoracotomy (MILT) and off-pump implantation strategies have been anecdotally reported for implantation of the HeartWare ventricular assist device (HVAD). We analyzed our experience with off-pump MILT implantation techniques and compared early in-hospital outcomes with conventional on-pump sternotomy (CS) implantation strategy. Between January 2013 and February 2014, 51 patients underwent HVAD implantation and were included in this study. Thirty-three patients had CS, whereas 18 patients underwent off-pump MILT. To compare outcomes of these techniques, a multivariate analysis using propensity score modeling was performed after adjusting for age, INTERMACS, Kormos and Leitz-Miller (LM) scores. Mean age at implant was 57 (range 18 to 69) years, and overall in-hospital mortality was 8%. Univariate analysis revealed a statistically significant reduction in days on inotropes (p = 0.04), and a trend toward reduced intra-operative blood product administration (p = 0.08) in the MILT group. There was no difference in intensive-care-unit length of stay (p = 0.5), total length of stay (p = 0.76), post-operative blood product administration (p = 0.34) and total time on mechanical ventilation (p = 0.32). After adjusting for age, INTERMACS profile and Kormos and LM scores, no statistically significant differences were observed between the MILT and CS groups. An off-pump MILT implantation strategy can be utilized as a safe surgical approach for patients undergoing HVAD implantation. Further large collaborative studies are needed to identify advantages of the MILT approach. Published by Elsevier Inc.

  19. Diagnosing in building main pipelines

    Energy Technology Data Exchange (ETDEWEB)

    Telegin, L.G.; Gorelov, A.S.; Kurepin, B.N.; Orekhov, V.I.; Vasil' yev, G.G.; Yakovlev, Ye. I.

    1984-01-01

    General principles are examined for technical diagnosis in building main pipelines. A technique is presented for diagnosis during construction, as well as diagnosis of the technical state of the pipeline-construction machines and mechanisms. The survey materials could be used to set up construction of main pipelines.

  20. Main Propulsion Test Article (MPTA)

    Science.gov (United States)

    Snoddy, Cynthia

    2010-01-01

    Scope: The Main Propulsion Test Article integrated the main propulsion subsystem with the clustered Space Shuttle Main Engines, the External Tank and associated GSE. The test program consisted of cryogenic tanking tests and short- and long duration static firings including gimbaling and throttling. The test program was conducted on the S1-C test stand (Position B-2) at the National Space Technology Laboratories (NSTL)/Stennis Space Center. 3 tanking tests and 20 hot fire tests conducted between December 21 1 1977 and December 17, 1980 Configuration: The main propulsion test article consisted of the three space shuttle main engines, flightweight external tank, flightweight aft fuselage, interface section and a boilerplate mid/fwd fuselage truss structure.

  1. Towards a new vision of economic policy: Discussion around the new paradigm proposed by David Romer in “Keynesian macroeconomics without the LM curve”

    Directory of Open Access Journals (Sweden)

    Marco Leonardo Penagos Rozo

    2013-01-01

    Full Text Available New Keynesians (NK refer to an advanced posture compared to the traditional paradigm of the IS-LM equilibrium, which, as a tool, satisfied economic policy explanations for the moment. The model had critics like be considered not to have microeconomic foundations, among others. Perhaps at the times presented: Keynes, in 1936, with the General Theory, Hicks, in 1937, with Mr. Keynes and the classics; Samuelson in 1948 and subsequent years, with his work Economy, it provided important elements in the balance. However, a new approach was needed for the Twenty-First Century, and it is the one proposed by David Romer. The purpose of this article is to make an initial review for understanding how some aspects of economic policy are linked as elements of economic growth.

  2. 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…

  3. 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…

  4. Experimental investigation of the impulse gas injection into liquid and the use of experimental data for verification of the HYDRA-IBRAE/LM thermohydraulic code

    Science.gov (United States)

    Lobanov, P. D.; Usov, E. V.; Butov, A. A.; Pribaturin, N. A.; Mosunova, N. A.; Strizhov, V. F.; Chukhno, V. I.; Kutlimetov, A. E.

    2017-10-01

    Experiments with impulse gas injection into model coolants, such as water or the Rose alloy, performed at the Novosibirsk Branch of the Nuclear Safety Institute, Russian Academy of Sciences, are described. The test facility and the experimental conditions are presented in details. The dependence of coolant pressure on the injected gas flow and the time of injection was determined. The purpose of these experiments was to verify the physical models of thermohydraulic codes for calculation of the processes that could occur during the rupture of tubes of a steam generator with heavy liquid metal coolant or during fuel rod failure in water-cooled reactors. The experimental results were used for verification of the HYDRA-IBRAE/LM system thermohydraulic code developed at the Nuclear Safety Institute, Russian Academy of Sciences. The models of gas bubble transportation in a vertical channel that are used in the code are described in detail. A two-phase flow pattern diagram and correlations for prediction of friction of bubbles and slugs as they float up in a vertical channel and of two-phase flow friction factor are presented. Based on the results of simulation of these experiments using the HYDRA-IBRAE/LM code, the arithmetic mean error in predicted pressures was calculated, and the predictions were analyzed considering the uncertainty in the input data, geometry of the test facility, and the error of the empirical correlation. The analysis revealed major factors having a considerable effect on the predictions. The recommendations are given on updating of the experimental results and improvement of the models used in the thermohydraulic code.

  5. Pattern of left ventricular geometry in hypertension: a study of a ...

    African Journals Online (AJOL)

    Background: Hypertension is a leading cause of cardioxasular morbidity and mortality in Nigeria. The main aim of this study was to deterine the prevalence of left ventricular hypertrophy and left ventricular geometric patterns among hypertensives in Kano, Nigeria. Methods: The study was cross-sectional in design, and ...

  6. Flavoured Dark Matter moving left

    Science.gov (United States)

    Blanke, Monika; Das, Satrajit; Kast, Simon

    2018-02-01

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

  7. TYPES OF SURGICAL TREATMENT FOR POSTINFARCTION LEFT VENTRICULAR ANEURYSMS

    Directory of Open Access Journals (Sweden)

    A. V. Pavlov

    2015-01-01

    Full Text Available Surgical treatment of postinfarction left ventricular aneurysms in ischemic heart disease patients allows for a significant improvement of outcomes and clinical endpoints, an increase in quality of life and survival. The article deals with historical periods in surgical treatment of left ventricular aneurysms and chronologically describes the history of methods for reconstruction of the left ventricle.Despite the fact that within the last 50 years, mainly due to improvements in surgical techniques, in-hospital mortality decreased two-fold, it still remains high. The choice of technique for any kind of ventricular reparation depends on localization of the lesion that defines which sites of left ventricular asynergia should be repaired and how its form should be restored. At present, it is not possible to reliably assess benefits of any type of reparative surgery over another. Risk factors of inhospital mortality are: age, incomplete myocardial revascularization, high grade heart failure, female gender, immediate surgery, ejection fraction below 30%. To improve clinical outcomes one should strive to approximate to the physiological form of the left ventricle, to minimize negative influence of surgery on myocardial contractility.

  8. Main: FEB3 [TP Atlas

    Lifescience Database Archive (English)

    Full Text Available nt to sterilization and rinsing - One of the main components of biofilms is polysaccharides - Some pit-formi...ng bacteria such as Sphingomonas species A1 possess superchannels that directly incorporate and decompose polysaccharides - Detai...e entrance of the superchannel have been elucidated - We have obtained the crystals of ABC importer complexe...of water pipes and dental plaque are examples of biofilms. One of the main components of biofilms is polysac

  9. 75 FR 27863 - Savings Bank of Maine, MHC and Savings Bank of Maine, Gardiner, Maine; Approval of Conversion...

    Science.gov (United States)

    2010-05-18

    ...] Savings Bank of Maine, MHC and Savings Bank of Maine, Gardiner, Maine; Approval of Conversion Application... Savings Bank of Maine, MHC and Savings Bank of Maine, Gardiner, Maine, to convert to the stock form of...

  10. Residential Energy Efficiency Potential: Maine

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, Eric J [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2017-11-02

    Energy used by Maine single-family homes that can be saved through cost-effective improvements. Prepared by Eric Wilson and Noel Merket, NREL, and Erin Boyd, U.S. Department of Energy Office of Energy Policy and Systems Analysis.

  11. Evaluating Research Excellence : Main Debates

    International Development Research Centre (IDRC) Digital Library (Canada)

    Corey Piccioni

    main criticisms that prompted its replacement with the REF (Bridges, 2009).4. Metrics. Metrics have gained a degree of popularity in research evaluation because they are perceived to be cheaper, less burdensome, and more transparent and objective than peer review process- es (Wooding & Grant, 2003). However, even ...

  12. The four main LHC experiments

    CERN Multimedia

    AC Team

    1999-01-01

    This diagram shows the locations of the four main experiments (ALICE, ATLAS, CMS and LHCb) that will take place at the LHC. Located between 50 m and 150 m underground, huge caverns have been excavated to house the giant detectors. The SPS, the final link in the pre-acceleration chain, and its connection tunnels to the LHC are also shown.

  13. Main Elements for Upscaling Recreation

    DEFF Research Database (Denmark)

    Zandersen, Marianne; Termansen, Mette

    2012-01-01

    This report provides information on the main elements used to scale up modelled local visitor flow data to regional level based on recreational de-mand models. These models are described in Report #1. This report also provides information on data sources such as spatial data (e.g. land cov...

  14. Main: FBB2 [TP Atlas

    Lifescience Database Archive (English)

    Full Text Available ion of the c-ring - A subunit packing model of E. coli c-ring has been proposed - The main chain secondary s...tructure of thermophile c-ring has been obtained ATP synthase is a general term for an enzyme that can synth

  15. Main: FEA5 [TP Atlas

    Lifescience Database Archive (English)

    Full Text Available al or an anti-cancer drug, is the main cause of hospital-acquired infection - Dru...e will elucidate the entire structure of the transport machinery in action to understand its functions in detail. FEA5.csml ...

  16. Compression syndrome of the left renal vein

    Energy Technology Data Exchange (ETDEWEB)

    Justich, E.

    1982-04-01

    Severe compression of the left renal vein produces a pressure gradient between it and the inferior vena cava and results in changes in haemodynamics. The cause of the narrowing is usually the aorta, less commonly the superior mesenteric artery. Compression of the left renal vein may be responsible for a number of abnormalities such as primary varicoceles, primary varices of the ovarian, renal, pelvic and ureteric veins on the left, the more frequent occurrence of unilateral renal vein thrombosis on the left and the development of renovascular hypertension. One hundred and twenty-three selective phlebograms of the left renal vein and CT examinations of this structure in a further 87 patients acting as a control group were carried out. The significance of compression of the left renal vein as an aetiological factor in the development of the above mentioned abnormalities is discussed.

  17. Multiplicativity of left centralizers forcing additivity

    Directory of Open Access Journals (Sweden)

    Mohammad Sayed Tammam El-Sayiad

    2014-01-01

    Full Text Available A multiplicative left centralizer for an associative ring R is a map satisfying T(xy = T\\(xy for all x,y in R. T is not assumed to be additive. In this paper we deal with the additivity of the multiplicative left centralizers in a ring which contains an idempotent element. Specially, we study additivity for multiplicative left centralizers in prime and semiprime rings which contain an idempotent element.

  18. 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.

  19. 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...... 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...

  20. A Main Sequence for Quasars

    Directory of Open Access Journals (Sweden)

    Paola Marziani

    2018-03-01

    Full Text Available The last 25 years saw a major step forward in the analysis of optical and UV spectroscopic data of large quasar samples. Multivariate statistical approaches have led to the definition of systematic trends in observational properties that are the basis of physical and dynamical modeling of quasar structure. We discuss the empirical correlates of the so-called “main sequence” associated with the quasar Eigenvector 1, its governing physical parameters and several implications on our view of the quasar structure, as well as some luminosity effects associated with the virialized component of the line emitting regions. We also briefly discuss quasars in a segment of the main sequence that includes the strongest FeII emitters. These sources show a small dispersion around a well-defined Eddington ratio value, a property which makes them potential Eddington standard candles.

  1. The role of Main Institutions

    DEFF Research Database (Denmark)

    Persson, H Thomas R; Chabanet, Didier; Rakar, Fredrik

    2017-01-01

    of the different chapters of the book are addressed in more detail in the academic papers, reports and publications available on the project website www.fp7-efeseiis.eu. Each chapter of the book briefly tackles one of the main subjects addressed during the research, as follows: - The first chapter presents......), in many countries the need emerged to understand the best methods to promote their establishment and continued success. In order to understand these issues, to contribute to the academic debate on SEs and to give useful policy advice on a truly enabling ecosystem, in November 2013 a consortium of 11...... organisations started an ambitious three-year research project covering 10 countries: Albania, Austria, Denmark, England, France, Germany, Italy, Poland, Serbia, Scotland and The Netherlands. The EFESEIIS research project had four main objectives: to identify the features of an “Enabling Eco-System for Social...

  2. ONKALO - Main drawings in 2007

    International Nuclear Information System (INIS)

    2008-05-01

    The first overall site characterisation programme for a Finnish repository of spent nuclear fuel was introduced in 1982. This programme already suggested that the site confirmation for a detailed repository design and safety assessment should include characterisation performed in an underground rock characterisation facility (URCF). This idea was confirmed during the detailed site characterisation. International views have also emphasised the importance of underground characterisation before the final decision to construct the repository is taken. The underground rock characterisation facility (ONKALO) is excavated at Olkiluoto in the municipality of Eurajoki. ONKALO should be constructed to allow characterisation work for site confirmation without jeopardising long-term safety of the repository site. It should also be possible to link ONKALO later to the repository as to a part of it. The construction of ONKALO was started in 2004 and will be completed in 2014. The characterisation work has started in ONKALO and will focus on the disposal depth. In the main drawings stage, ONKALO was described at the level of detail needed for a construction permit in 2003. This meant description of the location, final structures and final systems. This summary report describes the development of design to updated main drawings in 2007 at the same level of detail (no temporary arrangements are described). The main changes are the added exhaust air shaft and advancing the controlled area's inlet air shaft to the ONKALO phase. Also the layout and the depth of the characterisation levels have been updated according to the current bedrock information. Some buildings on the surface will house sets of equipment directly connected with underground facility and this equipment is described in this report. No buildings or other equipment are described in this report, because they are not directly connected with the underground facility. The main element of ONKALO is a system of

  3. At ISR Main Control Room

    CERN Multimedia

    1983-01-01

    After 13 years the exploitation of the Intersecting Storage Rings as a beam-beam collider went to an end. In this last year the demands were very exacting, both in terms of operating time and diversified running conditions (Annual Report 1983 p. 123). Before dismantelement the photographer made a last tour, see photos 8310889X --> 8310667X. This photo shows the Main Control Room.

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

    DEFF Research Database (Denmark)

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

    2008-01-01

    In hypertensive patients without prevalent cardiovascular disease, enhanced left atrial systolic force is associated with left ventricular hypertrophy and increased preload. It also predicts cardiovascular events in a population with high prevalence of obesity. Relations between left atrial...... with larger left ventricular diameter and higher left ventricular mass index (both P hypertrophy was greater (84 vs. 64%; P ..., transmitral peak E velocities and peak A velocities; and lower E/A ratio (all P hypertrophy, but normal left ventricular chamber systolic function with increased...

  5. The GFDL global atmosphere and land model AM4.0/LM4.0: 1. Simulation characteristics with prescribed SSTs

    Science.gov (United States)

    Zhao, M.; Golaz, J.-C.; Held, I. M.; Guo, H.; Balaji, V.; Benson, R.; Chen, J.-H.; Chen, X.; Donner, L. J.; Dunne, J. P.; Dunne, Krista A.; Durachta, J.; Fan, S.-M.; Freidenreich, S. M.; Garner, S. T.; Ginoux, P.; Harris, L. M.; Horowitz, L. W.; Krasting, J. P.; Langenhorst, A. R.; Liang, Z.; Lin, P.; Lin, S.-J.; Malyshev, S. L.; Mason, E.; Milly, Paul C.D.; Ming, Y.; Naik, V.; Paulot, F.; Paynter, D.; Phillipps, P.; Radhakrishnan, A.; Ramaswamy, V.; Robinson, T.; Schwarzkopf, D.; Seman, C. J.; Shevliakova, E.; Shen, Z.; Shin, H.; Silvers, L.; Wilson, J. R.; Winton, M.; Wittenberg, A. T.; Wyman, B.; Xiang, B.

    2018-01-01

    In this two‐part paper, a description is provided of a version of the AM4.0/LM4.0 atmosphere/land model that will serve as a base for a new set of climate and Earth system models (CM4 and ESM4) under development at NOAA's Geophysical Fluid Dynamics Laboratory (GFDL). This version, with roughly 100 km horizontal resolution and 33 levels in the vertical, contains an aerosol model that generates aerosol fields from emissions and a “light” chemistry mechanism designed to support the aerosol model but with prescribed ozone. In Part 1, the quality of the simulation in AMIP (Atmospheric Model Intercomparison Project) mode—with prescribed sea surface temperatures (SSTs) and sea‐ice distribution—is described and compared with previous GFDL models and with the CMIP5 archive of AMIP simulations. The model's Cess sensitivity (response in the top‐of‐atmosphere radiative flux to uniform warming of SSTs) and effective radiative forcing are also presented. In Part 2, the model formulation is described more fully and key sensitivities to aspects of the model formulation are discussed, along with the approach to model tuning.

  6. The GFDL global atmosphere and land model AM4.0/LM4.0: 2. Model description, sensitivity studies, and tuning strategies

    Science.gov (United States)

    Zhao, M.; Golaz, J.-C.; Held, I. M.; Guo, H.; Balaji, V.; Benson, R.; Chen, J.-H.; Chen, X.; Donner, L. J.; Dunne, J. P.; Dunne, Krista A.; Durachta, J.; Fan, S.-M.; Freidenreich, S. M.; Garner, S. T.; Ginoux, P.; Harris, L. M.; Horowitz, L. W.; Krasting, J. P.; Langenhorst, A. R.; Liang, Z.; Lin, P.; Lin, S.-J.; Malyshev, S. L.; Mason, E.; Milly, Paul C.D.; Ming, Y.; Naik, V.; Paulot, F.; Paynter, D.; Phillipps, P.; Radhakrishnan, A.; Ramaswamy, V.; Robinson, T.; Schwarzkopf, D.; Seman, C. J.; Shevliakova, E.; Shen, Z.; Shin, H.; Silvers, L.; Wilson, J. R.; Winton, M.; Wittenberg, A. T.; Wyman, B.; Xiang, B.

    2018-01-01

    In Part 2 of this two‐part paper, documentation is provided of key aspects of a version of the AM4.0/LM4.0 atmosphere/land model that will serve as a base for a new set of climate and Earth system models (CM4 and ESM4) under development at NOAA's Geophysical Fluid Dynamics Laboratory (GFDL). The quality of the simulation in AMIP (Atmospheric Model Intercomparison Project) mode has been provided in Part 1. Part 2 provides documentation of key components and some sensitivities to choices of model formulation and values of parameters, highlighting the convection parameterization and orographic gravity wave drag. The approach taken to tune the model's clouds to observations is a particular focal point. Care is taken to describe the extent to which aerosol effective forcing and Cess sensitivity have been tuned through the model development process, both of which are relevant to the ability of the model to simulate the evolution of temperatures over the last century when coupled to an ocean model.

  7. Assessment of the influence of Al–2Nb–2B master alloy on the grain refinement and properties of LM6 (A413) alloy

    Energy Technology Data Exchange (ETDEWEB)

    Bolzoni, L., E-mail: leandro.bolzoni@brunel.ac.uk; Nowak, M.; Hari Babu, N.

    2015-03-25

    Cast aluminium alloys are important structural materials but their performances are not optimised due to the lack of appropriate grain refiners. In this study, the effect of the addition of a novel Nb-based grain refiner on the microstructural features and mechanical behaviour of the LM6 alloy (A413) is studied. Specifically, the effect of Nb–B inoculation is assessed over a great range of cooling rates (2–100 °C/s). It is found that Nb-based compounds (i.e., NbB{sub 2} and Al{sub 3}Nb) are potent heterogeneous nucleation sites for aluminium and this leads to a significant refinement of the microstructural features. The refinement is not hindered by the formation of silicides, as it happens when using Al–Ti–B master alloys, because niobium silicides form at much higher temperature. It is concluded that the Al–2Nb–2B master alloy is a very effective refiner especially at slow cooling rate and the refinement of the grain size leads to improved performances (homogeneous fine grain structure, mechanical properties and porosity)

  8. Yağı Azaltılmış Et Ürünleri Üretim Tekniği

    Directory of Open Access Journals (Sweden)

    Meltem Serdaroğlu

    2015-02-01

    Full Text Available Son yıllarda tüketiciler diyetlerinde yağ ve kalori alımını sınırlamak amacıyla yağsız veya yağı azaltılmış gıdalara yönelmektedirler. Az yağlı et ürünlerinin üretiminde yağın azaltılması çeşitli teknolojik problemlere yol açarak ürünün kabul edilebilirliğini azaltmaktadır. Yağı azaltılan et ürünlerinde formülasyonda çeşitli katkıların kullanımı duyusal özelliklerin tüketici tercihi doğrultusunda iyileştirilmesini sağlamaktadır. Yapılan çalışmada et ürünlerinde yağın azaltılması ile ortaya çıkan problemler ve çeşitli katkıların kullanımı literatüre dayanılarak incelenmiştir.

  9. The Left Periphery and Agrammatism

    DEFF Research Database (Denmark)

    Nyvad, Anne Mette; Christensen, Ken Ramshøj; Vikner, Sten

    2014-01-01

    are required, namely, A-movement (impaired) vs. A-bar-movement (not impaired), main clause CP vs. embedded clause CP (impaired), and subject vs. object. In simple clauses, object extraction is most impaired, whereas in embedded clauses, the pattern is reversed. Together these distinctions provide an account......Data from a study on the comprehension of short and long extractions by four Danish agrammatic patients reveal an interesting asymmetry between subject and object extraction that cannot be explained with canonicity or with trace deletion. It is argued that three crucial linguistic distinctions...

  10. Space Shuttle Main Propulsion System

    Science.gov (United States)

    Wood, C. C.

    1976-01-01

    The Space Shuttle Main Propulsion System provides the impulse to transfer the reusable Orbiter of the Space Shuttle Transportation system and its payload from earth to earth orbit. Both cryogenic and solid rocket propulsion systems are utilized. The selected systems are characterized by (1) reusability wherever possible to reduce program cost, (2) design pressures, and other important design parameters, for the liquid propellant engine significantly higher than past programs for increased performance, and (3) advanced materials and manufacturing processes to withstand the extreme environments. The approaches for solution of these varied problems are emphasized.

  11. 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...

  12. Malignant phyllodes tumor of the left atrium

    Directory of Open Access Journals (Sweden)

    Anupam Bhambhani

    2014-03-01

    Full Text Available Metastatic tumors to the heart usually involve right sided chambers. We report a rare case of malignant phyllodes tumor of breast with metastatic involvement of left atrium occurring through direct invasion from mediastinal micro-metastasis and presenting as a left atrial mass causing arrhythmia.

  13. Left ventricular hypertrophy, geometric patterns and clinical ...

    African Journals Online (AJOL)

    Background: Left ventricular hypertrophy can be due to various reasons including hypertension. It constitutes an increased cardiovascular risk. Various left ventricular geometric patterns occur in hypertension and may affect the cardiovascular risk profile of hypertensive subjects. Methods: One hundred and eighty eight ...

  14. Leptogenesis with left-right domain walls

    Indian Academy of Sciences (India)

    the scale of left-right symmetry breaking. Keywords. Leptogenesis; baryogenesis; domain walls; left-right symmetry. PACS Nos 12.10.Dm; 98.80.Cq; 98.80.Ft. Explaining the observed baryon asymmetry of the Universe within the framework of gauge theories and the standard Big Bang cosmology remains an open problem.

  15. On establishing coreference in Left Dislocation constructions ...

    African Journals Online (AJOL)

    The phenomenon of left dislocation (LD) has received relatively little attention in the generative literature. In Government & Binding theory and early versions of Minimalist Syntax, the left-dislocated expression is conventionally taken to be base-generated in its sentence-initial surface position and the resumptive pronoun in ...

  16. A new clinical sign probably associated to left hemiplegia with left hemineglect syndrome: the crossed legs.

    Science.gov (United States)

    Bazan, Rodrigo; Fernandes, Thiago; Braga, Gabriel; Luvizutto, Gustavo; Resende, Luiz

    2014-06-01

    To describe a new clinical sign associated with left unilateral neglect syndrome (UNS) in patients with ischemic stroke. Head computed tomography (CT) and National Institute of Health Stroke Scale were obtained in 150 patients with ischemic stroke. Those with right cerebral vascular lesions, left hemiplegia and right leg persistently crossed over the left were submitted to specific tests for UNS. The tests were also applied to 30 patients with right cerebral vascular lesions, left hemiplegia but without crossed legs. From 9 patients with persistent tendency to cross the right leg over the left, UNS was detected in 8. One patient died before the clinical tests were applied. Of the 30 patients without the crossed legs, 20 had normal clinical tests for UNS and 10 had minimal alterations, not sufficient for the diagnosis of UNS. The right leg crossed over the left may represent a new neurological semiotic sign associated with left hemiplegia and left UNS.

  17. 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

  18. Main ring transition crossing simulations

    International Nuclear Information System (INIS)

    Kourbanis, I.; Ng, King-Yuen.

    1990-10-01

    We used ESME to simulate transition crossing in the Main Ring (MR). For the simulations, we followed the MR 29 cycle used currently for bar p production with a flat top of 120 GeV. In Sect. II, some inputs are discussed. In Sect. III, we present simulations with space charge turned off so that the effect of nonlinearity can be studied independently. When space charge is turned on in Sect. IV, we are faced with the problem of statistical errors due to binning, an analysis of which is given in the Appendices. Finally in Sects. V and VI, the results of simulations with space charge are presented and compared with the experimental measurements. 7 refs., 6 figs

  19. Improvement of main control room

    International Nuclear Information System (INIS)

    Chae, Sung Ki; Ham, Chang Sik; Kwon, Ki Chun

    1991-07-01

    Information display system, advanced alarm system and fiber optical communication system were developed to improve the main control room in nuclear power plant. Establishing the new hierachical information structure of plant operation data, plant overview status board(POSB) and digital indicator(DI) were designed and manufactured. The prototype advanced alarm system which employed the new alarm logics and algorithm compared with the conventional alarm system were developed and its effectiveness was proved. Optical communication system which has multi-drop feature and capability of upgrading to large-scale system by using BITBUS communication protocol which is proven technology, were developed. Reliability of that system was enhanced by using distributed control. (Author)

  20. Special Edition: Left Realism Today - Guest Editor’s Introduction

    Directory of Open Access Journals (Sweden)

    Walter DeKeseredy

    2016-09-01

    Full Text Available Since its birth in the mid-1980s, as a major variant of critical criminology, Left Realism continues to ebb and flow. Furthermore, not all Left realist contributions are alike and some are subject to very heated debates. The fact remains, however, that Left Realism is ‘alive and well’. Of course, given that I devoted 26 years of my life (much of it with Martin D Schwartz to the realist project, I could easily be accused of being biased. Nonetheless, some contemporary empirical support for my claim is the recent publication of Roger Matthews’ (2014 book Realist Criminology. The main objective of this volume is to use this offering as a ‘launching pad’ or ‘springboard’ for broader analyses of the relevance of Left Realism to critical criminology as we know it today. Matthews’ piece is the lead article. Following this are six others that, in part, address his monograph and that also point us to new directions in Left realist ways of knowing. In keeping with the spirit of the International Journal of Crime, Justice and Social Democracy, the authors constitute an international cadre of progressive scholars, including me, Joseph Donnermeyer, Steve Hall, Russell Hogg, John Lea, Claire Renzetti, and Simon Winlow. It cannot be emphasized enough, though, that this special issue is not a ‘love-in’ and there is no ‘party line’ here. All of the authors have strong positions on topics of major concern to academics and activists seeking new ways of thinking critically about crime, law and social control.

  1. Social aspects of left-handedness

    Directory of Open Access Journals (Sweden)

    Belojević Goran

    2010-01-01

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

  2. Multicultural Societies: Kálmán Mikszáth, Pál Závada and Péter Huncik

    Directory of Open Access Journals (Sweden)

    Enikő Molnár Basa

    2012-01-01

    Full Text Available Three Hungarian works, one from the 19th century and two contemporary novels, reflect changing attitudes to ethnicity and nationality questions within Hungary, including the area that became part of Czechoslovakia after World War I. Kálmán Mikszáth’s Tót Atyafiak shows a society in which the various nationalities of Upper Hungary live in harmony. Ethnic problems seem not to be present. Pál Závada’s Jadviga Párnája presents a more complex picture: while the protagonists seem free of nationalistic sentiments, they are conscious of their Slovak roots, their customs and language. A majority in the city and community which forms the backdrop to the story, they are a minority in the larger region of the Hungarian Plain. However, different customs and language are not perceived as setting themselves off from other Hungarians. Outside forces and prejudices do intrude since key sections of the story occur during World War I and its aftermath. The third novel, Péter Hunčik’s Határeset examines the fate of the population of Ipolyság, a town in what is now southern Slovakia. This is an area which still has a large Hungarian population; many families nevertheless have a background that includes Slovak and other nationalities. With the border changes of 1920, 1938 and 1945 lives are disrupted. Communism further complicates the tensions and absurdities fueled by outside forces. The works are testimonies to tolerance because the protagonists most affected are open to other ethnicities, other nationalities.

  3. Gömülmüs Atom Potansiyeli Kullanarak CuNi Alasımının Moleküler Dinamik Simulasyonu

    Directory of Open Access Journals (Sweden)

    Eşe Ergün AKPINAR

    2009-04-01

    Full Text Available Bu çalısmada, CuNi alasımının moleküler dinamik simulasyonu, Sutton-Chen (SC potansiyeli kullanılarak incelendi. Bu potansiyel Cu, Ni ve CuNi in deneysel bilgilerinin fonksiyon parametrelerine fit edilmesiyle elde edildi. CuNi alasımının kristalizasyon sürecini atomik olarak tanımlamak için, gömülmüs atom yöntemini esas alan sabit basınç, sabit sıcaklık (NPT moleküler dinamik simulasyonu uygulandı. Sıvı fazda iken 4x1011 K/s sogutma hızında sogutulan CuNi alasımının yapısı ve kristallesme olusum yetenegi radyal dagılım fonksiyonuyla incelendi. Simulasyon, üç temel dogrultu boyunca periyodik sınır sartlarını saglayan kübik bir hücrede 1024 atom içeren sistemle gerçeklestirildi. Hareket denklemleri Verlet algoritması kullanılarak sayısal olarak çözüldü. Sogutma deneyi için sıvı hal baslangıcı, katının sıvı sıcaklıgına ısıtılmasıyla elde edildi. Sistem 1300-1550K sıvılasma bölgesi üzerindeki sıcaklıkta eritildi ve homojenize edildi ve hızla oda sıcaklıgına sogutuldu.

  4. 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...... complex >150 ms, QRS complex narrowing under CRT, and sinus rhythm were included ≥3 months after CRT implantation. Echocardiographic assessment of left ventricular ejection fraction (LVEF), global peak systolic longitudinal strain (GLS), and contraction pattern by 2D strain was performed during intrinsic......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....

  5. [Vectorcardiographic manifestations of left intraventricular conduction disorders].

    Science.gov (United States)

    de Micheli, A; Medrano, G A

    1979-01-01

    Both, the vectorcardiographic changes produced by the various degrees of left bundle branch block and these observed with the different types of left distal block, are described. When a "wave jumping" phenomenon exists, the vectorcardiographic changes are more characteristic in the horizontal plane than in the frontal plane and can be interpreted satisfactorily in basis of the ventricular activation sequence. The normal counterclockwise rotation of the horizontal vectorcardiogram persists in the presence of left bundle branch block of slight and moderate degrees, since the electromotive forces of the free left ventricular wall are still predominant. In the majority of intermediate degree blocks, the middle portion of the RH loop develops with a clockwise rotation and general aspect with a clockwise rotation and the general aspect of the ventricular loop resembles an eight figure. This is due to the electromotive forces originated by the delayed depolarization of the left septal mass that starts to predominate. With advanced degrees of block, the largest portion of the RH loop shows a clockwise rotation, as well as marked notchings and slurrings. The initial anterior portion of the horizontal vectorcardiogram does not disappear, but is situated to the left of the anterior-posterior axis with a counterclockwise rotation (first right septal vector). Otherwise, the direct electrical sign of left distal block emphasized: evidence of delayed activation in a limited zone of the homolateral ventricle. This local delay gives rise to an asynchronism of the activation phenomenon between the upper and lower regions of the ventricle. The diagnosis of left bifascicular block is based essentially on the evidence of unequal delay of the activation sequence in the basal regions and in the inferior ones of the homolateral ventricle and also on the frequent persistence of the first left septal vector.

  6. Main technical topics in 1999

    International Nuclear Information System (INIS)

    2000-01-01

    This Safety Authority annual report strives to present current organizational provisions and future trends in nuclear safety supervision in France and to describe the most outstanding occurrences during the past year. A first part presents nine documents concerning the main topics of 1999: aging of nuclear installations, the Offsite Emergency Plans (PPI), the impact of nuclear activities on man and the environment, the criticality hazards, EDF in 1999, the EPR project, the Andra in 1999, the transport incidents, the nuclear safety in eastern Europe. The second part presents the missions and actions of the Nuclear Installations Safety in the domains of the liabilities, the organization of the nuclear safety control, the regulations of the INB, the public information, the international relations, the crisis management, the radioactive materials transportation, the radioactive wastes. The equipment, the radiation protection and the exploitation of the pressurized water reactors are also treated just as the experimental reactors, the fuel cycle installations and the the nuclear installations dismantling. (A.L.B.)

  7. Main challenges of residential areas

    Directory of Open Access Journals (Sweden)

    Oana Luca

    2017-06-01

    Full Text Available The present article is a position paper aiming to initiate a professional debate related to the aspects related to the urban dysfunctions leading to the wear of the residential areas. The paper proposes a definition of the wear process, identify the main causes leading to its occurrence and propose a number of solutions to neutralise the dysfunctions. The three wearing phases of residential areas components are emphasized, exploring their lifecycle. In order to perform the study of urban wear, the status of the residential areas components can be established and monitored, and also the variables of the function that can mathematically model the specific wear process may be considered. The paper is considered a first step for the model adjustment, to be tested and validated in the following steps. Based on the mathematical method and model, there can be created, in a potential future research, the possibility of determining the precarity degree for residential areas/neighbourhoods and cities, by minimising the subjective component of the analyses preceding the decision for renovation or regeneration.

  8. Research in auditing: main themes

    Directory of Open Access Journals (Sweden)

    Marcelo Porte

    Full Text Available ABSTRACT The passage of the Sarbanes-Oxley Act (SOX was a turning point in auditing and in auditors practice for the academic world. Research concerning the characterization of academic production related to auditing is in its third decade. Its analysis is accomplished by means of definition of keywords, abstracts or title, and information on thematic association within the academic production itself in auditing is undisclosed. In order to revise this gap in auditing literature, this study identified the main themes in auditing and their association in post-SOX era by analyzing the content of objectives and hypothesis of 1,650 publications in Web of Science (2002-2014. The findings in this study extended those from the study by Lesage and Wechtler (2012 from 16 auditing thematic typologies to 22. The results demonstrate that the themes audit report & financial statement users, corporate governance, audit market, external audit, socio-economic data of the company, international regulation, and fraud risk & audit risk were the most addressed in the publications about auditing. Corporate governance has a broader association with the other themes in the area. Future researches may use these themes and relate them to the methodologies applied to audit studies.

  9. Main injector synchronous timing system

    International Nuclear Information System (INIS)

    Blokland, W.; Steimel, J.

    1998-01-01

    The Synchronous Timing System is designed to provide sub-nanosecond timing to instrumentation during the acceleration of particles in the Main Injector. Increased energy of the beam particles leads to a small but significant increase in speed, reducing the time it takes to complete a full turn of the ring by 61 nanoseconds (or more than 3 rf buckets). In contrast, the reference signal, used to trigger instrumentation and transmitted over a cable, has a constant group delay. This difference leads to a phase slip during the ramp and prevents instrumentation such as dampers from properly operating without additional measures. The Synchronous Timing System corrects for this phase slip as well as signal propagation time changes due to temperature variations. A module at the LLRF system uses a 1.2 Gbit/s G-Link chip to transmit the rf clock and digital data (e.g. the current frequency) over a single mode fiber around the ring. Fiber optic couplers at service buildings split off part of this signal for a local module which reconstructs a synchronous beam reference signal. This paper describes the background, design and expected performance of the Synchronous Timing System. copyright 1998 American Institute of Physics

  10. Main injector synchronous timing system

    International Nuclear Information System (INIS)

    Blokland, Willem; Steimel, James

    1998-01-01

    The Synchronous Timing System is designed to provide sub-nanosecond timing to instrumentation during the acceleration of particles in the Main Injector. Increased energy of the beam particles leads to a small but significant increase in speed, reducing the time it takes to complete a full turn of the ring by 61 nanoseconds (or more than 3 rf buckets). In contrast, the reference signal, used to trigger instrumentation and transmitted over a cable, has a constant group delay. This difference leads to a phase slip during the ramp and prevents instrumentation such as dampers from properly operating without additional measures. The Synchronous Timing System corrects for this phase slip as well as signal propagation time changes due to temperature variations. A module at the LLRF system uses a 1.2 Gbit/s G-Link chip to transmit the rf clock and digital data (e.g. the current frequency) over a single mode fiber around the ring. Fiber optic couplers at service buildings split off part of this signal for a local module which reconstructs a synchronous beam reference signal. This paper describes the background, design and expected performance of the Synchronous Timing System

  11. Primary Left Cardiac Angiosarcoma with Mitral Valve Involvement Accompanying Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Cagdas Baran

    2015-01-01

    Full Text Available We report here on a 43-year-old female patient presenting with non-ST elevation myocardial infarction, severe mitral regurgitation, and mild mitral stenosis secondary to encroachment of the related structures by a primary cardiac angiosarcoma. A coronary angiography revealed significant stenosis in the left main and left circumflex arteries and at exploration, the tumour was arising from posterior left atrial free wall, invading the posterior mitral leaflet, and extending into all of the pulmonary veins and pericardium. Therefore, no further intervention was performed, except for left internal mammarian artery to left anterior descending artery anastomosis and biopsy. As far as we know, this case is unique with respect to its presentation.

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

    Directory of Open Access Journals (Sweden)

    L.F. Bogmat

    2016-08-01

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

  13. Beware the left-sided gallbladder

    African Journals Online (AJOL)

    %, and is defined as a gallbladder located to the left of the ligamentum teres and the falciform ligament.1 LSGB was first described by Hochstetter in 1886, and its identification is important because of the numerous and potentially hazardous.

  14. Introduction to left-right symmetric models

    International Nuclear Information System (INIS)

    Grimus, W.

    1993-01-01

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

  15. Electrocardiographic features suggestive of a left. ventricular ...

    African Journals Online (AJOL)

    Abstract. Electrocardiographic features suggestive of a transmural anterior myocardial infarction with resultant left ventricular aneurysm formation were found in a 22-year-old man who had sustained a ballistic missile injury to his chest.

  16. No Child Left Inside Week: Pilot Program

    OpenAIRE

    Clark, Jamie C.

    2013-01-01

    This program evaluation assessed the feasibility and effectiveness of a free No Child Left Inside (NCLI) week-long outdoor program to coincide with the Utah state-designated No Child Left Inside Week. The pilot program was implemented at the community level in Cache Valley, Utah, in 2012. Families attended eleven activities throughout the week that included hands-on experience and participation. A community BioBlitz was also planned as a conclusion to the week. Survey results demonstrate incr...

  17. Comparison of neurodegeneration between right and left hippocampus area in rats

    Directory of Open Access Journals (Sweden)

    Arezo Nahavandi

    2015-02-01

    Conclusion: Our study showed different manifestations of depression after UCMS. It showed that UCMS could lead to mental depression. This study showed that the right hippocampus was more sensitive to stress than the left hippocampus. In fact, UCMS resulted in depression. The study showed that the right hippocampus was more sensitive to stress than the left hippocampus. Therefore, the main function of the right hemisphere, which is adaptation to the new environment, is disturbed more.

  18. Drilling simulated temporal bones with left-handed tools: a left-hander's right?

    Science.gov (United States)

    Torgerson, Cory S; Brydges, Ryan; Chen, Joseph M; Dubrowski, Adam

    2007-11-01

    Left-handed trainees can be at a disadvantage in the surgical environment because of a right-handed bias. The effectiveness of teaching left-handed trainees to use an otologic drill designed for their dominant hand versus the conventional right-handed drill was examined. Novice medical students were recruited from the university community. Twenty-four subjects were left-handed, and 12 were right-handed. Eight left-handed surgeons also participated. A randomized controlled trial was conducted to compare the performance of left-handed trainees using novel left-handed drills to that of left-handed trainees using right-handed tools and to that of right-handed trainees using right-handed tools. The evaluation consisted of 3 phases: pretest, skill acquisition, and 2 post-tests. The measurement tools included expert assessment of performance, and subjective and objective final product analyses. An initial construct validity phase was conducted in which validity of the assessment tools was ensured. Both the left-handers using left-handed tools and the right-handers using right-handed tools significantly outperformed the left-handers using right-handed tools at pretest, immediate posttest, and delayed posttest. All participants improved their performance as a function of practice. The left-handed trainees learned bone drilling better with tools designed for the left hand. These tools may be incorporated into residency training programs for the development of surgical technical skills. Future studies should assess skill transfer between the left-handed and right-handed drills.

  19. Association between social capital and health-related quality of life among left behind and not left behind older people in rural China.

    Science.gov (United States)

    Zhong, Yaqin; Schön, Pär; Burström, Bo; Burström, Kristina

    2017-12-16

    The association between social capital and health-related quality of life (HRQoL) has not been thoroughly studied among older persons in rural China, especially among those who were left behind or not. This study investigates the association between social capital and HRQoL and examines possible differences of this association between being left behind or not in rural China. A cross-sectional survey of 825 people aged 60 years and older, residing in three rural counties in Jiangsu Province in China, was conducted in 2013. Factor analysis was performed to measure social capital. EQ-5D was used to measure HRQoL. Tobit regression analysis with upper censoring was conducted to explore the association between social capital and EQ-5D index. After controlling for individual characteristics, low social capital and being left behind were significantly associated with low HRQoL. Old people with low social capital had 0.055 lower EQ-5D index compared to those with high social capital. Old people being left behind had 0.040 lower EQ-5D index compared to those who were not left behind. For different dimensions of social capital, the main effects came from the domain of trust and reciprocity. There was a significant interaction between low social capital and being left behind on HRQoL, suggesting that low social capital was associated with low HRQoL among persons left behind. Our findings indicate that the left behind old people with low social capital were a potentially vulnerable group in rural China. Formulating and implementing initiatives and strategies which increase social capital may foster better HRQoL, especially for old people who were left behind.

  20. Book Review on: Patrick Barrett, Daniel Chavez and Cesar Rodriguez Garavito. The New Latin American Left. Utopia Reborn?

    NARCIS (Netherlands)

    R.A. Icaza Garza (Rosalba)

    2010-01-01

    textabstractBarret, Chavez and Rodriguez main task in The New Latin American Left. Utopia Reborn?, is that of identifying what are the factors that can explain the emergence of a new left in Latin America. The result is a nicely edited collection of expert voices on leftist politics in the region

  1. Comparison Between the Prognostic Value of Left Ventricular Function and Myocardial Perfusion Reserve in Patients with Ischemic Heart Disease

    NARCIS (Netherlands)

    Tio, Rene A.; Dabeshlim, Ali; Siebelink, Hans-Marc J.; de Sutter, Johan; Hillege, Hans L.; Zeebregts, Clark J.; Dierckx, Rudi A. J. O.; van Veldhuisen, Dirk J.; Zijlstra, Felix; Slart, Riemer H. J. A.

    The purpose of this study was to compare the prognostic value of left ventricular ejection fraction (LVEF) and myocardial perfusion reserve (MPR) assessed with PET in patients with ischemic heart disease (IHD). Myocardial perfusion is the main determinant of left ventricular function in patients

  2. Yapılandırılmış Okuma Yönteminin Okuma Hızı, Doğru Okuma ve Sesli Okuma Prozodisi Üzerindeki Etkisi

    Directory of Open Access Journals (Sweden)

    Hasan Keskin

    2014-10-01

    Full Text Available Bu çalışma ile yapılandırılmış okuma yönteminin, ilköğretim dördüncü sınıf öğrencilerinin, okuma hızı, doğru okuma ve prozodik okuma becerileri üzerindeki etkisinin araştırılması amaçlanmıştır. Araştırma için 2010-2011 öğretim yılı bahar döneminde Afyonkarahisar merkeze bağlı dört ilköğretim okulundan veri toplanmıştır. Bu okullar arasından basit tesadüfi yöntemle belirlenen bir okuldaki akıcı okuma becerisini yeterince kazanamamış dokuz öğrenci ile oluşturulan grupta 24 ders saati “yapılandırılmış okuma yöntemi” uygulanmıştır. Elde edilen bulgulara göre yapılandırılmış okuma yöntemi öğrencilerin okuma hızı, doğru okuma ve sesli okuma prozodisi becerileri üzerinde etkili olmuştur. Sonuç olarak, yapılandırılmış okuma yönteminin, akıcı okuma becerileri yönünden endişe düzeyinde olan öğrencilerin, bu becerilerini geliştirmede etkili olduğunu söylemek mümkündür.

  3. Pulmonary hypertension associated with left-sided heart disease.

    Science.gov (United States)

    Maeder, Micha Tobias; Schoch, Otto D; Kleiner, Rebekka; Joerg, Lucas; Weilenmann, Daniel; Swiss Society For Pulmonary Hypertension

    2017-01-19

    Pulmonary hypertension associated with left-sided heart disease (PH-LHD) is the most common type of pulmonary hypertension. In patients with left-sided heart disease, the presence of pulmonary hypertension is typically a marker of more advanced disease, more severe symptoms, and worse prognosis. In contrast to pulmonary arterial hypertension, PH-LHD is characterised by an elevated pulmonary artery wedge pressure (postcapillary pulmonary hypertension) without or with an additional precapillary component (isolated postcapillary versus combined postcapillary and precapillary pulmonary hypertension). Transthoracic echocardiography is the primary nonin-vasive imaging tool to estimate the probability of pulmonary hypertension and to establish a working diagnosis on the mechanism of pulmonary hyperten-sion. However, right heart catheterisation is always required if significant pulmonary hypertension is sus-pected and exact knowledge of the haemodynamic constellation is necessary. The haemodynamic con-stellation (mean pulmonary artery pressure, mean pulmonary artery wedge pressure, left ventricular end-diastolic pressure) in combination with clinical infor-mation and imaging findings (mainly echocardiog-raphy, coronary angiography and cardiac magnetic resonance imaging) will usually allow the exact mech-anism underlying PH-LHD to be defined, which is a prerequisite for appropriate treatment. The general principle for the management of PH-LHD is to treat the underlying left-sided heart disease in an optimal man-ner using drugs and/or interventional or surgical ther-apy. There is currently no established indication for pulmonary arterial hypertension-specific therapies in PH-LHD, and specific therapies may even cause harm in patients with PH-LHD.

  4. Left Right Patterning, Evolution and Cardiac Development

    Directory of Open Access Journals (Sweden)

    Iain M. Dykes

    2014-04-01

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

  5. Left behind radiological investigations: An inherent problem

    Directory of Open Access Journals (Sweden)

    Giridhar A Govindswamy

    2011-01-01

    Full Text Available Objectives: To assess the number of investigations left behind by patients in radiology department, their cost, and the possible methods of reducing the problem. Materials and Methods: A total of 1424 radiographs, 160 computed tomography (CT scans, 300 ultrasonography (USG reports, and 46 Doppler reports were left behind by patients in one financial year. The total cost of these left behind investigations was calculated and the reports were categorized into normal and abnormal for each modality. Results: Of the radiographs left behind 658 were abnormal, with 211 among these being radiographs of postoperative patients. Thirty-seven percent of CT scans had positive findings. Sixty-eight percent of USG reports had positive findings while 46% of Doppler reports were abnormal. Conclusion: We believe that the cost and number of these left behind investigations over a period of time would definitely be significant for the health care system in a developing country. It is time to think of the possible reasons and methods for containing this problem.

  6. Left atrial laceration with epicardial ligation device.

    Science.gov (United States)

    Keating, Vincent P; Kolibash, Christopher P; Khandheria, Bijoy K; Bajwa, Tanvir; Sra, Jasbir; Kress, David C

    2014-01-01

    Many new devices and techniques are being developed to attempt a reduction in embolic stroke risk for patients with atrial fibrillation who are either unable or unwilling to maintain long-term anticoagulation. One of these new devices (LARIAT®, SentreHEART Inc., Redwood City, California, USA) employs delivery of an epicardial suture to ligate the left atrial appendage after percutaneous pericardial and transseptal access. This series presents three clinical cases that demonstrate a serious and recurrent complication of left atrial laceration and cardiac tamponade shortly following delivery of an epicardial suture ligation to the left atrial appendage. Three clinical cases are described in detail with pre- and postprocedure angiography and echocardiography as well as illustrations reflecting the surgeon's findings on direct visualization of the left atrial lacerations postligation. Potential hypotheses of each injury are examined in light of the case timelines and findings at sternotomy. There was no suggestion that tamponade was related to pericardial or transseptal access, but rather a complication with device delivery. These three patients quickly progressed to clinical cardiac tamponade despite attempted drainage, stressing the importance of cardiovascular surgery backup, including a cardiopulmonary bypass pump, when delivering novel, percutaneous ligation devices for the left atrial appendage.

  7. ‘Colibacter massiliensis’ gen. nov., sp. nov., a new bacterial species isolated from human left colon

    Directory of Open Access Journals (Sweden)

    M. Mailhe

    2017-05-01

    Full Text Available We present here the main characteristics of the strain Marseille-P2911 (= CSUR P2911=DSMZ 103304, a bacterial species isolated from the left colon liquid sample of a 60-year-old man.

  8. 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.

  9. Main clause că ‘that’ in Romanian

    Directory of Open Access Journals (Sweden)

    Virginia Hill

    2010-01-01

    Full Text Available Romanian că ‘that’ is the Force head of subordinated clauses (Hill 2004. In this paper I point out that the complementizer că ‘that’ may occur in root (vs. subordinated declarative clauses as well, but only in certain environments, which I identify as being the speech act domain promoting the speaker’s point of view. I argue that in such contexts, main clause că ‘that’ marks the border between various pragmatic sub-fields derived at the left periphery (LP of clauses, rather than typing the clause, as it does in CP complements to V or N. In particular, main clause că ‘that’ draws the border between the injunction field and the Mood adverbial field (Cinque 1999, and between the latter and the discourse pragmatic field (ForceP-FinP.

  10. A Novel Tunable Triple-Band Left-Handed Metamaterial

    Directory of Open Access Journals (Sweden)

    Si Li

    2017-01-01

    Full Text Available A novel tunable triple-band left-handed metamaterial (LHM composed of a single-loop resonator (SLR and a variable capacitor-loaded short wire pair (CL-SWP printed on both sides of a substrate is presented in this paper. The CL-SWP-based metamaterial (MTM is a novel single-sided LHM. It is theoretically analyzed capable of extracting tunable negative permeability and a wide-band negative permittivity. We ran simulations for the CL-SWP-based MTM, the SLR-based MTM, and the proposed LHM. Together with the measured results, it is identified that this novel LHM exhibits a tunable triple-band left-handed (LH property. With the increase of the loaded capacitance, one LH band is relatively stable, while the other two are moving towards lower frequencies with their bandwidth getting wider and narrower, respectively. The surface current density distributions indicate that the first LH band is mainly decided by the SLR, one of the rest 2 LH bands is mainly decided by the CL-SWP, and the other one is decided by the SLR and CL-SWP together.

  11. Left ventricular performance during psychological stress

    International Nuclear Information System (INIS)

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

    1989-01-01

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

  12. 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.

  13. “Getting the Left Right”

    DEFF Research Database (Denmark)

    Klinke, Marianne E.; Zahavi, Dan; Hjaltason, Haukur

    2015-01-01

    experience was captured in the overarching theme, “getting the left right,” which encompasses the two subthemes of (a) surreal awareness of the left and (b) emergence of a different world. Patients had unclear perceptions of their own body and surroundings, their attention was brittle, and they encountered...... bewildering reactions from other people. They simultaneously pursued the ineffable neglected space and searched for coherence. The vulnerability, loss, and conflicting perceptions that patients with neglect face should be acknowledged and alleviation sought. Facilitating methods should provide additional...

  14. Clustered survival data with left-truncation

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  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. Aneurysm of the main trunk of the left coronary artery. Description of a clinical case and literature review

    International Nuclear Information System (INIS)

    Rodriguez, Julio C; Rivera, Alex; Pinzon, Bibiana

    2010-01-01

    Coronary artery aneurysm is a rare entity in the population. Its incidence rates vary between 1.5% - 5%, and is more frequent in males. There is limited literature on this disease, although its study goes back to the late eighteenth century. The most frequently affected artery is the right coronary artery, in approximately 40% of cases. The initial diagnostic difficulty lies in the fact that the initial approach is focused in confirming and treating properly the coronary acute syndrome, which is the most frequent initial presentation in these patients. Therefore, its diagnosis requires necessarily imaging or interventionist aid, or both. Many causes account for coronary aneurysms, being the most common atherosclerosis followed by congenital abnormalities, connective tissue diseases, vasculitis and cocaine consumption. Novel studies regarding the physiopathology and advances in pharmacological and interventionist therapy have been published, although treatment must focus on risk factors, associated pathologies and clinical manifestations.

  17. ST Segment Elevation Myocardial Infarction Due to Severe Ostial Left Main Stem Stenosis in a Patient with Syphilitic Aortitis

    Directory of Open Access Journals (Sweden)

    Predescu L.M.

    2016-03-01

    Full Text Available Cardiovascular manifestations of tertiary syphilis infections are uncommon, but represent an important cause of mortality and morbidity. Syphilitic aortitis is characterized by aortic regurgitation, dilatation of ascending aorta and ostial coronary artery lesions.

  18. Left ventricular atrioventricular plane displacement is preserved with lifelong endurance training and is the main determinant of maximal cardiac output

    DEFF Research Database (Denmark)

    Steding-Ehrenborg, Katarina; Boushel, Robert C; Calbet, José A

    2015-01-01

    subjects (29 ± 4 years) underwent cardiac MR. All subjects underwent maximal exercise testing and for elderly subjects maximal cardiac output during cycling was determined using dye dilution technique. RESULTS: Longitudinal and radial contribution to stroke volume did not differ between groups......BACKGROUND: Age-related decline in cardiac function can be prevented or postponed by lifelong endurance training. However, effects of normal ageing as well as of lifelong endurance exercise on longitudinal and radial contribution to stroke volume are unknown. The aim of this study was to determine...... groups for RVAVPD (P = 0.2). LVAVPD was an independent predictor of maximal cardiac output (R(2 = ) 0.61, P groups. However, how longitudinal pumping...

  19. 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.

  20. Contralateral white noise selectively changes left human auditory cortex activity in a lexical decision task.

    Science.gov (United States)

    Behne, Nicole; Wendt, Beate; Scheich, Henning; Brechmann, André

    2006-04-01

    In a previous study, we hypothesized that the approach of presenting information-bearing stimuli to one ear and noise to the other ear may be a general strategy to determine hemispheric specialization in auditory cortex (AC). In that study, we confirmed the dominant role of the right AC in directional categorization of frequency modulations by showing that fMRI activation of right but not left AC was sharply emphasized when masking noise was presented to the contralateral ear. Here, we tested this hypothesis using a lexical decision task supposed to be mainly processed in the left hemisphere. Subjects had to distinguish between pseudowords and natural words presented monaurally to the left or right ear either with or without white noise to the other ear. According to our hypothesis, we expected a strong effect of contralateral noise on fMRI activity in left AC. For the control conditions without noise, we found that activation in both auditory cortices was stronger on contralateral than on ipsilateral word stimulation consistent with a more influential contralateral than ipsilateral auditory pathway. Additional presentation of contralateral noise did not significantly change activation in right AC, whereas it led to a significant increase of activation in left AC compared with the condition without noise. This is consistent with a left hemispheric specialization for lexical decisions. Thus our results support the hypothesis that activation by ipsilateral information-bearing stimuli is upregulated mainly in the hemisphere specialized for a given task when noise is presented to the more influential contralateral ear.

  1. The study of radiosensitivity in left handed compared to right handed healthy women.

    Science.gov (United States)

    Khosravifarsani, Meysam; Monfared, Ali Shabestani; Akhavan-Niaki, Haleh; Moslemi, Dariush; Hajian-Tilaki, Karimollah; Elahimanesh, Farideh; Borzoueisileh, Sajad; Seyfizadeh, Nayer; Amiri, Mehrangiz

    2012-08-24

    Radiosensitivity is an inheriting trait that mainly depends on genetic factors. it is well known in similar dose of ionizing radiation and identical biological characteristics 9-10 percent of normal population have higher radiation response. Some reports indicate that distribution of breast cancer, immune diseases including autoimmune diseases as example lupus, Myasthenia Gravies and even the rate of allergy are more frequent in left handed individuals compared to right handed individuals. The main goal of the present study is determination of radiosensitivity in left handed compared to right handed in healthy women by cytokinesis blocked micronuclei [CBMN] assay.5 ml peripheral fresh blood sample was taken from 100 healthy women including 60 right handed and 40 left handed. The age of participants was between 20-25 old years and they had been matched by sex. After blood sampling, blood samples were divided to 2 groups including irradiated and non-irradiated lymphocytes that irradiated lymphocytes were exposed to 2 Gy CO-60 Gama rays source then chromosomal aberrations was analyzed by CBMN [Cytokinesis Blocked Micronuclei Assay]. Our results have shown radiosensitivity index [RI] in left-handers compared to right-handers is higher. Furthermore, the mean MN frequency is elevated in irradiated lymphocytes of left-handers in comparison with right-handers. Our results from CBMN assay have shown radiosensitivity in the left handed is higher than right handed women but more attempts need to prove this hypothesis.

  2. The application of phase analysis of gated myocardial perfusion imaging to assess left ventricular mechanical dyssynchrony in cardiovascular disease

    International Nuclear Information System (INIS)

    Wang Jianfeng; Wang Yuetao

    2013-01-01

    Left ventricular mechanical dyssynchrony is closely related to the severity of cardiovascular disease, it is essential to assess left ventricular mechanical dyssynchrony accurately for early prediction of adverse cardiac events and prognosis assessment of the cardiac resynchronization therapy. As a new technology to assess left ventricular mechanical dyssynchrony, the phase analysis of gated myocardial perfusion imaging (GMPI) can get both quantitative indicators of regional myocardial perfusion, evaluation of regional myocardial viability and scar tissue, as well as quantitative analysis of left ventricular function and left ventricular mechanical synchrony, it has broad application prospects in cardiovascular disease to assess left ventricular mechanical dyssynchrony and prognosis assessment. This review mainly described the applications of GMPI phase analysis in the cardiovascular disease. (authors)

  3. Magnetization of left-handed metamaterials

    International Nuclear Information System (INIS)

    Kourakis, I; Shukla, P K

    2006-01-01

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

  4. Left ventricular mass: Myxoma or thrombus?

    Directory of Open Access Journals (Sweden)

    Monish S Raut

    2015-01-01

    Full Text Available Patient with embolic episode should always be evaluated for cardiac mass. Mass in left ventricular can be a myxoma or thrombus even in a normal functioning heart . In either case, mobile mass with embolic potential should be surgically resected.

  5. Left atrial myxoma with biventricular dysfunction

    Directory of Open Access Journals (Sweden)

    Monish S. Raut

    2016-09-01

    Full Text Available Occurrence of left atrial myxoma with severe ventricular dysfunction without any obstructive coronary artery disease, as presented in our case, is very rare. It may be due to undiagnosed concomitant dilated cardiomyopathy or unknown cardiodepressant effect of myxoma which warrants further research.

  6. Left atrial myxoma with biventricular dysfunction.

    Science.gov (United States)

    Raut, Monish S; Shad, Sujay; Maheshwari, Arun

    2016-09-01

    Occurrence of left atrial myxoma with severe ventricular dysfunction without any obstructive coronary artery disease, as presented in our case, is very rare. It may be due to undiagnosed concomitant dilated cardiomyopathy or unknown cardiodepressant effect of myxoma which warrants further research. Copyright © 2016 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  7. Vergisson 4: a left-handed Neandertal.

    Science.gov (United States)

    Condemi, Silvana; Monge, Janet; Quertelet, Sylvain; Frayer, David W; Combier, Jean

    2017-01-01

    Handedness is an important marker for lateralization of humans in the modern and fossil record. For the most part, Neandertals and their ancestors are strongly right-handed. We describe a single tooth from a Neandertal level at Vergisson 4 (Vg 4-83). This left upper central incisor shows all the features typical of Neandertal incisors. It also exhibits a predominance of left-handed striations. Striations on the incisor's labial surface were mapped at 20x magnification using Photoshop. Angulations of the striations were determined from their deviation from the maximum mesio-distal line and were analyzed using NIH's freeware, Image J. Of the 60 labial surface striations, Vg 4-83 shows a strong predominance of left-handed striations (46; 76.7%), which are statistically significantly different (p handed striations. The identification of another left-handed Neandertal adds to our understanding about handedness variation in this fossil hominin. Given the high frequency of right-handed Neandertals, the 90: 10 modern ratio is still preserved in this group. © 2016 Wiley Periodicals, Inc.

  8. Electrocardiographic features suggestive of a left. ventricular ...

    African Journals Online (AJOL)

    1983-01-01

    Jan 1, 1983 ... sniper with an Armourlite assault rifle in Ireland. He had received a single bullet injury to the left ... His history negated any cardiovascular impairment, angina or limitation in effort tolerance. He plays ... In view of the patient's age, history and the cardiovascular findings, we would like to postulate that the ...

  9. Radiative left-right Dirac neutrino mass

    Science.gov (United States)

    Ma, Ernest; Sarkar, Utpal

    2018-01-01

    We consider the conventional left-right gauge extension of the standard model of quarks and leptons without a scalar bidoublet. We study systematically how one-loop radiative Dirac neutrino masses may be obtained. In addition to two well-known cases from almost 30 years ago, we find two new scenarios with verifiable predictions.

  10. Giant melanoma of the left thumb

    NARCIS (Netherlands)

    Zeebregts, CJAM; Schraffordt Koops, H.

    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

  11. Submitral Left Ventricular Aneurysm Associated with Thrombus

    African Journals Online (AJOL)

    2018-01-01

    Jan 1, 2018 ... She was given drugs for management of heart failure and ... treatment abroad. KEYWORDS: Ethiopia, heart failure, submitral aneurysm, thrombus. INTRODUCTION. Submitral left ventricle aneurysm is a rare cardiovascular disorder worldwide, but ... grade 2 pulmonary edema, and bilateral pleural effusion.

  12. Left-Right Symmetry at LHC

    CERN Document Server

    Maiezza, Alessio; Nesti, Fabrizio; Senjanovic, Goran

    2010-01-01

    We revisit the issue of the limit on the scale of Left-Right symmetry breaking. We focus on the minimal SU(2)_L x SU(2)_R x U(1)_B-L gauge theory with the seesaw mechanism and discuss the two possibilities of defining Left-Right symmetry as parity or charge conjugation. In the commonly adopted case of parity, we perform a complete numerical study of the quark mass matrices and the associated left and right mixing matrices without any assumptions usually made in the literature about the ratio of vacuum expectation values. We find that the usual lower limit on the mass of the right-handed gauge boson from the K mass difference, M_WR>2.5TeV, is subject to a possible small reduction due to the difference between right and left Cabibbo angles. In the case of charge conjugation the limit on M_WR is somewhat more robust. However, the more severe bounds from CP-violating observables are absent in this case. In fact, the free phases can also resolve the present mild discrepancy between the Standard Model and CP-violat...

  13. Left Dislocation: a typological overview | Westbury | Stellenbosch ...

    African Journals Online (AJOL)

    The Left Dislocation construction is a typologically universal phenomenon that has received detailed analysis, from both formal and functional perspectives, in a number of genetically and areally diverse languages. The present paper aims to provide a general overview of this cross-linguistic research with a concentration ...

  14. Left-forbidding cooperating distributed grammar systems

    Czech Academy of Sciences Publication Activity Database

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

    2010-01-01

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

  15. Left Ventricular Thrombus among patients undergoing Transthoracic ...

    African Journals Online (AJOL)

    Objective: Left Ventricular Thrombus (LVT) is a well recognized complication of various cardiac conditions, particularly following an acute anterior myocardial infarction and in those with systolic congestive heart failure. Transthoracic echocardiography (TTE) remains the most common imaging modality to make the diagnosis ...

  16. Modern Democratic Left and Economic Crisis

    Directory of Open Access Journals (Sweden)

    Dubravko Radošević

    2011-01-01

    Full Text Available Political left, notably social democracy, implies acceptance of market economy and parliamentary democracy, as a political framework within which the interests of large sections of the population could be preserved. Does the modern political left have a chance to revive, after the global economic crisis? We believe it does. The core idea of social democracy is the idea of equality. It is the growing inequality that could help the return of social democracy. In Croatia, during transition, there was predominantly the process of neoliberalization, and the democratic left accepted a neoliberal economic agenda. Currently Croatia has a structural economic problem and deep recession. Due to the global crisis, the democratic left in Croatia should abandon economic neoliberalism. Macroeconomic policy decision-makers in Croatia should reject orthodox policies, and it is necessary to implement heterodox economic policies. There is an urgent need to achieve a new (postKeynesian consensus, a new combination of post-Keynesian economics and social democracy

  17. Left-sided portal hypertension revisited

    Directory of Open Access Journals (Sweden)

    Antonio Manenti

    2016-12-01

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

  18. Mediterranean Left-Wing Populism: The Case of SYRIZA

    Directory of Open Access Journals (Sweden)

    Mavrozacharakis, Emmanouil

    2017-04-01

    Full Text Available Until recently the increasing impact of the right-wing populist parties in Europe was quite impressing. Several of these parties gained significant electoral power but expediently they collapsed while others were consecrated electorally. With SYRIZA’s electoral victory in Greece, the emergence of PODEMOS in Spain and of the Five Star Movement in Italy - which includes several aspects of a left-wing populism - and the coalition between social-democrats and radical left in Portugal, the creation of a peculiar left populism has been evolved, especially in the Mediterranean part of Europe. High electoral percentages and consequently, their involvement in government through partisan organization professionalism and charismatic leadership, are main characteristics of these parties. Another crucial factor, regardless of their ideological roots, is the anti-European rhetoric, even if it existed only for some period in the past. For instance, SYRIZA in Greece, intensely criticized the present European structure but at the same time promised that Greece will remain to the EU and the Eurozone. Furthermore, it appeared as a political entity that promised, with a demagogic way, to overcome the obvious principle of state continuation, by denying to implement the agreement that the previous governments have signed with Greece’s partners. Eventually, this promise was converted into a trap as left-wing SYRIZA in government, was finally succumbed to the strong demand for adherence and implementation of all the previous agreements. Thus, SYRIZA failed both ideologically and practically. Apart from the diverse ideological and political illusions that characterize this type of populism, another characteristic is the deficit in specific policy substance. This deficit has been transformed into a large gap in terms of strategic program priorities and options. Thus, it turns out that SYRIZA’s rise to power was based on versatility and on a high degree of classless

  19. Left ventricular function in chronic aortic regurgitation

    International Nuclear Information System (INIS)

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

    1983-01-01

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

  20. Assessment of stiffness of the hypertrophied left ventricle of bicyclists using left ventricular inflow Doppler velocimetry.

    Science.gov (United States)

    Fagard, R; Van den Broeke, C; Bielen, E; Vanhees, L; Amery, A

    1987-06-01

    Sixteen male bicyclists and 16 control subjects were studied to assess whether the left ventricular hypertrophy of athletes is associated with changes in diastolic left ventricular function. The cyclists had a larger left ventricular internal diameter on echocardiography (55.2 versus 47.9 mm; p less than 0.001) and a disproportionate increase in wall thickness relative to the internal diameter (0.48 versus 0.41; p less than 0.01), indicating a mixed eccentric-concentric type of hypertrophy. Left ventricular inflow Doppler velocimetry showed similar results in athletes and control subjects for peak flow velocities in the atrial contraction phase (30 versus 32 cm/s; p = NS) and in the early diastolic rapid filling phase (71 versus 67 cm/s; p = NS). The similar ratio of both velocities, that is, 0.43 in the cyclists and 0.49 in the control subjects, suggests that left ventricular distensibility is unaltered in cyclists. It is concluded that the left ventricular hypertrophy observed in cyclists is not associated with changes in ventricular stiffness, as estimated from left ventricular inflow Doppler velocimetry.

  1. The design of trachea-main bronchial covered embranchment stent and the primary clinical application

    International Nuclear Information System (INIS)

    Han Xinwei; Wu Gang; Gao Xuemei; Li Yongdong; Wang Yanli; Ma Nan

    2004-01-01

    Objective: To design the trachea-main bronchus covered embranchment stent and study the primary treatment for thoracostomach main bronchial fistula and main bronchial stenosis. Methods: The stent was designed on the bases of the peculiar anatomic structure and the pathological changes of thoracostomach-main bronchial fistula and main bronchial stenosis. Under the fluoroscopic guidance, implantations were carried out in thoracostomach-carina fistula 1 case thoracostomach-left main bronchial fistula 1, thoracostomach-right main bronchial fistula and left main bronchial stenosis 1 case, altogether with 5 stents. Results: Stents were placed successfully, not only improving the breathing and living quality but also completing the closure of the ora of the thoracostomach-airway fistula with further vanishing of the choke after drinking and eating together with the inhalation pneumonia. The bronchus became normal in a main bronchial stenosis after the stent was taken out. Conclusions: Trachea-main bronchial covered embranchment stent could be used to close thoracostomach-airway fistula and to treat main bronchial benign/malignant stenosis. The procedure is simple and safe. (authors)

  2. PICTORIAL ESSAY Is anomalous origin of the left vertebral artery ...

    African Journals Online (AJOL)

    The incidence of anomalous origin of the left vertebral artery from the aortic arch ranges between 1% and 5.8%.1,2 This anomaly has important implications for thoracic surgery and interventional procedures. The left vertebral artery may originate from: • the left common carotid artery. • the root of the left subclavian artery ...

  3. 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.

  4. Giant left coronary ostial aneurysm after modified Bentall procedure in a Marfan patient.

    Science.gov (United States)

    Okamoto, Kazuma; Casselman, Filip P; De Geest, Raphael; Vanermen, Hugo

    2008-12-01

    We performed surgical repair of a giant left coronary ostial aneurysm after aortic root replacement using composite valve graft (modified Bentall procedure) in a patient with Marfan syndrome. Aneurysmal formation in the left main stem itself is very rare. In order to avoid mobilizing the coronary ostium from severe adhesions after previous surgery and to reduce the tension on the anastomosis, the left main trunk was reconstructed using an interposition Dacron graft. In aortic root surgeries in Marfan patients, the size of the side hole on the composite graft should be kept relatively small to fit the diameter of the native coronary arteries for prevention of coronary buttons from forming aneurysms at the level of the coronary button anastomosis. In addition, close observation to the coronary button anastomosis is indispensable in postoperative check-up.

  5. Impact of Aortic Valve Replacement on Left Ventricular Remodeling in Patients with Severe Aortic Stenosis and Severe Left Ventricular Dysfunction

    Directory of Open Access Journals (Sweden)

    Abderrahmane Bakkali

    2016-12-01

    Full Text Available Objective: The aim of this study was to evaluate the effect of aortic valve replacement on left ventricular function and remodeling among patients with severe aortic stenosis and severe left ventricular dysfunction. Methods: In this retrospective bicentric study extended over a 15-year period, 61 consecutive patients underwent isolated AVR for severe AS associated to reduced LV function. The mean age was 58.21 ± 12.50 years and 83.60 % were men. 70.50% of patients were in class III or IV NYHA. The mean left ventricular ejection fraction (LVEF was 32.9 ± 5.6.The mean LVEDD and LVESD were respectively 63.6 ± 9.2 and 50.2 ± 8.8 mm. The mean calculated logistic EuroScore was 12.2 ±4.5. Results: The hospital mortality was 11.5%. Morbidity was marked mainly by low output syndrome in 40.8% of cases. After a median follow-up of 38 months we have recorded 3 deaths. Almost all survivors were in class I and II of NYHA. The mean LV end-diastolic and end-systolic diameters decreased significantly at late postoperative stage. The mean LV ejection fraction increased significantly from 32.9 ± 5.6 to 38.2 ± 9.3 and to 50.3 ± 9.6 in early and late postoperative stages, respectively. Multivariate linear regression analysis found that increased early postoperative LVEF (β= 0.44, 95% CI [0.14; 0.75], p=0.006 and low mean transprosthesis gradient (β=-0.72, 95% CI [-1.42; -0.02], p= 0.04 were the independent predictors of left ventricular systolic function recovery. Conclusion: Patients with aortic valve stenosis and impaired LV systolic function benefited from AVR as regard improvement of LV function parameters and regression of the LV diameters .This improvement depends mainly on early postoperative LVEF and mean transprosthesis gradient.

  6. 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.

  7. 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.

  8. Left ventricular non-compaction cardiomyopathy and left ventricular assist device: a word of caution.

    Science.gov (United States)

    Kornberger, A; Stock, U A; Risteski, P; Beiras Fernandez, A

    2016-07-15

    In patients with left ventricular non-compaction (LVNC), implantation of a left ventricular assist device (LVAD) may be performed as a bridge to transplantation. In this respect, the particular characteristics of the left ventricular myocardium may represent a challenge. We report a patient with LVNC who required urgent heart transplantation for inflow cannula obstruction nine months after receiving a LVAD. LVAD parameters, echocardiography and examination of the explanted heart suggested changes of left ventricular configuration brought about by LVAD support as the most likely cause of inflow cannula obstruction. We conclude that changes experienced by non-compacted myocardium during LVAD support may give rise to inflow cannula obstruction and flow reduction. Presence of LVNC mandates tight surveillance for changes in LV configuration and LVAD flow characteristics and may justify urgent transplantation listing status.

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

    Science.gov (United States)

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

    2009-12-01

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

  10. Left-right symmetric electroweak models

    International Nuclear Information System (INIS)

    Olness, F.I.

    1989-10-01

    We present a critical analysis of the spontaneous symmetry breaking and the Higgs sector of the conventional SU(2) L circle-times SU(2) R circle-times U(1) B-L left-right symmetric theory involving bi-doublet and triplet Higgs fields. We examine the phenomenological constraints imposed on the minimization of the Higgs potential arising from experimental observations, and explore the resulting consequences including the problem of ''fine- tuning'' arising from the hierarchy of mass scales involved. We show that it is non-trivial to satisfy all of these constraints. We contrast the benefits of this general class left-right models against the required ''fine-tuning'' necessary to force the phenomenology to conform to experimental fact. 17 refs., 1 fig

  11. 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.

  12. Why Children Are Left Behind and What We Can Do about It.

    Science.gov (United States)

    Reigeluth, Charles M.; Beatty, Brian J.

    2003-01-01

    Proposes four main reasons that children are left behind in schools: unmet needs, lack of motivation, lack of foundation and prior knowledge, and lack of support for learning. Discusses Maslow's hierarch of needs; partnerships with parents; connecting to student interests; insisting on mastery; curriculum sequencing; brain-based research; and…

  13. Hemodynamic effects of iodixanol and iohexol during ventriculography in patients with compromised left ventricular function

    NARCIS (Netherlands)

    Bergstra, A; van Dijk, RB; Brekke, O; Orozco, L; den Heijer, P; Crijns, HJGM

    A crossover study was performed to compare the hemodynamic effects of the isoosmolar contrast agent iodixanol (Visipaque(R)) 320 mg I/ml to those of the low-osmolar iohexol (Omnipaque(R)) 350 mg I/ml. The main hypothesis was that iodixanol and iohexol would affect left ventricular end-diastolic

  14. Unusual case of a vanishing bronchus of the left allograft in a lung transplant recipient

    Directory of Open Access Journals (Sweden)

    Don Hayes

    2013-01-01

    Full Text Available We present an interesting case of a complete vanishing of the left main bronchus in a lung transplant recipient who had a successful outcome due to acute respiratory support with venovenous extracorporeal membrane oxygenation in order to perform airway dilation.

  15. 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.

  16. The New Arab Left and 1967

    DEFF Research Database (Denmark)

    Haugbølle, Sune

    2017-01-01

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

  17. Primary malignant fibrous histiocytoma involving the left pulmonary vein presenting as a left atrial tumor

    Directory of Open Access Journals (Sweden)

    Saikat Bandyopadhyay

    2013-01-01

    Full Text Available A 35-year-old woman presented with 4 months history of progressively increasing intermittent dyspnea and hemoptysis. Transthoracic echocardiography revealed a loculated mass in the left atrium (LA. A provisional diagnosis of LA myxoma was made. Intraoperatively the tumor was found extending into and closely adherent to the left pulmonary vein and could not be completely cleared off from the pulmonary venous wall. The histopathological examination of the tumor revealed it to be a myxoid malignant fibrous histiocytoma.

  18. Implantation of left ventricular assist device in a patient with left ventricular non-compaction.

    Science.gov (United States)

    Balsara, Keki R; Bierhals, Andrew; Vader, Justin; Pasque, Michael K; Itoh, Aki

    2017-02-01

    Left ventricular noncompaction (LVNC) may result in systolic left ventricular (LV) failure resulting in the need for heart transplantation. LV assist devices (LVAD) have been used to bridge these patients to transplantation; however, the extensive trabeculations found in these patients predispose them to thromboembolic events and pump thrombosis. We describe a patient with LVNC in whom an aggressive surgical approach was used to debride the LV cavity of trabeculations to successfully implant an LVAD. © 2017 Wiley Periodicals, Inc.

  19. Pulmonary Hypertension secondary to Left Heart Disease.

    Science.gov (United States)

    Kabbach, Ghazal; Mukherjee, Debabrata

    2017-09-12

    Pulmonary hypertension (PH) related to left heart disease (LHD) is the most common form of PH, accounting for more than two third of all PH cases. The hemodynamic abnormalities seen in PH-LHD are complex, and there are currently minimal evidence-based recommendations for the management of PH-LHD. While it is accepted that PH in the context of left heart disease is a marker of worse prognosis, it remains unclear whether its primary treatment is beneficial or harmful. In this article, we discuss the prevalence and significance of PH in patients with heart failure (HF) with reduced ejection fraction (HFrEF) as well as HF with preserved ejection fraction (HFpEF), and those with valvular heart disease and provide insights into the complex pathophysiology of cardiopulmonary interrelationship in individuals with PH due to left heart disease. Furthermore, we provide a framework for diagnostic testing and an approach to optimal management of these complex patients based on current European Society of Cardiology (ESC) guidelines. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  20. 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

  1. Pulmonary hypertension due to left heart disease.

    Science.gov (United States)

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

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

  2. 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.

  3. Ipsilesional deficit of selective attention in left homonymous hemianopia and left unilateral spatial neglect.

    Science.gov (United States)

    Chokron, Sylvie; Peyrin, Carole; Perez, Céline

    2018-03-15

    Patients with homonymous hemianopia may present a subtle ipsilesional deficit, recently referred to as 'sightblindness' in addition to the contralesional visual field defect. We recently demonstrated that this deficit could be worse in right brain-damaged patients with left hemianopia than in left brain-damaged patients with right hemianopia, confirming right hemisphere dominance for visuo-spatial and attentional capacities. In the present study we investigate whether this ipsilesional deficit could be attentional in nature and to what extent it is comparable in right brain-damaged (RBD) patients with left hemianopia and in RBD patients with left neglect. The study was also conducted in RBD patients with neither left hemianopia nor left neglect signs in order to test if a right hemisphere lesion per se could be responsible for subtle ipsilesional attentional deficit. To reach this aim, we tested selective attentional capacities in both visual fields of 10 right brain-damaged patients with left neglect (LN), 8 right brain-damaged patients with left homonymous hemianopia (LHH), 8 right brain-damaged patients with no signs of left neglect or left hemianopia (RBD controls), and 17 healthy age-matched participants (Normal controls). A lateralized letter-detection task was used to test if right-brain damaged patients with LN or LH may present a deficit of selective attention in their right, ipsilesional visual field, in comparison to Normal and RBD controls. Participants were asked to detect a target letter in either a single large stimulus (low attentional load) or a small stimulus surrounded by flankers (high attentional load). Stimuli were displayed either in the left or in the right visual field. Accuracy and reaction times were recorded. Results on accuracy showed that both LN and LH patients exhibited lower correct responses than Normal controls in their ipsilesional right visual field, suggesting an attentional deficit in their ipsilesional, supposed healthy

  4. Isolators Including Main Spring Linear Guide Systems

    Science.gov (United States)

    Goold, Ryan (Inventor); Buchele, Paul (Inventor); Hindle, Timothy (Inventor); Ruebsamen, Dale Thomas (Inventor)

    2017-01-01

    Embodiments of isolators, such as three parameter isolators, including a main spring linear guide system are provided. In one embodiment, the isolator includes first and second opposing end portions, a main spring mechanically coupled between the first and second end portions, and a linear guide system extending from the first end portion, across the main spring, and toward the second end portion. The linear guide system expands and contracts in conjunction with deflection of the main spring along the working axis, while restricting displacement and rotation of the main spring along first and second axes orthogonal to the working axis.

  5. Micromorphological differentiation of left and right stridulatory apparatus in crickets (Orthoptera: Gryllidae).

    Science.gov (United States)

    Li, Xiaoqiang; Zhang, Xue; Luo, Wenqi; Wang, Yinliang; Ren, Bingzhong

    2016-06-24

    The present study compared micromorphological differentiation of stridulatory apparatus between the functional right tegmen and non-functional left tegmen, analyzed under scanning electron microscope (SEM), among eight Gryllidae species. The results showed that the main differences were found on the length and shape of files and teeth. The length of stridulatory file and teeth number were lower on the left stridulatory apparatus than that on right stridulatory apparatus in all species. However, the ratio between the length of stridulatory teeth and the interval of stridulatory teeth was significantly higher on the left stridulatory apparatus than that on right stridulatory apparatus in Dianemobius fascipes, Polionemobius taprobanensis, Pteronemobius gifuensis, Teleogryllus occipitalis and Oecanthus longicauda. In addition, the length of stridulatory teeth was positively related to number of stridulatory teeth, however, the interval of stridulatory teeth was negatively related to the ratio between the length of stridulatory teeth and the interval of stridulatory teeth for left and right stridulatory apparatus. Our result illustrated that the length of left and right stridulatory file and teeth length could be an effective character to distinguish species. Left stridulatory apparatus was not entirely degraded than right stridulatory apparatus.

  6. Computational Fluid Dynamics Analysis of the Effect of Plaques in the Left Coronary Artery

    Science.gov (United States)

    Chaichana, Thanapong; Sun, Zhonghua; Jewkes, James

    2012-01-01

    This study was to investigate the hemodynamic effect of simulated plaques in left coronary artery models, which were generated from a sample patient's data. Plaques were simulated and placed at the left main stem and the left anterior descending (LAD) to produce at least 60% coronary stenosis. Computational fluid dynamics analysis was performed to simulate realistic physiological conditions that reflect the in vivo cardiac hemodynamics, and comparison of wall shear stress (WSS) between Newtonian and non-Newtonian fluid models was performed. The pressure gradient (PSG) and flow velocities in the left coronary artery were measured and compared in the left coronary models with and without presence of plaques during cardiac cycle. Our results showed that the highest PSG was observed in stenotic regions caused by the plaques. Low flow velocity areas were found at postplaque locations in the left circumflex, LAD, and bifurcation. WSS at the stenotic locations was similar between the non-Newtonian and Newtonian models although some more details were observed with non-Newtonian model. There is a direct correlation between coronary plaques and subsequent hemodynamic changes, based on the simulation of plaques in the realistic coronary models. PMID:22400051

  7. Physiopathological approach to infective endocarditis in chronic hemodialysis patients: left heart versus right heart involvement.

    Science.gov (United States)

    Bentata, Yassamine

    2017-11-01

    Infectious endocarditis (IE), a complication that is both cardiac and infectious, occurs frequently and is associated with a heavy burden of morbidity and mortality in chronic hemodialysis patients (CHD). About 2-6% of chronic hemodialysis patients develop IE and the incidence is 50-60 times higher among CHD patients than in the general population. The left heart is the most frequent location of IE in CHD and the different published series report a prevalence of left valve involvement varying from 80% to 100%. Valvular and perivalvular abnormalities, alteration of the immune system, and bacteremia associated with repeated manipulation of the vascular access, particularly central venous catheters, comprise the main factors explaining the left heart IE in CHD patients. While left-sided IE develops in altered valves in a high-pressure system, right-sided IE on the contrary, generally develops in healthy valves in a low-pressure system. Right-sided IE is rare, with its incidence varying from 0% to 26% depending on the study, and the tricuspid valve is the main location. Might the massive influx of pathogenic and virulent germs via the central venous catheter to the right heart, with the tricuspid being the first contact valve, have a role in the physiopathology of IE in CHD, thus facilitating bacterial adhesion? While the physiopathology of left-sided IE entails multiple and convincing mechanisms, it is not the case for right-sided IE, for which the physiopathological mechanism is only partially understood and remains shrouded in mystery.

  8. Science in the Making: Right Hand, Left Hand. III: Estimating historical rates of left-handedness.

    Science.gov (United States)

    McManus, I C; Moore, James; Freegard, Matthew; Rawles, Richard

    2010-01-01

    The BBC television programme Right Hand, Left Hand, broadcast in August 1953, used a postal questionnaire to ask viewers about their handedness. Respondents were born between 1864 and 1948, and in principle therefore the study provides information on rates of left-handedness in those born in the nineteenth century, a group for which few data are otherwise available. A total of 6,549 responses were received, with an overall rate of left-handedness of 15.2%, which is substantially above that expected for a cohort born in the nineteenth and early twentieth centuries. Left-handers are likely to respond preferentially to surveys about handedness, and the extent of over-response can be estimated in modern control data obtained from a handedness website, from the 1953 BBC data, and from Crichton-Browne's 1907 survey, in which there was also a response bias. Response bias appears to have been growing, being relatively greater in the most modern studies. In the 1953 data there is also evidence that left-handers were more common among later rather than early responders, suggesting that left-handers may have been specifically recruited into the study, perhaps by other left-handers who had responded earlier. In the present study the estimated rate of bias was used to correct the nineteenth-century BBC data, which was then combined with other available data as a mixture of two constrained Weibull functions, to obtain an overall estimate of handedness rates in the nineteenth century. The best estimates are that left-handedness was at its nadir of about 3% for those born between about 1880 and 1900. Extrapolating backwards, the rate of left-handedness in the eighteenth century was probably about 10%, with the decline beginning in about 1780, and reaching around 7% in about 1830, although inevitably there are many uncertainties in those estimates. What does seem indisputable is that rates of left-handedness fell during most of the nineteenth century, only subsequently to rise in

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

    Science.gov (United States)

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

    2016-03-22

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

  10. Severe personality changes after unilateral left paramedian thalamic infarct.

    Science.gov (United States)

    Fukutake, Toshio; Akada, Koichi; Ito, Shoichi; Okuda, Tomoko; Ueki, Yoshihiro

    2002-01-01

    Personality changes are not uncommon after paramedian thalamic infarction, but usually bilateral or relatively large lesions, often complicated by other neurological or neuropsychological deficits, are present. 'Pure' cases of unilateral lesions are extremely rare. We report that a right-handed, 48-year-old man, who was hypertensive and diabetic but had no prior psychiatric history, developed severe personality changes and a frontal-like syndrome after recovery from acute-onset impairment of consciousness at the age of 43. Other neurological and neuropsychological disturbances, especially verbal and visual amnesia, were unremarkable. MRI showed a very small infarct in the left paramedian area of the thalamus, mainly involving the dorsomedial nucleus. Copyright 2002 S. Karger AG, Basel

  11. 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.

  12. Left atrio-vertebral ratio: A new computed-tomography measurement to identify left atrial dilation.

    Science.gov (United States)

    Baque-Juston, Marie; Volondat, Manuelle; Fontas, Eric; Roger, Coralie; Brunner, Philippe; Padovani, Bernard; Chevallier, Patrick

    2016-01-01

    Left cardiac chambers dilation, interstitial lung changes and pleural effusions are the characteristics of cardiogenic pulmonary oedema on computed tomography (CT) of the chest but mensuration of the left atrial size is not routinely performed. Cardiac chambers normal dimensions are known to be proportional to the patient's build and anthropomorphic data but adjustment of chambers dimensions to available elements seen on the axial CT images has never been evaluated before. Our objective was to use data easily available on axial images to directly scale the left atrium. We chose to divide the left atrial diameter by the thoracic vertebral diameter, using the latter as a body-mass indicator. As a preliminary study, we aimed to evaluate the range of values of this left atrio-vertebral ratio (LAVR) by comparing patients suffering from cardiogenic pulmonary oedema with patients free of cardiac disease. We hypothesized that if the difference of values in these two populations of patients was significant enough, this ratio would be relevant and could be used as a quick criterion in different clinical situations. Two radiologists reviewed CT scans of 32 of patients free of cardiac disease and 40 patients in acute cardiac failure. The maximum diameter of the left atrium at the level of the right inferior pulmonary vein was divided by the vertebral transverse diameter to generate a left atrio-vertebral ratio. Receiver operating characteristic curves identified the threshold associated with pulmonary oedema. The mean LAVR was 1.85 ± 0.27 in asymptomatic patients and 2.48 ± 0.35 in patients with pulmonary oedema. A LAVR of 2.1 yielded 85% sensitivity and 88% specificity for the diagnosis of cardiogenic pulmonary oedema. LAVR is a simple new measure directly scaling the left atrial diameter to the anthropomorphic characteristics of the patient. In our series, a ratio above 2.1 is strongly associated with cardiogenic pulmonary oedema indirectly suggesting left atrial dilation

  13. Left ventricular heart failure and pulmonary hypertension†

    Science.gov (United States)

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

    2016-01-01

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

  14. Left ventricular noncompaction in a patient presenting with a left ventricular failure

    Directory of Open Access Journals (Sweden)

    Ristić-Anđelkov Anđelka

    2018-01-01

    Full Text Available Introduction. Left ventricular noncompaction (LVNC is a congenital disorder characterised by prominent trabeculations in the left ventricular myocardium. This heart condition very often goes completely undetected, or is mistaken for hypertrophic cardiomyopathy or coronary disease. Case report. A middle-aged female with a positive family history of coronary disease was admitted with chest pain, electrocardiography (ECG changes in the area of the inferolateral wall and elevation in cardiac specific enzymes. Initially, she was suspected of having acute coronary syndrome. However, in the left ventricular apex, especially alongside the lateral and inferior walls, cardiac ultrasound visualised hypertrabeculation with multiple trabeculae projecting inside the left ventricular cavity. A short-axis view of the heart above the papillary muscles revealed the presence of two layers of the myocardium: a compacted homogeneous layer adjacent to the epicardium and a spongy layer with trabeculae and sinusoids under the endocardium. The thickness ratio between the two layers was 2.2:1. The same abnormalities were corroborated by multislice computed tomography (MSCT of the heart. Conclusion. Left ventricular noncompaction is a rare, usually hereditary cardiomyopathy, which should be considered as a possibility in patients with myocardial hypertrophy. It is very often mistaken for coronary disease owing to ECG changes and elevated cardiac specific enzymes associated with myocardial hypertrophy and heart failure.

  15. MAIN: Multilingual Assessment Instrument for Narratives

    OpenAIRE

    Gagarina, Natalʹja Vladimirovna; Klop, Daleen; Kunnari, Sari; Tantele, Koula; Välimaa, Taina; Balčiūnienė, Ingrida; Bohnacker, Ute; Walters, Joel

    2016-01-01

    The Multilingual Assessment Instrument for Narratives (MAIN) was designed in order to assess narrative skills in children who acquire one or more languages from birth or from early age. MAIN is suitable for children from 3 to 10 years and evaluates both comprehension and production of narratives. Its design allows for the assessment of several languages in the same child, as well as for different elicitation modes: Model Story, Retelling, and Telling. MAIN contains four parallel stories, e...

  16. Anomalous origin of the left anterior descending coronary artery from the right coronary artery

    Directory of Open Access Journals (Sweden)

    Kyriacos Papadopoulos

    2013-01-01

    Full Text Available Dual left anterior descending coronary artery (LAD originating from the left main stem and the right coronary artery (RCA (Type IV dual LAD is a very rare coronary artery anomaly. In this report, we describe a 49 year old woman presenting with unstable angina and positive for myocardial ischemia exercise tolerance test who subsequently was found to have this coronary anomaly.The diagnosis was made with coronary angiography.This anomaly has been reported to occur in 0.01 — 0.7% of patients under going cardiac catheterization. To our knowledge, only a few such cases have been published in the literature so far.

  17. Left side approach for aortic valve replacement in patient with dextrocardia and situs inversus totalis

    Directory of Open Access Journals (Sweden)

    Salah E. Altarabsheh

    2017-10-01

    Full Text Available Aortic valve replacement in patients with dextrocardia and situs inversus totalis is technically challenging due to anatomical considerations. Modifications of the cannulation strategy and operative tool sets are helpful. We report a 47-year-old man who had dextrocardia with situs inversus totalis with severe aortic regurgitation. Our approach was precisely planned depending on the clear anatomy outlined by preoperative contrast-enhanced computed tomography of the chest. We used a surgical approach in which the main surgeon was standing on the left side of the patient. Left sided approach provided excellent exposure for aortic valve replacement in this case scenario.

  18. Mycobacterium chimaera left ventricular assist device infections.

    Science.gov (United States)

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

    2017-06-01

    A global outbreak of invasive Mycobacterium chimaera infections after cardiac surgery has recently been linked to bioaerosols from contaminated heater-cooler units. The majority of cases have occurred after valvular surgery or aortic graft surgery and nearly half have resulted in death. To date, infections in patients with left ventricular assist devices (LVADs) have not been characterized in the literature. We report two cases of device-associated M. chimaera infection in patients with continuous-flow LVADs and describe challenges related to diagnosis and management in this population. © 2017 Wiley Periodicals, Inc.

  19. Anomalous Origin of Left Circumflex Artery

    OpenAIRE

    ?itaku, Hajdin; Kamberi, Lulzim; Gorani, Daut; Ko?inaj, 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 departme...

  20. Multiple Coronary Artery Microfistulas Associated with Apical Hypertrophic Cardiomyopathy: Left and Right Coronary Artery to the Left Ventricle

    Directory of Open Access Journals (Sweden)

    Jeong-Woo Choi

    2015-01-01

    Full Text Available A 76-year-old woman underwent coronary angiography for chest pain. On the coronary angiogram, no significant coronary artery atherosclerotic stenosis was observed. Multiple coronary artery microfistulas, draining from the left anterior descending artery to the left ventricle and from the posterior descending artery of the right coronary artery to the left ventricle, were observed. Apical wall thickening and fistula flow from the left anterior descending artery were demonstrated by using transthoracic echocardiography. We describe a rare case of multiple coronary artery microfistulas from the left and right coronary artery to the left ventricle combined with apical hypertrophic cardiomyopathy.

  1. 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.

  2. Nonlinear left-handed transmission line metamaterials

    International Nuclear Information System (INIS)

    Kozyrev, A B; Weide, D W van der

    2008-01-01

    Metamaterials, exhibiting simultaneously negative permittivity ε and permeability μ, more commonly referred to as left-handed metamaterials (LHMs) and also known as negative-index materials, have received substantial attention in the scientific and engineering communities [1]. Most studies of LHMs (and electromagnetic metamaterials in general) have been in the linear regime of wave propagation and have already inspired new types of microwave circuits and devices. The results of these studies have already been the subject of numerous reviews and books. This review covers a less explored but rapidly developing area of investigation involving media that combine nonlinearity (dependence of the permittivity and permeability on the magnitude of the propagating field) with the anomalous dispersion exhibited by LHM. The nonlinear phenomena in such media will be considered on the example of a model system: the nonlinear left-handed transmission line. These nonlinear phenomena include parametric generation and amplification, harmonic and subharmonic generation as well as modulational instabilities and envelope solitons. (topical review)

  3. Emission computer tomography of the left ventricle

    Energy Technology Data Exchange (ETDEWEB)

    Semmler, W.; Felix, R.; Calder, D.; Golde, G.; Botsch, H.

    1983-10-01

    Tomographic studies and time-dependent tomograms on phantoms and patients were carried out using a 7-pinhole collimator in order to study the clinical value of ECG-triggered tomographic radionuclid ventriculography. A suitable computer programme has been developed. The results have shown that it is possible to evaluate local contraction abnormalities by this method. Using a left oblique position of the collimator (LAO (45/sup 0/) - cranial (15/sup 0/)), emission computer tomography is aligned with the longitudinal axis for the heart. In this way, a single projection is sufficient to show the montility of the anterior and posterior walls and of the septum. Hypokinesis, akinesis or dyskinesis can be recognised visually. The localisation and extent of the defect can be determined through the 7-pinhole collimator. Reconstructed images of the triggered radionuclide scintigrams show excellent marginal definition. In the RAO projection the left ventricle can be seen without superimposition and images obtained which equal those of a first-pass technique.

  4. Left hepatectomy after right paramedian sectoriectomy.

    Science.gov (United States)

    Takamoto, Takeshi; Hashimoto, Takuya; Makuuchi, Masatoshi

    2017-12-01

    Repeat hepatectomy is beneficial for selected patients with recurrence of liver malignancies. However, the operative procedure becomes technically demanding when the previous hepatectomy was complex, with hepatic veins and stump of portal pedicles exposed on the liver transection surface. We performed left hepatectomy after right paramedian sectoriectomy (RPMS) for three patients. Here, we describe our surgical technique and the postoperative outcomes achieved. This procedure allowed for safe adhesiolysis between the middle and right hepatic veins by following a fibrous plane. The mean operative time was 8.7 h, including 4.9 h of adhesiolysis. The mean remnant liver volume (right lateral sector and the caudate lobe) was calculated as 704 ml, being 62% of total liver volume. There was no postoperative liver failure or mortality. In conclusion, left hepatectomy after RPMS is a feasible procedure for patients with sufficient remnant liver volume, even though the middle and right hepatic veins run side by side after liver regeneration.

  5. Reversal of left ventricular hypertrophy by propranolol in ...

    African Journals Online (AJOL)

    Background: Hypertension contributes significantly to the development of left ventricular hypertrophy. Left ventricular hypertrophy is associated with increased incidence of sudden cardiac death. Recognition and management of hypertension is, therefore, imperative. Objective: To establish whether propranolol can reverse ...

  6. Incidental retroaortic left innominate vein in adult patient

    Directory of Open Access Journals (Sweden)

    Alexandre Semionov, MD, PhD

    2017-09-01

    Full Text Available Retro-aortic left innominate vein is a rare vascular abnormality, usually associated with congenital heart disease. Here we report a case of isolated retro-aortic left innominate vein in an adult female.

  7. Rare occurrence of the left maxillary horizontal third molar impaction ...

    African Journals Online (AJOL)

    Rare occurrence of the left maxillary horizontal third molar impaction, the right maxillary third molar vertical impaction and the left mandibular third molar vertical impaction with inferior alveolar nerve proximity in a 30 year old female: a case report.

  8. Non-nursing tasks, nursing tasks left undone and job satisfaction among professional nurses in South African hospitals.

    Science.gov (United States)

    Bekker, Monique; Coetzee, Siedine K; Klopper, Hester C; Ellis, Suria M

    2015-11-01

    To investigate the relationship between non-nursing tasks (NNTs), nursing tasks left undone (NTLU) and job satisfaction among professional nurses (PNs) in South Africa (SA). This study adds to the international debate about the relationship between non-nursing tasks, nursing tasks left undone and job satisfaction by studying the variables at individual nurse and hospital unit level. A cross-sectional survey design of 1166 PNs in 60 medical and surgical units in 55 private hospitals and seven public hospitals. Nationally, the three main non-nursing tasks performed were clerical duties (M = 1.81), arranging discharge referrals and transport (M = 1.38) and performing non-nursing care (M = 1.31), while the main nursing tasks left undone were comfort/talk with patients (62.2%), educating patients and family (57.9%) and develop/update nursing care plans/pathways (51.6%). Nursing tasks left undone were only related to three non-nursing tasks, and job satisfaction correlated most highly with nursing tasks left undone. Professional nurses conduct many non-nursing tasks, and leave several important nursing tasks left undone. Nursing tasks left undone cause the greatest degree of job dissatisfaction amongst professional nurses. Role overlapping and work performed by professional nurses below their skill level should be identified and re-organised; support services should be employed and efficiently used. © 2014 John Wiley & Sons Ltd.

  9. Status Of the ILC Main Linac Design

    Energy Technology Data Exchange (ETDEWEB)

    Saini, Arun [Fermilab; Kapin, Valery [Fermilab; Solyak, Nikolay [Fermilab

    2017-05-01

    International Linear collider (ILC) is a proposed accelerator facility which is primarily based on two 11-km long superconducting main linacs. In this paper we present recent updates on the main linac design and discuss changes made in order to meet specification outlined in the technical design report (TDR).

  10. 47 CFR 73.1665 - Main transmitters.

    Science.gov (United States)

    2010-10-01

    ... Rules Applicable to All Broadcast Stations § 73.1665 Main transmitters. (a) Each AM, FM, TV and Class A..., however, the maximum rated transmitter power of a main transmitter stalled at an AM station shall be as... availability of AM broadcast transmitters that are approved or verified for use in the 1605-1705 kHz band...

  11. Engineering Design of KSTAR tokamak main structure

    International Nuclear Information System (INIS)

    Im, K.H.; Cho, S.; Her, N.I.

    2001-01-01

    The main components of the KSTAR (Korea Superconducting Tokamak Advanced Research) tokamak including vacuum vessel, plasma facing components, cryostat, thermal shield and magnet supporting structure are in the final stage of engineering design. Hundai Heavy Industries (HHI) has been involved in the engineering design of these components. The current configuration and the final engineering design results for the KSTAR main structure are presented. (author)

  12. Riigikogu maine ja armastus / Aune Past

    Index Scriptorium Estoniae

    Past, Aune, 1954-

    2007-01-01

    Autor arutleb Riigikogu maine üle, toetudes TÜ ajakirjanduse ja kommunikatsiooni osakonna 2007. aastal tehtud uuringu tulemustele. Riigikogu liikmete maine paraneks, kui neil endil oleks selge, mis eesmärgil Toompeale mindi ja sellest siis ka rahvale kõneldaks

  13. Main Ideas and Organization: Theme 6, Reading.

    Science.gov (United States)

    Gadway, Charles J.

    As part of the National Assessment of Educational Progress in reading, this volume, "Theme 6: Main Ideas and Organization," directs attention to the fact that identifying the main idea of a passage or discovering its organization requires a higher level of comprehension than merely gleaning the important facts. Some of the exercises…

  14. 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.

  15. Visualisation of the left superior intercostal vein in MR

    International Nuclear Information System (INIS)

    Medrea, M.; Meydam, K.; Schmitt, W.

    1987-01-01

    A retrospective study of 56 MRT chest examinations showed the left intercostal vein in its horizontal trajectory in 3 patients with left mediastinal masses compressing the superior vena cava. In 2 patients the posterior trajectory of the horizontal segment was clearly visualised. In the third case the anterior part, namely the insertion of the left superior intercostal vein into the left brachiocephalic trunk, was demonstrated. (orig.) [de

  16. EDUCATIONAL PECULIARITIES AND DIFFICULTIES OF CHILDREN WITH LEFT-SIDED LATERALITY: THE TECHNOLOGICAL SOLUTION OF THE PROBLEM

    Directory of Open Access Journals (Sweden)

    Maria Sitnikova

    2011-09-01

    Full Text Available Nowadays there is a significant increase of the incidence of left-handedness and sinistrality among schoolchildren. Theydemonstrate a large number of left-sided motor and sensory preferences which are considered as external markers offunctional hemispheric asymmetry of the brain. The purposes of this study are to investigate gender peculiarities and specificityof age-related dynamics of laterality pattern’s formation in junior schoolchildren and to find out educational peculiarities anddifficulties of left-handed children. The findings show that left-handers differ greatly in their mental development by havingsome peculiarities of intelligence, world’s perception and prevailing thinking strategies, ways of memorization, specificity ofemotional-affective expression. The main problems of left-handed children in school performance are academic failure, lack ofperseverance, anxiety neurosis, and extreme emotional lability. Integrated development of the left hemisphere and the righthemisphere thinking of left-handed schoolchildren is a favorable condition for harmonious personal and intellectualdevelopment and effective mastering of various modules of the school curriculum. The technological solution of the problem ofteaching the children with left-sided laterality is to include in educational programs some special exercises to developimagination, emotional sensitivity, integrity of perception, global view to the problems, creativeness, and original approachesto tasks’ solving. So a complex program for the intensive development of the right hemisphere of children who demonstrateleft-sided laterality to overcome the possible failure at primary school is proposed in this paper.

  17. Fundamentals, current state of the development of, and prospects for further improvement of the new-generation thermal-hydraulic computational HYDRA-IBRAE/LM code for simulation of fast reactor systems

    Science.gov (United States)

    Alipchenkov, V. M.; Anfimov, A. M.; Afremov, D. A.; Gorbunov, V. S.; Zeigarnik, Yu. A.; Kudryavtsev, A. V.; Osipov, S. L.; Mosunova, N. A.; Strizhov, V. F.; Usov, E. V.

    2016-02-01

    The conceptual fundamentals of the development of the new-generation system thermal-hydraulic computational HYDRA-IBRAE/LM code are presented. The code is intended to simulate the thermalhydraulic processes that take place in the loops and the heat-exchange equipment of liquid-metal cooled fast reactor systems under normal operation and anticipated operational occurrences and during accidents. The paper provides a brief overview of Russian and foreign system thermal-hydraulic codes for modeling liquid-metal coolants and gives grounds for the necessity of development of a new-generation HYDRA-IBRAE/LM code. Considering the specific engineering features of the nuclear power plants (NPPs) equipped with the BN-1200 and the BREST-OD-300 reactors, the processes and the phenomena are singled out that require a detailed analysis and development of the models to be correctly described by the system thermal-hydraulic code in question. Information on the functionality of the computational code is provided, viz., the thermalhydraulic two-phase model, the properties of the sodium and the lead coolants, the closing equations for simulation of the heat-mass exchange processes, the models to describe the processes that take place during the steam-generator tube rupture, etc. The article gives a brief overview of the usability of the computational code, including a description of the support documentation and the supply package, as well as possibilities of taking advantages of the modern computer technologies, such as parallel computations. The paper shows the current state of verification and validation of the computational code; it also presents information on the principles of constructing of and populating the verification matrices for the BREST-OD-300 and the BN-1200 reactor systems. The prospects are outlined for further development of the HYDRA-IBRAE/LM code, introduction of new models into it, and enhancement of its usability. It is shown that the program of development and

  18. 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…

  19. 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)

  20. 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…

  1. 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…

  2. Prevalence of left ventricular diastolic dysfunction in newly ...

    African Journals Online (AJOL)

    They were divided into hypertensives without left ventricular hypertrophy and those with left ventricular hypertrophy based on echocardiographically determined left ventricular mass index. Pulsed Doppler transmitral inflow and the pulmonary venous flow waves were used to categorise the patterns of diastolic dysfunction.

  3. Left Ventricular Geometry In Nigerians With Type II Diabetes Mellitus ...

    African Journals Online (AJOL)

    Background: Left ventricular hypertrophy is independently associated with increased incidence of cardiovascular disease, cardiovascular and all cause mortality. In a relatively healthy hypertensive adult population, type II diabetes is associated with higher left ventricular mass, concentric left ventricular geometry and lower ...

  4. Isolated left carotid artery in CHARGE association: diagnosis and repair.

    Science.gov (United States)

    Ghalili, K; Issenberg, H J; Freeman, N J; Brodman, R F

    1990-07-01

    Isolation of the left carotid artery is extremely rare. We report a case of isolation of the left carotid artery with CHARGE association. Aortic arch abnormalities should be looked for in all children with CHARGE association. The technique of repair involved implantation of the isolated left carotid artery to the ascending aorta.

  5. Fluid loading and norepinephrine infusion mask the left ventricular preload decrease induced by pleural effusion

    DEFF Research Database (Denmark)

    Wemmelund, Kristian Borup; Ringgård, Viktor Kromann; Vistisen, Simon Tilma

    2017-01-01

    BACKGROUND: Pleural effusion (PLE) may lead to low blood pressure and reduced cardiac output. Low blood pressure and reduced cardiac output are often treated with fluid loading and vasopressors. This study aimed to determine the impact of fluid loading and norepinephrine infusion on physiologic......, n = 12), norepinephrine infusion (0.01, 0.03, 0.05, 0.1, 0.2 and 0.3 μg/kg/min (15 min each, n = 12)) or control (n = 6). Main outcome was left ventricular preload measured as left ventricular end-diastolic area. Secondary endpoints included contractility and afterload as well as global measures...... of circulation. All endpoints were assessed with echocardiography and invasive pressure-flow measurements. RESULTS: PLE decreased left ventricular end-diastolic area, mean arterial pressure and cardiac output (p values infusion (0.05 μg/kg/min) restored...

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

    Directory of Open Access Journals (Sweden)

    Solmaz Fakhari

    2016-01-01

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

  7. Recognition of emotion in hemifaces presented to the left and right visual fields.

    Science.gov (United States)

    Wedding, D; Cyrus, P

    1986-09-01

    Thirty-two right-handed subjects (16 males and 16 females) participated in a choice reaction time experiment replicating two previous studies which demonstrated the superiority of the left hemisphere in rapidly identifying facial emotion as either positive or negative. Slides of hemifaces split along the vertical axis, showing either positive (happiness, surprise) or negative (anger, disgust, or sadness) affect were presented tachistoscopically to either the left or right visual field. A 2 X 2 X 2 mixed ANOVA revealed main effects for visual field and type of affect. In contrast to earlier studies which presented full face stimuli, presentation of hemifaces produced a strong left visual field advantage and, as expected, positive faces produced faster reaction times than negative faces.

  8. Left ventricular assist device implantation in patients after left ventricular reconstruction.

    Science.gov (United States)

    Palmen, Meindert; Braun, Jerry; Beeres, Saskia L M A; Klautz, Robert J M

    2016-12-01

    Left ventricular assist device (LVAD) implantation can be challenging in patients with a prior surgical ventricular restoration (SVR). In this case series of heart failure patients with a history of SVR, we describe the surgical technique and outcome of a customized approach for inflow cannula orientation. Seven patients with a history of SVR with end-stage chronic heart failure were accepted for long-term LVAD support. In all patients, the Dacron patch was removed through left ventriculotomy and a Hegar 22 dilator was inserted at the estimated optimal position of the LVAD inflow cannula. The left ventricle was reconstructed around the dilator from the left ventricular (LV) apex to the base. Finally, the LVAD sewing ring was sutured onto the remaining apical defect and a HeartWare® LVAD was implanted. LVAD implantation was successful in all 7 patients. Transoesophageal echocardiography ensured an adequate LVAD position and inflow and outflow cannula Doppler flow recordings. The mean intensive care unit stay was 5.8 ± 2.6 days, and the hospital stay after surgery was 32 ± 16 days. All patients follow regular visits (follow-up 20 ± 16 months) at the outpatient clinic without any remarkable event. Using the technique described, LVAD implantation in patients after SVR is feasible and safe. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  9. Left laterality is an independent prognostic factor for metastasis in N3 stage breast cancer.

    Science.gov (United States)

    Karatas, Fatih; Sahin, Sanja; Erdem, Gokmen U; Ates, Ozturk; Babacan, Taner; Akin, Serkan; Sever, Ali R; Ozisik, Yavuz; Altundag, Kadri

    2016-01-01

    Development of metastasis in patients with breast cancer (BC) is the most important negative prognostic factor and this process mainly begins with lymphatic involvement. Therefore, axillary, subclavicular, internal mammary or supraclavicular nodal involvement is a crucial step before metastasis. Anatomical differences between the right and left lymphatic drainages of the breasts may significantly affect the rate, site and time to development of distant metastasis. The purpose of this study was to investigate if laterality is an independent prognostic factor for metastasis in N3 breast cancer patients. From a total of 4215 BC patients diagnosed between 1994 and 2015 in our center, 305 non-metastatic women with pathological N3 (pN3) nodal status at presentation were enrolled in this study. Patients were divided into two groups: left and right BC. Analysis of overall survival (OS) and time to first metastasis (TTM) was performed according to Kaplan-Meier method with log-rank test. The median number of lymph node involvement and lymph node ratio (number of positive lymph nodes / total number of excised lymph nodes) between the two groups was equal (14 and 0,66 respectively). Recurrence was observed in 123 patients [53 (35%) right vs 70 (44%) left group]. Patients with left BC had significantly higher rate of axial bone metastases compared with the right BC group (55.7 vs 35.8%, p<0.02, respectively). TTM was significantly shorter in the left BC group [49.1 months (95% CI 36.5-61.8) vs 103.6 months (95% CI 47.0-160); p7equals;0.03, respectively]. Median OS did not differ between the groups, however, there was a trend towards lower OS in patients with left BC (p=0.68). Left laterality in patients with pN3 non-metastatic BC is an independent prognostic factor associated with shorter TTM, increased risk of distant metastases and axial bone involvement compared with right laterality.

  10. Slow Progress in Dune (Left Front Wheel)

    Science.gov (United States)

    2005-01-01

    The left front wheel of NASA's Mars Exploration Rover Opportunity makes slow but steady progress through soft dune material in this movie clip of frames taken by the rover's front hazard identification camera over a period of several days. The sequence starts on Opportunity's 460th martian day, or sol (May 10, 2005) and ends 11 days later. In eight drives during that period, Opportunity advanced a total of 26 centimeters (10 inches) while spinning its wheels enough to have driven 46 meters (151 feet) if there were no slippage. The motion appears to speed up near the end of the clip, but that is an artifact of individual frames being taken less frequently.

  11. Slow Progress in Dune (Left Rear Wheel)

    Science.gov (United States)

    2005-01-01

    The left rear wheel of NASA's Mars Exploration Rover Opportunity makes slow but steady progress through soft dune material in this movie clip of frames taken by the rover's rear hazard identification camera over a period of several days. The sequence starts on Opportunity's 460th martian day, or sol (May 10, 2005) and ends 11 days later. In eight drives during that period, Opportunity advanced a total of 26 centimeters (10 inches) while spinning its wheels enough to have driven 46 meters (151 feet) if there were no slippage. The motion appears to speed up near the end of the clip, but that is an artifact of individual frames being taken less frequently.

  12. 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.

  13. ODEs: is there anything left to do

    Energy Technology Data Exchange (ETDEWEB)

    Gear, C.W.

    1979-10-01

    Two decades ago many people thought that there was very little left to occupy the researcher in the numerical initial-value problem for ordinary differential equations, but there has since been an enormous increase in the effort devoted to this problem and related software. The question is whether everything is finally done so that more difficult areas can be studied. The development of numerical solution techniques is examined from the identification of a problem to the never-final preparation of automatic codes for the solution of classes of similar problems. A number of ODE problems that are only a part of the way along this path of development are discussed. These problems include ones with highly oscillatory solutions, ones with frequent discontinuities, and ones in which very little accuracy is needed (and which should be integrated at low cost). 4 figures.

  14. Seasonal Composite Chlorophyll Concentrations - Gulf of Maine

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This personal geodatabase contains raster images of chlorophyll concentrations in the Gulf of Maine. These raster images are seasonal composites, and were calculated...

  15. Hillshades for the main 8 Hawaiian Islands

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — These hillshade datasets were derived from USGS 7.5' DEM Quads for the main 8 Hawaiian Islands. Individual DEM quads were first converted to a common datum, and...

  16. 2015 City of Portland, Maine, Lidar

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — 2015 City of Portland Maine Lidar Data Acquisition and Processing Woolpert Order No. 75564 Contractor: Woolpert, Inc. This task is for a high resolution data set of...

  17. 2016 USGS Lidar DEM: Maine QL2

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Product: These are Digital Elevation Model (DEM) data for Franklin, Oxford, Piscataquis, and Somerset Counties, Maine as part of the required deliverables for the...

  18. Distributed PV Adoption in Maine Through 2021

    Energy Technology Data Exchange (ETDEWEB)

    Gagnon, Pieter; Sigrin, Ben

    2015-11-06

    NREL has used its dSolar (distributed solar) model to generate low-medium-high estimates of distributed PV adoption in Maine through 2021. This presentation gives a high-level overview of the model and modeling results.

  19. 2004 Maine Coastline LiDAR

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This metadata document describes the collection and processing of Light Detection and Ranging (LIDAR) data over an area along the coast of Maine. Data was collected...

  20. Collins' bypass for the main ring

    International Nuclear Information System (INIS)

    Ohnuma, S.

    1982-01-01

    Design of the bypass for the main ring at Fermilab is discussed. Specific design features discussed include space, path length, geometric closure, matching of betatron functions, and external dispersion. Bypass parameters are given