Evaluation of tracheal bronchus in Chinese children using multidetector CT

International Nuclear Information System (INIS)

Ming, Zhu; Lin, Zhang

2007-01-01

Tracheal bronchus is a congenital bronchial anomaly. The diagnosis should be considered early in intubated patients. Multidetector computed tomography (MDCT) is the newest modality for evaluating tracheal bronchus. To evaluate the utility of 16-slice MDCT in children with tracheal bronchus and to characterize the frequency of tracheal bronchus in children with congenital heart disease. From June 2005 to May 2007, 3,187 consecutive children (1,124 with congenital heart disease and 2,063 without congenital heart disease) underwent MDCT examination. Minimum-intensity projection reconstruction was performed to show the tracheobronchial tree in every case. Tracheal bronchus was found in 42 children (3.74%) with congenital heart disease but in only 6 children (0.29%) without congenital heart disease. Among the 48 children with tracheal bronchus, 45 had right-side tracheal bronchus and 3 had bilateral tracheal bronchi with heterotaxy syndrome. The diagnostic sensitivity of MDCT was 100% (48/48). MDCT is a reliable imaging technique for the diagnosis of tracheal bronchus. Our data showed that right-side tracheal bronchus was more common and bilateral tracheal bronchi usually occurred with heterotaxy syndrome. In addition, tracheal bronchus often occurred with congenital heart disease. The angle between the tracheal bronchus and the trachea is important and should be measured. (orig.)

Reversible ventilation and perfusion abnormalities in unilateral obstructed lung

International Nuclear Information System (INIS)

Ward, H.E.; Jones, R.L.; King, E.G.; Sproule, B.J.; Fortune, R.L.

1982-01-01

An intraluminal carcinoid tumor obstructing the left mainstem bronchus produced hypoxemia through alteration in ventilation/perfusion matching. Studies of regional lung function using 133-xenon (/sup 133/Xe) and a multiprobe computerized instrumentation system documented a reduction of perfusion to 22 percent and ventilation to 6 percent of the total. There was negligible washout of intravenously injected /sup 133/Xe from the left lung consistent with air trapping. Four days after left mainstem bronchial sleeve resection, perfusion, ventilation and washout of injected xenon had significantly improved and by four months postresection, all measurements were virtually normal, although complete restoration of perfusion in relation to ventilation was delayed. Regional lung function studied with a multiprobe system in this patient provided a clinical model for the study of ventilation and perfusion inter-relationships in large airway obstruction and demonstrated that a prolonged time may be required for return of perfusion to normal

[Transbronchoscopic end-tidal carbon dioxide detection for location of the leading bronchus in patients with pneumothorax].

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Zeng, Yiming; Lin, Huihuang

2015-04-01

To evaluate the effect of end-tidal carbon dioxide (EtCO2) detection for location of the leading bronchus in patients with pneumothorax. Transbronchoscopic EtCO2 detection was performed in 4 patients with intractable pneumothorax in whom transbronchoscopic balloon detection failed to localize the leading bronchus. A specific bronchus was suspected to be the leading bronchus when its EtCO2 value was significantly lower than that of the main bronchus of the affected lung. After the pleural air leakage was successfully sealed by bronchial occlusion of the suspected bronchus, the EtCO2 was confirmed to indicate the leading bronchus. Transbronchoscopic EtCO2 detection successfully located the leading bronchus in all 4 patients. Transbronchoscopic EtCO2 detection is a new method of locating the leading bronchus in patients with intractable pneumothorax.

Bronchus-associated lymphoid tissue in pulmonary hypertension produces pathologic autoantibodies.

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Colvin, Kelley L; Cripe, Patrick J; Ivy, D Dunbar; Stenmark, Kurt R; Yeager, Michael E

2013-11-01

Autoimmunity has long been associated with pulmonary hypertension. Bronchus-associated lymphoid tissue plays important roles in antigen sampling and self-tolerance during infection and inflammation. We reasoned that activated bronchus-associated lymphoid tissue would be evident in rats with pulmonary hypertension, and that loss of self-tolerance would result in production of pathologic autoantibodies that drive vascular remodeling. We used animal models, histology, and gene expression assays to evaluate the role of bronchus-associated lymphoid tissue in pulmonary hypertension. Bronchus-associated lymphoid tissue was more numerous, larger, and more active in pulmonary hypertension compared with control animals. We found dendritic cells in and around lymphoid tissue, which were composed of CD3(+) T cells over a core of CD45RA(+) B cells. Antirat IgG and plasma from rats with pulmonary hypertension decorated B cells in lymphoid tissue, resistance vessels, and adventitia of large vessels. Lymphoid tissue in diseased rats was vascularized by aquaporin-1(+) high endothelial venules and vascular cell adhesion molecule-positive vessels. Autoantibodies are produced in bronchus-associated lymphoid tissue and, when bound to pulmonary adventitial fibroblasts, change their phenotype to one that may promote inflammation. Passive transfer of autoantibodies into rats caused pulmonary vascular remodeling and pulmonary hypertension. Diminution of lymphoid tissue reversed pulmonary hypertension, whereas immunologic blockade of CCR7 worsened pulmonary hypertension and hastened its onset. Bronchus-associated lymphoid tissue expands in pulmonary hypertension and is autoimmunologically active. Loss of self-tolerance contributes to pulmonary vascular remodeling and pulmonary hypertension. Lymphoid tissue-directed therapies may be beneficial in treating pulmonary hypertension.

Basic data for making a mockup of the bronchus(I)

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Kim, Heung Tai; Kwon, Dal Gwan

1984-01-01

This is presented as basic data for making a mockup of the bronchus. Tubercluosis is an infectious disease designated by law and efforts to conquer it are exerted nationally. Whether the patient is infected or not can be diagnosed by photo fluorography intended for groups and also by Radio graphing which enables people to observe the film which is as long as the object. It is important to take photographs for the purpose of compacting as much information as possible in a film. But it is more important to gather information about the living bodies in the photographed film. Therefore, Knowledge of anatomy is most important for the accurate diagnosis of tuberculosis. Blood vessels of the lungs and the bronchus have a very complicated structure, so that they require efforts to understand them. To make a mockup of the bronchus is needed for better understanding of the complicated structure of the blood vessels in the lungs and the bronchus. I wrote this because I thought making a mockup is a foundation to understand the anatomy of the lungs

Diagnosis of multidetector spiral CT and its reconstruction techniques in trachea and principal bronchus tumors

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Mingyue, Luo; Hong, Shan; Zaibo, Jiang; Lufang, Li; Jiansheng, Zhang [Zhongshan Univ., Guangzhou (China). The Third Univ. Hospital, Dept. of Radiology; Lijia, Gu; Shaohong, Huang; Yi, Jin; Zhiqiang, Hou

2003-12-01

Objective: To investigate the clinical diagnostic value of multidetector spiral CT (MSCT) and its reconstruction techniques including multiplanar volume reformation (MPVR), volume rendering (VR), and virtual bronchoscopy (VB) in the trachea and principal bronchus tumors. Methods: Thin slice MSCT scanning was performed in 31 patients with suspected trachea or principal bronchus tumors, and image reconstruction data were formed after retro-reconstructing of initial scanning data. MPVR, VR, and VB images were obtained respectively by postprocessing of image reconstruction data with MPVR, VR, and VB image processing software in AW workstation. The findings of MSCT initial axial images, MPVR, VR, and VB images were compared with surgical and pathological results. Results: MSCT initial axial images combined with MPVR, VR, and VB images displayed the locations (tracheae, n=19; right principal bronchi, n=6; left principal bronchi, n=6), morphologies (endoluminal nodular tumors with narrow bases, n=2; endoluminal nodular tumors with wide bases, n=13; intraluminal and extraluminal massive tumors, n=16), internal features (1 had homogeneous density, 1 had low density, they both without obvious enhancement; 23 squamous cell carcinomas and 3 adenocarcinomas had fairly homogeneous density and rather obvious enhancement; 1 had homogeneous density, 1 had inhomogeneous density, 1 had punctate calcification, all with obvious enhancement), extramural invasion situations (broke through only serous membrane, n=1; no clear border with right atelectatic lung tissue, n=1; ranges of extramural invasion 4-56 mm, n=14), morphologies of luminal stenoses (eccentric, n=1; irregular, n=26; circular, n=3; conical interruption, n=1), extents (mild, n=5; moderate, n=7; severe, n=19); measured longitudinal invasion ranges (only 3 mm, n=1; invaded the whole right principal bronchus wall and carina, n=1; 5-68 mm, n=29), and distances between principal bronchus tumors and carina (invaded carina, n=1

Mounier-Kuhn Syndrome in an Elderly Female with Pulmonary Fibrosis

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Panagiotis Boglou

2016-01-01

Full Text Available Mounier-Kuhn syndrome (MKS, or tracheobronchomegaly, is a rare clinical and radiologic condition characterized by pronounced tracheobronchial dilation and recurrent lower respiratory tract infections. Tracheobronchomegaly presents when the defect extends to the central bronchi. MKS can be diagnosed in adult women when the transverse and sagittal diameters of the trachea, right mainstem bronchus, and left mainstem bronchus exceed 21, 23, 19.8, and 17.4 mm, respectively. Its diagnosis is based on chest radiograph and chest computed tomography (CT. Patients, usually middle-aged men, may be asymptomatic or present with clinical manifestations ranging from minimal symptoms with preserved lung function to severe respiratory failure. Pulmonary function tests (PFTs typically reveal a restrictive pattern. This report presents an elderly woman with previously diagnosed pulmonary fibrosis with symptoms of increased sputum production and haemoptysis. High-resolution chest CT showed tracheal and main stem bronchi dilatation along with bronchial diverticulosis. PFTs indicated a restrictive pattern characteristic of the underlying pulmonary fibrosis. The patient is the oldest, referred to the female gender, at presentation of MKS hitherto reported. This case highlights the need to include MKS in the differential diagnosis of recurrent lower respiratory tract infections, even in older subjects.

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

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

1988-09-01

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

Diagnostic Value of Multidetector CT and Its Multiplanar Reformation, Volume Rendering and Virtual Bronchoscopy Postprocessing Techniques for Primary Trachea and Main Bronchus Tumors.

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Mingyue Luo

Full Text Available To evaluate the diagnostic value of multidetector CT (MDCT and its multiplanar reformation (MPR, volume rendering (VR and virtual bronchoscopy (VB postprocessing techniques for primary trachea and main bronchus tumors.Detection results of 31 primary trachea and main bronchus tumors with MDCT and its MPR, VR and VB postprocessing techniques, were analyzed retrospectively with regard to tumor locations, tumor morphologies, extramural invasions of tumors, longitudinal involvements of tumors, morphologies and extents of luminal stenoses, distances between main bronchus tumors and trachea carinae, and internal features of tumors. The detection results were compared with that of surgery and pathology.Detection results with MDCT and its MPR, VR and VB were consistent with that of surgery and pathology, included tumor locations (tracheae, n = 19; right main bronchi, n = 6; left main bronchi, n = 6, tumor morphologies (endoluminal nodes with narrow bases, n = 2; endoluminal nodes with wide bases, n = 13; both intraluminal and extraluminal masses, n = 16, extramural invasions of tumors (brokethrough only serous membrane, n = 1; 4.0 mm-56.0 mm, n = 14; no clear border with right atelectasis, n = 1, longitudinal involvements of tumors (3.0 mm, n = 1; 5.0 mm-68.0 mm, n = 29; whole right main bronchus wall and trachea carina, n = 1, morphologies of luminal stenoses (irregular, n = 26; circular, n = 3; eccentric, n = 1; conical, n = 1 and extents (mild, n = 5; moderate, n = 7; severe, n = 19, distances between main bronchus tumors and trachea carinae (16.0 mm, n = 1; invaded trachea carina, n = 1; >20.0 mm, n = 10, and internal features of tumors (fairly homogeneous densities with rather obvious enhancements, n = 26; homogeneous density with obvious enhancement, n = 1; homogeneous density without obvious enhancement, n = 1; not enough homogeneous density with obvious enhancement, n = 1; punctate calcification with obvious enhancement, n = 1; low density

Diagnostic Value of Multidetector CT and Its Multiplanar Reformation, Volume Rendering and Virtual Bronchoscopy Postprocessing Techniques for Primary Trachea and Main Bronchus Tumors.

Science.gov (United States)

Luo, Mingyue; Duan, Chaijie; Qiu, Jianping; Li, Wenru; Zhu, Dongyun; Cai, Wenli

2015-01-01

To evaluate the diagnostic value of multidetector CT (MDCT) and its multiplanar reformation (MPR), volume rendering (VR) and virtual bronchoscopy (VB) postprocessing techniques for primary trachea and main bronchus tumors. Detection results of 31 primary trachea and main bronchus tumors with MDCT and its MPR, VR and VB postprocessing techniques, were analyzed retrospectively with regard to tumor locations, tumor morphologies, extramural invasions of tumors, longitudinal involvements of tumors, morphologies and extents of luminal stenoses, distances between main bronchus tumors and trachea carinae, and internal features of tumors. The detection results were compared with that of surgery and pathology. Detection results with MDCT and its MPR, VR and VB were consistent with that of surgery and pathology, included tumor locations (tracheae, n = 19; right main bronchi, n = 6; left main bronchi, n = 6), tumor morphologies (endoluminal nodes with narrow bases, n = 2; endoluminal nodes with wide bases, n = 13; both intraluminal and extraluminal masses, n = 16), extramural invasions of tumors (brokethrough only serous membrane, n = 1; 4.0 mm-56.0 mm, n = 14; no clear border with right atelectasis, n = 1), longitudinal involvements of tumors (3.0 mm, n = 1; 5.0 mm-68.0 mm, n = 29; whole right main bronchus wall and trachea carina, n = 1), morphologies of luminal stenoses (irregular, n = 26; circular, n = 3; eccentric, n = 1; conical, n = 1) and extents (mild, n = 5; moderate, n = 7; severe, n = 19), distances between main bronchus tumors and trachea carinae (16.0 mm, n = 1; invaded trachea carina, n = 1; >20.0 mm, n = 10), and internal features of tumors (fairly homogeneous densities with rather obvious enhancements, n = 26; homogeneous density with obvious enhancement, n = 1; homogeneous density without obvious enhancement, n = 1; not enough homogeneous density with obvious enhancement, n = 1; punctate calcification with obvious enhancement, n = 1; low density without

Correlation study of multislice spiral CT and pathology in relationship between solitary pulmonary nodule and bronchus

International Nuclear Information System (INIS)

Qiang Jinwei; Ye Xuanguang; Zhou Kangrong; Jiang Yaping; Wang Qun; Xu Songtao; Tan Lijie

2003-01-01

Objective: To investigate the relationship between solitary pulmonary nodule (SPN) and bronchus and its value in predicting the nature of nodule. Methods: Continuous volume targeted scans of 0.5 mm collimation were prospectively performed with multislice spiral CT (MSCT) and reconstructed images of MPR, CPR, and SSD in workstation in 75 patients of SPN with ≤3 cm in diameter were acquired. The emphasis was paid on the manifestation of the shapes and patterns of SPN with related bronchi. The results were correlated with macroscopic and microscopic specimens. Results: (1) The SPN-bronchus relationship was shown very clearly in all patients by the designed protocol. CT demonstrated the relations between SPN and bronchus in 44 (86.3%) malignant and 16 (66.7%) benign nodules. There was no statistically significant difference (P=0.065). (2) Five types of SPN-bronchus relationship were identified with MSCT. Type I: bronchus was obstructed abruptly by the SPN, type II: bronchus penetrated into SPN with tapered narrow and interruption, type III: bronchus lumen shown within SPN was patent and intact, type IV: bronchus ran at the periphery of SPN with intact lumen, and type V: bronchus was displaced, compressed, and narrowed by SPN. (3) With respect to the nature of SPN, malignant nodule most commonly showed type I, secondly type IV, and rarely type V. Benign nodule most often showed type V, secondly type I, and no type II. With respect to the pattern, type I, II, and IV patterns were more commonly seen in malignant nodule, whereas type V pattern was seen frequently in benign nodule. Type III pattern was slightly more common in benign cases. Conclusion: Spiral targeted scan of ultra-thin section with MSCT and followed by MPR, CPR, and SSD reconstruction can greatly improve the manifestation of the bronchioles and accurately demonstrate the patterns of SPN-bronchus relationship. Varied patterns are corresponding to certain nodule and reflect definite pathologic changes

Bronchoscopic brachytherapy in roentgenologically occult cancer of the trachea and bronchus

Energy Technology Data Exchange (ETDEWEB)

Ono, Ryosuke; Hirano, Hiroshi (National Cancer Center, Tokyo (Japan). Central Hospital)

1994-12-01

Bronchoscopic brachytherapy is a new technique presently being investigated for the treatment of cancer involving the tracheobronchial tree. This paper reports on the potential application of bronchoscopic brachytherapy to the local treatment of cancer of the respiratory tract. Bronchoscopic brachytherapy was performed on 8 patients with roentgenographically occult lung cancer after biopsies proved malignant lesions of the trachea and bronchus in each case. These patients came to the National Cancer Center Hospital during the period from September 1992 to December 1992. Among these 8 cases of malignant lesions of the trachea and bronchus, 5 malignant lesions of the bronchus were diagnosed by bronchoscopic ultrasonography prior to the bronchoscopic brachytherapy, and these 5 patients have completed at least three courses of this therapy carried out by means of a videobronchoscope. Among the 8 cases of malignant lesions of the trachea and bronchus, complete remission was obtained in 7 cases. Of the 8 patients, the death of one patient was caused by amyotrophic lateral sclerosis, while the remaining 7 patients have survived for 13-15 months (14.1 months on average) to date, without showing recurrence or metastasis. As for the complications involved in this treatment, only a light degree of excessive secretions was observed, and there was no abscess formation in any of the cases. (author).

Bronchoscopic brachytherapy in roentgenologically occult cancer of the trachea and bronchus

International Nuclear Information System (INIS)

Ono, Ryosuke; Hirano, Hiroshi

1994-01-01

Bronchoscopic brachytherapy is a new technique presently being investigated for the treatment of cancer involving the tracheobronchial tree. This paper reports on the potential application of bronchoscopic brachytherapy to the local treatment of cancer of the respiratory tract. Bronchoscopic brachytherapy was performed on 8 patients with roentgenographically occult lung cancer after biopsies proved malignant lesions of the trachea and bronchus in each case. These patients came to the National Cancer Center Hospital during the period from September 1992 to December 1992. Among these 8 cases of malignant lesions of the trachea and bronchus, 5 malignant lesions of the bronchus were diagnosed by bronchoscopic ultrasonography prior to the bronchoscopic brachytherapy, and these 5 patients have completed at least three courses of this therapy carried out by means of a videobronchoscope. Among the 8 cases of malignant lesions of the trachea and bronchus, complete remission was obtained in 7 cases. Of the 8 patients, the death of one patient was caused by amyotrophic lateral sclerosis, while the remaining 7 patients have survived for 13-15 months (14.1 months on average) to date, without showing recurrence or metastasis. As for the complications involved in this treatment, only a light degree of excessive secretions was observed, and there was no abscess formation in any of the cases. (author)

Timing, frequency and environmental conditions associated with mainstem-tributary movement by a lowland river fish, golden perch (Macquaria ambigua.

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Wayne M Koster

Full Text Available Tributary and mainstem connections represent important links for the movement of fish and other biota throughout river networks. We investigated the timing, frequency and environmental conditions associated with movements by adult golden perch (Macquaria ambigua between the mainstem of the mid-Murray River and a tributary, the Goulburn River, in south-eastern Australia, using acoustic telemetry over four years (2007-2011. Fish were tagged and released in autumn 2007-2009 in the mid-Murray (n = 42 and lower Goulburn (n = 37 rivers within 3-6 km of the mid-Murray-lower Goulburn junction. 38% of tagged fish undertook mainstem-tributary movements, characterised mostly by temporary occupation followed by return of fish to the original capture river. Approximately 10% of tagged fish exhibited longer-term shifts between the mainstem and tributary. Movement of fish from the tributary into the mainstem occurred primarily during the spawning season and in some years coincided with the presence of golden perch eggs/larvae in drift samples in the mainstem. Many of the tributary-to-mainstem movements occurred during or soon after changes in flow. The movements of fish from the mainstem into the tributary were irregular and did not appear to be associated with spawning. The findings show that golden perch moved freely across the mainstem-tributary interface. This demonstrates the need to consider the spatial, behavioural and demographic interdependencies of aquatic fauna across geographic management units such as rivers.

Timing, frequency and environmental conditions associated with mainstem-tributary movement by a lowland river fish, golden perch (Macquaria ambigua).

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Koster, Wayne M; Dawson, David R; O'Mahony, Damien J; Moloney, Paul D; Crook, David A

2014-01-01

Tributary and mainstem connections represent important links for the movement of fish and other biota throughout river networks. We investigated the timing, frequency and environmental conditions associated with movements by adult golden perch (Macquaria ambigua) between the mainstem of the mid-Murray River and a tributary, the Goulburn River, in south-eastern Australia, using acoustic telemetry over four years (2007-2011). Fish were tagged and released in autumn 2007-2009 in the mid-Murray (n = 42) and lower Goulburn (n = 37) rivers within 3-6 km of the mid-Murray-lower Goulburn junction. 38% of tagged fish undertook mainstem-tributary movements, characterised mostly by temporary occupation followed by return of fish to the original capture river. Approximately 10% of tagged fish exhibited longer-term shifts between the mainstem and tributary. Movement of fish from the tributary into the mainstem occurred primarily during the spawning season and in some years coincided with the presence of golden perch eggs/larvae in drift samples in the mainstem. Many of the tributary-to-mainstem movements occurred during or soon after changes in flow. The movements of fish from the mainstem into the tributary were irregular and did not appear to be associated with spawning. The findings show that golden perch moved freely across the mainstem-tributary interface. This demonstrates the need to consider the spatial, behavioural and demographic interdependencies of aquatic fauna across geographic management units such as rivers.

CT bronchus sign in malignant solitary pulmonary lesions: value in the prediction of cell type

International Nuclear Information System (INIS)

Choi, J.A.; Kim, J.H.; Hong, K.T.; Kim, H.S.; Oh, Y.W.; Kang, E.Y.

2000-01-01

The aim of this study was to evaluate differences in the prevalence of patterns of CT bronchus sign in malignant solitary pulmonary lesions (SPLs), according to their histologic cell types and with respect to size, location, and degree of cell differentiation. Computed tomography scans of 78 patients, in whom pathologically confirmed malignant SPLs with CT bronchus sign were present, were randomly selected and reviewed by two radiologists under consensus. All 78 were CT scans done using spiral technique with 10-mm collimation and 10-mm reconstruction intervals with enhancement, and 75 included additional high-resolution CT scans. Lesions were classified into four cell types as squamous cell carcinoma (n=24), small cell carcinoma (n=12), adenocarcinoma (n=23), bronchioloalveolar carcinoma (BAC; n=9), and others (n=12), into three degrees of differentiation, into three size groups, and according to location (central or peripheral). Patterns of CT bronchus sign were classified into abruptly obstructing (I), patent (II), displacing (III), or tapered narrowing (IV) types. The relationships between the patterns of CT bronchus sign and cell type and degree of cell differentiation were evaluated. Eighty patterns of CT bronchus sign were observed in 78 patients. According to cell type, squamous cell carcinoma showed most often type-I pattern (45.8%) but no type-II pattern, which was the most common pattern observed in BAC (77.8%) and adenocarcinoma (34.8%; p<0.01). Small cell carcinoma showed a varied distribution among the four patterns of CT bronchus sign. According to location, in central squamous cell carcinomas, type-I pattern was more common(55%; p<0.01). Bronchioloalveolar carcinoma showed more peripheral lesions and in both central and peripheral lesions, type-II pattern was significantly more common (100 and 66.7%; p<0.01). In SPLs with CT bronchus sign of obstructing pattern, especially if central location, squamous cell carcinoma should be suspected, whereas in

Endobronchial angiofibroma in the aberrant tracheal bronchus presenting as spontaneous pneumomediastinum.

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Kim, Kyung Soo; Moon, Young Kyu; Jeon, Hyun Woo; Park, Chan Beom; Ahn, Myeong Im; Lee, Kyo Young; Park, Jae Kil

2015-07-22

Spontaneous pneumomediastinum is a self-limiting benign disease but abnormal bronchial lesions can be rarely found incidentally, and in selected cases will require surgical resection. A 38-year-old man presented with a spontaneous pneumomediastinum. Chest computed tomography revealed an incidental linear endobronchial tumour in the aberrant tracheal bronchus. The tumour was removed surgically and diagnosed with a rare benign tumour of endobronchial angiofibroma. We report a rare case of endobronchial angiofibroma in the aberrant tracheal bronchus which was detected during the evaluation of a spontaneous pneumomediastinum.

Arctigenin exhibits relaxation effect on bronchus by affecting transmembrane flow of calcium.

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Zhao, Zhenying; Yin, Yongqiang; Wang, Zengyong; Fang, Runping; Wu, Hong; Jiang, Min; Bai, Gang; Luo, Guo'an

2013-12-01

Arctigenin, a lignan extract from Arctium lappa (L.), exhibits anti-inflammation, antioxidation, vasodilator effects, etc. However, the effects of arctigenin on bronchus relaxation are not well investigated. This study aimed to investigate how arctigenin regulates bronchus tone and calcium ion (Ca(2+)) flow. Trachea strips of guinea pigs were prepared for testing the relaxation effect of arctigenin to acetylcholine, histamine, KCl, and CaCl2, respectively. Furthermore, L-type calcium channel currents were detected by patch-clamp, and intracellular Ca(2+) concentration was detected by confocal microscopy. The results showed that arctigenin exhibited relaxation effect on tracheae to different constrictors, and this was related to decreasing cytoplasmic Ca(2+) concentration by inhibiting Ca(2+) influx partly through L-type calcium channel as well as promoting Ca(2+) efflux. In summary, this study provides new insight into the mechanisms by which arctigenin exhibits relaxation effect on bronchus and suggests its potential use for airway disease therapy.

Imaging features of nontumorous conditions involving the trachea and main-stem bronchi

International Nuclear Information System (INIS)

Jeon, Kyung Nyeo; Kang, Duk Sik; Bae, Kyung Soo

2002-01-01

A number of nontumorous diseases may affect the trachea and main-stem bronchi, and their nonspecific symptoms may include coughing, dyspnea, wheezing and stridor. The clinical course is often long-term and a misdiagnosis of bronchial asthma is common. The imaging findings of these nontumorous conditions are, however, relatively characteristic, and diagnosis either without or in conjunction with clinical information is often possible. For specific diagnosis, recognition of their imaging features is therefore of prime importance. In this pictorial essay, we illustrate the imaging features of various nontumorous conditions involving the trachea and main-stem bronchi

Physical and technical quality assurance in the CHARTWEL-bronchus trial

International Nuclear Information System (INIS)

Lehmann, D.; Voigtmann, L.; Herrmann, T.; Baumann, M.; Leetz, H.K.; Hodapp, N.

2003-01-01

Background: On-site physical quality assurance (QA) was performed in the participating centers of the CHARTWEL-Bronchus trial to ensure that physical and technical treatment parameters correspond with the requirements of this trial. Material and Methods: Questionnaires were sent to the clinics to obtain information on the equipment and in-house QA policies. In addition, two phantoms with drillings for an ionization chamber were shipped with detailed instructions for CT-based treatment planning of a fixed field (RW3 phantom) and a standardized isocentric 3-field technique (Rando trademark humanoid phantom). Using their routine treatment planning system, the participating centers performed point dose calculations for the isocenters in both phantoms and for defined points in the lungs and the spinal cord of the Rando trademark phantom. During the on-site visit, the doses in these points and the deviation of the actual monitor calibration from the internal reference value of the department were determined. In addition, relevant geometric parameters of the accelerator were checked. Results: In the RW3 phantom, the maximum dose deviations from the prescribed value were 3.5% without correction for the actual monitor calibration and 2.1% after correction. The maximum dose deviation in the isocenter of the Rando trademark phantom was 4.0%. To separate the influence of the treatment planning system on this deviation from other sources, all measurements in the Rando trademark phantom were corrected for the deviations determined in the RW3 phantom. After this correction, the maximum deviation was 3.0% in the isocenter. For the other measurement points, the largest dose deviation of 7% was found in the left lung. Deviations of geometric parameters were negligible in all audited departments. Conclusion: The CHARTWEL-Bronchus physical QA program revealed a high conformity of geometric and dosimetric parameters and valid dose calculations by the CT-based treatment planning systems

Airflow in Tracheobronchial Tree of Subjects with Tracheal Bronchus Simulated Using CT Image Based Models and CFD Method.

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Qi, Shouliang; Zhang, Baihua; Yue, Yong; Shen, Jing; Teng, Yueyang; Qian, Wei; Wu, Jianlin

2018-03-01

Tracheal Bronchus (TB) is a rare congenital anomaly characterized by the presence of an abnormal bronchus originating from the trachea or main bronchi and directed toward the upper lobe. The airflow pattern in tracheobronchial trees of TB subjects is critical, but has not been systemically studied. This study proposes to simulate the airflow using CT image based models and the computational fluid dynamics (CFD) method. Six TB subjects and three health controls (HC) are included. After the geometric model of tracheobronchial tree is extracted from CT images, the spatial distribution of velocity, wall pressure, wall shear stress (WSS) is obtained through CFD simulation, and the lobar distribution of air, flow pattern and global pressure drop are investigated. Compared with HC subjects, the main bronchus angle of TB subjects and the variation of volume are large, while the cross-sectional growth rate is small. High airflow velocity, wall pressure, and WSS are observed locally at the tracheal bronchus, but the global patterns of these measures are still similar to those of HC. The ratio of airflow into the tracheal bronchus accounts for 6.6-15.6% of the inhaled airflow, decreasing the ratio to the right upper lobe from 15.7-21.4% (HC) to 4.9-13.6%. The air into tracheal bronchus originates from the right dorsal near-wall region of the trachea. Tracheal bronchus does not change the global pressure drop which is dependent on multiple variables. Though the tracheobronchial trees of TB subjects present individualized features, several commonalities on the structural and airflow characteristics can be revealed. The observed local alternations might provide new insight into the reason of recurrent local infections, cough and acute respiratory distress related to TB.

[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.

A Study of Variations of the Branching Patterns of right Upper Lobar Bronchus by Corrosive Cast Method

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SV Solanki

2015-06-01

Full Text Available Introduction: Respiratory system is the basic prerequisite for living organisms. So precise knowledge of normal anatomy and various dimensions of human respiratory tract is inevitable. The right upper lobe bronchus is prevailingly trifurcates into apical, anterior and posterior segmental bronchi. Material and Methods: The present study was done on 28 tracheo-bronchial casts prepared by corrosive cast method in the anatomy department of B. J. medical college of Ahmedabad, Gujarat, India from 2011 to 2013. Result and Observation: In 16 specimens (57% normal trifurcate branching pattern was seen in right upper lobar bronchus. Most common variation observed was bifurcate pattern in right upper lobar bronchus in 36% of specimens. In 7% specimens quadrivial pattern was seen in right upper lobar bronchus in which it divided into four bronchi. Conclusion: The knowledge of anatomy and variation in branching pattern of the tracheo-bronchial tree enables the physicians to recognize clinical picture and pathology of human lungs, as well as the application of therapeutic and diagnostic methods like tracheal intubation, bronchoscopy, bronchography and postural drainage etc.

Infant with a foreign body bronchus: a fishy situation!

African Journals Online (AJOL)

which gave him brief respite. However, his situation deteriorated and he was referred to our center, as the suspicion of a foreign body in the bronchus was high by then and the referring physician had become concerned. After a detailed clinical examination in our casualty, we suspected that he might have aspirated a small ...

Anesthetic Management of Patients Undergoing Right Lung Surgery After Left Upper Lobectomy: Selection of Tubes for One-Lung Ventilation (OLV) and Oxygenation During OLV.

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Kawagoe, Izumi; Hayashida, Masakazu; Suzuki, Kenji; Kitamura, Yoshitaka; Oh, Shiaki; Satoh, Daizoh; Inada, Eiichi

2016-08-01

To investigate anesthesia management in patients undergoing right lung surgery after a previous left upper lobectomy (LUL) that may require special precautions since angulation of the left bronchus can hamper correct placement of a left-sided double-lumen tube (DLT), and one-lung ventilation (OLV) depending solely on the left lower lobe may lead to inadequate oxygenation. A retrospective data analysis. Single university hospital. Patients underwent right lung surgery after previous LUL. None. Anesthesia management was investigated in 18 patients who underwent right lung surgery following LUL. All intubation procedures were performed under bronchoscopic guidance to prevent airway trauma. OLV could be achieved with a left-sided DLT in 12 patients, while tubes other than this were required in 6 patients, including a right-sided DLT (n = 3) and a bronchial blocker (n = 3). The presence or absence of remarkable bronchial angulation, characterized by a combination of a wide (>140°) angle between the trachea and left main bronchus and a narrow (right lung surgery after LUL. Copyright © 2016 Elsevier Inc. All rights reserved.

True tracheal bronchus: Classification and anatomical relationship on multi-detector computed tomography

International Nuclear Information System (INIS)

Kim, Hyun Jeong; Kim, Young Tong; Jou, Sung Shick; Lee, Woong Hee

2017-01-01

To propose the imaging classification of true tracheal bronchus (TTB) on multi-detector computed tomography (MDCT), and to evaluate its anatomical relationship with surrounding structures. This study included 44 patients who were diagnosed with TTB on MDCT for 6 years. We classified TTB into five types, based on the existence of the right upper lobe bronchus originating from the right main bronchus and the number of segmental bronchi of TTB. We analyzed the site of origin and the running direction of TTB based on its anatomical relationship with surrounding structures and some ancillary findings. The imaging classification of TTB included Type I (47.7%), Type II (13.6%), Type III (11.4%), Type IV (25.0%), and Type V (2.0%). According to the site of origin of TTB, below the aortic arch (52.3%) and at the level of the aortic arch (43.1%) were the two main sites of origin, whereas the frequency of the site of origin above the azygos arch, at the level of the azygos arch, and below the azygos arch was 27.3%, 38.6%, and 34.1%, respectively. Considering both aortic and azygos arches, below the aortic arch and below the azygos arch were the most common sites of origin (27.3%). With respect to the running direction of TTB, in all cases, TTB passed below the azygos arch to the right upper lobe. There was no statistically significant (p > 0.05) difference in age or sex between types of TTB. Ancillary findings included tracheal stenosis (n = 2), narrowing of the right main bronchus (n = 2), luminal narrowing of TTB and bronchiectasis at the distal portion (n = 1), and a highly located azygos arch above the aortic arch (n = 2). The proposed imaging classification of TTB and its anatomical relationship with surrounding structures will improve our understanding of various imaging features and embryological development of TTB. Radiologists should pay careful attention to evaluation of the airway including the trachea on thoracic imaging

True tracheal bronchus: Classification and anatomical relationship on multi-detector computed tomography

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Kim, Hyun Jeong; Kim, Young Tong; Jou, Sung Shick; Lee, Woong Hee [Dept. of Radiology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan (Korea, Republic of)

2017-04-15

To propose the imaging classification of true tracheal bronchus (TTB) on multi-detector computed tomography (MDCT), and to evaluate its anatomical relationship with surrounding structures. This study included 44 patients who were diagnosed with TTB on MDCT for 6 years. We classified TTB into five types, based on the existence of the right upper lobe bronchus originating from the right main bronchus and the number of segmental bronchi of TTB. We analyzed the site of origin and the running direction of TTB based on its anatomical relationship with surrounding structures and some ancillary findings. The imaging classification of TTB included Type I (47.7%), Type II (13.6%), Type III (11.4%), Type IV (25.0%), and Type V (2.0%). According to the site of origin of TTB, below the aortic arch (52.3%) and at the level of the aortic arch (43.1%) were the two main sites of origin, whereas the frequency of the site of origin above the azygos arch, at the level of the azygos arch, and below the azygos arch was 27.3%, 38.6%, and 34.1%, respectively. Considering both aortic and azygos arches, below the aortic arch and below the azygos arch were the most common sites of origin (27.3%). With respect to the running direction of TTB, in all cases, TTB passed below the azygos arch to the right upper lobe. There was no statistically significant (p > 0.05) difference in age or sex between types of TTB. Ancillary findings included tracheal stenosis (n = 2), narrowing of the right main bronchus (n = 2), luminal narrowing of TTB and bronchiectasis at the distal portion (n = 1), and a highly located azygos arch above the aortic arch (n = 2). The proposed imaging classification of TTB and its anatomical relationship with surrounding structures will improve our understanding of various imaging features and embryological development of TTB. Radiologists should pay careful attention to evaluation of the airway including the trachea on thoracic imaging.

Immunological state of patients with carcinoma of the bronchus before and after radiotherapy

International Nuclear Information System (INIS)

Savage, A.M.; Pritchard, J.A.V.; Deeley, T.J.; Davies, B.H.; Sully Hospital

1980-01-01

The immunological state of 30 patients with carcinoma of the bronchus was assessed before and after radiotherapy by lymphocyte response to PHA and E and EAC rosette formation. The results were compared with those from age-matched patients with benign chest disease and a group of healthy control subjects. Differences were found between the three groups and decreased immunological responses were found to correlate with shorter survival times for patients with cancer of the bronchus. These differences were associated with the extent of the disease, or with the smoking habits of the patients. Significant differences in percentage EAC cell rosetting were demonstrated between lymphocytes from patients with malignant disease (31.3 +- 2.0) and those for control groups (21.5 +- 1.9 and 24.0 +- 2.2). Cancer patients and benign chest disease patients both had significantly decreased mean E rosetting values (59.3% and 55.6%) compared with healthy control subjects (69.7%). The group of cancer patients with a normal percentage of T lymphocytes and total number of lymphocytes and radiotherapy, or those with low percentage EAC cell rosettes, had a greater than 80% survival after seven months compared with less than 50% for the rest of the patients with carcinoma of the bronchus. (author)

The mean green popsicle: using cryotherapy to remove aspirated foreign bodies.

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Seaman, Joseph C; Knepler, James L; Bauer, Karen; Rashkin, Mitchell

2010-10-01

Foreign body (FB) aspiration can be a life-threatening event. Although more common in children, FB aspiration can occur at any age. Symptoms related to FB aspiration range from coughing and shortness of breath to asphyxiation. Chest imaging can be nonspecific and infrequently identifies an FB. Herein, we describe a case of a 54-year-old male patient who aspirated an FB and experienced respiratory arrest. He failed to improve with conservative measures and required emergent bronchoscopy. He was found to have an FB in his proximal left mainstem bronchus that could not be removed using standard bronchoscopy and he was referred to our center for definitive care. We used a cryotherapy probe to remove the FB. We propose that cryotherapy is a useful tool to remove FBs that are soft and amenable to freezing.

Accessory cardiac bronchus: Proposed imaging classification on multidetector CT

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Kim, Kang Min; Kim, Young Tong; Han, Jong Kyu; Jou, Sung Shick [Dept. of Radiology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan (Korea, Republic of)

2016-02-15

To propose the classification of accessory cardiac bronchus (ACB) based on imaging using multidetector computed tomography (MDCT), and evaluate follow-up changes of ACB. This study included 58 patients diagnosed as ACB since 9 years, using MDCT. We analyzed the types, division locations and division directions of ACB, and also evaluated changes on follow-up. We identified two main types of ACB: blind-end (51.7%) and lobule (48.3%). The blind-end ACB was further classified into three subtypes: blunt (70%), pointy (23.3%) and saccular (6.7%). The lobule ACB was also further classified into three subtypes: complete (46.4%), incomplete (28.6%) and rudimentary (25%). Division location to the upper half bronchus intermedius (79.3%) and medial direction (60.3%) were the most common in all patients. The difference in division direction was statistically significant between the blind-end and lobule types (p = 0.019). Peribronchial soft tissue was found in five cases. One calcification case was identified in the lobule type. During follow-up, ACB had disappeared in two cases of the blind-end type and in one case of the rudimentary subtype. The proposed classification of ACB based on imaging, and the follow-up CT, helped us to understand the various imaging features of ACB.

Pilot studies of superfractionated radiotherapy and combination chemotherapy in limited oat cell carcinoma of the bronchus

International Nuclear Information System (INIS)

Hodson, D.I.; Malaker, K.; Meikle, A.L.; Levitt, M.

1984-01-01

There are sound radiobiologic and suggestive clinical rationale for superfractionating the radiotherapeutic regimens employed for the therapy of rapidly growing malignancies. Oat cell carcinoma of the bronchus is such a tumor. The authors report their experience combining aggressive systemic combination chemotherapy with supperfractionated radiotherapy for the treatment of limited oat cell carcinoma of the bronchus. Overall, patient tolerance was satisfactory and a complete remission rate of 74% was achieved. It remains to be proven, in a prospective randomized fashion, whether this approach is superior to current conventional management

Do Knickpoints Unzip Watersheds? Longitudinal Observations of Terrace and Hillslope Response to Mainstem Incision along the South Fork Eel River, California

Science.gov (United States)

Wehrs, K.; Crosby, B. T.

2017-12-01

River response to changes in climate and relative base level often leave behind a legacy of transient landforms that enable the interpretation of past events. The dominant paradigm is that base level fall initiates a wave of mainstem incision that progressively transmits change upstream. Mainstem-adjacent hillslopes coupled to the channel subsequently respond as their toe slopes are steepened. To test this paradigm, we first use a longitudinal set of mainstem terrace ages to evaluate whether incision incrementally progresses upstream or is contemporaneous. Second, we explore longitudinal variations in mainstem-adjacent mass movements to evaluate whether they reflect a time and space progression in response. The South Fork Eel River in northern California contains over 600 mainstem-adjacent mass movements and 60 m tall, longitudinally extensive strath terraces that record a landscape response to river incision. We use Optically Stimulated Luminescence, with feldspars and coarse-grained sampling technique, to determine the depositional age of alluvial fill atop the strath terrace. If terrace abandonment progressively young upstream, this suggests that base level fall was not spatially contemporaneous, but rather time progressive. As a consequence, the age, form, and extent of mass wasting events should also vary longitudinally. Because terraces isolate hillslopes from the base level fall signal, we use these surfaces to quantify hillslope form and function independent of that forcing. Preliminary results using mainstem-parallel, 1 m LiDAR, show significant variation in size of mass movements throughout the basin, with planar, linearly moving translational landslides dominating throughout the catchment. In the lower basin, well downstream of the current knickzone, we see an increase in mass movement concentration, reactivation, and overall extent of mass movements. Multiple factors confound our interpretation of hillslope morphology and response, due to changes in

Complete Right Main Bronchus Rupture in a Child: Report of a Case

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Bayram Altuntas

2014-03-01

Full Text Available Blunt chest trauma resulting in rupture of a main bronchus is rare and probably have a high prehospital mortality.These injuries are often fatal because of respiratory distress and the high frequency of associated multiple organ injuries. A six-year-old boy was admitted our clinic due to blunt chest trauma. The tube thoracostomy was performed for the right pneumothorax at another surgical center. He was referred to our clinic due to inadequate expansion of the lung. On the physical examination, there was middle intercostal retraction, cyanosis and tachypnoea. The initial chest x-ray showed total pnemothorax on the right side and the hilum replaced by inferiorly. The rigid bronchoscopy was performed and the the rupture of main bronchus was seen. The sleeve upper lobectomy was performed. We aimed to emphasize the important of early diagnosis and treatment in the bronchial ruptures.

[Lymphadenectomy performed along the left recurrent laryngeal nerve after anterior detachment of the esophagus via thoracoscopic esophagectomy in the prone position under artificial pneumothorax].

Science.gov (United States)

Yamamoto, Shinichi; Ohshima, Hisami; Katsumori, Takashi; Hamaguchi, Hiromitsu; Tsukamoto, Yukika; Iwanaga, Tomohiro

2014-11-01

Thoracoscopic esophagectomy was performed in the prone position under artificial pneumothorax and did not affect the surgical area during lung ventilation; tracheal mobility was also improved. Lymphadenectomy around the left recurrent laryngeal nerve was performed by separating the left main bronchus and trachea between the esophagus and pericardium before detaching the dorsal side of the esophagus.

Long-term follow-up of bronchus-associated lymphoid tissue lymphomas (BALTOMA)

International Nuclear Information System (INIS)

Gaffke, G.; Jost, D.; Stroszcynski, C.; Puls, R.; Schlecht, I.; Felix, R.; Ludwig, W.D.; Hosten, N.

2002-01-01

Purpose: The purpose of this work was to describe the findings and the long term follow up of pathologically confirmed bronchus-associated lymphoid tissue lymphoma (BALTOMA) in 6 patients. Methods: CT examinations and conventional radiological examinations were reviewed and compared to describe typical radiological findings and patterns of pulmonary manifestations. It were described the number of lesions and characteristics like presence of airspace consolidation, ground-glass attenuation, bubble-like radio-lucencies, air bronchogram, bronchial dilatation, Infiltration and the long term behaviour of the manifestations. Results: Lesions with a positive air bronchogram, no infiltration of extrapulmonary tissue or extrapulmonary manifestations were revealed as typical findings. Only a slow or no progression of disease was shown in most patients over a term of up to twelve years. Conclusions: The lymphoma of the bronchus-associated lymphoid tissue of the lung is a rare tumor. A positive air bronchogram, a multiplicity of disease, bilateral lesions, a fibrotic transformation of the lung tissue and no growth or only a slow groth over al long term of observation are typical radiological findings. (orig.) [de

Experimental study of gene expression in lung and bronchus of radon-exposed mice

International Nuclear Information System (INIS)

Guo Zhiying; Tian Mei; Liu Jianxiang; Ruan Jianlei; Piao Chunnan; Su Xu

2008-01-01

Objective: To construct and identify differentially expressed cDNA library in lung and bronchus of mice exposed to radon. Methods: 2 week old, weighing (18-22)g, male BALB/c mice were placed in a SR-NIM02 radon chamber. One group of mice was exposed to radon, which was equivalent to the accumulative dose of 30 WLM. The control group was about 0.02 WLM. To construct a subtracted cDNA library enriched with differentially expressed genes, the Super SMART technique and the suppression subtractive hybridization (SSH) were performed. The obtained forward and reverse cDNA fragments were directly inserted into pGEM-T-easy vector and transformed into E. coli DH5α. The inserts in plasmid were amplified by nested polymerase chain reaction (PCR), and some of which were sequenced. In the end these sequences were BLASTed with GeneBank. Results: 146 of 460 clones obtained randomly were positive clones contained (1000-1500)bp inserted cDNA fragments. The forward and reverse subtracted cDNA library in lung and bronchus of mice exposed to radon was constructed, and 48 up-regulation and 61 down-regulation cDNA sequences selected were homologous with GeneBank in different extent. Conclusions: The subtracted cDNA library in lung and bronchus of mice exposed to radon is successfully constructed, and genes that differentially expressed are identified. Some genes might have relation with the immunity, cell cycle and apoptosis. (authors)

Tracheal involvement of bronchus-associated lymphoid tissue lymphoma: a case report

International Nuclear Information System (INIS)

Sohn, Kyung Sik; Jeon, Kyung Neough; Kang, Duk Sik

2002-01-01

Primary malignant tumors of the trachea are rare, the most prevalent histologies beeing squamous cell and adenoid cystic carcinoma. A review of the literature revealed only ten cases of primary tracheal or bronchial non-Hodgkin's lymphoma. We describe a case in which tracheal involvement of bronchus-associated lymphoid tissue lymphoma, a subtype of non-Hodgkin's lymphoma, occurred

Population Estimates for Chum Salmon Spawning in the Mainstem Columbia River, 2002 Technical Report.

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Rawding, Dan; Hillson, Todd D. (Washington Department of Fish and Wildlife, Olympia, WA)

2003-11-15

Accurate and precise population estimates of chum salmon (Oncorhynchus keta) spawning in the mainstem Columbia River are needed to provide a basis for informed water allocation decisions, to determine the status of chum salmon listed under the Endangered Species Act, and to evaluate the contribution of the Duncan Creek re-introduction program to mainstem spawners. Currently, mark-recapture experiments using the Jolly-Seber model provide the only framework for this type of estimation. In 2002, a study was initiated to estimate mainstem Columbia River chum salmon populations using seining data collected while capturing broodstock as part of the Duncan Creek re-introduction. The five assumptions of the Jolly-Seber model were examined using hypothesis testing within a statistical framework, including goodness of fit tests and secondary experiments. We used POPAN 6, an integrated computer system for the analysis of capture-recapture data, to obtain maximum likelihood estimates of standard model parameters, derived estimates, and their precision. A more parsimonious final model was selected using Akaike Information Criteria. Final chum salmon escapement estimates and (standard error) from seining data for the Ives Island, Multnomah, and I-205 sites are 3,179 (150), 1,269 (216), and 3,468 (180), respectively. The Ives Island estimate is likely lower than the total escapement because only the largest two of four spawning sites were sampled. The accuracy and precision of these estimates would improve if seining was conducted twice per week instead of weekly, and by incorporating carcass recoveries into the analysis. Population estimates derived from seining mark-recapture data were compared to those obtained using the current mainstem Columbia River salmon escapement methodologies. The Jolly-Seber population estimate from carcass tagging in the Ives Island area was 4,232 adults with a standard error of 79. This population estimate appears reasonable and precise but batch

Fatal stroke after completion pneumonectomy for torsion of left upper lobe following left lower lobectomy

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Apostolakis Efstratios

2006-09-01

Full Text Available Abstract Background The lobar torsion after lung surgery is a rare complication with an incidence of 0.09 to 0.4 %. It may occur after twisting of the bronchovascular pedicle of the remaining lobe after lobectomy, usually on the right side. The 180-degree rotation of the pedicle produces an acute obstruction of the lobar bronchus (atelectasis and of the lobar vessels as well. Without prompt treatment it progresses to lobar ischemia, pulmonary infarction and finally fatal gangrene. Case Presentation A 62 years old female patient was admitted for surgical treatment of lung cancer. She underwent elective left lower lobectomy for squamous cell carcinoma (pT2 N0. The operation was unremarkable, and the patient was extubated in the operating room. After eight hours the patient established decrease of pO2 and chest x-ray showed atelectasis of the lower lobe. To establish diagnosis, bronchoscopy was performed, demonstrating obstructed left lobar bronchus. The patient was re-intubated, and admitted to the operating room where reopening of the thoracotomy was performed. Lobar torsion was diagnosed, with the diaphragmatic surface of the upper lobe facing in an anterosuperior orientation. A completion pneumonectomy was performed. At the end of the procedure the patient developed a right pupil dilatation, presumably due to a cerebral embolism. A subsequent brain angio-CT scan established the diagnosis. She died at the intensive care unit 26 days later. Conclusion The thoracic surgeon should suspect this rare early postoperative complication after any thoracic operation in every patient with atelectasis of the neighboring lobe. High index of suspicion and prompt diagnosis may prevent catastrophic consequences, such as, infarction or gangrene of the pulmonary lobe. During thoracic operations, especially whenever the lung or lobe hilum is full mobilized, fixation of the remaining lobe may prevent this life threatening complication.

Lateral chest radiographic findings in lobar collapse of the left lung : the distance between both upper lobe bronchi

International Nuclear Information System (INIS)

Chin, G. H.; Sung, D. W.; Yoon, Y.; Kim, H. C.

1996-01-01

To evaluate the distance between both upper love bronchi on lateral radiographs and its change in left upper or lower lobe collapse. 144 true lateral radiographs were analyzed on which both upper lobe bronchi were clearly identified. They included 116 normal cases, 11 cases of left upper lobe collapse, 13 of left lower lobe collapse, and 4 cases of left lower lobe lobectomy. Line A was drawn parallel to the vertebral end plate through the upper margin of the lift upper lobe bronchus. Line B was drawn parallel to line A through the upper margin of the right upper love bronchus. The shortest distance between line A and line B was measured as the distance between both upper lobe bronchi. In normal cases, the mean value of the distance was 2.19 cm ± S.D. 0.37 cm on right and on right and 2.16 cm ± S.D. 0.40 cm on left lateral radiographs ; these results were not significantly different(P=0.79). In cases of collapse, the mean value of the distance was 0.43 cm ± S.D. 0.99 cm in upper lobe collapse and 3.56 cm ± S.D. 0.72 cm in lower lobe collapse, results which were significantly different from those of normal cases(p<0.01). In eight cases(73%) of left upper lobe collapse, the distance was less than 1 cm and in 10 cases(77%) of left lower lobe collapse, the distance was more than 3 cm. The distance between both upper lobe bronchi varies markedly in case of lobar collapse. A distance of less than 1 cm suggests collapse of the left upper lobe and a distance more than 3 cm suggests collapse of the left lower lobe

Metabolism of aflatoxin B1 and identification of the major aflatoxin B1-DNA adducts formed in cultured human bronchus and colon

DEFF Research Database (Denmark)

Autrup, Herman; Essigmann, John M.; Croy, Robert G.

1979-01-01

Aflatoxin B1 and benzo(a)pyrene were activated by both cultured human bronchus and human colon as measured by binding to cellular DNA and protein. The binding of aflatoxin B1 to DNA was dose dependent, and the level of binding was higher in cultured human bronchus than it was in the colon. When c...

Effect of implanted radioactive 125I seeds on normal tissue structures of bronchus, esophagus, pulmonary artery, pulmonary vein and alveolus in dogs

International Nuclear Information System (INIS)

Qi Liangchen; Han Zhenguo; Yang Bin; Heersitai

2008-01-01

Objective: To investigate the effect of implanted radioactive 125 I seeds on normal tissue structures of bronchus, esophagus, pulmonary artery, pulmonary vein and alveolus in dogs. Methods: Nine healthy male dogs weighing 17-21 kg were randomly divided into three groups: 30 d, 60 d experimental groups and control group. Radioactive 125 I seeds (3.7 x 10 7 Bg, 1.0 mCi) were implanted into the sides of bronchus, esophagus, pulmonary artery, pulmonary vein respectively, the samples of bronchus, esophagus, pulmonary artery, pulmonary vein were taken 30 and 60 d after transplantation, HE staining was used to observe the pathologic changes of the tissues under light microscope. Results: The damages of normal bronchus, esophagus, pulmonary artery, pulmonary vein and alveolus after radioactive 125 I seeds implantation in 30 d group were weaker than those in control group and 60 d group, there were no complications such as perforation, hemorrhage, necrosis, etc. Histopathological score indicated that the scores of bronchus, esophagus and alveolar in 30 d group and 60 d group were higher than those in control group (P 0.05); there was no significant difference in histopathological score of pulmonary vein among all groups (P>0.05). Conclusion: The implanted radioactive 125 I seeds can damage all kinds of tissues at different degrees, but this kind of damage is reversible, the dog may repair the damage through its own repair ability, its clinical application is safe. (authors)

Induction and Analysis of Bronchus-Associated Lymphoid Tissue.

Science.gov (United States)

Fleige, Henrike; Förster, Reinhold

2017-01-01

Bronchus-associated lymphoid tissue (BALT) forms spontaneously in the lung after pulmonary infection and has been identified as a highly organized lymphoid structure supporting the efficient priming of T cells in the lung. To explore the mechanisms and instructive signals controlling BALT neogenesis we used both, a single dose of vaccinia virus MVA and repeated inhalations of heat-inactivated Pseudomonas aeruginosa (P. aeruginosa). Intranasal administration of both pathogens induces highly organized BALT but distinct pathways and molecules are used to promote the development of BALT. Here, we describe the induction and phenotype of the distinct types of BALT as well as the immunofluorescence microscopy-based analysis of the induced lymphoid tissue in the lung.

Recurrent Embolotherapy in Dieulafoy's Disease of the Bronchus

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Praveen Bhatia

2003-01-01

Full Text Available Dieulafoy's disease is a vascular anomaly characterized by the presence of a dysplastic artery that is related to an epithelial ulcer. The French surgeon Georges Dieulafoy first described it in 1898. Most frequently, it is a gastrointestinal condition, but occurrence in the bronchus has been reported in a few cases. The case of a 52-year-old man with massive hemoptysis, for which he underwent successful embolotherapy 10 years previously, is described. Over the next 10 years, he had several hospital admissions due to hemoptysis, and he underwent successful embolotherapy on each occasion. This case report underlines the importance of bronchial arteriography as the investigation of choice for massive hemoptysis.

Left lower lobe sleeve lobectomy for lung cancer using the Da Vinci surgical system.

Science.gov (United States)

Zhao, Yandong; Jiao, Wenjie; Ren, Xiaoyang; Zhang, Liangdong; Qiu, Tong; Fu, Bo; Wang, Lei

2016-04-12

Despite the robotic surgery is widely applied, sleeve lobectomy for lung cancer using the Da Vinci surgical system is still less performed. We described a sleeve lobectomy for adenocarcinoma located at the left lower lobe using the Da Vinci surgical system. A case of 57-year old female referred to our hospital. Computed tomography scan showed an occupation located at the left lower lobe and adenocarcinoma project from the lobe bronchus was diagnosed by bronchoscope examination. A sleeve lobectomy was performed using the Da Vinci surgical system and the postoperative recovery was uneventful. Robotic thoracic surgery is feasible to perform sleeve lobectomy inspite of inadequate experience.

Metabolic activation and DNA binding of benzo(a)pyrene in cultured human bronchus

DEFF Research Database (Denmark)

Yang, Shen K.; Gelboin, Harry V.; Trump, Benjamin F.

1977-01-01

. The predominant metabolite formed by human bronchus from the (-)-trans-7,8-diol is found by high-pressure liquid chromatographic analysis to be the diol-epoxide r-7,t-8-dihydroxy-t-9,10-oxy-7,8,9,10-tetrahy-drobenzo(a)pyrene. The results suggest that this diol-epoxide is the major benzo(a)pyrene metabolite bound...

A Rare Presentation of a Rare Disease: Pulmonary Lymphomatoid Granulomatosis

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Ghulam Rehman Mohyuddin

2012-01-01

Full Text Available A 70-year-old female presented with a 4-week history of dry cough and wheezing. Chest radiograph showed a 10.5 cm mass-like density in the anterior mediastinum which had not been previously visualized. Computed tomography scan (CT of the chest showed a right hilar mass encasing and narrowing right upper lobe bronchus and right mainstem bronchus and secondary atelectatic changes. Biopsy was consistent with a diagnosis of lymphomatoid granulomatosis Grade 3. She responded well clinically and radiologically to therapy. Lymphomatoid granulomatosis is a rare EBV-associated disorder which is considered a lymphoproliferative disease. The most common radiographic feature is multiple lung nodules. An isolated hilar mass is an exceptionally rare presentation of this rare disease.

CT evaluation of decrease in attenuation in the superior segment of the left lower lobe

International Nuclear Information System (INIS)

Inaoka, Tsutomu; Takahashi, Koji; Ono, Hidetoshi

2003-01-01

We occasionally see decrease in attenuation in the superior segment of the left lower lobe on normal chest CT and notice that this finding could be seen in elder population. Then, we assessed the frequency, age distribution and cause of decrease in attenuation in the superior segment of the left lower lobe. Chest CT scans of 246 patients without lung or cardiac disorders were retrospectively reviewed. Segmental low attenuation area in the superior segment of the left lower lobe was identified in 12 patients (4.9%), which were 65-92 years old with mean age of 77.2 years old. In all of them, chest CT demonstrated that the tortuous descending aorta compressed directly the superior segmental bronchus of the left lower lobe. It is concluded that the lateral tortuousity of the descending aorta could cause decrease in attenuation in the superior segment of the left lower lobe. (author)

Hydrological pulse regulating the bacterial heterotrophic metabolism between Amazonian mainstems and floodplain lakes

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Luciana Oliveira Vidal

2015-09-01

Full Text Available We evaluated in situ rates of bacterial carbon processing in Amazonian floodplain lakes and mainstems, during both high and low water phases (p < 0.05. Our results showed that Bacterial Production (BP was lower and more variable than Bacterial Respiration (BR, determined as total respiration. Bacterial Carbon Demand (BCD was mostly accounted by BR and presented the same pattern that BR in both water phases. Bacterial growth efficiency showed a wide range (0.2–23% and low mean value of 3 and 6 %, (in high and low water respectively suggesting that dissolved organic carbon (DOC was mostly allocated to catabolic metabolism. However, BGE was regulated by BP in low water phase. Consequently, changes in BGE showed the same pattern that BP. In addition, the hydrological pulse effects on mainstems and floodplains lakes connectivity were found for BP and BGE in low water. Multiple correlation analyses revealed that indexes of organic matter quality (chlorophyll-a, N stable isotopes and C/N ratios were the strongest seasonal drivers of bacterial carbon metabolism. Our work indicated that: (1 the bacterial metabolism was mostly driven by respiration in Amazonian aquatic ecosystems resulting in low BGE in either high and low water phase; (2 the hydrological pulse regulated

Distinctly visible right upper lobe bronchus on the lateral chest: A clue to adolescent cystic fibrosis

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Reinig, J.W.; Sanchez, F.W.; Thomason, D.M.; Gobien, R.P.

1985-05-01

Radiographic differentiation between cystic fibrosis and asthma presenting in teenagers and young adults can be difficult. Many patients with a late presentation of cystic fibrosis display minimal changes on a chest radiograph. However, a large majority (90%) of cystic fibrosis patients with an essentially normal PA chest radiograph will have a distinctly outlined orifice of right upper lobe bronchus on a lateral chest film as opposed to a small number of asthmatics (25%) or normal patients (18%). This observation correlates well with the pathologic finding that the initial pulmonary involvement in cystic fibrosis is typically in the right upper lobe in adolescents. Teenager or young adult patients presenting with a history of repeated respiratory infections, asthma-like symptoms and a distinctly visible right upper lobe bronchus on a lateral chest film should be sweat-tested to exclude cystic fibrosis.

The distinctly visible right upper lobe bronchus on the lateral chest: A clue to adolescent cystic fibrosis

International Nuclear Information System (INIS)

Reinig, J.W.; Sanchez, F.W.; Thomason, D.M.; Gobien, R.P.

1985-01-01

Radiographic differentiation between cystic fibrosis and asthma presenting in teenagers and young adults can be difficult. Many patients with a late presentation of cystic fibrosis display minimal changes on a chest radiograph. However, a large majority (90%) of cystic fibrosis patients with an essentially normal PA chest radiograph will have a distinctly outlined orifice of right upper lobe bronchus on a lateral chest film as opposed to a small number of asthmatics (25%) or normal patients (18%). This observation correlates well with the pathologic finding that the initial pulmonary involvement in cystic fibrosis is typically in the right upper lobe in adolescents. Teenager or young adult patients presenting with a history of repeated respiratory infections, asthma-like symptoms and a distinctly visible right upper lobe bronchus on a lateral chest film should be sweat-tested to exclude cystic fibrosis. (orig.)

CT assessment of tracheobronchial anomaly in left pulmonary artery sling

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Zhong, Yu-Min M.; Zhu, Ming; Sun, Ai-Min M.; Wang, Qian [Shanghai Jiao Tong University School of Medicine, Department of Radiology, Shanghai Children' s Medical Center, Shanghai (China); Jaffe, Richard B. [Primary Children' s Medical Center, Department of Medical Imaging, Salt Lake City, UT (United States); Gao, Wei [Shanghai Jiao Tong University School of Medicine, Department of Cardiology, Shanghai Children' s Medical Center, Shanghai (China)

2010-11-15

The left pulmonary artery sling (LPAS) is a rare vascular anomaly where the left pulmonary artery arises from the right pulmonary artery, passes over the right bronchus, and goes posteriorly between the trachea and esophagus. The LPAS is frequently associated with cardiac and non-cardiac defects including tracheobronchial abnormalities. To evaluate the utility of multislice CT (MSCT) and helical CT (HCT) in diagnosing and defining the tracheobronchial anomaly and anatomic relationships between the trachea and aberrant left pulmonary artery. MSCT or HCT was performed in 27 children to determine the tracheobronchial anatomy and identify tracheobronchial stenosis. Eighteen children underwent surgery. According to the Wells [6] classification of LPAS, which includes two main types and two subtypes, there were eight cases of type 1A, five cases of type 1B, six cases of type 2A and eight cases of type 2B in this group. Twenty-four of the 27 children had substantial tracheobronchial stenosis. Four died before surgery; the 18 had reanastomosis of the left pulmonary artery. Five children also had tracheoplasty; three died after surgery. CT, especially MSCT, is an ideal modality for simultaneously identifying aberrant left pulmonary artery and any associated tracheobronchial anomaly. The Wells classification is useful for operative planning. (orig.)

CT imaging of bronchus related to solitary pulmonary lesion: comparison of minimum intensity projection and multi-planar reconstruction

International Nuclear Information System (INIS)

Zhou Jun; Shan Fei; Zhang Zhiyong; Yang Shan; Zhang Xingwei; Wu Dong; Zhan Songhua

2011-01-01

Objective: To investigate the clinical value of 64-slice computed tomography with MinIP and MPR for imaging the bronchus related to a solitary pulmonary lesion (SPL). Methods: Seventy-five subjects with solitary pulmonary lesions underwent chest 64-slice CT and their bronchi were analyzed retrospectively. All images of thin-section (0.625 mm) were reconstructed with MPR and MinIP into images of 1, 2, 3, and 5 mm thickness and 1 mm gap in two orthogonal planes along the long axis of bronchus related to the SPL. The image quality of four series of MinIP and MPR images was evaluated in the aspect of bronchus visibility and pulmonary vascular masking. One-way ANOVA with Bonferroni correction and interclass correlation coefficient were used in the statistical analysis. Results: (1) The mean scores of display of the bronchi on MinIP images of four series (4.85, 4.77 and 4.84, 4.63 and 4.67, 4.25 and 4.28, in 1, 2, 3, and 5 mm thickness, respectively) and on MPR images of 1 or 2 mm thickness (4.77 and 4.76, 4.04 and 4.27, in 1 and 2 mm thickness, respectively) were good or excellent. MPR images of 1 mm thickness and MinIP images of 1-3 mm thickness showed no significant differences (t=0.318, P> 0.05 for all), but they were superior to MinIP images of 5 mm thickness (t=6.318 and 6.610, P 0.05). (2) The effect of suppression of pulmonary vascular markings on MinIP images was better with the increase of slice thickness (F= 45.312 and 40.415, P<0.01). The mean scores of MinIP images of 3 mm and 5 mm thickness (4.67 and 4.64, 5.00 and 4.97, for 3 and 5 mm thickness, respectively) were good or excellent, but MinIP images of 2 mm thickness were just acceptable. Conclusion: MinIP images of 3 mm thickness may display the bronchus related to SPL more clearly. (authors)

Effects of water temperature on breeding phenology, growth and timing of metamorphosis of foothill yellow-legged frogs (Rana boylii) on the mainstem and selected tributaries of California's Trinity River - 2004-2009.

Science.gov (United States)

Clara Wheeler; James Bettaso; Donald Ashton; Hartwell Welsh

2013-01-01

The cold temperatures maintained in the Trinity River are beneficial to fish but may be problematic for foothill yellow-legged frogs. We examined the timing of breeding, reproductive output, and growth and development of tadpoles for populations of foothill yellow-legged frogs on the mainstem and six tributaries of the Trinity River. On the colder mainstem, onset of...

Metabolism of benzo(a)pyrene and 7,12-dimethylbenz(a)anthracene in cultured human bronchus and pancreatic duct

DEFF Research Database (Denmark)

Harris, Curtis C.; Autrup, Herman; Stoner, Gary

1977-01-01

The metabolism of two carcinogenic polynuclear aro matic hydrocarbons, benzo[a]pyrene (BP) and 7,12-dimethylbenz[a]anthracene, was studied in expiants of human pancreatic duct and bronchus cultured in a chemically defined medium. In cultured human bronchial mucosa, activity of aryl hydrocarbon hy...

Early Bronchus-Associated Lymphoid Tissue Lymphoma Diagnosed with Immunoglobulin Heavy Chain Molecular Testing

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Pen Li

2016-01-01

Full Text Available When extranodal marginal zone B-cell lymphoma of mucosa associated lymphoid tissue (MALT, a low grade B-cell lymphoma, arises in the lung it is referred to as bronchus-associated lymphoid tissue (BALT lymphoma. We describe a patient with a history of Sjögren’s syndrome and rheumatoid arthritis with dyspnea and imaging consistent with lymphoid interstitial pneumonia (LIP. However, while histology and immunohistochemistry lacked definitive features of a lymphoma, immunoglobulin heavy chain (IgH polymerase chain reaction testing demonstrated B-cell monoclonality, consistent with an early BALT lymphoma.

Serpine2 deficiency results in lung lymphocyte accumulation and bronchus-associated lymphoid tissue formation.

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Solleti, Siva Kumar; Srisuma, Sorachai; Bhattacharya, Soumyaroop; Rangel-Moreno, Javier; Bijli, Kaiser M; Randall, Troy D; Rahman, Arshad; Mariani, Thomas J

2016-07-01

Serine proteinase inhibitor, clade E, member 2 (SERPINE2), is a cell- and extracellular matrix-associated inhibitor of thrombin. Although SERPINE2 is a candidate susceptibility gene for chronic obstructive pulmonary disease, the physiologic role of this protease inhibitor in lung development and homeostasis is unknown. We observed spontaneous monocytic-cell infiltration in the lungs of Serpine2-deficient (SE2(-/-)) mice, beginning at or before the time of lung maturity, which resulted in lesions that resembled bronchus-associated lymphoid tissue (BALT). The initiation of lymphocyte accumulation in the lungs of SE2(-/-) mice involved the excessive expression of chemokines, cytokines, and adhesion molecules that are essential for BALT induction, organization, and maintenance. BALT-like lesion formation in the lungs of SE2(-/-) mice was also associated with a significant increase in the activation of thrombin, a recognized target of SE2, and excess stimulation of NF-κB, a major regulator of chemokine expression and inflammation. Finally, systemic delivery of thrombin rapidly stimulated lung chemokine expression in vivo These data uncover a novel mechanism whereby loss of serine protease inhibition leads to lung lymphocyte accumulation.-Solleti, S. K., Srisuma, S., Bhattacharya, S., Rangel-Moreno, J., Bijli, K. M., Randall, T. D., Rahman, A., Mariani, T. J. Serpine2 deficiency results in lung lymphocyte accumulation and bronchus-associated lymphoid tissue formation. © FASEB.

Upper-half body irradiation for oat cell carcinoma of the bronchus

International Nuclear Information System (INIS)

Stockdale, A.D.; Rostom, A.Y.

1989-01-01

Small-cell anaplastic carcinoma of the bronchus (SCCB) is considered to be a chemosensitive tumour. For many physicians, chemotherapy is the treatment of first choice. However, despite prolonged and aggressive therapy, overall 2-year survival of less than 10% may be expected. Radiotherapy has an established role in the palliation of advances disease. We have previously investigated the use of single, large fractions of radiotherapy in patients with drug-resistant multiple myeloma and shown excellent responses and prolonged survival. As the majority of patients present with disseminated disease, we have investigated the use of a single fraction of radiotherapy to the upper half of the body (including the liver) in 24 patients with SCCB. (author)

Upper-half body irradiation for oat cell carcinoma of the bronchus

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Stockdale, A.D.; Rostom, A.Y. (Saint Luke' s Hospital, Guildford (UK))

1989-06-01

Small-cell anaplastic carcinoma of the bronchus (SCCB) is considered to be a chemosensitive tumour. For many physicians, chemotherapy is the treatment of first choice. However, despite prolonged and aggressive therapy, overall 2-year survival of less than 10% may be expected. Radiotherapy has an established role in the palliation of advances disease. We have previously investigated the use of single, large fractions of radiotherapy in patients with drug-resistant multiple myeloma and shown excellent responses and prolonged survival. As the majority of patients present with disseminated disease, we have investigated the use of a single fraction of radiotherapy to the upper half of the body (including the liver) in 24 patients with SCCB. (author).

MDCT abnormalities of small- and medium-sized bronchus in active tuberculosis: a new angle on an old disease

International Nuclear Information System (INIS)

Oh, Jin Kyoung; Ahn, Myeong Im; Jung, Jung Im; Han, Dae Hee; Kim, Young Kyoon; Oh, Eun-Jee; Park, Yeon-Joon

2011-01-01

Background: The incidence and findings of tuberculous invasion of the peripheral bronchus have not been fully investigated with MDCT. Purpose: To evaluate the prevalence and findings of MDCT abnormalities of small- and medium-sized bronchus (SMB) in active pulmonary tuberculosis (TB). Material and Methods: Using multiplanar reformation, 35 consecutive MDCT scans (follow-up exams available in 14 patients with a mean interval of 8.1 months) were assessed for following abnormalities of SMB: bronchial impaction (BI), wall thickening, dilatation, peribronchial cuff of soft tissue, and bronchocavitary fistula. It was also assessed whether tree-in-buds (TIB) have a tendency to distribute in the territories of diseased SMB, and whether SMB abnormalities are present in patients with relatively mild disease. Results: SMB abnormalities were observed in 23 (65.7%) patients with active TB. The most frequent finding was wall thickening (n=18, 51.4%), followed by BI (n=13, 37.1%; zigzag-shaped in four), dilatation (n =11, 31.4%), amputated appearance of air column (n=11, 31.4%), peribronchial cuff of soft tissue (n=10, 28.6%), and bronchocavitary fistula (n=8, 22.9%). TIB (n=29; absent in two patients with SMB) was mainly within (n=14) or close to (n=4) the territory of diseased SMB. Follow-up CT frequently showed improvement of wall thickening (11/12) and persistence of bronchial dilatation (11/13). SMB abnormality was present in all of six patients with mild disease. Conclusion: MDCT shows that tuberculous invasion of the peripheral bronchus may be more frequent than previously thought, of which findings include wall thickening, BI, dilatation, amputated appearance of air column, peribronchial cuff of soft tissue and bronchocavitary fistula

MDCT abnormalities of small- and medium-sized bronchus in active tuberculosis: a new angle on an old disease

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Oh, Jin Kyoung; Ahn, Myeong Im; Jung, Jung Im; Han, Dae Hee (Dept. of Radiology, Seoul St Mary' s Hospital, The Catholic Univ. of Korea, Seoul (Korea, Republic of)), email: lepolder@gmail.com; Kim, Young Kyoon (Dept. of Internal Medicine, Seoul St Mary' s Hospital, The Catholic Univ. of Korea, Seoul (Korea, Republic of)); Oh, Eun-Jee; Park, Yeon-Joon (Dept. of Laboratory Medicine, Seoul St Mary' s Hospital, The Catholic Univ. of Korea, Seoul (Korea, Republic of))

2011-02-15

Background: The incidence and findings of tuberculous invasion of the peripheral bronchus have not been fully investigated with MDCT. Purpose: To evaluate the prevalence and findings of MDCT abnormalities of small- and medium-sized bronchus (SMB) in active pulmonary tuberculosis (TB). Material and Methods: Using multiplanar reformation, 35 consecutive MDCT scans (follow-up exams available in 14 patients with a mean interval of 8.1 months) were assessed for following abnormalities of SMB: bronchial impaction (BI), wall thickening, dilatation, peribronchial cuff of soft tissue, and bronchocavitary fistula. It was also assessed whether tree-in-buds (TIB) have a tendency to distribute in the territories of diseased SMB, and whether SMB abnormalities are present in patients with relatively mild disease. Results: SMB abnormalities were observed in 23 (65.7%) patients with active TB. The most frequent finding was wall thickening (n=18, 51.4%), followed by BI (n=13, 37.1%; zigzag-shaped in four), dilatation (n =11, 31.4%), amputated appearance of air column (n=11, 31.4%), peribronchial cuff of soft tissue (n=10, 28.6%), and bronchocavitary fistula (n=8, 22.9%). TIB (n=29; absent in two patients with SMB) was mainly within (n=14) or close to (n=4) the territory of diseased SMB. Follow-up CT frequently showed improvement of wall thickening (11/12) and persistence of bronchial dilatation (11/13). SMB abnormality was present in all of six patients with mild disease. Conclusion: MDCT shows that tuberculous invasion of the peripheral bronchus may be more frequent than previously thought, of which findings include wall thickening, BI, dilatation, amputated appearance of air column, peribronchial cuff of soft tissue and bronchocavitary fistula

Inducible Bronchus-Associated Lymphoid Tissue: Taming Inflammation in the Lung.

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Hwang, Ji Young; Randall, Troy D; Silva-Sanchez, Aaron

2016-01-01

Following pulmonary inflammation, leukocytes that infiltrate the lung often assemble into structures known as inducible Bronchus-Associated Lymphoid Tissue (iBALT). Like conventional lymphoid organs, areas of iBALT have segregated B and T cell areas, specialized stromal cells, high endothelial venules, and lymphatic vessels. After inflammation is resolved, iBALT is maintained for months, independently of inflammation. Once iBALT is formed, it participates in immune responses to pulmonary antigens, including those that are unrelated to the iBALT-initiating antigen, and often alters the clinical course of disease. However, the mechanisms that govern immune responses in iBALT and determine how iBALT impacts local and systemic immunity are poorly understood. Here, we review our current understanding of iBALT formation and discuss how iBALT participates in pulmonary immunity.

Elevated temperature intensity, timing, and duration of exposure affect soybean internode elongation, mainstem node number, and pod number per plant

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Leon Hartwell Allen, Jr.

2018-04-01

Full Text Available A study was conducted in four compartments of a polycarbonate greenhouse at Gainesville, FL, USA to investigate how a soybean (Glycine max L. Merr. cultivar, Maverick (maturity group III, indeterminate, responded to three elevated temperatures, ELT, (day/night of 34/26 °C, 38/30 °C, and 42/34 °C in comparison to a control growth temperature (30/22 °C. Carbon dioxide (CO2 concentration was maintained at 700 μmol mol−1 in each compartment by a processor controlled air-sampling and CO2-injection system. Three sequential experiments were conducted at different times of year (summer, autumn, and early spring to investigate the effect of intensity, timing, and duration of ELT on soybean node number, internode elongation, mainstem length, and number of pods set per plant. At the control temperature, the soybean plants grown in the polycarbonate greenhouse were taller than field-grown plants. When plants were grown under continuous ELT applied soon after sowing or at initial flowering, the number of nodes increased with increasing ELT intensity, whereas the length of individual internodes decreased. When ELT treatment was applied during the beginning of flowering stage (R1–R2 or earlier, more nodes were produced and the length of affected internodes was decreased. When the ELT was imposed later at reproductive stage R5+ just before the beginning of seed filling, effects on node numbers and internode lengths were negligible. Short-term (10-day duration of ELT applied at four stages from V3 to R5+ did not significantly affect final mean numbers of nodes or mean mainstem lengths. Possible mechanisms of elevated temperature effects on soybean internode elongation and node number (internode number are discussed. Total pod numbers per plant increased linearly with mainstem node numbers and mainstem length. Furthermore, total pod numbers per plant were greatest at 34/26 °C rather than at the control temperature of 30/22 °C (and

The Use of Extracorporeal Membrane Oxygenation in the Surgical Repair of Bronchial Rupture

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Ju-Hee Park

2016-02-01

Full Text Available Extracorporeal membrane oxygenation (ECMO has been used successfully in critically ill patients with traumatic lung injury and offers an additional treatment modality. ECMO is mainly used as a bridge treatment to delayed surgical management; however, only a few case reports have presented the successful application of ECMO as intraoperative support during the surgical repair of traumatic bronchial injury. A 38-year-old man visited our hospital after a blunt chest trauma. His chest imaging showed hemopneumothorax in the left hemithorax and a finding suspicious for left main bronchus rupture. Bronchoscopy was performed and confirmed a tear in the left main bronchus and a congenital tracheal bronchus. We decided to provide venovenous ECMO support during surgery for bronchial repair. We successfully performed main bronchial repair in this traumatic patient with a congenital tracheal bronchus. We suggest that venovenous ECMO offers a good option for the treatment of bronchial rupture when adequate ventilation is not possible.

Focal Stenosis in Right Upper Lobe Bronchus in a Recurrently Wheezing Child Sequentially Studied by Multidetector-row Spiral Computed Tomography and Scintigraphy

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I-Chen Chen

2009-12-01

Full Text Available Lower respiratory tract infections associated with wheezing are not uncommon in infants and young children. Among the wheezing-associated disorders, allergic etiologies are more commonly encountered than anatomic anomalies. We present a 3-year-old girl with a sudden attack of asthmatic symptoms including dyspnea, cyanosis and diffuse wheezing. Based on a history of choking, and atelectasis in the right upper lobe detected by chest films, flexible tracheobronchoscopy was arranged and incidentally detected a stenotic orifice in the right upper lobe bronchus. Multidetector-row spiral computed tomography and pulmonary scintigraphy subsequently also disclosed the focal stenosis. She suffered from recurrent wheezing, pneumonia and lung atelectasis during 1 year of follow-up. We emphasize the diagnosis, clinical course and management of focal stenosis in the right upper lobe bronchus.

Right Upper Lobe Shadow and Tracheobronchopathia Osteochondroplastica Confined to Right Main Bronchus: A Case Report and Literature Review

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Stylianos A. Michaelides

2015-01-01

Full Text Available Tracheobronchopathia osteochondroplastica (TO is a well documented benign entity of endoscopic interest. We describe a case of 76-year-old patient who presented with fever, cough, purulent sputum during the past four days, and presence of an ovoid shadow in right upper zone of his chest X-ray. Medical history included diagnosis of colon diverticuli identified by colonoscopy 3 months ago. Chest CT revealed a compact elongated lesion containing air-bronchogram stripes. Bronchoscopy showed normal upper airways and trachea but presence of unequal sized mucosal nodules, protruding into the lumen, along the entire length of the right main bronchial mucosa. No other abnormal findings were detected. Moreover, brushing and washing smears from the apical segment of right upper lobe (RUL, where the compact lesion was located, were negative for malignancy. Biopsy from the mucosal nodules of right main bronchus showed presence of cartilaginous tissue in continuity through thin pedicles with submucosal cartilage. This finding posed the diagnosis of TO while RUL lesion was cleared by antibiotic treatment. Case is reported because, to our knowledge, it represents a unique anatomic location of TO which was confined exclusively in the right main bronchus mucosa without affecting trachea.

Bronchus-associated lymphoid tissue (BALT) lymphoma of the lung showing mosaic pattern of inhomogeneous attenuation on thin-section CT: a case report

International Nuclear Information System (INIS)

Lee, In Jae; Kim, Sung Hwan; Koo, Soo Hyun; Kim, Hyun Beom; Hwang, Dae Hyun; Lee, Kwan Seop; Lee, Yul; Jang, Kee Taek; Kim, Duck Hwan

2000-01-01

The authors present a case of histologically proven bronchus-associated lymphoid tissue (BALT) lymphoma of the lung in a patient with primary Sjogren's syndrome that manifested on thin-section CT scan as a mosaic pattern of inhomogeneous attenuation due to mixed small airway and infiltrative abnormalities

Bronchus-associated lymphoid tissue (BALT) lymphoma of the lung showing mosaic pattern of inhomogeneous attenuation on thin-section CT: a case report

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Lee, In Jae; Kim, Sung Hwan; Koo, Soo Hyun; Kim, Hyun Beom; Hwang, Dae Hyun; Lee, Kwan Seop; Lee, Yul; Jang, Kee Taek; Kim, Duck Hwan [Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of)

2000-09-01

The authors present a case of histologically proven bronchus-associated lymphoid tissue (BALT) lymphoma of the lung in a patient with primary Sjogren's syndrome that manifested on thin-section CT scan as a mosaic pattern of inhomogeneous attenuation due to mixed small airway and infiltrative abnormalities.

Kootenai River fisheries investigations. Chapter 3: Mainstem habitat use and recruitment estimates of rainbow trout in the Kootenai River, Idaho. Annual report 1996

International Nuclear Information System (INIS)

Fredericks, J.; Hendricks, S.

1997-09-01

The objective of this study was to determine if recruitment is limiting the population of rainbow trout Oncorhynchus mykiss in the mainstem Kootenai River. The authors used snorkeling and electrofishing techniques to estimate juvenile rainbow trout density and total numbers in Idaho tributaries, and they trapped juvenile outmigrants to identify the age at which juvenile trout migrate from tributaries to the Kootenai River. The authors radio and reward-tagged post-spawn adult rainbow trout captured in Deep Creek to identify river reach and habitat used by those fish spawning and rearing in the Deep Creek drainage. They also conducted redd surveys in the Kootenai River to determine the extent of mainstem spawning. Based on the amount of available habitat and juvenile rainbow trout densities, the Deep Creek drainage was the most important area for juvenile production. Population estimates of age 0, age 1+, and age 2+ rainbow trout indicated moderate to high densities in several streams in the Deep Creek drainage whereas other streams, such as Deep Creek, had very low densities of juvenile trout. The total number of age 0, age 1+, and age 2+ rainbow trout in Deep Creek drainage in 1996 was estimated to be 63,743, 12,095, and 3,095, respectively. Radio telemetry efforts were hindered by the limited range of the transmitters, but movements of a radio-tagged trout and a returned reward tag indicated that at least a portion of the trout utilizing the Deep Creek drainage migrated downriver from the mouth of Deep Creek to the meandering section of river. They found no evidence of mainstem spawning by rainbow trout, but redd counting efforts were hindered by high flows from mid-April through June

A morphological study of bronchi and lung tissues in long-term survived dogs

OpenAIRE

松本, 伸

1984-01-01

Morphological changes of the bronchus and lung tissue of ten adult dogs were examined at various intervals after sleeve resection of the left upper lobe was performed in combination with bronchoplasty and pulmonary artery angioplasty. Postoperative changes in the bronchus and pulmonary artery were investigated by bronchoscopy and pulmonary angiography 8 months to 14 months after the operation. The dogs were sacrificed 9 months to 32 months after the operation, and the bronchus and lung tissue...

A Case of Chronic Granulomatous Disease with a Necrotic Mass in the Bronchus: A Case Report and a Review of Literature

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Ali Cheraghvandi

2012-01-01

Full Text Available Chronic granulomatous disease is a rare phagocytic disorder with recurrent, severe bacterial and fungal infections. We describe an unusual case of chronic granulomatous disease manifesting as an invasive pulmonary aspergillosis with an obstructive necrotic mass at the right middle bronchus. The patient was successfully treated with a bronchoscopic intervention for the removal of the obstructive mass and a medical therapy.

Long-term Outcome of Short Metallic Stents for Lobar Airway Stenosis.

Science.gov (United States)

Fruchter, Oren; Abed El Raouf, Bayya; Rosengarten, Dror; Kramer, Mordechai R

2017-07-01

Whereas stents are considered an excellent treatment for proximal central major airway stenosis, the value of stenting for distal lobar airway stenosis is still controversial. Our aim was to explore the short-term and long-term outcome of metallic stents placed for benign and malignant lobar airway stenosis. Between July 2007 and July 2014, 14 patients underwent small airway stent insertion. The clinical follow-up included serial semiannual physical examinations, pulmonary function tests, imaging, and bronchoscopy. The etiologies for airway stenosis were: early post-lung transplantation bronchial stenosis (N=5), sarcoidosis (N=1), amyloidosis (N=1), anthracofibrosis (N=1), right middle lobe syndrome due to external lymph node compression (N=1), lung cancer (N=4), and stenosis of the left upper lobe of unknown etiology (N=1). Stents were placed in the right upper lobe bronchus (N=2), right middle lobe bronchus (N=6), left upper lobe bronchus (N=4), linguar bronchus (N=1), and left lower lobe bronchus (N=1). The median follow-up period ranged from 2 to 72 months (median 18 mo). Immediate relief of symptoms was achieved in the vast majority of patients (13/14, 92%). Out of 10 patients with benign etiology for stenosis, 9 (90%) experienced sustained and progressive improvement in pulmonary function tests and clinical condition. We describe our positive experience with small stents for lobar airway stenosis; further prospective trials are required to evaluate the value of this novel modality of treatment.

Different dissecting orders of the pulmonary bronchus and vessels during right upper lobectomy are associated with surgical feasibility and postoperative recovery for lung cancer patients.

Science.gov (United States)

Zhai, Hao-Ran; Yang, Xue-Ning; Nie, Qiang; Liao, Ri-Qiang; Dong, Song; Li, Wei; Jiang, Ben-Yuan; Yang, Jin-Ji; Zhou, Qing; Tu, Hai-Yan; Zhang, Xu-Chao; Wu, Yi-Long; Zhong, Wen-Zhao

2017-06-27

Right upper lobectomy (RUL) for lung cancer with different dissecting orders involves the most variable anatomical structures, but no studies have analyzed its effects on postoperative recovery. This study compared the conventional surgical approach, VAB (dissecting pulmonary vessels first, followed by the bronchus), and the alternative surgical approach, aBVA (dissecting the posterior ascending arterial branch first, followed by the bronchus and vessels) on improving surgical feasibility and postoperative recovery for lung cancer patients. According to the surgical approach, consecutive lung cancer patients undergoing RUL were grouped into aBVA and VAB cohorts. Their clinical, pathologic, and perioperative characteristics were collected to compare perioperative outcomes. Three hundred one patients were selected (109 in the aBVA cohort and 192 in the VAB cohort). The mean operation time was shorter in the aBVA cohort than in the VAB cohort (164 vs. 221 min, P  0.05). The median disease-free survival was comparable for all patients in the two cohorts (not arrived vs. 41.97 months) and for patients with disease recurrences (13.25 vs. 9.44 months) (both P > 0.05). The recurrence models in two cohorts were also comparable for patients with local recurrences (6.4% vs. 7.8%), distant metastases (10.1% vs. 8.3%), and both (1.8% vs. 1.6%) (all P > 0.05). Dissecting the right upper bronchus before turning over the lobe repeatedly and dissecting veins via the aBVA approach during RUL would promote surgical feasibility and achieve comparable postoperative recovery for lung cancer patients.

CT quantification of central airway in tracheobronchomalacia

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Im, Won Hyeong; Jin, Gong Yong; Han, Young Min; Kim, Eun Young [Dept. of Radiology, Chonbuk National University Hospital, Jeonju (Korea, Republic of)

2016-05-15

To know which factors help to diagnose tracheobronchomalacia (TBM) using CT quantification of central airway. From April 2013 to July 2014, 19 patients (68.0 ± 15.0 years; 6 male, 13 female) were diagnosed as TBM on CT. As case-matching, 38 normal subjects (65.5 ± 21.5 years; 6 male, 13 female) were selected. All 57 subjects underwent CT with end-inspiration and end-expiration. Airway parameters of trachea and both main bronchus were assessed using software (VIDA diagnostic). Airway parameters of TBM patients and normal subjects were compared using the Student t-test. In expiration, both wall perimeter and wall thickness in TBM patients were significantly smaller than normal subjects (wall perimeter: trachea, 43.97 mm vs. 49.04 mm, p = 0.020; right main bronchus, 33.52 mm vs. 42.69 mm, p < 0.001; left main bronchus, 26.76 mm vs. 31.88 mm, p = 0.012; wall thickness: trachea, 1.89 mm vs. 2.22 mm, p = 0.017; right main bronchus, 1.64 mm vs. 1.83 mm, p = 0.021; left main bronchus, 1.61 mm vs. 1.75 mm, p = 0.016). Wall thinning and decreased perimeter of central airway of expiration by CT quantification would be a new diagnostic indicators in TBM.

Primary endobronchial marginal zone B-cell lymphoma of bronchus-associated lymphoid tissue: CT findings 7 patients

International Nuclear Information System (INIS)

Yoon, Ra Gyoung; Kim, Mi Young; Song, Jae Woo; Chae, Eun Jin; Choi, Chang Min; Jang, Se Jin

2013-01-01

To investigate CT and 1 8F -fluorodeoxyglucose (1 8F -FDG) positron-emission tomography/CT findings of primary endobronchial marginal zone B-cell lymphoma of the bronchus-associated lymphoid tissue (BALT). From June 2006 through April 2012, seven patients (six female, one male; age range, 21-61 years; mean age, 49 years) were examined who were pathologically diagnosed with the primary endobronchial marginal zone B-cell lymphoma of BALT. We evaluated the locations and characteristics of the lesions on CT and 1 8F -FDG-PET/CT scans. The lesions were classified into the following three patterns: 1) solitary intraluminal nodule; 2) several tiny nodular protrusions; and 3) diffuse wall thickening. A solitary intraluminal nodule was observed in four patients (57.1%), several tiny nodular protrusion in two patients (28.6%), and diffuse wall thickening in one patient (14.3%). The lesions were categorized into 3 major locations: confined to the trachea (n 3), confined to the lobar bronchus (n = 2), and diffuse involvement of the trachea and both main bronchi (n = 2). All lesions demonstrated homogeneous iso-attenuation as compared with muscle on pre- and post-enhancement scans. Secondary findings in the lungs (n = 3; 42.9%) included postobstructive lobar atelectasis (n = 1), air trapping (n = 1), and pneumonia (n = 1). On 1 8F -FDG-PET/CT (n = 5), 4 lesions showed homogeneous uptake with maximum standardized uptake values (mSUV), ranging 2.3-5.7 (mean mSUV: 3.3). One lesion showed little FDG uptake. Primary endobronchial marginal zone B-cell lymphoma of the BALT manifests as three distinct patterns on CT, with the solitary intraluminal nodule presenting as the main pattern. Most lesions demonstrate homogeneous but weak FDG uptake on 1 8F -FDG-PET/CT.

Primary endobronchial marginal zone B-cell lymphoma of bronchus-associated lymphoid tissue: CT findings 7 patients

Energy Technology Data Exchange (ETDEWEB)

Yoon, Ra Gyoung; Kim, Mi Young; Song, Jae Woo; Chae, Eun Jin; Choi, Chang Min; Jang, Se Jin [University of Ulsan College of Medicine, Seoul (Korea, Republic of)

2013-04-15

To investigate CT and 1{sup 8F}-fluorodeoxyglucose (1{sup 8F}-FDG) positron-emission tomography/CT findings of primary endobronchial marginal zone B-cell lymphoma of the bronchus-associated lymphoid tissue (BALT). From June 2006 through April 2012, seven patients (six female, one male; age range, 21-61 years; mean age, 49 years) were examined who were pathologically diagnosed with the primary endobronchial marginal zone B-cell lymphoma of BALT. We evaluated the locations and characteristics of the lesions on CT and 1{sup 8F}-FDG-PET/CT scans. The lesions were classified into the following three patterns: 1) solitary intraluminal nodule; 2) several tiny nodular protrusions; and 3) diffuse wall thickening. A solitary intraluminal nodule was observed in four patients (57.1%), several tiny nodular protrusion in two patients (28.6%), and diffuse wall thickening in one patient (14.3%). The lesions were categorized into 3 major locations: confined to the trachea (n 3), confined to the lobar bronchus (n = 2), and diffuse involvement of the trachea and both main bronchi (n = 2). All lesions demonstrated homogeneous iso-attenuation as compared with muscle on pre- and post-enhancement scans. Secondary findings in the lungs (n = 3; 42.9%) included postobstructive lobar atelectasis (n = 1), air trapping (n = 1), and pneumonia (n = 1). On 1{sup 8F}-FDG-PET/CT (n = 5), 4 lesions showed homogeneous uptake with maximum standardized uptake values (mSUV), ranging 2.3-5.7 (mean mSUV: 3.3). One lesion showed little FDG uptake. Primary endobronchial marginal zone B-cell lymphoma of the BALT manifests as three distinct patterns on CT, with the solitary intraluminal nodule presenting as the main pattern. Most lesions demonstrate homogeneous but weak FDG uptake on 1{sup 8F}-FDG-PET/CT.

Community structure of age-0 fishes in paired mainstem and created shallow-water habitats in the Lower Missouri River

Science.gov (United States)

Starks, Trevor A.; Long, James M.; Dzialowski, Andrew R.

2016-01-01

Anthropogenic alterations to aquatic ecosystems have greatly reduced and homogenized riverine habitat, especially those used by larval and juvenile fishes. Creation of shallow-water habitats is used as a restoration technique in response to altered conditions in several studies globally, but only recently in the USA. In the summer of 2012, the U.S. Army Corps of Engineers sampled larval and juvenile fishes at six paired sites (mainstem and constructed chute shallow-water habitats) along a section of the Missouri River between Rulo, NE and St. Louis, MO, USA. From those samples, we enumerated and identified a total of 7622 fishes representing 12 families. Community responses of fishes to created shallow-water habitats were assessed by comparisons of species richness and diversity measures between paired sites and among sampling events. Shannon entropy measures were transformed, and gamma diversity (total diversity) was partitioned into two components, alpha (within community) and beta (between community) diversity using a multiplicative decomposition method. Mantel test results suggest site location, time of sampling event and habitat type were drivers of larval and juvenile community structure. Paired t-test results indicated little to no differences in beta diversity between habitat types; however, chute habitats had significantly higher alpha and gamma diversity as well as increased abundances of Asian carp larvae when compared with mainstem shallow-water habitat. Our results not only show the importance of created shallow-water habitat in promoting stream fish diversity but also highlight the role space and time may play in future restoration and management efforts. 

Evaluation of the Biological Effects of the Northwest Power Conservation Council's Mainstem Amendment on the Fisheries Upstream and Downstream of Libby Dam, Montana, 2007-2008 Annual Report.

Energy Technology Data Exchange (ETDEWEB)

Sylvester, Ryan; Stephens, Brian; Tohtz, Joel [Montana Fish, Wildlife & Parks

2009-04-03

A new project began in 2005 to monitor the biological and physical effects of improved operations of Hungry Horse and Libby Dams, Montana, called for by the Northwest Power and Conservation Council (NPCC) Mainstem Amendment. This operating strategy was designed to benefit resident fish impacted by hydropower and flood control operations. Under the new operating guidelines, July through September reservoir drafts will be limited to 10 feet from full pool during the highest 80% of water supply years and 20 feet from full pool during the lowest 20% of water supply (drought) years. Limits were also established on how rapidly discharge from the dams can be increased or decreased depending on the season. The NPCC also directed the federal agencies that operate Libby and Hungry Horse Dams to implement a new flood control strategy (VARQ) and directed Montana Fish, Wildlife & Parks to evaluate biological responses to this operating strategy. The Mainstem Amendment operating strategy has not been fully implemented at the Montana dams as of June 2008 but the strategy will be implemented in 2009. This report highlights the monitoring methods used to monitor the effects of the Mainstem Amendment operations on fishes, habitat, and aquatic invertebrates upstream and downstream of Libby Dam. We also present initial assessments of data and the effects of various operating strategies on physical and biological components of the systems upstream and downstream of Libby Dam. Annual electrofishing surveys in the Kootenai River and selected tributaries, along with gill net surveys in the reservoir, are being used to quantify the impacts of dam operations on fish populations upstream and downstream of Libby Dam. Scales and otoliths are being used to determine the age structure and growth of focal species. Annual population estimates and tagging experiments provide estimates of survival and growth in the mainstem Kootenai River and selected tributaries. Radio telemetry will be used to

"Detachment of the carinal hook following endobronchial intubation with a double lumen tube"

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Rocha Ana C

2011-10-01

Full Text Available Abstract Background Carinal hooks increases difficulty at endotracheal intubation. Amputation of the carinal hook during passage and malpositioning of the tube to the hook are some of the potential problems related with left-sided Carlens double lumen tube (DLT. This article reports an amputation of the hook during a difficult selective intubation and aimed at calling the attention to complications associated with DLTs and the importance of fiberoptic bronchoscopy. Case presentation A 68 year-old woman was scheduled for right-sided thoracotomy in whom blind DLT insertion was performed. Narrowed trachea causes difficulty in rotating the DLT 90° counter-clockwise. After carinal hook was noticed upon visual inspection of the DLT, fiberoptic bronchoscopy was used to remove the missing part (with the use of forceps from the right mainstem bronchus. Conclusion Insertion of DLTs with carinal hook is associated with technical problems and potentially life-threatening hazards have discouraged their use. Fiberoptic evaluation and repositioning solves most of the problems. Although amputation of the carinal hook has not been previously reported, clinicians should be alert. This case report emphasizes the utility of the fiberoptic bronchoscopy in the operating theatre for placement, positioning and inspection of the carinal hook DLT.

French experience of silicone tracheobronchial stenting in children.

Science.gov (United States)

Fayon, Michael; Donato, Lionel; de Blic, Jacques; Labbé, André; Becmeur, François; Mely, Laurent; Dutau, Hervé

2005-01-01

Silicone stents were inserted into the trachea or left main-stem bronchus in 14 children aged 2-69 months (median, 7 months). Indications were as follows: tracheomalacia or airway kinking (7 cases), vascular compression (5 cases), and surgically corrected congenital tracheal stenoses (2 cases). The best results were obtained in tracheomalacia. Overall, 6 cases out of 14 (43%) were considered successful, with a stent placement duration of 3-15 months (median, 7 months). Two cases were considered a technical success, although they were clinical failures. Five cases were considered failures primarily due to stent migration. A retrospective analysis of failures suggests that most of these could have been avoided by the use of larger stents. One patient died of stent obstruction. No wall erosion was observed, and the development of granulation tissue was infrequent. Endoscopic removal of the prostheses was uneventful. The biocompatibility of silicone stents appears to be better than what is reported for metal ones, although the stability of the former is less satisfactory. The present study shows the feasibility of silicone stent placement in infants. These stents should be considered as a possible therapeutic option in certain types of childhood airway disorders, although further studies are required.

Metagenomic evidence for reciprocal particle exchange between the mainstem estuary and lateral bay sediments of the lower Columbia River

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Mariya W Smith

2015-10-01

Full Text Available Lateral bays of the lower Columbia River estuary are areas of enhanced water retention that influence net ecosystem metabolism through activities of their diverse microbial communities. Metagenomic characterization of sediment microbiota from three disparate sites in two brackish lateral bays (Baker and Youngs produced approximately 100 Gbp of DNA sequence data analyzed subsequently for predicted SSU rRNA and peptide-coding genes. The metagenomes were dominated by Bacteria. A large component of Eukaryota was present in Youngs Bay samples, i.e. the inner bay sediment was enriched with the invasive New Zealand mudsnail, Potamopyrgus antipodarum, known for high ammonia production. The metagenome was also highly enriched with an archaeal ammonia oxidizer closely related to Nitrosoarchaeum limnia. Combined analysis of sequences and continuous, high-resolution time series of biogeochemical data from fixed and mobile platforms revealed the importance of large-scale reciprocal particle exchanges between the mainstem estuarine water column and lateral bay sediments. Deposition of marine diatom particles in sediments near Youngs Bay mouth was associated with a dramatic enrichment of Bacteroidetes (58% of total Bacteria and corresponding genes involved in phytoplankton polysaccharide degradation. The Baker Bay sediment metagenome contained abundant Archaea, including diverse methanogens, as well as functional genes for methylotrophy and taxonomic markers for syntrophic bacteria, suggesting that active methane cycling occurs at this location. Our previous work showed enrichments of similar anaerobic taxa in particulate matter of the mainstem estuarine water column. In total, our results identify the lateral bays as both sources and sinks of biogenic particles significantly impacting microbial community composition and biogeochemical activities in the estuary.

Characterization and Monitoring Data for Evaluating Constructed Emergent Sandbar Habitat in the Missouri River Mainstem

Energy Technology Data Exchange (ETDEWEB)

Duberstein, Corey A.; Downs, Janelle L.

2008-11-06

Emergent sandbar habitat (ESH) in the Missouri River Mainstem System is a critical habitat element for several federally listed bird species: the endangered interior least tern (Sterna antillarum) and the threatened Northern Great Plains piping plover (Charadrius melodus). The Army Corps of Engineers (Corps) provides the primary operational management of the Missouri River and is responsible under the Endangered Species Act (ESA) to take actions within its authorities to conserve listed species. To comply with the 2000 USFWS BiOp and the 2003 amended USFWS BiOp, the Corps has created habitats below Gavins Point Dam using mechanical means. Initial monitoring indicates that constructed sandbars provide suitable habitat features for nesting and foraging least terns and piping plovers. Terns and plovers are using constructed sandbars and successfully reproducing at or above levels stipulated in the BiOp. However, whether such positive impacts will persist cannot yet be adequately assessed at this time.

Medical image of the week: healthcare-associated pneumonia secondary to aspiration

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Nissim L

2015-07-01

Full Text Available A 57 year-old bedbound paraplegic man developed a worsening productive cough after being hospitalized for several days. He was brought to the radiology suite for a CT scan of the chest, revealing a soft tissue density within his right main-stem bronchus, with volume loss of his right lung (Figure 1. Bronchoscopy was performed, yielding a 2 cm piece of broccoli, successfully removed with forceps (Figure 2. Culture from the bronchial aspirate was positive for Pseudomonas aeruginosa. The patient’s respiratory status dramatically improved after removal of the foreign body and commencement of pathogen-directed antibiotics. This study illustrates a dramatic example of healthcare-associated pneumonia (HCAP secondary to aspiration, as described by the American Thoracic Society / Infectious Diseases Society of America (1.

Protect Anadromous Salmonids in the Mainstem Corridor, Monitoring and Evaluation, Annual Report 200-2001.

Energy Technology Data Exchange (ETDEWEB)

Vigg, Steven; Johnson, John

2002-02-01

In this annual Monitoring & Evaluation (M&E) report to the Bonneville Power Administration (BPA), we summarize significant activities and performance measures resultant from enhanced protection by Columbia River Inter-Tribal Fisheries Enforcement (CRITFE) in the mainstem corridor (BPA Project 2000-056). This report covers the Fiscal Year (FY) 2000 performance period -- May 15, 2000 to May 14, 2001. Quarterly progress reports have previously been submitted to BPA and are posted on the M&E Web site (www.Eco-Law.net) -- for the time period April-December 2000 (Vigg 2000b,c,d) and for the period January-June 2001 (Vigg 2001a,b). We also present comprehensive data representing the first quarter of year 2000 in this report for a pre-project comparison. In addition, we have analyzed specific annual enforcement statistics to evaluate trends during the baseline period 1996-2000. Additional statistics and more years of comprehensive baseline data are now being summarized, and will be presented in future M&E annual reports--to provide a longer time series for evaluation of trends in input, output and outcome performance standards.

A combined technique using a muscular flap and endobronchial stent to repair complex broncho-oesophageal fistulae supported by ECMO.

Science.gov (United States)

Baste, Jean-Marc; Haddad, Laura; Philouze, Guillaume

2018-02-01

Certain broncho-oesophageal fistulae require surgical repair. Herein, we describe an innovative surgical technique combining intercostal flap and endobronchial stenting. Two patients, each with a with complex broncho-oesophageal fistula 2 years after radio-chemotherapy, were hospitalised for severe respiratory infection and extension of the fistula despite previous endoscopic treatment. The first patient presented with respiratory distress (ARDS). She had emergency surgery under extra corporeal membrane oxygenation: oesophagectomy and reconstruction of the left bronchus by a vascularised intercostal flap. Stenting was performed on day 10, due to persistence of the fistula. At 3 months the bronchus was healed, but the patient died of cerebral bleeding. For the second patient, repair was proposed before severe ARDS with the same surgical and ventilatory strategy and a stent was preventively inserted after surgery. After 3 months, the stent was removed and the left bronchus was healed. Complex post-radiotherapy broncho-oesophageal fistulae should be treated surgically before respiratory complications arise, by combining reconstruction with a vascularised flap and transient stenting.

Topographic radiologic anatomy of the right subcarinal and retrobronchial pulmonary recess

International Nuclear Information System (INIS)

Remy, J.; Lemaitre, L.; Smith, M.

1981-01-01

Depending on the size of the subcarinal and retrobronchial recess the medial wall of the right and perhaps the left main bronchus can be recognized. The medial extension of the recess is very variable. On lateral films with slight anterior rotation of the right shoulder, the posterior wall of the right main bronchus can be shown in 97% of patients. Awareness of this recess and its boundaries is essential for diagnosis of subcarinal and tracheobronchial node enlargement. The following 4 signs will assist in diagnosis: 1. The dorsal margin of enlarged nodes may be recognized posterior and inferior to the carina. 2. The posterior wall of the right main bronchus can no longer be seen. 3. The medial wall of the right main bronchus can no longer be seen. 4. Clearer demonstration of the right main bronchus or bronchus intermedius occurs, due to an 'air bronchogram' effect. Due to the application of these 4 signs, enlargements of the subcarinal or tracheobronchial nodes can be recognized, at a stage where the tracheal bifurcation is not yet splayed, and when the nodes have not yet caused bronchostenosis. (orig.) [de

Pulmonary Aplasia in an Adult : A Case Report

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Nurettin Yiyit

2016-01-01

Full Text Available Pulmonary aplasia is a rare congenital anomaly in which there are absence of pulmonary vessels, bronchus and parenchyma. It is distinguished from pulmonary agenesis by the presence of rudimentary stump bronchus. Patients are usually diagnosed in childhood. Patients without additional anomaly and the patients with mild disease can be diagnosed in adulthood. The left lung was not observed at the chest X-ray of 19-year-old male patient with respiratory distress in exercise. Left lung aplasia was diagnosed by computed tomography and ventilation perfusion scintigraphy. The patients with lung aplasia have an increased risk of infections. Therefore the follow-up of the patients is important.

Successful stent-in-stent insertion of an expandable metallic stent covered with polyuretane placed to obliterate a large bronchial fistula after chemoradiotherapy for inoperable lung cancer

International Nuclear Information System (INIS)

Minami, Hiroya; Tsubota, Noriaki; Miyamoto, Yoshifumi; Yoshimura, Masahiro; Obayashi, Kayoko; Takada, Yoshiki

1999-01-01

Bronchial fistulas in cases of inoperable lung cancer caused by radiochemotherapy are quite refractory and generally cannot be surgically closed. A 45-year-old man with squamous cell carcinoma in the right lung underwent two courses of induction chemotherapy (135 mg CDDP, 5 mg VDS, 13.5 mg MMC) and radiation therapy (2 Gy x 22 times) for invasion of the right main bronchus, the pulmonary artery and superior vena cava. Just before the end of the second course, the empyem second to the bronchial fistula caused by tumor necrosis developed in the right upper bronchus, and fenestration was performed. After the operation, his condition improved remarkably, however the fistula enlarged into the right main bronchus and the purulent discharge flowed into the left lung. An expandable metallic stent (EMS) covered with polyuretane was inserted in the trachea and the left main bronchus to break aspiration pneumonia. As the covered EMS was too unstable to be fixed, a bare EMS was inserted in a stent-in-stent fashion. After the procedure he was followed at the O.P.D. and lived a relatively comfortable life for 9 months until his death due to tumor. We inserted the covered EMS in a stent-in-stent fashion to successfully obliterate a large bronchial fistula. (author)

[Metastatic lung cancer origin from osteosarcoma of mandible invading tracheal lumen].

Science.gov (United States)

Taguchi, K; Noriyuki, T; Furonaka, O; Kuroda, Y; Akimoto, E; Kuranishi, F; Nakahara, M; Fukuda, T; Ishizaki, Y; Okuda, H; Hashimoto, M; Yonehara, S

2009-07-01

A 52-year-old woman underwent the surgical treatment for osteosarcoma of the left mandible in 2003 and was followed up afterward. She suffered from dry cough and bloody sputum, and was admitted to our hospital in April 2007. Computed tomography (CT) revealed several nodules in bilateral lung, and bronchofiberscopy showed the endobronchial tumor obstructing in the right main bronchus. The metastatic tumor progressed in the right main bronchus from the right S6 lung segment. The tumor rapidly progressed in the right bronchus in comparison with the CT findings in about 2 weeks, and the possibility of the tracheal obstruction was considered. She underwent the right middle and lower lobectomy, and the endobronchial tumor was pulled through the right main bronchus. The postoperative course was uneventful, the patient was discharged on 14th postoperative day, and the chemotherapy using cisplatin (CDDP) and adriamycin (ADR) is on-going.

Stridor Post-Pneumonectomy - “The Post-pneumonectomy Syndrome”

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Manoj Waghmare

2017-04-01

Full Text Available We report a case of a 33 year old lady who presented to our department with complaints of breathlessness and stridor. On enquiry she gave history of right pneumonectomy for right main bronchus carcinoid 15 years ago. Chest X-ray as initial investigation showed homogenous opacity in right hemothorax with mediastinal shift to right. Computed tomography of thorax showed post-pneumonectomy status with left lower lobe bronchus compression between the aorta and main pulmonary artery with post obstructive overinflation of left lower lobe. Spirometry was suggestive of an obstructive abnormality. Diagnosis of post-pneumonectomy syndrome was made and patient was treated with inhaled corticosteroids and inhaled long acting beta2 agonist.

Rescue patient from tracheal obstruction by dislocated bronchial stent during tracheostomy surgery with readily available tools: A case report.

Science.gov (United States)

Chang, Hung-Yu; Man, Kee-Ming; Liao, Kate Hsiurong; Chiang, Yi-Ying; Chen, Kuen-Bao

2017-09-01

Airway stenting is a well-established method that relieves symptoms and maintains airway patency in patients with airway obstruction. Serious complications caused by airway stents such as stent dislocation and airway obstruction during surgery are life-threatening. An 80-year-old man was treated with bronchial stent for left bronchus obstruction caused by metastatic esophageal cancer. During tracheostomy surgery, he suffered from acute tracheal obstruction caused by dislocated bronchial stent. Esophageal cancer, left bronchus obstruction, respiratory failure, tracheal obstruction. Threading a 5.0-sized endotracheal tube combined with an Eschmann tracheal tube introducer to prop up the collapsed stent. The bronchial stent was re-expanded and threaded into right main bronchus and ventilation restored. Patient with airway stent undergoing surgery with airway involved should be performed under the support of a backup physician and equipment that are capable of handling potentially life-threatening complications of airway stent. If not, in the emergent situation of tracheal obstruction due to tracheal/bronchial stent, protruding through the stent with a suitable, small-sized endotracheal tube with Eschmann tracheal tube introducer may be an alternative skill for saving life weighted with possible complications.

Resolution of Toll-like receptor 4-mediated acute lung injury is linked to eicosanoids and suppressor of cytokine signaling 3.

Science.gov (United States)

Hilberath, Jan N; Carlo, Troy; Pfeffer, Michael A; Croze, Roxanne H; Hastrup, Frantz; Levy, Bruce D

2011-06-01

The purpose of this study was to investigate roles for Toll-like receptor 4 (TLR4) in host responses to sterile tissue injury. Hydrochloric acid was instilled into the left mainstem bronchus of TLR4-defective (both C3H/HeJ and congenic C.C3-Tlr4(Lps-d)/J) and control mice to initiate mild, self-limited acute lung injury (ALI). Outcome measures included respiratory mechanics, barrier integrity, leukocyte accumulation, and levels of select soluble mediators. TLR4-defective mice were more resistant to ALI, with significantly decreased perturbations in lung elastance and resistance, resulting in faster resolution of these parameters [resolution interval (R(i)); ∼6 vs. 12 h]. Vascular permeability changes and oxidative stress were also decreased in injured HeJ mice. These TLR4-defective mice paradoxically displayed increased lung neutrophils [(HeJ) 24×10(3) vs. (control) 13×10(3) cells/bronchoalveolar lavage]. Proresolving mechanisms for TLR4-defective animals included decreased eicosanoid biosynthesis, including cysteinyl leukotrienes (80% mean decrease) that mediated CysLT1 receptor-dependent vascular permeability changes; and induction of lung suppressor of cytokine signaling 3 (SOCS3) expression that decreased TLR4-driven oxidative stress. Together, these findings indicate pivotal roles for TLR4 in promoting sterile ALI and suggest downstream provocative roles for cysteinyl leukotrienes and protective roles for SOCS3 in the intensity and duration of host responses to ALI.

Costs of conventional radical radiotherapy versus continuous hyperfractionated accelerated radiotherapy (CHART) in the treatment of patients with head and neck cancer or carcinoma of the bronchus. Medical Research Council CHART Steering Committee.

Science.gov (United States)

Coyle, D; Drummond, M F

1997-01-01

The objective of this study was to compare the costs of treatment with continuous hyperfractionated accelerated radiotherapy (CHART) and those of conventional radiotherapy for patients with (1) head and neck cancer and (2) carcinoma of the bronchus. The study was conducted concurrently with two multicentre randomized controlled trials. Data were collected on the use of hospital and community service resources and patients' travel for treatment. Data on resource use up to 3 months after entry to the study were available for 526 head and neck patients (314 receiving CHART and 212 conventional therapy) and 284 bronchus patients (175 CHART and 109 conventional therapy). For patients with head and neck cancer, CHART cost Pounds 1092 (P hostel facilities. The results of this cost analysis will help to facilitate a decision about whether the benefits of CHART, as determined by the clinical trials, are worth the additional costs of hospital-based resource use. The collection of detailed patient-specific resource-use data from a number of centres allows the determination of ways for reducing the cost differential between therapies and making CHART a more cost effective treatment alternative.

Bronchus-associated lymphoid tissue (BALT and survival in a vaccine mouse model of tularemia.

Directory of Open Access Journals (Sweden)

Damiana Chiavolini

2010-06-01

Full Text Available Francisella tularensis causes severe pulmonary disease, and nasal vaccination could be the ideal measure to effectively prevent it. Nevertheless, the efficacy of this type of vaccine is influenced by the lack of an effective mucosal adjuvant.Mice were immunized via the nasal route with lipopolysaccharide isolated from F. tularensis and neisserial recombinant PorB as an adjuvant candidate. Then, mice were challenged via the same route with the F. tularensis attenuated live vaccine strain (LVS. Mouse survival and analysis of a number of immune parameters were conducted following intranasal challenge. Vaccination induced a systemic antibody response and 70% of mice were protected from challenge as showed by their improved survival and weight regain. Lungs from mice recovering from infection presented prominent lymphoid aggregates in peribronchial and perivascular areas, consistent with the location of bronchus-associated lymphoid tissue (BALT. BALT areas contained proliferating B and T cells, germinal centers, T cell infiltrates, dendritic cells (DCs. We also observed local production of antibody generating cells and homeostatic chemokines in BALT areas.These data indicate that PorB might be an optimal adjuvant candidate for improving the protective effect of F. tularensis antigens. The presence of BALT induced after intranasal challenge in vaccinated mice might play a role in regulation of local immunity and long-term protection, but more work is needed to elucidate mechanisms that lead to its formation.

Pneumocystis-Driven Inducible Bronchus-Associated Lymphoid Tissue Formation Requires Th2 and Th17 Immunity.

Science.gov (United States)

Eddens, Taylor; Elsegeiny, Waleed; Garcia-Hernadez, Maria de la Luz; Castillo, Patricia; Trevejo-Nunez, Giraldina; Serody, Katelin; Campfield, Brian T; Khader, Shabaana A; Chen, Kong; Rangel-Moreno, Javier; Kolls, Jay K

2017-03-28

Inducible bronchus-associated lymphoid tissue (iBALT) is an ectopic lymphoid structure composed of highly organized T cell and B cell zones that forms in the lung in response to infectious or inflammatory stimuli. Here, we develop a model for fungal-mediated iBALT formation, using infection with Pneumocystis that induces development of pulmonary lymphoid follicles. Pneumocystis-dependent iBALT structure formation and organization required CXCL13 signaling. Cxcl13 expression was regulated by interleukin (IL)-17 family members, as Il17ra -/- , Il17rb -/- , and Il17rc -/- mice failed to develop iBALT. Interestingly, Il17rb -/- mice have intact Th17 responses, but failed to generate an anti-Pneumocystis Th2 response. Given a role for Th2 and Th17 immunity in iBALT formation, we demonstrated that primary pulmonary fibroblasts synergistically upregulated Cxcl13 transcription following dual stimulation with IL-13 and IL-17A in a STAT3/GATA3-dependent manner. Together, these findings uncover a role for Th2/Th17 cells in regulating Cxcl13 expression and provide an experimental model for fungal-driven iBALT formation. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

Use of endobronchial valve insertion to treat relapsing pneumothorax: a case report and literature review.

Science.gov (United States)

Qi, Fei; Tian, Qing; Chen, Liang'an; Li, Chunyan; Zhang, Shu; Liu, Xingchen; Xiao, Binbin

2017-07-01

Backgorund and Aims: Unidirectional endobronchial valves have recently been shown to be beneficial as treatment for persistent air leaks. This report presents a first case of endobronchial valve implantation to treat relapsing pneumothorax in a Chinese patient, and also presents a review of the literature on the use of one-way valve insertion for the treatment of persistent air leaks. The patient did undergo a recent but failed chest tube intervention. By bronchoscopy and using Chartis® system measurements, the upper left lobe (including the left apical bronchus) was closed using a catheter. After the expected decrease in airflow following bronchial occlusion, increased air pressure and decreased spilled air were noted; it was concluded that the pneumothorax was located in the left upper lobe. A Zephyr ® endobronchial valve was placed in the left upper apical bronchus. The health benefits of the procedure were noticed in the following days. Our review suggests that the use of endobronchial valves could be used as an effective, minimally invasive, low-risk intervention for patients with pneumothorax that cannot be treated surgically. © 2015 John Wiley & Sons Ltd.

A Case of Multiple Cardiovascular and Tracheal Anomalies Presented with Wolff-Parkinson-White Syndrome in a Middle-aged Adult.

Science.gov (United States)

Shi, Hyejin; Sohn, Sungmin; Wang, SungHo; Park, Sungrock; Lee, SangKi; Kim, Song Yi; Jeong, Sun Young; Kim, Changhwan

2017-12-01

Congenital cardiovascular anomalies, such as dextrocardia, persistent left superior vena cava (SVC), and pulmonary artery (PA) sling, are rare disorders. These congenital anomalies can occur alone, or coincide with other congenital malformations. In the majority of cases, congenital anomalies are detected early in life by certain signs and symptoms. A 56-year-old man with no previous medical history was admitted due to recurrent wide QRS complex tachycardia with hemodynamic collapse. A chest radiograph showed dextrocardia. After synchronized cardioversion, an electrocardiogram revealed Wolff-Parkinson-White (WPW) syndrome. Persistent left SVC, PA sling, and right tracheal bronchus were also detected by a chest computed tomography (CT) scan. He was diagnosed with paroxysmal supraventricular tachycardia (PSVT) associated with WPW syndrome, and underwent radiofrequency ablation. We reported the first case of situs solitus dextrocardia coexisting with persistent left SVC, PA sling and right tracheal bronchus presented with WPW and PSVT in a middle-aged adult. In patients with a cardiovascular anomaly, clinicians should consider thorough evaluation of possibly combined cardiovascular and airway malformations and cardiac dysrhythmia. © 2017 The Korean Academy of Medical Sciences.

Treatment of multiple-level tracheobronchial stenosis secondary to endobronchial tuberculosis using bronchoscopic balloon dilatation with topical mitomycin-C.

Science.gov (United States)

Faisal, Mohamed; Harun, Hafaruzi; Hassan, Tidi M; Ban, Andrea Y L; Chotirmall, Sanjay H; Abdul Rahaman, Jamalul Azizi

2016-04-14

Tracheobronchial stenosis is a known complication of endobronchial tuberculosis. Despite antituberculous and steroid therapy, the development of bronchial stenosis is usually irreversible and requires airway patency to be restored by either bronchoscopic or surgical interventions. We report the use of balloon dilatation and topical mitomycin-C to successful restore airway patency. We present a 24-year old lady with previous pulmonary tuberculosis and laryngeal tuberculosis in 2007 and 2013 respectively who presented with worsening dyspnoea and stridor. She had total left lung collapse with stenosis of both the upper trachea and left main bronchus. She underwent successful bronchoscopic balloon and manual rigid tube dilatation with topical mitomycin-C application over the stenotic tracheal segment. A second bronchoscopic intervention was performed after 20 weeks for the left main bronchus stenosis with serial balloon dilatation and topical mitomycin-C application. These interventions led to significant clinical and radiographic improvements. This case highlights that balloon dilatation and topical mitomycin-C application should be considered in selected patients with tracheobronchial stenosis following endobronchial tuberculosis, avoiding airway stenting and invasive surgical intervention.

Browse Title Index

African Journals Online (AJOL)

Items 1 - 50 of 566 ... ... fenestrated tracheostomy tube fragment removed from the right main bronchus, Abstract PDF ... thoracoscopic surgical biopsy combined with left pneumonectomy ... Vol 20, No 3 (2014), A comparison of non-invasive versus invasive .... during awake bilateral deep brain stimulation surgery, Abstract PDF.

Clinical observation of covered for malignant esophageal stricture and esophagus-bronchial fistula

International Nuclear Information System (INIS)

Luo Hailong; Lin Youen; Ye Zhi; Zhu Yifen

2010-01-01

Objective: To evaluate clinical value of self-expanded covered stents for advanced stage esophageal cancer complicated by esophageal stricture and esophagus-bronchial fistula. Methods: Self-expanded covered stents were placed into 48 patients with advanced stage esophageal cancer under fluoroscopy. Of the 48 patients, 39 had malignant esophageal stricture and 9 had esophagus-bronchus fistula. Results: Stents were successfully inserted into all but one patient with lower esophageal cancer and gastric volvulus. Deglutition was improved in all patients and coughing resolved in patients with esophagus-bronchus fistula. Thoracodynia and foreign body sensation vanished within one week after operation in all patients. Dyspnea caused by compression of the left main bronchus occurred in one patient. Re-stenosis of the stents occurred three to seven months after operation in eight patients. The mean survival time was seven months in all patients. Conclusion: Self-expanded covered stent placement is a simple, safe and reliable treatment method for advanced stage esophageal cancer and can effectively lengthen survival time. (authors)

Smoking-induced gene expression changes in the bronchial airway are reflected in nasal and buccal epithelium

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Zhang Xiaohui

2008-05-01

Full Text Available Abstract Background Cigarette smoking is a leading cause of preventable death and a significant cause of lung cancer and chronic obstructive pulmonary disease. Prior studies have demonstrated that smoking creates a field of molecular injury throughout the airway epithelium exposed to cigarette smoke. We have previously characterized gene expression in the bronchial epithelium of never smokers and identified the gene expression changes that occur in the mainstem bronchus in response to smoking. In this study, we explored relationships in whole-genome gene expression between extrathorcic (buccal and nasal and intrathoracic (bronchial epithelium in healthy current and never smokers. Results Using genes that have been previously defined as being expressed in the bronchial airway of never smokers (the "normal airway transcriptome", we found that bronchial and nasal epithelium from non-smokers were most similar in gene expression when compared to other epithelial and nonepithelial tissues, with several antioxidant, detoxification, and structural genes being highly expressed in both the bronchus and nose. Principle component analysis of previously defined smoking-induced genes from the bronchus suggested that smoking had a similar effect on gene expression in nasal epithelium. Gene set enrichment analysis demonstrated that this set of genes was also highly enriched among the genes most altered by smoking in both nasal and buccal epithelial samples. The expression of several detoxification genes was commonly altered by smoking in all three respiratory epithelial tissues, suggesting a common airway-wide response to tobacco exposure. Conclusion Our findings support a relationship between gene expression in extra- and intrathoracic airway epithelial cells and extend the concept of a smoking-induced field of injury to epithelial cells that line the mouth and nose. This relationship could potentially be utilized to develop a non-invasive biomarker for

TRACHEAL AND BRONCHIAL ABNORMALITIES IN PATIENTS WITH SIGNIFICANT OBSTRUCTIVE SYNDROME: ACCORDING TO BRONCHOSCOPIC

OpenAIRE

M. L. Shteiner

2014-01-01

The endobronchial pattern of significant bronchial obstructive syndrome of various etiologies was analyzed in 4,000 patients with this condition. At the same time, bronchial malformations were encountered as supplementary bronchi of the left and right basal pyramids, axillary left bronchi, supplementary and displaced tracheal bronchi, and a single case of distal transposition of the right proximal bronchus in 1.58% of cases. According to the bronchoscopic findings, supplementary bronchi and t...

Usefulness of a functional tracheobronchial phantom for interventional procedure

International Nuclear Information System (INIS)

Kim, Tae Hyung; Lim, Cheong Hwan; Kim, Jeong Koo

2003-01-01

To evaluate usefulness of a functional tracheobronchial phantom for interventional procedure. The functional phantom was made as a actual size with human normal anatomy used silicone and a paper clay mold. A tracheobronchial-shape clay mold was placed inside a square box and liquid silicone was poured. After the silicone was formed, the clay was removed. We measured film density and tracheobronchial angle at the human, animal and phantom respectively. The film density of trachea part were 0.76 (± 0.011) in human, 0.97 (± 0.015) in animal, 0.45 (± 0.016) in phantom. The tracheobronchial bifurcation part measured 0.51 (± 0.006) in human, 0.65 (± 0.005) in animal, 0.65 (± 0.008) in phantom. The right bronchus part measured 0.14 (± 0.008) in human, 0.59 (± 0.014) in animal and 0.04 (± 0.007) in phantom. The left bronchus were 0.54 (± 0.004) in human, 0.54 (± 0.008) in animal and 0.08 (± 0.008) in phantom. At the stent part were 0.54 (± 0.004) in human, 0.59 (± 0.011) in animal and 0.04 (± 0.007) in phantom, respectively. The tracheobronchial angle of the left bronchus site were 42.6 (± 2.07).deg. in human, 43.4 (± 2.40).deg. in animal and 35 (± 2.00).deg. in phantom, respectively. The right bronchus site were 32.8 (± 2.77).deg. in human, 34.6 (± 1.94).deg. in animal and 50.2 (± 1.30).deg. in phantom, respectively. The phantom was useful for in-vitro testing of tracheobronchial interventional procedure, since it was easy to reproduce

TRACHEAL AND BRONCHIAL ABNORMALITIES IN PATIENTS WITH SIGNIFICANT OBSTRUCTIVE SYNDROME: ACCORDING TO BRONCHOSCOPIC

Directory of Open Access Journals (Sweden)

M. L. Shteiner

2014-01-01

Full Text Available The endobronchial pattern of significant bronchial obstructive syndrome of various etiologies was analyzed in 4,000 patients with this condition. At the same time, bronchial malformations were encountered as supplementary bronchi of the left and right basal pyramids, axillary left bronchi, supplementary and displaced tracheal bronchi, and a single case of distal transposition of the right proximal bronchus in 1.58% of cases. According to the bronchoscopic findings, supplementary bronchi and transpositions of the left bronchi are the most common anatomic bronchial abnormalities (1.08%.

Chest radiograph in the acute traumatic rupture of the aorta

International Nuclear Information System (INIS)

Pinterits, F.; Grabenwoeger, F.; Dock, W.; Bardach, G.

1987-01-01

We tried to find out the validity of 16 wellknown signs indicating an acute traumatic aortic rupture on plain chest radiographs of 22 patients. Angiographically 11 of all patients had a tear at the aortic isthmus. It turned out that 7 of the 16 signs (widened mediastinum, loss of the aortic knob contour, opacification in the aortopulmonary window, bulging of the vascular pedicle predominantly to the left, left apical cap, depression of the left main stem bronchus and displacement of the right paraspinous interface) are of great diagnostic value. (orig.) [de

Ectopic pancreas in a giant mediastinal cyst

NARCIS (Netherlands)

Li, Wilson W.; van Boven, Wim Jan; Jurhill, Roy R.; Bonta, Peter I.; Annema, Jouke T.; de Mol, Bas A.

2016-01-01

Ectopic pancreas located in the mediastium is an extremely rare anomaly. We present a case of an ectopic pancreas located in a giant mediastinal cyst in an 18-year-old man. He presented with symptoms of dyspnea due to external compression of the cyst on the left main bronchus. Complete surgical

Fatal haemoptysis from the pulmonary artery as a late complication of pulmonary irradiation

International Nuclear Information System (INIS)

Makker, H.K.; Barnes, P.C.

1991-01-01

Fatal massive haemoptysis occured as a late complication of erosion of the pulmonary artery by a non-malignant ulcer of the left main bronchus. Symptoms attributed to radiation pulmonary fibrosis are uncommon. We report a case of fatal massive haemoptysis in a patient known to have postirradiation pulmonary fibrosis. (author)

An unusual cure for a foreign body in the airway: A case report ...

African Journals Online (AJOL)

If diagnosed, however, the definitive management is removal of the foreign body. We report a case of a long-standing foreign body (pencil eraser with a metal rim) in the left main bronchus of a child which had remained undiagnosed until after five weeks but coincidentally expelled following hard coughing triggered by ...

Penile metastases from primary bronchus carcinoma – A case report ...

African Journals Online (AJOL)

Case presentation: Our case is a 55-year-old builder who presented with a painfully enlarged penis and loss of weight. He had a smoking history and was cachectic, with generalised lymphadenopathy and a firm mass on his left olecranon. His penis contained multiple firm nodules. Complete laboratory and imaging workup ...

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

Diagnosis of invasive aspergillus tracheobronchitis facilitated by endobronchial ultrasound-guided transbronchial needle aspiration: a case report

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Casal Roberto F

2009-11-01

Full Text Available Abstract Introduction Invasive pulmonary aspergillosis is the most common form of infection by Aspergillus species among immunocompromised patients. Although this infection frequently involves the lung parenchyma, it is unusual to find it limited to the tracheobronchial tree, a condition known as invasive aspergillus tracheobronchitis. Case presentation A 65 year-old Hispanic man from Bolivia with a history of chronic lymphocytic leukemia developed cough and malaise eight months after having an allogenic stem cell transplant. A computed tomography of the chest revealed an area of diffuse soft tissue thickening around the left main stem bronchus, which was intensely fluorodeoxyglucose-avid on positron emission tomography scanning. An initial bronchoscopic exam revealed circumferential narrowing of the entire left main stem bronchus with necrotic and friable material on the medial wall. Neither aspirates from this necrotic area nor bronchial washing were diagnostic. A second bronchoscopy with endobronchial ultrasound evidenced a soft tissue thickening on the medial aspect of the left main stem bronchus underlying the area of necrosis visible endoluminally. Endobronchial ultrasound-guided transbronchial needle aspiration performed in this area revealed multiple fungal elements suggestive of Aspergillus species. Conclusion We describe the first case of invasive aspergillus tracheobronchitis in which the diagnosis was facilitated by the use of endobronchial ultrasound guided trans-bronchial needle aspiration. To the best of our knowledge, we are also presenting the first positron emission tomography scan images of this condition in the literature. We cautiously suggest that endobronchial ultrasound imaging may be a useful tool to evaluate the degree of invasion and the involvement of vascular structures in these patients prior to bronchoscopic manipulation of the affected areas in an effort to avoid potentially fatal hemorrhage.

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)

Left regular bands of groups of left quotients

International Nuclear Information System (INIS)

El-Qallali, A.

1988-10-01

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

A review of cases of tracheobronchial foreign bodies in children

International Nuclear Information System (INIS)

Asai, Masatsugu; Adachi, Yuichi; Nakagawa, Hajime

2007-01-01

Twenty-three children with tracheobronchial foreign bodies were statistically studied. The number of cases under 3 years of age was 16 (70%). The male-female ratio was 1.9:1. In 19 cases, the foreign bodies were radiolucent. Within these 19 cases, 12 cases involved peanuts. In 4 cases, the foreign bodies were radiopaque. Eight patients underwent extirpation more than 1 week after inhalation because of diagnostic delay. Some of these cases showed granulation in the bronchus and other complications. For early diagnosis, education is necessary not only for parents but also for general physicians. Foreign bodies were lodged in the right bronchus in 11 cases, left bronchus in 11 cases, and trachea in 1 case. Chest X-ray was performed in all patients. Auxiliary examinations performed were lung perfusion scintigraphy (n=9), CT scan (n=8) and MR imaging (n=4). Lung perfusion scintigraphy and CT scan are easy to perform and seemed to be effective for diagnosis. Observation of the trachea and bronchus using a flexible fiberoptic bronchoscope before insertion of rigid ventilation bronchoscopy (VBS) is useful for avoiding subglottic swelling. Furthermore, it is helpful for suctioning sputum and for collecting useful information on the airway before using VBS. For extirpation, we used VBS in 20 cases and a flexible fiberoptic bronchoscope in 3 cases. Sometimes, after extirpation patients suffer respiratory disturbance from complications such as pneumonia. Cooperation of otolaryngologists and pediatricians as a team is necessary for treatment of tracheobronchial foreign bodies. (author)

Rare anomalies of the architecture of the bronchial tree

Energy Technology Data Exchange (ETDEWEB)

Scheel, W.; Eger, H.

1986-12-01

Six cases of rare bronchial anomalies are presented (3 complete rightsided hyparterial bronchial distributions, 1 partial rightsided hyparterial bronchial supply of the upper lobe, 2 cases of atresia of the left apico-posterior bronchus). Emphasis is placed on the bronchographic elucidation of the changed bronchial segmental topic if additive or subtractive bronchial anomalies are found endoscopically especially with regard to preoperative aspects.

Foreign Body Aspiration in Pregnancy

Directory of Open Access Journals (Sweden)

Andrew L. Atkinson

2012-01-01

Full Text Available A 24-year-old morbidly obese African American gravida 1, with a history of severe asthma complicated by multiple inpatient admissions, presents at 30 weeks gestation with a foreign body in her left main stem bronchus. After a failed bronchoscopy postpartum, the patient slipped into respiratory failure and was subsequently intubated, spending two weeks in the intensive care unit. After two more attempts of trying to retrieve the foreign object from her lung via bronchoscopy, she eventually contracted a postobstructive pneumonia and underwent a left lower lung lobectomy for curative treatment.

Bronchial Mucus Properties in Lung Cancer: Relationship with Site of Lesion

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J Gustavo Zayas

1999-01-01

Full Text Available OBJECTIVE: To compare the biophysical properties of mucus from the left and right mainstem bronchi in patients undergoing diagnostic bronchoscopy because of a unilateral radiological abnormality. It was hypothesized that abnormalities in the properties of mucus would be greater on the side with the lesion and that this would be most obvious in patients with unilateral lung cancer.

An elusive persistent left superior vena cava draining into left atrium

NARCIS (Netherlands)

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

1986-01-01

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

Rare anomalies of the architecture of the bronchial tree

International Nuclear Information System (INIS)

Scheel, W.; Eger, H.

1986-01-01

Six cases of rare bronchial anomalies are presented (3 complete rightsided hyparterial bronchial distributions, 1 partial rightsided hyparterial bronchial supply of the upper lobe, 2 cases of atresia of the left apico-posterior bronchus). Emphasis is placed on the bronchographic elucidation of the changed bronchial segmental topic if additive or subtractive bronchial anomalies are found endoscopically especially with regard to preoperative aspects. (orig.) [de

STUDY OF TIME LAPSE IN FOREIGN BODY ASPIRATION IN RELATION TO CHEST X - RAY AND TYPE OF FOREIGN BODY

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Salma

2015-10-01

Full Text Available INTRODUCTI ON: Foreign body aspiration in pediatrics is a potentially fatal accident which will continue until children explore their surroundings with their hand and mouth. Pediatric aspirations will persist until mankind exists. Not all foreign body aspirations are witnessed hence chances of delay in diagnosing an aspiration are high. Delay in diagnosis depends on site and character of foreign body aspirated. The chest x - ray findings and type of foreign body extracted vary depending on the duration the foreign body remains in airway . OBJECTIVE: To study the X - ray finding in pediatric airway aspiration and its relation to time lapse, the type and site of lodgment of foreign body extracted via bronchoscopy. The type of foreign body in relation to time lapse in aspiration. MATERIAL AND METHODS: This was a prospective study done in Bapuji child health institute and research center, JJM Medical College, Davangere . History and pre bronchoscopy x - Ray finding were noted for 65 children who were posted for suspicious bronchoscopy from August 2011 to September 2013. 11 children were excluded from study as they showed no foreign body on bronchoscopy. Time lapse in aspir ation and seeking medical care was noted. The bronchoscopic findings regarding site of foreign body lodgment and type of foreign body were recorded. The type of foreign body and variation of x - ray picture in relation to time lapse in aspiration were noted. Data collected was analyzed using descriptive statistics. RESULT: It was observed that mean age was 28 months. About 80% of the cases were between 1 to 3 years age. 82% (n=53/54 were radio lucent foreign body, only 1.5% (n=1/54 were radio o paque. Site of lodgment of foreign body was right main bronchus in 48% (n=26/54, left main bronchus 46% (n=25/54 , tracheal 1.85% (n=1/54, subglottic 1.85% (n=1/54, carinal 1.85% (n=1/54, multiple site i.e. left bronchus +right bronchus+ carinal 1.85% (n=1/54. Groundnut was most common

Resecciones en manguito

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Edelberto Fuentes Valdés

2003-09-01

Full Text Available La resección en manguito con conservación de parénquima pulmonar está indicada en una amplia variedad de lesiones tumorales benignas y malignas, así como inflamatorias endobronquiales. Se realizó la revisión de 6 pacientes a los cuales a 3 se les había practicado resección carinal y a 3 lobectomía en manguito. Las causas fueron un tumor carcinoide típico de bronquio superior izquierdo, un tumor mucoepidermoide de bronquio principal izquierdo con invasión de carina y los restantes fueron carcinomas epidermoides: 2 de bronquio principal derecho que infiltraba la carina y 2 del bronquio del lóbulo superior derecho que protruían hacia el bronquio principal. Las indicaciones fueron la toma de carina por el tumor,3 un tumor de bajo grado (carcinoide típico con infiltración del bronquio principal correspondiente y en 2 pacientes que se consideró su estado general ofrecía alto riesgo de complicaciones y mortalidad si se realizaba una neumonectomía. Hubo una sola complicación que fue la sobreinfección de un pulmón atelectásico y no se presentó mortalidad posoperatoria. Se realizó la revisión de la literatura médica. La resección en manguito es una opción adecuada en el tratamiento quirúrgico de enfermos con lesiones endobronquiales benignas, tumores de bajo grado de malignidad y en casos seleccionados de carcinomas bronquialesThe resección in sleeve with pulmonary conservation of parénquima is indicated in an ample variety of benign tumorlike injuries and you vitiate, as well as inflammatory endobronquiales. The revision of 6 patients was made to who to 3 them carinal resección had practiced 3 and to lobectomía in sleeve. The causes were a typical carcinoide tumor of left superior bronchus, a mucoepidermoide tumor of left main bronchus with carina invasion and the rest were epidermoides carcinomas: 2 of main bronchus straight that infiltrated the carina and 2 of the bronchus of the superior lobe straight that protru

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

DEFF Research Database (Denmark)

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

2013-01-01

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

Pulmonary response to ozone: Reaction of bronchus-associated lymphoid tissue and lymph node lymphocytes in the rat

International Nuclear Information System (INIS)

Dziedzic, D.; Wright, E.S.; Sargent, N.E.

1990-01-01

The purpose of this work is to assess the effect of ozone, a reactive product of environmental photochemical oxidation, on lymphocytes of the lung. We exposed male Fischer rats to ozone at a concentration of 0.5 ppm for 20 hr/day for 1-14 days. Animals were treated with radioactive thymidine and were sacrificed at Day 1, 2, 3, 7, or 14 of exposure. Lungs and mediastinal lymph nodes were removed and prepared for histologic examination, evaluation of labeling indexes, and morphometric measurement. We examined two components of the lymphocyte response of the lung: the airway-related response, represented by the reaction of the bronchus-associated lymphoid tissue (BALT), and the deep lung-related response, represented by reaction of the mediastinal lymph node. Lymphocytes of both the BALT and the mediastinal lymph node showed elevated radioactive thymidine uptake; however, no evidence of cell death was observed at either site. The cells of the specialized epithelium covering the BALT (lymphoepithelium) showed increased vacuolization, indicating altered cellular function. The average size of BALTs was unchanged by ozone exposure. Under experimental conditions ozone can affect a variety of cells in the lung including bronchial epithelial cells, macrophages, and Type 1 cells. We have shown for the first time that in addition to these cells, the rat BALT also proliferates in response to ozone. In addition we confirm previous work in the mouse which shows that the mediastinal lymph node reacts as well. The airways can be affected by inflammation, can be targets of infection, and can respond to chemical irritants with bronchoconstrictive responses. They are an important target organ for hypersensitivity responses and are a primary site for pulmonary cancer formation. A role for lymphocytes has been implicated in each of these processes

Left-handedness and health

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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. .

[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.

Mitral Stenosis: A Review

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By C. Richard Conti, MD, MACC

2018-01-01

Full Text Available Mitral stenosis due to rheumatic heart disease is not common in the United States but is common in the developing world because rheumatic fever is still occurring frequently. Symptoms usually gradually occur in the young adult (most commonly female. Atrial fibrillation is a common accompanying rhythm in patients with proven mitral stenosis. The main physiologic event is a pressure gradient between the left atrium and the left ventricle. Diagnosis is relatively straight forward using physical exam and simple laboratory studies such as Chest X-Ray (elevated Left main stem bronchus, Double Density indicating enlarged left atrium and ECG (P-Mitrale. Cardiac ultrasound confirms the clinical diagnosis (Doming of mitral valve in diastole, Hockey stick deformity of the anterior mitral valve leaflet, large left atrium, Doppler estimation of valve gradient. Mitral commisurotomy (surgical or Balloon is warranted if the valve is pliable and not heavily calcified.

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

DEFF Research Database (Denmark)

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

2015-01-01

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

Bronchial compression in an infant with isolated secundum atrial septal defect associated with severe pulmonary arterial hypertension

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Sung-Hee Park

2012-08-01

Full Text Available Symptomatic pulmonary arterial hypertension (PAH in patients with isolated atrial septal defect (ASD is rare during infancy. We report a case of isolated ASD with severe PAH in an infant who developed airway obstruction as cardiomegaly progressed. The patient presented with recurrent severe respiratory insufficiency and failure to thrive before the repair of the ASD. Echocardiography confirmed volume overload on the right side of heart and severe PAH (tricuspid regurgitation [TR] with a peak pressure gradient of 55 to 60 mmHg. The chest radiographs demonstrated severe collapse of both lung fields, and a computed tomography scan showed narrowing of the main bronchus because of an intrinsic cause, as well as a dilated pulmonary artery compressing the main bronchus on the left and the intermediate bronchus on the right. ASD patch closure was performed when the infant was 8 months old. After the repair of the ASD, echocardiography showed improvement of PAH (TR with a peak pressure gradient of 22 to 26 mmHg, and the patient has not developed recurrent respiratory infections while showing successful catch-up growth. In infants with symptomatic isolated ASD, especially in those with respiratory insufficiency associated with severe PAH, extrinsic airway compression should be considered. Correcting any congenital heart diseases in these patients may improve their symptoms.

The therapeutic effects and experience of tracheal stent implantation in managing severe tracheal stenosis

International Nuclear Information System (INIS)

Lv Weifu; Zhang Xingming; Zhang Xuebing; Wang Weiyu; Hou Changlong

2006-01-01

Objective: To evaluate the therapeutic effects and experience of the tracheal stent implantation for the management of severe tracheal stenosis. Materials: Thirteen patients with severe tracheal stenosis of various causes underwent high kilovoltage radiography and computed tomography for evaluating the site, form and extent of the stenosis including 10 at the trachea, 1 at the right main bronchus and 2 at left main bronchus. The C2 catheter assisted with ultra-slipping guide wire was inserted into the trachea under fluoroscopy and then a replaced high shoring guide wire was pushed through the stenotic segment and retained the stent. Results: All stents were implanted successfully with successful rate 100% together with dyspnoeic improvements. The mean survival time was 6.2 months for patients with malignant neoplasm. One patient with benign tracheal stenosis has been followed-up for 5 years without restenosis. Conclusions: The tracheal stent implantation is an effective means for severe tracheal stenosis. (authors)

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

DEFF Research Database (Denmark)

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

2008-01-01

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

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

Science.gov (United States)

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

2010-05-01

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

Bronchoscopic management of benign bronchial stenosis by electrocautery and balloon dilatation.

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Garg, M; Gogia, Pratibha; Manoria, P; Goyal, R

2012-01-01

Benign bronchial stenosis is managed by surgical or bronchoscopic methods. Although surgical approach is definitive, it is technically demanding and is costlier than bronchoscopic treatment. Here, we report the case of a 27-year-old female patient with symptomatic benign bronchial stenosis of the left main bronchus. The stenosis was dilated successfully through a fibreoptic bronchoscope by electrocautery followed by balloon bronchoplasty and application of mitomycin-C. On follow up, there was no evidence of re-stenosis.

What's Left of the Left-Right Dimension? Why the Economic Policy Positions of Europeans Do Not Fit the Left-Right Dimension.

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Otjes, Simon

2018-01-01

In political science the economic left-right dimension plays a central role. A growing body of evidence shows that the economic policy preferences of a large segment of citizens do not scale sufficiently. Using Mokken scale analysis, this study determines the causes of this phenomenon. Differences in the extent to which the economic policy preferences of citizens fit the left-right dimension can be explained in terms of the interaction between individual level and political system-level variables: citizens who spend more attention to politicians with views that conform to the left-right dimension, have views that conform to the left-right dimension. There is also a role for the legacy of communist dictatorship: citizens who were socialised in democratic countries have views that fit the left-right dimension better than those socialised during communism.

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

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

2017-07-01

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

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

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

2014-09-01

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

Measuring of the airway dimensions with spiral CT images: an experimental study in Japanese white big-ear rabbits

International Nuclear Information System (INIS)

Han Xinwei; Lu Huibin; Ma Ji; Wu Gang; Wang Nan; Si Jiangtao

2009-01-01

Objective: To measure the length, angle and their correlation of the main anatomical dimensions of the trachea and bronchus in experimental Japanese white big-ear rabbits with the help of spiral CT 3D images, in order to lay the foundation of treating the airway disorders with stenting in animal experiment. Methods: Multi-slice CT scanning of cervico-thoracic region was performed in 30 healthy adult Japanese white big-ear rabbits, the longitudinal, transversal dimensions of the trachea, the glottis-carina length, the inner diameter and length of bronchi, and the angle formed by bronchial long axis and sagittal section were measured. Results: No significant difference was found in the inner diameters of various parts of the trachea and upper apical bronchi. The angle formed by bronchial long axis and sagittal section were smaller than that of the left ones. And the inner diameters of the right main bronchus was bigger than the left ones. Conclusion: The complex branching structure of the rabbit airway tree can be well displayed on spiral CT 3D images. Through measuring and statistical analysis of the results the authors have got a regressive equation for estimating the value of the inner diameter, length, angle, etc. concerning the airway tree, which is very helpful for providing the useful anatomical parameters in rabbit experiment. (authors)

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

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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.

Tracheal transplantation for carinal reconstruction in dogs.

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Kawahara, K; Inutsuka, K; Hiratsuka, M; Makihata, S; Okabayashi, K; Shiraishi, T; Shirakusa, T

1998-09-01

Experimental carinal allotransplantation has been performed with tracheocarinal Y-shaped allografts in dogs. In this study we tried canine carinal reconstruction with cylindrical allografts. Carinal reconstruction was performed with allotransplantation of cylindrical trachea in dogs, and graft healing was evaluated by bronchoscopic observation, mucosal blood flow measurement, and histologic examination. A section of the recipient carina containing five tracheal rings and two main stem bronchi was removed, and a donor trachea seven rings long was inserted between the recipient trachea and the left main stem bronchus; then side-to-end anastomosis was performed between the graft midportion and recipient right main stem bronchus (new carina). The grafts were wrapped with pedicled omentum. Fresh grafts were transplanted into one group of dogs (n=8 ), and grafts cryopreserved for 1 week were transplanted into another group (n=7). No anastomotic leakage occurred in any dog. Excellent healing of grafts and graft anastomoses was observed by fiberoptic bronchoscopy in six dogs (75%) in the fresh graft group and in four dogs (57%) in the cryopreserved graft group. The mucosal blood flow in the new carina decreased remarkably and, although it recovered, mucosal blood flow remained under the preoperative level on day 28 after the operation. Cylindrical tracheal allotransplantation is useful for carinal reconstruction, and the method of side-to-end anastomosis between the donor trachea and recipient bronchus is a feasible and accessible procedure in dogs.

An experience of bronchotomy and resectional procedures after failed bronchoscopic foerign body retrieval

International Nuclear Information System (INIS)

Khan, Y.S.; Majeed, F.A.

2015-01-01

Foreign body bronchus is a surgical emergency and is associated with a high mortality if neglected or complicated. The objective of this study was to analyse the outcome of bronchotomy and resectional procedures after failed bronchoscopic foreign body retrieval. Methods: This study of 24 cases of bronchotomy and resectional procedures after failed bronchoscopic foreign body retrieval was done from June 2008 to June 2009 and March 2010 to Sep 2013. Patients after failed retrieval of foreign body by bronchoscopy either by ENT specialists or thoracic surgeons underwent bronchotomy or resectional procedures were included in the study. We used the posterolateral thoracotomy approach for the surgical procedures. Results: Bronchotomy and resectional procedures were done in 24 cases. Age of patients ranged from 2 years to 51 years. Most patients were children and right side was mostly involved. Bronchotomy procedures were 10 (41%) and resectional surgeries were 13 (58%). Emergency lobectomies were 3 out of 13 resectional surgeries. Right intermedius bronchus was opened up and incision was extended in the direction of foreign body in 6 cases and left bronchus intermedius was opened in 4 cases. Haemoptysis was the main symptom in late presenters. Range of objects retrieved in our study was from pins, needles to whistles. Conclusion: Retention causes endobronchial obstruction with stasis leading to irreversible damaged parenchyma. Foreign body with structural changes require resection, others can be offered bronchotomy which is a safe procedure for retained non retrievable foreign bodies. (author)

Vaccination reduces macrophage infiltration in bronchus-associated lymphoid tissue in pigs infected with a highly virulent Mycoplasma hyopneumoniae strain

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Vranckx Katleen

2012-03-01

Full Text Available Abstract Background Mycoplasma hyopneumoniae is the causative agent of enzootic pneumonia and is responsible for significant economic losses to the pig industry. To better understand the mode of action of a commercial, adjuvanted, inactivated whole cell vaccine and the influence of diversity on the efficacy of vaccination, we investigated samples from vaccinated and non-vaccinated pigs experimentally infected with either a low (LV or a highly virulent (HV M. hyopneumoniae strain. Non-vaccinated and sham-infected control groups were included. Lung tissue samples collected at 4 and 8 weeks post infection (PI were immunohistochemically tested for the presence of T-lymphocytes, B-lymphocytes and macrophages in the bronchus-associated lymphoid tissue (BALT. The number of M. hyopneumoniae organisms in bronchoalveolar lavage (BAL fluid was determined using quantitative PCR at 4 and 8 weeks PI. Serum antibodies against M. hyopneumoniae were determined at 0, 2, 4, 6 and 8 weeks PI. Results The immunostaining revealed a lower density of macrophages in the BALT of the vaccinated groups compared to the non-vaccinated groups. The highest number of M. hyopneumoniae organisms in the BAL fluid was measured at 4 weeks PI for the HV strain and at 8 weeks PI for the LV strain. Vaccination reduced the number of organisms non-significantly, though for the HV strain the reduction was clinically more relevant than for the LV strain. At the level of the individual pigs, a higher lung lesion score was associated with more M. hyopneumoniae organisms in the lungs and a higher density of the investigated immune cells in the BALT. Conclusions In conclusion, the infiltration of macrophages after infection with M. hyopneumoniae is reduced by vaccination. The M. hyopneumoniae replication in the lungs is also reduced in vaccinated pigs, though the HV strain is inhibited more than the LV strain.

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

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

2011-01-01

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

Influence of a dexamethasone-eluting covered stent on tissue reaction: an experimental study in a canine bronchial model

International Nuclear Information System (INIS)

Shin, Ji Hoon; Song, Ho-Young; Choi, Gi Bok; Kim, Tae-Hyung; Suh, Ji-Yeon; Seo, Tae-Seok; Yuk, Soon Hong; Kim, Young-Hwa; Cho, Yong-Mee

2005-01-01

This study was designed to evaluate the feasibility and efficacy of a dexamethasone (DXM)-eluting, covered, self-expanding metallic stent to reduce tissue reaction following stent placement in a canine bronchial model. We placed a DXM-eluting, polyurethane-covered, self-expanding metallic stent (drug stent, DS) and a polyurethane-covered, self-expanding metallic stent (control stent, CS) alternately in each left main bronchus and left lower lobe bronchus in 12 dogs. The stents were 20 mm in diameter and length when fully expanded. The dose of DXM was approximately 36.7 mg in each DS, but was absent in the CS. The dogs were euthanased 1 week (n=4), 2 weeks (n=4) or 4 weeks (n=4) after stent placement. Histologic findings, such as epithelial erosion/ulcer or granulation tissue thickness, were obtained from the mid-portion of the bronchus, where the stent had been placed, and evaluated between DS and CS. There were no procedure-related complications or malpositioning of any of the bronchial stents. Stent migration was detected in one dog just before euthanasia 1 week following stent placement. Stent patency was maintained until euthanasia in all dogs. Epithelial erosion/ulcer (%) was significantly less in the DS (mean±standard deviation, 46.88±23.75) than in the CS (73.75±14.08) (P=0.026) for all time-points. There was a decrease in epithelial erosion/ulcer as the follow-up period increased in both DS and CS. The granulation tissue thickness (mm) was less in DS (2.63±2.05) than in CS (3.49±2.95), although the difference was not significant (P=0.751) for all time-points. There was a tendency toward an increase in granulation tissue thickness and chronic lymphocytic infiltration as the follow-up period increased in both DS and CS. In conclusion, DXM-eluting, covered, self-expanding metallic stent seems to be effective in reducing tissue reaction secondary to stent placement in a canine bronchial model. (orig.)

Influence of a dexamethasone-eluting covered stent on tissue reaction: an experimental study in a canine bronchial model

Energy Technology Data Exchange (ETDEWEB)

Shin, Ji Hoon; Song, Ho-Young; Choi, Gi Bok; Kim, Tae-Hyung; Suh, Ji-Yeon [University of Ulsan College of Medicine, Department of Radiology, Asan Medical Center, Seoul (Korea); Seo, Tae-Seok [Gachon Medical School, Department of Radiology, Gil Medical Center, Inchon (Korea); Yuk, Soon Hong [Hannam University, Department of Polymer Science and Engineering, College of Engineering, Daejeon (Korea); Kim, Young-Hwa [Soonchunhyang University Chonan Hospital, Department of Radiology, Chonan (Korea); Cho, Yong-Mee [University of Ulsan College of Medicine, Department of Pathology, Asan Medical Center, Seoul (Korea)

2005-06-01

This study was designed to evaluate the feasibility and efficacy of a dexamethasone (DXM)-eluting, covered, self-expanding metallic stent to reduce tissue reaction following stent placement in a canine bronchial model. We placed a DXM-eluting, polyurethane-covered, self-expanding metallic stent (drug stent, DS) and a polyurethane-covered, self-expanding metallic stent (control stent, CS) alternately in each left main bronchus and left lower lobe bronchus in 12 dogs. The stents were 20 mm in diameter and length when fully expanded. The dose of DXM was approximately 36.7 mg in each DS, but was absent in the CS. The dogs were euthanased 1 week (n=4), 2 weeks (n=4) or 4 weeks (n=4) after stent placement. Histologic findings, such as epithelial erosion/ulcer or granulation tissue thickness, were obtained from the mid-portion of the bronchus, where the stent had been placed, and evaluated between DS and CS. There were no procedure-related complications or malpositioning of any of the bronchial stents. Stent migration was detected in one dog just before euthanasia 1 week following stent placement. Stent patency was maintained until euthanasia in all dogs. Epithelial erosion/ulcer (%) was significantly less in the DS (mean{+-}standard deviation, 46.88{+-}23.75) than in the CS (73.75{+-}14.08) (P=0.026) for all time-points. There was a decrease in epithelial erosion/ulcer as the follow-up period increased in both DS and CS. The granulation tissue thickness (mm) was less in DS (2.63{+-}2.05) than in CS (3.49{+-}2.95), although the difference was not significant (P=0.751) for all time-points. There was a tendency toward an increase in granulation tissue thickness and chronic lymphocytic infiltration as the follow-up period increased in both DS and CS. In conclusion, DXM-eluting, covered, self-expanding metallic stent seems to be effective in reducing tissue reaction secondary to stent placement in a canine bronchial model. (orig.)

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

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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.

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.

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

Scintigraphic Demonstration of Endobronchial Foreign Body Aspiration

International Nuclear Information System (INIS)

Lee, Sun Wha

1986-01-01

A 2 year-old boy was presented with wheezing, cough and stridor for 1 1/2 months. The analysis of arterial blood sample disclosed PO 2 , 44 mmHg and PCO 2 , 58 mmHg. The diagnostic procedures, chest radiography including inspiratory, expiratory and lateral decubitus views and 99m Tc-MAA lung perfusion scintigraphy, were performed, on the presumptive diagnosis of foreign body aspiration. At bronchoscopy, a foreign body (fish vertebra), partially occluding the left main bronchus from 1 cm below carima, was removed.

Left ventricular filling under elevated left atrial pressure

Science.gov (United States)

Gaddam, Manikantam; Samaee, Milad; Santhanakrishnan, Arvind

2017-11-01

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

Topography of the accessory left gastric artery (ALGA) analyzed by CT angiography from the left hepatic artery

International Nuclear Information System (INIS)

Shioyama, Yasukazu; Takasaka, Isao; Onaya, Hiroaki

2003-01-01

To avoid gastric complications when we perform transcatheter treatment via left hepatic artery, we analyzed the topography of ALGA (accessory left gastric artery) by left hepatic arteriography and CT angiography from left hepatic artery. Six hundred seventy eight cases of CT angiography were performed between 1995 and 2000. Among them, selective left hepatic arteriography was done in 85 cases. We analyzed the frequency and the course of ALGA on the hepatic angiogram and CT angiogram. ALGA were identified in eighteen (21.2 %) of the 85 cases. We classified them into eleven cases of the proximal type and six cases of the distal type. When ALGA bifurcated from the left hepatic artery very close to the bifurcation of A2 (dorsolateral branch) and A3 (ventrolateral branch), we classified them as the distal type on hepatic angiogram. On the other hand, when ALGA bifurcated from the left hepatic artery apart from the bifurcation of A2 and A3 they were classified as the proximal type. In one rare case ALGA originated from the dorsolateral branch of the left hepatic artery. ALGA were classified as the distal and proximal types. Distal type of ALGA often overlapped dorsolateral branch of the left hepatic artery, and it was sometimes difficult to notice the existence of them. We should check the existence of ALGA on the arterial phase of dynamic CT before we plan to make a transcatheter treatment from the left hepatic artery. Then we can avoid gastric complications caused by a transcatheter treatment from the left hepatic artery. (author)

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

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Ha Eun Kim

2016-06-01

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

Social aspects of left-handedness

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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.

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.

Esophageal bypass for the treatment of bronchoesophageal fistula in a case of squamous cell carcinoma of the lung

International Nuclear Information System (INIS)

Uchibori, Ken; Suhara, Kozo; Chiba, Sahoko; Tsuchiya, Kimitake; Fujie, Toshihide; Tamaoka, Meiyo; Sakashita, Hiroyuki; Inase, Naohiko

2013-01-01

Bronchoesophageal fistula in lung cancer is very rare. While these cases usually receive an implanted expandable stent in the esophagus or trachea, no standard therapeutic strategy has been developed. Our patient was a 63-year-old woman who had visited a local clinic because of productive cough. Lung cancer was suspected from her chest CT findings and an additional work-up with bronchoscopy and sputum cytology revealed squamous cell cancer of the lung. She also had obstructive pneumonia caused by a severe stricture from the trachea to the left main bronchus. Radiochemotherapy was begun for treatment of the obstruction by the tumor, with concurrent administration of antibiotics. In spite of apparent improvement of the disease by the fifth week of treatment, a large bronchoesophageal fistula appeared at the inlet of the left main bronchus. Stent implantation was judged contraindicated for either the trachea or the esophagus, because of the large size of the fistula. We performed an esophageal bypass procedure in an attempt to restore her dysphagia She regained oral intake ability and she required no antibiotic administration for pneumonia after the procedure. We performed an esophageal bypass for the treatment of a bronchoesophageal fistula that had occurred during radiochemotherapy for lung cancer. The procedure was successful and the patient regained the ability to eat from the mouth. The esophageal bypass procedure might be a viable choice of treatment for tracheo- or bronchoesophageal fistula in lung cancer patients. (author)

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

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Sesi

2015-03-01

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

Effect of left ventricular diastolic dysfunction on left atrial appendage function and thrombotic potential in nonvalvular atrial fibrillation.

Science.gov (United States)

Demirçelik, Muhammed Bora; Çetin, Mustafa; Çiçekcioğlu, Hülya; Uçar, Özgül; Duran, Mustafa

2014-05-01

We aimed to investigate effects of left ventricular diastolic dysfunction on left atrial appendage functions, spontaneous echo contrast and thrombus formation in patients with nonvalvular atrial fibrillation. In 58 patients with chronic nonvalvular atrial fibrilation and preserved left ventricular systolic function, left atrial appendage functions, left atrial spontaneous echo contrast grading and left ventricular diastolic functions were evaluated using transthoracic and transoesophageal echocardiogram. Patients divided in two groups: Group D (n=30): Patients with diastolic dysfunction, Group N (n=28): Patients without diastolic dysfunction. Categorical variables in two groups were evaluated with Pearson's chi-square or Fisher's exact test. The significance of the lineer correlation between the degree of spontaneous echo contrast (SEC) and clinical measurements was evaluated with Spearman's correlation analysis. Peak pulmonary vein D velocity of the Group D was significantly higher than the Group N (p=0.006). However, left atrial appendage emptying velocity, left atrial appendage lateral wall velocity, peak pulmonary vein S, pulmonary vein S/D ratio were found to be significantly lower in Group D (p=0.028, patrial appendage emptying, filling, pulmonary vein S/D levels and lateral wall velocities respectively (r=-0.438, r=-0.328, r=-0.233, r=-0.447). Left atrial appendage emptying, filling, pulmonary vein S/D levels and lateral wall velocities were significantly lower in SEC 2-3-4 than SEC 1 (p=0.003, p=0.029, patrial fibrillation and preserved left ventricular ejection fraction, left atrial appendage functions are decreased in patients with left ventricular diastolic dysfunction. Left ventricular diastolic dysfunction may constitute a potential risk for formation of thrombus and stroke.

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.

Variations of right bronchial tree: a study with multi-detector CT.

Science.gov (United States)

Wang, Tao; Meng, Min; Huang, Min; Zhao, Xinya

2018-05-03

The aim was to display variations of right bronchial tree. The bronchial tree images of 238 patients were reconstructed using the postprocessing technique of CT. We revealed four cases rare bronchial branching patterns of right superior lobe. 1 case was referred to as tracheal bronchus. In 1 case, B1 was located in the place of the right superior lobar bronchus and B2 + 3 arose from the right merge of the IB. In 1 case, the right superior lobar bronchus has only two divisions for B1 and B3, and the bronchus B2 arose from the right merge of the IB. In 1 case, B1 branched into four bronchi. We revealed 15 cases of rare bronchial branching patterns of right inferior lobe. In nine cases, the basal trunk bronchus bifurcated into B7 + 8 and B9 + l0. In three cases, B8 branched from the basal trunk bronchus before B7. In two cases, basal trunk bronchus bifurcated into B7 + 8 + 9 and B10. In 1 case, the basal trunk bronchus bifurcated into the common stem of B7 + 10 and B8 + 9. Variations of right bronchial tree were displayed in the present study. This information may have important implications for diagnosis of symptomatic patients and performing certain procedures, including bronchoscopy, endotracheal intubation, and lung resection.

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

International Nuclear Information System (INIS)

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

2009-01-01

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

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

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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.

What is Beyond Right/Left?

DEFF Research Database (Denmark)

Dyrberg, Torben Bech

2009-01-01

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

Vaccination against H9N2 avian influenza virus reduces bronchus-associated lymphoid tissue formation in cynomolgus macaques after intranasal virus challenge infection.

Science.gov (United States)

Nakayama, Misako; Ozaki, Hiroichi; Itoh, Yasushi; Soda, Kosuke; Ishigaki, Hirohito; Okamatsu, Masatoshi; Sakoda, Yoshihiro; Park, Chun-Ho; Tsuchiya, Hideaki; Kida, Hiroshi; Ogasawara, Kazumasa

2016-12-01

H9N2 avian influenza virus causes sporadic human infection. Since humans do not possess acquired immunity specific to this virus, we examined the pathogenicity of an H9N2 virus isolated from a human and then analyzed protective effects of a vaccine in cynomolgus macaques. After intranasal challenge with A/Hong Kong/1073/1999 (H9N2) (HK1073) isolated from a human patient, viruses were isolated from nasal and tracheal swabs in unvaccinated macaques with mild fever and body weight loss. A formalin-inactivated H9N2 whole particle vaccine derived from our virus library was subcutaneously inoculated to macaques. Vaccination induced viral antigen-specific IgG and neutralization activity in sera. After intranasal challenge with H9N2, the virus was detected only the day after inoculation in the vaccinated macaques. Without vaccination, many bronchus-associated lymphoid tissues (BALTs) were formed in the lungs after infection, whereas the numbers of BALTs were smaller and the cytokine responses were weaker in the vaccinated macaques than those in the unvaccinated macaques. These findings indicate that the H9N2 avian influenza virus HK1073 is pathogenic in primates but seems to cause milder symptoms than does H7N9 influenza virus as found in our previous studies and that a formalin-inactivated H9N2 whole particle vaccine induces protective immunity against H9N2 virus. © 2016 Japanese Society of Pathology and John Wiley & Sons Australia, Ltd.

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

DEFF Research Database (Denmark)

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

2013-01-01

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

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.)

Evaluation of left ventricular function by cardiac CT

International Nuclear Information System (INIS)

Naito, Hiroaki; Kozuka, Takahiro

1982-01-01

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

Aetiological factors in left-handedness

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Milenković Sanja M.

2005-01-01

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

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.

Left-handedness and language lateralization in children.

Science.gov (United States)

Szaflarski, Jerzy P; Rajagopal, Akila; Altaye, Mekibib; Byars, Anna W; Jacola, Lisa; Schmithorst, Vincent J; Schapiro, Mark B; Plante, Elena; Holland, Scott K

2012-01-18

This fMRI study investigated the development of language lateralization in left- and righthanded children between 5 and 18 years of age. Twenty-seven left-handed children (17 boys, 10 girls) and 54 age- and gender-matched right-handed children were included. We used functional MRI at 3T and a verb generation task to measure hemispheric language dominance based on either frontal or temporo-parietal regions of interest (ROIs) defined for the entire group and applied on an individual basis. Based on the frontal ROI, in the left-handed group, 23 participants (85%) demonstrated left-hemispheric language lateralization, 3 (11%) demonstrated symmetric activation, and 1 (4%) demonstrated right-hemispheric lateralization. In contrast, 50 (93%) of the right-handed children showed left-hemispheric lateralization and 3 (6%) demonstrated a symmetric activation pattern, while one (2%) demonstrated a right-hemispheric lateralization. The corresponding values for the temporo-parietal ROI for the left-handed children were 18 (67%) left-dominant, 6 (22%) symmetric, 3 (11%) right-dominant and for the right-handed children 49 (91%), 4 (7%), 1 (2%), respectively. Left-hemispheric language lateralization increased with age in both groups but somewhat different lateralization trajectories were observed in girls when compared to boys. The incidence of atypical language lateralization in left-handed children in this study was similar to that reported in adults. We also found similar rates of increase in left-hemispheric language lateralization with age between groups (i.e., independent of handedness) indicating the presence of similar mechanisms for language lateralization in left- and right-handed children. Copyright © 2011 Elsevier B.V. All rights reserved.

On the compensating filter in pulmonary hilar tomography

International Nuclear Information System (INIS)

Okayama, Akio; Nakanishi, Takashi; Fujikawa, Tsuyoshi; Inaba, Nobuo; Fujii, Shinichi

1979-01-01

In recent years, it has been an important theme for the diagnosis of pulmonary hilar cancer to evaluate whether the lesion in hilar lymph nodes and the vicinity of the hilar bronchus exists or does not. It is shown that pulmonary hilar region is from main bronchus to segmental bronchus which is separating subsegmental bronchus. It is difficult to make the optimal density for all area of the pulmonary hilar region on a same film, because there is too much difference of density between medial region under the veil of thoracic vertebra, sternum, heart and great vessels, and lateral region in conventional tomography. Therefore, a compensating filter was constructed to equalize the uneven density of pulmonary hilar region on a X-ray film. As a result, trachea, main bronchus, upper local and segmental bronchus were observed simultaneously and serially on a same film by using this filter. In addition, we could study the condition in the inside and outside of bronchial wall in detail, and have many informations compared with conventional tomogram. Particularly, this is an useful method to determine the range of lesion in the pulmonary hilar cancer. (author)

[Prediction of the efficiency of endoscopic lung volume reduction by valves in severe emphysema].

Science.gov (United States)

Bocquillon, V; Briault, A; Reymond, E; Arbib, F; Jankowski, A; Ferretti, G; Pison, C

2016-11-01

In severe emphysema, endoscopic lung volume reduction with valves is an alternative to surgery with less morbidity and mortality. In 2015, selection of patients who will respond to this technique is based on emphysema heterogeneity, a complete fissure visible on the CT-scan and absence of collateral ventilation between lobes. Our case report highlights that individualized prediction is possible. A 58-year-old woman had severe, disabling pulmonary emphysema. A high resolution thoracic computed tomography scan showed that the emphysema was heterogeneous, predominantly in the upper lobes, integrity of the left greater fissure and no collateral ventilation with the left lower lobe. A valve was inserted in the left upper lobe bronchus. At one year, clinical and functional benefits were significant with complete atelectasis of the treated lobe. The success of endoscopic lung volume reduction with a valve can be predicted, an example of personalized medicine. Copyright © 2016 SPLF. Published by Elsevier Masson SAS. All rights reserved.

A Rare Case of Idiopathic Plastic Bronchitis

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Mohammed Raoufi

2017-01-01

Full Text Available Plastic bronchitis is a rare disorder characterized by formation of large, branching bronchial casts, which are often expectorated. We present an interesting case of a 35-year-old woman who presented for evaluation of a chronic cough productive of voluminous secretions. Clinical and radiological examination confirmed a total left lung atelectasis without any pathological mediastinal node. Flexible bronchoscopy demonstrated tenacious, thick, and sticky whitish secretions blocking the left stem bronchus. This material was extracted, and inspection demonstrated a bronchial cast, whose pathological analysis revealed necrotic epithelial cells, some eosinophils, and Charcot-Leyden crystals. Two days after bronchoscopy, the patient rejected more bronchial casts, and dyspnea improved. Control of chest x-ray revealed complete left lung aeration and the diagnosis of idiopathic plastic bronchitis was obtained. This article shows the interest in clinical practice to evoke the diagnosis of plastic bronchitis in front of a productive chronic cough. Our case illustrates a rare clinical presentation represented by an atelectasis of an entire lung.

Retrograde Instillation of Methylene Blue in the Difficult Diagnosis of BPF

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F. Ravenna

2012-01-01

Full Text Available We report two cases in which we were able to diagnose bronchopleural fistula through retrograde methylene blue instillation during bronchoscopy. In the first case, methylene blue was injected through an abdominal drain, followed by air instillation and detected in the left bronchial tree, demonstrating the presence of a fistula in the lingula’s bronchus. In the second case, methylene blue was injected into a pleural drain, through a breach on a surgical suture and detected in the right bronchial tree, demonstrating the presence of a fistula in the right inferior bronchus. The retrograde instillation of methylene blue, through a drain in the abdomen or the thoracic wall, is a safe, cheap, and practical method that allows the bronchoscopist to identify the presence of a fistula and, more importantly, to identify the exact point on the bronchial tree where a fistula is located. This provides the possibility of sealing the fistula with a variety of devices. It is our opinion that this procedure should be considered a primary method of diagnosis when a bronchopleural fistula is suspected and a drain on the thoracic or abdominal wall is positioned such that effusions are able to drain.

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

Science.gov (United States)

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

2014-11-06

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

Producing The New Regressive Left

DEFF Research Database (Denmark)

Crone, Christine

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

CT findings of primary lung cancer

International Nuclear Information System (INIS)

Park, Yeon Won; Kim, So Seon; Woo, Young Hoon; Kim, Ho Joon; Chun, Byung Hee; Suh, Jung Hyek; Suh, Soo Jhi

1985-01-01

Authors retrospectively analyzed the CT findings of 102 cases of histologically proven bronchogenic carcinoma during last 4 years from January 1980 to July 1984 at Kosin Medical College. The results were as follows: 1. The sex ratio was 86 males to 16 females and the greatest number (66.7%) of cases were seen in fourth and fifth decades. 2. The distribution of histologic types of primary lung cancer as follows: Squamous cell carcinoma 66 cases, Adenocarcinoma 10 cases, Small cell carcinoma 7 cases, Large cell carcinoma 5 cases, Bronchioloalveolar cell carcinoma 1 case, Unclassified 13 cases. 3. Location of primary lesions as follows: Right lung 61 cases, Left lung 40 cases. In both lungs, the greatest number of cases were found in the upper lobes. Ratio between central and peripheral mass was 2.5:1, except adenocarcinoma (6:4). 4. CT findings were as follows: Hilar or central mass (75 cases), Peripheral mass (26), Bronchial abnormalities such as narrowing, obstruction, or displacement (60), Thickening of the posterior wall of the right upper lobe bronchus, bronchus intermedius, or left main bronchus (17), Post-obstructive changes; Atelectasis, Pneumonitis, Emphysema (34, 17, 1 respectively), Hilar adenopathy (21), Mediastinal lymph node enlargement (50), Mediastinal invasion (51), Pericardial thickening (5), SVC syndrome with collateral vessels (3), Pleural effusion (27), Pleural thickening or invasion (14), Chest wall invasion (2), Distant metastasis (26). 5. In most of patients (92 cases), the size of mass was above 3cm, but in 9 cases below 3cm. Margins of the masses were serrated or lobulated in most cases. In 5 cases, cavitary formations were noted, walls of which were thick and irregular, and air-fluid level was noted in 1 case. In 2 cases, eccentric calcification were noted within mass. 6. Among 51 cases of whom direct mediastinal invasion was suspected, 8 cases were operated upon, and this revealed that the masses were not resectable. Among the patients in

Expandable metallic stents in the palliative treatment of malignant tracheobronchial stenosis

Energy Technology Data Exchange (ETDEWEB)

Park, Jong Woong; Jung, Gyoo Sik; Kim, Seong Min; Lee, Seung Ryong; Kim, Hyun Sook; Huh, Jin Do; Joh, Young Duk [Kosin Medical College, Pusan (Korea, Republic of)

1998-05-01

The purpose of this study is to report the outcome of using expandable metallic stent in the management of malignant tracheobronchial stenosis with dyspnea. Under fluoroscopic and bronchoscopic guidance, seven patients with malignant airway stenosis were treated with ten expandable metallic stents. The cause of stenosis was metastasis from esophageal cancer in five patients, recurrent adenoid cystic carcinoma of the trachea in one, and primary lung cancer in one. The major sites of obstruction were the trachea in four patients, the left main bronchus in one, the trachea and left main bronchus in one, and the trachea and both bronchi in one. Chest radiography (n=7), bronchoscopy (n=5), pulmonary function test (PFT)(n=3), and spirometry(n=1) were performed before and after stent placement. In all seven patients, the stent was successfully placed at the lesion sites and dyspnea began to improve immediately. After the procedure, chest radiography and bronchoscopy showed an increase in airway diameter. After the procedure, chest radiography and bronchoscopy showed an increase in airway diameter. After stent placement, forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) improved 53% and 56%, respectively. Peak flow velocity also changed from 46 L/min to 200 L/min. During median follow-up of 67 (41-1565) days, one stent migration occurred. In one patient, proximal tumor overgrowth occurred, and in one, tumor ingrowth was treated with balloon dilatation. For in the palliative treatment of malignant tracheobronchial stenosis with dyspnea, placement of expandable metal stents is safe and effective. (author). 21 refs., 1 tabs., 3 figs.

Expandable metallic stents in the palliative treatment of malignant tracheobronchial stenosis

International Nuclear Information System (INIS)

Park, Jong Woong; Jung, Gyoo Sik; Kim, Seong Min; Lee, Seung Ryong; Kim, Hyun Sook; Huh, Jin Do; Joh, Young Duk

1998-01-01

The purpose of this study is to report the outcome of using expandable metallic stent in the management of malignant tracheobronchial stenosis with dyspnea. Under fluoroscopic and bronchoscopic guidance, seven patients with malignant airway stenosis were treated with ten expandable metallic stents. The cause of stenosis was metastasis from esophageal cancer in five patients, recurrent adenoid cystic carcinoma of the trachea in one, and primary lung cancer in one. The major sites of obstruction were the trachea in four patients, the left main bronchus in one, the trachea and left main bronchus in one, and the trachea and both bronchi in one. Chest radiography (n=7), bronchoscopy (n=5), pulmonary function test (PFT)(n=3), and spirometry(n=1) were performed before and after stent placement. In all seven patients, the stent was successfully placed at the lesion sites and dyspnea began to improve immediately. After the procedure, chest radiography and bronchoscopy showed an increase in airway diameter. After the procedure, chest radiography and bronchoscopy showed an increase in airway diameter. After stent placement, forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) improved 53% and 56%, respectively. Peak flow velocity also changed from 46 L/min to 200 L/min. During median follow-up of 67 (41-1565) days, one stent migration occurred. In one patient, proximal tumor overgrowth occurred, and in one, tumor ingrowth was treated with balloon dilatation. For in the palliative treatment of malignant tracheobronchial stenosis with dyspnea, placement of expandable metal stents is safe and effective. (author). 21 refs., 1 tabs., 3 figs

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

DEFF Research Database (Denmark)

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

2008-01-01

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

Macrophages are related to goblet cell hyperplasia and induce MUC5B but not MUC5AC in human bronchus epithelial cells.

Science.gov (United States)

Silva, Manuel A; Bercik, Premysl

2012-06-01

Airway goblet cell hyperplasia (GCH)--detectable by mucin staining--and abnormal macrophage infiltrate are pathological features present in many chronic respiratory disorders. However, it is unknown if both factors are associated. Using in-vivo and in-vitro models, we investigated whether macrophages are related with GCH and changes in mucin immunophenotypes. Lung sections from Sprague-Dawley rats treated for 48 h with one intra-tracheal dose of PBS or LPS (n=4-6 per group) were immunophenotyped for rat-goblet cells, immune, and proliferation markers. Human monocyte-derived macrophages (MDM) were pre-treated with or without LPS, immunophenotyped, and their supernatant, as well as cytokines at levels equivalent to supernatant were used to challenge primary culture of normal human bronchus epithelial cells (HBEC) in air-liquid interface, followed by MUC5B and MUC5AC mucin immunostaining. An association between increased bronchiolar goblet cells and terminal-bronchiolar proliferative epithelial cells confirmed the presence of GCH in our LPS rat model, which was related with augmented bronchiolar CD68 macrophage infiltration. The in-vitro experiments have shown that MUC5AC phenotype was inhibited when HBEC were challenged with supernatant from MDM pre-treated with or without LPS. In contrast, TNF-α and interleukin-1β at levels equivalent to supernatant from LPS-treated MDM increased MUC5AC. MUC5B was induced by LPS, supernatant from LPS-treated MDM, a mix of cytokines including TNF-α and TNF-α alone at levels present in supernatant from LPS-treated MDM. We demonstrated that macrophages are related with bronchiolar GCH, and that they induced MUC5B and inhibited MUC5AC in HBEC, suggesting a role for them in the pathogenesis of airway MUC5B-related GCH.

Balloon-occluded retrograde transvenous obliteration of gastric varix draining via the left inferior phrenic vein into the left hepatic vein

International Nuclear Information System (INIS)

Ibukuro, Kenji; Mori, Koichi; Tsukiyama, Toshitaka; Inoue, Yoshihiro; Iwamoto, Yukako; Tagawa, Kazumi

1999-01-01

We encountered a patient with gastric varix draining not via the usual left suprarenal vein but via the left inferior phrenic vein joining the left hepatic vein. Transfemoral balloon-occluded retrograde transvenous obliteration (BRTO) of the varix was performed under balloon occlusion of the left inferior phrenic vein via the left hepatic vein and retrograde injection of the sclerosing agent (5% of ethanolamine oleate) into the gastric varix. Disappearance of the gastric varix was confirmed on endoscopic examination 2 months later.

Timing, Frequency and Environmental Conditions Associated with Mainstem–Tributary Movement by a Lowland River Fish, Golden Perch (Macquaria ambigua)

Science.gov (United States)

Koster, Wayne M.; Dawson, David R.; O’Mahony, Damien J.; Moloney, Paul D.; Crook, David A.

2014-01-01

Tributary and mainstem connections represent important links for the movement of fish and other biota throughout river networks. We investigated the timing, frequency and environmental conditions associated with movements by adult golden perch (Macquaria ambigua) between the mainstem of the mid-Murray River and a tributary, the Goulburn River, in south-eastern Australia, using acoustic telemetry over four years (2007–2011). Fish were tagged and released in autumn 2007–2009 in the mid-Murray (n = 42) and lower Goulburn (n = 37) rivers within 3–6 km of the mid-Murray-lower Goulburn junction. 38% of tagged fish undertook mainstem–tributary movements, characterised mostly by temporary occupation followed by return of fish to the original capture river. Approximately 10% of tagged fish exhibited longer-term shifts between the mainstem and tributary. Movement of fish from the tributary into the mainstem occurred primarily during the spawning season and in some years coincided with the presence of golden perch eggs/larvae in drift samples in the mainstem. Many of the tributary-to-mainstem movements occurred during or soon after changes in flow. The movements of fish from the mainstem into the tributary were irregular and did not appear to be associated with spawning. The findings show that golden perch moved freely across the mainstem–tributary interface. This demonstrates the need to consider the spatial, behavioural and demographic interdependencies of aquatic fauna across geographic management units such as rivers. PMID:24788137

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

Science.gov (United States)

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

2012-11-01

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

Successful Use of Extracorporeal Life Support after Double Traumatic Tracheobronchial Injury in a Patient with Severe Acute Asthma

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Xavier Valette

2011-01-01

Full Text Available We report the case of an asthmatic patient with blunt trachea and left main bronchus injuries who developed acute severe asthma after surgical repair. Despite medical treatment and ventilatory support, asthma persisted with high airway pressures and severe respiratory acidosis. We proposed venovenous extracorporeal life support for CO2 removal which allowed arterial blood gas normalization and airway pressures decrease. Extracorporeal life support was removed on day five after medical treatment of acute severe asthma. So we report the successful use of extracorporeal life support for operated double blunt tracheobronchial injury with acute severe asthma.

Delayed recurrence of ulcerative colitis manifested by tracheobronchitis, bronchiolitis, and bronchiolectasis

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Iclal Ocak MD,

2017-12-01

Full Text Available Ulcerative colitis can cause inflammation of small and large airways, characterized by mucosal inflammation, tracheobronchial stenosis, bronchiestasis, and bronchiolitis. We present a case of tracheobronchitis and bronchiolitis associated with ulcerative colitis in a 58-year-old nonsmoking man, 17 years after the total colectomy and complete resolution of intestinal findings. Computed tomography demonstrated wall thickening of trachea and left main stem bronchus, and multiple bronchi around the both hilum with mild to moderate stenosis. Fiberoptic bronchial biopsy showed inflammation of the airways, similar to histologic findings of ulcerative colitis within colon. Keywords: Ulcerative colitis, Trachea, Lung

Successful Treatment of Carcinomatous Central Airway Obstruction with Bronchoscopic Electrocautery Using Hot Biopsy Forceps during Mechanical Ventilation

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Motoi Ugajin

2017-01-01

Full Text Available We report the case of a 72-year-old man with occlusion of the left main bronchus due to squamous cell carcinoma of the lung. He required tracheal intubation and mechanical ventilation because of the aggravation of atelectasis and obstructive pneumonia. Electrocautery using hot biopsy forceps was performed during mechanical ventilation with a 40% fraction of inspired oxygen. He was extubated following improvement in the atelectasis and obstructive pneumonia and discharged with shrinkage of the tumor after chemotherapy. We describe a safe electrocautery procedure using hot biopsy forceps during mechanical ventilation with reference to previous reports.

Left atrial appendage occlusion

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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.

Anosognosia for hemiparesis after left-sided stroke.

Science.gov (United States)

Baier, Bernhard; Vucurevic, Goran; Müller-Forell, Wibke; Glassl, Oliver; Geber, Christian; Dieterich, Marianne; Karnath, Hans-Otto

2014-12-01

In patients with left-sided lesions, anosognosia for hemiparesis (AHP) seems to be a rare phenomenon. It has been discussed whether this rareness might be due to an inevitable bias due to language dysfunction and whether the left hemisphere's role for our self-awareness of motor actions thus is underestimated. By applying functional magnetic resonance imaging (fMRI) we examined whether patients with AHP following a left hemisphere stroke show a regular, left-sided or a reversed, right-sided lateralization of language functions. Only the former observation would argue for an original role of the left hemisphere in self-awareness about limb function. In a consecutive series of 44 acute left-sided stroke patients, only one patient (=2%) was identified showing AHP. In this case, we could verify by using fMRI that lateralization of AHP and spatial neglect on the one hand and of language functions on the other hand were reversed. The present single case observation thus argues against an original role of the left hemisphere in self-awareness about limb function. We discuss the data in the context of previous observations in the literature. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

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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.

Left Ventricular Assist Devices

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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.

Visceral subpleural hematoma of the left diaphragmatic surface following left upper division segmentectomy

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Yasushi Mizukami

2017-10-01

Full Text Available Abstract Background Pulmonary visceral subpleural hematoma is rare. We report visceral subpleural hematoma of the left diaphragmatic surface following left upper division segmentectomy. This very rare case was difficult to distinguish from thoracic abscess. Case presentation A 68-year-old man with hypertension had undergone video-assisted thoracoscopic left upper division segmentectomy for suspected lung carcinoma. Deep vein thrombosis of the lower leg was identified and edoxaban, a so-called novel oral anticoagulant, was started on postoperative day 7. The chest drainage tube was removed on postoperative day 12 because of persistent air leakage, but fever appeared the same day. Computed tomography revealed a cavity with mixed air and fluid, so antibiotics were started on suspicion of abscess. Computed tomography-guided drainage was attempted, but proved unsuccessful. Fever continued and surgical investigation was therefore performed. Visceral subpleural hematoma was identified under the diaphragmatic surface of the left basal lung. We excised the pleura, then performed drainage and applied running sutures. The parenchyma and visceral pleura were covered with polyglycolic acid sheet and fibrin glue. Edoxaban was restarted on postoperative day 12 of video-assisted thoracoscopic surgery and no recurrence of hematoma has been revealed. Conclusions Visceral subpleural hematoma after thoracic surgery is extremely rare. Furthermore, correct diagnosis was difficult and surgery offered a good diagnostic and therapeutic procedure.

Utilization of low-dose multidetector CT and virtual bronchoscopy in children with suspected foreign body aspiration

International Nuclear Information System (INIS)

Adaletli, Ibrahim; Kurugoglu, Sebuh; Ulus, Sila; Ozer, Harun; Kantarci, Fatih; Mihmanli, Ismail; Akman, Canan; Elicevik, Mehmet

2007-01-01

Foreign body aspiration is common in children, especially those under 3 years of age. Chest radiography and CT are the main imaging modalities for the evaluation of these children. Management of children with suspected foreign body aspiration (SFBA) mainly depends on radiological findings. To investigate the potential use of low-dose multidetector CT (MDCT) and virtual bronchoscopy (VB) in the evaluation and management of SFBA in children. Included in the study were 37 children (17 girls, 20 boys; age 4 months to 10 years, mean 32 months) with SFBA. Chest radiographs were obtained prior to MDCT in all patients. MDCT was performed using a low-dose technique. VB images were obtained in the same session. Conventional bronchoscopy (CB) was performed within 24 h on patients in whom an obstructive abnormality had been found by MDCT and VB. Obstructive pathology was found in 16 (43.25%) of the 37 patients using MDCT and VB. In 13 of these patients, foreign bodies were detected and removed via CB. The foreign bodies were located in the right main bronchus (n = 5), in the bronchus intermedius (n = 6), in the medial segment of the middle lobe bronchus (n = 1), and in the left main bronchus (n = 1). In the remaining three patients, the diagnosis was false-positive for an obstructive pathology by MDCT and VB; the final diagnoses were secretions (n = 2) and schwannoma (n = 1), as demonstrated by CB. In 21 patients in whom no obstructive pathology was detected by MDCT and VB, CB was not performed. These patients were followed for 5-20 months without any recurrent obstructive symptomatology. Low-dose MDCT and VB are non-invasive radiological modalities that can be used easily in the investigation of SFBA in children. MDCT and VB provide the exact location of the obstructive pathology prior to CB. If obstructive pathology is depicted with MDCT and VB, CB should be performed either for confirmation of the diagnosis or for the diagnosis of an alternative cause for the obstruction

Increased prevalences of left-handedness and left-eye sighting dominance in individuals with Williams-Beuren syndrome

NARCIS (Netherlands)

J.W. van Strien (Jan)

2005-01-01

textabstractHandedness and eye sighting dominance were assessed in a sample of 50 individuals (25 male, 25 female; aged 5 – 38 years) with Williams-Beuren syndrome (WBS). The prevalences of left-handedness and left-eyedness were compared to the normative prevalences in the general population. We

Hypoplastic left heart syndrome

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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

Left ventricular lipoma with pseudoaneurysm-like appearance.

Science.gov (United States)

Kawarai, Shun-ichi; Yaginuma, Gen-ya; Abe, Kazuo; Hamasaki, Azumi; Ishikawa, Kazunori; Tanaka, Daizo

2010-06-01

We describe an extremely rare cardiac lipoma, with electrocardiographic changes in ST segments and T waves, suggesting ischemic heart disease. The abnormal electrocardiogram was identified during a routine physical examination of an asymptomatic 57-year-old man. Coronary angiography showed no stenotic or occlusive lesions in the coronary arteries except that the left anterior descending artery followed a winding course in the apical region. Left ventriculography revealed a pseudoaneurysm-like mass around the apical portion. Computed tomography and magnetic resonance imaging revealed a cardiac lipoma that communicated with the left ventricle and resembled a pseudoaneurysm. After complete resection of the lipoma and left ventricle patch plasty, the postoperative course was uneventful. Histologically, the tumor was an intramyocardiac lipoma with no evidence of malignancy. To our knowledge, we are the first to describe an intramyocardiac lipoma resembling a left ventricle pseudoaneurysm.

Detection of left ventricular thrombi by computerised tomography

International Nuclear Information System (INIS)

Nair, C.K.; Sketch, M.H.; Mahoney, P.D.; Lynch, J.D.; Mooss, A.N.; Kenney, N.P.

1981-01-01

Sixteen patients suspected of having left ventricular mural thrombi were studied. All had suffered transmural myocardial infarction. Fifteen patients had a ventricular aneurysm. One had had systemic emboli. The mean length of time between the myocardial infarction and the study was 14.8 months, with a range of one month to 79 months. All patients underwent computerised tomography of the heart, M-mode echocardiography (M-mode), and two-dimensional echocardiography (2-D). Eight patients underwent left ventricular cineangiography. Five patients had surgical confirmation. Computerised tomography, two-dimensional, and M-mode echocardiography predicted left ventricular mural thrombi in 10, eight, and one of the 16 patients, respectively. Left ventricular cineangiography predicted left ventricular mural thrombi in four out of eight patients. Computerised tomography and left ventricular cineangiography correctly predicted the presence or absence of left ventricular thrombi in all five patients who underwent operation. In the same group, however, two-dimensional and M-mode echocardiography failed to predict the presence of thrombi in one and three patients, respectively. Among the 11 patients without surgical confirmation, one, in whom no left ventricular thrombi were shown by M-mode and two-dimensional echocardiography, was found to have thrombi on computerised tomography. In another, two-dimensional echocardiography was positive but this finding was not confirmed either by computerised tomography or by left ventricular angiography. (author)

[Surgical angioplasty of the left main coronary artery].

Science.gov (United States)

Vranes, Mile; Velinović, Milos; Kocica, Mladen; Mikić, Aleksandar; Velimirović, Dusan; Djukić, Petar

2010-01-01

The conventional treatment for isolated stenosis of the left main coronary artery is bypass surgery (myocardial revascularization). However, the process of atherosclerosis is not arrested by myocardial revascularization and it will lead to the occlusion of the left main coronary artery. Revascularization will establish retrograde perfusion for 50-70% of the myocardium of the left ventricle. Direct surgical angioplasty of the left main coronary artery enables normal physiological perfusion of the whole myocardium and better myocardial function. The aim of our study is to point out a new surgical approach of treating left main coronary artery stenosis. Between October 2002 and October 2003, direct surgical angioplasty of the main left coronary artery was performed on three patients with isolated stenosis of the left main coronary artery using the anterior approach and the pericardium as a patch. The procedure was performed under total endotracheal anaesthesia and standard cardiopulmonary circulation, moderate hypothermia, anterograde St. Tomas cardioplegia and local cooling. Patients were followed clinically, echocardiographically and by load-tests. All three patients were without complications. In postoperative follow-up (54-68 months) neither angina pectoris nor electrocardiographically registered ischaemic changes were found. Load-tests performed every six months on all three patients were negative. Surgical angioplasty of isolated stenosis of the left main coronary artery is a preferred method for treating this type of coronary disease. Contraindications for this type of treatment are stenosis of the left main coronary artery with bifurcation and advanced calcification of the left main coronary artery.

Dual Balloon-Occluded Retrograde Transvenous Obliteration of Gastric Varix Draining into the Left Adrenal Vein and Left Inferior Phrenic Vein

International Nuclear Information System (INIS)

Nishida, Norifumi; Ninoi, Teruhisa; Kitayama, Toshiaki; Yamamoto, Akira; Sakai, Yukimasa; Sato, Kimihiko; Hamuro, Masao; Nakamura, Kenji; Inoue, Yuichi; Yamada, Ryusaku

2004-01-01

A 66-year-old woman with a gastric varix, draining into a dilated left adrenal vein and a left inferior phrenic vein, was treated with dual balloon-occluded retrograde transvenous obliteration (B-RTO). Under balloon occlusion of the left adrenal vein and the left inferior phrenic vein, retrograde injection of a sclerosant (5% ethanolamine oleate) into the gastric varix was performed. Two weeks later, disappearance of flow in the gastric varix was confirmed on endoscopic ultrasound examination

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)

Count-based left ventricular volume determination utilizing a left posterior oblique view for attenuation correction

International Nuclear Information System (INIS)

Rabinovitch, M.A.; Kalff, V.; Koral, K.

1984-01-01

This study aimed to determine the inherent error of the left ventricular volume measurement from the gated equilibrium blood pool scintigram utilizing the count-based technique. The study population consisted of 26 patients who had undergone biplane contrast ventriculography. The patients were imaged with a parallel-hole collimator in the left anterior oblique position showing the septum to best advantage. A reference blood sample was counted and radionuclide volumes calculated without correction for attenuation. Attenuation corrected volumes were derived with the factor 1/e/sup -/+d/, where d = distance from skin marker to center of the left ventricle in the orthogonal left posterior oblique view and μ = linear attenuation coefficient. A series of μ values from 0.08 to 0.15 cm -1 was evaluated. The tightest 95% confidence limits achieved for an end-diastolic 150-ml ventricle were +/- 44ml, and for an end-systolic 75-ml ventricle +/- 32 ml. In view of the magnitude of inherent error, the count-based volume measurement may be more suitable for group analyses and in cases in which an individual patient serves as his own control

Congenital Absence of Left Circumflex Coronary Artery

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Zahra Ansari

2009-09-01

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

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.

Left ventricular systolic and diastolic function in hyperthyroidism

International Nuclear Information System (INIS)

Friedman, M.J.; Okada, R.D.; Ewy, G.A.; Hellman, D.J.

1982-01-01

In order to assess the effect of hyperthyroidism on systolic and diastolic function of the left ventricle, M-mode echocardiograms and systolic time intervals were obtained in 13 patients while they were clinically hyperthyroid and again when they were euthyroid following radioactive iodine therapy. Echocardiographic tracings of the septum and left ventricular posterior wall were digitized and analyzed to provide the maximum velocity of shortening and maximum velocity of lengthening. These velocities were normalized for left ventricular diastolic dimension. The left ventricular minor axis fractional shortening and the normalized maximum velocity of shortening were both increased during the hyperthyroid state. The normalized maximum velocity of lengthening, a measure of diastolic left ventricular function, was also increased during the hyperthyroid state when compared to the euthyroid state. The preejection period index and the preejection period/left ventricular ejection time ratio were lower when the patients were hyperthyroid than when they were euthyroid. These data confirm the increased inotropic state and demonstrated increased diastolic relaxation velocities of the hyperthyroid left ventricle

Early Lung Adenocarcinoma in Mice: Micro-Computed Tomography Manifestations and Correlation with Pathology

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Lin Deng

2017-06-01

Full Text Available Lung cancer is the most common fatal malignancy for both men and women and adenocarcinoma is the most common histologic type. Early diagnosis of lung cancer can significantly improve the survival rate of patients. This study aimed to investigate the micro-computed tomography (micro-CT manifestations of early lung adenocarcinoma (LAC in mice and to provide a new perspective for early clinical diagnosis. Early LAC models in 10 mice were established by subcutaneously injecting 1-methyl-3-nitro-1-nitrosoguanidine (MNNG solution. Micro-CT scan and multiple planar reconstruction (MPR were used for mouse lungs. Micro-CT features of early LAC, especially the relationships between tumor and bronchus, were analyzed and correlated with pathology. Micro-CT findings of early LAC were divided into three types: non-solid (n = 8, 6%, partly solid (n = 85, 64% and totally solid (n = 39, 30%. Tumor-bronchus relationships, which could be observed in 110 of 132(83% LAC, were classified into four patterns: type I (n = 16, 15%, bronchus was truncated at the margin of the tumor; type II (n = 33, 30%, bronchus penetrated into the tumor with tapered narrowing and interruption; type III (n = 38, 35%, bronchus penetrated into the tumor with a patent and intact lumen; type IV (n = 99, 90%, bronchus ran at the border of the tumor with an intact or compressed lumen. Micro-CT manifestations of early LAC correlated well with pathological findings. Micro-CT can clearly demonstrate the features of mouse early LAC and bronchus-tumor relationships, and can also provide a new tool and perspective for the study of early LAC.

Left heart catheterization

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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 ...

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...

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

A study on roentgen anatomy of the normal lateral chest radiograph

International Nuclear Information System (INIS)

Konishi, Keiko

1985-01-01

CT findings of the various anatomical structures in 70 cases were classified into three types according to their relation to lung, mediastinal tissue (or fat) and the other thoracic organs. Posterior margin of right brachiocephalic vein-superior vena cava complex (RB-SVC), anterior and posterior margins of inferior vena cava, anterior margin of ascending aorta, anterior and posterior margins of aortic arch, posterior wall of bronchus intermedius (PWBI), posterior wall of distal portion of left main bronchus (PWDPLMB) and posterior wall of trachea (posterior tracheal stripe, PTS) were frequently visualized when lung outlined more than half of them. Anterior margin of ascending aorta was also occasionally visualized when a small amount of mediastinal fat outlined it. Anterior margin of right ventricular outflow tract was frequently visualized when lung outlined more than half of it and it was situated anterior to that of ascending aorta. Anterior tracheal stripe was frequently visualized when a large amount of mediastinal fat outlined it. PWBI, PWDPLMB and PTS were frequently visualized when lung outlined them. Cardiac incisura was frequently visualized when a large amount of anterior mediastinal fat outlined left anterior margin of heart. The statistical studies on roentgen anatomy including the visualization rates of various anatomical structures and the morphological analysis and measurements of various anatomical structures in 300 normal cases. The visualization rates were compared between Japanese and Americans, between age groups over and under 50 years old, and between males and females. The structures which were visualized by the contact with fat or made by fat were more frequently seen in Americans, and the arterial structures were more frequently shown in older people. Other differences were also seen. (J.P.N.)

Relationship of left ventricular systolic function to persistence or development of electrocardiographic left ventricular hypertrophy in hypertensive patients

DEFF Research Database (Denmark)

Okin, Peter M; Wachtell, Kristian; Gerdts, Eva

2014-01-01

left ventricular systolic function in patients with new or persistent ECG LVH. METHODS: Baseline and year-3 ECG LVH and left ventricular midwall shortening (MWS) were examined in 725 hypertensive patients in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) echocardiographic...... 1.03-3.50, P = 0.040) at year 3. CONCLUSION: Persistence or development of new ECG LVH during antihypertensive therapy is associated with an increased risk of left ventricular systolic dysfunction after 3 years' follow-up. These findings provide insight into a possible mechanism by which changes......BACKGROUND: Persistence or development of ECG left ventricular hypertrophy (LVH) by Cornell product criteria is associated with an increased risk of developing heart failure compared with regression or continued absence of LVH. We postulated that this association might be in part mediated via worse...

Alterations in Bronchial Airway miRNA Expression for Lung Cancer Detection.

Science.gov (United States)

Pavel, Ana B; Campbell, Joshua D; Liu, Gang; Elashoff, David; Dubinett, Steven; Smith, Kate; Whitney, Duncan; Lenburg, Marc E; Spira, Avrum

2017-11-01

We have previously shown that gene expression alterations in normal-appearing bronchial epithelial cells can serve as a lung cancer detection biomarker in smokers. Given that miRNAs regulate airway gene expression responses to smoking, we evaluated whether miRNA expression is also altered in the bronchial epithelium of smokers with lung cancer. Using epithelial brushings from the mainstem bronchus of patients undergoing bronchoscopy for suspected lung cancer (as part of the AEGIS-1/2 clinical trials), we profiled miRNA expression via small-RNA sequencing from 347 current and former smokers for which gene expression data were also available. Patients were followed for one year postbronchoscopy until a final diagnosis of lung cancer ( n = 194) or benign disease ( n = 153) was made. Following removal of 6 low-quality samples, we used 138 patients (AEGIS-1) as a discovery set to identify four miRNAs (miR-146a-5p, miR-324-5p, miR-223-3p, and miR-223-5p) that were downregulated in the bronchial airway of lung cancer patients (ANOVA P cancer patients (GSEA FDR lung cancer significantly improves its performance (AUC) in the 203 samples (AEGIS-1/2) serving an independent test set (DeLong P lung cancer, and that they may regulate cancer-associated gene expression differences. Cancer Prev Res; 10(11); 651-9. ©2017 AACR . ©2017 American Association for Cancer Research.

Neglect severity after left and right brain damage.

Science.gov (United States)

Suchan, Julia; Rorden, Chris; Karnath, Hans-Otto

2012-05-01

While unilateral spatial neglect after left brain damage is undoubtedly less common than spatial neglect after a right hemisphere lesion, it is also assumed to be less severe. Here we directly test this latter hypothesis using a continuous measure of neglect severity: the so-called Center of Cancellation (CoC). Rorden and Karnath (2010) recently validated this index for right brain damaged neglect patients. A first aim of the present study was to evaluate this new measure for spatial neglect after left brain damage. In a group of 48 left-sided stroke patients with and without neglect, a score greater than -0.086 on the Bells Test and greater than -0.024 on the Letter Cancellation Task turned out to indicate neglect behavior for acute left brain damaged patients. A second aim was to directly compare the severity of spatial neglect after left versus right brain injury by using the new CoC measure. While neglect is less frequent following left than right hemisphere injury, we found that when this symptom occurs it is of similar severity in acute left brain injury as in patients after acute right brain injury. Copyright © 2012 Elsevier Ltd. All rights reserved.

Treatment of tracheobronchial stenosis with a self-expandable metallic stents

Energy Technology Data Exchange (ETDEWEB)

Kim, Yong Soo; Jeon, Seok Chol; Choi, Chul Seung; Choi, Yo Won; Hahm, Chang Kok [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

1994-07-15

We analysed the role of modified Gianturco self-expandable stents in the treatment of tracheobronchial stenosis in 13 patients. We inserted modified Gianturco self-expandable stents under the fluoroscopic and bronchoscopic guidance. There were stenosis in the trachea(n=2), the right main bronchus(n=2), and the left main bronchus(n=9). The causes of the stenosis were endobronchial tuberculosis(n=10), intubation granuloma(n=1), restenosis after surgical reconstruction(n=2). Dyspnea or wheezing was improved within 1 or 2 days following the procedure. There were 32% and 22% respective increase in average FEV1 and FVC. Lung perfusion scan showed 9.6% increase of perfusion in the involved lung. No complications related to the procedure were encountered. During follow-up period of up to 31 months, 2 patients showed tracheal or bronchial restenosis, at 3 and 6 months, retrospectively. There was a distal migration of the stents in one case. During the follow up period after stent insertion, improvement of the obstructive changes and dyspnea persisted in 10 out of 13 patients. The modified Gianturco self-expandable metallic stents may be a good choice for the treatment of tracheobronchial stenosis, either as a primary treatment, or when the reconstruction failed.

Is there any relationship between right and left hand dominance and right and left nasal airflow dominance?

Science.gov (United States)

Price, A; Eccles, R

2017-10-01

Left- or right-handedness is a common human trait, and it has been previously reported that human nasal airflow dominance correlates with hand dominance. Any relationship between hand dominance and nasal airflow dominance would be unusual. This study aimed to measure nasal airflow and look for any relationship to handedness. The modified Glatzel mirror was used to record the dominant nasal passage at 15-minute intervals over a 6-hour period in 29 healthy participants consisting of 15 left-handers and 14 right-handers. In left-handers, the percentage of time that the left nasal passage was dominant ranged from 0 to 100 per cent. In right-handers, the percentage of time that the right nasal passage was dominant ranged from 4.2 to 95.8 per cent. No correlation between nasal airflow dominance and hand dominance was identified. The results do not support the hypothesis that nasal airflow and handedness are related.

Greater Activity in the Frontal Cortex on Left Curves: A Vector-Based fNIRS Study of Left and Right Curve Driving.

Directory of Open Access Journals (Sweden)

Noriyuki Oka

Full Text Available In the brain, the mechanisms of attention to the left and the right are known to be different. It is possible that brain activity when driving also differs with different horizontal road alignments (left or right curves, but little is known about this. We found driver brain activity to be different when driving on left and right curves, in an experiment using a large-scale driving simulator and functional near-infrared spectroscopy (fNIRS.The participants were fifteen healthy adults. We created a course simulating an expressway, comprising straight line driving and gentle left and right curves, and monitored the participants under driving conditions, in which they drove at a constant speed of 100 km/h, and under non-driving conditions, in which they simply watched the screen (visual task. Changes in hemoglobin concentrations were monitored at 48 channels including the prefrontal cortex, the premotor cortex, the primary motor cortex and the parietal cortex. From orthogonal vectors of changes in deoxyhemoglobin and changes in oxyhemoglobin, we calculated changes in cerebral oxygen exchange, reflecting neural activity, and statistically compared the resulting values from the right and left curve sections.Under driving conditions, there were no sites where cerebral oxygen exchange increased significantly more during right curves than during left curves (p > 0.05, but cerebral oxygen exchange increased significantly more during left curves (p < 0.05 in the right premotor cortex, the right frontal eye field and the bilateral prefrontal cortex. Under non-driving conditions, increases were significantly greater during left curves (p < 0.05 only in the right frontal eye field.Left curve driving was thus found to require more brain activity at multiple sites, suggesting that left curve driving may require more visual attention than right curve driving. The right frontal eye field was activated under both driving and non-driving conditions.

Greater Activity in the Frontal Cortex on Left Curves: A Vector-Based fNIRS Study of Left and Right Curve Driving

Science.gov (United States)

Oka, Noriyuki; Yoshino, Kayoko; Yamamoto, Kouji; Takahashi, Hideki; Li, Shuguang; Sugimachi, Toshiyuki; Nakano, Kimihiko; Suda, Yoshihiro; Kato, Toshinori

2015-01-01

Objectives In the brain, the mechanisms of attention to the left and the right are known to be different. It is possible that brain activity when driving also differs with different horizontal road alignments (left or right curves), but little is known about this. We found driver brain activity to be different when driving on left and right curves, in an experiment using a large-scale driving simulator and functional near-infrared spectroscopy (fNIRS). Research Design and Methods The participants were fifteen healthy adults. We created a course simulating an expressway, comprising straight line driving and gentle left and right curves, and monitored the participants under driving conditions, in which they drove at a constant speed of 100 km/h, and under non-driving conditions, in which they simply watched the screen (visual task). Changes in hemoglobin concentrations were monitored at 48 channels including the prefrontal cortex, the premotor cortex, the primary motor cortex and the parietal cortex. From orthogonal vectors of changes in deoxyhemoglobin and changes in oxyhemoglobin, we calculated changes in cerebral oxygen exchange, reflecting neural activity, and statistically compared the resulting values from the right and left curve sections. Results Under driving conditions, there were no sites where cerebral oxygen exchange increased significantly more during right curves than during left curves (p > 0.05), but cerebral oxygen exchange increased significantly more during left curves (p right premotor cortex, the right frontal eye field and the bilateral prefrontal cortex. Under non-driving conditions, increases were significantly greater during left curves (p right frontal eye field. Conclusions Left curve driving was thus found to require more brain activity at multiple sites, suggesting that left curve driving may require more visual attention than right curve driving. The right frontal eye field was activated under both driving and non-driving conditions

Heart Failure with Transient Left Bundle Branch Block in the Setting of Left Coronary Fistula

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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.

The left ventricle as a mechanical engine: from Leonardo da Vinci to the echocardiographic assessment of peak power output-to-left ventricular mass.

Science.gov (United States)

Dini, Frank L; Guarini, Giacinta; Ballo, Piercarlo; Carluccio, Erberto; Maiello, Maria; Capozza, Paola; Innelli, Pasquale; Rosa, Gian M; Palmiero, Pasquale; Galderisi, Maurizio; Razzolini, Renato; Nodari, Savina

2013-03-01

The interpretation of the heart as a mechanical engine dates back to the teachings of Leonardo da Vinci, who was the first to apply the laws of mechanics to the function of the heart. Similar to any mechanical engine, whose performance is proportional to the power generated with respect to weight, the left ventricle can be viewed as a power generator whose performance can be related to left ventricular mass. Stress echocardiography may provide valuable information on the relationship between cardiac performance and recruited left ventricular mass that may be used in distinguishing between adaptive and maladaptive left ventricular remodeling. Peak power output-to-mass, obtained during exercise or pharmacological stress echocardiography, is a measure that reflects the number of watts that are developed by 100 g of left ventricular mass under maximal stimulation. Power output-to-mass may be calculated as left ventricular power output per 100 g of left ventricular mass: 100× left ventricular power output divided by left ventricular mass (W/100 g). A simplified formula to calculate power output-to-mass is as follows: 0.222 × cardiac output (l/min) × mean blood pressure (mmHg)/left ventricular mass (g). When the integrity of myocardial structure is compromised, a mismatch becomes apparent between maximal cardiac power output and left ventricular mass; when this occurs, a reduction of the peak power output-to-mass index is observed.

Isolated Left Pulmonary Artery Agenesis: A Case Report

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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

Arch reconstruction with autologous pulmonary artery patch in interrupted aortic arch.

Science.gov (United States)

Lee, Won-Young; Park, Jeong-Jun

2014-04-01

Various surgical techniques have been developed for the repair of an interrupted aortic arch. However, tension and Gothic arch formation at the anastomotic site have remained major problems for these techniques: Excessive tension causes arch stenosis and left main bronchus compression, and Gothic arch configuration is related to cardiovascular complications. To resolve these problems, we adopted a modified surgical technique of distal aortic arch augmentation using an autologous main pulmonary artery patch. The descending aorta was then anastomosed to the augmented aortic arch in an end-to-side manner. Here, we report two cases of interrupted aortic arch that were repaired using this technique.

Pure Left Neglect for Arabic Numerals

Science.gov (United States)

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

2013-01-01

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

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

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Parimala Prasanna Simha

2012-01-01

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

Left Right Patterning, Evolution and Cardiac Development

Science.gov (United States)

Dykes, Iain M.

2018-01-01

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

Left-right asymmetry in neutrino-produced hadron jets

International Nuclear Information System (INIS)

Ballagh, H.C.; Bingham, H.H.; Lawry, T.J.; Lys, J.; Lynch, G.R.; Sokoloff, M.D.; Stevenson, M.L.; Huson, F.R.; Schmidt, E.; Smart, W.; Treadwell, E.; Cence, R.J.; Harris, F.A.; Jones, M.D.; Koide, A.; Peters, M.W.; Peterson, V.Z.; Lubatti, H.J.; Moriyasu, K.; Wolin, E.

1989-01-01

In an experiment (E546) to study interactions of left-angle E right-angle=100 GeV and left-angle Q 2 right-angle=17 GeV 2 neutrinos in the Fermilab 15-foot bubble chamber, we have looked for a left-right asymmetry in the azimuthal angle φ of individual hadrons about the direction of the lepton momentum transfer (q vector). Significant asymmetry is found for forward positive hadrons; for x F >0.10, we find left-angle cosφ right-angle=-0.029±0.008, where x F is the Feynman x variable. Negative hadrons with x F >0.10 show no asymmetry, left-angle cosφ right-angle=0.004±0.011. A model which includes parton intrinsic transverse momentum k t reproduces the asymmetry of combined positive and negative hadrons with x F >0.10, left-angle cosφ right-angle=-0.018±0.0065, if left-angle k t 2 right-angle=0.065±0.024 GeV 2 /c 2 . But the model predicts almost equal asymmetries for positive and negative hadrons. The model also agrees poorly with the observed dependence on the kinematic variables x and Q 2 if the k t distribution is assumed to be independent of kinematic variables

A Right Brain/Left Brain Model of Acting.

Science.gov (United States)

Bowlen, Clark

Using current right brain/left brain research, this paper develops a model that explains acting's underlying quality--the actor is both himself and the character. Part 1 presents (1) the background of the right brain/left brain theory, (2) studies showing that propositional communication is a left hemisphere function while affective communication…

Computed tomography and upper gastrointestinal series findings of esophageal bronchi in infants

Energy Technology Data Exchange (ETDEWEB)

Colleran, Gabrielle C. [Boston Children' s Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Our Lady' s Children' s Hospital Crumlin, Department of Radiology, Dublin (Ireland); Ryan, Ciara E. [Our Lady' s Children' s Hospital Crumlin, Department of Pathology, Dublin (Ireland); Lee, Edward Y. [Boston Children' s Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Sweeney, Brian [Our Lady' s Children' s Hospital Crumlin, Department of Surgery, Dublin (Ireland); Rea, David; Brenner, Clare [Our Lady' s Children' s Hospital Crumlin, Department of Radiology, Dublin (Ireland)

2017-02-15

Esophageal bronchus is a rare form of communicating bronchopulmonary foregut malformation and a rare but important cause of an opaque hemithorax on chest radiography. A higher incidence of esophageal bronchus is associated with esophageal atresia, tracheo-esophageal fistula (TEF) and VACTERL (vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies, and limb abnormalities) association. In the presence of these conditions, the pediatric radiologist may be the first to consider the diagnosis of esophageal bronchus or esophageal lung. To describe the imaging features in five children with esophageal bronchus. We reviewed hospital records and teaching files at two large pediatric tertiary referral centers over the 24-year period from January 1992 to January 2016. We reviewed all imaging studies and tabulated findings on radiography, fluoroscopic upper gastrointestinal (GI) series and CT. We then described the imaging features of esophageal bronchi with emphasis on CT and upper GI findings in four infants and one toddler. Three cases were identified from one institution (cases 2, 3, 4) and two from another (cases 1, 5). All five cases occurred in association with other midline malformations: four of the five had VACTERL association and three of the five had esophageal atresia and TEF. Lung opacification, ipsilateral mediastinal shift, and an abnormal carina and anomalous vascular anatomy suggest an esophageal bronchus or an esophageal lung on CT. While esophageal bronchus is a rare cause of an opaque hemithorax, CT and upper GI imaging play key roles in its diagnosis. Associations with esophageal atresia with tracheo-esophageal fistula and VACTERL association are particularly pertinent. Early diagnosis of esophageal bronchus might prevent complications such as aspiration and infection, which can allow for parenchymal sparing surgery as opposed to pneumonectomy. (orig.)

Post-surgery lung torsion and haemorrhagic infarction - a case report; Postoperative Lungentorsion und haemorrhagischer Lungeninfarkt - ein Fallbericht

Energy Technology Data Exchange (ETDEWEB)

Noemayr, A.; Schmitt, R.; Wichert, C.; Bautz, W. [Erlangen-Nuernberg Univ., Erlangen (Germany). Inst. fuer Diagnostische Radiologie; Rupprecht, H. [Erlangen-Nuernberg Univ., Erlangen (Germany). Chirurgische Klinik mit Poliklinik

1998-12-31

Lung or lobe torsion may occur after thoracic surgery, chest trauma, pneumothorax, pneumonia, or even spontaneously. Lung infarction is a possible complication. The characteristic radiological signs on plain radiographs are opacification and/or displacement of lobes and hilus structures. CT-signs of haemorrhagic infarction are opacification and multiple punctate gas accumulations. The bronchus could be interrupted at the level of the torsion (``bronchus cutoff``). (orig.) [Deutsch] Die Torsion der Lunge oder einzelner Lappen kann nach thorax-chirurgischen Eingriffen, Traumen, Pneumothorax, Pneumonie oder spontan auftreten. Der Lungeninfarkt kann die Folge sein. Charakteristische radiologische Zeichen auf der konventionellen Thoraxaufnahme sind die Verdichtung der betroffenen Lungenareale und/oder die Verlagerung von Hilusstrukturen und Lungenlappen. CT-morphologisch lassen sich ebenfalls die Verdichtung sowie kleine Lufteinschluesse als Zeichen der haemorrhagischen Infarzierung nachweisen. Der zugehoerige Bronchus ist peripher verschlossen und scheint zentral `abzubrechen` (`bronchus cutoff`). (orig.)

Unusual Behavior of a Lung Inflammatory Myofibroblastic Tumor: Case Report.

Science.gov (United States)

Rodrigues, Cristina; Cabral, Daniel; Almodovar, Teresa; Ribeiro, Analisa; Delgado, Diogo; Mota, Leonor; Mendes, Samuel; Alvoeiro, Magda; Torres, Carolina; Calado, Telma; Antunes, Mariana; Félix, Francisco

2017-01-01

55 years old, male patient. History of heavy smoking (65 UMA) and COPD. Admitted to hospital due to a left pneumonia. Thoracic CT and PET-Scan, showed left lower lobe mass measuring 92x89 mm (SUVmax 49). Several mediastinal node groups presented increased uptake of FDG. A fiberoptic bronchoscopy was performed. Citology of the bronchoalveolar lavage suggested a squamous carcinoma. EBUS of node stations 4R, 4L e 7 without evidence of malignancy. The case was taken to a multidisciplinary meeting staged as IIIA (T3N2M0). Neoadjuvant therapy (four cycles cysplatine and gemcitabine) was decided based on station 5, suspected disease. A left lower lobectomy was performed after a cervical mediastinoscopy excluded metastasis of node stations 4R and 4L. Histology of the specimen was compatible with inflammatory myofibroblastic tumor (IMT). No lymph node involvement was reported. It was restaged as IIB (ypT3N0M0). Three months after surgery one de novo nodule in the lingula with 12,7 of SUVmax was reported. The nodule was removed confirming a IMT metastasis. Four months after the nodule ressection a CT showed new lung and liver nodules. A total oclusion of the left main bronchus was documented and bronchoscopic debulking of the endobronchial mass again revealed IMT. Paliative radiotherapy was decided in the multidisciplinar group targeting the left main bronchus (five sessions of radiotherapy on a dose of 20Gy in 4Gy daily fractions). Ten months after surgery due to the onset of back pain, a CT revealed a sacrum lesion whose needle biopsy was suspicious for multiple myeloma. The patient was referred to another oncological center where previous non-surgical cases had been sent in the past. The patient is now proposed for histology reassessment and discussion by the hematology and pneumology medical teams. Inflammatory myofibrobastic tumors are considered benign or low-grade malignant tumors. The size of the tumour (cut-off of 3 cm) and secure surgical resection with free

MYOCARDIAL DEFORMATION AND COMPLETE LEFT BUNDLE BRANCH BLOCK

Directory of Open Access Journals (Sweden)

E. N. Pavlyukova

2015-12-01

Full Text Available Tissue Doppler imaging is evolving as a useful echocardiographic tool for quantitative assessment of left ventricular systolic and diastolic function. Over the last 10 years, myocardial deformation imaging has become possible initially with tissue Doppler , and more recently with myocardial speckle-tracking using 2D echocardiography. Unlike simple tissue velocity measurements, deformation measurements are specific for the region of interest. Strain rate or strain measurements have been used as sensitive indicators for subclinical diseases, and it is the most widely used tool to assess mechanical dyssynchrony. Left bundle branch block is a frequent, etiologically heterogeneous, clinically hostile and diagnostically challenging entity. About 2% of patients underwent cardiac stress testing show stable or intermittent left bundle branch block. Presence of left bundle branch block is associated with a lower and slower diastolic coronary flow velocity especially during hyperemia. Stress echocardiography is the best option for the diagnosis of ischemic heart disease, albeit specificity and sensitivity reduce in patients with left bundle branch block in the territory of left anterior descending artery in presence of initial septum dyskinesia.

Evaluation of left ventricular function using digital subtraction angiography

International Nuclear Information System (INIS)

Kozuka, Takahiro; Ohta, Mitsushige

1985-01-01

To evaluate function of the left ventricle and myocardial perfusion images, digital subtraction angiography (DSA) was performed in 45 patients with ischemic heart disease. Validity of the technique was compared with data obtained from cine left ventriculogram in all patients and 201 T1 myocardial images in 20 patients. End-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (EF) calculated from DSA were correlated closely with those from cine left ventriculogram (r = 0.92, r = 0.94 and r = 0.86, respectively). Regional contractility at the antero-lateral wall of the left ventricle, assessed by DSA, was also correlated well with cine left ventriculogram (r = 0.75). Evaluation of the inferior wall motion showed less correlation in both procedures (r = 0.68). Phase and amplitude analysis with the same technique with radionuclide cardiac angiography was successfully applied in left ventriculogram obtained by DSA. The procedure seems to be helpful for objective evaluation of the left ventricular wall motion. Myocardial perfusion image, obtained with modified Radtke's technique, showed good coincidence with 201 T1 images. Thus, DSA is applicable for evaluation of function of the left ventricle and myocardial perfusion in patients with ischemic heart disease. (author)

Extreme premature with persistent left superior vena cava.

Science.gov (United States)

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

2017-10-01

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

Annular subvalvular left ventricular aneurysm in Bahia, Brazil.

Science.gov (United States)

Guimarães, A C; Filho, A S; Esteves, J P; Abreu, W N; Vinhaes, L A; de Almeida Souza, J A; Machado, A

1976-10-01

Two cases of left ventricular aneurysm, a 16-year-old black boy and a 23-year-old white girl, from Bahia, Brazil, are presented. In both patients there was enlargement of the cardiac silhouette and a prominent bulge of the left inferior border. On the right oblique view a ring of calcium at the ventricular opening of the aneurysms was visualized. A left ventriculogram showed a huge aneurysm in the first case and a bulge on the lateral wall of the left ventricle in the other. Cardiac catheterization showed a rise in left and right ventricular end-diastolic pressures and in the mean pulmonary artery pressure. In the first case the contour of the right ventricular pressure curve showed a restrictive pattern. The similarities of these aneurysms with the annular submitral type described in young black Africans are stressed.

Ultrasound-guided catheterization of the left subclavian vein without recognition of persistent left superior vena cava

OpenAIRE

Park, Sun Young; Yoo, Jae Hwa; Kim, Mun Gyu; Kim, Sang Ho; Park, Byoung-Won; Oh, Hong Chul; Kim, Hojoon

2017-01-01

Abstract Rationale: A persistent left superior vena cava (PLSVC) is rare, but the most common thoracic venous anomaly. We report a case of PLSVC unrecognized during left subclavian vein catheterization using real-time ultrasound-guided supraclavicular approach. Patient concerns: A 79-year-old man with history of hypertension presented with traumatic subdural hemorrhage, subarachnoid hemorrhage, and epidural hemorrhage. Before the operation, a central venous catheter (CVC) was placed into the ...

Modulation of left primary motor cortex excitability after bimanual training and intermittent theta burst stimulation to left dorsal premotor cortex.

Science.gov (United States)

Neva, Jason L; Vesia, Michael; Singh, Amaya M; Staines, W Richard

2014-03-15

Bimanual visuomotor movement training (BMT) enhances the excitability of human preparatory premotor and primary motor (M1) cortices compared to unimanual movement. This occurs when BMT involves mirror symmetrical movements of both upper-limbs (in-phase) but not with non-symmetrical movements (anti-phase). The neural mechanisms mediating the effect of BMT is unclear, but may involve interhemispheric connections between homologous M1 representations as well as the dorsal premotor cortices (PMd). The purpose of this study is to assess how intermittent theta burst stimulation (iTBS) of the left PMd affects left M1 excitability, and the possible combined effects of iTBS to left PMd applied before a single session of BMT. Left M1 excitability was quantified using transcranial magnetic stimulation (TMS) in terms of both the amplitudes and spatial extent of motor evoked potentials (MEPs) for the extensor carpi radialis (ECR) before and multiple time points following (1) BMT, (2) iTBS to left PMd or (3) iTBS to left PMd and BMT. Although there was not a greater increase in either specific measure of M1 excitability due to the combination of the interventions, iTBS applied before BMT showed that both the spatial extent and global MEP amplitude for the ECR became larger in parallel, whereas the spatial extent was enhanced with BMT alone and global MEP amplitude was enhanced with iTBS to left PMd alone. These results suggest that the modulation of rapid functional M1 excitability associated with BMT and iTBS of the left PMd could operate under related early markers of neuro-plastic mechanisms, which may be expressed in concurrent and distinct patterns of M1 excitability. Critically, this work may guide rehabilitation training and stimulation techniques that modulate cortical excitability after brain injury. Copyright © 2013 Elsevier B.V. All rights reserved.

Assessment of Intrafraction Breathing Motion on Left Anterior Descending Artery Dose During Left-Sided Breast Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

El-Sherif, Omar, E-mail: Omar.ElSherif@lhsc.on.ca [Department of Medical Biophysics, University of Western Ontario, London, Ontario (Canada); Department of Physics, London Regional Cancer Program, London, Ontario (Canada); Yu, Edward [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Xhaferllari, Ilma [Department of Medical Biophysics, University of Western Ontario, London, Ontario (Canada); Department of Physics, London Regional Cancer Program, London, Ontario (Canada); Gaede, Stewart [Department of Medical Biophysics, University of Western Ontario, London, Ontario (Canada); Department of Physics, London Regional Cancer Program, London, Ontario (Canada); Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada)

2016-07-01

Purpose: To use 4-dimensional computed tomography (4D-CT) imaging to predict the level of uncertainty in cardiac dose estimates of the left anterior descending artery that arises due to breathing motion during radiation therapy for left-sided breast cancer. Methods and Materials: The fast helical CT (FH-CT) and 4D-CT of 30 left-sided breast cancer patients were retrospectively analyzed. Treatment plans were created on the FH-CT. The original treatment plan was then superimposed onto all 10 phases of the 4D-CT to quantify the dosimetric impact of respiratory motion through 4D dose accumulation (4D-dose). Dose-volume histograms for the heart, left ventricle (LV), and left anterior descending (LAD) artery obtained from the FH-CT were compared with those obtained from the 4D-dose. Results: The 95% confidence interval of 4D-dose and FH-CT differences in mean dose estimates for the heart, LV, and LAD were ±0.5 Gy, ±1.0 Gy, and ±8.7 Gy, respectively. Conclusion: Fast helical CT is a good approximation for doses to the heart and LV; however, dose estimates for the LAD are susceptible to uncertainties that arise due to intrafraction breathing motion that cannot be ascertained without the additional information obtained from 4D-CT and dose accumulation. For future clinical studies, we suggest the use of 4D-CT–derived dose-volume histograms for estimating the dose to the LAD.

Radionuclide evaluation of left ventricular function with nonimaging probes.

Science.gov (United States)

Wexler, J P; Blaufox, M D

1979-10-01

Portable nonimaging probes have been developed that can evaluate left ventricular function using radionuclide techniques. Two modes of data acquisition are possible with these probe systems, first-pass and gated. Precordial radiocardiograms obtained after a bolus injection can be used to determine cardiac output, pulmonary transit time, pulmonary blood volume, left ventricle ejection fraction, and left-to-right shunts. Gated techniques can be used to determine left ventricular ejection fraction and sytolic time intervals. Probe-determined indices of left ventricular function agree excellently with comparable measurements determined by conventional camera-computer methods as well as by invasive techniques. These have begun to be used in a preliminary manner in a variety of clinical problems associated with left ventricular dysfunction. This review discusses the types of probe systems available, the methods used in positioning them, and details the specifics of their data acquisition and processing capacity. The major criticisms of probe methods are that they are nonimaging and that they measure global rather than regional left ventricular function. In spite of these criticisms, probe systems, because of their portability, high sensitivity, and relatively low cost are useful supplements to conventional camera-computer systems for the measurement of parameters of left ventricular performance using radionuclide techniques.

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

OpenAIRE

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

2010-01-01

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

Component formulae for hadroproduction of left- and right-handed squarks

International Nuclear Information System (INIS)

Baer, H.; Tata, X.

1985-01-01

We present differential cross section formulae for left-left, right-right, and left-right squark pair production in hadronic collisions, for unequal left- and right-handed squark masses. These formulae are useful in calculations involving weak decays of squarks to winos and zinos. (orig.)

Assessment of left ventricular global function

International Nuclear Information System (INIS)

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

1985-01-01

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

Right-Brained Kids in Left-Brained Schools

Science.gov (United States)

Hunter, Madeline

1976-01-01

Students who learn well through left hemisphere brain input (oral and written) have minimal practice in using the right hemisphere, while those who are more proficient in right hemisphere (visual) input processing are handicapped by having to use primarily their left brains. (MB)

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.

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.

Reciprocal Signaling between the Ectoderm and a Mesendodermal Left-Right Organizer Directs Left-Right Determination in the Sea Urchin Embryo

Science.gov (United States)

Bessodes, Nathalie; Haillot, Emmanuel; Duboc, Véronique; Röttinger, Eric; Lahaye, François; Lepage, Thierry

2012-01-01

During echinoderm development, expression of nodal on the right side plays a crucial role in positioning of the rudiment on the left side, but the mechanisms that restrict nodal expression to the right side are not known. Here we show that establishment of left-right asymmetry in the sea urchin embryo relies on reciprocal signaling between the ectoderm and a left-right organizer located in the endomesoderm. FGF/ERK and BMP2/4 signaling are required to initiate nodal expression in this organizer, while Delta/Notch signaling is required to suppress formation of this organizer on the left side of the archenteron. Furthermore, we report that the H+/K+-ATPase is critically required in the Notch signaling pathway upstream of the S3 cleavage of Notch. Our results identify several novel players and key early steps responsible for initiation, restriction, and propagation of left-right asymmetry during embryogenesis of a non-chordate deuterostome and uncover a functional link between the H+/K+-ATPase and the Notch signaling pathway. PMID:23271979

Basal cell carcinoma on the left cheek

International Nuclear Information System (INIS)

Jancar, B.

2007-01-01

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

On left (θ,ϕ-derivations in BCI-algebras

Directory of Open Access Journals (Sweden)

G. Muhiuddin

2014-07-01

Full Text Available The notion of (regular left (θ,ϕ-derivations of a BCI-algebra is introduced, some useful examples are discussed, and related properties are investigated. Conditions for a left (θ,ϕ-derivation to be regular are provided. The concepts of a d(θ,ϕ-invariant left (θ,ϕ-derivation and θ-ideal are introduced, and their relations are discussed. Furthermore, some more interesting results are established.

Quantum levitation by left-handed metamaterials

Energy Technology Data Exchange (ETDEWEB)

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

2007-08-15

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

Quantum levitation by left-handed metamaterials

International Nuclear Information System (INIS)

Leonhardt, Ulf; Philbin, Thomas G

2007-01-01

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

[Trauma induced left maxillary sinus dislocation of eyeball--a case report].

Science.gov (United States)

Chen, Yu; Liu, Cuiping; Cui, Liping

2013-01-01

Patient male, 27 year old. Left facial and head trauma for 6 hours, due to motor vehicle accident. Patient state of mind was clear at arrival to hospital. Body temperature: 36C; Pulse: 80 Time/Minute; Breath: 20 Time/Minute; Blood pressure: 120/80 mm Hg. An irregular, horizontal laceration at arch of left eyebrow, approximately 8-10 cm. A laceration on left wing of nose skin, approximately 1 cm. A laceration also under lower eyelid skin of right eye, approximately 2 cm. Left blepharedema and enophthalmos. Orbital and nasal sinuses CT indications:contusion and laceration of the left frontal lobe of brain; fracture of the left orbital frontal, ethmoid, sphenoid bone, left nasal, maxillary sinus and zygoma with soft tissue contusion and laceration; the left eyeball and optic nerve sunk into the maxillary sinus (See figure 1). (1) Multiple orbital fractures; (2) Left maxillary sinus dislocation of eyeball; (3) The left frontal lobe contusion and laceration of brain.

Detection and evaluation of left atrial myxoma by gated radionuclide imaging

International Nuclear Information System (INIS)

Sugihara, Hiroki; Adachi, Haruhiko; Nakagawa, Hiroaki

1985-01-01

Radionuclide imaging plays an important role in diagnosising left atrial myxoma (LAM). We discussed diagnostic value of Fourier analysis with phase image and evaluated left ventricular filling function using indices such as 1/3 Filling Fraction, Rapid Filling Fraction and Peak Filling Rate derived from left ventricular volume curve. Equillibrium radionuclide angiocardiography was performed in 6 LAM patients. Phase delay in the basal portion of the left ventricle was shown in 5 of 6 LAM patients, and standard deviation of left ventricular phase was larger than these of controls. Left ventricular filling disturbance was suggested in 5 of 6 LAM patients. After surgical remove of myxoma phase delay was disappeared and standard deviation was normalized. And left ventricular filling was improved. We concluded that the phase image of Fourier analysis revealed a left atrial mass prolapsing in the left ventricule during the diastole, and that diastolic indices were useful for left ventricular filling disturbance due to LAM. (author)

Left heart ventricular angiography

Science.gov (United States)

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

The new left and democracy in Latin America

Directory of Open Access Journals (Sweden)

Francisco Panizza

2009-05-01

Full Text Available Without embarking on a theoretical debate over the meaning of the term, it is obvious that the left is on the rise in Latin America. However, we should not ignore the fact that the coming to power of left-wing and centre-left parties and movements presents a certain amount of paradoxes and questions. One of the most important of the many paradoxes is the fact that, in spite of the leftwards electoral shift in the region, there is no evidence that the electorate of Latin America has moved to the left in a significant manner. As for the questions, these concern the connection between left-wing governments and democracy, and especially the future challenges that these governments must face to preserve and develop democracy. In an attempt to unravel the paradox and answer these questions, this article examines the roots, contexts and political challenges of left-wing governments in Latin America. To this end, the author analyses a number of issues, such as the tensions between different logics of political representation and their implications for democracy, in addition to discussing the conditions under which the tensions between the different logics of political representation can contribute (or not to the developing of democracy in the region.

Left ventricular hypertrophy: virtuous intentions, malign consequences.

Science.gov (United States)

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

2003-06-01

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

Effects of sedation on echocardiographic variables of left atrial and left ventricular function in healthy cats.

Science.gov (United States)

Ward, Jessica L; Schober, Karsten E; Fuentes, Virginia Luis; Bonagura, John D

2012-10-01

Although sedation is frequently used to facilitate patient compliance in feline echocardiography, the effects of sedative drugs on echocardiographic variables have been poorly documented. This study investigated the effects of two sedation protocols on echocardiographic indices in healthy cats, with special emphasis on the assessment of left atrial size and function, as well as left ventricular diastolic performance. Seven cats underwent echocardiography (transthoracic two-dimensional, spectral Doppler, color flow Doppler and tissue Doppler imaging) before and after sedation with both acepromazine (0.1 mg/kg IM) and butorphanol (0.25 mg/kg IM), or acepromazine (0.1 mg/kg IM), butorphanol (0.25 mg/kg IM) and ketamine (1.5 mg/kg IV). Heart rate increased significantly following acepromazine/butorphanol/ketamine (mean±SD of increase, 40±26 beats/min) and non-invasive systolic blood pressure decreased significantly following acepromazine/butorphanol (mean±SD of decrease, 12±19 mmHg). The majority of echocardiographic variables were not significantly different after sedation compared with baseline values. Both sedation protocols resulted in mildly decreased left ventricular end-diastolic dimension and mildly increased left ventricular end-diastolic wall thickness. This study therefore failed to demonstrate clinically meaningful effects of these sedation protocols on echocardiographic measurements, suggesting that sedation with acepromazine, butorphanol and/or ketamine can be used to facilitate echocardiography in healthy cats.

Accessory hepatic lobe simulating a left hemidiaphragmatic tumor

International Nuclear Information System (INIS)

Kuroiwa, Toshiro; Hirata, Hitoshi; Iwashita, Akinori; Yasumori, Kotaro; Mogami, Hiroshi; Teraoka, Hiroaki

1984-01-01

A 72-year-old woman with a 20-year history of neuralgia was confirmed at surgery to have a tumor in the left hemidiaphragmatic region which was connected with the left lobe of the liver. Reassessment of radiological diagnosis after surgery revealed that hepatobiliary scintigraphy and computed tomography using left anterior oblique scanning are useful in differentiating the accessory hepatic lobe of the liver from a tumor and in confirming the diagnosis, respectively. (Namekawa, K.)

Improving left spatial neglect through music scale playing.

Science.gov (United States)

Bernardi, Nicolò Francesco; Cioffi, Maria Cristina; Ronchi, Roberta; Maravita, Angelo; Bricolo, Emanuela; Zigiotto, Luca; Perucca, Laura; Vallar, Giuseppe

2017-03-01

The study assessed whether the auditory reference provided by a music scale could improve spatial exploration of a standard musical instrument keyboard in right-brain-damaged patients with left spatial neglect. As performing music scales involves the production of predictable successive pitches, the expectation of the subsequent note may facilitate patients to explore a larger extension of space in the left affected side, during the production of music scales from right to left. Eleven right-brain-damaged stroke patients with left spatial neglect, 12 patients without neglect, and 12 age-matched healthy participants played descending scales on a music keyboard. In a counterbalanced design, the participants' exploratory performance was assessed while producing scales in three feedback conditions: With congruent sound, no-sound, or random sound feedback provided by the keyboard. The number of keys played and the timing of key press were recorded. Spatial exploration by patients with left neglect was superior with congruent sound feedback, compared to both Silence and Random sound conditions. Both the congruent and incongruent sound conditions were associated with a greater deceleration in all groups. The frame provided by the music scale improves exploration of the left side of space, contralateral to the right hemisphere, damaged in patients with left neglect. Performing a scale with congruent sounds may trigger at some extent preserved auditory and spatial multisensory representations of successive sounds, thus influencing the time course of space scanning, and ultimately resulting in a more extensive spatial exploration. These findings offer new perspectives also for the rehabilitation of the disorder. © 2015 The British Psychological Society.

Influence of left ventricular hypertrophy on infarct size and left ventricular ejection fraction in ST-elevation myocardial infarction

International Nuclear Information System (INIS)

Małek, Łukasz A.; Śpiewak, Mateusz; Kłopotowski, Mariusz; Petryka, Joanna; Mazurkiewicz, Łukasz; Kruk, Mariusz; Kępka, Cezary; Miśko, Jolanta; Rużyłło, Witold; Witkowski, Adam

2012-01-01

Background: Left ventricular hypertrophy (LVH) predisposes to larger infarct size, which may be underestimated by the left ventricular ejection fraction (LVEF) due to supranormal systolic performance often present in patients with LVH. The aim of the study was to compare infarct size and LVEF in patients with ST-segment elevation myocardial infarction (STEMI) and increased left ventricular mass on cardiac magnetic resonance (CMR). Methods: The study included unselected group of 52 patients (61 ± 11 years, 69% male) with first STEMI who had CMR after median 5 days from the onset of the event. Left ventricular hypertrophy (LVH) was defined as left ventricular mass index exceeding 95th percentile of references values for age and gender. Infarct size was assessed with means of late gadolinium enhancement (LGE). Results: LVH was found in 16 patients (31%). In comparison to the rest of the group, patients with LVH had higher absolute and relative infarct mass (p = 0.002 and p = 0.02, respectively). LVH was related to higher prevalence of microvascular obstruction and myocardial haemorrhage and higher number of LV segments with transmural necrosis (p = 0.02, p = 0.01 and p = 0.01, respectively). Despite marked difference in the infarct size between both studied subgroups there was no difference in LVEF and mean number of dysfunctional LV segments. Conclusions: Patients with LVH undergoing STEMI have larger infarct size underestimated by the LV systolic performance in comparison to patients without LVH.

Dynamics of neuroepithelial body (NEB) formation in developing hamster lung: Light microscopic autoradiography after 3H-thymidine labeling in vivo

International Nuclear Information System (INIS)

Hoyt, R.F. Jr.; McNelly, N.A.; Sorokin, S.P.

1990-01-01

Autoradiographs were prepared from lungs of a newborn Syrian golden hamster exposed continuously to 3H-thymidine for the final 4.5 days of a normal 16 day gestation. Silver grains were counted over nuclei of 1,298 small-granule endocrine cells in 165 neuroepithelial bodies (NEBs) in the right upper lobe and along the left axial bronchus, where nodal NEBs occurred at branch points and internodal NEBs in the airway between them. Nuclei of 1,005 nonendocrine airway epithelial cells were counted next to the NEBs. Label was distributed differently in the two populations: All nonendocrine cells were labeled, whereas many endocrine cells were not. In NEBs of the right upper lobe, total label (net grains/nuclear profile) averaged only 23% of that in nonendocrine cells. Along the left axial bronchus, mean label in nonendocrine cells and internodal NEBs rose 10-fold between the hilum and the periphery. Increases for both populations were linear and parallel, but total label in the NEBs was consistently lower than that in the surrounding epithelium by 15 grains/nuclear profile. Nodal NEBs were more lightly labeled than those of the internodes, consistent with their earlier formation. A few very heavily labeled small-granule cells (0.9%) occurred singly in the periphery of large, otherwise lightly labeled NEBs. In contrast to NEBs, neurons in 10 bronchial ganglia of the right lung were virtually unlabeled. These arise from vagal neural crest and seem to comprise an entirely distinct population. We conclude that NEBs belong intrinsically to pulmonary endoderm, not neural crest. During fetal life each develops from a cell or cells programmed to stop dividing well ahead of other elements in the epithelium. Their formation is linked closely to early proliferation of the bronchial tree and is an integral part of growth and differentiation of the airway lining

Left ventricular function in right ventricular overload

International Nuclear Information System (INIS)

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

1989-01-01

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

Phase image characterization of ventricular contraction in left anterior hemiblock

International Nuclear Information System (INIS)

Ono, Akifumi; Mizuno, Haruyoshi; Tahara, Yorio; Ishikawa, Kyozo

1991-01-01

We investigated whether or not left anterior hemiblock is present in patients with left axis deviation using first-harmonic Fourier analysis of gated blood-pool images. Gated blood-pool images were taken in 50 patients without contraction abnormality. They included 14 normal subjects, 8 patients with right bundle branch block (RBBB), 20 with left axis deviation (LAD) and 8 with both RBBB and LAD (RBBB+LAD). ECG gated blood-pool scans were acquired in the anterior and 'best septal' left anterior oblique projections. First, the phase images were displayed cinematically as a continuous-loop movie. Next, for quantitative analysis of the phase image, the whole left ventricular and left ventricular high lateral regions of interest were drawn. The 'regional phase shift' (RPS) was then defined as {RPS=A-a} where 'A' is the mean value of the whole left ventricular phase angles and 'a' is that of phase angles in the high lateral region. The left ventricular phase changes and the RPSs in the RBBB and LAD groups were similar to those in the normal group. In the RBBB+LAD group, the latest phase changes occurred in the high anterolateral region. The RPSs of this group were significantly lower than those in the other 3 groups (p<0.01). These data suggest that left anterior hemiblock might coexist with RBBB in patients with RBBB+LAD, whereas left anterior hemiblock might not exist in the majority of patients with LAD alone. (author)

Biliary tract variations of the left liver with special reference to the left medial sectional bile duct in 500 patients.

Science.gov (United States)

Furusawa, Norihiko; Kobayashi, Akira; Yokoyama, Takahide; Shimizu, Akira; Motoyama, Hiroaki; Kanai, Keita; Arakura, Norikazu; Yamada, Akira; Kitou, Yoshihiro; Miyagawa, Shin-Ichi

2015-08-01

Among the intrahepatic bile ducts, the biliary system of the left medial sectional bile duct (B4) is known to have relatively complex patterns. The records of 500 patients who had been diagnosed as having hepato-pancreatico-biliary disease were retrospectively studied for anatomical biliary variations of the left liver with special reference to the drainage system of B4 using magnetic resonance images. The left hepatic duct was present in 494 patients (98.8%), whereas it was lacking in 6 patients (1.2%), and these patients exhibited the following B4 confluence patterns: B4 drained into the common hepatic duct in 2 patients (.4%), the right anterior sectional bile duct in 3 patients (.6%), and the right posterior sectional bile duct in 1 patient (.2%). The left hepatic duct was absent more frequently in patients with portal venous variations than in patients with a common branching pattern (8.2% vs .4%, P = .0011). The presently reported data are useful for obtaining a better understanding of the surgical anatomy of the biliary system of the left liver. Copyright © 2015 Elsevier Inc. All rights reserved.

Etiological aspect of left-handedness in adolescents.

Science.gov (United States)

Dragović, Milan; Milenković, Sanja; Kocijancić, Dusica; Zlatko, Sram

2013-01-01

Lateralization of brain functions such as language and manual dominance (hand preferences and fine motor control) are most likely under genetic control. However, this does not preclude the effect of various environmental factors on functional brain lateralization. A strong association of non-right-handedness (left- and mixed-handedness) with various neurodevelopmental conditions (e.g. schizophrenia, autism, Rett syndrome) implies that in some cases, non-right-handedness may be acquired rather than inherited (i.e., pathologically determined). The aim of the study was: (a) re-investigation of several known risk factors for left-handedness (age of mother and/or father, twin pregnancies, and birth order), and (b) examination of hitherto uninvestigated factors (type of birth, Apgar score, maternal smoking during pregnancy). Putative, causative environmental agents for this shift in manual distributions are explored in a sample of 1031 high school students (404 males and 627 females) from Belgrade. Both pre-existing (age of parents, twin pregnancy, and birth order) and new (Apgar score, maternal smoking, type of birth) putative agents are examined. We found that maternal smoking and low Apgar score (2-6) can significantly increase risk for left-handedness (p=0.046 and p=0.042, respectively).The remaining factors showed no significant association with left-handedness in adolescents. Our study clearly demonstrates that left-handedness may be related to maternal smoking during pregnancy and a low Apgar score on birth.

Left main coronary artery disease: pathophysiology, diagnosis, and treatment.

Science.gov (United States)

Collet, Carlos; Capodanno, Davide; Onuma, Yoshinobu; Banning, Adrian; Stone, Gregg W; Taggart, David P; Sabik, Joseph; Serruys, Patrick W

2018-06-01

The advent of coronary angiography in the 1960s allowed for the risk stratification of patients with stable angina. Patients with unprotected left main coronary artery disease have an increased risk of death related to the large amount of myocardium supplied by this vessel. Although coronary angiography remains the preferred imaging modality for the evaluation of left main coronary artery stenosis, this technique has important limitations. Angiograms of the left main coronary artery segment can be difficult to interpret, and almost one-third of patients can be misclassified when fractional flow reserve is used as the reference. In patients with clinically significant unprotected left main coronary artery disease, surgical revascularization was shown to improve survival compared with medical therapy and has been regarded as the treatment of choice for unprotected left main coronary artery disease. Two large-scale clinical trials published in 2016 support the usefulness of catheter-based revascularization in selected patients with unprotected left main coronary artery disease. In this Review, we describe the pathophysiology of unprotected left main coronary artery disease, discuss diagnostic approaches in light of new noninvasive and invasive imaging techniques, and detail risk stratification models to aid the Heart Team in the decision-making process for determining the best revascularization strategy for these patients.

Bronchus anastomosis after sleeve resection for lung cancer: does the suture technique have an impact on postoperative complication rate?

Science.gov (United States)

Palade, Emanuel; Holdt, Holger; Passlick, Bernward

2015-06-01

Bronchoplastic resections emerged as an alternative to pneumonectomy for patients with impaired pulmonary function and have gained popularity due to a marked decrease in morbidity and at least similar oncological outcome. Actual guidelines recommend sleeve resections whenever technically feasible, even in cases with adequate pulmonary reserve for pneumonectomy, in order to maximally preserve functional lung parenchyma. Various suture techniques were described; the existing evidence, however, is insufficient to recommend one of them as standard. The aim of this study was to compare two suture techniques for bronchus repair after sleeve resection. Two groups of patients from two separate institutions were retrospectively analysed. In Group A (n = 20), the anastomosis was performed with a running suture at the membranous part and an interrupted suture for the rest of the circumference. In Group B (n = 40), a telescoping continuous suture was used. Intra- and postoperative findings directly related to the anastomosis were compared. The parameters were assessed as absolute numbers and percentages; the statistical significance was determined using Pearson's χ(2) test for categorical variables and Student's t-test for continuous data (P resection type (predominance of the right upper lobe for Group B), the groups were comparable regarding patient characteristics. The intraoperative anastomotic assessment revealed: patency 100% in both groups, initial air tightness (100 vs 82.5%; P = 0.047) and buttressing 85 vs 5%. No suture revision was necessary in both groups. The analysis of anastomosis-related morbidity revealed no significant difference: atelectasis (1 in Group A and 2 in Group B; P = 1), reversible anastomotic changes (0 vs 2; P = 0.309), early stenosis (0 vs 0), bronchopleural fistula (1 vs 0; P = 0.154), bronchovascular fistula (0 vs 0), late stenosis (1 vs 0; P = 0.119) and reoperations (15 vs 5%; P = 0.186). The operative mortality rate was similar (2 vs 3; P

Left versus right deceased donor renal allograft outcome.

LENUS (Irish Health Repository)

Phelan, Paul J

2009-12-01

It has been suggested that the left kidney is easier to transplant than the right kidney because of the longer length of the left renal vein, facilitating the formation of the venous anastomosis. There are conflicting reports of differing renal allograft outcomes based on the side of donor kidney transplanted (left or right).We sought to determine the effect of side of donor kidney on early and late allograft outcome in our renal transplant population. We performed a retrospective analysis of transplanted left-right deceased donor kidney pairs in Ireland between January 1, 1998 and December 31, 2008. We used a time to death-censored graft failure approach for long-term allograft survival and also examined serum creatinine at different time points post-transplantation. All outcomes were included from day of transplant onwards. A total of 646 transplants were performed from 323 donors. The incidence of delayed graft function was 16.1% in both groups and there was no significant difference in acute rejection episodes or serum creatinine from 1 month to 8 years post-transplantation.There were 47 death-censored allograft failures in the left-sided group compared to 57 in the right-sided group (P = 0.24). These observations show no difference in renal transplant outcome between the recipients of left- and right-sided deceased donor kidneys.

Primary study of quantitative measurement in different grades of COPD using low-dose multislice CT

International Nuclear Information System (INIS)

Li Yiming; Yin Jianzhong; Yang Wenjie; Tan Zhengshuai

2012-01-01

Objective: To study the feasibility of airway measurement at the trunk of apical bronchus of right upper lobe in chronic obstructive pulmonary disease (COPD), and airway dimensions and lung density changes in different COPD stages. Methods: 1) Fifteen randomly selected COPD patients underwent low -dose chest multi -slice CT scan. The wall thickness-to-diameter ratio (TDR) and percentage wall area (WA%) at apical bronchus of right upper lobe section and mean TDR and WA% of small airway (<2 mm) were calculated. 2) Another fifty-five randomly selected COPD patients were divided into 4 groups on the basis of pulmonary function tests. There were sixteen patients with grade 1, sixteen patients with grade 2, fourteen patients with grade 3. and nine patients with grade 4. Fifteen non-COPD patients were selected as controls. The total lung was scanned with low-dose multi-slice CT during inspiration. The mean lung attenuation (MLA) and voxel index (VI) were measured. Inner area of bronchus (A i ), TDR and WA% of the apical bronchus of right upper lobe were measured. Results: 1) The TDR of the apical bronchus of right were smaller than the mean TDR of the small airways; The WA% of the apical bronchus of right were larger than the mean WA% of the small airways; but there were good correlation (r=0.793 and 0.784, respectively). 2) The MLA values were decreased with increase of COPD stage. The VI values were increased with increase of COPD stage. However, the values did not differ between adjacent stages. The luminal areas of stage 3-4 patients were smaller than that of other stages. There was no statistics difference in TDR between adjacent groups, except between stages 3 and 4. For WA%, the higher stage group had higher WA%. Conclusion: There were good correlations for TDR and WA% between the apical bronchus of right upper lobe and small airway. WA% is the most sensitive index for detecting thickened airway. (authors)

Echocardiographic study of left atrial myxoma

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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.

Treatment of an Unusual Occurrence of a Complex Left Subclavian Artery/Left Internal Mammary Artery Bifurcation Stenosis in the Setting of Coronary Subclavian Steal Syndrome and Ischemic Left Ventricular Systolic Dysfunction

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Michael J. Martinelli

2018-01-01

Full Text Available This case will illustrate the clinical and unique technical challenges, not previously reported, in a patient with a history of progressive left ventricular (LV systolic dysfunction, congestive heart failure (CHF, myocardial infarction (MI, and a complex bifurcation lesion of the left subclavian artery (SA involving the left internal mammary artery (LIMA in the setting of coronary subclavian steal syndrome (CSSS. The approach to this lesion is complicated by significant LIMA involvement requiring intervention directed toward both the SA and the LIMA in the presence of severe LV systolic dysfunction. This clinical scenario necessitates a careful technique, utilizing bifurcation methods similar to those used in coronary intervention.

Massive haemoptysis death and other morbidity associated with high dose rate intraluminal radiotherapy for carcinoma of the bronchus

International Nuclear Information System (INIS)

Gollins, S.W.; Ryder, W.D.J.; Burt, P.A.; Barber, P.V.; Stout, R.

1996-01-01

Four hundred and six patients with primary non-small cell carcinoma of the bronchus causing symptoms due to endobronchial disease, were treated with intraluminal radiotherapy (ILT) using the microSelectron-HDR machine at the Christie Hospital, Manchester, between April 1988 and the end of 1992. An assessment of morbidity for this treatment is presented, particularly with regard to the risk factors and causes of massive haemoptysis death. The most common early side-effect was a mild transient exacerbation of cough which usually resolved within 2-3 weeks. At various times following ILT treatment 83 bronchoscopies were carried out randomly in 55 patients. In bronchoscopies carried out within the first 3 months following ILT, no tumour was visible in 80% of cases. A mucosal radiation reaction score (RRS) was used to grade bronchoscopic appearance after ILT treatment. Overall, 55% of bronchoscopic examinations showed some degree of mucosal radiation reaction. The majority of radiation reactions from 6 months onwards after ILT demonstrated a degree of fibrosis. A radiation reaction was seen more frequently after treatment with 2000 cGy as opposed to 1500 cGy at 1 cm from the central axis of the radiation source. Thirty-two patients were identified who had died from massive haemoptysis (MH) as a terminal event. A Cox multivariate regression analysis showed that the treatment-related factors of increased dose at first ILT (P = 0.004), prior laser treatment at the site of ILT (P = 0.020) and second ILT treatment in the same location as the first ILT treatment (P 0.047), all significantly increased the relative risk of MH death compared with their effect on the relative risk of death from other causes (OC). (In addition a fourth treatment-related factor, namely the concurrent use of ILT and external beam radiotherapy (EB) had a P value of 0.08). Twenty out of 25 assessable MH-death patients (80%) had evidence of recurrent or residual tumour before death but 5 patients (20

Enhancing No Child Left Behind-School mental health connections.

Science.gov (United States)

Daly, Brian P; Burke, Robert; Hare, Isadora; Mills, Carrie; Owens, Celeste; Moore, Elizabeth; Weist, Mark D

2006-11-01

The No Child Left Behind Act of 2001 was signed into law by President George W. Bush in January 2002 and is regarded as the most significant federal education policy initiative in a generation. The primary focus of the No Child Left Behind Act is on promoting educational success for all children; however, the legislation also contains opportunities to advance school-based mental health. Unfortunately, the complexities of the provisions of the No Child Left Behind Act have made it difficult for educators, stakeholders, and mental health professionals to understand the legal and practical interface between No Child Left Behind and the school mental health movement. Therefore, the goals of this article are to (1) raise awareness about the challenges educators and school mental health professionals face as a result of the implementation of No Child Left Behind and (2) provide ideas and recommendations to advance the interface between No Child Left Behind and school mental health, which will support key provisions of the act and the growth of the field.

Radical Left in Albania and Kosovo: Differences and Similarities

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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.

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...

Left ventricular mass in male adolescent athletes and non-athletes

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Erling David Kaunang

2014-10-01

Full Text Available Background Systematic exercise leads to increased left ventricular mass, which may be misleading in a differential diagnosis of heart disease in athletes (physiologic hypertrophy versus pathologic hypertrophy. T he cause of left ventricular hypertrophy is an important risk factor in the morbidity and mortality of cardiovascular diseases. Objective To compare left ventricular mass and left ventricular hypertrophy in male adolescent athletes and non-athletes. Methods We conducted a cross-sectional, analytic study, from September to December 2012 in male adolescents aged 15-18 years. The case group included athletes from the Bina Taruna Football Club Manado, while the control group included non-athlete adolescents. All subjects underwent history-taking, physical examinations and further supporting examinations. Left ventricular mass was measured by cardiovascular echocardiography (Esaote Mylab 4.0 and calculated based on a formula. Left ventricular hypertrophy was defined as left ventricular mass of > 134 g/m2 body surface area. Results Subjects' mean left ventricular masses were 359.69 (SD 188.4; 95%CI 283.58 to 435.81 grams in the athlete group and 173.04 (SD 50.69; 95%CI 152.56 to 103.51 grams in the non· athlete group, a statistically significant difference (P=0.0001. Ventricular hypertrophy was found 76.9% compared to 11.5% in  the non-athlete group (P= 0.0001. Conclusion Left ventricular mass in athletes is bigger than in non-athletes. In addition, left ventricular hypertrophy is more cornmon in male adolescent athletes than in non-athletes.

Incidental retroaortic left innominate vein in adult patient

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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.

Left-right subtraction of brain CT

International Nuclear Information System (INIS)

Ishiguchi, Tsuneo; Sakuma, Sadayuki

1986-01-01

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

Quantifying lung morphology with respiratory-gated micro-CT in a murine model of emphysema

Science.gov (United States)

Ford, N. L.; Martin, E. L.; Lewis, J. F.; Veldhuizen, R. A. W.; Holdsworth, D. W.; Drangova, M.

2009-04-01

Non-invasive micro-CT imaging techniques have been developed to investigate lung structure in free-breathing rodents. In this study, we investigate the utility of retrospectively respiratory-gated micro-CT imaging in an emphysema model to determine if anatomical changes could be observed in the image-derived quantitative analysis at two respiratory phases. The emphysema model chosen was a well-characterized, genetically altered model (TIMP-3 knockout mice) that exhibits a homogeneous phenotype. Micro-CT scans of the free-breathing, anaesthetized mice were obtained in 50 s and retrospectively respiratory sorted and reconstructed, providing 3D images representing peak inspiration and end expiration with 0.15 mm isotropic voxel spacing. Anatomical measurements included the volume and CT density of the lungs and the volume of the major airways, along with the diameters of the trachea, left bronchus and right bronchus. From these measurements, functional parameters such as functional residual capacity and tidal volume were calculated. Significant differences between the wild-type and TIMP-3 knockout groups were observed for measurements of CT density over the entire lung, indicating increased air content in the lungs of TIMP-3 knockout mice. These results demonstrate retrospective respiratory-gated micro-CT, providing images at multiple respiratory phases that can be analyzed quantitatively to investigate anatomical changes in murine models of emphysema.

Quantifying lung morphology with respiratory-gated micro-CT in a murine model of emphysema

International Nuclear Information System (INIS)

Ford, N L; Martin, E L; Lewis, J F; Veldhuizen, R A W; Holdsworth, D W; Drangova, M

2009-01-01

Non-invasive micro-CT imaging techniques have been developed to investigate lung structure in free-breathing rodents. In this study, we investigate the utility of retrospectively respiratory-gated micro-CT imaging in an emphysema model to determine if anatomical changes could be observed in the image-derived quantitative analysis at two respiratory phases. The emphysema model chosen was a well-characterized, genetically altered model (TIMP-3 knockout mice) that exhibits a homogeneous phenotype. Micro-CT scans of the free-breathing, anaesthetized mice were obtained in 50 s and retrospectively respiratory sorted and reconstructed, providing 3D images representing peak inspiration and end expiration with 0.15 mm isotropic voxel spacing. Anatomical measurements included the volume and CT density of the lungs and the volume of the major airways, along with the diameters of the trachea, left bronchus and right bronchus. From these measurements, functional parameters such as functional residual capacity and tidal volume were calculated. Significant differences between the wild-type and TIMP-3 knockout groups were observed for measurements of CT density over the entire lung, indicating increased air content in the lungs of TIMP-3 knockout mice. These results demonstrate retrospective respiratory-gated micro-CT, providing images at multiple respiratory phases that can be analyzed quantitatively to investigate anatomical changes in murine models of emphysema.

Quantifying lung morphology with respiratory-gated micro-CT in a murine model of emphysema

Energy Technology Data Exchange (ETDEWEB)

Ford, N L [Department of Physics, Ryerson University, 350 Victoria Street, Toronto, Ontario M5B 2K3 (Canada); Martin, E L; Lewis, J F; Veldhuizen, R A W [Lawson Health Research Institute, 268 Grosvenor Street, London, Ontario N6A 4V2 (Canada); Holdsworth, D W; Drangova, M [Imaging Research Laboratories, Robarts Research Institute, 100 Perth Drive, PO Box 5015, London, Ontario N6A 5K8 (Canada)], E-mail: nlford@ryerson.ca

2009-04-07

Non-invasive micro-CT imaging techniques have been developed to investigate lung structure in free-breathing rodents. In this study, we investigate the utility of retrospectively respiratory-gated micro-CT imaging in an emphysema model to determine if anatomical changes could be observed in the image-derived quantitative analysis at two respiratory phases. The emphysema model chosen was a well-characterized, genetically altered model (TIMP-3 knockout mice) that exhibits a homogeneous phenotype. Micro-CT scans of the free-breathing, anaesthetized mice were obtained in 50 s and retrospectively respiratory sorted and reconstructed, providing 3D images representing peak inspiration and end expiration with 0.15 mm isotropic voxel spacing. Anatomical measurements included the volume and CT density of the lungs and the volume of the major airways, along with the diameters of the trachea, left bronchus and right bronchus. From these measurements, functional parameters such as functional residual capacity and tidal volume were calculated. Significant differences between the wild-type and TIMP-3 knockout groups were observed for measurements of CT density over the entire lung, indicating increased air content in the lungs of TIMP-3 knockout mice. These results demonstrate retrospective respiratory-gated micro-CT, providing images at multiple respiratory phases that can be analyzed quantitatively to investigate anatomical changes in murine models of emphysema.

Etiological aspect of left-handedness in adolescents

Directory of Open Access Journals (Sweden)

Dragović Milan

2013-01-01

Full Text Available Introduction. Lateralization of brain functions such as language and manual dominance (hand preferences and fine motor control are most likely under genetic control. However, this does not preclude the effect of various environmental factors on functional brain lateralization. A strong association of non-right-handedness (left- and mixed-handedness with various neurodevelopmental conditions (e.g. schizophrenia, autism, Rett syndrome implies that in some cases, non-right-handedness may be acquired rather than inherited (i.e., pathologically determined. Objective. The aim of the study was: (a re-investigation of several known risk factors for left-handedness (age of mother and/or father, twin pregnancies, and birth order, and (b examination of hitherto uninvestigated factors (type of birth, Apgar score, maternal smoking during pregnancy. Methods. Putative, causative environmental agents for this shift in manual distributions are explored in a sample of 1031 high school students (404 males and 627 females from Belgrade. Both pre-existing (age of parents, twin pregnancy, and birth order and new (Apgar score, maternal smoking, type of birth putative agents are examined. Results. We found that maternal smoking and low Apgar score (2-6 can significantly increase risk for left-handedness (p=0.046 and p=0.042, respectively. The remaining factors showed no significant association with left-handedness in adolescents. Conclusion. Our study clearly demonstrates that left-handedness may be related to maternal smoking during pregnancy and a low Apgar score on birth.

Left ventricular mass in borderline hypertension assessed by echo cardiography

International Nuclear Information System (INIS)

Mezzasalma, L.; Ghione, S.; Palonebo, C.

1989-01-01

The relationship between clinical measurement of blood pressure (BP) and left ventricular hypertrophy in arterial hypertension appears to be weak in most studies. On the contrary, stronger correlations with target organ damage in general, and left ventricular hypertrophy in particular, have been reported for blood pressure measurements obtained by ambulatory monitoring; this finding may indicate a possible role for blood pressure response to naturally occurring stresses in determining left ventricular hypertrophy. Aim of this study was to investigate, in 18 patients with borderline arterial hypertension, the relationships between echocardiographically assessed left ventricular mass and, respectively, casual BP and BP responses to some standardized stress tests. Only three patients had a diastolic wall thickness of the interventricular septum and of the posterior wall ≥1.2 cm and none had a pathologically increased left ventricular mass index. The following statistically significant correlations were found: casual diastolic BP vs. left ventricular mass index (r=0.53, p<0.02), systolic BP response to bicycle exercise test vs. left ventricular mass index (r=0.55, p<0.05). Multiple regression analysis showed that almost fifty percent of the variability of left ventricular mass index could be predicted by these two BP measurements. These findings suggest that besides the chronically increased afterload, also the transient hypertensive responses to naturally occuring physical stresses may have a role in determining the extent of cardiac structural changes in borderline hypertensive patients. In addition, they indicate a direct relation between left ventricular mass and blood pressure levels also in borderline hypertension, as previously shown for established hypertension, despite the fact that left ventricular hypertrophy represents only an occasional finding in early stages of hypertension

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

International Nuclear Information System (INIS)

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

2018-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2018-03-15

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

Left insular cortex and left SFG underlie prismatic adaptation effects on time perception: evidence from fMRI.

Science.gov (United States)

Magnani, Barbara; Frassinetti, Francesca; Ditye, Thomas; Oliveri, Massimiliano; Costantini, Marcello; Walsh, Vincent

2014-05-15

Prismatic adaptation (PA) has been shown to affect left-to-right spatial representations of temporal durations. A leftward aftereffect usually distorts time representation toward an underestimation, while rightward aftereffect usually results in an overestimation of temporal durations. Here, we used functional magnetic resonance imaging (fMRI) to study the neural mechanisms that underlie PA effects on time perception. Additionally, we investigated whether the effect of PA on time is transient or stable and, in the case of stability, which cortical areas are responsible of its maintenance. Functional brain images were acquired while participants (n=17) performed a time reproduction task and a control-task before, immediately after and 30 min after PA inducing a leftward aftereffect, administered outside the scanner. The leftward aftereffect induced an underestimation of time intervals that lasted for at least 30 min. The left anterior insula and the left superior frontal gyrus showed increased functional activation immediately after versus before PA in the time versus the control-task, suggesting these brain areas to be involved in the executive spatial manipulation of the representation of time. The left middle frontal gyrus showed an increase of activation after 30 min with respect to before PA. This suggests that this brain region may play a key role in the maintenance of the PA effect over time. Copyright © 2014. Published by Elsevier Inc.

Blunt traumatic bronchial transection in a 28-month-old child

Directory of Open Access Journals (Sweden)

Sung Mi Hwang

2014-01-01

Full Text Available Tracheobronchial injury is uncommon in children, but may result in life-threatening conditions. We present a case of transection of the right intermediate bronchus, right middle lobe bronchus and right lower lobe bronchus in a 28-month-old child with blunt chest injury. The gold standard for diagnosis is tracheobronchoscopy, however, the bronchoscopy may not always be available for little children. For diagnosis in similar cases, a high index of suspicion should be needed based on symptoms, chest X-ray and computed tomography findings. In addition, anesthesiologists should be aware of this dangerous condition and must be fully prepared for rapid and appropriate management during operation.

Tensor product of left n-invertible operators

Czech Academy of Sciences Publication Activity Database

Duggal, B.P.; Müller, Vladimír

2013-01-01

Roč. 215, č. 2 (2013), s. 113-125 ISSN 0039-3223 R&D Projects: GA ČR GA201/09/0473 Institutional support: RVO:67985840 Keywords : Banach space * essentially left n- invertible operator * left n-invertible operator Subject RIV: BA - General Mathematics Impact factor: 0.630, year: 2013 http://journals.impan.pl/cgi-bin/doi?sm215-2-2

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

Science.gov (United States)

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

2017-10-01

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

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...

Total anomalous systemic venous drainage in left heterotaxy syndrome.

Science.gov (United States)

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

2013-04-01

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

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 ...

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

International Nuclear Information System (INIS)

Sartor, K.; Freckmann, N.; Boeker, D.K.; Allgemeines Krankenhaus Altona, Hamburg

1981-01-01

The known rare occurrence of related anomalies of origin of vertebral and inferior thyroid arteries appears not to be documented in the angiographic literature. Three cases with manifestation on the left side are presented. Embryology is discussed briefly. Knowledge of such anomalies is of importance to surgeons as well as angiographers. (orig.) [de

A CT-assisted method of dosimetry in brachytherapy of lung cancer

International Nuclear Information System (INIS)

Senan, S.; Lagerwaard, F.J.; Pan, C. de; Sipkema, D.; Murrer, L.H.P.; Burgers, S.A.

2000-01-01

The toxicity of endobronchial brachytherapy (EB), in particular fatal haemoptysis and bronchial wall necrosis, has been correlated with the total dose, fraction size, volume encompassed by the 100% isodose, and a proximal tumor location. We describe a CT-based planning method which, by improving target volume definition and volumeric dose information, can improve the therapeutic ratio of EB. Sixteen CT-assisted EB procedures were performed in patients who were treated with palliative high-dose rate EB. The CT data were used to analyze applicator position in relation to anatomy. An example of a three-dimensional optimized treatment plan was generated and analyzed using different types of dose-volume histograms. The procedure was well tolerated by patients and no post-procedure complications were observed. The bronchial applicator was eccentrically positioned at the level of the carina/mainstem bronchus in 12 (of 14) CT scans. A planning CT prior to EB was not found to be useful as the final target volume and/or the final applicator position were not reliably predicted before the therapeutic bronchoscopy. CT-scans performed with the applicator in situ allowed the bronchial segments in the target volume to be identified and enabled dose prescription to the bronchial mucosa. CT-assisted EB is feasible and underlines the need for using centered applicators for proximally located tumors. By enabling accurate mucosal dose prescription, CT-assisted EB may reduce the toxicity of fractionated EB in the curative setting. However, faster on-line EB treatment planning is needed for the routine clinical application of this technique. (author)

Metastatic Neuroendocrine Carcinoma of the Breast Identified by Tc-99m-HYNIC-TOC SPECT/CT: A Rare Case Report.

Science.gov (United States)

Claimon, Apichaya; Chuthapisith, Suebwong; Samarnthai, Norasate; Pusuwan, Pawana

2015-08-01

The authors reported an uncommon presentation of metastatic neuroendocrine carcinoma to the breast detected by Tc-99m-HYNIC-TOC SPECT/CT in a 49 years old woman who, previously, had carcinoid tumor of left main bronchus and invasive ductal carcinoma of the right breast. Later, the patient developed left breast mass. Core needle biopsy of the mass revealed poorly differentiated invasive ductal carcinoma. The disease remained stable for 12 years without any treatment on that left breast (due to patient's rejection). On the later investigation using Tc-99m-HYNIC-TOC scintigraphy examination, rather than invasive ductal carcinoma, metastatic neuroendocrine cancer was suggested. The final diagnosis was confirmed by pathological examination after surgical excision. Multiple metastatic lesions of neuroendocrine carcinoma at lung, liver, ovaries, and bones were also depicted. Due to the good behavior of the disease, patient had been doing well for eight months, without specific treatment. This report confirmed the advantage and the accuracy of Tc-99m-HYNIC-TOC scintigraphy in detection of neuroendocrine carcinoma. Furthermore, metastatic neuroendocrine tumor should be in differential diagnosis for patient with breast mass together with history of neuroendocrine tumor

Left cytoarchitectonic BA 44 processes syntactic gender violations in determiner phrases.

Science.gov (United States)

Heim, Stefan; van Ermingen, Muna; Huber, Walter; Amunts, Katrin

2010-10-01

Recent neuroimaging studies make contradictory predictions about the involvement of left Brodmann's area (BA) 44 in processing local syntactic violations in determiner phrases (DPs). Some studies suggest a role for BA 44 in detecting local syntactic violations, whereas others attribute this function to the left premotor cortex. Therefore, the present event-related functional magnetic resonance imaging (fMRI) study investigated whether left-cytoarchitectonic BA 44 was activated when German DPs involving syntactic gender violations were compared with correct DPs (correct: 'der Baum'-the[masculine] tree[masculine]; violated: 'das Baum'--the[neuter] tree[masculine]). Grammaticality judgements were made for both visual and auditory DPs to be able to generalize the results across modalities. Grammaticality judgements involved, among others, left BA 44 and left BA 6 in the premotor cortex for visual and auditory stimuli. Most importantly, activation in left BA 44 was consistently higher for violated than for correct DPs. This finding was behaviourally corroborated by longer reaction times for violated versus correct DPs. Additional brain regions, showing the same effect, included left premotor cortex, supplementary motor area, right middle and superior frontal cortex, and left cerebellum. Based on earlier findings from the literature, the results indicate the involvement of left BA 44 in processing local syntactic violations when these include morphological features, whereas left premotor cortex seems crucial for the detection of local word category violations. © 2010 Wiley-Liss, Inc.

Diagnostic electrocardiographic dyad criteria of emphysema in left ventricular hypertrophy.

Science.gov (United States)

Lanjewar, Swapnil S; Chhabra, Lovely; Chaubey, Vinod K; Joshi, Saurabh; Kulkarni, Ganesh; Kothagundla, Chandrasekhar; Kaul, Sudesh; Spodick, David H

2013-01-01

The electrocardiographic diagnostic dyad of emphysema, namely a combination of the frontal vertical P-vector and a narrow QRS duration, can serve as a quasidiagnostic marker for emphysema, with specificity close to 100%. We postulated that the presence of left ventricular hypertrophy in emphysema may affect the sensitivity of this electrocardiographic criterion given that left ventricular hypertrophy generates prominent left ventricular forces and may increase the QRS duration. We reviewed the electrocardiograms and echocardiograms for 73 patients with emphysema. The patients were divided into two groups based on the presence or absence of echocardiographic evidence of left ventricular hypertrophy. The P-vector, QRS duration, and forced expiratory volume in one second (FEV1) were computed and compared between the two subgroups. There was no statistically significant difference in qualitative lung function (FEV1) between the subgroups. There was no statistically significant difference in mean P-vector between the subgroups. The mean QRS duration was significantly longer in patients with left ventricular hypertrophy as compared with those without left ventricular hypertrophy. The presence of left ventricular hypertrophy may not affect the sensitivity of the P-vector verticalization when used as a lone criterion for diagnosing emphysema. However, the presence of left ventricular hypertrophy may significantly reduce the sensitivity of the electrocardiographic diagnostic dyad in emphysema, as it causes a widening of the QRS duration.

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

Science.gov (United States)

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

2016-06-01

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

Left atrial strain: a new parameter for assessment of left ventricular filling pressure.

Science.gov (United States)

Cameli, Matteo; Mandoli, Giulia Elena; Loiacono, Ferdinando; Dini, Frank Lloyd; Henein, Michael; Mondillo, Sergio

2016-01-01

In order to obtain accurate diagnosis, treatment and prognostication in many cardiac conditions, there is a need for assessment of left ventricular (LV) filling pressure. While systole depends on ejection function of LV, diastole and its disturbances influence filling function and pressures. The commonest condition that represents the latter is heart failure with preserved ejection fraction in which LV ejection is maintained, but diastole is disturbed and hence filling pressures are raised. Significant diastolic dysfunction results in raised LV end-diastolic pressure, mean left atrial (LA) pressure and pulmonary capillary wedge pressure, all referred to as LV filling pressures. Left and right heart catheterization has traditionally been used as the gold standard investigation for assessing these pressures. More recently, Doppler echocardiography has taken over such application because of its noninvasive nature and for being patient friendly. A number of indices are used to achieve accurate assessment of filling pressures including: LV pulsed-wave filling velocities (E/A ratio, E wave deceleration time), pulmonary venous flow (S wave and D wave), tissue Doppler imaging (E' wave and E/E' ratio) and LA volume index. LA longitudinal strain derived from speckle tracking echocardiography (STE) is also sensitive in estimating intracavitary pressures. It is angle-independent, thus overcomes Doppler limitations and provides highly reproducible measures of LA deformation. This review examines the application of various Doppler echocardiographic techniques in assessing LV filling pressures, in particular the emerging role of STE in assessing LA pressures in various conditions, e.g., HF, arterial hypertension and atrial fibrillation.

Left Ulnar Artery Pseudoaneurysm and Left Hand Swelling Simulated by Elephantiasis in a Patient with Neurofibromatosis Type 1

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Ta-Pin Lee

2017-06-01

Full Text Available Elephantiasis is a condition featured by gross enlargement of body parts to massive proportions. Neurofibromatosis type 1 (NF1 is a multisystem genetic disorder. Vascular anomaly is one among the complications of NF1. We report a case of NF1 who had a left hand vascular pseudoaneurysm with left hand swelling mimicking elephantiasis. The characteristics of sonography make it an excellent imaging modality to investigate this sort of superficial vascular lesion.

Normal left ventricular wall motion measured with two-dimensional myocardial tagging

DEFF Research Database (Denmark)

Qi, P; Thomsen, C; Ståhlberg, F

1993-01-01

contraction towards the center of the left ventricle, a motion of the base of the heart towards the apex, and a rotation of the left ventricle around its long axis. The direction of left ventricular rotation changed from early systole to late systole. The base and middle levels of the left ventricle rotated...

Left atrial isolation associated with mitral valve operations.

Science.gov (United States)

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

1992-12-01

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

Fallopian Tube Herniation through Left Sided Abdominal Drain Site.

Science.gov (United States)

Hussain, Khalid; Masood, Jovaria

2016-06-01

Intra-abdominal drains have been used since long to prevent intra-abdominal collection, and detect any anastomotic leaks. We report a case of left sided fallopian tube herniation from a left lower abdominal drain site in a 27-year female who underwent caesarian section for breach presentation. Several complications related to drain usage has been described but left sided fallopian tube prolapse through drain site has not been reported in literature.

Assessment of cardiac performance with quantitative radionuclide angiocardiography: sequential left ventricular ejection fraction, normalized left ventricular ejection rate, and regional wall motion

International Nuclear Information System (INIS)

Marshall, R.C.; Berger, H.J.; Costin, J.C.; Freedman, G.S.; Wolberg, J.; Cohen, L.S.; Gotischalk, A.; Zaret, B.L.

1977-01-01

Sequential quantitative first pass radionuclide angiocardiograms (RA) were used to measure left ventricular ejection fraction (LVEF) and left ventricular ejection rate (LVER), and to assess regional wall motion (RWM) in the anterior (ANT) and left anterior oblique (LAO) positions. Studies were obtained with a computerized multicrystal scintillation camera suitable for acquiring high count-rate data. Background was determined in a new fashion by selecting frames temporally from the left ventricular region of interest time-activity curve. A ''representative'' cardiac cycle was formed by summing together counts over three to six cardiac cycles. From this background corrected, high count-rate ''representative''cardiac cycle, LVEF, LVER, and RWM were determined. In 22 patients with normal sinus rhythm in the absence of significant valvular regurgitation, RA LVEF correlated well with that measured by contrast angiography (r = 0.95). LVER correlated well with LVEF measured at contrast angiography (r = 0.90) and allowed complete separation of those with normal (LVER = 3.4 +- 0.17 sec -1 ) and abnormal (LVER = 1.22 +- 0.11 sec -1 ) (P < 0.001) left ventricular performance. This separation was independent of background. Isoproterenol infusion in five normal subjects caused LVER to increase by 81 +- 17% while LVEF increased by 10 +- 2.0%. RWM was correctly defined in 21/22 patients and 89% of left ventricular segments with abnormal wall motion

Left-sided gall bladder: Report of two cases

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Chrungoo R

2007-01-01

Full Text Available Left-sided gall bladder without situs inversus viscerum is a rare albeit recognized clinical entity. We report our experience of two cases of left-sided gall bladder in two women aged 36 and 48 who underwent laparoscopic cholecystectomy for chronic calculous cholecystitis. Left-sided gall bladder may provide an unusual surprise to the surgeons during laparoscopy as routine pre-operative studies may not always detect the anomaly. Awareness of the unpredictable confluence of the cystic duct into the common bile duct (CBD and selective use of intraoperative cholangiography aid in the safe laparoscopic management of this unusual entity.

Evaluation of left cardiac function by exercise in hypertrophic cardiomyopathy

International Nuclear Information System (INIS)

Konishi, Tokuji; Horayama, Norihisa; Hamada, Masayuki; Nakano, Takeshi; Takezawa, Hideo

1981-01-01

Left ventricular systolic and diastolic features at rest and exercise in hypertrophic cardiomyopathy were evaluated by Fourier analysis of blood pool scintigraphy (intracorporeal labelling with sup(99m)Tc-RBC). In the normal group (17 subjects), the left ventricular ejection fraction showed a linear increase, but no abnormality of regional ventricular wall motion, by multistage exercises. The hypertrophic cardiomyopathy group showed higher left ventricular ejection fractions at rest than those of the normal group, and in the HCM group (non-obstructive, from morphological features; 7 cases) the left ventricular ejection fraction did not increase any more when it reached a certain plateau in accordance with increased stress. In the HOCM (obstructive; 5 cases), the left ventricular ejection fraction showed a decreasing tendency as the stress was increased and also showed contractile abnormalities from the left ventricular center to the apex. Fourier analysis was effective for the evaluation of these changes. (Chiba, N.)

Preterm Delivery in the Setting of Left Calyceal Rupture

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Brent Hanson

2015-01-01

Full Text Available Spontaneous rupture of the renal collecting system is a rare but serious complication of pregnancy. We report a case of nontraumatic left renal calyceal rupture in a pregnancy which ultimately progressed to preterm delivery. A 29-year-old primigravida with a remote history of urolithiasis presented with left flank pain, suprapubic pain, and signs of preterm labor at 33 weeks of gestation. The patient was believed to have urolithiasis, although initial renal ultrasound failed to demonstrate definitive calculi. After a temporary improvement in flank pain with medication, the patient experienced acute worsening of her left flank pain. Urology was consulted and further imaging was obtained. Magnetic resonance imaging (MRI was consistent with bilateral hydronephrosis and rupture of the left renal calyx. Given the patient’s worsening pain in the setting of left calyceal rupture, the urology team planned for placement of a left ureteral stent. However, before the patient could receive her stent, she progressed to active labor and delivered a viable female infant vaginally. Following delivery, the patient’s flank pain resolved rapidly and spontaneously, so no surgical intervention was performed. A summary of the literature and the details of this specific clinical situation are provided.

The effects of left and right monocular viewing on hemispheric activation.

Science.gov (United States)

Wang, Chao; Burtis, D Brandon; Ding, Mingzhou; Mo, Jue; Williamson, John B; Heilman, Kenneth M

2018-03-01

Prior research has revealed that whereas activation of the left hemisphere primarily increases the activity of the parasympathetic division of the autonomic nervous system, right-hemisphere activation increases the activity of the sympathetic division. In addition, each hemisphere primarily receives retinocollicular projections from the contralateral eye. A prior study reported that pupillary dilation was greater with left- than with right-eye monocular viewing. The goal of this study was to test the alternative hypotheses that this asymmetric pupil dilation with left-eye viewing was induced by activation of the right-hemispheric-mediated sympathetic activity, versus a reduction of left-hemisphere-mediated parasympathetic activity. Thus, this study was designed to learn whether there are changes in hemispheric activation, as measured by alteration of spontaneous alpha activity, during right versus left monocular viewing. High-density electroencephalography (EEG) was recorded from healthy participants viewing a crosshair with their right, left, or both eyes. There was a significantly less alpha power over the right hemisphere's parietal-occipital area with left and binocular viewing than with right-eye monocular viewing. The greater relative reduction of right-hemisphere alpha activity during left than during right monocular viewing provides further evidence that left-eye viewing induces greater increase in right-hemisphere activation than does right-eye viewing.

Return to the river: strategies for salmon restoration in the Columbia River Basin.

Science.gov (United States)

Richard N. Williams; Jack A. Standford; James A. Lichatowich; William J. Liss; Charles C. Coutant; Willis E. McConnaha; Richard R. Whitney; Phillip R. Mundy; Peter A. Bisson; Madison S. Powell

2006-01-01

The Columbia River today is a great "organic machine" (White 1995) that dominates the economy of the Pacific Northwest. Even though natural attributes remain—for example, salmon production in Washington State's Hanford Reach, the only unimpounded reach of the mainstem Columbia River—the Columbia and Snake River mainstems are dominated...

Current status of ultrafast CT to evaluate the left ventricle

International Nuclear Information System (INIS)

MacMillan, R.M.; Rees, M.R.; Maranhao, V.

1987-01-01

Contrast-enhanced ultrafast CT with the cine mode can enable reliable assessment of left ventricular mass and function. Two oblique planar views, the long axis and short axis, are required. Right and left ventricular end-diastolic volumes, end-systolic volumes, stroke volume and ejection fraction, left ventricular segmental wall motion, and left ventricular mass can be measured. This exhibit emphasizes the methods and pitfalls in acquiring this information. Results from the authors' studies thus far to validate these measurements against reference standards are reviewed

Linear regression models for quantitative assessment of left ...

African Journals Online (AJOL)

Changes in left ventricular structures and function have been reported in cardiomyopathies. No prediction models have been established in this environment. This study established regression models for prediction of left ventricular structures in normal subjects. A sample of normal subjects was drawn from a large urban ...

Political Left and Right: Our Hands-On Logic

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Frits Bienfait

2014-12-01

Full Text Available The origins and immediate vitality of the left/right divide which emerged in French revolutionary politics from 1789 can only be understood against the background of a much older classification dynamic based on the primacy of the right hand, first described by Robert Hertz in 1909. This dynamic infused political thinking first in Versailles and since 1815 in democracies throughout the world. In the process, the classical left/right polarity acquired a new dimension: the complementary notions of ‘accepting’ and ‘questioning’ the existing social order. An essential feature of both the age-old classical polarity and the ensuing political polarity is that they are intimately bound up with local and evolving social contexts: there is no single content-based definition of left and right. As long as the majority of us are predisposed to use our right hand when acting in the world, ‘left versus right’ will remain the most important political antithesis in western-type democracies.

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

International Nuclear Information System (INIS)

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

2006-01-01

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

Left atrial remodelling in patients with myocardial infarction complicated by heart failure, left ventricular dysfunction, or both: the VALIANT Echo study

DEFF Research Database (Denmark)

Meris, Alessandra; Amigoni, Maria; Uno, Hajime

2009-01-01

AIMS: To assess the relationship between left atrial (LA) size and outcome after high-risk myocardial infarction (MI) and to study dynamic changes in LA size during long-term follow-up. METHODS AND RESULTS: The VALIANT Echocardiography study prospectively enrolled 610 patients with left ventricul...

Associations of Blood Pressure Dipping Patterns With Left Ventricular Mass and Left Ventricular Hypertrophy in Blacks: The Jackson Heart Study.

Science.gov (United States)

Abdalla, Marwah; Caughey, Melissa C; Tanner, Rikki M; Booth, John N; Diaz, Keith M; Anstey, D Edmund; Sims, Mario; Ravenell, Joseph; Muntner, Paul; Viera, Anthony J; Shimbo, Daichi

2017-04-05

Abnormal diurnal blood pressure (BP), including nondipping patterns, assessed using ambulatory BP monitoring, have been associated with increased cardiovascular risk among white and Asian adults. We examined the associations of BP dipping patterns (dipping, nondipping, and reverse dipping) with cardiovascular target organ damage (left ventricular mass index and left ventricular hypertrophy), among participants from the Jackson Heart Study, an exclusively black population-based cohort. Analyses included 1015 participants who completed ambulatory BP monitoring and had echocardiography data from the baseline visit. Participants were categorized based on the nighttime to daytime systolic BP ratio into 3 patterns: dipping pattern (≤0.90), nondipping pattern (>0.90 to ≤1.00), and reverse dipping pattern (>1.00). The prevalence of dipping, nondipping, and reverse dipping patterns was 33.6%, 48.2%, and 18.2%, respectively. In a fully adjusted model, which included antihypertensive medication use and clinic and daytime systolic BP, the mean differences in left ventricular mass index between reverse dipping pattern versus dipping pattern was 8.3±2.1 g/m 2 ( P pattern versus dipping pattern was -1.0±1.6 g/m 2 ( P =0.536). Compared with participants with a dipping pattern, the prevalence ratio for having left ventricular hypertrophy was 1.65 (95% CI, 1.05-2.58) and 0.96 (95% CI, 0.63-1.97) for those with a reverse dipping pattern and nondipping pattern, respectively. In this population-based study of blacks, a reverse dipping pattern was associated with increased left ventricular mass index and a higher prevalence of left ventricular hypertrophy. Identification of a reverse dipping pattern on ambulatory BP monitoring may help identify black at increased risk for cardiovascular target organ damage. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Times of Crisis : Success or Decline of the Left

Directory of Open Access Journals (Sweden)

Valeria Tarditi

2015-03-01

Full Text Available The crisis that especially since the 2008 has shown the deep weakness of the capitalistic economic model induces to reflect on the role of the radical left parties and on their capacity to propose alternative policies, interpreting the citizens’ demands. Starting from these premises this article analyses three parties of the radical left party family- United Left, Left Freedom and Ecology and Syriza- that act respectively in Spain, Italy and Greece, three of the European democracies most affected by the social consequences of the crisis. The article proposes a diachronic comparison of the three parties’ policy pro-posals, organizational model and strategies in order to explain their greater or lesser ability to attract con-sensus in the last years.

The Colombian Left: A Paradoxical Past; A Promising Future?

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Charles Bergquist

2017-07-01

Full Text Available The essay explores the paradoxical history of the left in Colombia: how and why one of the weakest lefts in Latin America brought about the strongest and most lasting Marxist insurrection in the hemisphere in the decades following the Cuban Revolution. The article argues that the terms of this paradox are related, that the historic weakness of the left partly explains the force and longevity of revolutionary guerrillas, and that said paradox helps clarify not only the failure of several attempts to achieve a negotiated settlement of the armed conflict, but also the negative vote in the October 2016 plebiscite. Finally, it envisions a more promising future for the country’s left, provided that a lasting peace is consolidated.

Placement of the Left Side AED Pad is Poor: Training on the Left Compared to the Right Side of a Manikin Does Not Improve Pad Placement

DEFF Research Database (Denmark)

Stærk, Mathilde; Bødtker, Henrik; Rahbek, Søren

2015-01-01

participating in a first aid course were randomized to learn automated external defibrillation sitting on the left or right side of a manikin during AED training. After course completion participants operated a training AED (Lifepak® CR-T AED Trainer, PhysioControl) and placed AED pads according to instructions...... volunteers were included and randomized to AED training on the left (n=14, 43% male, age: 47.9 years) and right (n=16, 25% male, age: 46.7 years) side of a manikin. There was no difference in left pad placement when trained on the left or right side (distance to recommended left apical pad position (mean...

Central-Approach Surgical Repair of Coarctation of the Aorta with a Back-up Left Ventricular Assist Device for an Infant Presenting with Severe Left Ventricular Dysfunction

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Tae Hoon Kim

2015-12-01

Full Text Available A two-month-old infant presented with coarctation of the aorta, severe left ventricular dysfunction, and moderate to severe mitral regurgitation. Through median sternotomy, the aortic arch was repaired under cardiopulmonary bypass and regional cerebral perfusion. The patient was postoperatively supported with a left ventricular assist device for five days. Left ventricular function gradually improved, eventually recovering with the concomitant regression of mitral regurgitation. Prompt surgical repair of coarctation of the aorta is indicated for patients with severe left ventricular dysfunction. A central approach for surgical repair with a back-up left ventricular assist device is a safe and effective treatment strategy for these patients.

Central-Approach Surgical Repair of Coarctation of the Aorta with a Back-up Left Ventricular Assist Device for an Infant Presenting with Severe Left Ventricular Dysfunction.

Science.gov (United States)

Kim, Tae Hoon; Shin, Yu Rim; Kim, Young Sam; Kim, Do Jung; Kim, Hyohyun; Shin, Hong Ju; Htut, Aung Thein; Park, Han Ki

2015-12-01

A two-month-old infant presented with coarctation of the aorta, severe left ventricular dysfunction, and moderate to severe mitral regurgitation. Through median sternotomy, the aortic arch was repaired under cardiopulmonary bypass and regional cerebral perfusion. The patient was postoperatively supported with a left ventricular assist device for five days. Left ventricular function gradually improved, eventually recovering with the concomitant regression of mitral regurgitation. Prompt surgical repair of coarctation of the aorta is indicated for patients with severe left ventricular dysfunction. A central approach for surgical repair with a back-up left ventricular assist device is a safe and effective treatment strategy for these patients.

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

Molecular analysis of population genetic structure and recolonization of rainbow trout following the Cantara spill

Science.gov (United States)

Nielsen, J.L.; Heine, Erika L.; Gan, Christina A.; Fountain, Monique C.

2000-01-01

Mitochondrial DNA (mtDNA) sequence and allelic frequency data for 12 microsatellite loci were used to analyze population genetic structure and recolonization by rainbow trout, Oncorhynchus mykiss, following the 1991 Cantara spill on the upper Sacramento River, California. Genetic analyses were performed on 1,016 wild rainbow trout collected between 1993 and 1996 from the mainstem and in 8 tributaries. Wild trout genotypes were compared to genotypes for 79 Mount Shasta Hatchery rainbow trout. No genetic heterogeneity was found 2 years after the spill (1993) between tributary populations and geographically proximate mainstem fish, suggesting recolonization of the upper mainstem directly from adjacent tributaries. Trout collections made in 1996 showed significant year-class genetic variation for mtDNA and microsatellites when compared to fish from the same locations in 1993. Five years after the spill, mainstem populations appeared genetically mixed with no significant allelic frequency differences between mainstem populations and geographically proximate tributary trout. In our 1996 samples, we found no significant genetic differences due to season of capture (summer or fall) or sampling technique used to capture rainbow trout, with the exception of trout collected by electrofishing and hook and line near Prospect Avenue. Haplotype and allelic frequencies in wild rainbow trout populations captured in the upper Sacramento River and its tributaries were found to differ genetically from Mount Shasta Hatchery trout for both years, with the notable exception of trout collected in the lower mainstem river near Shasta Lake, where mtDNA and microsatellite data both suggested upstream colonization by hatchery fish from the reservoir. These data suggest that the chemical spill in the upper Sacramento River produced significant effects over time on the genetic population structure of rainbow trout throughout the entire upper river basin.

Left-right entanglement entropy of Dp-branes

Energy Technology Data Exchange (ETDEWEB)

Zayas, Leopoldo A. Pando [The Abdus Salam International Centre for Theoretical Physics,Strada Costiera 11, 34014 Trieste (Italy); Michigan Center for Theoretical Physics, Randall Laboratory of Physics,The University of Michigan,450 Church Street, Ann Arbor, MI 48109-1120 (United States); Quiroz, Norma [Departamento de Ciencias Exactas, Tecnología y Metodología,Centro Universitario del Sur, Universidad de Guadalajara,Enrique Arreola Silva 883, C.P. 49000, Cd. Guzmán, Jalisco (Mexico)

2016-11-04

We compute the left-right entanglement entropy for Dp-branes in string theory. We employ the CFT approach to string theory Dp-branes, in particular, its presentation as coherent states of the closed string sector. The entanglement entropy is computed as the von Neumann entropy for a density matrix resulting from integration over the left-moving degrees of freedom. We discuss various crucial ambiguities related to sums over spin structures and argue that different choices capture different physics; however, we advance a themodynamic argument that seems to favor a particular choice of replica. We also consider Dp branes on compact dimensions and verify that the effects of T-duality act covariantly on the Dp brane entanglement entropy. We find that generically the left-right entanglement entropy provides a suitable generalization of boundary entropy and of the D-brane tension.

Studies of left ventricular volume estimation from single photon emission computed tomography

International Nuclear Information System (INIS)

Hiraki, Yoshio; Shimizu, Mitsuharu; Joja, Ikuo; Aono, Kaname; Yanagi, Hidekiyo; Indo, Haruaki; Seno, Yoshimasa; Teramoto, Shigeru; Nagaya, Isao.

1988-01-01

We studied the comparative accuracy of 99m Tc cardiac blood pool Single Photon Emission Computed Tomography (SPECT) for the measurement of left ventricular volume in 20 patients undergoing SPECT and single plane contrast left ventriculography (LVG). Left ventricular volume was calculated based on the total number of voxels in left ventricle. End-diastolic left ventricular volume (EDV) and end-systolic left ventricular volume (ESV) calculated from SPECT were compared with those from LVG. SPECT volume values showed a high degree of correlation with those by LVG (r = 0.923 for EDV, r = 0.903 for ESV). We appreciated the usefulness and accuracy of SPECT in measuring left ventricular volume because of its three-dimensional information. (author)

Diagnostic electrocardiographic dyad criteria of emphysema in left ventricular hypertrophy

Directory of Open Access Journals (Sweden)

Lanjewar SS

2013-11-01

Full Text Available Swapnil S Lanjewar,1 Lovely Chhabra,1 Vinod K Chaubey,1 Saurabh Joshi,1 Ganesh Kulkarni,1 Chandrasekhar Kothagundla,1 Sudesh Kaul,1 David H Spodick21Department of Internal Medicine, 2Department of Cardiovascular Medicine, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, MA, USABackground: The electrocardiographic diagnostic dyad of emphysema, namely a combination of the frontal vertical P-vector and a narrow QRS duration, can serve as a quasidiagnostic marker for emphysema, with specificity close to 100%. We postulated that the presence of left ventricular hypertrophy in emphysema may affect the sensitivity of this electrocardiographic criterion given that left ventricular hypertrophy generates prominent left ventricular forces and may increase the QRS duration.Methods: We reviewed the electrocardiograms and echocardiograms for 73 patients with emphysema. The patients were divided into two groups based on the presence or absence of echocardiographic evidence of left ventricular hypertrophy. The P-vector, QRS duration, and forced expiratory volume in one second (FEV1 were computed and compared between the two subgroups.Results: There was no statistically significant difference in qualitative lung function (FEV1 between the subgroups. There was no statistically significant difference in mean P-vector between the subgroups. The mean QRS duration was significantly longer in patients with left ventricular hypertrophy as compared with those without left ventricular hypertrophy.Conclusion: The presence of left ventricular hypertrophy may not affect the sensitivity of the P-vector verticalization when used as a lone criterion for diagnosing emphysema. However, the presence of left ventricular hypertrophy may significantly reduce the sensitivity of the electrocardiographic diagnostic dyad in emphysema, as it causes a widening of the QRS duration.Keywords: emphysema, electrocardiogram, left ventricular hypertrophy, chronic

The modern mythology of the left-handedness of Alexander the Great.

Science.gov (United States)

McManus, I C

2006-11-01

The prevalent modern suggestion that Alexander the Great was left-handed probably derives from Michael Barsley's (1966) book, Left-handed man is a right-handed word, perhaps by mutation from as earlier story cited by Wile in 1934 from a 17th century Rabbirical exegesis, which said that Alexander discovered a country where all the inhabitants were left-handed. That itself may derive in part from the medieval Hebrew Book of Jossippon, which mentions Alexander talking of the superiority of the left hand and of how "kings stemming from the tribe of kings are left-handed".

challenges left-handed students face in kenyan girls' secondary

African Journals Online (AJOL)

IICBA01

Previous research on left-handedness has mainly taken place in developed countries. This ... participants were five left-handed science students and their respective subject teachers from a ... Qualitative data was collected through classroom.

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

International Nuclear Information System (INIS)

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

1984-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

1984-09-15

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

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

Science.gov (United States)

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

1990-02-01

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

Tracheobronchial Branching Anomalies

International Nuclear Information System (INIS)

Hong, Min Ji; Kim, Young Tong; Jou, Sung Shick; Park, A Young

2010-01-01

There are various congenital anomalies with respect to the number, length, diameter, and location of tracheobronchial branching patterns. The tracheobronchial anomalies are classified into two groups. The first one, anomalies of division, includes tracheal bronchus, cardiac bronchus, tracheal diverticulum, pulmonary isomerism, and minor variations. The second one, dysmorphic lung, includes lung agenesis-hypoplasia complex and lobar agenesis-aplasia complex

Tracheobronchial Branching Anomalies

Energy Technology Data Exchange (ETDEWEB)

Hong, Min Ji; Kim, Young Tong; Jou, Sung Shick [Soonchunhyang University, Cheonan Hospital, Cheonan (Korea, Republic of); Park, A Young [Soonchunhyang University College of Medicine, Asan (Korea, Republic of)

2010-04-15

There are various congenital anomalies with respect to the number, length, diameter, and location of tracheobronchial branching patterns. The tracheobronchial anomalies are classified into two groups. The first one, anomalies of division, includes tracheal bronchus, cardiac bronchus, tracheal diverticulum, pulmonary isomerism, and minor variations. The second one, dysmorphic lung, includes lung agenesis-hypoplasia complex and lobar agenesis-aplasia complex

The organisational and ideological development of Green Left

NARCIS (Netherlands)

Lucardie, Anthonie; Voerman, Gerrit; Botella, Joan; Ramiro, Luis

2003-01-01

In 1991 the Communist Party of the Netherlands (CPN) dissolved itself into the new organisation GreenLeft, founded in 1990. Thus, GreenLeft may be considered the major ‘post-communist party’ in the Netherlands. Yet it is not the only one. A minority of former CPN-members established in 1992 the New

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.

Significant correlation of P-wave parameters with left atrial volume index and left ventricular diastolic function.

Science.gov (United States)

Tsai, Wei-Chung; Lee, Kun-Tai; Wu, Ming-Tsang; Chu, Chih-Sheng; Lin, Tsung-Hsien; Hsu, Po-Chao; Su, Ho-Ming; Voon, Wen-Chol; Lai, Wen-Ter; Sheu, Sheng-Hsiung

2013-07-01

The 12-lead electrocardiogram (ECG) is a commonly used tool to access left atrial enlargement, which is a marker of left ventricular diastolic dysfunction (LVDD). The aim of this study was to evaluate any association of the P-wave measurements in ECG with left atrial volume (LAV) index and LVDD. This study enrolled 270 patients. In this study, 4 ECG P-wave parameters corrected by heart rate, that is, corrected P-wave maximum duration (PWdurMaxC), corrected P-wave dispersion (PWdisperC), corrected P-wave area (PWareaC) and corrected mean P-wave duration (meanPWdurC), were measured. LAV and left ventricular diastolic parameters were measured from echocardiography. LVDD was defined as a pseudonormal or restrictive mitral inflow pattern. The 4 P-wave parameters were significantly correlated with the LAV index after adjusting for age, sex, diabetes, hypertension, coronary artery disease, body mass index and diastolic blood pressure in multivariate analysis. The standardized β coefficients of PWdurMaxC, PWdisperC, meanPWdurC and PWareaC were 0.338, 0.298, 0.215 and 0.296, respectively. The 4 P-wave parameters were also significantly correlated with LVDD after multivariate logistic regression analysis. The odds ratios (95% confidence intervals) of PWdurMaxC, PWdisperC, meanPWdurC and PWareaC were 1.03 (1.01-1.04), 1.02 (1.04-1.04), 1.04 (1.02-1.07) and 1.01 (1.00-1.02), respectively. This study demonstrated that PWdurMaxC, PWdisperC, meanPWdurC and PWareaC were important determinants of the LAV index and LVDD. Therefore, screening patients by means of the 12-lead ECG may be helpful in identifying a high-risk group of increased LAV index and LVDD.

''Natural'' left-right symmetry

International Nuclear Information System (INIS)

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

1975-01-01

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

The experiment of interventional pulmonary lobectomy

International Nuclear Information System (INIS)

You Yufeng; Gan Wanchong; Ke Wei; Ying Wenhua

2006-01-01

Objective: To study the feasibility of interventional pulmonary lobectomy by animal experiment. Methods: Twelve healthy dogs were divided into three groups randomly, with 4 in each. Group A: the target bronchus and alveoli were filled with emulsion of lipiodol and alveolar cells damage liquors and then the target bronchus was occluded with Polymethylmethacrylate (PMMA) . Group B: The target bronchus was only occluded with PMMA. Group C: Pulmonary lobe was resected surgically. Arterial blood gases were measured at the time of pre-procedure and post-procedure and then 1st, 2nd, 3rd and 4th week after the procedure respectively. Chest radiography histology and bacterial culture of tissue of target lung lobe were made after 4 weeks. Results: There was a significant difference in arterial blood-gas among 3 groups pre-procedure in comparison with those of post-procedure immediately (P 0.05) in comparing with 1st, 2nd, 3rd and 4th week after the procedure. Atelectasis was shown radiologically with histological formation of fibrosis of target lung lobe but no bacteria grew in target tissue 4th week after the procedure. There were two cases of lung atelectasis but no pulmonary fibrosis occluded in group B. Conclusions: Interventional pulmonary lobectomy might be obtained after the target bronchus and pulmonary alveoli were filled with emulsion of lipiodol and alveolar cells damage liquors and then the target bronchus was occluded with PMMA. (authors)

Varus deformity of the left lower extremity causing degenerative lesion of the posterior horn of the left medial meniscus in a patient with Paget’s disease of bone

Directory of Open Access Journals (Sweden)

Al Kaissi, Ali

2014-09-01

Full Text Available [english] We report on a 42-year-old woman who presented with persistent pain in her left knee with no history of trauma. Sagittal T1-weighted MRI of the left knee showed discontinuity between the anterior and posterior horns of the left medial meniscus, causing effectively the development of degenerative lesion of the posterior horn. The latter was correlated to varus deformity of the left lower extremity associated with subsequent narrowing of the medial knee joint. The unusual craniofacial contour of the patient, the skeletal survey and the elevated serum alkaline phosphatase were compatible with the diagnosis of Paget’s disease of the bone. To alleviate the adverse effect of the mal-alignment of the left femur onto the left knee, corrective osteotomy of the left femoral diaphysis by means of fixators was performed. To the best of our knowledge this is the first clinical report describing the management and the pathological correlation of a unilateral varus deformity of the femoral shaft and degenerative lesions of the left knee in a patient with Paget’s disease of the bone.

Left-right correlation in coupled F-center defects.

Science.gov (United States)

Janesko, Benjamin G

2016-08-07

This work explores how left-right correlation, a textbook problem in electronic structure theory, manifests in a textbook example of electrons trapped in crystal defects. I show that adjacent F-center defects in lithium fluoride display symptoms of "strong" left-right correlation, symptoms similar to those seen in stretched H2. Simulations of UV/visible absorption spectra qualitatively fail to reproduce experiment unless left-right correlation is taken into account. This is of interest to both the electronic structure theory and crystal-defect communities. Theorists have a new well-behaved system to test their methods. Crystal-defect groups are cautioned that the approximations that successfully model single F-centers may fail for adjacent F-centers.

Left-right correlation in coupled F-center defects

International Nuclear Information System (INIS)

Janesko, Benjamin G.

2016-01-01

This work explores how left-right correlation, a textbook problem in electronic structure theory, manifests in a textbook example of electrons trapped in crystal defects. I show that adjacent F-center defects in lithium fluoride display symptoms of “strong” left-right correlation, symptoms similar to those seen in stretched H 2 . Simulations of UV/visible absorption spectra qualitatively fail to reproduce experiment unless left-right correlation is taken into account. This is of interest to both the electronic structure theory and crystal-defect communities. Theorists have a new well-behaved system to test their methods. Crystal-defect groups are cautioned that the approximations that successfully model single F-centers may fail for adjacent F-centers.

Interrupted inferior vena cava with hemiazygos continuation in an adult with a persistent left superior vena cava and left single coronary artery: A case report

Energy Technology Data Exchange (ETDEWEB)

Kim, Yeo Jin; Kwon, Se Hwan; Ahn, Sung Eun; Kim, Soo Joong; Oh, Joo Hyeong [College of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Shin, Jong Soo [Dept. of Radiology, Kyung Hee University Hospital at Gangdong, Seoul (Korea, Republic of)

2016-06-15

A 50-year-old woman was referred to our institution for medical screening due to an incidental finding on abdominal ultrasonography. She underwent chest, abdomen and cardiac multi-detector computed tomography (MDCT). Her MDCT revealed absence of the hepatic segment of the inferior vena cava (IVC), with hemiazygos continuation and a left single coronary artery. The dilated hemiazygos vein drained directly into the persistent left superior vena cava (SVC). Herein, we reported a very rare case combining an incidentally found interrupted IVC with hemiazygos vein continuation, persistent left SVC and a left single coronary artery diagnosed by MDCT.

Videodensitometric assessment of right and left ventricular functions by digital subtraction angiography

International Nuclear Information System (INIS)

Ikeda, Hisao; Yoshiga, Osamu; Shibao, Keigo

1987-01-01

Intravenous digital subtraction (DS) ventriculography was performed in a series of 50 patients with heart diseases to determine right and left ventricular volumes and systolic indices. Right ventricular volume and right ventricular ejection fraction obtained by DS ventriculography were well correlated with those by geometric methods. In 43 patients with left ventricular ejection fraction of 55 % or greater, end-diastolic volume, stroke volume, and ejection fraction in the right ventricle did not differ from those in the left ventricle ; however, both the 1/3 ejection fraction and the peak ejection rate of the right ventricle were significantly lower than those of the left ventricle, suggesting the different modes of left and right ventricular contraction. In the other seven patients with chronic left ventricular failure, right ventricular systolic function may be preserved, even when left ventricular function is severely impaired. Digital subtraction ventriculography has proved to be a simple, useful method in the quanlitative and quantitative assessments of the right and left ventricles. (Namekawa, K.)

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

Directory of Open Access Journals (Sweden)

Gustavo Restrepo

2005-06-01

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

Evaluation of left ventricular function by digital subtraction angiography

International Nuclear Information System (INIS)

Kuribayashi, Sachio; Ootaki, Makoto; Matsuyama, Seiya; Kanemoto, Nariaki; Furuya, Hideo

1985-01-01

Effects of contrast medium doses on left ventriculographic images using intravenous digital subtraction angiography (IVDSA-LVG) were assessed. The validity of IVDSA-LVG in evaluating ejection fraction (FF) and left ventricular regional wall motion was determined by comparison with conventional left ventriculography using direct injection (direct LVG). The advantages of left ventriculography using intraarterial subtraction angiography (IADSA-LVG) performed by injecting small doses of contrast media directly into the left ventricle were stressed. 1. To assess the effects of doses of contrast media on IVDSA-LVG, 10, 20, and 30 ml Urografin-76 were injected into the superior vena cava in 16 patients, and the resulting images were compared in each patient. With only 10 ml contrast medium, left ventricular opacification was fairly good, and regional wall motion was evaluated in many cases, but 30 ml were needed to calculate ventricular volume and EF. 2. To determine the validity of IVDSA-LVG in evaluating EF and regional wall motion, we compared IVDSA-LVG using 30 ml of contrast medium with direct LVG in 18 patients. There was a good correlation between the two methods in determining EF (r = 0.877), and 90 % of the interpretations of regional wall motion were in agreement by the two methods. IVDSA-LVG was useful and accurate in evaluating EF and regional wall motion of the left ventricle. 3. IADSA-LVG was performed for five patients, and good quality images were obtained in many cases, even with relatively small doses (10 ml) of contrast media. These results suggested that this method may be used in cases with impaired LV function, to avoid hemodynamic derangement induced by conventional direct LVG using large doses of contrast medium. (author)

Right Site, Wrong Route - Cannulating the Left Internal Jugular Vein.

Science.gov (United States)

Paik, Peter; Arukala, Sanjay K; Sule, Anupam A

2018-01-09

Central venous catheters are placed in approximately five million patients annually in the US. The preferred site of insertion is one with fewer risks and easier access. Although the right internal jugular vein is preferred, on occasion, the left internal jugular may have to be accessed. A patient was admitted for septic shock, cerebrovascular accident, and non-ST-segment elevation myocardial infarction. A central venous line was needed for antibiotic and vasopressor administration. Due to trauma from a fall to the right side and previously failed catheterization attempts at the left subclavian and femoral veins, the left internal jugular vein was accessed. On chest radiography for confirmation, the left internal jugular central venous catheter was seen projecting down the left paraspinal region. It did not take the expected course across the midline toward the right and into the superior vena cava (SVC). A review of a computed tomography (CT) scan of the chest with contrast done on a prior admission revealed a duplicated SVC on the left side that had not been reported in the original CT scan interpretation. A left-sided SVC is present in approximately 0.3% to 0.5% of the population, with 90% of these draining into the coronary sinus. During placements of central venous lines and pacemakers, irritation of the coronary sinus may result in hypotension, arrhythmia, myocardial ischemia, or cardiac arrest. A widened mediastinum can be an indication of a duplicated SVC. When attempting a left internal jugular vein central venous catheter placement, it is important to be aware of venous anomalies in order to prevent complications.

Left ventricular systolic function in sickle cell anaemia: an ...

African Journals Online (AJOL)

42) and 24.17 ± 4.39 ... Aortic root diameter (Ao), left atrial dimension (LAD), left ventricu- ... Key: *Statistically significant, a= Chi-square, SCA= sickle cell anaemia, SD= standard deviation. ..... of fluctuations in response to changes in sympathetic.

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.)

The Children Left Behind

Science.gov (United States)

Gillard, Sarah A.; Gillard, Sharlett

2012-01-01

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

A case of luftsichel sign for left upper lobe collapse

Directory of Open Access Journals (Sweden)

Erden Erol Ünlüer

2015-01-01

Full Text Available The differential diagnosis of dyspnea in Emergency Department (ED patients is broad and atelectasis is one of the differentials among these. We present a 29-year-old women presented to our ED for evaluation of shortness of breath. On her chest examination, air entry and breath sounds were diminished on the left side but normal on the right. A posteroanterior chest radiograph showed radioluscent area in the upper zone of the left lung, around the aortic arch and also hyperdens area neighbouring this, like covered by a veil. Luftsichel sign together with this hiperdensity were consistent with the diagnose of left lung upper lobe collapse. The Luftsichel sign represents the hyperexpanded superior segment of the left lower lobe interposed between the atelectatic left upper lobe and aortic arch. Patient was discharged to home with chest physiotherapy and breathing exercises together with analgesic prescreption.

Behavioral evidence for left-hemisphere specialization of motor planning

NARCIS (Netherlands)

Janssen, L.; Meulenbroek, R.G.; Steenbergen, B.

2011-01-01

Recent studies suggest that the left hemisphere is dominant for the planning of motor actions. This left-hemisphere specialization hypothesis was proposed in various lines of research, including patient studies, motor imagery studies, and studies involving neurophysiological techniques. However,

Cardiovascular malformations caused by NOTCH1 mutations do not keep left : data on 428 probands with left-sided CHD and their families

NARCIS (Netherlands)

Kerstjens-Frederikse, Wilhelmina S.; van de Laar, Ingrid M. B. H.; Vos, Yvonne J.; Verhagen, Judith M. A.; Berger, Rolf M. F.; Lichtenbelt, Klaske D.; Wassink-Ruiter, Jolien S. Klein; van der Zwaag, Paul A.; Sarvaas, Gideon J. du Marchie; Bergman, Klasien A.; Bilardo, Catia M.; Roos-Hesselink, Jolien W.; Janssen, Johan H. P.; Frohn-Mulder, Ingrid M.; van Spaendonck-Zwarts, Karin Y.; Melle, van Joost P.; Hofstra, Robert M. W.; Wessels, M. W.

Purpose: We aimed to determine the prevalence and phenotypic spectrum of NOTCH1 mutations in left-sided congenital heart disease (LS-CHD). LS-CHD includes aortic valve stenosis, a bicuspid aortic valve, coarctation of the aorta, and hypoplastic left heart syndrome. Methods: NOTCH1 was screened for

Preliminary study of left ventricular cavity-to-myocardial count ratio. A new parameter for left ventricular function

International Nuclear Information System (INIS)

Zhou Ying; Qu Wanying; Zhu Ming; Gao Wenping; Zhao Hongshan

1995-01-01

A new simple quantitative parameter, left ventricular cavity-to-myocardial count ratio (C/M ratio) was suggested and compared with LVEF to assess its reliability and clinical value. Of 220 patients in the study, 102 had both exercise 99m Tc-MIBI myocardial SPECT imaging and resting radionuclide ventriculography, another 118 patients had both rest 99m Tc-MIBI myocardial SPECT imaging and rest radionuclide ventriculography, 740 MBq of 99m Tc-MIBI was injected intravenously. Both the exercise and rest C/M ratio were determined on short-axis tomograms and LVEF were calculated from radionuclide ventriculography. The correlation between LVEF and the C/M (exercise and rest) was analyzed. There was a positive linear correlation between LVEF measured by ventriculography and both C/M exercise ratio (r = 0.6964) and C/M rest ratio (r = 0.6995). The sensitivity of C/M exercise and rest ratio for detecting patients with left ventricular dysfunction is 71.9%, 68.6%; the specificity is 92.9%, 97.0%; the accuracy is 86.3%, 84.7% respectively. C/M ratio can accurately identify patients with CAD who have resting left ventricular dysfunction. It was highly reproducible, reliable and useful in clinical diagnosis

Grammatical distinctions in the left frontal cortex.

Science.gov (United States)

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

2001-08-15

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

Left-Handed W bosons at the LHC

International Nuclear Information System (INIS)

Dixon, Lance

2011-01-01

The production of W bosons in association with jets is an important background to new physics at the LHC. Events in which the W carries large transverse momentum and decays leptonically lead to large missing energy and are of particular importance. We show that the left-handed nature of the W coupling, combined with valence quark domination at a pp machine, leads to a large left-handed polarization for both W + and W - bosons at large transverse momenta. The polarization fractions are very stable with respect to QCD corrections. The leptonic decay of the W +- bosons translates the common left-handed polarization into a strong asymmetry in transverse momentum distributions between positrons and electrons, and between neutrinos and anti-neutrinos (missing transverse energy). Such asymmetries may provide an effective experimental handle on separating W +jets from top quark production, which exhibits very little asymmetry due to C invariance, and from various types of new physics.

Left-Handed W bosons at the LHC

Energy Technology Data Exchange (ETDEWEB)

Bern, Z.; /UCLA; Diana, G.; /Saclay, SPhT; Dixon, L.J.; /CERN /SLAC; Cordero, F.Febres; /Simon Bolivar U.; Forde, D.; /Simon Bolivar U. /NIKHEF, Amsterdam; Gleisberg, T.; Hoeche, S.; /SLAC; Ita, H.; /UCLA; Kosower, D.A.; /Saclay, SPhT; Maitre, D.; /CERN /Durham U.; Ozeren, K.; /UCLA

2011-05-20

The production of W bosons in association with jets is an important background to new physics at the LHC. Events in which the W carries large transverse momentum and decays leptonically lead to large missing energy and are of particular importance. We show that the left-handed nature of the W coupling, combined with valence quark domination at a pp machine, leads to a large left-handed polarization for both W{sup +} and W{sup -} bosons at large transverse momenta. The polarization fractions are very stable with respect to QCD corrections. The leptonic decay of the W{sup +-} bosons translates the common left-handed polarization into a strong asymmetry in transverse momentum distributions between positrons and electrons, and between neutrinos and anti-neutrinos (missing transverse energy). Such asymmetries may provide an effective experimental handle on separating W +jets from top quark production, which exhibits very little asymmetry due to C invariance, and from various types of new physics.

Left ventricular diastolic dysfunction in chronic renal failure patients on chronic hemodialysis in Dr. Cipto-Mangunkusumo Hospital : the association with left ventricular mass

Directory of Open Access Journals (Sweden)

Idrus Alwi

2006-06-01

Full Text Available Fourty three patients with chronic renal failure undergoing chronic hemodialysis in Division of Nephrology and Hypertension, Faculty of Medicine, University of Indonesia/Cipto-Mangunkusumo Hospital, Jakarta, since October 2003 until February 2004, were examined for echocardiography (2-D, M-mode, Doppler imaging.Diastolic dysfunction was found in 58.1 % of chronic renal failure patients on hemodialysis. There was no significant difference between left ventricular mass in the group with or without left ventricular diastolic dysfunction. (Med J Indones 2006; 15:105-8Keywords: Left ventricular mass, diastolic function, chronic renal failure, hemodyalisis

Longitudinal strain predicts left ventricular mass regression after aortic valve replacement for severe aortic stenosis and preserved left ventricular function.

Science.gov (United States)

Gelsomino, Sandro; Lucà, Fabiana; Parise, Orlando; Lorusso, Roberto; Rao, Carmelo Massimiliano; Vizzardi, Enrico; Gensini, Gian Franco; Maessen, Jos G

2013-11-01

We explored the influence of global longitudinal strain (GLS) measured with two-dimensional speckle-tracking echocardiography on left ventricular mass regression (LVMR) in patients with pure aortic stenosis (AS) and normal left ventricular function undergoing aortic valve replacement (AVR). The study population included 83 patients with severe AS (aortic valve area regression (all P regression in patients with pure AS undergoing AVR. Our findings must be confirmed by further larger studies.

Left cardiac isomerism in the Sonic hedgehog null mouse.

Science.gov (United States)

Hildreth, Victoria; Webb, Sandra; Chaudhry, Bill; Peat, Jonathan D; Phillips, Helen M; Brown, Nigel; Anderson, Robert H; Henderson, Deborah J

2009-06-01

Sonic hedgehog (Shh) is a secreted morphogen necessary for the production of sidedness in the developing embryo. In this study, we describe the morphology of the atrial chambers and atrioventricular junctions of the Shh null mouse heart. We demonstrate that the essential phenotypic feature is isomerism of the left atrial appendages, in combination with an atrioventricular septal defect and a common atrioventricular junction. These malformations are known to be frequent in humans with left isomerism. To confirm the presence of left isomerism, we show that Pitx2c, a recognized determinant of morphological leftness, is expressed in the Shh null mutants on both the right and left sides of the inflow region, and on both sides of the solitary arterial trunk exiting from the heart. It has been established that derivatives of the second heart field expressing Isl1 are asymmetrically distributed in the developing normal heart. We now show that this population is reduced in the hearts from the Shh null mutants, likely contributing to the defects. To distinguish the consequences of reduced contributions from the second heart field from those of left-right patterning disturbance, we disrupted the movement of second heart field cells into the heart by expressing dominant-negative Rho kinase in the population of cells expressing Isl1. This resulted in absence of the vestibular spine, and presence of atrioventricular septal defects closely resembling those seen in the hearts from the Shh null mutants. The primary atrial septum, however, was well formed, and there was no evidence of isomerism of the atrial appendages, suggesting that these features do not relate to disruption of the contributions made by the second heart field. We demonstrate, therefore, that the Shh null mouse is a model of isomerism of the left atrial appendages, and show that the recognized associated malformations found at the venous pole of the heart in the setting of left isomerism are likely to arise from

Metallic stent implantation in the treatment of malignant tracheal stenosis under general anaesthesia

International Nuclear Information System (INIS)

Bai Xuming; Jin Yong; Xie Hong; Cheng Long; Gu Xingshi; Chang Liuhui

2012-01-01

Objective: To evaluate the safety and feasibility of the tracheal stent implantation for treatment of malignant tracheal stenosis under general anaesthesia. Methods: Eighteen patients with malignant tracheal stenosis underwent preoperative 64-slice spiral CT scan and airway reconstruction. The stenotic sites were located in main tracheal trunk (5 patients), in right main bronchus (1 patient), in trachea and left main bronchus (4 patients), in trachea and right main bronchus (3 patients), in main tracheal trunk and bilateral main bronchus (5 patients). The degree of stenosis was rated 51% to 70% in 7 cases, 71% to 90% in 11 cases. All patients, 17 patients of ASA grade Ⅳ and 1 patient of grade Ⅲ, presented with severe dyspnea. Under general anaesthesia, implantation of metallic stent was performed through the sputum aspiration hole of the connecting tubing with DSA guidance. The NBP, ECG, RR, SaO 2 of the patients were recorded and compared with t test during the entire procedure. At the end of the procedure, relief of dyspnea, complications related to anesthesia and operation were recorded. Results: The success rate of stent placement was 18/18, and dyspnea was significantly relived in all patients. Slightly bloody sputum occurred in 7 cases. The stent was obstructed by sputum in 1 case,and the patient was treated with medication. There were no severe complications. The operative course were rated 11 to 9 in 17 cases, and 6 to 8 in 1 case. All 18 patients were cooperative during the procedure. Sixteen patients rated the procedure as very comfortable and 2 rated the procedure as comfortable. Respiratory rate (RR) and heart rate (HR) decreased in all patients after the operation [(37.1 ± 2.8)/min and (106.5 ± 14.2) bpm before the operation respectively, (18.6 ± 1.4)/min and (73.2 ± 7.6) bpm after the operation respectively], t=17.81 and 3.80, P<0.01. Pulse oxygen saturation (SaO 2 ) during the operation [(91.2 ± 1.8)%]increased [(76.3 ± 8.6 )% before the

On Functional Inequalities Originating from Module Jordan Left Derivations

OpenAIRE

Kang Sheon-Young; Chang Ick-Soon; Kim Hark-Mahn

2008-01-01

Abstract We first examine the generalized Hyers-Ulam stability of functional inequality associated with module Jordan left derivation (resp., module Jordan derivation). Secondly, we study the functional inequality with linear Jordan left derivation (resp., linear Jordan derivation) mapping into the Jacobson radical.

Fetal Diagnosis of Abnormal Origin of the Left Pulmonary Artery.

Science.gov (United States)

Tretter, Justin T; Tretter, Eric M; Rafii, Daniela Y; Anderson, Robert H; Bhatla, Puneet

2016-08-01

Isolated anomalies of the branch pulmonary arteries are rare, more often occurring in the setting of complex congenital heart disease. These isolated anomalies are often not identified in the prenatal period. We describe two cases of isolated anomalies of the left pulmonary artery which were identified on fetal echocardiography and confirmed postnatally, an anomalous left pulmonary artery arising from the base of the left-sided brachiocephalic artery in the setting of a right-sided aortic arch, and a left pulmonary artery sling. These two cases support our current understanding of normal and abnormal development of the extrapericardial arterial vessels and highlight the importance of meticulous attention when sweeping from the three-vessel tracheal view. © 2016, Wiley Periodicals, Inc.

Economic analysis of medical management applied for left colostomy.

Science.gov (United States)

Savlovschi, C; Serban, D; Andreescu, Cv; Dascalu, Am; Pantu, H

2013-01-01

This paper presents an analysis of surgical treatment costs for left colostomy, aiming to calculate a medium cost per procedure and to identify the means to maximize the economic management of this type of surgicale procedure. A retrospective study was conducted on a group of 8 patients hospitalized in the 4th Surgery Department,Emergency University Hospital Bucharest, during the year 2012 for left colic neoplasms with obstruction signs that were operated on with a left colostomy. The followed parameters in the studied group of patients were represented by medical expenses, divided in: preoperative, intra-operative and immediate postoperative (postop. hospitalization). Two major types of colostomy were performed: left loop colostomy with intact tumour for 6 patients and left end colostomy and tumour resection (Hartmann's procedure) for 2 patients. The medium cost of this type of surgical intervention was 4396.807 RON, representing 1068.742 euro. Statistic data analysis didn't reveal average costs to vary with the type of procedure. The age of the study subjects was between 49 and 88, with an average of 61 years, without it being possible to establish a correlation between patient age and the level of medical spendings. Reducing the costs involved by left colostomy can be efficiently done by decreasing the number of days of hospitalisation in the following ways: preoperative preparation and assessment of the subject in an outpatient regimen; the accuracy of the surgical procedure with the decrease of early postoperative complications and antibiotherapy- the second major cause of increased postoperative costs. Celsius.

No Community Left Behind

Science.gov (United States)

Schlechty, Phillip C.

2008-01-01

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

Left-side changes in thoracic X-ray follow-ups after cardiosurgery

Energy Technology Data Exchange (ETDEWEB)

Witte, G.; Buecheler, E.; Grabbe, E.; Darup, J.

1983-03-01

In routine thoracic X-ray follow-ups after cardiosurgical procedures, 93.2% of our patients (n=88) showed radiologically perceivable pathological changes, reduced ventilation being the most common phenomenon. 77.1% of the patients showed signs of reduced ventilation, mostly the left side. Limited motility of the diaphragm on the left side was visible in 69% of the cases studied. The defective motility of the left diaphragm is attributable to direct damage to the left nervus phrenicus caused by extracardial heart cooling during surgery.

Left-side changes in thoracic X-ray follow-ups after cardiosurgery

International Nuclear Information System (INIS)

Witte, G.; Buecheler, E.; Grabbe, E.; Darup, J.

1983-01-01

In routine thoracic X-ray follow-ups after cardiosurgical procedures, 93.2% of our patients (n=88) showed radiologically perceivable pathological changes, reduced ventilation being the most common phenomenon. 77.1% of the patients showed signs of reduced ventilation, mostly the left side. Limited motility of the diaphragm on the left side was visible in 69% of the cases studied. The defective motility of the left diaphragm is attributable to direct damage to the left nervus phrenicus caused by extracardial heart cooling during surgery. (orig.) [de

LEFT VENTRICULAR ROTATION, TWIST AND UNTWIST: PHYSIOLOGICAL ROLE AND CLINICAL RELEVANCE

Directory of Open Access Journals (Sweden)

E. N. Pavlyukova

2015-09-01

Full Text Available The helical ventricular myocardial band of Torrent-Guasp is a new concept, which provides strong grounds for reconciliation of some important aspects in cardiovascular medicine. Oblique fiber orientation provides left ventricular rotation, which in addition to radial thickening and longitudinal shortening, is predicted as an essential component of the effective left ventricular pumping. Left ventricular rotation can be measured in clinical practice noninvasively using echocardiography and this provides new opportunities for the assessment of different aspects of left ventricular mechanical function.

Skin Sodium Concentration Correlates with Left Ventricular Hypertrophy in CKD.

Science.gov (United States)

Schneider, Markus P; Raff, Ulrike; Kopp, Christoph; Scheppach, Johannes B; Toncar, Sebastian; Wanner, Christoph; Schlieper, Georg; Saritas, Turgay; Floege, Jürgen; Schmid, Matthias; Birukov, Anna; Dahlmann, Anke; Linz, Peter; Janka, Rolf; Uder, Michael; Schmieder, Roland E; Titze, Jens M; Eckardt, Kai-Uwe

2017-06-01

The pathogenesis of left ventricular hypertrophy in patients with CKD is incompletely understood. Sodium intake, which is usually assessed by measuring urinary sodium excretion, has been inconsistently linked with left ventricular hypertrophy. However, tissues such as skin and muscle may store sodium. Using 23 sodium-magnetic resonance imaging, a technique recently developed for the assessment of tissue sodium content in humans, we determined skin sodium content at the level of the calf in 99 patients with mild to moderate CKD (42 women; median [range] age, 65 [23-78] years). We also assessed total body overhydration (bioimpedance spectroscopy), 24-hour BP, and left ventricular mass (cardiac magnetic resonance imaging). Skin sodium content, but not total body overhydration, correlated with systolic BP ( r =0.33, P =0.002). Moreover, skin sodium content correlated more strongly than total body overhydration did with left ventricular mass ( r =0.56, P skin sodium content is a strong explanatory variable for left ventricular mass, unaffected by BP and total body overhydration. In conclusion, we found skin sodium content to be closely linked to left ventricular mass in patients with CKD. Interventions that reduce skin sodium content might improve cardiovascular outcomes in these patients. Copyright © 2017 by the American Society of Nephrology.

Temporal order processing of syllables in the left parietal lobe.

Science.gov (United States)

Moser, Dana; Baker, Julie M; Sanchez, Carmen E; Rorden, Chris; Fridriksson, Julius

2009-10-07

Speech processing requires the temporal parsing of syllable order. Individuals suffering from posterior left hemisphere brain injury often exhibit temporal processing deficits as well as language deficits. Although the right posterior inferior parietal lobe has been implicated in temporal order judgments (TOJs) of visual information, there is limited evidence to support the role of the left inferior parietal lobe (IPL) in processing syllable order. The purpose of this study was to examine whether the left inferior parietal lobe is recruited during temporal order judgments of speech stimuli. Functional magnetic resonance imaging data were collected on 14 normal participants while they completed the following forced-choice tasks: (1) syllable order of multisyllabic pseudowords, (2) syllable identification of single syllables, and (3) gender identification of both multisyllabic and monosyllabic speech stimuli. Results revealed increased neural recruitment in the left inferior parietal lobe when participants made judgments about syllable order compared with both syllable identification and gender identification. These findings suggest that the left inferior parietal lobe plays an important role in processing syllable order and support the hypothesized role of this region as an interface between auditory speech and the articulatory code. Furthermore, a breakdown in this interface may explain some components of the speech deficits observed after posterior damage to the left hemisphere.

On Functional Inequalities Originating from Module Jordan Left Derivations

Directory of Open Access Journals (Sweden)

Kang Sheon-Young

2008-01-01

Full Text Available Abstract We first examine the generalized Hyers-Ulam stability of functional inequality associated with module Jordan left derivation (resp., module Jordan derivation. Secondly, we study the functional inequality with linear Jordan left derivation (resp., linear Jordan derivation mapping into the Jacobson radical.

Gender specific pattern of left ventricular cardiac adaptation to ...

African Journals Online (AJOL)

Background: Cardiac adaptation to hypertension and obesity may be related to many factors such as race, gender and haemodynamic status. Some gender specific associations with left ventricular structure and function have been described among Caucasians. Objectives: To describe the sex specific pattern of left ...

Evaluation of left ventricular function using digital subtraction ventriculography

International Nuclear Information System (INIS)

Yiannikas, J.; Detrano, R.

1986-01-01

Digital subtraction ventriculography following injections of contrast via peripheral veins provides excellent images to assess left ventricular function. The images are essentially identical to those following DCV, but allow more uniform mixing of contrast in the left ventricular chamber. Furthermore, few, if any, cardiac arrhythmias occur, hence obviating difficulties that arise from DCV. The spatial resolution of the method is such that regional wall motion assessment of ventricular function is more accurate than that of other noninvasive imaging methods. The use of video-densitometry allows accurate assessment of left ventricular function even when the left ventricular cavity is nonsymmetrically deformed and aneurysmal. In the setting of the cardiac catheterization laboratory, digital ventriculography may provide a safer means of assessing left ventricular function when critical coronary or myocardial disease is present and allows multiple assessments of ventricular function during the same study. Although excellent correlations with standard ventriculography have been noted by all workers, significant discrepancies still exist in individual patients, particularly in the calculations of end diastolic volumes. In the authors experience and in those of most workers, the largest discrepancies existed in patients in whom suboptimal studies are included for analysis. The most frequent reason for the occasional suboptimal study as with all digital subtraction work is the misregistration that results from motion

Prevalence of left-sided melanomas in an Irish population.

LENUS (Irish Health Repository)

de Blacam, C

2012-02-01

BACKGROUND: A predominance of melanomas on the left side of the body has recently been described. No associations between tumour laterality and gender, age or anatomical site have been identified. AIM: The aim of this study was to investigate the prevalence of left-sided melanomas in an Irish population and to examine potential associations with various patient and tumour characteristics. METHODS: A retrospective chart review of patients with cutaneous melanoma who were treated over a 10-year period was carried out. Lateral distribution of melanoma on either side of the body was compared using chi(2) analysis and evaluated by gender, age group, anatomic location, histologic subtype and Breslow depth. RESULTS: More melanomas occurred on the left side (57%, P = 0.015), and this finding was particularly significant in females. For both genders combined, there were no statistically significant differences in laterality by age group, anatomic location, type of melanoma and Breslow depth. There were significantly more superficial spreading melanomas on the left side in both men and women. CONCLUSIONS: This study demonstrates a predominance of left-sided melanomas in Irish patients. While a number of demographic and molecular associations have been proposed, further research is required to fully explain this phenomenon.

Prevalence of left-sided melanomas in an Irish population.

LENUS (Irish Health Repository)

de Blacam, C

2011-04-17

BACKGROUND: A predominance of melanomas on the left side of the body has recently been described. No associations between tumour laterality and gender, age or anatomical site have been identified. AIM: The aim of this study was to investigate the prevalence of left-sided melanomas in an Irish population and to examine potential associations with various patient and tumour characteristics. METHODS: A retrospective chart review of patients with cutaneous melanoma who were treated over a 10-year period was carried out. Lateral distribution of melanoma on either side of the body was compared using χ(2) analysis and evaluated by gender, age group, anatomic location, histologic subtype and Breslow depth. RESULTS: More melanomas occurred on the left side (57%, P = 0.015), and this finding was particularly significant in females. For both genders combined, there were no statistically significant differences in laterality by age group, anatomic location, type of melanoma and Breslow depth. There were significantly more superficial spreading melanomas on the left side in both men and women. CONCLUSIONS: This study demonstrates a predominance of left-sided melanomas in Irish patients. While a number of demographic and molecular associations have been proposed, further research is required to fully explain this phenomenon.

Giant left atrium encountered during right-sided thoracentesis

Directory of Open Access Journals (Sweden)

Rashmi Advani

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

Left Activism, Succour and Selfhood

DEFF Research Database (Denmark)

Hughes, Celia Penelope

2014-01-01

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

Impact of aortic prosthesis-patient mismatch on left ventricular mass regression.

Science.gov (United States)

Alassal, Mohamed A; Ibrahim, Bedir M; Elsadeck, Nabil

2014-06-01

Prostheses used for aortic valve replacement may be small in relation to body size, causing prosthesis-patient mismatch and delaying left ventricular mass regression. This study examined the effect of prosthesis-patient mismatch on regression of left ventricular mass after aortic valve replacement. We prospectively studied 96 patients undergoing aortic valve replacement between 2007 and 2012. Mean and peak gradients and indexed effective orifice area were measured by transthoracic echocardiography at 3 and 6 months postoperatively. Patient-prosthesis mismatch was defined as indexed effective orifice area ≤0.85 cm(2)·m(-2). Moderate prosthesis-patient mismatch was present in 25% of patients. There were no significant differences in demographic and operative data between patients with and without prosthesis-patient mismatch. Left ventricular dimensions, posterior wall thickness, transvalvular gradients, and left ventricular mass decreased significantly after aortic valve replacement in both groups. The interventricular septal diameter and left ventricular mass index regression, and left ventricular ejection fraction were better in patients without prosthesis-patient mismatch. There was a significant positive correlation between the postoperative indexed effective orifice area of each valve prosthesis and the rate of left ventricular mass regression. Prosthesis-patient mismatch leads to higher transprosthetic gradients and impaired left ventricular mass regression. A small-sized valve prosthesis does not necessarily result in prosthesis-patient mismatch, and may be perfectly adequate in patient with small body size. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Laser application in tracheobronchial tumors

Science.gov (United States)

Rau, B. Krishna; Krishna, Sharon

2004-09-01

Ninety three patients with obstructing tracheobronchial tumors were treated with Neodymium: Yttrium - Aluminum - Garnet (Nd:YAG) laser photocoagulation over a period of six years. There were sixty seven Males and 26 Females with a mean age of 44.3 years (range 6- 79 years). 21 benign and 72 malignant lesions were treated with a total 212 sessions of laser photocoagulation (mean 2.4 sessions). The anatomical distribution of lesions were as follows; larynx 9 (three benign and 6 malignant) trachea 39 (27 benign and 12 malignant) left main bronchus 27 (14 malignant) right main bronchus 24 (14 malignant) and vocal cords - 9 (three malignant). There were 21 patients with squamous cell carcinoma, two adenocarcinomas, one adenoid cystic carcinoma, 7 cases of locally infiltrating tumors from thyroid and esophagus, 6 cases of carcinoid tumor and 16 benign lesions. Twenty one patients had a tracheostomy tube in place when treatment was started. Eighteen of the 21 patients with tracheostomy were weaned off the tube in a mean of 5.5 days from the start of treatment. Lumen was restored in 31 (79.4%) patients. In the other eight (20.6%), lumen was achieved, but not sustained. Complications included bleeding in three cases which were managed conservatively, two cases of pneumothorax, and four cases of bronchospasm. There were six deaths during the follow up but none attributable to the procedure. Laser photocoagulation offered effective treatment in the majority of patients with obstructing tracheobronchial tumors, with acceptable morbidity.

Aberrant Left Inferior Bronchial Artery Originating from the Left Gastric Artery in a Patient with Acute Massive Hemoptysis

International Nuclear Information System (INIS)

Jiang, Sen; Sun, Xi-Wen; Yu, Dong; Jie, Bing

2013-01-01

Massive hemoptysis is a life-threatening condition, and the major source of bleeding in this condition is the bronchial circulation. Bronchial artery embolization is a safe and effective treatment for controlling hemoptysis. However, the sites of origin of the bronchial arteries (BAs) have numerous anatomical variations, which can result in a technical challenge to identify a bleeding artery. We present a rare case of a left inferior BA that originated from the left gastric artery in a patient with recurrent massive hemoptysis caused by bronchiectasis. The aberrant BA was embolized, and hemoptysis has been controlled for 8 months

Aberrant Left Inferior Bronchial Artery Originating from the Left Gastric Artery in a Patient with Acute Massive Hemoptysis

Energy Technology Data Exchange (ETDEWEB)

Jiang, Sen, E-mail: jasfly77@vip.163.com; Sun, Xi-Wen, E-mail: xwsun@citiz.net; Yu, Dong, E-mail: yudong_mail@126.com; Jie, Bing, E-mail: jbshh@163.com [Shanghai Pulmonary Hospital, Tongji University School of Medicine, Department of Radiology (China)

2013-10-15

Massive hemoptysis is a life-threatening condition, and the major source of bleeding in this condition is the bronchial circulation. Bronchial artery embolization is a safe and effective treatment for controlling hemoptysis. However, the sites of origin of the bronchial arteries (BAs) have numerous anatomical variations, which can result in a technical challenge to identify a bleeding artery. We present a rare case of a left inferior BA that originated from the left gastric artery in a patient with recurrent massive hemoptysis caused by bronchiectasis. The aberrant BA was embolized, and hemoptysis has been controlled for 8 months.

Hemangioma of the left coronary artery: Diagnosis and treatment

International Nuclear Information System (INIS)

Just, A.; Wiesmann, W.; Peters, P.E.; Haesfeld, M.; Sciuk, J.

1992-01-01

The authors describe the case of a histologically proven hemangioma in the left coronary artery of the left ventricle of a 24-year-old woman. The results of the different medical imaging methods applied are described and the treatment of cardiac angiomas is discussed. (orig.) [de

Left-Right Asymmetric Morphogenesis in the Xenopus Digestive System

Science.gov (United States)

Muller, Jennifer K.; Prather, D.R.; Nascone-Yoder, N. M.

2003-01-01

The morphogenetic mechanisms by which developing organs become left-right asymmetric entities are unknown. To investigate this issue, we compared the roles of the left and right sides of the Xenopus embryo during the development of anatomic asymmetries in the digestive system. Although both sides contribute equivalently to each of the individual digestive organs, during the initial looping of the primitive gut tube, the left side assumes concave topologies where the right side becomes convex. Of interest, the concave surfaces of the gut tube correlate with expression of the LR gene, Pitx2, and ectopic Pitx2 mRNA induces ectopic concavities in a localized manner. A morphometric comparison of the prospective concave and convex surfaces of the gut tube reveals striking disparities in their rate of elongation but no significant differences in cell proliferation. These results provide insight into the nature of symmetry-breaking morphogenetic events during left-right asymmetric organ development. ?? 2003 Wiley-Liss, Inc.

Left Sided Amyand's Hernia, A Rare Occurance: A Case Report.

Science.gov (United States)

Ravishankaran, Praveen; Mohan, G; Srinivasan, A; Ravindran, G; Ramalingam, A

2013-06-01

This is a case report about a 35 year old man admitted with complains of obstructed left sided inguinal hernia. On exploration of the left inguinal canal to our surprise a normal appendix was found in addition to a gangrenous omentum. Resection of the gangrenous omentum was done. Appendectomy was done. This case is reported for its rare occurance as only three such cases of left sided amyand's hernia has been reported so far in literature[4-6].

The high opening of the right bronchial artery with a non-typical course.

Science.gov (United States)

Maciejewski, R; Madej, B; Anasiewicz, A

1995-01-01

Authors describing the bronchial vessels agree to the fact that they are characterised by a great variability in regard to their number and the place where they leave aorta (1, 2, 6). The characteristic feature of the right bronchial artery is that it often forms common trunks with other vessels (mainly with the first right aortic intercostal branch or with one of the upper oesophageal arteries). It can also have a common let-out trunk with the left upper bronchial artery (4). Bearing in mind that the operations on trachea and bronchi are difficult, and that it is very important to maintain the blood supply of the walls in the operated organs we have decided to publish our observations. They refer to a case, not described before, in which the right bronchial artery left the aortic arch in a high position making the vascular supply to the front lower half of the trachea and its bifurcation. Then, it went down to the membranous part of the right bronchus.

Echocardiographic assessment of fetal left ventricular function in hypertensive disorder of pregnancy

International Nuclear Information System (INIS)

Liu Xiaozhen; Liu Shaozhong

2011-01-01

Objective: To investigate fetal left ventricular function in hypertensive disorder of pregnancy (HDP). Methods: Fetuses of hypertensive (84) and normotensive (147) mothers were enrolled in this study. The fetal left ventricular ejection fractions, E/A ratios of mitral valves, left atrial shortening fractions and Tei indexes of the two groups were measured on fetal echocardiography. Results: The left ventricular ejection fractions (P=0.040), E/A ratios of the mitral valves (P=0.042) and the left atrial shortening fractions (P=0.036) in fetuses of HDP were significantly smaller than those of the normal group whereas the Tei indexes (P=0.030) were significantly larger than those of the normal group. Conclusion: The hypertensive disorder of pregnancy may cause decreased systolic, diastolic and global function of the fetal left ventricle. (authors)

Enhanced activation of the left hemisphere promotes normative decision making.

Science.gov (United States)

Corser, Ryan; Jasper, John D

2014-01-01

Previous studies have reported that enhanced activation of the left cerebral hemisphere reduces risky-choice, attribute, and goal-framing effects relative to enhanced activation of the right cerebral hemisphere. The present study sought to extend these findings and show that enhanced activation of the left hemisphere also reduces violations of other normative principles, besides the invariance principle. Participants completed ratio bias (Experiment 1, N = 296) and base rate neglect problems (Experiment 2, N = 145) under normal (control) viewing or with the right or left hemisphere primarily activated by imposing a unidirectional gaze. In Experiment 1 we found that enhanced left hemispheric activation reduced the ratio bias relative to normal viewing and a group experiencing enhanced right hemispheric activation. In Experiment 2 enhanced left hemispheric activation resulted in using base rates more than normal viewing, but not significantly more than enhanced right hemispheric activation. Results suggest that hemispheric asymmetries can affect higher-order cognitive processes, such as decision-making biases. Possible theoretical accounts are discussed as well as implications for dual-process theories.

Paradox image: a noninvasive index of regional left-ventricular dyskinesis

International Nuclear Information System (INIS)

Holman, B.L.; Wynne, J.; Idoine, J.; Zielonka, J.; Neill, J.

1979-01-01

The paradox image, a functional image of regional dyskinesis derived from the equilibrium (gated) radionuclide ventriculogram, was constructed by subtracting the background-corrected end-diastolic frame from the background-corrected end-systolic frame. In 11 patients showing dyskinesis by contrast ventriculography, the percentage of left-ventricular picture elements containing paradox ranged from 3.6 to 55.6% (21.44% +- 4.45 s.e.m.). In 11 patients with normokinesis and in eight patients with hypookinesis by contrast ventriculography, the left-ventricular picture elements demonstrating paradox were less than 1.1% in all cases. In nine patients with akinesis, the percentage of left-ventricular picture elements containing paradox was 2.05% +- 0.96 s.e.m. and was less than 2% in seven patients. There was also an excellent agreement between the location of dyskinesis on the paradox image and that by contrast ventriculography. The paradox image is a sensitive indicator of left-ventricular dyskinesis and should be useful in the evaluation of patients with suspected left-ventricular asynergy

Post-surgery lung torsion and haemorrhagic infarction - a case report

International Nuclear Information System (INIS)

Noemayr, A.; Schmitt, R.; Wichert, C.; Bautz, W.; Rupprecht, H.

1998-01-01

Lung or lobe torsion may occur after thoracic surgery, chest trauma, pneumothorax, pneumonia, or even spontaneously. Lung infarction is a possible complication. The characteristic radiological signs on plain radiographs are opacification and/or displacement of lobes and hilus structures. CT-signs of haemorrhagic infarction are opacification and multiple punctate gas accumulations. The bronchus could be interrupted at the level of the torsion (''bronchus cutoff''). (orig.) [de

Time left in the mouse.

Science.gov (United States)

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

2007-02-22

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

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.

Patterns of left ventricular remodeling among patients with essential and secondary hypertension.

Science.gov (United States)

Radulescu, Dan; Stoicescu, Laurentiu; Buzdugan, Elena; Donca, Valer

2013-12-01

High blood pressure causes left ventricular hypertrophy, which is a negative prognostic factor among hypertensive patients. To assess left ventricular geometric remodeling patterns in patients with essential hypertension or with hypertension secondary to parenchymal renal disease. We analyzed data from echocardiograms performed in 250 patients with essential hypertension (150 females) and 100 patients with secondary hypertension (60 females). The interventricular septum and the left ventricular posterior wall thickness were measured in the parasternal long-axis. Left ventricular mass was calculated using the Devereaux formula. The most common remodeling type in females and males with essential hypertension were eccentric and concentric left ventricular hypertrophy (cLVH), respectively. Among patients with secondary arterial hypertension, cLVH was most commonly observed in both genders. The prevalence of left ventricular hypertrophy was higher among patients with secondary hypertension. The left ventricular mass index and the relative left ventricular wall thickness were higher in males and also in the secondary hypertension group. Age, blood pressure values and the duration of hypertension, influenced remodeling patterns. We documented a higher prevalence of LVH among patients with secondary hypertension. The type of ventricular remodeling depends on gender, age, type of hypertension, blood pressure values and the duration of hypertension.

Novel nonsurgical left ventricular assist device and system.

Science.gov (United States)

Misiri, Juna; DeSimone, Christopher V; Park, Soon J; Kushwaha, Sudhir S; Friedman, Paul A; Bruce, Charles J; Asirvatham, Samuel J

2013-01-01

Treatment options for advanced stages of congestive heart failure remain limited. Left ventricular assist devices (LVADs) have emerged as a means to support failing circulation. However, these devices are not without significant risk such as major open chest surgery. We utilized a novel approach for device placement at the aorto-left atria continuity as a site to create a conduit capable of accommodating a percutaneous LVAD system. We designed and developed an expandable nitinol based device for placement at this site to create a shunt between the LA and aorta. Our experiments support this anatomic location as an accessible and feasible site for accommodation of an entirely percutaneous LVAD. The novelty of this approach would bypass the left ventricle, and thereby minimize complications and morbidities associated with current LVAD placement. Copyright © 2013 Elsevier Inc. All rights reserved.

Echocardiographic left ventricular masses in distance runners and weight lifters

Science.gov (United States)

Longhurst, J. C.; Gonyea, W. J.; Mitchell, J. H.; Kelly, A. R.

1980-01-01

The relationships of different forms of exercise training to left ventricular mass and body mass are investigated by echocardiographic studies of weight lifters, long-distance runners, and comparatively sized untrained control subjects. Left ventricular mass determinations by the Penn convention reveal increased absolute left ventricular masses in long-distance runners and competitive weight lifters with respect to controls matched for age, body weight, and body surface area, and a significant correlation between ventricular mass and lean body mass. When normalized to lean body mass, the ventricular masses of distance runners are found to be significantly higher than those of the other groups, suggesting that dynamic training elevates left ventricular mass compared to static training and no training, while static training increases ventricular mass only to the extent that lean body mass is increased.

Unusual metastasis of left colon cancer: considerations on two cases.

Science.gov (United States)

Gubitosi, Adelmo; Moccia, Giancarlo; Malinconico, Francesca Antonella; Gilio, Francesco; Iside, Giovanni; Califano, Umberto G A; Foroni, Fabrizio; Ruggiero, Roberto; Docimo, Giovanni; Parmeggiani, Domenico; Agresti, Massimo

2009-04-01

Usually, left colon cancer metastasis concerns liver, abdominal lymph nodes and lungs. Other localizations are quite rare occurrences. In spite of this, some uncommon metastasis sites are reported in literature, such as: peritoneum, ovaries, uterus, kidney testis, bones, thyroid, oral cavity and central nervous system. We report two cases of unusual localizations of left colon cancer metastasis localization, one into the retroperitoneal space and the other at the left axillary lynphnodes and between liver and pancreas. In the first reported case the diffusion pathway may have been the lymphatic mesocolic vessels, partially left in place from the previous surgery. In the second case the alleged metastatic lane may have been through the periumbilical lymph nodes to the parasternal lymph nodes and then to the internal mammary ones, finally reaching the axillary limph nodes.

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

Phonological decisions require both the left and right supramarginal gyri

DEFF Research Database (Denmark)

Hartwigsen, Gesa; Baumgaertner, Annette; Price, Cathy J

2010-01-01

Recent functional imaging studies demonstrated that both the left and right supramarginal gyri (SMG) are activated when healthy right-handed subjects make phonological word decisions. However, lesion studies typically report difficulties with phonological processing after left rather than right...... the right or left SMG. Taken together, these findings provide converging evidence that the right SMG contributes to accurate and efficient phonological decisions in the healthy brain, with no evidence that the left and right SMG can compensate for one another during TMS. Our findings motivate detailed...... hemisphere damage. Here, we used a unique dual-site transcranial magnetic stimulation (TMS) approach to test whether the SMG in the right hemisphere contributes to modality-independent (i.e., auditory and visual) phonological decisions. To test task-specificity, we compared the effect of real or sham TMS...

Anatomical and histological profile of bronchus-associated lymphoid tissue and localization of melatonin receptor types (Mel 1a and Mel 1b) in the lung-associated immune system of a tropical bird, Perdicula asiatica.

Science.gov (United States)

Kumar Kharwar, Rajesh; Haldar, Chandana

2011-05-01

The histological distribution of the lung-associated immune system (LAIS) and the expressional pattern of melatonin receptors are still unknown in birds. The aim of the present study was to determine the localization of the bronchus-associated lymphoid tissue (BALT nodule) in a tropical bird, the Indian jungle bush quail, Perdicula asiatica. We also demonstrate the expression of melatonin receptor types (Mel(1a) and Mel(1b)) in order to propose an immunomodulatory role of melatonin in LAIS. Localization of melatonin receptors in the lung of the Indian jungle bush quail, P. asiatica was supported immunohistochemically and by Western blot analysis using specific antibodies for those receptors. Immunolocalization for Mel(1b) receptor was noted in the bronchial region of the lungs, in finger-like projections of mucosal foldings, in lymphocytes in the BALT nodule as well as in free form. In contrast, immunolocalization for Mel(1a) receptor was noted in various areas of the lung instead of in the bronchial region. Western blot analysis showed a single band at 37 and 39kDa for Mel(1a) and Mel(1b) receptors, respectively, with the latter showing higher expression. The results demonstrate a well-developed LAIS and region-specific distribution of melatonin receptors in the lung and provide evidence for a possible functional role for melatonin in the LAIS of birds. Copyright © 2010 Elsevier GmbH. All rights reserved.

Jordan and left derivations on locally C*-algebras

International Nuclear Information System (INIS)

Shahzad, Naseer

2002-07-01

We show that left derivations as well as Jordan derivations on locally G*-algebras are always continuous. We also obtain some noncommutative extensions of the classical Singer-Wermer theorem for locally C*-algebras: (1) Every left derivation D on a locally (7*-algebra A is identically zero. (2) Every Jordan derivation D on a locally C*-algebra A which satisfies [D(x), x]D(x]=0 for all x in A, is identically zero. (author)

Left preference for sport tasks does not necessarily indicate left-handedness: sport-specific lateral preferences, relationship with handedness and implications for laterality research in behavioural sciences.

Directory of Open Access Journals (Sweden)

Florian Loffing

Full Text Available In the elite domain of interactive sports, athletes who demonstrate a left preference (e.g., holding a weapon with the left hand in fencing or boxing in a 'southpaw' stance seem overrepresented. Such excess indicates a performance advantage and was also interpreted as evidence in favour of frequency-dependent selection mechanisms to explain the maintenance of left-handedness in humans. To test for an overrepresentation, the incidence of athletes' lateral preferences is typically compared with an expected ratio of left- to right-handedness in the normal population. However, the normal population reference values did not always relate to the sport-specific tasks of interest, which may limit the validity of reports of an excess of 'left-oriented' athletes. Here we sought to determine lateral preferences for various sport-specific tasks (e.g., baseball batting, boxing in the normal population and to examine the relationship between these preferences and handedness. To this end, we asked 903 participants to indicate their lateral preferences for sport-specific and common tasks using a paper-based questionnaire. Lateral preferences varied considerably across the different sport tasks and we found high variation in the relationship between those preferences and handedness. In contrast to unimanual tasks (e.g., fencing or throwing, for bimanually controlled actions such as baseball batting, shooting in ice hockey or boxing the incidence of left preferences was considerably higher than expected from the proportion of left-handedness in the normal population and the relationship with handedness was relatively low. We conclude that (i task-specific reference values are mandatory for reliably testing for an excess of athletes with a left preference, (ii the term 'handedness' should be more cautiously used within the context of sport-related laterality research and (iii observation of lateral preferences in sports may be of limited suitability for the

Left preference for sport tasks does not necessarily indicate left-handedness: sport-specific lateral preferences, relationship with handedness and implications for laterality research in behavioural sciences.

Science.gov (United States)

Loffing, Florian; Sölter, Florian; Hagemann, Norbert

2014-01-01

In the elite domain of interactive sports, athletes who demonstrate a left preference (e.g., holding a weapon with the left hand in fencing or boxing in a 'southpaw' stance) seem overrepresented. Such excess indicates a performance advantage and was also interpreted as evidence in favour of frequency-dependent selection mechanisms to explain the maintenance of left-handedness in humans. To test for an overrepresentation, the incidence of athletes' lateral preferences is typically compared with an expected ratio of left- to right-handedness in the normal population. However, the normal population reference values did not always relate to the sport-specific tasks of interest, which may limit the validity of reports of an excess of 'left-oriented' athletes. Here we sought to determine lateral preferences for various sport-specific tasks (e.g., baseball batting, boxing) in the normal population and to examine the relationship between these preferences and handedness. To this end, we asked 903 participants to indicate their lateral preferences for sport-specific and common tasks using a paper-based questionnaire. Lateral preferences varied considerably across the different sport tasks and we found high variation in the relationship between those preferences and handedness. In contrast to unimanual tasks (e.g., fencing or throwing), for bimanually controlled actions such as baseball batting, shooting in ice hockey or boxing the incidence of left preferences was considerably higher than expected from the proportion of left-handedness in the normal population and the relationship with handedness was relatively low. We conclude that (i) task-specific reference values are mandatory for reliably testing for an excess of athletes with a left preference, (ii) the term 'handedness' should be more cautiously used within the context of sport-related laterality research and (iii) observation of lateral preferences in sports may be of limited suitability for the verification of

Left Preference for Sport Tasks Does Not Necessarily Indicate Left-Handedness: Sport-Specific Lateral Preferences, Relationship with Handedness and Implications for Laterality Research in Behavioural Sciences

Science.gov (United States)

Loffing, Florian; Sölter, Florian; Hagemann, Norbert

2014-01-01

In the elite domain of interactive sports, athletes who demonstrate a left preference (e.g., holding a weapon with the left hand in fencing or boxing in a ‘southpaw’ stance) seem overrepresented. Such excess indicates a performance advantage and was also interpreted as evidence in favour of frequency-dependent selection mechanisms to explain the maintenance of left-handedness in humans. To test for an overrepresentation, the incidence of athletes' lateral preferences is typically compared with an expected ratio of left- to right-handedness in the normal population. However, the normal population reference values did not always relate to the sport-specific tasks of interest, which may limit the validity of reports of an excess of ‘left-oriented’ athletes. Here we sought to determine lateral preferences for various sport-specific tasks (e.g., baseball batting, boxing) in the normal population and to examine the relationship between these preferences and handedness. To this end, we asked 903 participants to indicate their lateral preferences for sport-specific and common tasks using a paper-based questionnaire. Lateral preferences varied considerably across the different sport tasks and we found high variation in the relationship between those preferences and handedness. In contrast to unimanual tasks (e.g., fencing or throwing), for bimanually controlled actions such as baseball batting, shooting in ice hockey or boxing the incidence of left preferences was considerably higher than expected from the proportion of left-handedness in the normal population and the relationship with handedness was relatively low. We conclude that (i) task-specific reference values are mandatory for reliably testing for an excess of athletes with a left preference, (ii) the term ‘handedness’ should be more cautiously used within the context of sport-related laterality research and (iii) observation of lateral preferences in sports may be of limited suitability for the

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

The left ventricle in aortic stenosis--imaging assessment and clinical implications.

Science.gov (United States)

Călin, Andreea; Roşca, Monica; Beladan, Carmen Cristiana; Enache, Roxana; Mateescu, Anca Doina; Ginghină, Carmen; Popescu, Bogdan Alexandru

2015-04-29

Aortic stenosis has an increasing prevalence in the context of aging population. In these patients non-invasive imaging allows not only the grading of valve stenosis severity, but also the assessment of left ventricular function. These two goals play a key role in clinical decision-making. Although left ventricular ejection fraction is currently the only left ventricular function parameter that guides intervention, current imaging techniques are able to detect early changes in LV structure and function even in asymptomatic patients with significant aortic stenosis and preserved ejection fraction. Moreover, new imaging parameters emerged as predictors of disease progression in patients with aortic stenosis. Although proper standardization and confirmatory data from large prospective studies are needed, these novel parameters have the potential of becoming useful tools in guiding intervention in asymptomatic patients with aortic stenosis and stratify risk in symptomatic patients undergoing aortic valve replacement.This review focuses on the mechanisms of transition from compensatory left ventricular hypertrophy to left ventricular dysfunction and heart failure in aortic stenosis and the role of non-invasive imaging assessment of the left ventricular geometry and function in these patients.

Persistent Left Superior Vena Cava, The View of a Rare Case

Directory of Open Access Journals (Sweden)

H.Volkan Kara

2013-10-01

Full Text Available The glenohumeral joint is the most commonly dislocated joint in the human body. Anterior dislocatin is the most common type and posterior dislocations account for <1% of shoulder dislocations.  A 68-yearold woman was brought to the emergency department by ambulance  with shoulder pain following a fall from stairs. On local physical examination, there was severe pain on the left proximal humerus. The left arm was in internal rotation in the adducted position. Active and passive movements of the left shoulder were painful and limited. The neurovascular examination of the left upper extremity revealed no deficit. Radiographs of her left shoulder were performed and no significant pathology was identified in the left shoulder anteroposterior (AP X-ray (Figure 1. Axillary radiography could not be performed because of painful arm movements. Therefore, CT was performed to clarify any existing shoulder pathology (Figure 2. Closed reduction under conscious sedation was performed with longitudinal and lateral traction on the arm to protect the humeral head. Control CT was performed and this revealed that reduction had improved the shoulder (Figure 3. She was then treated with an arm sling and discharged with an outpatient orthopaedic control visit.

Functional and anatomical connectivity abnormalities in left inferior frontal gyrus in schizophrenia.

Science.gov (United States)

Jeong, Bumseok; Wible, Cynthia G; Hashimoto, Ryu-ichiro; Kubicki, Marek

2009-12-01

Functional studies in schizophrenia demonstrate prominent abnormalities within the left inferior frontal gyrus (IFG) and also suggest the functional connectivity abnormalities in language network including left IFG and superior temporal gyrus during semantic processing. White matter connections between regions involved in the semantic network have also been indicated in schizophrenia. However, an association between functional and anatomical connectivity disruptions within the semantic network in schizophrenia has not been established. Functional (using levels of processing paradigm) as well as diffusion tensor imaging data from 10 controls and 10 chronic schizophrenics were acquired and analyzed. First, semantic encoding specific activation was estimated, showing decreased activation within the left IFG in schizophrenia. Second, functional time series were extracted from this area, and left IFG specific functional connectivity maps were produced for each subject. In an independent analysis, tract-based spatial statistics (TBSS) was used to compare fractional anisotropy (FA) values between groups, and to correlate these values with functional connectivity maps. Schizophrenia patients showed weaker functional connectivity within the language network that includes left IFG and left superior temporal sulcus/middle temporal gyrus. FA was reduced in several white matter regions including left inferior frontal and left internal capsule. Finally, left inferior frontal white matter FA was positively correlated with connectivity measures of the semantic network in schizophrenics, but not in controls. Our results indicate an association between anatomical and functional connectivity abnormalities within the semantic network in schizophrenia, suggesting further that the functional abnormalities observed in this disorder might be directly related to white matter disruptions. 2009 Wiley-Liss, Inc.

Phonological decisions require both the left and right supramarginal gyri.

Science.gov (United States)

Hartwigsen, Gesa; Baumgaertner, Annette; Price, Cathy J; Koehnke, Maria; Ulmer, Stephan; Siebner, Hartwig R

2010-09-21

Recent functional imaging studies demonstrated that both the left and right supramarginal gyri (SMG) are activated when healthy right-handed subjects make phonological word decisions. However, lesion studies typically report difficulties with phonological processing after left rather than right hemisphere damage. Here, we used a unique dual-site transcranial magnetic stimulation (TMS) approach to test whether the SMG in the right hemisphere contributes to modality-independent (i.e., auditory and visual) phonological decisions. To test task-specificity, we compared the effect of real or sham TMS during phonological, semantic, and perceptual decisions. To test laterality and anatomical specificity, we compared the effect of TMS over the left, right, or bilateral SMG and angular gyri. The accuracy and reaction times of phonological decisions were selectively disrupted relative to semantic and perceptual decisions when real TMS was applied over the left, right, or bilateral SMG. These effects were not observed for TMS over the angular gyri. A follow-up experiment indicated that the threshold-intensity for inducing a disruptive effect on phonological decisions was identical for unilateral TMS over the right or left SMG. Taken together, these findings provide converging evidence that the right SMG contributes to accurate and efficient phonological decisions in the healthy brain, with no evidence that the left and right SMG can compensate for one another during TMS. Our findings motivate detailed studies of phonological processing in patients with acute or long-term damage of the right SMG.

Beware the left-sided gallbladder

African Journals Online (AJOL)

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

Advantages in exploring a new environment with the left eye in lizards.

Science.gov (United States)

Bonati, Beatrice; Csermely, Davide; Sovrano, Valeria Anna

2013-07-01

Lizards (Podarcis muralis) preferentially use the left eye during spatial exploration in a binocular condition. Here we allowed 44 adult wild lizards to explore an unknown maze for 20 min under a temporary monocular condition whilst recording their movements, particularly the direction of turns made whilst walking within the maze. Lizards with a patch on their right eye, i.e. using their left eye to monitor the environment, moved faster than lizards with a patch on their left eye when turning both leftward and rightward in a T-cross. Hence, right eye-patched lizards were faster than left eye-patched lizards also in turning right, although their right eye was covered. Thus, lizards that could use the left eye/right hemisphere to attend spatial cues appeared to have more control and to be more prompt in exploring the maze. In addition, female lizards with their left eye covered stopped very frequently when they reached crosses, showing a high level of indecision. Results confirm that P. muralis lizards using their left eye only in exploring a new environment react faster and more efficiently than those using the right eye only in exploration. Hence lateralisation of spatial stimuli mediated by the left eye/right hemisphere could provide an advantage to this species. Copyright © 2013 Elsevier B.V. All rights reserved.

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

Science.gov (United States)

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

2011-01-01

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

["Habitual" left branch block alternating with 2 "disguised" bracnch block].

Science.gov (United States)

Lévy, S; Jullien, G; Mathieu, P; Mostefa, S; Gérard, R

1976-10-01

Two cases of alternating left bundle branch block and "masquerading block" (with left bundle branch morphology in the stnadard leads and right bundle branch block morphology in the precordial leads) were studied by serial tracings and his bundle electrocardiography. In case 1 "the masquerading" block was associated with a first degree AV block related to a prolongation of HV interval. This case is to our knowledge the first cas of alternating bundle branch block in which his bundle activity was recorded in man. In case 2, the patient had atrial fibrilation and His bundle recordings were performed while differents degrees of left bundle branch block were present: The mechanism of the alternation and the concept of "masquerading" block are discussed. It is suggested that this type of block represents a right bundle branch block associated with severe lesions of the "left system".

Political Left and Right: Our Hands-On Logic

OpenAIRE

Frits Bienfait; Walter E. A. van Beek

2014-01-01

The origins and immediate vitality of the left/right divide which emerged in French revolutionary politics from 1789 can only be understood against the background of a much older classification dynamic based on the primacy of the right hand, first described by Robert Hertz in 1909. This dynamic infused political thinking first in Versailles and since 1815 in democracies throughout the world. In the process, the classical left/right polarity acquired a new dimension: the complementary notions ...

Left-handed materials in metallic magnetic granular composites

International Nuclear Information System (INIS)

Chui, S.T.; Lin, Z.F.; Hu, L.-B.

2003-01-01

There is recently interests in the 'left-handed' materials. In these materials the direction of the wave vector of electromagnetic radiation is opposite to the direction of the energy flow. We present simple arguments that suggests that magnetic composites can also be left-handed materials. However, the physics involved seems to be different from the original argument. In our argument, the imaginary part of the dielectric constant is much larger than the real part, opposite to the original argument

How right is left? Handedness modulates neural responses during morphosyntactic processing.

Science.gov (United States)

Grey, Sarah; Tanner, Darren; van Hell, Janet G

2017-08-15

Most neurocognitive models of language processing generally assume population-wide homogeneity in the neural mechanisms used during language comprehension, yet individual differences are known to influence these neural mechanisms. In this study, we focus on handedness as an individual difference hypothesized to affect language comprehension. Left-handers and right-handers with a left-handed blood relative, or familial sinistrals, are hypothesized to process language differently than right-handers with no left-handed relatives (Hancock and Bever, 2013; Ullman, 2004). Yet, left-handers are often excluded from neurocognitive language research, and familial sinistrality in right-handers is often not taken into account. In the current study we used event-related potentials to test morphosyntactic processing in three groups that differed in their handedness profiles: left-handers (LH), right-handers with a left-handed blood relative (RH FS+), and right-handers with no reported left-handed blood relative (RH FS-; both right-handed groups were previously tested by Tanner and Van Hell, 2014). Results indicated that the RH FS- group showed only P600 responses during morphosyntactic processing whereas the LH and RH FS+ groups showed biphasic N400-P600 patterns. N400s in LH and RH FS+ groups are consistent with theories that associate left-handedness (self or familial) with increased reliance on lexical/semantic mechanisms during language processing. Inspection of individual-level results illustrated that variability in RH FS- individuals' morphosyntactic processing was remarkably low: most individuals were P600-dominant. In contrast, LH and RH FS+ individuals showed marked variability in brain responses, which was similar for both groups: half of individuals were N400-dominant and half were P600-dominant. Our findings have implications for neurocognitive models of language that have been largely formulated around data from only right-handers without accounting for familial

Caffeine improves left hemisphere processing of positive words.

Science.gov (United States)

Kuchinke, Lars; Lux, Vanessa

2012-01-01

A positivity advantage is known in emotional word recognition in that positive words are consistently processed faster and with fewer errors compared to emotionally neutral words. A similar advantage is not evident for negative words. Results of divided visual field studies, where stimuli are presented in either the left or right visual field and are initially processed by the contra-lateral brain hemisphere, point to a specificity of the language-dominant left hemisphere. The present study examined this effect by showing that the intake of caffeine further enhanced the recognition performance of positive, but not negative or neutral stimuli compared to a placebo control group. Because this effect was only present in the right visual field/left hemisphere condition, and based on the close link between caffeine intake and dopaminergic transmission, this result points to a dopaminergic explanation of the positivity advantage in emotional word recognition.

Caffeine improves left hemisphere processing of positive words.

Directory of Open Access Journals (Sweden)

Lars Kuchinke

Full Text Available A positivity advantage is known in emotional word recognition in that positive words are consistently processed faster and with fewer errors compared to emotionally neutral words. A similar advantage is not evident for negative words. Results of divided visual field studies, where stimuli are presented in either the left or right visual field and are initially processed by the contra-lateral brain hemisphere, point to a specificity of the language-dominant left hemisphere. The present study examined this effect by showing that the intake of caffeine further enhanced the recognition performance of positive, but not negative or neutral stimuli compared to a placebo control group. Because this effect was only present in the right visual field/left hemisphere condition, and based on the close link between caffeine intake and dopaminergic transmission, this result points to a dopaminergic explanation of the positivity advantage in emotional word recognition.

Brain abscesses associated with right-to-left shunts in adults.

Science.gov (United States)

Memon, Kashif A; Cleveland, Kerry O; Gelfand, Michael S

2012-04-01

Although brain abscesses are frequently cryptogenic in origin, bacteria must reach the brain either by direct or hematogenous spread. Right-to-left shunts, caused either by intrapulmonary vascular malformations or congenital heart defects, may allow microorganisms to evade the normal host defenses in the lungs and lead to development of brain abscesses. Two patients recently presented with brain abscesses and were found to have conditions associated with right-to-left shunts. The diagnosis of brain abscess should prompt the clinician to consider right-to-left shunts as a possible predisposing condition for brain abscess.

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.

Association between circulating fibroblast growth factor 23, α-Klotho, and the left ventricular ejection fraction and left ventricular mass in cardiology inpatients.

Directory of Open Access Journals (Sweden)

Kensaku Shibata

Full Text Available BACKGROUND: Fibroblast growth factor 23 (FGF23, with its co-receptor Klotho, plays a crucial role in phosphate metabolism. Several recent studies suggested that circulating FGF23 and α-Klotho concentrations might be related to cardiovascular abnormalities in patients with advanced renal failure. PURPOSE: Using data from 100 cardiology inpatients who were not undergoing chronic hemodialysis, the association of circulating levels of FGF23, α-Klotho, and other calcium-phosphate metabolism-related parameters with the left ventricular ejection fraction (LVEF and left ventricular mass (LVM was analyzed. METHODS AND RESULTS: LVEF was measured using the modified Simpson method for apical 4-chamber LV images and the LVM index (LVMI was calculated by dividing the LVM by body surface area. Univariate analysis showed that log transformed FGF23, but not that of α-Klotho, was significantly associated with LVEF and LVMI with a standardized beta of -0.35 (P<0.001 and 0.26 (P<0.05, respectively. After adjusting for age, sex, estimated glomerular filtration rate, and serum concentrations of intact parathyroid hormone, and 25-hydroxyvitamin D as covariates into the statistical model, log-transformed FGF23 was found to be a statistically positive predictor for decreased left ventricular function and left ventricular hypertrophy. CONCLUSIONS: In cardiology department inpatients, circulating FGF23 concentrations were found to be associated with the left ventricular mass and LVEF independent of renal function and other calcium-phosphate metabolism-related parameters. Whether modulation of circulating FGF23 levels would improve cardiac outcome in such a high risk population awaits further investigation.

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

Science.gov (United States)

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

2014-09-01

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

Midgut malrotation presenting with left-sided acute appendicitis and CT inversion sign

Science.gov (United States)

Çağlar, Emrah; Arıbaş, Bilgin; Tiken, Ramazan; Keskin, Suat

2014-01-01

In patients presenting with abdominal pain, appendicitis is the most common surgical disorder. Appendicitis causing pain in the left lower quadrant is extremely rare and can occur with congenital abnormalities that include true left-sided appendix or as an atypical presentation of right-sided long appendix, which projects into the left lower quadrant. We report a case of a 69-year-old man showing midgut malrotation with acute appendicitis presenting as left lower quadrant abdominal pain. PMID:24682135

Evaluation of global and regional left ventricular function obtained by quantitative gated SPECT using {sup 99m}Tc-tetrofosmin for left ventricular dysfunction

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Ban, Kazunobu; Nakajima, Tohru; Iseki, Harukazu; Abe, Sumihisa; Handa, Shunnosuke; Suzuki, Yutaka [Tokai Univ., Isehara, Kanagawa (Japan). School of Medicine

2000-08-01

The quantitative gated SPECT (QGS) software is able to calculate LV volumes and visualize LV wall motion and perfusion throughout the cardiac cycle using an automatic edge detection algorithm of the left ventricle. We evaluated the reliability of global and regional LV function assessment derived from QGS by comparing it with the results from left ventriculo-cineangiography (LVG). In 20 patients with left ventricular dysfunction who underwent ECG gated {sup 99m}Tc-tetrofosmin SPECT, the end-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (LVEF) were calculated. The QGS-assessed regional wall motion was determined using the cinematic display. QGS-derived EDV, ESV and LVEF correlated well with those by LVG (p<0.001 for each). There was a good correlation between wall motion score (WMS) derived from the QGS and the LVG (r=0.40, p<0.05). In some patients with extensive myocardial infarction, there was a discrepancy in the regional wall motion results between QGS and LVG. The ECG-gated SPECT using QGS is useful to evaluate global and regional LV functions in left ventricular dysfunction. (author)

Leptomeningeal angiomatosis of the left occipital surface detected by CT scan

International Nuclear Information System (INIS)

Niiro, Masaki; Mihara, Tadahiro; Maeda, Yoshiki; Awa, Hiroshi; Kadota, Koki; Asakura, Tetsuhiko

1982-01-01

A case of left occipital leptomeningeal angiomatosis was reported. The patient was a 12-year-old boy who had episodes of severe vascular type headache accompanied by transient right homonymous hemianopsia. CT scan showed localized superficial high density area in the left occipital pole. Remarkable enhancement of the lower and inner surface of the left occipital lobe was demonstrated. Angiography showed poor filling of the distal portion of the left posterior cerebral artery. Skull tomograms showed linear calcifications in the left occipital region. Brain scan showed increased RI uptake in the left occipital region. During operation, the surface of the left occipital lobe was covered by excessive, fine, vascular networks which extended over the arachnoid membrane. The abnormal vessels were cauterized by a CO 2 laser as throughly as possible. The occipital pole, felt gritty. Histologically, the abnormal vessels had spread into the subarachnoid space and were predominantly veins with thin and enlarged walls. The abnormal vessels followed the leptomeninges in the sulci of the cerebral cortex. Underneath the abnormal vessels, in the external layers of the cerebral cortex, calcium deposits were scattered and gliosis and degeneration of the ganglion cells were observed. The lesion was comparable with leptomeningeal angiomatosis. Though the pathological findings of the specimen, CT findings, and brain scan findings were extremely similar to those of Sturge-Weber disease, in this case, the typical clinical and roentgenographic findings of Sturge-Weber disease were all absent. (author)

Inference for shared-frailty survival models with left-truncated data

NARCIS (Netherlands)

van den Berg, G.J.; Drepper, B.

2016-01-01

Shared-frailty survival models specify that systematic unobserved determinants of duration outcomes are identical within groups of individuals. We consider random-effects likelihood-based statistical inference if the duration data are subject to left-truncation. Such inference with left-truncated

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

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)

Regional ejection fraction: a quantitative radionuclide index of regional left ventricular performance

International Nuclear Information System (INIS)

Maddox, D.E.; Wynne, J.; Uren, R.; Parker, J.A.; Idoine, J.; Siegel, L.C.; Neill, J.M.; Cohn, P.F.; Holman, B.L.

1979-01-01

Left ventricular regional ejection fractions were derived from background-corrected, time-activity curves in 43 patients assessed by both gated equilibrium radionuclide angiocardiography and left ventricular contrast angiography. From a single, modified left anterior oblique projection, the regional change in background corrected counts was determined in each of three anatomic regions. The normal range for regional radionuclide ejection fraction was determined in 10 patients with normal contrast ventriculograms and without obstructive coronary artery disease at coronary arteriography. Regional ejection fraction was compared with percent segmental axis shortening and extent of akinetic segments in corresponding regions of the contrast ventriculogram. Radionuclide and roentgenographic methods were in agreement as to the presence or absence of abnormal wall motion in 83 of 99 left ventricular regions (84%) in 33 patients evaluated prospectively. Comparison of regional ejection fraction demonstrated significant differences between regions with roentgenographically determined normokinesis hypokinesis, and akinesis. We conclude that the left ventricular regional ejection fraction provides a reliable quantitative assessment of regional left ventricular performance

Intracerebral stimulation of left and right ventral temporal cortex during object naming.

Science.gov (United States)

Bédos Ulvin, Line; Jonas, Jacques; Brissart, Hélène; Colnat-Coulbois, Sophie; Thiriaux, Anne; Vignal, Jean-Pierre; Maillard, Louis

2017-12-01

While object naming is traditionally considered asa left hemisphere function, neuroimaging studies have reported activations related to naming in the ventral temporal cortex (VTC) bilaterally. Our aim was to use intracerebral electrical stimulation to specifically compare left and right VTC in naming. In twenty-three epileptic patients tested for visual object naming during stimulation, the proportion of naming impairments was significantly higher in the left than in the right VTC (31.3% vs 13.6%). The highest proportions of positive naming sites were found in the left fusiform gyrus and occipito-temporal sulcus (47.5% and 31.8%). For 17 positive left naming sites, an additional semantic picture matching was carried out, always successfully performed. Our results showed the enhanced role of the left compared to the right VTC in naming and suggest that it may be involved in lexical retrieval rather than in semantic processing. Copyright © 2017 Elsevier Inc. All rights reserved.

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

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Mücahit Yetim

2013-11-01

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

Left handedness and spine deformities in early adolescence

International Nuclear Information System (INIS)

Milenkovic, Sanja; Kocijancic, Radojka; Belojevic, Goran

2004-01-01

The aim of this study was to investigate the relation between laterality and spine deformities in early adolescence, with special reference to sex differences. Interviews, anthropometric measurements and clinical examinations of body posture were carried out on a sample of 2546 schoolchildren, aged from 11 to 14 years, in seven elementary schools in the centre of Belgrade. Possible confounding factors (age, sex, body weight and body height) were controlled for. The overall prevalence of spine deformities (scoliosis and/or thoracic hyperkyphosis) in the investigated population was 11.8%, out of which there were 7.8% adolescents with scoliosis, 4.0% with thoracic hyperkyphosis, and 0.3% with both spine deformities. The prevalence of scoliosis was 2.7 times higher in girls compared to boys (11.7% vs. 4.3%) while the prevalence of thoracic hyperkyphosis was 1,6 higher among boys (5.0% vs. 3.2%). We found 7.6% of the schoolchildren examined to be left-handed. Left handedness was significantly related to scoliosis in girls (crude OR=1.60 and 95% confidence interval=1.01-2.54). Multivariate analysis showed that significant independent factors for scoliosis were female sex (p < 0.001), age (p=0.01) and left handedness (p=0.02). We did not find any appreciable relation between left handedness and thoracic hyperkyphosis in both sexes

The determination factors of left-right asymmetry disorders- a short review.

Science.gov (United States)

Catana, Andreea; Apostu, Adina Patricia

2017-01-01

Laterality defects in humans, situs inversus and heterotaxy, are rare disorders, with an incidence of 1:8000 to 1:10 000 in the general population, and a multifactorial etiology. It has been proved that 1.44/10 000 of all cardiac problems are associated with malformations of left-right asymmetry and heterotaxy accounts for 3% of all congenital heart defects. It is considered that defects of situs appear due to genetic and environmental factors. Also, there is evidence that the ciliopathies (defects of structure or function) are involved in development abnormalities. Over 100 genes have been reported to be involved in left-right patterning in model organisms, but only a few are likely to candidate for left-right asymmetry defects in humans. Left-right asymmetry disorders are genetically heterogeneous and have variable manifestations (from asymptomatic to serious clinical problems). The discovery of the right mechanism of left-right development will help explain the clinical complexity and may contribute to a therapy of these disorders.

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.

Deep Vein Thrombosis of the Left Leg: A Case of May-Thurner Syndrome

Directory of Open Access Journals (Sweden)

Jiten Desai

2018-02-01

Full Text Available A 56-year-old woman presented with gradually worsening shortness of breath associated with dull left leg pain over 5 days. She denied any recent travel, recent surgeries or immobilization. CT pulmonary angiography and CT venography revealed multiple bilateral pulmonary emboli and extensive left pelvic and left lower extremity deep vein thromboses. Contrast-enhanced CT showed that the right common iliac artery crossed the left common iliac vein and compressed it externally, indicative of May–Thurner syndrome. Catheter-directed thrombolysis of the left lower extremity was performed and heparin infusion was started. The patient also underwent left iliac vein balloon angioplasty with stenting and infra-renal inferior vena cava filter placement via the jugular approach to prevent further embolization.

Left subclavian artery revascularization as part of thoracic stent grafting

NARCIS (Netherlands)

Saouti, N.; Hindori, V.; Morshuis, W.J.; Heijmen, R.H.

2015-01-01

OBJECTIVES: Intentional covering of the left subclavian artery (LSA) as part of thoracic endovascular aortic repair (TEVAR) can cause (posterior) strokes or left arm malperfusion. LSA revascularization can be done as prophylaxis against, or as treatment of, these complications. We report our

Left brain, right brain: facts and fantasies.

Directory of Open Access Journals (Sweden)

Michael C Corballis

2014-01-01

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

Aortic atresia with normal sized left ventricle

Directory of Open Access Journals (Sweden)

Priya Jagia

2016-01-01

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

Left brain, right brain: facts and fantasies.

Science.gov (United States)

Corballis, Michael C

2014-01-01

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

Reduced dream-recall frequency in left-handed adolescents: a replication.

Science.gov (United States)

Schredl, Michael; Beaton, Alan A; Henley-Einion, Josie; Blagrove, Mark

2014-01-01

The ability to recall a dream upon waking up in the morning has been linked to a broad variety of factors such as personality, creativity, sleep behaviour and cognitive function. There have been conflicting findings as to whether dream recall is related more to the right or to the left hemisphere, and conflicting findings regarding the relationship of dream-recall frequency to handedness. We have found previously that right- and mixed-handers report having more dreams than left-handers, a finding more pronounced among adolescents than adults. In the present sample of 3535 participants aged from 6 to 18 years, right-handedness and mixed/inconsistent handedness were associated with higher dream-recall frequency compared to that of left-handed persons, again especially in adolescents compared with children. Further research is required to uncover the reason for the lower frequency of dream recall by left-handers.

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)

Psychological Development and Educational Problems of Left-Behind Children in Rural China

Science.gov (United States)

Sun, Xiaojun; Tian, Yuan; Zhang, Yongxin; Xie, Xiaochun; Heath, Melissa A.; Zhou, Zongkui

2015-01-01

With China's rapidly developing economy and increasing urbanization, many adults from rural areas migrate to urban areas for better paid jobs. A side effect of this migration is that parents frequently leave their children behind (left-behind children). This research investigated left-behind children's and non-left-behind children's psychological,…

Differences in graph theory functional connectivity in left and right temporal lobe epilepsy.

Science.gov (United States)

Chiang, Sharon; Stern, John M; Engel, Jerome; Levin, Harvey S; Haneef, Zulfi

2014-12-01

To investigate lateralized differences in limbic system functional connectivity between left and right temporal lobe epilepsy (TLE) using graph theory. Interictal resting state fMRI was performed in 14 left TLE patients, 11 right TLE patients, and 12 controls. Graph theory analysis of 10 bilateral limbic regions of interest was conducted. Changes in edgewise functional connectivity, network topology, and regional topology were quantified, and then left and right TLE were compared. Limbic edgewise functional connectivity was predominantly reduced in both left and right TLE. More regional connections were reduced in right TLE, most prominently involving reduced interhemispheric connectivity between the bilateral insula and bilateral hippocampi. A smaller number of limbic connections were increased in TLE, more so in left than in right TLE. Topologically, the most pronounced change was a reduction in average network betweenness centrality and concurrent increase in left hippocampal betweenness centrality in right TLE. In contrast, left TLE exhibited a weak trend toward increased right hippocampal betweenness centrality, with no change in average network betweenness centrality. Limbic functional connectivity is predominantly reduced in both left and right TLE, with more pronounced reductions in right TLE. In contrast, left TLE exhibits both edgewise and topological changes that suggest a tendency toward reorganization. Network changes in TLE and lateralized differences thereof may have important diagnostic and prognostic implications. Published by Elsevier B.V.

Rare Chronic Gastric Volvulus Associated with Left Atrial and Mediastinal Compression

OpenAIRE

Shriki, Jabi E.; Nguyen, Khanh; Rozo, Juan Carlos; Reul, George J.; Mortazavi, Ali

2002-01-01

We report a case of chronic gastric volvulus associated with left atrial compression in a 75-year-old woman who presented with chest pain, shortness of breath, and hypotension after elective hemiarthroplasty of the left hip. The patient's medical history included a paraesophageal hernia and gastric volvulus diagnosed in 1997 but left untreated. The present diagnosis of gastric volvulus was made on the basis of a chest radiograph and subsequent computed tomography. Echocardiography showed the ...

Evaluation of left ventricular volumes measured by magnetic resonance imaging

DEFF Research Database (Denmark)

Møgelvang, J; Thomsen, C; Mehlsen, J

1986-01-01

Left ventricular end-diastolic and end-systolic volumes were determined in 17 patients with different levels of left ventricular function by magnetic resonance imaging (MRI). A 1.5 Tesla Magnet was used obtaining ECG triggered single and multiple slices. Calculated cardiac outputs were compared...

Transient left atrial dysfunction is a feature of Takotsubo syndrome

DEFF Research Database (Denmark)

Stiermaier, Thomas; Graf, Tobias; Möller, Christian

2017-01-01

BACKGROUND: Takotsubo syndrome (TTS) is characterized by a transient left and/or right ventricular dysfunction as a consequence of a distinctive pattern of regional wall motion abnormalities. However, a systematic evaluation of the left atrial (LA) function in patients with TTS is lacking. The ai...

Socintigraphic evaluation of lateral segment of the left lobe of the liver

International Nuclear Information System (INIS)

Oyama, Kazuyuki; Hayashi, Sanshin; Kogure, Takashi; Hirakawa, Ken; Akaike, Akira

1979-01-01

Lateral segment of left lobe of the liver is clearly demarcated on sup(99m) Tc-labeled cholescintigram. With analysis of 112 sup(99m) Tc-pyridoxylideneisoleucine scintigrams about lateral border of left lobe, there are some variants in 22 cases (19.7%) in shape in lateral segment of Type 4 left lobe in morphologic classification. Of lateral segment of left lobe, there are classified into five types in the anterior view according to the degeneration; Type 1 is gradually elongated tapered type in 8 cases (36.4%), Type 2 is laterally elongated type as rod shape or island shape in 5 cases (22.7%), Type 3 is lobulated type in 1 case (4.6%), Type 4 is narrowing type in 5 cases (22.7%), Type 5 is indentation type in 3 cases (13.6%). Using colloidal radiopharmaceuticals in liver scintigraphy, lateral segment of left lobe often overlapps with the spleen, which disturb to interpret the abnormality in left lobe of the liver and in the spleen. This analysis depends upon the recent advances in sup(99m) Tc-labeled hepatobiliary radiopharmaceuticals and equipment, and there has never discussed about the shape of lateral segment of left lobe in roentgenologic and scintigraphic evaluations. (author)

Correlation of vocals and lyrics with left temporal musicogenic epilepsy.

Science.gov (United States)

Tseng, Wei-En J; Lim, Siew-Na; Chen, Lu-An; Jou, Shuo-Bin; Hsieh, Hsiang-Yao; Cheng, Mei-Yun; Chang, Chun-Wei; Li, Han-Tao; Chiang, Hsing-I; Wu, Tony

2018-03-15

Whether the cognitive processing of music and speech relies on shared or distinct neuronal mechanisms remains unclear. Music and language processing in the brain are right and left temporal functions, respectively. We studied patients with musicogenic epilepsy (ME) that was specifically triggered by popular songs to analyze brain hyperexcitability triggered by specific stimuli. The study included two men and one woman (all right-handed, aged 35-55 years). The patients had sound-triggered left temporal ME in response to popular songs with vocals, but not to instrumental, classical, or nonvocal piano solo versions of the same song. Sentimental lyrics, high-pitched singing, specificity/familiarity, and singing in the native language were the most significant triggering factors. We found that recognition of the human voice and analysis of lyrics are important causal factors in left temporal ME and provide observational evidence that sounds with speech structure are predominantly processed in the left temporal lobe. A literature review indicated that language-associated stimuli triggered ME in the left temporal epileptogenic zone at a nearly twofold higher rate compared with the right temporal region. Further research on ME may enhance understanding of the cognitive neuroscience of music. © 2018 New York Academy of Sciences.

Left-colon antegrade continence enema (LACE) procedure for fecal incontinence.

Science.gov (United States)

Churchill, Bernard M; De Ugarte, Daniel A; Atkinson, James B

2003-12-01

Antegrade continence enemas (ACE) are an efficacious therapeutic option for patients with fecal incontinence. The authors review their institution's experience with a variation of the Monti-Malone ACE procedure using the left colon as a source of an intestinal conduit and enema reservoir. From 2000 to 2002, 18 patients with fecal incontinence or intractable constipation underwent left-colon ACE (LACE) procedure. Concomitant Mitrofanoff appendicovesicostomy was performed in 15 patients and bladder augmentation in 9. The majority of patients had neural tube defects. A segment of left colon was tubularized, tunneled into the muscular wall of the distal colon, and exteriorized through the left upper quadrant or midabdomen. Stomal catherization and enema installation were started one month postoperatively. Fifteen patients (83%) achieved fecal continence, 2 remain incontinent of stool, and 1 experienced stomal closure (mean follow-up was 24 +/- 9 months). Two patients had stomal stenosis that required revision. The mean enema volume in patient's achieving continence was 360 +/- 216 mL, and the mean transit time was 18 +/- 12 minutes. LACE is an efficacious procedure for fecal incontinence that can be performed safely at the time of major urologic reconstruction. Administration of enemas into the left colon has several physiologic advantages that result in predictable bowel evacuation.

Differential neuropsychological test sensitivity to left temporal lobe epilepsy.

Science.gov (United States)

Loring, David W; Strauss, Esther; Hermann, Bruce P; Barr, William B; Perrine, Kenneth; Trenerry, Max R; Chelune, Gordon; Westerveld, Michael; Lee, Gregory P; Meador, Kimford J; Bowden, Stephen C

2008-05-01

We examined the sensitivity of the Rey Auditory Verbal Learning Test (AVLT), California Verbal Learning Test (CVLT), Boston Naming Test (BNT), and Multilingual Aphasia Examination Visual Naming subtest (MAE VN) to lateralized temporal lobe epilepsy (TLE) in patients who subsequently underwent anterior temporal lobectomy. For the AVLT (n = 189), left TLE patients performed more poorly than their right TLE counterparts [left TLE = 42.9 (10.6), right TLE = 47.7 (9.9); p LTE = 40.7 (11.1), right TLE = 43.8 (9.9); (p measures of confrontation naming ability [BNT: left LTE = 43.1 (8.9), right TLE = 48.1 (8.9); p < .001 (Cohen's d = .56); MAE VN: left TLE = 42.2, right TLE = 45.6, p = .02 (Cohen's d = .36)]. When these data were modeled in independent logistic regression analyses, the AVLT and BNT both significantly predicted side of seizure focus, although the positive likelihood ratios were modest. In the subset of 108 patients receiving both BNT and AVLT, the AVLT was the only significant predictor of seizure laterality, suggesting individual patient variability regarding whether naming or memory testing may be more sensitive to lateralized TLE.

Effect of Left Ventricular Outflow Tract Obstruction on Left Atrial Mechanics in Hypertrophic Cardiomyopathy

Directory of Open Access Journals (Sweden)

Lynne K. Williams

2015-01-01

Full Text Available Left atrial (LA volumes are known to be increased in hypertrophic cardiomyopathy (HCM and are a predictor of adverse outcome. In addition, LA function is impaired and is presumed to be due to left ventricular (LV diastolic dysfunction as a result of hypertrophy and myocardial fibrosis. In the current study, we assess the incremental effect of outflow tract obstruction (and concomitant mitral regurgitation on LA function as assessed by LA strain. Patients with HCM (50 obstructive, 50 nonobstructive were compared to 50 normal controls. A subset of obstructive patients who had undergone septal myectomy was also studied. Utilising feature-tracking software applied to cardiovascular magnetic resonance images, LA volumes and functional parameters were calculated. LA volumes were significantly elevated and LA ejection fraction and strain were significantly reduced in patients with HCM compared with controls and were significantly more affected in patients with obstruction. LA volumes and function were significantly improved after septal myectomy. LVOT obstruction and mitral regurgitation appear to further impair LA mechanics. Septal myectomy results in a significant reduction in LA volumes, paralleled by an improvement in function.

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

Science.gov (United States)

Fu, Yuan; Li, Kuibao; Yang, Xinchun

2017-08-01

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

Primary epithelial myoepithelial carcinoma of lung, reporting of a rare entity, its molecular histogenesis and review of the literature.

Science.gov (United States)

Arif, Farzana; Wu, Susan; Andaz, Shahriyour; Fox, Stewart

2012-01-01

Primary epithelial myoepithelial carcinoma of lung is a rare entity and is thought to arise from the submucosal bronchial glands distributed throughout the lower respiratory tract. Because of the rarity of this tumor, we describe one case of epithelial myoepithelial carcinoma arising in the bronchus intermedius and presenting as an endobronchial mass. A 57-year-old male patient presented with an incidental finding of an endobronchial mass located in the lumen of the right lower lobe bronchus and caused near total luminal occlusion of the bronchus. An endobronchial carcinoid tumor was entertained clinically. Subsequently the patient underwent an uneventful videothoracoscopic lobectomy of lower and middle lobes of the right lung. Morphologically and immunohistochemically the tumor was characterized by two cell populations with epithelial and myoepithelial cells forming duct-like structure. The final diagnosis of epithelial myoepithelial carcinoma of lung was rendered.

On the calculation of principle curvatures of the left-ventricular surfaces.

Science.gov (United States)

Claus, Piet; Choi, Hon Fai; D'hooge, Jan; Rademakers, Frank E

2008-01-01

A local description of the shape of the left ventricle is relevant in assessing the process of adverse ventricular remodeling, associated with most cardiac pathologies, and in monitoring reverse remodeling by therapy. To quantify local shape of the left ventricle, one can calculate the curvature of its epicardial or endocardial surface. The 3D geometry of the heart and especially the ventricles, can typically be described using finite element meshes. From a mathematical point of view these meshes provide a local parametrization of the surface in the 3-dimensional space. We discuss the analytic derivation of the principle curvatures of the left-ventricular surfaces given their smooth finite-element meshes and apply this derivation to assess the regional shape of the normal porcine left ventricle.

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

Science.gov (United States)

Devinsky, Orrin

2009-01-06

When the delusional misidentification syndromes reduplicative paramnesia and Capgras syndromes result from neurologic disease, lesions are usually bifrontal and/or right hemispheric. The related disorders of confabulation and anosognosis share overlapping mechanisms and anatomic pathology. A dual mechanism is postulated for the delusional misidentification syndromes: negative effects from right hemisphere and frontal lobe dysfunction as well as positive effects from release (i.e., overactivity) of preserved left hemisphere areas. Negative effects of right hemisphere injury impair self-monitoring, ego boundaries, and attaching emotional valence and familiarity to stimuli. The unchecked left hemisphere unleashes a creative narrator from the monitoring of self, memory, and reality by the frontal and right hemisphere areas, leading to excessive and false explanations. Further, the left hemisphere's cognitive style of categorization, often into dual categories, leads it to invent a duplicate or impostor to resolve conflicting information. Delusions result from right hemisphere lesions. But it is the left hemisphere that is deluded.

Left coronary aneurysmal dilation and subaortic stenosis in a dog.

Science.gov (United States)

Hernandez, Juan L; Bélanger, Marie-Claude; Benoit-Biancamano, Marie-Odile; Girard, Christiane; Pibarot, Philippe

2008-06-01

A 6-month-old German shepherd dog was referred for evaluation of a cardiac murmur. Upon physical examination, the auscultated heart rate was 120 beats/min, and a grade IV/VI systolic heart murmur with a point of maximal intensity over the left heart base radiating up the neck was heard. The standard echocardiographic examination showed subaortic stenosis and an anechoic tubular structure extending from the sinus of Valsalva to the left ventricular posterior wall. Aneurysmal left coronary artery (CA) was confirmed by angiography. The dog was euthanized and post-mortem examination showed severe dilatation of the proximal left CA and confirmed the subaortic stenosis. Histopathology did not demonstrate abnormalities in the walls of the CA, aorta or pulmonary artery. The exact cause of the CA aneurysmal dilation remains unknown. Subaortic stenosis, elevated coronary vascular resistance or a congenital anomaly may have contributed to the dilation. To our knowledge, coronary aneurysmal dilation has never been described in dogs. Standard echocardiography provides reliable information on coronary anatomy.

Why Dora Left

DEFF Research Database (Denmark)

Gammelgård, Judy

2017-01-01

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

Normalised radionuclide measures of left ventricular diastolic function

International Nuclear Information System (INIS)

Lee, K.J.; Southee, A.E.; Bautovich, G.J.; Freedman, B.; McLaughlin, A.F.; Rossleigh, M.A.; Hutton, B.F.; Morris, J.G.; Royal Prince Alfred Hospital, Sydney

1989-01-01

Abnormal left ventricular diastolic function is being increasingly recognised in patients with clinical heart failure and normal systolic function. A simple routine radionuclide measure of diastolic function would therefore be useful. To establish, the relationship of peak diastolic filling rate (normalized for either end diastolic volume, stroke volume, or peak systolic emptying rate), and heart rate, age, and left ventricular ejection fraction was studied in 64 subjects with normal cardiovascular systems using routine gated heart pool studies. The peak filling rate when normalized to end diastolic volume correlated significantly with heart rate, age and left ventricular ejection fraction, whereas normalization to stroke volume correlated significantly to heart rate and age but not to left ventricular ejection fraction. Peak filling rate normalized for peak systolic emptying rate correlated with age only. Multiple regression equations were determined for each of the normalized peak filling rates in order to establish normal ranges for each parameter. When using peak filling rate normalized for end diastolic volume or stroke volume, appropriate allowance must be made for heart rate, age and ejection fraction. Peak filling rate normalized to peak ejection rate is a heart rate independent parameter which allows the performance of the patient's ventricle in diastole to be compared with its systolic function. It may be used in patients with normal systolic function to serially follow diastolic function, or if age corrected to screen for diastolic dysfunction. (orig.)

Surgical myocardial revascularization in patients with reduced systolic left ventricular function.

Science.gov (United States)

Bruno, Piergiorgio; Iafrancesco, Mauro; Massetti, Massimo

2018-04-20

Surgical myocardial revascularization in patients with reduced left ventricular function has been a matter of debate for decades. Recently published 10-years extension follow-up of the STICH trial have conclusively demonstrated benefit of surgical myocardial revascularization in patients with significant coronary artery disease and low left ventricular ejection fraction. However, selection of patients for surgery remains challenging as well as decision to perform percutaneous rather than surgical revascularization in this class of patients. New evidence helped to clarify the role of preoperative patients' characteristics as risk factors for surgery and to identify those patients who may benefit the most from surgery. Focus of this review is to review epidemiology, aetiology and pathophysiology of coronary artery disease in patients with reduced left ventricular function, role of viability and results of observational and investigational studies on revascularization in patients with reduced left ventricular function with a particular emphasis on relative indication of coronary artery bypass grafting and percutaneous coronary intervention and the surgical implications of development of ischemic mitral regurgitation or ischemic left ventricular aneurysm.

Image processing of x-ray left ventricular cineangiocardiograms and displays of cardiac functions

International Nuclear Information System (INIS)

Eiho, Shigeru; Yamada, Shigeru; Kuwahara, Michiyoshi

1980-01-01

Cineangiocardiography has been often used as one of the highly helpful techniques to examine the cardiac function. This paper deals with the method of tracing automatically the boundaries of the left ventricle on cineangiocardiograms, the method to evaluate and display various cardiac functions, the method to reconstruct the left ventricular cavity from biplane cineangiocardiograms and the method to display a 3-dimensional shape of the left ventricle reconstructed. Our algorithm of boundary tracing is based on a heuristic search for a local maximum of the changing rate in the gray level of cineangiocardiogram. The boundaries of endocardial margins of the left ventricle on 80 to 120 consecutive frames are automatically traced by our method. By using the detected boundaries of the left ventricle, a lot of quantitative information may be established on the cardiac function. The volume change, the wall motions and the %-shortening are displayed graphically. The motion of the boundary of the left ventricle is displayed on a CRT as a moving picture. The left ventricular cavity is reconstructed from the detected boundaries of the left ventricle on biplane cineangiocardiograms. A reconstructed image can be shown as superimposed lines or halftone planes to produce a 3-dimensional perspective. The %-shortening which shows the contractility of the regional myocardium is displayed on a silhouette of the left ventricle. We can easily recognize the abnormal area of contraction and the level and spread of abnormality from this displayed image. With the use of the system described in this paper, we can grasp the movement of the left ventricle exactly and evaluate the cardiac function quantitatively. (author)

Impact of obstructive sleep apnea and snoring on left ventricular ...

African Journals Online (AJOL)

Background: Systemic hypertension (HTN) and obstructive sleep apnea (OSA) are individually associated with left ventricular structural and functional adaptations. However, little is known about the impact of OSA on the left ventricle in Africans with HTN. Aim: The aim of this study is to determine the association between ...

Independence of intrapericardial right and left ventricular performance in septic pulmonary hypertension

International Nuclear Information System (INIS)

Boeck, J.C.; Eichstaedt, H.; Barker, B.C.; Lewis, F.R.; Lim, A.D.; Pollycove, M.

1990-01-01

To study the effect of septic pulmonary hypertension on right/left ventricular intrapericardial interactions thirteen trauma patients, seven septic and six nonseptic controls, were compared. Ventricular volumes were derived from firstpass or gated equilibrium radionuclide angiocardiography, and related to body surface area. Systemic and pulmonary pressures were measured invasively. Pulmonary arterial pressure was significantly increased in the sepsis group. Although right ventricular end-diastolic volumes were higher in sepsis, left ventricular end-diastolic volumes were not decreased. In terms of intrapericardial right/left ventricular interactions these results indicate that the right and left ventricles operate independently in septic pulmonary hypertension. (orig.) [de

Percutaneous Repair of Postoperative Mitral Regurgitation After Left Ventricular Assist Device Implant.

Science.gov (United States)

Cork, David P; Adamson, Robert; Gollapudi, Raghava; Dembitsky, Walter; Jaski, Brian

2018-02-01

Mitral regurgitation commonly improves after implantation of a left ventricular assist device without concomitant valvular repair owing to the mechanical unloading of the left ventricle. However, the development (or persistence) of significant mitral regurgitation after implantation of a left ventricular assist device is associated with adverse clinical events. We present a case of a left ventricular assist device patient who successfully underwent a percutaneous MitraClip procedure for repair of persistent late postoperative mitral insufficiency with demonstrable clinical and hemodynamic improvement. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Right Versus Left Colon Cancer Biology: Integrating the Consensus Molecular Subtypes.

Science.gov (United States)

Lee, Michael S; Menter, David G; Kopetz, Scott

2017-03-01

Although clinical management of colon cancer generally has not accounted for the primary tumor site, left-sided and right-sided colon cancers harbor different clinical and biologic characteristics. Right-sided colon cancers are more likely to have genome-wide hypermethylation via the CpG island methylator phenotype (CIMP), hypermutated state via microsatellite instability, and BRAF mutation. There are also differential exposures to potential carcinogenic toxins and microbiota in the right and left colon. Gene expression analyses further shed light on distinct biologic subtypes of colorectal cancers (CRCs), with 4 consensus molecular subtypes (CMSs) identified. Importantly, these subtypes are differentially distributed between right- and left-sided CRCs, with greater proportions of the "microsatellite unstable/immune" CMS1 and the "metabolic" CMS3 subtypes found in right-sided colon cancers. This review summarizes important biologic distinctions between right- and left-sided CRCs that likely impact prognosis and may predict for differential responses to biologic therapy. Given the inferior prognosis of stage III-IV right-sided CRCs and emerging data suggesting that anti-epidermal growth factor receptor antibody therapy is associated with worse survival in right-sided stage IV CRCs compared with left-sided cancers, these biologic differences between right- and left-sided CRCs provide critical context and may provide opportunities to personalize therapy. Copyright © 2017 by the National Comprehensive Cancer Network.

Persistent Left Superior Vena Cava Associated with Hemiazygos Vein Draining in It and Absence of Left Brachiocephalic Vein, in a Patient with Congenital Heart Defect

Directory of Open Access Journals (Sweden)

Opincariu Diana

2016-09-01

Full Text Available Persistent left superior vena cava is an anomalous vein that derives from a malfunction of obliteration of the left common cardinal vein during intrauterine life. The diagnosis can be suggested by a dilated coronary sinus as seen in echocardiography, or other imagistic methods. Due to the lack of hemodynamic impairment, and consequently with few or no symptoms, this vascular anomaly is frequently discovered incidentally. In this brief report we present the case of a 35-year-old male known with a complex congenital cardiovascular malformation that included atrial septum defect, persistent left superior vena cava and anomalous right pulmonary vein drainage in the PLSVC, diagnosed with sinoatrial block that required pacemaker implantation. Due to the patient’s medical history, investigations to decide the best approach needed for pacemaker implantation were performed, including a thoracic CT that incidentally found additional anomalies — the hemiazygos vein draining in PLSVC and the lack of the left brachiocephalic vein.

Simultaneous determination of left ventricular perfusion and function

International Nuclear Information System (INIS)

Gremillet, E.; Champailler, A.; Esquerre, J.P.; Ouhayoun, E.; Coca, F.; Furber, A.; Le Jeune, J.J.

1997-01-01

Myocardial perfusion scintigraphy is a very useful tool for the diagnosis and prognosis of coronary artery disease. The evaluation of left ventricular function during stress testing in also very useful to determine the prognosis of coronary artery disease. This chapter highlights three different imaging methods to assess left ventricular function and myocardial perfusion/ The first one consists of sequential dual isotope myocardial SPECT with ECG-gating. The second concerns magnetic resonance imaging and the third explores first pass exercise ventriculography and myocardial perfusion scintigraphy simultaneously evaluated by means of 99m Tc-sestamibi. (authors)

Congenital diaphragmatic hernia with concurrent aplasia of the pericardium in a foal.

Science.gov (United States)

Tăbăran, Alexandru-Flaviu; Nagy, Andras Laszlo; Cătoi, Cornel; Morar, Iancu; Tăbăran, Alexandra; Mihaiu, Marian; Bolfa, Pompei

2015-12-30

In veterinary medicine congenital abnormalities of the diaphragm and pericardium are rare, idiopathic malformations, being reported mainly in dogs. This report documents an unusual case of developmental defects in a foal consisting of diaphragmatic hernia concurrent with pericardial aplasia. Following a normal delivery, a full term, female Friesian stillborn foal with the placenta was presented for necropsy. External morphological examination indicated a normally developed foal. At necropsy, a large oval defect (approximately 20 × 15 cm in size) was observed in the left-dorsal side of the diaphragm (left lumbocostal triangle). This defect allowed the intestinal loops, spleen and partially the liver to translocate into the thorax. The loops of the left ascending colon, including the pelvic flexure and partially the small intestine covered the cranial and dorsal posterior parts of the heart due to the complete absence of the left pericardium. The remaining pericardium presented as a white, semi-transparent strip, partially covering the right side of the heart. The left lung and the main bronchus were severely hypoplastic to approximately one-fifth the size of their right homologue. The intermediate part of the liver, containing mainly the enlarged quadrate lobe was translocated in the thorax, severely enlarged and showed marked fibrosis. Histologically in the herniated lobes we diagnosed hepatic chronic passive congestion, telangiectasia and medial hypertrophy of blood vessels. Concomitant malformation involving diaphragmatic hernia and pericardial aplasia in horses have not been previously reported. Moreover, this is the first case describing pericardial aplasia in horse.

Left-Right Asymmetry of Maturation Rates in Human Embryonic Neural Development.

Science.gov (United States)

de Kovel, Carolien G F; Lisgo, Steven; Karlebach, Guy; Ju, Jia; Cheng, Gang; Fisher, Simon E; Francks, Clyde

2017-08-01

Left-right asymmetry is a fundamental organizing feature of the human brain, and neuropsychiatric disorders such as schizophrenia sometimes involve alterations of brain asymmetry. As early as 8 weeks postconception, the majority of human fetuses move their right arms more than their left arms, but because nerve fiber tracts are still descending from the forebrain at this stage, spinal-muscular asymmetries are likely to play an important developmental role. We used RNA sequencing to measure gene expression levels in the left and right spinal cords, and the left and right hindbrains, of 18 postmortem human embryos aged 4 to 8 weeks postconception. Genes showing embryonic lateralization were tested for an enrichment of signals in genome-wide association data for schizophrenia. The left side of the embryonic spinal cord was found to mature faster than the right side. Both sides transitioned from transcriptional profiles associated with cell division and proliferation at earlier stages to neuronal differentiation and function at later stages, but the two sides were not in synchrony (p = 2.2 E-161). The hindbrain showed a left-right mirrored pattern compared with the spinal cord, consistent with the well-known crossing over of function between these two structures. Genes that showed lateralization in the embryonic spinal cord were enriched for association signals with schizophrenia (p = 4.3 E-05). These are the earliest stage left-right differences of human neural development ever reported. Disruption of the lateralized developmental program may play a role in the genetic susceptibility to schizophrenia. Copyright © 2017 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

A double-chambered left ventricle in a patient with palpitation

International Nuclear Information System (INIS)

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

2005-01-01

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

Primary left ventricular hydatid cyst in a child: case report

International Nuclear Information System (INIS)

Turkvatan, A.; Yelgec, N.S.; Calikoglu, U.; Olcer, T.

2000-01-01

The most common cause of echinococcosis in humans is Echinococcus granulosus. Although hydatid cyst is most frequently localized in liver (more than 65% of cases) and lung (25%) by means of portal and systemic circulation, it may involve other tissues and organs. Cardiac hydatid cysts account for only 0.5%-2% of all hydatid cysts, even in endemic areas. Of all cardiac hydatid cysts, the left ventricle accounts for 60%, right ventricle 10%, pericardium 7%, pulmonary artery 6%, left atrial appendage 6%, and interventricular septum 4%. We report the case of a myocardial hydatid cyst of the left ventricle in a 9-year-old boy. (author)

Primary left ventricular hydatid cyst in a child: case report

Energy Technology Data Exchange (ETDEWEB)

Turkvatan, A. [Turkiye Yuksek Ihtisas Hospital, Dept. of Radiology, Ankara (Turkey); Yelgec, N.S. [Turkiye Yuksek Ihtisas Hospital, Dept. of Cardiology, Ankara (Turkey); Calikoglu, U.; Olcer, T. [Turkiye Yuksek Ihtisas Hospital, Dept. of Radiology, Ankara (Turkey)

2000-12-01

The most common cause of echinococcosis in humans is Echinococcus granulosus. Although hydatid cyst is most frequently localized in liver (more than 65% of cases) and lung (25%) by means of portal and systemic circulation, it may involve other tissues and organs. Cardiac hydatid cysts account for only 0.5%-2% of all hydatid cysts, even in endemic areas. Of all cardiac hydatid cysts, the left ventricle accounts for 60%, right ventricle 10%, pericardium 7%, pulmonary artery 6%, left atrial appendage 6%, and interventricular septum 4%. We report the case of a myocardial hydatid cyst of the left ventricle in a 9-year-old boy. (author)

A case of hypoplasia of left lung with very rare associations with congenital absence of left pulmonary artery and right-sided aortic arch

Directory of Open Access Journals (Sweden)

Trilok Chand

2017-01-01

Full Text Available The absence of one of the pulmonary artery with associated hypoplasia of lung and great vessel abnormality is a rare finding. The incidence of this rare congenital abnormality is around 1 in 200,000 live birth. The absence of the left side pulmonary artery is again uncommon, and associated cardiac malformations are usually tetralogy of fallot or septal defects rather than an aortic arch defect. Our case is a unique case in It’s associated congenital anomalies. He was presented with recurrent pneumothorax and hemoptysis, and on thorough workup, he was diagnosed to have an absence of left pulmonary artery with hypoplasia of the left lung and associated right-sided aortic arch. The patient’s family has declined the surgical option, and he was managed conservatively and kept in close follow-up.

Flank Attacks : Populism and Left-Right Radicalism in Western Europe

NARCIS (Netherlands)

Rooduijn, M.; Akkerman, T.

2017-01-01

How is populism distributed over the political spectrum? Are right-wing parties more populist than left-wing parties? Based on the analysis of 32 parties in five Western European countries between 1989 and 2008, we show that radical parties on both the left and the right are inclined to employ a

Flank attacks : Populism and left-right radicalism in Western Europe

NARCIS (Netherlands)

Rooduijn, Matthijs; Akkerman, Tjitske

2017-01-01

How is populism distributed over the political spectrum? Are right-wing parties more populist than left-wing parties? Based on the analysis of 32 parties in five Western European countries between 1989 and 2008, we show that radical parties on both the left and the right are inclined to employ a

Orthodontic intervention of an impacted upper left central incisor due ...

African Journals Online (AJOL)

A fixed orthodontic appliance was used to facilitate traction and correction of malalignement of the impacted upper left central incisor.Treatment outcome: Successful removal of the odontoma, full exposure of the crown of upper left central incisor and good alignment on the arch were achieved. Crowding on the upper and ...

Congenital bicuspid stenosis with left ventricular hypoplasia in a kitten.

Science.gov (United States)

van Nie, C J; van Messel, M A; Straatman, T J

1980-01-15

Congenital bicuspid stenosis with left ventricular hypoplasia was diagnosed in a kitten. Clinical weakness, dyspnoea and marked cardiomegaly (X rays) were related to postmortem findings. The cardiomegaly had resulted from an enlargement of the left auricular appendage. It is supposed the cardiomegaly developed after the closing of the foramen ovale.

A constrained supersymmetric left-right model

Energy Technology Data Exchange (ETDEWEB)

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

2016-03-02

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

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

Relation between the left ventricular mass and the left coronary artery dimensions as determined by 16-channel multidetector CT: comparison between the normotensive group and the hypertensive group

International Nuclear Information System (INIS)

Kang, Doo Kyung; Park, Kyung Joo; Tahk, Seung Jea; Kim, Sun Yong

2006-01-01

The purpose of this study is to determine the left ventricular mass (LVM) and the left coronary artery dimension and to investigate the relationship between the two values in the normotensive group and hypertensive group with using 16-channel multidetector CT (MDCT). Among the patients who underwent a CT coronary angiogram procedure using 16-channel MDCT at Ajou University Hospital from October 2004 to February 2005, 33 patient became the subjects of this study. These 33 patients showed normal findings without calcification or stenosis of the coronary arteries. The total volume of the left ventricular wall was calculated using work-in-progress cardiac CT reconstruction software. The LVM could then be directly calculated by multiplying the left ventricular muscle volume by the myocardial tissue density, which was assumed to be 1.05 g/cm 3 . The coronary diameter was measured by a fixed threshold method from the transverse reformation images obtained along the long-axis of each coronary artery. We calculated the cross-sectional area (CSA) of the coronary arteries from the equation of π D2/4 (D = diameter). Regression analysis was performed for the relationship between LVM and the left coronary artery dimensions with using a linear least-squares method. Comparison between the normotensive group and the hypertensive group was done using the Student test. The average LVM was 127.9 ± 36.2 g (mean ± standard deviation) and the average left ventricular mass index (LVMI) was 74.7 ± 15.5 g in this study population. The average diameter of the coronary arteries was 4.38 ± 0.69 mm for the left coronary artery. In all the subjects (n = 33, r = 0.67, ρ = 0.000) and the normotensive group (n = 21, r = 0.68, ρ = 0.000), the LVM was significantly correlated with the CSA of the left coronary artery, but not in the hypertensive group (n= 12, r = 0.57, ρ = 0.062). In the hypertensive group, the CSA of the left coronary arteries per 100 g of muscle mass tended to decrease as