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Sample records for left superior longitudinal

  1. The Left Superior Longitudinal Fasciculus within the Primary Sensory Area of Inferior Parietal Lobe Plays a Role in Dysgraphia of Kana Omission within Sentences

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    Nobusada Shinoura

    2012-01-01

    Full Text Available Functional neurological changes after surgery combined with diffusion tensor imaging (DTI tractography can directly provide evidence of anatomical localization of brain function. Using these techniques, a patient with dysgraphia before surgery was analyzed at our hospital in 2011. The patient showed omission of kana within sentences before surgery, which improved after surgery. The brain tumor was relatively small and was located within the primary sensory area (S1 of the inferior parietal lobe (IPL. DTI tractography before surgery revealed compression of the branch of the superior longitudinal fasciculus (SLF by the brain tumor. These results suggest that the left SLF within the S1 of IPL plays a role in the development of dysgraphia of kana omission within sentences.

  2. Visualisation of the left superior intercostal vein in MR

    International Nuclear Information System (INIS)

    Medrea, M.; Meydam, K.; Schmitt, W.

    1987-01-01

    A retrospective study of 56 MRT chest examinations showed the left intercostal vein in its horizontal trajectory in 3 patients with left mediastinal masses compressing the superior vena cava. In 2 patients the posterior trajectory of the horizontal segment was clearly visualised. In the third case the anterior part, namely the insertion of the left superior intercostal vein into the left brachiocephalic trunk, was demonstrated. (orig.) [de

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

    International Nuclear Information System (INIS)

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

    2003-01-01

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

  4. Right superior vena cava draining into the left atrium

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

    2008-08-15

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

  5. High prevalence rate of left superior vena cava determined by ...

    African Journals Online (AJOL)

    Background: Persistent left superior vena cava (LSVC) is one of the common anomalies of the systemic veins. Its prevalence is 0.10.3% in the general population and is more common with congenital heart disease (CHD). The importance of detecting persistent LSVC prior to cardiac surgery is paramount for systemic veins ...

  6. Concomitant Persistent Left Superior Vena Cava and Horseshoe Kidney

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    Faraz Jaffer

    2015-01-01

    Full Text Available Persistent left superior vena cava (PLSVC and horseshoe kidney (HSK are common congenital abnormalities; however presence of both in the same person is extremely rare. A patient with hepatitis C cirrhosis awaiting transplant presented with worsening liver dysfunction, diagnosed with acute renal failure secondary to hepatorenal syndrome, and required X-ray fluoroscopy guided tunneled venous catheter placement for hemodialysis. Review of imaging studies demonstrated coexistence of PLSVC and HSK. PLSVC in adulthood is usually incidental with the most common drainage pattern being without physiologic dysfunction. Isolated horseshoe kidney is still the most common of renal fusion anomalies; however etiology of coexistent PLSVC remains unknown.

  7. Persistent Left Superior Vena Cava in Fetuses: An Autopsy Series.

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    Ramakrishnan, Deepa; Chidambarathanu, Shanthi; Murli, Lata; Micheal, John; Jagadeesh, Sujatha; Suresh, Indrani; Seshadri, Suresh

    2017-08-01

    To review fetal autopsy reports with persistent left superior vena cava (PLSVC) and identify its associations. Autopsy reports of all fetuses diagnosed with PLSVC in our center from January 2011 to December 2015 were reviewed. Fetuses less than 15 weeks gestational age along with autolyzed and damaged hearts were excluded from the study. The study group was compared with controls during this period. Prenatal ultrasound detection rate of PLSVC was 13.06%. All the cases had associated anomalies of which 96% had extra cardiac anomalies and 67% had intrinsic cardiac defects among which septal defects were most common (39.6%). Anomalies of cardiovascular, respiratory, genitourinary and musculoskeletal, hypoplastic thymus and single umbilical artery were significantly higher in the study group. This study emphasizes on the importance of improving the technical skill for imaging the three-vessel view as PLSVC seems to have significant associations.

  8. Implantation of a Resynchronization Implantable Cardioverter Defibrillator in a Patient with Persistent Left Superior Vena Cava

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    Dante Antonelli

    2007-10-01

    Full Text Available Implantation of resynchronization implantable cardioverter defibrillator was performed in a patient with persistent left superior vena cava. A dual coil defibrillation lead was inserted in the right ventricle apex via a small innominate vein. Left ventricular and atrial leads were implanted through persistent left superior vena cava. Left ventricular lead was easily implanted into the postero lateral vein. Pacing thresholds and sensing values were excellent and remained stable at 18 months follow-up. Presence of persistent left superior vena cava generally makes transvenous lead implantation difficult. However when a favorable coronary sinus anatomy is also present, it may facilitate left ventricular lead positioning in the coronary sinus branches.

  9. Widening of mediastinum with persistent left superior Vena cava - CT diagnosis

    International Nuclear Information System (INIS)

    Neuwirth, J.; Kolar, J.

    1992-01-01

    Described in this paper are radiographic findings recorded from a case of persistent left superior vena cava which grew manifest by widening of the left contour of the upper mediastinal region. Contrast-enhanced computed tomography (CT) was undertaken to clear up suspicion of mediastinal tumour and revealed double superior vena cava. The diagnosis was then confirmed by digital subtraction venography. (orig.) [de

  10. Persistent left superior vena cava leads to catheter malposition during PICC Port placement.

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    Konstantinou, Evangelos A; Mariolis Sapsakos, Theodoros D; Katsoulas, Theodoros A; Velecheris, Dimitrios; Tsitsimelis, Dimitrios; Bonatsos, Gerasimos

    2016-03-09

    We present a case of peripherally inserted central catheter (PICC) port placement where the catheter had been malpositioned to the persistent left superior vena cava. Despite the obvious elevation of the P-wave signaling proximity of the catheter tip to the sinus node, the catheter was not in the desired location within the superior vena cava or the right atrium, because of the presence of a persistent left superior vena cava. Computed tomography was used in order to locate the catheter. The catheter was located in the persistent left superior vena cava. Malpositioning of the catheter in the persistent left superior vena cava occurs in 0.3%-0.5% of patients. The catheter was subsequently removed.

  11. a case of persistent left superior vena cava detected by post-contrast CT scan

    International Nuclear Information System (INIS)

    Sasaki, Fumio; Koga, Sukehiko; Takeuchi, Akira; Hattori, Yoshinobu; Ino, Akio

    1983-01-01

    A case of persistent left superior vena cava and large anastomosis between double superior vena cava was incidentally detected by post-contrast CT scans. This abnormal vein did not connect to the right atrium via coronary sinus. The usefulness for the diagnosis of post-contrast CT scans and RI venography should be emphasized. (author)

  12. Superior Temporal Gyrus Volume Abnormalities and Thought Disorder in Left-Handed Schizophrenic Men

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    Holinger, Dorothy P.; Shenton, Martha E.; Wible, Cynthia G.; Donnino, Robert; Kikinis, Ron; Jolesz, Ferenc A.; McCarley, Robert W.

    2010-01-01

    Objective Studies of schizophrenia have not clearly defined handedness as a differentiating variable. Moreover, the relationship between thought disorder and anatomical anomalies has not been studied extensively in left-handed schizophrenic men. The twofold purpose of this study was to investigate gray matter volumes in the superior temporal gyrus of the temporal lobe (left and right hemispheres) in left-handed schizophrenic men and left-handed comparison men, in order to determine whether thought disorder in the left-handed schizophrenic men correlated with tissue volume abnormalities. Method Left-handed male patients (N=8) with DSM-III-R diagnoses of schizophrenia were compared with left-handed comparison men (N=10) matched for age, socioeconomic status, and IQ. Magnetic resonance imaging (MRI) with a 1.5-T magnet was used to obtain scans, which consisted of contiguous 1.5-mm slices of the whole brain. MRI analyses (as previously defined by the authors) included the anterior, posterior, and total superior temporal gyrus in both the left and right hemispheres. Results There were three significant findings regarding the left-handed schizophrenic men: 1) bilaterally smaller gray matter volumes in the posterior superior temporal gyrus (16% smaller on the right, 15% smaller on the left); 2) a smaller volume on the right side of the total superior temporal gyrus; and 3) a positive correlation between thought disorder and tissue volume in the right anterior superior temporal gyrus. Conclusions These results suggest that expression of brain pathology differs between left-handed and right-handed schizophrenic men and that the pathology is related to cognitive disturbance. PMID:10553736

  13. Multi-site multi-polar left ventricular pacing through persistent left superior vena cava in tricuspid valve disease

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    Ernest W. Lau

    2017-09-01

    Full Text Available Multi-site multi-polar left ventricular pacing through the coronary sinus (CS may be preferred over endocardial right ventricular or surgical epicardial pacing in the presence of tricuspid valve disease. However, the required lead placement can be difficult through a persistent left superior vena cava (PLSVC, as the CS tends to be hugely dilated and side branches tend to have sharp angulations (>90° when approached from the PLSVC. Pre-shaped angiography catheters and techniques used for finding venous grafts from the ascending aorta post coronary bypass surgery may help with lead placement in such a situation.

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

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    Samarjit Bisoyi

    2017-01-01

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

  15. Stenting of the Superior Vena Cava and Left Brachiocephalic Vein with Preserving the Central Venous Catheter in Situ

    International Nuclear Information System (INIS)

    Isfort, Peter; Penzkofer, Tobias; Goerg, Fabian; Mahnken, Andreas H.

    2011-01-01

    Stenting of the central veins is well established for treating localized venous stenosis. The techniques regarding catheter preservation for central venous catheters in the superior vena cava have been described. We describe here a method for stent implantation in the superior vena cava and the left brachiocephalic vein, and principally via a single jugular venous puncture, while saving a left sided jugular central venous catheter in a patient suffering from central venous stenosis of the superior vena cava and the left brachiocephalic vein.

  16. MR image analysis: Longitudinal cardiac motion influences left ventricular measurements

    International Nuclear Information System (INIS)

    Berkovic, Patrick; Hemmink, Maarten; Parizel, Paul M.; Vrints, Christiaan J.; Paelinck, Bernard P.

    2010-01-01

    Background: Software for the analysis of left ventricular (LV) volumes and mass using border detection in short-axis images only, is hampered by through-plane cardiac motion. Therefore we aimed to evaluate software that involves longitudinal cardiac motion. Methods: Twenty-three consecutive patients underwent 1.5-Tesla cine magnetic resonance (MR) imaging of the entire heart in the long-axis and short-axis orientation with breath-hold steady-state free precession imaging. Offline analysis was performed using software that uses short-axis images (Medis MASS) and software that includes two-chamber and four-chamber images to involve longitudinal LV expansion and shortening (CAAS-MRV). Intraobserver and interobserver reproducibility was assessed by using Bland-Altman analysis. Results: Compared with MASS software, CAAS-MRV resulted in significantly smaller end-diastolic (156 ± 48 ml versus 167 ± 52 ml, p = 0.001) and end-systolic LV volumes (79 ± 48 ml versus 94 ± 52 ml, p < 0.001). In addition, CAAS-MRV resulted in higher LV ejection fraction (52 ± 14% versus 46 ± 13%, p < 0.001) and calculated LV mass (154 ± 52 g versus 142 ± 52 g, p = 0.004). Intraobserver and interobserver limits of agreement were similar for both methods. Conclusion: MR analysis of LV volumes and mass involving long-axis LV motion is a highly reproducible method, resulting in smaller LV volumes, higher ejection fraction and calculated LV mass.

  17. [Persistence of left superior vena cava associated to esophageal atresia: presentation of 5 cases].

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    Knoblich, Maria; Silva, Aline Vaz; Ladeira, Catarina; Carmo, Sara; Murinello, Rafaela; Casella, Paolo

    2014-01-01

    Esophageal atresia is known to be associated with a variety of additional congenital anomalies in multiple organ systems. Persistent left superior vena cava is one of the most common venous thoracic anomaly, occurring in about 0,3% of the population. The aim of this study was to characterize persistent left superior vena cava in infants treated in Hospital Dona Estefânia with esophageal atresia. A retrospective review of all children treated for esophageal atresia from January 2002 to December 2013 was undertaken. Charts were reviewed for gestational age, weight, type of atresia, preoperative echocardiogram, associated anomalies, surgical approach, eventual postoperative echocardiogram and angioresonance for the study of congenital venous anomaly. Of 107 children, five had persistent left superior vena cava. Of the five cases, one had prenatal diagnosis. Further investigation showed duodenal atresia in one, urologic malformation, coloboma and bilateral ear deformities in other. All five patients were operated on through right thoracotomy and primary anastomosis was performed after ligation of the trachea-esophageal fistula and underwent angioresonance to characterize the vascular anomaly. No operative or post-operative complications were registered. Inspite of the preoperative workup, the anomaly was only identified in one of the patients. Generally, diagnosis of PLSVC is incidentally found during routine left-sided central venous catheterizations. It is essential to characterize the pattern of cardiac venous return that places those patients at a risk for paradoxical embolic complications to the arterial system.

  18. Comparison of superior septal approach with left atriotomy in mitral valve surgery

    OpenAIRE

    Aydin, Ebuzer; Arslan, Akin; Ozkokeli, Mehmet

    2014-01-01

    Objective: In this study, we aimed to compare clinical outcomes of superior transseptal approach with the conventional left atriotomy in patients undergoing mitral valve surgery. Methods: Between January 2010 and November 2012, a total of 91 consecutive adult patients (39 males, 52 females; mean age: 54.0±15.4 years; range, 16 to 82 years) who underwent mitral valve surgery in the Division of Cardiovascular Surgery at Koşuyolu Training Hospital were included. The patients were randomized ...

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

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    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.

  20. Veia cava superior esquerda anômala com ausência de veia cava superior direita: achados de imagem Persistent left superior vena cava with absent right superior vena cava: image findings

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    Cyrillo Rodrigues de Araújo Júnior

    2003-10-01

    Full Text Available A persistência da veia cava superior esquerda com ausência da veia cava superior direita é uma anomalia rara, com menos de 150 casos descritos na literatura. A não-obliteração e regressão da veia cardinal anterior esquerda durante o desenvolvimento embriológico promove uma variação sistêmica de retorno venoso ao coração, com persistência da veia cava superior esquerda. Sua incidência varia de 0,3% em pacientes sem alterações cardíacas congênitas concomitantes a 4,3% naqueles com cardiopatias. Na maioria das vezes coexiste a veia cava superior direita, porém se houver regressão e degeneração da veia cardinal anterior direita, implicará a sua ausência e a drenagem venosa para o coração será feita pela veia cava superior esquerda ao átrio direito, através do seio coronariano. Mostramos um caso de um paciente submetido a radiografia de tórax e tomografia computadorizada para avaliação de doença pulmonar obstrutiva crônica, tendo como achado a persistência da veia cava superior esquerda com ausência da direita, sem qualquer cardiopatia associada e com a drenagem cardíaca sendo feita, através do seio coronariano, para o átrio direito.Persistent left superior vena cava with absent right superior vena cava is a rare anomaly, with less than 150 cases reported in the literature. Congenitally persistent left superior vena cava is the most common variant of systemic venous return to the heart, resulting embryologically from failure of the left anterior cardinal vein to become obliterated. Its incidence varies from 0.3% in patients with otherwise normal heart to 4.3% in patients with congenital heart disease. In the majority of the patients, a right superior vena cava is present as well, but rarely the right anterior cardinal vein degenerates resulting in the absence of the normal right superior vena cava. The blood from the right side is carried by the persistent left superior vena cava to the right atrium through the

  1. Combined Double Sleeve Lobectomy and Superior Vena Cava Resection for Non-small Cell Lung Cancer with Persistent Left Superior Vena Cava

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    Daxing ZHU

    2015-11-01

    Full Text Available A 65-year-old man with right central type of lung squamous carcinoma was admitted to our department. Bronchoscopy displayed complete obstruction of right upper lobe bronchus and infiltration of the bronchus intermedius with tumor. Chest contrast computed tomography revealed the tumor invaded right pulmonary artery, superior vena cava, and the persistant left superior vena cava flowed into the coronary sinus. The tumor was successfully removed by means of bronchial and pulmonary artery sleeve resection of the right upper and middle lobes combined with resection and reconstruction of superior vena cava (SVC utilizing ringed polytetrafluoroethylene graft. To the best of our knowledge, this was the first report of complete resection of locally advanced lung cancer involving superior vena cava, right pulmonary artery trunk and main bronchus with persistant left superior vena cava.

  2. Activation of the left superior temporal gyrus of musicians by music-derived sounds.

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    Matsui, Toshie; Tanaka, Satomi; Kazai, Koji; Tsuzaki, Minoru; Katayose, Haruhiro

    2013-01-09

    Previous studies have suggested that professional musicians comprehend features of music-derived sound even if the sound sequence lacks the traditional temporal structure of music. We tested this hypothesis through behavioral and functional brain imaging experiments. Musicians were better than nonmusicians at identifying scrambled pieces of piano music in which the original temporal structure had been destroyed. Bilateral superior temporal gyri (STG) activity was observed while musicians listened to the scrambled stimuli, whereas this activity was present only in the right STG of nonmusicians under the same experimental conditions. We suggest that left STG activation is related to the processing of deviants, which appears to be enhanced in musicians. This may be because of the superior knowledge of musical temporal structure held by this population.

  3. Superior vena caval syndrome caused by the tumor of the left hilum in a patient with unilateral persistent left superior vena cava diagnosed with multislice spiral computed tomography-a case report

    International Nuclear Information System (INIS)

    Czekajska-Chehab, E.; Uhlig, S.; Staskiewicz, G.; Drop, A.

    2007-01-01

    Unilateral persistent left superior vena cava (PLSVC) is an infrequent finding with incidence of 18-20% among the individuals with PLSVC. The persistence of the left-sided superior vena cava is an effect of disturbances in development of the connection between the precardinal veins (anterior cardinal veins) and formation of the sinus venosus in early stages of embryogenesis. The paper presents a case of a 62-year-old patient with a mass lesion of the left hilum, which caused left-sided superior vena caval syndrome in the presence of unilateral SVC. Developmental mechanisms of superior vena caval syndrome are discussed. The evolution of changes related to infiltration and occlusion of PLSVC is shown on the basis of three selected MSCT examinations. (author)

  4. The cristal (right superior septal) coronary artery and its relationship to anomalous left coronary origin.

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    Partridge, J B; Ridley, L J

    2011-10-01

    The cristal artery is an occasional finding, being visible in around 3% of coronary angiograms, arising from the proximal right coronary artery (RCA) and passing downwards and forwards through the muscle of the crista superventricularis. It supplies a variable volume of the superior interventricular septum, and can contribute to collateralization of the other septal vessels. When part or all of the left coronary artery (LCA) arises anomalously from the right coronary sinus, its passage to the left may be in the same pathway as a cristal artery, bearing a tell-tale septal vessel arising from its proximal segment. This helps to differentiate it from one that has a higher pathway, running between the great vessels, and which may have a greater correlation with sudden cardiac death. Copyright © 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  5. The cristal (right superior septal) coronary artery and its relationship to anomalous left coronary origin

    International Nuclear Information System (INIS)

    Partridge, J.B.; Ridley, L.J.

    2011-01-01

    The cristal artery is an occasional finding, being visible in around 3% of coronary angiograms, arising from the proximal right coronary artery (RCA) and passing downwards and forwards through the muscle of the crista superventricularis. It supplies a variable volume of the superior interventricular septum, and can contribute to collateralization of the other septal vessels. When part or all of the left coronary artery (LCA) arises anomalously from the right coronary sinus, its passage to the left may be in the same pathway as a cristal artery, bearing a tell-tale septal vessel arising from its proximal segment. This helps to differentiate it from one that has a higher pathway, running between the great vessels, and which may have a greater correlation with sudden cardiac death.

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

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    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.

  7. Genetic underpinnings of left superior temporal gyrus thickness in patients with schizophrenia.

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    Wolthusen, Rick P F; Hass, Johanna; Walton, Esther; Turner, Jessica A; Rössner, Veit; Sponheim, Scott R; Ho, Beng-Choon; Holt, Daphne J; Gollub, Randy L; Calhoun, Vince; Ehrlich, Stefan

    2015-08-07

    Schizophrenia is a highly disabling psychiatric disorder with a heterogeneous phenotypic appearance. We aimed to further the understanding of some of the underlying genetics of schizophrenia, using left superior temporal gyrus (STG) grey matter thickness reduction as an endophenoptype in a genome-wide association (GWA) study. Structural magnetic resonance imaging (MRI) and genetic data of the Mind Clinical Imaging Consortium (MCIC) study of schizophrenia were used to analyse the interaction effects between 1,067,955 single nucleotide polymorphisms (SNPs) and disease status on left STG thickness in 126 healthy controls and 113 patients with schizophrenia. We next used a pathway approach to detect underlying pathophysiological pathways that may be related to schizophrenia. No SNP by diagnosis interaction effect reached genome-wide significance (5 × 10 -8 ) in our GWA study, but 10 SNPs reached P-values less than 10 -6 . The most prominent pathways included those involved in insulin, calcium, PI3K-Akt and MAPK signalling. Our strongest findings in the GWA study and pathway analysis point towards an involvement of glucose metabolism in left STG thickness reduction in patients with schizophrenia only. These results are in line with recently published studies, which showed an increased prevalence of psychosis among patients with metabolic syndrome-related illnesses including diabetes.

  8. 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

  9. 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

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    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.

  10. Left Superior Temporal Gyrus Is Coupled to Attended Speech in a Cocktail-Party Auditory Scene.

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    Vander Ghinst, Marc; Bourguignon, Mathieu; Op de Beeck, Marc; Wens, Vincent; Marty, Brice; Hassid, Sergio; Choufani, Georges; Jousmäki, Veikko; Hari, Riitta; Van Bogaert, Patrick; Goldman, Serge; De Tiège, Xavier

    2016-02-03

    Using a continuous listening task, we evaluated the coupling between the listener's cortical activity and the temporal envelopes of different sounds in a multitalker auditory scene using magnetoencephalography and corticovocal coherence analysis. Neuromagnetic signals were recorded from 20 right-handed healthy adult humans who listened to five different recorded stories (attended speech streams), one without any multitalker background (No noise) and four mixed with a "cocktail party" multitalker background noise at four signal-to-noise ratios (5, 0, -5, and -10 dB) to produce speech-in-noise mixtures, here referred to as Global scene. Coherence analysis revealed that the modulations of the attended speech stream, presented without multitalker background, were coupled at ∼0.5 Hz to the activity of both superior temporal gyri, whereas the modulations at 4-8 Hz were coupled to the activity of the right supratemporal auditory cortex. In cocktail party conditions, with the multitalker background noise, the coupling was at both frequencies stronger for the attended speech stream than for the unattended Multitalker background. The coupling strengths decreased as the Multitalker background increased. During the cocktail party conditions, the ∼0.5 Hz coupling became left-hemisphere dominant, compared with bilateral coupling without the multitalker background, whereas the 4-8 Hz coupling remained right-hemisphere lateralized in both conditions. The brain activity was not coupled to the multitalker background or to its individual talkers. The results highlight the key role of listener's left superior temporal gyri in extracting the slow ∼0.5 Hz modulations, likely reflecting the attended speech stream within a multitalker auditory scene. When people listen to one person in a "cocktail party," their auditory cortex mainly follows the attended speech stream rather than the entire auditory scene. However, how the brain extracts the attended speech stream from the whole

  11. Persistent left superior vena cava: an overlooked feature of CHARGE syndrome?

    Directory of Open Access Journals (Sweden)

    Paula Goldenberg

    2015-12-01

    Full Text Available CHARGE is a well-characterized syndrome (OMIM 2148400 associated with multiple congenital anomalies including cardiovascular malformations. Mutations in CHD7 are the most common cause of CHARGE syndrome. Persistent left superior vena cava (LSVC has been described in patients with CHARGE syndrome in one study of LSVC associations. A retrospective chart review was conducted for all patients with CHARGE syndrome, diagnosed by Blake criterion features and/or the presence of a pathogenic CHD7 mutation. Echocardio - grams were performed on a clinical basis for all patients and were systematically reviewed and classified. Persistent LSVC was present in 50% of patients with CHARGE syndrome (4/8 and was seen in 3 out of 33 patients seen by cardiovascular genetics with 22q11.2 deletion syndrome. Persistent LSVC is a common finding in patients with CHARGE syndrome and its presence may increase the index of suspicion in patients with other characteristic congenital anomalies.

  12. Graded representations of emotional expressions in the left superior temporal sulcus

    Directory of Open Access Journals (Sweden)

    Christopher P Said

    2010-03-01

    Full Text Available Perceptual categorization is a fundamental cognitive process that gives meaning to an often graded sensory environment. Previous research has subdivided the visual pathway into posterior regions that processes the physical properties of a stimulus, and frontal regions that process more abstract properties such as category information. The superior temporal sulcus (STS is known to be involved in face and emotion perception, but the nature of its processing remains unknown. Here, we used targeted fMRI measurements of the STS to investigate whether its representations of facial expressions are categorical or noncategorical. Multivoxel pattern analysis showed that even though subjects were performing a categorization task, the left STS contained graded, noncategorical representations. In the right STS, representations showed evidence for both stimulus-related gradations and a categorical boundary.

  13. Language development at 2 years is correlated to brain microstructure in the left superior temporal gyrus at term equivalent age: a diffusion tensor imaging study.

    Science.gov (United States)

    Aeby, Alec; De Tiège, Xavier; Creuzil, Marylise; David, Philippe; Balériaux, Danielle; Van Overmeire, Bart; Metens, Thierry; Van Bogaert, Patrick

    2013-09-01

    This study aims at testing the hypothesis that neurodevelopmental abilities at age 2 years are related with local brain microstructure of preterm infants at term equivalent age. Forty-one preterm infants underwent brain MRI with diffusion tensor imaging sequences to measure mean diffusivity (MD), fractional anisotropy (FA), longitudinal and transverse diffusivity (λ// and λ[perpendicular]) at term equivalent age. Neurodevelopment was assessed at 2 years corrected age using the Bayley III scale. A voxel-based analysis approach, statistical parametric mapping (SPM8), was used to correlate changes of the Bayley III scores with the regional distribution of MD, FA, λ// and λ[perpendicular]. We found that language abilities are negatively correlated to MD, λ// and λ[perpendicular] in the left superior temporal gyrus in preterm infants. These findings suggest that higher MD, λ// and λ[perpendicular] values at term-equivalent age in the left superior temporal gyrus are associated with poorer language scores in later childhood. Consequently, it highlights the key role of the left superior temporal gyrus for the development of language abilities in children. Further studies are needed to assess on an individual basis and on the long term the prognostic value of brain DTI at term equivalent age for the development of language. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Prediction of all-cause mortality and heart failure admissions from global left ventricular longitudinal strain in patients with acute myocardial infarction and preserved left ventricular ejection fraction

    DEFF Research Database (Denmark)

    Ersbøll, Mads; Valeur, Nana; Mogensen, Ulrik Madvig

    2013-01-01

    This study sought to test the hypothesis that semiautomated calculation of left ventricular global longitudinal strain (GLS) can identify high-risk subjects among patients with myocardial infarctions (MIs) with left ventricular ejection fractions (LVEFs) >40%....

  15. 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.

  16. Left ventricular global longitudinal strain in acute myocardial infarction

    DEFF Research Database (Denmark)

    Ersbøll, Mads

    Systolic dysfunction, clinical heart failure and elevated levels of neurohormonal peptides are major predictors of adverse outcome after acute myocardial infarction (MI). In the present thesis we evaluated global longitudinal strain (GLS) in patients with acute MI in relation to neurohormonal...

  17. The prognostic value of left atrial peak reservoir strain in acute myocardial infarction is dependent on left ventricular longitudinal function and left atrial size

    DEFF Research Database (Denmark)

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

    2013-01-01

    BACKGROUND: Peak atrial longitudinal strain (PALS) during the reservoir phase has been proposed as a measure of left atrium function in a range of cardiac conditions, with the potential for added pathophysiological insight and prognostic value. However, no studies have assessed the interrelation ...

  18. 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

    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 ...

  19. Left ventricular global longitudinal strain in acute myocardial infarction

    DEFF Research Database (Denmark)

    Ersbøll, Mads

    Systolic dysfunction, clinical heart failure and elevated levels of neurohormonal peptides are major predictors of adverse outcome after acute myocardial infarction (MI). In the present thesis we evaluated global longitudinal strain (GLS) in patients with acute MI in relation to neurohormonal act...... activation, in-hospital heart failure and prognosis with specific attention to the group of patients with preserved LVEF that currently do not meet the criteria for anti remodeling therapies.......Systolic dysfunction, clinical heart failure and elevated levels of neurohormonal peptides are major predictors of adverse outcome after acute myocardial infarction (MI). In the present thesis we evaluated global longitudinal strain (GLS) in patients with acute MI in relation to neurohormonal...

  20. Persistencia de la vena cava superior izquierda: Diagnóstico e importancia prenatal Persistency of the left superior caval vein: Diagnosis and its prenatal importance

    Directory of Open Access Journals (Sweden)

    Juan F Jaramillo

    2010-04-01

    Full Text Available Durante un ultrasonido obstétrico de rutina se deben realizar ciertos planos del corazón en los cuales no es complejo identificar un grupo de anomalías como la persistencia de la vena cava superior izquierda. Cuando se identifica una vena cava superior izquierda aislada, sin otras anomalías del corazón fetal, no existe ninguna repercusión perinatal. Su importancia radica en que un grupo considerable de estos casos se acompaña de cardiopatías congénitas y anomalías anatómicas y cromosómicas. En este artículo se describen nueve casos de vena cava superior izquierda persistente, al igual que las anomalías del corazón asociadas, como también las alteraciones extracardiacas encontradas.Certain heart fetal planes must be realized during a routine obstetric ultrasound in order to identify a group of anomalies such as the persistency of the left superior caval vein. When an isolated left superior venal vein is identified without any other anomaly of the fetal heart, it does not have any perinatal repercussion. Its importance lies in the fact that a considerable number of these cases are associated with a high incidence of congenital heart diseases and anatomic and chromosomal abnormalities. This article reports nine cases of persistency of the left superior caval vein as well as the associated heart abnormalities and the extra-cardiac alterations found.

  1. Prenatal Diagnosis of Persistent Left Superior Vena Cava and its Clinical Significance

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    Aytül Çorbacıoğlu Esmer

    2014-03-01

    Full Text Available Background: Persistent left superior vena cava (PLSVC is a variant of systemic venous return which is observed in 0.3% of autopsies in the general population and in 4-8% of patients with congenital heart disease. Aims: To evaluate associated cardiac, extracardiac and chromosomal anomalies in prenatally diagnosed cases of PLSVC and to review their outcome. Study Design: Retrospective comparative study. Methods: The data of patients with a prenatal diagnosis of PLSVC between May 2008 and January 2013 were reviewed retrospectively. Results: Data of 31 cases were reviewed. Fifteen (48.4% cases were associated with cardiac defects and 17 (54.8% cases had associated extracardiac sonographic or postpartum findings. Two fetuses had karyotype anomalies. Outcome was significantly more favorable in cases not associated with cardiac defects in comparison to those associated with cardiac anomalies (84.6% vs. 33.3%, p=0.009. All cases with isolated PLSVC survived, while among the cases associated with extracardiac anomalies, with cardiac anomalies and with both extracardiac and cardiac anomalies, the survival rate was 75%, 50% and 22.2%, respectively. The most frequent group of cardiac anomalies associated with PLSVC was septal defects and VSD was the most common heart defect individually, being observed in nine fetuses. Conclusion: Prenatally diagnosed PLSVC is associated with cardiac and extracardiac anomalies in the majority of cases. Outcome is significantly worse if PLSVC is associated with a cardiac defect, and the prognosis is excellent in isolated cases.

  2. Superior transseptal approach to mitral valve is associated with a higher need for pacemaker implantation than the left atrial approach

    DEFF Research Database (Denmark)

    Lukac, Peter; Hjortdal, Vibeke E; Pedersen, Anders K

    2006-01-01

    retrospectively evaluated. The surgeons used either the superior transseptal (group A) or left atrial approach (group B). The risk of pacemaker implantation associated with the superior transseptal approach as compared with the left atrial approach was estimated using the multivariate Cox regression analysis...... to adjust for possible confounders. RESULTS: We included 577 patients, 150 in group A and 427 in group B. Forty-four patients had a pacemaker implanted after the surgery; 17 in group A and 27 in group B (p = 0.010). The superior transseptal approach was an independent risk factor of pacemaker implantation...... in multivariate analysis (hazard ratio 2.2 [1.2 to 4.1], p = 0.014). Nineteen patients had a pacemaker implanted because of sinus node dysfunction; 9 in group A and 10 in group B (p = 0.017). Group A was an independent predictor of pacemaker implantation because of sinus node dysfunction in bivariate analyses...

  3. Superior vena cava syndrome associated with right-to left shunt through systemic-to-pulmonary venous collaterals

    International Nuclear Information System (INIS)

    Juan, Yu Hsiang; Saboo, Sachin S.; Anand, Vishal; Chatzizisis, Yiannis S.; Steigner, Michael L.; Lin, Yu Ching

    2014-01-01

    Superior vena cava (SVC) obstruction is associated with the gradual development of venous collaterals. We present a rare form of systemic-to-pulmonary subpleural collateral pathway that developed in the bridging subpleural pulmonary veins in a 54-year-old woman with complete SVC obstruction. This uncommon collateral pathway represents a rare form of acquired right-to-left shunt due to previous pleural adhesions with an increased risk of stroke due to right-to-left venous shunting, which requires lifelong anticoagulation.

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

    Directory of Open Access Journals (Sweden)

    Nagaraja Moorthy

    2013-09-01

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

  5. RIGHT-SIDED AORTIC ARCH WITH ABERRANT LEFT SUBCLAVIAN ARTERY AND DUPLICATION OF SUPERIOR VENA CAVA

    Directory of Open Access Journals (Sweden)

    Parikhita Hazarika

    2017-08-01

    Full Text Available Right-sided aortic arch is a rare anatomical variant present in about 0.1% of the adult population.1,2 Half of the cases are associated with an aberrant left subclavian artery (0.05%-0.1%. Right-sided aortic arch with aberrant left subclavian artery is less common than left-sided aortic arch with aberrant right subclavian artery (0.5-2.0%.3,4 A rightsided aortic arch is an anatomic variant resulting from persistence of the right fourth aortic arch and involution of the left. It can be associated with an aberrant left subclavian artery arises from Kommerell’s diverticulum. It is usually asymptomatic and diagnosed incidentally during adult age. A 40-year-old male presented with cough and a hump in the back. The patient was evaluated for scoliosis and plain CT thorax was done.

  6. Language, aging, and cognition: frontal aslant tract and superior longitudinal fasciculus contribute toward working memory performance in older adults.

    Science.gov (United States)

    Rizio, Avery A; Diaz, Michele T

    2016-06-15

    Previous research has documented change in white matter tract integrity with increasing age. Both interhemispheric and intrahemispheric tracts that underlie language processing are susceptible to these age-related changes. The aim of the current study was to explore age and white matter integrity in language-related tracts as predictors of cognitive task performance in younger and older adults. To this end, we carried out principal component analyses of white matter tracts and confirmatory factor analysis of neuropsychological measures. We next carried out a series of regression analyses that used white matter components to predict scores on each of the neuropsychological components. For both younger and older adults, age was a significant predictor of processing speed and working memory. However, white matter integrity did not contribute independently toward these models. In older adults only, both age and a white matter component that included the bilateral frontal aslant tract and left superior longitudinal fasciculus were significant predictors of working memory. Taken together, these results extend our understanding of the contributions of language-related white matter structure to cognitive processing and highlight the effects of age-related differences in both frontal and dorsal tracts.

  7. Feasibility and reference values of left atrial longitudinal strain imaging by two-dimensional speckle tracking

    Directory of Open Access Journals (Sweden)

    Lisi Matteo

    2009-02-01

    Full Text Available Abstract Background The role of speckle tracking in the assessment of left atrial (LA deformation dynamics is not established. We sought to determine the feasibility and reference ranges of LA longitudinal strain indices measured by speckle tracking in a population of normal subjects. Methods In 60 healthy individuals, peak atrial longitudinal strain (PALS and time to peak longitudinal strain (TPLS were measured using a 12-segment model for the left atrium. Values were obtained by averaging all segments (global PALS and TPLS and by separately averaging segments measured in the two apical views (4- and 2-chamber average PALS and TPLS. Results Adequate tracking quality was achieved in 97% of segments analyzed. Inter and intra-observer variability coefficients of measurements ranged between 2.9% and 5.4%. Global PALS was 42.2 ± 6.1% (5–95° percentile range 32.2–53.2%, and global TPLS was 368 ± 30 ms (5–95° percentile range 323–430 ms. The 2-chamber average PALS was slightly higher than the 4-chamber average PALS (44.3 ± 6.0% vs 40.1 ± 7.9%, p Conclusion Speckle tracking is a feasible technique for the assessment of longitudinal myocardial LA deformation. Reference ranges of strain indices were reported.

  8. Atrial fibrillation per se was a major determinant of global left ventricular longitudinal systolic strain.

    Science.gov (United States)

    Lee, Hung-Hao; Lee, Meng-Kuang; Lee, Wen-Hsien; Hsu, Po-Chao; Chu, Chun-Yuan; Lee, Chee-Siong; Lin, Tsung-Hsien; Voon, Wen-Chol; Lai, Wen-Ter; Sheu, Sheng-Hsiung; Su, Ho-Ming

    2016-06-01

    Atrial fibrillation (AF) may cause systolic abnormality via inadequate diastolic filling and tachycardia-induced cardiomyopathy. Global longitudinal strain (GLS) is a very sensitive method for detecting subtle left ventricular systolic dysfunction. Hence, this study aimed to evaluate whether AF patients had a more impaired GLS, AF was a major determinant of GLS, and determine the major correlates of GLS in AF patients.The study included 137 patients with persistent AF and left ventricular ejection fraction (LVEF) above 50% and 137 non-AF patients matched according to age, gender, and LVEF. Comprehensive echocardiography with GLS assessment was performed for all cases.Compared with non-AF patients, AF patients had a more impaired GLS, a larger left atrial volume index, higher transmitral E wave velocity (E), and early diastolic mitral velocity (Ea) (all P determinant of GLS even after adjustment for relevant clinical and echocardiographic parameters.

  9. You talkin' to me? Communicative talker gaze activates left-lateralized superior temporal cortex during perception of degraded speech.

    Science.gov (United States)

    McGettigan, Carolyn; Jasmin, Kyle; Eisner, Frank; Agnew, Zarinah K; Josephs, Oliver J; Calder, Andrew J; Jessop, Rosemary; Lawson, Rebecca P; Spielmann, Mona; Scott, Sophie K

    2017-06-01

    Neuroimaging studies of speech perception have consistently indicated a left-hemisphere dominance in the temporal lobes' responses to intelligible auditory speech signals (McGettigan and Scott, 2012). However, there are important communicative cues that cannot be extracted from auditory signals alone, including the direction of the talker's gaze. Previous work has implicated the superior temporal cortices in processing gaze direction, with evidence for predominantly right-lateralized responses (Carlin & Calder, 2013). The aim of the current study was to investigate whether the lateralization of responses to talker gaze differs in an auditory communicative context. Participants in a functional MRI experiment watched and listened to videos of spoken sentences in which the auditory intelligibility and talker gaze direction were manipulated factorially. We observed a left-dominant temporal lobe sensitivity to the talker's gaze direction, in which the left anterior superior temporal sulcus/gyrus and temporal pole showed an enhanced response to direct gaze - further investigation revealed that this pattern of lateralization was modulated by auditory intelligibility. Our results suggest flexibility in the distribution of neural responses to social cues in the face within the context of a challenging speech perception task. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Persistent left superior vena cava with thrombus formed in the catheter lumen 4 h after dialysis catheter placed.

    Science.gov (United States)

    Kawasaki, Tomoki; Tanaka, Hiroyuki; Oba, Miki; Takada, Megumi; Tanaka, Haruna; Suda, Shin

    2018-02-17

    Persistent left superior vena cava (PLSVC) is one of the most common thoracic venous anomaly and rarely noticed, because it is asymptomatic. However, for nephrologists, it is frequent enough to be encountered while placing hemodialysis catheters through the jugular vein. We report the case of 66-year-old patient with PLSVC presenting intrinsic thrombosis formation 4 h after dialysis catheter placed. Dialysis catheter was placed in the left internal jugular vein without resistance and any complication. PLSVC was detected after dialysis catheter insertion. We decided to remove the catheter, because the patient has other veins in which the catheter can be placed. When it was removed 4 h after catheter placing, thrombus was recognized in the catheter lumen. Transesophageal echocardiography was performed and no thrombus formation was observed in the heart chamber. For patients with PLSVC, if there were other veins in which the catheter can be placed, catheter replacement should be considered.

  11. Increased cortical thickness and altered functional connectivity of the right superior temporal gyrus in left-handers.

    Science.gov (United States)

    Li, Meiling; Chen, Heng; Wang, Junping; Liu, Feng; Wang, Yifeng; Lu, Fengmei; Yu, Chunshui; Chen, Huafu

    2015-01-01

    Altered structure in the temporal cortex has been implicated in the variable language laterality of left-handers (LH). The neuroanatomy of language lateralization and the corresponding synchronous functional connectivity (FC) in handedness cohorts are not, however, fully understood. We used structural and resting-state functional magnetic resonance imaging (fMRI) data to investigate the effect of altered cortical thickness on FC in LH and right-handers (RH). Whole-brain cortical thickness was calculated and compared between the LH and RH. We observed increased cortical thickness in the right superior temporal gyrus (STG) in the LH. A further FC analysis was conducted between the right STG and the remaining voxels in the brain. Compared with RH, the LH showed significantly higher FC in the left STG, right occipital cortex, and lower FC in the left inferior frontal gyrus and supramarginal gyrus. Our findings suggest that LH have atypical connectivity in the language network, with an enhanced role of the STG, findings which provide novel insights into the structural and functional substrates underlying the atypical language development of left-handed individuals. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Left Ventricular global longitudinal strain predicts heart failure readmission in acute decompensated heart failure.

    Science.gov (United States)

    Romano, Simone; Mansour, Ibrahim N; Kansal, Mayank; Gheith, Hana; Dowdy, Zachary; Dickens, Carolyn A; Buto-Colletti, Cassandra; Chae, June M; Saleh, Hussam H; Stamos, Thomas D

    2017-03-15

    The goal of this study was to determine if left ventricular (LV) global longitudinal strain (GLS) predicts heart failure (HF) readmission in patients with acute decompensated heart failure. Two hundred ninety one patients were enrolled at the time of admission for acute decompensated heart failure between January 2011 and September 2013. Left ventricle global longitudinal strain (LV GLS) by velocity vector imaging averaged from 2, 3 and 4-chamber views could be assessed in 204 out of 291 (70%) patients. Mean age was 63.8 ± 15.2 years, 42% of the patients were males and 78% were African American or Hispanic. Patients were followed until the first HF hospital readmission up to 44 months. Patients were grouped into quartiles on the basis of LV GLS. Kaplan-Meier curves showed significantly higher readmission rates in patients with worse LV GLS (log-rank p heart disease, dementia, New York Heart Association class, LV ejection fraction, use of angiotensin converting enzyme inhibitors or angiotensin receptor blockers, systolic and diastolic blood pressure on admission and sodium level on admission, worse LV GLS was the strongest predictor of recurrent HF readmission (p heart failure with a higher risk of readmission in case of progressive worsening of LV GLS, independent of the ejection fraction.

  13. Future Orientation, Social Support, and Psychological Adjustment among Left-behind Children in Rural China: A Longitudinal Study

    Directory of Open Access Journals (Sweden)

    Shaobing Su

    2017-08-01

    Full Text Available Existing research has found that parental migration may negatively impact the psychological adjustment of left-behind children. However, limited longitudinal research has examined if and how future orientation (individual protective factor and social support (contextual protective factor are associated with the indicators of psychological adjustment (i.e., life satisfaction, school satisfaction, happiness, and loneliness of left-behind children. In the current longitudinal study, we examined the differences in psychological adjustment between left-behind children and non-left behind children (comparison children in rural areas, and explored the protective roles of future orientation and social support on the immediate (cross-sectional effects and subsequent (lagged effects status of psychological adjustment for both groups of children, respectively. The sample included 897 rural children (Mage = 14.09, SD = 1.40 who participated in two waves of surveys across six months. Among the participants, 227 were left-behind children with two parents migrating, 176 were with one parent migrating, and 485 were comparison children. Results showed that, (1 left-behind children reported lower levels of life satisfaction, school satisfaction, and happiness, as well as a higher level of loneliness in both waves; (2 After controlling for several demographics and characteristics of parental migration among left-behind children, future orientation significantly predicted life satisfaction, school satisfaction, and happiness in both cross-sectional and longitudinal regression models, as well as loneliness in the longitudinal regression analysis. Social support predicted immediate life satisfaction, school satisfaction, and happiness, as well as subsequent school satisfaction. Similar to left-behind children, comparison children who reported higher scores in future orientation, especially future expectation, were likely to have higher scores in most indicators of

  14. Maintaining Superior Follow-Up Rates in a Longitudinal Study: Experiences from the College Life Study

    OpenAIRE

    Vincent, Kathryn B.; Kasperski, Sarah J.; Caldeira, Kimberly M.; Garnier-Dykstra, Laura M.; Pinchevsky, Gillian M.; O’Grady, Kevin E.; Arria, Amelia M.

    2012-01-01

    Longitudinal studies are often considered to be a gold standard for research, but the operational management of such studies is not often discussed in detail; this paper describes strategies used to track and maintain high levels of participation in a longitudinal study involving annual personal interviews with a cohort of 1,253 undergraduates (first-time, first-year students at time of enrollment) at a large public mid-Atlantic university.

  15. Maintaining Superior Follow-Up Rates in a Longitudinal Study: Experiences from the College Life Study.

    Science.gov (United States)

    Vincent, Kathryn B; Kasperski, Sarah J; Caldeira, Kimberly M; Garnier-Dykstra, Laura M; Pinchevsky, Gillian M; O'Grady, Kevin E; Arria, Amelia M

    2012-01-01

    Longitudinal studies are often considered to be a gold standard for research, but the operational management of such studies is not often discussed in detail; this paper describes strategies used to track and maintain high levels of participation in a longitudinal study involving annual personal interviews with a cohort of 1,253 undergraduates (first-time, first-year students at time of enrollment) at a large public mid-Atlantic university.

  16. Hemodynamic effects of left pulmonary artery stenosis after superior cavopulmonary connection: a patient-specific multiscale modeling study.

    Science.gov (United States)

    Schiavazzi, Daniele E; Kung, Ethan O; Marsden, Alison L; Baker, Catriona; Pennati, Giancarlo; Hsia, Tain-Yen; Hlavacek, Anthony; Dorfman, Adam L

    2015-03-01

    Currently, no quantitative guidelines have been established for treatment of left pulmonary artery (LPA) stenosis. This study aims to quantify the effects of LPA stenosis on postoperative hemodynamics for single-ventricle patients undergoing stage II superior cavopulmonary connection (SCPC) surgery, using a multiscale computational approach. Image data from 6 patients were segmented to produce 3-dimensional models of the pulmonary arteries before stage II surgery. Pressure and flow measurements were used to tune a 0-dimensional model of the entire circulation. Postoperative geometries were generated through stage II virtual surgery; varying degrees of LPA stenosis were applied using mesh morphing and hemodynamics assessed through coupled 0-3-dimensional simulations. To relate metrics of stenosis to clinical classifications, pediatric cardiologists and surgeons ranked the degrees of stenosis in the models. The effects of LPA stenosis were assessed based on left-to-right pulmonary artery flow split ratios, mean pressure drop across the stenosis, cardiac pressure-volume loops, and other clinically relevant parameters. Stenosis of >65% of the vessel diameter was required to produce a right pulmonary artery:LPA flow split 3.0 mm Hg, defined as clinically significant changes. The effects of SCPC hemodynamics and physiology were minor and may not justify the increased complexity of adding LPA arterioplasty to the SCPC operation. However, in the longer term, pulmonary augmentation may affect outcomes of the Fontan completion surgery, as pulmonary artery distortion is a risk factor that may influence stage III physiology. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  17. The Incidental Finding of a Persistent Left Superior Vena Cava: Implications for Primary Care Providers—Case and Review

    Directory of Open Access Journals (Sweden)

    Loren Garrison Morgan

    2015-01-01

    Full Text Available Persistent left superior vena cava (PLSVC is the most common thoracic venous anomaly and is a persistent congenital remnant of the vena caval system from early cardiac development. Patients with congenital anomalous venous return are at increased risk of developing various cardiac arrhythmias, due to derangement of embryologic conductive tissue during the early development of the heart. Previously this discovery was commonly made during the placement of pacemakers or defibrillators for the treatment of the arrhythmias, when the operator encountered difficulty with proper lead deployment. However, in today’s world of various easily obtainable imaging modalities, PLSVC is being discovered more and more by primary care providers during routine testing or screening for other ailments. Given the known association between anomalous venous return and the propensity for cardiac arrhythmias, we review the embryology of PLSVC and the mechanisms by which it leads to conduction abnormalities. We also provide the practitioner with recommendations for certain baseline cardiac observations and suggestions for proper surveillance in hopes that better understanding will reduce unnecessary and potentially harmful testing, premature subspecialty referral, and unneeded patient anxiety.

  18. Left Ventricular Systolic Function Assessed by Global Longitudinal Strain is Impaired in Atrial Fibrillation Compared to Sinus Rhythm

    DEFF Research Database (Denmark)

    Agner, Bue Fridolin Ross; Katz, Michael G; Williams, Zachary R

    2018-01-01

    Background: Atrial fibrillation (AF) is the most common aberrant cardiac arrhythmia. Many AF patients present with symptoms of dyspnea and fatigue, but have normal left ventricular ejection fraction (LVEF). Purpose: To determine the reproducibility of measurements of global longitudinal strain (G...

  19. Stability of left ventricular longitudinal and circumferential deformation over time and standard loading conditions.

    Science.gov (United States)

    Kosmala, Wojciech; Przewlocka-Kosmala, Monika; Sharman, James E; Schultz, Martin G; Marwick, Thomas H

    2017-09-01

    Load dependence is an important source of variation in left ventricular (LV) deformation. This impacts on the precision of information obtained from serial measurements. However, it is clinically important to distinguish actual myocardial dysfunction from changes associated with altered loading conditions. We sought to investigate the association of changes of loading parameters with changes in LV longitudinal (GLS) and circumferential (GCS) strains. Baseline and a 12-month follow-up 2D echocardiograms were performed in 191 Stage A heart failure patients with uncomplicated hypertension. These patients underwent simultaneous measurement of conventional and central blood pressures (BPs) and haemodynamic measurements by applanation tonometry. Significant, but weak correlations (r = 0.15-0.28) of LV strain parameters and their changes over the follow-up period were shown for the majority of LV afterload-associated variables, including central and brachial systolic, diastolic, and mean BPs; 24-h systolic and diastolic BPs; peak reservoir and excess pressures; central augmented pressure (CAP) and pulse pressure; augmentation index; and arterial elastance index (EaI). Central mean BP, EaI, and changes in CAP and EaI over follow-up were independent contributors to LV deformation in multivariable analysis. No improvement in the Bland-Altman 95% limits of agreement and correlation coefficients was seen with LV afterload correction of GLS and GCS using central BP indices. LV longitudinal and circumferential strains in a population without apparent heart disease is relatively insusceptible to changes in LV afterload within physiological range, which, therefore, seem unlikely to be a significant confounder in repeated GLS or GCS observations. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

  20. White Matter Microstructure in Superior Longitudinal Fasciculus Associated with Spatial Working Memory Performance in Children

    DEFF Research Database (Denmark)

    Vestergaard, Martin; Madsen, Kathrine Skak; Baaré, William F C

    2011-01-01

    memory (SWM) performance improves significantly throughout the childhood years, and several lines of evidence implicate the left fronto-parietal cortices and connecting fiber tracts in SWM processing. Here we report results from a study of 76 typically developing children, 7 to 13 years of age. We...

  1. Connections of the superior paraolivary nucleus of the rat: II. Reciprocal connections with the tectal longitudinal column

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    Antonio eViñuela

    2011-02-01

    Full Text Available The superior paraolivary nucleus (SPON, a prominent GABAergic center of the mammalian auditory brainstem, projects to the ipsilateral inferior colliculus (IC and sends axons through the commissure of the IC (CoIC. Herein we demonstrate that the SPON is reciprocally connected with the recently discovered tectal longitudinal column (TLC. The TLC is a long and narrow structure that spans nearly the entire midbrain tectum longitudinally, immediately above the periaqueductal gray matter (PAG and very close to the midline.Unilateral injections of biotinylated dextran into the SPON of the rat label abundant terminal fibers in the TLC of both sides, with an ipsilateral predominance. The SPON provides a dense innervation of the entire rostrocaudal extent of the ipsilateral TLC, and a relatively sparser innervation of the caudal and rostral portions of the contralateral TLC. SPON fibers reach the TLC by two routes: as collaterals of axons of the CoIC, and as axons that circumvent the ipsilateral IC before traveling in the deep layers of the superior colliculus.The density of these projections identifies SPON as a significant source of input to the TLC. Other targets of the SPON discovered in this study include the deep layers of the superior colliculus and the PAG. The same experiments reveal numerous labeled cell bodies in the TLC, interspersed among the labeled SPON fibers. This observation suggests that the SPON is a significant target of TLC projections.The discovery of novel reciprocal connections between the SPON and the TLC opens unexpected avenues for investigation of sound processing in mammalian brainstem circuits.

  2. Estudo longitudinal sobre as pesquisas de evasão no ensino superior: diretório IBICT

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    Daniela Freire Cardoso

    2017-06-01

    Full Text Available O presente trabalho objetiva apresentar estudo longitudinal sobre as pesquisas de evasão no Ensino Superior, mapeando o publicado sobre o assunto nos últimos cinco anos (2011 a 2016, analisando e identificando se as pesquisas realizadas apresentam propostas de ações efetivas para o enfrentamento do problema evasão. A metodologia aplicada é a pesquisa bibliográfica e exploratória, visando oferecer meios que auxiliam na definição e descrição de conceitos sobre o tema em questão. Adicionalmente à pesquisa bibliográfica, foi realizado o levantamento das pesquisas publicadas, como teses e dissertações, que possibilitará agrupar em uma única base de dados todas as informações coletadas, para que se possa obter um panorama mais completo sobre a evasão no Ensino Superior nos últimos cinco anos. Os resultados mostram que os pesquisadores identificaram a evasão como um problema a ser enfrentado, delinearam diagnósticos sobre sua causa e por fim propuseram ações que vão desde atuações pontuais das Instituições do Ensino Superior até atuações mais amplas de políticas públicas a serem levadas para discussão nos âmbitos governamentais.

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

    International Nuclear Information System (INIS)

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

    2017-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-08-15

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

  5. The association between left ventricular global longitudinal strain, renal impairment and all-cause mortality.

    Science.gov (United States)

    Krishnasamy, Rathika; Isbel, Nicole M; Hawley, Carmel M; Pascoe, Elaine M; Leano, Rodel; Haluska, Brian A; Stanton, Tony

    2014-06-01

    Left ventricular (LV) systolic dysfunction is an important predictor of cardiovascular death. Global longitudinal strain (GLS) is a widely available echocardiographic technique proven to be more sensitive than conventional ejection fraction (EF) in detecting subtle changes in LV function. However, the prognostic value of GLS in patients with chronic kidney disease (CKD) is unknown. We studied 447 patients from a single center who were stratified according to estimated glomerular filtration rate (eGFR). GLS was calculated using two-dimensional speckle tracking and EF was measured using Simpson's biplane. Cox proportional hazard model was used to identify independent predictors of survival and measures of discrimination and reclassification were used to assess the predictive value of GLS. Multivariable regression models were used to evaluate clinical and laboratory factors associated with GLS. The mean EF was 58 ± 11% and GLS was -16.6 ± 4.2%. eGFR correlated negatively with GLS (r = -0.14, P = 0.004). Factors that were independently associated with GLS include gender, previous myocardial infarction, eGFR and phosphate (R(2) = 0.16, P cause mortality [hazard ratio (HR) 1.08, 95% confidence interval (CI) 1.01-1.15] following adjustment for age, diabetes mellitus, hypertension, eGFR and left ventricular mass index (LVMI). The strength of association between demographic data, eGFR, LVMI and mortality increased following addition of GLS [c-statistic 0.68 (95% CI 0.61-0.74) to 0.71 (95% CI 0.64-0.77), P = 0.04]. Addition of GLS also demonstrated a 21% net reclassification improvement in risk prediction for all-cause mortality over clinical factors. GLS is an important predictor of all-cause mortality in CKD patients. Traditional and non-traditional risk factors such as phosphate are important determinants of GLS. Strain assessment in CKD patients may provide greater cardiovascular risk stratification. © The Author 2014. Published by Oxford University Press on behalf of

  6. Longitudinally and circumferentially directed movements of the left ventricle studied by cardiovascular magnetic resonance phase contrast velocity mapping

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    Codreanu Ion

    2010-08-01

    Full Text Available Abstract Objective Using high resolution cardiovascular magnetic resonance (CMR, we aimed to detect new details of left ventricular (LV systolic and diastolic function, to explain the twisting and longitudinal movements of the left ventricle. Methods Using CMR phase contrast velocity mapping (also called Tissue Phase Mapping regional wall motion patterns and longitudinally and circumferentially directed movements of the left ventricle were studied using a high temporal resolution technique in healthy male subjects (n = 14, age 23 ± 3 years. Results Previously undescribed systolic and diastolic motion patterns were obtained for left ventricular segments (based on the AHA segmental and for basal, mid and apical segments. The summation of segmental motion results in a complex pattern of ventricular twisting and longitudinal motion in the normal human heart which underlies systolic and diastolic function. As viewed from the apex, the entire LV initially rotates in a counter-clockwise direction at the beginning of ventricular systole, followed by opposing clockwise rotation of the base and counter-clockwise rotation at the apex, resulting in ventricular torsion. Simultaneously, as the entire LV moves in an apical direction during systole, the base and apex move towards each other, with little net apical displacement. The reverse of these motion patterns occur in diastole. Conclusion Left ventricular function may be a consequence of the relative orientations and moments of torque of the sub-epicardial relative to the sub-endocardial myocyte layers, with influence from tethering of the heart to adjacent structures and the directional forces associated with blood flow. Understanding the complex mechanics of the left ventricle is vital to enable these techniques to be used for the evaluation of cardiac pathology.

  7. Repeated measurements of cerebral blood flow in the left superior temporal gyrus reveal tonic hyperactivity in patients with auditory verbal hallucinations: A possible trait marker

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    Philipp eHoman

    2013-06-01

    Full Text Available Background: The left superior temporal gyrus (STG has been suggested to play a key role in auditory verbal hallucinations in patients with schizophrenia. Methods: Eleven medicated subjects with schizophrenia and medication-resistant auditory verbal hallucinations and 19 healthy controls underwent perfusion magnetic resonance imaging with arterial spin labeling. Three additional repeated measurements were conducted in the patients. Patients underwent a treatment with transcranial magnetic stimulation (TMS between the first 2 measurements. The main outcome measure was the pooled cerebral blood flow (CBF, which consisted of the regional CBF measurement in the left superior temporal gyrus (STG and the global CBF measurement in the whole brain.Results: Regional CBF in the left STG in patients was significantly higher compared to controls (p < 0.0001 and to the global CBF in patients (p < 0.004 at baseline. Regional CBF in the left STG remained significantly increased compared to the global CBF in patients across time (p < 0.0007, and it remained increased in patients after TMS compared to the baseline CBF in controls (p < 0.0001. After TMS, PANSS (p = 0.003 and PSYRATS (p = 0.01 scores decreased significantly in patients.Conclusions: This study demonstrated tonically increased regional CBF in the left STG in patients with schizophrenia and auditory hallucinations despite a decrease in symptoms after TMS. These findings were consistent with what has previously been termed a trait marker of auditory verbal hallucinations in schizophrenia.

  8. Damage of the right dorsal superior longitudinal fascicle by awake surgery for glioma causes persistent visuospatial dysfunction.

    Science.gov (United States)

    Nakajima, Riho; Kinoshita, Masashi; Miyashita, Katsuyoshi; Okita, Hirokazu; Genda, Ryoji; Yahata, Tetsutaro; Hayashi, Yutaka; Nakada, Mitsutoshi

    2017-12-07

    Patients with glioma frequently present with neuropsychological deficits preoperatively and/or postoperatively, and these deficits may remain after the chronic phase. However, little is known about postoperative recovery course of right hemispheric function. We therefore studied the characteristics and causes of persistent cognitive dysfunction in right cerebral hemispheric glioma. Eighteen patients who underwent awake surgery participated in this study. All patients who received preoperative neuropsychological examinations were assigned to two groups according to their test results: preoperative deficit and normal. They were reassessed 1 week and 3 months after surgery. The rates of remaining deficits in the deficit group at chronic phase were higher than those of the normal group for all functions. Despite preoperative normal function, the remaining rate for visuospatial cognitive deficits was the highest among all functions. The voxel-based lesion-symptom mapping analysis for visuospatial cognition revealed that a part of the medial superior and middle frontal gyri were resected with high probability in patients with low visuospatial cognitive accuracy. Our study indicates that in patients with preoperative neuropsychological deficits, these deficits tend to remain until the chronic phase. Visuospatial dysfunction frequently persists until the chronic phase, which might reflect damage to the superior longitudinal fasciclus I and II.

  9. Spontaneous Activity Associated with Delusions of Schizophrenia in the Left Medial Superior Frontal Gyrus: A Resting-State fMRI Study.

    Directory of Open Access Journals (Sweden)

    Bin Gao

    Full Text Available Delusions of schizophrenia have been found to be associated with alterations of some brain regions in structure and task-induced activation. However, the relationship between spontaneously occurring symptoms and spontaneous brain activity remains unclear. In the current study, 14 schizophrenic patients with delusions and 14 healthy controls underwent a resting-state functional magnetic resonance imaging (RS-fMRI scan. Patients with delusions of schizophrenia patients were rated with Positive and Negative Syndrome Scale (PANSS and Characteristics of Delusional Rating Scale (CDRS. Regional homogeneity (ReHo was calculated to measure the local synchronization of the spontaneous activity in a voxel-wise way. A two-sample t-test showed that ReHo of the right anterior cingulate gyrus and left medial superior frontal gyrus were higher in patients, and ReHo of the left superior occipital gyrus was lower, compared to healthy controls. Further, among patients, correlation analysis showed a significant difference between delusion scores of CRDS and ReHo of brain regions. ReHo of the left medial superior frontal gyrus was negatively correlated with patients' CDRS scores but not with delusional PANSS scores. These results suggested that altered local synchronization of spontaneous brain activity may be related to the pathophysiology of delusion in schizophrenia.

  10. Association between left ventricular global longitudinal strain and natriuretic peptides in outpatients with chronic systolic heart failure

    DEFF Research Database (Denmark)

    Gaborit, F; Bosselmann, H; Tønder, N

    2015-01-01

    .28-8.30, P = 0.013) and linear regression (NT-proBNP: βGLS: 1.19, 95 %-CI: 0.62-1.76, P body-mass-index, atrial fibrillation, renal function) and left atrial volume index......BACKGROUND: Both impaired left ventricular (LV) global longitudinal strain (GLS) and increased plasma concentrations of natriuretic peptides(NP) are associated with a poor outcome in heart failure (HF). Increased levels of NP reflect increased wall stress of the LV. However, little is known about....... CONCLUSION: Impaired LV GLS is associated with increased plasma concentrations of NP and our data suggest that left ventricular myocardial mechanics estimated by LV GLS reflects myocardial wall stress in chronic systolic HF....

  11. Right to left shunt as a collateral circulation in a patient with superior vena cava syndrome: a case report

    International Nuclear Information System (INIS)

    Kim, Young Sun; Jeon, Seok Chol; Moon, Won Jin; Choi, Yo Won; Seo, Heung Suk; Hahm, Chang Kok; Park, Choong Ki

    1999-01-01

    In patients with superior vena cava syndrome, the form of the collateral circulatory system which communicates with the inferior vena cava via various systemic veins usually varics. We found an instance of unusual collateral circulation : direct communication between the systemic and pulmonary vein in a woman with superior vena cava syndrome caused by metastatic lymph node enlargement. In this report, we describe the CT and radionuclide venographic findings

  12. Exercise-induced changes in left ventricular global longitudinal strain in asymptomatic severe aortic stenosis.

    Science.gov (United States)

    Lech, Agnieszka K; Dobrowolski, Piotr P; Klisiewicz, Anna; Hoffman, Piotr

    2017-01-01

    The management of patients with asymptomatic severe aortic stenosis (ASAS) is still under discussion. Therefore, it is advisable to search for the parameters of early damage to left ventricular (LV) function. The aim of the study was to assess exercise-induced changes in LV global longitudinal strain (GLS) in ASAS. The ASAS group consisted of 50 patients (26 women and 24 men, aged 38.4 ± 18.1 years) meeting the echocardiographic criteria of severe aortic stenosis (AVA 4 m/s, mean aortic gradient > 40 mm Hg), with normal LV ejection fraction (LVEF ≥ 55%) and sinus rhythm on electrocardiogram, and without significant concomitant valvular heart diseases. The control group consisted of 21 people matched for age and sex. Echocardiographic examinations and echocardiographic stress tests with the assessment of GLS using the speckle tracking imaging were performed. The ASAS group was characterised by statistically significantly higher LV mass index (LVMI) and higher LVEF. GLS values at rest in both groups were within normal limits but were significantly higher in the control group (-18.9 ± 2.4% vs. -20.7 ± 1.7%, p = 0.006). An increase in GLS at peak exercise in both groups was observed, lower in the ASAS group (the difference was not statistically significant: -0.8 ± 3.0% vs. -2.2 ± 3.1%, p = 0.086). Changes in GLS during exercise (ΔGLS) did not correlate with the parameters of the severity of aortic stenosis. In the multivariate model, LVMI proved to be a factor associated with GLS at rest and during exercise. In patients with ASAS, GLS is a non-invasive marker of an early stage of LV myocardial damage associated with myocardial hypertrophy. An increase in GLS during exercise in the ASAS group, smaller than in the control group, indicates a preserved functional reserve of the LV myocardium but smaller than in healthy individuals. The assessment of the clinical usefulness of exercise-induced changes in GLS requires further research.

  13. The impact of preload reduction with head-up tilt testing on longitudinal and transverse left ventricular mechanics.

    Science.gov (United States)

    Schneider, Caroline; Forsythe, Lynsey; Somauroo, John; George, Keith; Oxborough, David

    2018-01-03

    Left ventricular (LV) function is dependent on load, intrinsic contractility and relaxation with a variable impact on specific mechanics. Strain (ε) imaging allows the assessment of cardiac function however the direct relationship between volume and strain is currently unknown. The aim of this study was to establish the impact of preload reduction through head-up tilt (HUT) testing on simultaneous left ventricular (LV) longitudinal and transverse function and their respective contribution to volume change. A focused transthoracic echocardiogram was performed on 10 healthy male participants (23 ± 3 years,) in the supine position and following 1 min and 5 min of HUT testing. Raw temporal longitudinal ε (Ls) and transverse ε (Ts) values were exported and divided into 5% increments across the cardiac cycle and corresponding LV volumes were traced at each 5% increment. This provided simultaneous LV longitudinal and transverse ε and volume-loops (deformation-volume analysis - DVA). There was a leftward- shift of the ε -volume loop from supine to 1 min and 5 min of HUT, pmaintenance of LV filling in the setting of reduced preload. DVA provides information on the relative contribution of mechanics to a change in LV volume and may have a role in the assessment of clinical populations. © 2018 The authors.

  14. The Sport Expert's Attention Superiority on Skill-related Scene Dynamic by The Activation of Left Medial Frontal Gyrus: An ERP and LORETA Study.

    Science.gov (United States)

    He, Mengyang; Qi, Changzhu; Lu, Yang; Song, Amanda; Hayat, Saba Z; Xu, Xia

    2018-03-07

    Extensive studies have shown that a sports expert is superior to a sports novice in visually perceptual-cognitive processes of sports scene information, however the attentional and neural basis of it has not been thoroughly explored. The present study examined whether a sport expert has the attentional superiority on scene information relevant to his/her sport skill, and explored what factor drives this superiority. To address this problem, EEGs were recorded as participants passively viewed sport scenes (tennis vs. non-tennis) and negative emotional faces in the context of a visual attention task, where the pictures of sport scenes or of negative emotional faces randomly followed the pictures with overlapping sport scenes and negative emotional faces. ERP results showed that for experts, the evoked potential of attentional competition elicited by the overlap of tennis scene was significantly larger than that evoked by the overlap of non-tennis scene, while this effect was absent for novices. The LORETA showed that the experts' left medial frontal gyrus (MFG) cortex was significantly more active as compared to the right MFG when processing the overlap of tennis scene, but the lateralization effect was not significant in novices. Those results indicate that experts have attentional superiority on skill-related scene information, despite intruding the scene through negative emotional faces that are prone to cause negativity bias towards their visual field as a strong distractor. This superiority is actuated by the activation of left MFG cortex and probably due to self-reference. Copyright © 2018. Published by Elsevier Ltd.

  15. Microstructure of the superior longitudinal fasciculus predicts stimulation-induced interference with on-line motor control.

    Science.gov (United States)

    Rodríguez-Herreros, Borja; Amengual, Julià L; Gurtubay-Antolín, Ane; Richter, Lars; Jauer, Philipp; Erdmann, Christian; Schweikard, Achim; López-Moliner, Joan; Rodríguez-Fornells, Antoni; Münte, Thomas F

    2015-10-15

    A cortical visuomotor network, comprising the medial intraparietal sulcus (mIPS) and the dorsal premotor area (PMd), encodes the sensorimotor transformations required for the on-line control of reaching movements. How information is transmitted between these two regions and which pathways are involved, are less clear. Here, we use a multimodal approach combining repetitive transcranial magnetic stimulation (rTMS) and diffusion tensor imaging (DTI) to investigate whether structural connectivity in the 'reaching' circuit is associated to variations in the ability to control and update a movement. We induced a transient disruption of the neural processes underlying on-line motor adjustments by applying 1Hz rTMS over the mIPS. After the stimulation protocol, participants globally showed a reduction of the number of corrective trajectories during a reaching task that included unexpected visual perturbations. A voxel-based analysis revealed that participants exhibiting higher fractional anisotropy (FA) in the second branch of the superior longitudinal fasciculus (SLF II) suffered less rTMS-induced behavioral impact. These results indicate that the microstructural features of the white matter bundles within the parieto-frontal 'reaching' circuit play a prominent role when action reprogramming is interfered. Moreover, our study suggests that the structural alignment and cohesion of the white matter tracts might be used as a predictor to characterize the extent of motor impairments. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Longitudinal two-dimensional strain for the diagnosis of left ventricular segmental dysfunction in patients with acute myocardial infarction.

    Science.gov (United States)

    Eitan, Amnon; Kehat, Izhak; Mutlak, Diab; Lichtenberg, Gershom; Amar, Dina; Agmon, Yoram

    2018-02-01

    The objectives of this study were to assess whether 2-dimensional strain (2DS) can detect left ventricular (LV) segmental dysfunction and to compare the diagnostic accuracy of various 2DS parameters. Multiple segmental longitudinal 2DS parameters were measured in 54 patients with a first myocardial infarction and single vessel coronary artery disease (age: 56 ± 11 years, 74% men, LV ejection fraction: 47 ± 10%, left anterior descending artery occlusion in 63%) and 14 age-matched subjects. 2DS parameters were compared to visual assessment of segmental function by multiple observers. Using receiver-operating characteristics analysis, the area under the curve (AUC) for peak systolic strain in diagnosing segmental dysfunction (akinetic or hypokinetic LV segments) and for diagnosing akinetic segments was 0.85 (95% confidence interval 0.83-0.88) and 0.88 (0.85-0.90), respectively (all P values echocardiographic definition of segmental abnormality.

  17. Left Ventricular Longitudinal Systolic Function in Septic Shock Patients with Normal Ejection Fraction: A Case-control Study.

    Science.gov (United States)

    Zhang, Hong-Min; Wang, Xiao-Ting; Zhang, Li-Na; He, Wei; Zhang, Qing; Liu, Da-Wei

    2017-05-20

    Septic cardiomyopathy is a common finding in septic shock patients. The accepted definition of septic cardiomyopathy is often based on the left ventricular ejection fraction (LVEF). The aim of this study was to determine whether the left ventricular longitudinal systolic function was more sensitive than the LVEF in heart function appraisal of septic shock patients. This was a case-control study conducted at a 40-bed Intensive Care Unit (ICU) of Peking Union Medical College Hospital. Septic shock patients admitted to the ICU were consecutively enrolled in the study group from March 1, 2016 to September 1, 2016. The control group was selected from nonsepsis patients who were admitted to the ICU and were comparable to the study group. Transthoracic echocardiography was performed to obtain the LVEF measurement, mitral annular plane systolic excursion (MAPSE), tissue Doppler velocity measurement of mitral annulus (Sa), and tricuspid annular plane systolic excursion. The study group consisted of 45 septic shock patients. Another 45 nonsepsis patients were selected as the control group. There was no difference in the LVEF between the two groups (64.6% vs. 67.2%, t= -1.426, P= 0.161). MAPSE in the study group was much lower than in the control group (1.2 cm vs. 1.5 cm, t= -4.945, Pseptic shock patients. In the heart function appraisal of septic shock patients with a normal ejection fraction, more attention should be given to longitudinal function parameters such as MAPSE and Sa.

  18. Left ventricular global longitudinal strain predicts major adverse cardiac events and all-cause mortality in heart transplant patients.

    Science.gov (United States)

    Clemmensen, Tor Skibsted; Eiskjær, Hans; Løgstrup, Brian Bridal; Ilkjær, Lars Bo; Poulsen, Steen Hvitfeldt

    2017-05-01

    Left ventricular global longitudinal strain (LVGLS) is a robust longitudinal myocardial deformation marker that is strongly affected by cardiac allograft vasculopathy (CAV), microvascular dysfunction, and acute cellular rejection (ACR). We evaluated graft deformation for risk stratification in long-term heart transplant (HTx) patients. The study included 196 patients who underwent HTx between 2011 and 2013. Patients underwent comprehensive echocardiography and coronary angiography. Previous rejection burden was assessed, and ACR grades were calculated. Patients were prospectively followed until February 24, 2016. Major adverse cardiac events (MACE), including coronary event, heart failure, treated rejection, and cardiovascular death, and all-cause mortality were recorded. During follow-up, 57 patients experienced MACE. Median follow-up was 1,035 (interquartile range [IQR] 856-1,124) days. Median time to first event was 534 (IQR 276-763) days. LVGLS was a strong predictor of MACE (hazard ratio [HR] 4.9, 95% confidence interval [CI] 2.7-8.9, p transplantation. Measurement of LVGLS strongly predicts MACE and mortality in long-term HTx patients. Predictive ability was seen in patients with and without CAV. A combined model of left ventricular systolic deformation by LVGLS and diastolic graft performance by LVFP was a stronger model for prediction of MACE and all-cause mortality. Copyright © 2017 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  19. Relationship between left ventricular longitudinal deformation and clinical heart failure during admission for acute myocardial infarction

    DEFF Research Database (Denmark)

    Ersbøll, Mads; Valeur, Nana; Mogensen, Ulrik Madvig

    2012-01-01

    Heart failure (HF) complicating acute myocardial infarction (MI) is an ominous prognostic sign frequently caused by left ventricular (LV) systolic dysfunction. However, many patients develop HF despite preserved LV ejection fractions. The aim of this study was to test the hypothesis that LV longi...

  20. Human middle longitudinal fascicle: segregation and behavioral-clinical implications of two distinct fiber connections linking temporal pole and superior temporal gyrus with the angular gyrus or superior parietal lobule using multi-tensor tractography.

    Science.gov (United States)

    Makris, N; Preti, M G; Wassermann, D; Rathi, Y; Papadimitriou, G M; Yergatian, C; Dickerson, B C; Shenton, M E; Kubicki, M

    2013-09-01

    The middle longitudinal fascicle (MdLF) is a major fiber connection running principally between the superior temporal gyrus and the parietal lobe, neocortical regions of great biological and clinical interest. Although one of the most prominent cerebral association fiber tracts, it has only recently been discovered in humans. In this high angular resolution diffusion imaging (HARDI) MRI study, we delineated the two major fiber connections of the human MdLF, by examining morphology, topography, cortical connections, biophysical measures, volume and length in seventy-four brains. These two fiber connections course together through the dorsal temporal pole and the superior temporal gyrus maintaining a characteristic topographic relationship in the mediolateral and ventrodorsal dimensions. As these pathways course towards the parietal lobe, they split to form separate fiber pathways, one following a ventrolateral trajectory and connecting with the angular gyrus and the other following a dorsomedial route and connecting with the superior parietal lobule. Based on the functions of their cortical affiliations, we suggest that the superior temporal-angular connection of the MdLF, i.e., STG(MdLF)AG plays a role in language and attention, whereas the superior temporal-superior parietal connection of the MdLF, i.e., STG(MdLF)SPL is involved in visuospatial and integrative audiovisual functions. Furthermore, the MdLF may have clinical implications in neurodegenerative disorders such as primary progressive aphasia, frontotemporal dementia, posterior cortical atrophy, corticobulbar degeneration and Alzheimer's disease as well as attention-deficit/hyperactivity disorder and schizophrenia.

  1. Longitudinal changes and prognostic implications of left ventricular diastolic function in first acute myocardial infarction

    DEFF Research Database (Denmark)

    Poulsen, S H; Jensen, S E; Egstrup, K

    1999-01-01

    BACKGROUND: Left ventricular (LV) diastolic dysfunction contributes to signs and symptoms of clinical heart failure and may be related to prognosis in heart diseases. LV diastolic dysfunction is reported to be present in acute myocardial infarction (MI); however, little is known about the time....../restrictive. Patients with MI were observed for development of congestive heart failure (Killip class >I) during hospitalization and for death during 1-year follow-up, and these complications were related to LV diastolic function. LV diastolic dysfunction was present in the very early phase of acute MI, with signs......-hospital congestive heart failure and cardiac death during 12 months of follow-up. CONCLUSIONS: LV diastolic dysfunction is present in the very early phase of MI. LV remodeling and development of in-hospital congestive heart failure appear in patients with very early signs of LV diastolic dysfunction. Furthermore...

  2. Independent Value of Cardiac Troponin T and Left Ventricular Global Longitudinal Strain in Predicting All-Cause Mortality among Stable Hemodialysis Patients with Preserved Left Ventricular Ejection Fraction

    Directory of Open Access Journals (Sweden)

    Junne-Ming Sung

    2014-01-01

    Full Text Available Using a speckle-tracking echocardiography (STE, we recently demonstrated that a left ventricular (LV global longitudinal strain (GLS ≥ −15% and the serum cardiac troponin T (cTnT concentration are associated with mortality in stable hemodialysis patients with preserved LV ejection fraction (LVEF. In this study, we explored the relationship between cTnT and echocardiographic parameters and evaluated whether the prognostic value provided by cTnT is independent of a GLS ≥ −15% and vice versa. Eighty-eight stable hemodialysis patients with preserved LVEF were followed for 31 months. STE studies and measurements of cTnT were performed at baseline. CTnT concentration had a modest correlation with GLS (rs=0.44; P<0.001 but had a weak or nonsignificant correlation with other echocardiographic parameters. Adjusting for clinical parameters, hazard ratios for each increase of 0.01 ng/mL in cTnT, and a GLS ≥ −15% on mortality were 1.13 (P=0.009 and 3.09 (P=0.03 without significant interaction between cTnT and GLS ≥ −15%. In addition, an increased cTnT concentration, a GLS ≥ −15%, or their combination showed significant additional predictive value for mortality when included in models consisting of clinical parameters. Therefore, both cTnT and a GLS ≥ −15% are independent predictors of mortality and are useful for risk stratification.

  3. Full-root aortic valve replacement with stentless xenograft achieves superior regression of left ventricular hypertrophy compared to pericardial stented aortic valves.

    Science.gov (United States)

    Tavakoli, Reza; Auf der Maur, Christoph; Mueller, Xavier; Schläpfer, Reinhard; Jamshidi, Peiman; Daubeuf, François; Frossard, Nelly

    2015-02-03

    Full-root aortic valve replacement with stentless xenografts has potentially superior hemodynamic performance compared to stented valves. However, a number of cardiac surgeons are reluctant to transform a classical stented aortic valve replacement into a technically more demanding full-root stentless aortic valve replacement. Here we describe our technique of full-root stentless aortic xenograft implantation and compare the early clinical and midterm hemodynamic outcomes to those after aortic valve replacement with stented valves. We retrospectively compared the pre-operative characteristics of 180 consecutive patients who underwent full-root replacement with stentless aortic xenografts with those of 80 patients undergoing aortic valve replacement with stented valves. In subgroups presenting with aortic stenosis, we further analyzed the intra-operative data, early postoperative outcomes and mid-term regression of left ventricular mass index. Patients in the stentless group were younger (62.6 ± 13 vs. 70.3 ± 11.8 years, p regression of the left ventricular mass index in the stentless (p replacement can be performed without adversely affecting the early morbidity or mortality in patients operated on for aortic valve stenosis provided that the coronary ostia are not heavily calcified. The additional time necessary for the full-root stentless compared to the classical stented aortic valve replacement is therefore not detrimental to the early clinical outcomes and is largely rewarded in patients with aortic stenosis by lower transvalvular gradients at mid-term and a better regression of their left ventricular mass index.

  4. Spontaneous neural activity in the right superior temporal gyrus and left middle temporal gyrus is associated with insight level in obsessive-compulsive disorder.

    Science.gov (United States)

    Fan, Jie; Zhong, Mingtian; Gan, Jun; Liu, Wanting; Niu, Chaoyang; Liao, Haiyan; Zhang, Hongchun; Tan, Changlian; Yi, Jinyao; Zhu, Xiongzhao

    2017-01-01

    Insight into illness is an important issue for psychiatry disorder. Although the existence of a poor insight subtype of obsessive-compulsive disorder (OCD) was recognized in the DSM-IV, and the insight level in OCD was specified further in DSM-V, the neural underpinnings of insight in OCD have been rarely explored. The present study was designed to bridge this research gap by using resting-state functional magnetic resonance imaging (fMRI). Spontaneous neural activity were examined in 19 OCD patients with good insight (OCD-GI), 18 OCD patients with poor insight (OCD-PI), and 25 healthy controls (HC) by analyzing the amplitude of low-frequency fluctuation (ALFF) in the resting state. Pearson correlation analysis was performed between regional ALFFs and insight levels among OCD patients. OCD-GI and OCD-PI demonstrated overlapping and distinct brain alterations. Notably, compared with OCD-GI, tOCD-PI had reduced ALFF in left middle temporal gyrus (MTG) and right superior temporal gyrus (STG), as well as increased ALFF in right middle occipital gyrus. Further analysis revealed that ALFF values for the left MTG and right STG were correlated negatively with insight level in patients with OCD. Relatively small sample size and not all patients were un-medicated are our major limitations. Spontaneous brain activity in left MTG and right STG may be neural underpinnings of insight in OCD. Our results suggest the great role of human temporal brain regions in understanding insight, and further underscore the importance of considering insight presentation in understanding the clinical heterogeneity of OCD. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Does global longitudinal speckle-tracking strain predict left ventricular remodeling in patients with myocardial infarction? a systematic review

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    Afsoon Fazlinejad

    2016-07-01

    Full Text Available Introduction: Left ventricular remodeling is a relatively prevalent complication of acute myocardial infarction (AMI, and it is associated with higher rates of medical issues and mortality. Left ventricle ejection fraction (LVEF and wall motion score index (WMSI are unable to detect accurately minor lesions following AMI. Global longitudinal strain (GLS, which is obtained through 2D-speckle tracking echocardiography (2D-STE, provides an angle-dependent measurement by which the infarcted area can be assessed as a means of identifying potential dysfunction. The main objective of this study was to evaluate whether GLS could adequately predict LV remodeling in AMI patients. Methods: The MEDLINE database from database inception to May 6th, 2015, was searched for relevant keywords and the reference lists of systematic reviews and eligible studies were also screened. All studies involving patients with their first reported case of AMI were examined for GLS by 2D-STE and were evaluated for LV remodeling at a three-month follow-up point.  Four English-language prospective cohort studies were eligible for inclusion in this study.Result: A total of 291 AMI patients (mean age=57.92 years were investigated across four different studies. The main finding of this study was that the most reliable and consistent measurement for the purposes of predicting LV remodeling in AMI patients is GLS obtained at the time of discharge, especially in STEMI patients.Discussion: In addition to their poor reproducibility, inability to stratify risks, and inter-observer variability, compensatory hyperkinesis of intact myocytes and myocardial stunning after an AMI are among the main reasons why LVEF and WMSI may not be the most effective predictors of LV remodeling in AMI.Conclusion: GLS obtained by 2D-STE at the time of discharge could be used as a reliable predictor of LV remodeling in AMI patients.

  6. Is right ventricular mid-septal pacing superior to apical pacing in patients with high degree atrio-ventricular block and moderately depressed left ventricular function?*

    Science.gov (United States)

    Chen, Kang; Mao, Ye; Liu, Shao-hua; Wu, Qiong; Luo, Qing-zhi; Pan, Wen-qi; Jin, Qi; Zhang, Ning; Ling, Tian-you; Chen, Ying; Gu, Gang; Shen, Wei-feng; Wu, Li-qun

    2014-01-01

    Objective: We are aimed to investigate whether right ventricular mid-septal pacing (RVMSP) is superior to conventional right ventricular apical pacing (RVAP) in improving clinical functional capacity and left ventricular ejection fraction (LVEF) for patients with high-degree atrio-ventricular block and moderately depressed left ventricle (LV) function. Methods: Ninety-two patients with high-degree atrio-ventricular block and moderately reduced LVEF (ranging from 35% to 50%) were randomly allocated to RVMSP (n=45) and RVAP (n=47). New York Heart Association (NYHA) functional class, echocardiographic LVEF, and distance during a 6-min walk test (6MWT) were determined at 18 months after pacemaker implantation. Serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured using an enzyme-linked immunosorbent assay (ELISA) kit. Results: Compared with baseline, NYHA functional class remained unchanged at 18 months, distance during 6MWT (485 m vs. 517 m) and LVEF (36.7% vs. 41.8%) were increased, but BNP levels were reduced (2352 pg/ml vs. 710 pg/ml) in the RVMSP group compared with those in the RVAP group, especially in patients with LVEF 35%–40% (for all comparisons, P<0.05). However, clinical function capacity and LV function measurements were not significantly changed in patients with RVAP, despite the pacing measurements being similar in both groups, such as R-wave amplitude and capture threshold. Conclusions: RVMSP provides a better clinical utility, compared with RVAP, in patients with high-degree atrioventricular block and moderately depressed LV function whose LVEF levels ranged from 35% to 40%. PMID:24903987

  7. Is right ventricular mid-septal pacing superior to apical pacing in patients with high degree atrio-ventricular block and moderately depressed left ventricular function?

    Science.gov (United States)

    Chen, Kang; Mao, Ye; Liu, Shao-hua; Wu, Qiong; Luo, Qing-zhi; Pan, Wen-qi; Jin, Qi; Zhang, Ning; Ling, Tian-you; Chen, Ying; Gu, Gang; Shen, Wei-feng; Wu, Li-qun

    2014-06-01

    We are aimed to investigate whether right ventricular mid-septal pacing (RVMSP) is superior to conventional right ventricular apical pacing (RVAP) in improving clinical functional capacity and left ventricular ejection fraction (LVEF) for patients with high-degree atrio-ventricular block and moderately depressed left ventricle (LV) function. Ninety-two patients with high-degree atrio-ventricular block and moderately reduced LVEF (ranging from 35% to 50%) were randomly allocated to RVMSP (n=45) and RVAP (n=47). New York Heart Association (NYHA) functional class, echocardiographic LVEF, and distance during a 6-min walk test (6MWT) were determined at 18 months after pacemaker implantation. Serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured using an enzyme-linked immunosorbent assay (ELISA) kit. Compared with baseline, NYHA functional class remained unchanged at 18 months, distance during 6MWT (485 m vs. 517 m) and LVEF (36.7% vs. 41.8%) were increased, but BNP levels were reduced (2352 pg/ml vs. 710 pg/ml) in the RVMSP group compared with those in the RVAP group, especially in patients with LVEF 35%-40% (for all comparisons, P<0.05). However, clinical function capacity and LV function measurements were not significantly changed in patients with RVAP, despite the pacing measurements being similar in both groups, such as R-wave amplitude and capture threshold. RVMSP provides a better clinical utility, compared with RVAP, in patients with high-degree atrioventricular block and moderately depressed LV function whose LVEF levels ranged from 35% to 40%.

  8. TISSUE DOPPLER IMAGING OF LONGITUDINAL MOVEMENT OF A FIBROUS RING OF MITRAL VALVE DURING ISOVOLUMIC PERIODS IN LEFT VENTRICULAR HYPERTROPHY

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    B. Amarjagal

    2015-12-01

    Full Text Available Aim. To study change of rate and duration indicators of longitudinal movement of a fibrous ring of mitral valve (MFR during isovolumic contraction (IVC and relaxation (IVR in hypertensive patients with various degree of a left ventricular hypertrophy (LVH.Material and methods. 80 hypertensive patients with moderate LVH (n=40 and severe LVH (n=40 are examined. The control group was presented by 30 healthy volunteers. Transthoracic echocardiography and Tissue Doppler imaging has been performed with ultrasonic tomograph “HDI 5000” (Philips.Results. Increase in LVH (Smm and Е/Еmm associates with reduction in systolic velocity of movement of medial MFR (Smm. There is direct relation with duration of IVC-negative and IVR-positive components and myocardium mass index. Maximal velocity of IVC-positive component increases and maximal velocity of IVR-negative component decreases when LVH is growing.Conclusion. Velocities curves of IVC and IVR were bi-phase both in healthy persons and in hypertensive patients with LVH. Velocity and duration of positive and negative components of IVC and IVR depended on LVH degree.

  9. TISSUE DOPPLER IMAGING OF LONGITUDINAL MOVEMENT OF A FIBROUS RING OF MITRAL VALVE DURING ISOVOLUMIC PERIODS IN LEFT VENTRICULAR HYPERTROPHY

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    B. Amarjagal

    2007-01-01

    Full Text Available Aim. To study change of rate and duration indicators of longitudinal movement of a fibrous ring of mitral valve (MFR during isovolumic contraction (IVC and relaxation (IVR in hypertensive patients with various degree of a left ventricular hypertrophy (LVH.Material and methods. 80 hypertensive patients with moderate LVH (n=40 and severe LVH (n=40 are examined. The control group was presented by 30 healthy volunteers. Transthoracic echocardiography and Tissue Doppler imaging has been performed with ultrasonic tomograph “HDI 5000” (Philips.Results. Increase in LVH (Smm and Е/Еmm associates with reduction in systolic velocity of movement of medial MFR (Smm. There is direct relation with duration of IVC-negative and IVR-positive components and myocardium mass index. Maximal velocity of IVC-positive component increases and maximal velocity of IVR-negative component decreases when LVH is growing.Conclusion. Velocities curves of IVC and IVR were bi-phase both in healthy persons and in hypertensive patients with LVH. Velocity and duration of positive and negative components of IVC and IVR depended on LVH degree.

  10. Global longitudinal strain corrected by RR interval is a superior predictor of all-cause mortality in patients with systolic heart failure and atrial fibrillation

    DEFF Research Database (Denmark)

    Modin, Daniel; Sengeløv, Morten; Jørgensen, Peter Godsk

    2018-01-01

    failure (HFrEF) with AF remains unknown. This study investigates the prognostic value of RR interval-corrected peak global longitudinal strain {GLSc = GLS/[RR^(1/2)]} in relation to all-cause mortality in HFrEF patients displaying AF during echocardiographic examination. METHODS AND RESULTS......: Echocardiograms from 151 patients with HFrEF and AF during examination were analysed offline. Peak global longitudinal strain (GLS) was averaged from 18 myocardial segments obtained from three apical views. GLS was indexed with the square root of the RR interval {GLSc = GLS/[RR^(1/2)]}. Endpoint was all......-cause mortality. During a median follow-up of 2.7 years, 40 patients (26.5%) died. Neither uncorrected GLS (P = 0.056) nor left ventricular ejection fraction (P = 0.053) was significantly associated with all-cause mortality. After RR^(1/2) indexation, GLSc became a significant predictor of all-cause mortality...

  11. Serum Cardiac Troponin-I is Superior to Troponin-T as a Marker for Left Ventricular Dysfunction in Clinically Stable Patients with End-Stage Renal Disease.

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    Maurits S Buiten

    Full Text Available Serum troponin assays, widely used to detect acute cardiac ischemia, might be useful biomarkers to detect chronic cardiovascular disease (CVD. Cardiac-specific troponin-I (cTnI and troponin-T (cTnT generally detect myocardial necrosis equally well. In dialysis patients however, serum cTnT levels are often elevated, unlike cTnI levels. The present study aims to elucidate the associations of cTnI and cTnT with CVD in clinically stable dialysis patients.Troponin levels were measured using 5th generation hs-cTnT assays (Roche and STAT hs-cTnI assays (Abbott in a cohort of dialysis patients. Serum troponin levels were divided into tertiles with the lowest tertile as a reference value. Serum troponins were associated with indicators of CVD such as left ventricular mass index (LVMI, left ventricular ejection fraction (LVEF and the presence of coronary artery disease (CAD. Associations were explored using regression analysis.We included 154 consecutive patients, 68±7 years old, 77% male, 70% hemodialysis. Median serum cTnT was 51ng/L (exceeding the 99th percentile of the healthy population in 98% and median serum cTnI was 13ng/L (elevated in 20%. A high cTnI (T3 was significantly associated with a higher LVMI (Beta 31.60; p=0.001 and LVEF (Beta -4.78; p=0.005 after adjusting for confounders whereas a high serum cTnT was not. CAD was significantly associated with a high cTnT (OR 4.70 p=0.02 but not with a high cTnI. Unlike cTnI, cTnT was associated with residual renal function (Beta:-0.09; p=0.006.In the present cohort, serum cTnI levels showed a stronger association with LVMI and LVEF than cTnT. However, cTnT was significantly associated with CAD and residual renal function, unlike cTnI. Therefore, cTnI seems to be superior to cTnT as a marker of left ventricular dysfunction in asymptomatic dialysis patients, while cTnT might be better suited to detect CAD in these patients.

  12. Ecocardiografia transesofágica e diagnóstico intraoperatório de veia cava superior esquerda persistente Ecocardiografía transesofágica y diagnóstico intraoperatorio de vena cava superior izquierda persistente Transesophageal echocardiography and intraoperative diagnosis of persistent left superior vena cava

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    Alexander Alves da Silva

    2009-12-01

    persistent left superior vena cava has an incidence of 0.5% in the normal population, but in patients with congenital cardiopathy its incidence ranges from 3% to 10%. The objective of this report was to present a case of intraoperative diagnosis with transesophageal echocardiography and to emphasize the importance of its routine use in surgical procedures for correction of congenital cardiopathies. CASE REPORT: This is a 16-year old male patient, ASA II, with a diagnosis of superior sinus venosus interatrial communication (IAC with partial anomalous drainage of the pulmonary veins scheduled for the surgical correction of the cardiopathy. After induction of general anesthesia, transesophageal echocardiography (TEE showed initially a dilation of the right cardiac chambers, a 17-mm superior sinus venosus IAC, anomalous drainage of the right superior pulmonary vein draining into the right superior vena cava (SVC, and dilation of the coronary sinus raising the possibility of persistent left superior vena cava. To confirm this suspicion, 10 mL of NS (works as a contrast in echocardiography were injected in the venous access of the left arm, and microbubbles crossing the coronary sinus were observed immediately afterwards confirming the diagnosis of persistent left superior vena cava. CONCLUSIONS: Routine intraoperative transesophageal echocardiography in patients with congenital cardiopathy is a fundamental auxiliary method, not only for the surgeon, often having direct influence on the surgical technique used, but also for the anesthesiologist, who can get useful information for the hemodynamic management of the patient.

  13. Systematic review and meta-analysis of persistent left superior vena cava on prenatal ultrasound: associated anomalies, diagnostic accuracy and postnatal outcome.

    Science.gov (United States)

    Gustapane, S; Leombroni, M; Khalil, A; Giacci, F; Marrone, L; Bascietto, F; Rizzo, G; Acharya, G; Liberati, M; D'Antonio, F

    2016-12-01

    To quantify the prevalence of chromosomal anomalies in fetuses with persistent left superior vena cava (PLSVC), assess the strength of the association between PLSVC and coarctation of the aorta and ascertain the diagnostic accuracy of antenatal ultrasound in correctly identifying isolated cases of PLSVC. MEDLINE, EMBASE, CINHAL and the Cochrane databases were searched from the year 2000 onwards using combinations of keywords 'left superior vena cava' and 'outcome'. Two authors reviewed all abstracts independently. Quality assessment of the included studies was performed using the Newcastle-Ottawa Scale for cohort studies. The rates of the following outcomes were analyzed: chromosomal abnormalities; associated intracardiac anomalies (ICAs) and extracardiac anomalies (ECAs) diagnosed prenatally; additional ICAs and ECAs detected only at postnatal imaging or clinical evaluation but missed at prenatal imaging; and association of PLSVC and coarctation of the aorta. Meta-analyses of proportions were used to combine data. In total, 2708 articles were identified and 13 (n = 501) were included in the systematic review. Associated ICAs and ECAs were detected at the prenatal ultrasound examination or at a follow-up assessment in 60.7% (95% CI, 44.2-75.9%) and 37.8% (95% CI, 31.0-44.8%) of cases, respectively. Chromosomal anomalies occurred in 12.5% (95% CI, 9.0-16.4%) of cases in the overall population of fetuses with PLSVC and in 7.0% (95% CI, 2.7-13.0%) of isolated cases. Additional ICAs and ECAs were detected only after birth and missed at ultrasound in 2.4% (95% CI, 0.5-5.8%) and 6.7% (95% CI, 2.2-13.2%) of cases, respectively. Coarctation of the aorta was associated with isolated PLSVC in 21.3% (95% CI, 13.6-30.3%) of cases. PLSVC is commonly associated with ICAs, ECAs and chromosomal anomalies. Fetuses with isolated PLSVC should be followed up throughout pregnancy in order to rule out coarctation of the aorta. As most of the data in this review were derived from

  14. Left ventricular global longitudinal strain is predictive of all-cause mortality independent of aortic stenosis severity and ejection fraction.

    Science.gov (United States)

    Ng, Arnold C T; Prihadi, Edgard A; Antoni, M Louisa; Bertini, Matteo; Ewe, See Hooi; Ajmone Marsan, Nina; Leung, Dominic Y; Delgado, Victoria; Bax, Jeroen J

    2017-07-28

    Left ventricular (LV) global longitudinal strain (GLS) may identify subclinical myocardial dysfunction in patients with aortic stenosis (AS). The aims of the present retrospective single centre study were to determine the independent prognostic value of LV GLS over LV ejection fraction (EF) and the role of LV GLS to further risk stratify severe AS patients before aortic valve replacement. A total of 688 patients (median age 72 years, 61.2% men) with mild (n = 130), moderate (n = 264) and severe AS (n = 294) were included. LV GLS was determined by 2D speckle tracking echocardiography. A total of 114 (16.6%) patients died before surgery during the study. When patients with severe AS and normal LVEF were dichotomized based on the median LV GLS value (-14.0%), patients with normal LVEF and 'preserved' LV GLS of ≤ -14% had significantly higher survival than patients with 'impaired' LV GLS of > -14%. There was no difference in survival between patients with normal LVEF but 'impaired' LV GLS ( > -14%) and patients with impaired LVEF (log-rank P = 0.34). LV GLS was independently associated with all-cause mortality on multivariable Cox regression analysis (hazard ratio 1.17, 95% confidence interval 1.09-1.26; P optimal timing of aortic valve replacement. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  15. Incidence of Persistent Left Superior Vena Cava in the Normal Population and in Patients with Congenital Heart Diseases Detected Using Echocardiography.

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    Nagasawa, Hiroyuki; Kuwabara, Naoki; Goto, Hiroko; Omoya, Kentarou; Yamamoto, Tetsuya; Terazawa, Atsushi; Kohno, Yoshinori; Kuwahara, Takashi

    2018-03-01

    Reports on the incidence of persistent left superior vena cava (PLSVC) in the normal population are limited to studies involving pacemaker implantation candidates and cadavers. The incidence in patients with congenital heart diseases (CHDs) is estimated to be higher than that in the normal population; however, the details are unclear. To investigate the incidence of PLSVC in the normal population and in patients with CHDs, subjects were examined prospectively using echocardiography. Normal subjects consisted of 2841 successive neonates without intra-cardiac or congenital anomalies born in Gifu Prefectural General Medical Center. Additionally, 1920 patients with CHDs were evaluated. The incidence of PLSVC in normal neonates was 0.21% (95% confidence interval 0.042-0.38%). A high incidence (more than 7.0 times the incidence in normal subjects) was observed in all CHD patients. The high incidence group included coarctation of the aorta (CoA) (23.7%) and double outlet right ventricle (DORV) patients (24.6%). The second group consisted of CHD patients with ventricular septal defect (VSD), with an incidence ranging from 5.1 to 6.1%. The low incidence group comprised patients with other CHDs, with an incidence between 1.5 and 3.1%. The incidence of PLSVC in trisomy 21 and atrial septal defect patients was significantly higher than that in normal neonates. The incidence of PLSVC in the normal population and in patients with CHDs was systematically evaluated for the first time. The incidence in CHD patients appeared to be positively influenced by the type of CHD, particularly by DORV, CoA, and VSD.

  16. A prospective randomised longitudinal MRI study of left ventricular adaptation to endurance and resistance exercise training in humans.

    Science.gov (United States)

    Spence, Angela L; Naylor, Louise H; Carter, Howard H; Buck, Christopher L; Dembo, Lawrence; Murray, Conor P; Watson, Philip; Oxborough, David; George, Keith P; Green, Daniel J

    2011-11-15

    The principle that 'concentric' cardiac hypertrophy occurs in response to strength training, whilst 'eccentric' hypertrophy results from endurance exercise has been a fundamental tenet of exercise science. This notion is largely based on cross-sectional comparisons of athletes using echocardiography. In this study, young (27.4 ± 1.1 years) untrained subjects were randomly assigned to supervised, intensive, endurance (END, n = 10) or resistance (RES, n = 13) exercise and cardiac MRI scans and myocardial speckle tracking echocardiography were performed at baseline, after 6 months of training and after a subsequent 6 weeks of detraining. Aerobic fitness increased significantly in END (3.5 to 3.8 l min(-1), P < 0.05) but was unchanged in RES. Muscular strength significantly improved compared to baseline in both RES and END ( = 53.0 ± 1.1 versus 36.4 ± 4.5 kg, both P < 0.001) as did lean body mass (2.3 ± 0.4 kg, P < 0.001 versus 1.4 ± 0.6 kg P < 0.05). MRI derived left ventricular (LV) mass increased significantly following END (112.5 ± 7.3 to 121.8 ± 6.6 g, P < 0.01) but not RES, whilst training increased end-diastolic volume (LVEDV, END: +9.0 ± 5.0 versus RES +3.1 ± 3.6 ml, P = 0.05). Interventricular wall thickness significantly increased with training in END (1.06 ± 0.0 to 1.14 ± 0.06, P < 0.05) but not RES. Longitudinal strain and strain rates did not change following exercise training. Detraining reduced aerobic fitness, LV mass and wall thickness in END (P < 0.05), whereas LVEDV remained elevated. This study is the first to use MRI to compare LV adaptation in response to intensive supervised endurance and resistance training. Our findings provide some support for the 'Morganroth hypothesis', as it pertains to LV remodelling in response to endurance training, but cast some doubt over the proposal that remodelling occurs in response to resistance training.

  17. Impaired left ventricular global longitudinal strain in patients with heart failure with preserved ejection fraction: insights from the RELAX trial.

    Science.gov (United States)

    DeVore, Adam D; McNulty, Steven; Alenezi, Fawaz; Ersboll, Mads; Vader, Justin M; Oh, Jae K; Lin, Grace; Redfield, Margaret M; Lewis, Gregory; Semigran, Marc J; Anstrom, Kevin J; Hernandez, Adrian F; Velazquez, Eric J

    2017-07-01

    While abnormal left ventricular (LV) global longitudinal strain (GLS) has been described in patients with heart failure with preserved ejection fraction (HFpEF), its prevalence and clinical significance are poorly understood. Patients enrolled in the RELAX trial of sildenafil in HFpEF (LV ejection fraction ≥50%) in whom two-dimensional, speckle-tracking LV GLS was possible (n = 187) were analysed. The distribution of LV GLS and its associations with clinical characteristics, LV structure and function, biomarkers, exercise capacity and quality of life were assessed. Baseline median LV GLS was -14.6% (25th and 75th percentile, -17.0% and -11.9%, respectively) and abnormal (≥ - 16%) in 122/187 (65%) patients. Patients in the tertile with the best LV GLS had lower N-terminal pro-brain natriuretic peptide (NT-proBNP) [median 505 pg/mL (161, 1065) vs. 875 pg/mL (488, 1802), P = 0.008) and lower collagen III N-terminal propeptide (PIIINP) levels [median 6.7 µg/L (5.1, 8.1) vs. 8.1 µg/L (6.5, 10.5), P = 0.001] compared with the tertile with the worst LV GLS. There was also a modest linear relationship with LV GLS and log-transformed NT-proBNP and PIIINP (r = 0.29, P < 0.001 and r = 0.19, P = 0.009, respectively). We observed no linear association of LV GLS with Minnesota Living with Heart Failure scores, 6-min walk distance, peak oxygen consumption, or expiratory minute ventilation/carbon dioxide excretion slope. Impaired LV GLS is common among HFpEF patients, indicating the presence of covert systolic dysfunction despite normal LV ejection fraction. Impaired LV GLS was associated with biomarkers of wall stress and collagen synthesis and diastolic dysfunction but not with quality of life or exercise capacity, suggesting other processes may be more responsible for these aspects of the HFpEF syndrome. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

  18. Linfedema Primário em Membro Superior Esquerdo em Paciente Idosa / Primary Lymphedema in Upper Left Member in Elderly Patient

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    Melissa Andreia de Moraes Silva

    2016-09-01

    Full Text Available Introdução: O Linfedema Primário (LP é caracterizado por disfunção do sistema linfático de etiologia idiopática. Este pode ser dividido em congênito, precoce e tardio, sendo o tipo congênito o mais raro. O diagnóstico desta patologia é predominantemente clínico, podendo ser solicitado linfocintilografia quando há dúvida diagnóstica. O diagnóstico precoce está diretamente relacionado com o melhor prognóstico do paciente, postergando limitações físicas e psico­sociais. O tratamento do LP é clínico e multiprofissional. Relato do Caso: Relatou­se caso raro de uma paciente de 78 anos de idade, sexo feminino, portadora de Linfedema Primário em membro superior esquerdo desde o nascimento, o qual foi investigado durante a infância, porém com resultados inconclusivos. Conclusão: Embora seja pequena a quantidade de trabalhos sobre o tema, este relato confirma que o diagnóstico precoce é fundamental e que o tratamento igualmente precoce e multiprofissional melhora a qualidade de vida dos pacientes. Introduction: Primary lymphedema (PL is characterized by dysfunction of the lymphatic system of idiopathic etiology. It can be divided into congenital, early and late, with the congenital type being the rarest. The diagnosis of this pathology is predominantly clinical, and a lymphoscintilography may be requested when the diagnostic is uncertain. Early diagnosis is directly related to better patient prognosis, delaying physical and psychosocial limitations. Treatment of PL is clinical and multiprofessional. Case Report: The aim of this paper is to describe a rare case of a 78­ year­old female with primary lymphedema in the left arm since her birth, which was investigated during childhood, but with inconclusive results. Conclusion: Although there is small amount of work on the topic, this report confirms that early diagnosis is crucial and also that early and multidisciplinary treatment improves the quality of life of patients.

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

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    Ríos Giovanny

    2012-06-01

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

  20. The impact of preload reduction with head-up tilt testing on longitudinal and transverse left ventricular mechanics: a study utilizing deformation volume analysis.

    Science.gov (United States)

    Schneider, Caroline; Forsythe, Lynsey; Somauroo, John; George, Keith; Oxborough, David

    2018-03-01

    Left ventricular (LV) function is dependent on load, intrinsic contractility and relaxation with a variable impact on specific mechanics. Strain (ε) imaging allows the assessment of cardiac function; however, the direct relationship between volume and strain is currently unknown. The aim of this study was to establish the impact of preload reduction through head-up tilt (HUT) testing on simultaneous left ventricular (LV) longitudinal and transverse function and their respective contribution to volume change. A focused transthoracic echocardiogram was performed on 10 healthy male participants (23 ± 3 years) in the supine position and following 1 min and 5 min of HUT testing. Raw temporal longitudinal ε (Ls) and transverse ε (Ts) values were exported and divided into 5% increments across the cardiac cycle and corresponding LV volumes were traced at each 5% increment. This provided simultaneous LV longitudinal and transverse ε and volume loops (deformation volume analysis - DVA). There was a leftward shift of the ε-volume loop from supine to 1 min and 5 min of HUT ( P  maintenance of LV filling in the setting of reduced preload. DVA provides information on the relative contribution of mechanics to a change in LV volume and may have a role in the assessment of clinical populations. © 2018 The authors.

  1. Altered Connectivity of the Anterior Cingulate and the Posterior Superior Temporal Gyrus in a Longitudinal Study of Later-life Depression

    Directory of Open Access Journals (Sweden)

    Kenichiro Harada

    2018-02-01

    Full Text Available Patients with later-life depression (LLD show abnormal gray matter (GM volume, white matter (WM integrity and functional connectivity in the anterior cingulate cortex (ACC and posterior superior temporal gyrus (pSTG, but it remains unclear whether these abnormalities persist over time. We examined whether structural and functional abnormalities in these two regions are present within the same subjects during depressed vs. remitted phases. Sixteen patients with LLD and 30 healthy subjects were studied over a period of 1.5 years. Brain images obtained with a 3-Tesla magnetic resonance imaging (MRI system were analyzed by voxel-based morphometry of the GM volume, and diffusion tensor imaging (DTI and resting-state functional MRI were used to assess ACC–pSTG connectivity. Patients with LLD in the depressed and remitted phases showed significantly smaller GM volume in the left ACC and left pSTG than healthy subjects. Both patients with LLD in the depressed and remitted phases had significantly higher diffusivities in the WM tract of the left ACC–pSTG than healthy subjects. Remitted patients with LLD showed lower functional ACC–pSTG connectivity compared to healthy subjects. No difference was found in the two regions between depressed and remitted patients in GM volume, structural or functional connectivity. Functional ACC–pSTG connectivity was positively correlated with lower global function during remission. Our preliminary data show that structural and functional abnormalities of the ACC and pSTG occur during LLD remission. Our findings tentatively reveal the brain pathophysiology involved in LLD and may aid in developing neuroanatomical biomarkers for this condition.

  2. Altered Connectivity of the Anterior Cingulate and the Posterior Superior Temporal Gyrus in a Longitudinal Study of Later-life Depression.

    Science.gov (United States)

    Harada, Kenichiro; Ikuta, Toshikazu; Nakashima, Mami; Watanuki, Toshio; Hirotsu, Masako; Matsubara, Toshio; Yamagata, Hirotaka; Watanabe, Yoshifumi; Matsuo, Koji

    2018-01-01

    Patients with later-life depression (LLD) show abnormal gray matter (GM) volume, white matter (WM) integrity and functional connectivity in the anterior cingulate cortex (ACC) and posterior superior temporal gyrus (pSTG), but it remains unclear whether these abnormalities persist over time. We examined whether structural and functional abnormalities in these two regions are present within the same subjects during depressed vs. remitted phases. Sixteen patients with LLD and 30 healthy subjects were studied over a period of 1.5 years. Brain images obtained with a 3-Tesla magnetic resonance imaging (MRI) system were analyzed by voxel-based morphometry of the GM volume, and diffusion tensor imaging (DTI) and resting-state functional MRI were used to assess ACC-pSTG connectivity. Patients with LLD in the depressed and remitted phases showed significantly smaller GM volume in the left ACC and left pSTG than healthy subjects. Both patients with LLD in the depressed and remitted phases had significantly higher diffusivities in the WM tract of the left ACC-pSTG than healthy subjects. Remitted patients with LLD showed lower functional ACC-pSTG connectivity compared to healthy subjects. No difference was found in the two regions between depressed and remitted patients in GM volume, structural or functional connectivity. Functional ACC-pSTG connectivity was positively correlated with lower global function during remission. Our preliminary data show that structural and functional abnormalities of the ACC and pSTG occur during LLD remission. Our findings tentatively reveal the brain pathophysiology involved in LLD and may aid in developing neuroanatomical biomarkers for this condition.

  3. Lower white matter microstructure in the superior longitudinal fasciculus is associated with increased response time variability in adults with attention-deficit/ hyperactivity disorder.

    Science.gov (United States)

    Wolfers, Thomas; Onnink, A Marten H; Zwiers, Marcel P; Arias-Vasquez, Alejandro; Hoogman, Martine; Mostert, Jeanette C; Kan, Cornelis C; Slaats-Willemse, Dorine; Buitelaar, Jan K; Franke, Barbara

    2015-09-01

    Response time variability (RTV) is consistently increased in patients with attention-deficit/hyperactivity disorder (ADHD). A right-hemispheric frontoparietal attention network model has been implicated in these patients. The 3 main connecting fibre tracts in this network, the superior longitudinal fasciculus (SLF), inferior longitudinal fasciculus (ILF) and the cingulum bundle (CB), show microstructural abnormalities in patients with ADHD. We hypothesized that the microstructural integrity of the 3 white matter tracts of this network are associated with ADHD and RTV. We examined RTV in adults with ADHD by modelling the reaction time distribution as an exponentially modified Gaussian (ex-Gaussian) function with the parameters μ, σ and τ, the latter of which has been attributed to lapses of attention. We assessed adults with ADHD and healthy controls using a sustained attention task. Diffusion tensor imaging-derived fractional anisotropy (FA) values were determined to quantify bilateral microstructural integrity of the tracts of interest. We included 100 adults with ADHD and 96 controls in our study. Increased τ was associated with ADHD diagnosis and was linked to symptoms of inattention. An inverse correlation of τ with mean FA was seen in the right SLF of patients with ADHD, but no direct association between the mean FA of the 6 regions of interest with ADHD could be observed. Regions of interest were defined a priori based on the attentional network model for ADHD and thus we might have missed effects in other networks. This study suggests that reduced microstructural integrity of the right SLF is associated with elevated τ in patients with ADHD.

  4. Longitudinal left ventricular function for prediction of survival in systemic light-chain amyloidosis: incremental value compared with clinical and biochemical markers.

    Science.gov (United States)

    Buss, Sebastian J; Emami, Mostafa; Mereles, Derliz; Korosoglou, Grigorios; Kristen, Arnt V; Voss, Andreas; Schellberg, Dieter; Zugck, Christian; Galuschky, Christian; Giannitsis, Evangelos; Hegenbart, Ute; Ho, Anthony D; Katus, Hugo A; Schonland, Stefan O; Hardt, Stefan E

    2012-09-18

    The aim of the study was to determine whether longitudinal left ventricular (LV) function provides prognostic information in a large cohort of patients with systemic light-chain (AL) amyloidosis. AL amyloidosis is associated with a high incidence of cardiovascular events. Reduced myocardial longitudinal function is one of the hallmarks of myocardial involvement in this rare disease. Two hundred six consecutive patients with biopsy-proven AL amyloidosis were investigated in this prospective observational study. Echocardiographic imaging parameters, mean tissue Doppler-derived longitudinal strain (LS), and two-dimensional global longitudinal strain (2D-GLS) of the LV, cardiac serological biomarkers, and comprehensive clinical disease characteristics were assessed. The primary endpoint was all-cause mortality or heart transplantation. After a median follow-up of 1207 days, LS and 2D-GLS were significant predictors of survival in AL amyloidosis. The cutoff values discriminating survivors from nonsurvivors were -10.65% for LS and -11.78% for 2D-GLS. In a multivariable echocardiographic Cox model, only diastolic dysfunction and 2D-GLS remained as independent predictors of survival. In comprehensive clinical models, 2D-GLS (p chains (p value compared with that derived from pathologic free light chains or cTnT in patients evaluated before firstline chemotherapy (n = 113; p < 0.0001), and remained the only independent predictor besides the Karnofsky index in subjects with preserved LV ejection fraction (≥50%; n = 127; p < 0.01). LS and 2D-GLS both offered significant incremental information (p < 0.001) for the assessment of outcome compared with clinical variables (age, Karnofsky index, and New York Heart Association functional class) and serological biomarkers. In the largest serial investigation reported so far, reduced LV longitudinal function served as an independent predictor of survival in AL amyloidosis and offered incremental information beyond standard clinical

  5. Development of left ventricular longitudinal speckle tracking echocardiography in very low birth weight infants with and without bronchopulmonary dysplasia during the neonatal period.

    Directory of Open Access Journals (Sweden)

    Christoph Czernik

    Full Text Available OBJECTIVES: In preterm infants, postnatal myocardial adaptation may be complicated by bronchopulmonary dysplasia (BPD. We aimed to describe the development of left ventricular function by serial 2D, Doppler, and speckle tracking echocardiography (2D-STE in infants with and without BPD during the neonatal period and compare these to anthropometric and conventional hemodynamic parameters. STUDY DESIGN: Prospective echocardiography on day of life (DOL 1, 7, 14, and 28 in 119 preterm infants 10% were seen for the apical segment. While anthropometric parameters show rapid development during the first 4 weeks of life, the speckle tracking parameters did not differ statistically significantly during the neonatal period. Infants with and without BPD differed significantly (p<0.001 in the development of anthropometric parameters, conventional hemodynamic parameters except for heart rate, and 2D-STE parameters: global longitudinal systolic strain rate (GLSSR and longitudinal systolic strain for the mid left wall (LSSR. The largest differences were seen at DOL 1 and 7 in GLSSR (p<0.001 and in LSSR (p<0.01. CONCLUSIONS: Reproducible 2D-STE measurements are possible in preterm infants <1500 g. Cardiac deformation reveals early (DOL 1 and 7 ventricular changes (GLSSR and LSSR in very low birth weight infants who develop BPD.

  6. The relationship between visceral adiposity and left ventricular diastolic function: Results from the Baltimore Longitudinal Study of Aging

    NARCIS (Netherlands)

    Canepa, M.; Strait, J.B.; Milaneschi, Y.; AlGhatrif, M.; Ramachandran, R.; Makrogiannis, S.; Moni, M.; David, M.; Brunelli, C.; Lakatta, E.G.; Ferrucci, L.

    2013-01-01

    Background and aims: It is unclear whether subcutaneous and visceral fat are differentially correlated to the decline in left ventricular (LV) diastolic function with aging. This study sought to examine the hypothesis that age-related changes in the regional fat distribution account for changes in

  7. Right ventricular longitudinal strain and right ventricular stroke work index in patients with severe heart failure: left ventricular assist device suitability for transplant candidates.

    Science.gov (United States)

    Cameli, M; Bernazzali, S; Lisi, M; Tsioulpas, C; Croccia, M G; Lisi, G; Maccherini, M; Mondillo, S

    2012-09-01

    Right ventricular (RV) systolic function has a critical role in determining the clinical outcome and the success of using left ventricular assist devices in patients with refractory heart failure. RV deformation analysis by speckle tracking echocardiography (STE) has recently allowed the analysis of RV longitudinal function. Using cardiac catheterization as the reference standard, this study aimed to explore the correlation between RV longitudinal function by STE and RV stroke work index (RVSWI) among patients referred for cardiac transplantation. Right heart catheterization and transthoracic echo-Doppler were simultaneously performed in 47 patients referred for cardiac transplant assessment due to refractory heart failure (ejection fraction 25.1 ± 4.5%). Thermodilution RV stroke volume and invasive pulmonary pressures were used to obtain RVSWI. RV longitudinal strain (RVLS) by STE was assessed averaging RV free-wall segments (free-wall RVLS). We also calculated. Tricuspid S' and tricuspid annular plane systolic excursion (TAPSE). No significant correlation was observed for TAPSE on tricuspid S' with RV stroke volume (r = 0.14 and r = 0.06, respectively). A close negative correlation between free-wall RVLS and RVSWI was found (r = -0.82; P rights reserved.

  8. Importance of human right inferior frontoparietal network connected by inferior branch of superior longitudinal fasciculus tract in corporeal awareness of kinesthetic illusory movement.

    Science.gov (United States)

    Amemiya, Kaoru; Naito, Eiichi

    2016-05-01

    It is generally believed that the human right cerebral hemisphere plays a dominant role in corporeal awareness, which is highly associated with conscious experience of the physical self. Prompted by our previous findings, we examined whether the right frontoparietal activations often observed when people experience kinesthetic illusory limb movement are supported by a large-scale brain network connected by a specific branch of the superior longitudinal fasciculus fiber tracts (SLF I, II, and III). We scanned brain activity with functional magnetic resonance imaging (MRI) while nineteen blindfolded healthy volunteers experienced illusory movement of the right stationary hand elicited by tendon vibration, which was replicated after the scanning. We also scanned brain activity when they executed and imagined right hand movement, and identified the active brain regions during illusion, execution, and imagery in relation to the SLF fiber tracts. We found that illusion predominantly activated the right inferior frontoparietal regions connected by SLF III, which were not substantially recruited during execution and imagery. Among these regions, activities in the right inferior parietal cortices and inferior frontal cortices showed right-side dominance and correlated well with the amount of illusion (kinesthetic illusory awareness) experienced by the participants. The results illustrated the predominant involvement of the right inferior frontoparietal network connected by SLF III when people recognize postural changes of their limb. We assume that the network bears a series of functions, specifically, monitoring the current status of the musculoskeletal system, and building-up and updating our postural model (body schema), which could be a basis for the conscious experience of the physical self. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. Self-face recognition shares brain regions active during proprioceptive illusion in the right inferior fronto-parietal superior longitudinal fasciculus III network.

    Science.gov (United States)

    Morita, Tomoyo; Saito, Daisuke N; Ban, Midori; Shimada, Koji; Okamoto, Yuko; Kosaka, Hirotaka; Okazawa, Hidehiko; Asada, Minoru; Naito, Eiichi

    2017-04-21

    Proprioception is somatic sensation that allows us to sense and recognize position, posture, and their changes in our body parts. It pertains directly to oneself and may contribute to bodily awareness. Likewise, one's face is a symbol of oneself, so that visual self-face recognition directly contributes to the awareness of self as distinct from others. Recently, we showed that right-hemispheric dominant activity in the inferior fronto-parietal cortices, which are connected by the inferior branch of the superior longitudinal fasciculus (SLF III), is associated with proprioceptive illusion (awareness), in concert with sensorimotor activity. Herein, we tested the hypothesis that visual self-face recognition shares brain regions active during proprioceptive illusion in the right inferior fronto-parietal SLF III network. We scanned brain activity using functional magnetic resonance imaging while twenty-two right-handed healthy adults performed two tasks. One was a proprioceptive illusion task, where blindfolded participants experienced a proprioceptive illusion of right hand movement. The other was a visual self-face recognition task, where the participants judged whether an observed face was their own. We examined whether the self-face recognition and the proprioceptive illusion commonly activated the inferior fronto-parietal cortices connected by the SLF III in a right-hemispheric dominant manner. Despite the difference in sensory modality and in the body parts involved in the two tasks, both tasks activated the right inferior fronto-parietal cortices, which are likely connected by the SLF III, in a right-side dominant manner. Here we discuss possible roles for right inferior fronto-parietal activity in bodily awareness and self-awareness. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  10. Off-pump coronary artery bypass surgery in selected patients is superior to the conventional approach for patients with severely depressed left ventricular function

    Directory of Open Access Journals (Sweden)

    Guido Marco Caputti

    2011-01-01

    Full Text Available OBJECTIVES: Patients with coronary artery disease and left ventricular dysfunction have high mortality when kept in clinical treatment. Coronary artery bypass grafting can improve survival and the quality of life. Recently, revascularization without cardiopulmonary bypass has been presented as a viable alternative. The aim of this study is to compare patients with left ventricular ejection fractions of less than 20% who underwent coronary artery bypass graft with or without cardiopulmonary bypass. METHODS: From January 2001 to December 2005, 217 nonrandomized, consecutive, and nonselected patients with an ejection fraction less than or equal to 20% underwent coronary artery bypass graft surgery with (112 or without (off-pump (105 the use of cardiopulmonary bypass. We studied demographic, operative, and postoperative data. RESULTS: There were no demographic differences between groups. The outcome variables showed similar graft numbers in both groups. Mortality was 12.5% in the cardiopulmonary bypass group and 3.8% in the off-pump group. Postoperative complications were statistically different (cardiopulmonary bypass versus off-pump: total length of hospital stay (days-11.3 vs. 7.2, length of ICU stay (days-3.7 vs. 2.1, pulmonary complications-10.7% vs. 2.8%, intubation time (hours-22 vs. 10, postoperative bleeding (mL-654 vs. 440, acute renal failure-8.9% vs. 1.9% and left-ventricle ejection fraction before discharge-22% vs. 29%. CONCLUSION: Coronary artery bypass grafting without cardiopulmonary bypass in selected patients with severe left ventricular dysfunction is valid and safe and promotes less mortality and morbidity compared with conventional operations.

  11. Assessment value of 3-dimensional speckle tracking imaging for changes of early left ventricular longitudinal systolic function in patients with primary hypertension

    Directory of Open Access Journals (Sweden)

    Jing Yu

    2016-08-01

    Full Text Available Objective: To study the assessment value of 3-dimensional speckle tracking imaging for changes of early left ventricular longitudinal systolic function in patients with primary hypertension. Methods: Patients with primary hypertension who were treated in our hospital from May 2012 to October 2015 were selected, and 40 patients with left ventricular normal (LVN primary hypertension and 40 patients with left ventricular remodeling (LVR primary hypertension were screened according to Ganau typing and enrolled in the LVN group and LVR group of the study respectively; 40 cases of healthy volunteers who received physical examination in our hospital during the same period were selected as control group. Ultrasonic testing was conducted to determine conventional ultrasonic indicators and 3D-STI parameters, and serum was collected to determine AngII, ALD, TGF-β1 and Ang1-7 levels. Results: LVEDd, LVPWT and LVEF of LVN group were not significantly different from those of control group, LVEF of LVR group was not significantly different from those of LVN group and control group, and LVEDd and LVPWT of LVR group were significantly higher than those of LVN group and control group; absolute values of GLS, GCS, GRS and GAS as well as serum Ang1-7 level of LVN group was significantly lower than those of control group, serum AngII, ALD and TGF-β1 levels were higher than those of control group, absolute values of GLS, GCS, GRS and GAS as well as serum Ang1-7 level of LVR group was significantly lower than those of LVN group and control group, and serum AngII, ALD and TGF-β1 levels were higher than those of LVN group and control group; absolute values of GLS, GCS, GRS and GAS were negatively correlated with serum AngII, ALD and TGF-β1 levels, and positively correlated with serum Ang1-7 level. Conclusion: 3-dimensional speckle tracking imaging can be used for early evaluation of left ventricular longitudinal systolic function in patients with primary

  12. Correlation between Left Ventricular Global and Regional Longitudinal Systolic Strain and Impaired Microcirculation in Patients with Acute Myocardial Infarction

    DEFF Research Database (Denmark)

    Bridal Løgstrup, Brian; Hofsten, D. E.; Christophersen, T. B.

    2012-01-01

    . Assessment of CFR by TTE was performed in a modified apical view using color Doppler guidance. Results: The study population consisted of 183 patients (51 females) with a median age of 63 [54;70] years. Eighty-nine (49%) patients had a non-ST elevation myocardial infarction and 94 (51%) patients had a ST...... elevation myocardial infarction. The GLS was -15.2 [-19.3;-10.1]% in the total population of 183 patients. Total wall motion score index (WMSI) in the population was 1.19 [1;1.5]. Eighty-five patients suffered from culprit lesion in left anterior descending artery (LAD). The CFR in these patients was 1...

  13. The left superior temporal gyrus is a shared substrate for auditory short-term memory and speech comprehension: evidence from 210 patients with stroke.

    Science.gov (United States)

    Leff, Alexander P; Schofield, Thomas M; Crinion, Jennifer T; Seghier, Mohamed L; Grogan, Alice; Green, David W; Price, Cathy J

    2009-12-01

    Competing theories of short-term memory function make specific predictions about the functional anatomy of auditory short-term memory and its role in language comprehension. We analysed high-resolution structural magnetic resonance images from 210 stroke patients and employed a novel voxel based analysis to test the relationship between auditory short-term memory and speech comprehension. Using digit span as an index of auditory short-term memory capacity we found that the structural integrity of a posterior region of the superior temporal gyrus and sulcus predicted auditory short-term memory capacity, even when performance on a range of other measures was factored out. We show that the integrity of this region also predicts the ability to comprehend spoken sentences. Our results therefore support cognitive models that posit a shared substrate between auditory short-term memory capacity and speech comprehension ability. The method applied here will be particularly useful for modelling structure-function relationships within other complex cognitive domains.

  14. Longitudinal changes in white matter microstructure after heavy cannabis use

    Directory of Open Access Journals (Sweden)

    Mary P. Becker

    2015-12-01

    Full Text Available Diffusion tensor imaging (DTI studies of cannabis users report alterations in brain white matter microstructure, primarily based on cross-sectional research, and etiology of the alterations remains unclear. We report findings from longitudinal voxelwise analyses of DTI data collected at baseline and at a 2-year follow-up on 23 young adult (18–20 years old at baseline regular cannabis users and 23 age-, sex-, and IQ-matched non-using controls with limited substance use histories. Onset of cannabis use was prior to age 17. Cannabis users displayed reduced longitudinal growth in fractional anisotropy in the central and parietal regions of the right and left superior longitudinal fasciculus, in white matter adjacent to the left superior frontal gyrus, in the left corticospinal tract, and in the right anterior thalamic radiation lateral to the genu of the corpus callosum, along with less longitudinal reduction of radial diffusion in the right central/posterior superior longitudinal fasciculus, corticospinal tract, and posterior cingulum. Greater amounts of cannabis use were correlated with reduced longitudinal growth in FA as was relatively impaired performance on a measure of verbal learning. These findings suggest that continued heavy cannabis use during adolescence and young adulthood alters ongoing development of white matter microstructure, contributing to functional impairment.

  15. Global longitudinal strain corrected by RR interval is a superior predictor of all-cause mortality in patients with systolic heart failure and atrial fibrillation

    DEFF Research Database (Denmark)

    Modin, Daniel; Sengeløv, Morten; Jørgensen, Peter Godsk

    2017-01-01

    AIMS: Quantification of systolic function in patients with atrial fibrillation (AF) is challenging. A novel approach, based on RR interval correction, to counteract the varying heart cycle lengths in AF has recently been proposed. Whether this method is superior in patients with systolic heart fa...

  16. Left ventricular global longitudinal strain in patients with heart failure with preserved ejection fraction: outcomes following an acute heart failure hospitalization.

    Science.gov (United States)

    Buggey, Jonathan; Alenezi, Fawaz; Yoon, Hyun Ju; Phelan, Matthew; DeVore, Adam D; Khouri, Michel G; Schulte, Phillip J; Velazquez, Eric J

    2017-11-01

    While abnormal resting LV GLS has been described in patients with chronic heart failure with preserved ejection fraction (HFpEF), its prognostic significance when measured during an acute heart failure hospitalization remains unclear. We assessed the association between left ventricular global longitudinal strain (LV GLS) and outcomes in patients hospitalized with acute HFpEF. We studied patients discharged alive for acute HFpEF from Duke University Medical Center between 2007 and 2010. Among patients with measurable LV GLS, we performed 2D, speckle-tracking analysis and Cox proportional hazards models assessed the association between continuous LV GLS and outcomes. Baseline characteristics were stratified by normal (≤-16%) or abnormal (>-16%) LV GLS for comparison. Among 463 patients, the median LV GLS was -12.8% (Interquartile range, -15.8 to -10.8%) and was abnormal in 352 (76%). Overall patients in the cohort were generally elderly, female and had hypertension. After multivariable adjustment, worse outcomes were noted between LV GLS and mortality (HR 1.19 per 1% increase; 95% CI 1.00-1.42; P = 0.046) and a composite endpoint of mortality or rehospitalization at 30 days (HR 1.08 per 1% increase; 95% CI 0.99-1.18; P = 0.08). There was no association between LV GLS and mortality or a composite of mortality or rehospitalization at 1 year. A high prevalence of patients hospitalized with acute HFpEF have abnormal LV GLS suggesting unrecognized myocardial systolic dysfunction. Furthermore, worse LV GLS is associated with worse clinical outcomes at 30 days but not by1 year. © 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

  17. T'ain't what you say, it's the way that you say it--left insula and inferior frontal cortex work in interaction with superior temporal regions to control the performance of vocal impersonations.

    Science.gov (United States)

    McGettigan, Carolyn; Eisner, Frank; Agnew, Zarinah K; Manly, Tom; Wisbey, Duncan; Scott, Sophie K

    2013-11-01

    Historically, the study of human identity perception has focused on faces, but the voice is also central to our expressions and experiences of identity [Belin, P., Fecteau, S., & Bedard, C. Thinking the voice: Neural correlates of voice perception. Trends in Cognitive Sciences, 8, 129-135, 2004]. Our voices are highly flexible and dynamic; talkers speak differently, depending on their health, emotional state, and the social setting, as well as extrinsic factors such as background noise. However, to date, there have been no studies of the neural correlates of identity modulation in speech production. In the current fMRI experiment, we measured the neural activity supporting controlled voice change in adult participants performing spoken impressions. We reveal that deliberate modulation of vocal identity recruits the left anterior insula and inferior frontal gyrus, supporting the planning of novel articulations. Bilateral sites in posterior superior temporal/inferior parietal cortex and a region in right middle/anterior STS showed greater responses during the emulation of specific vocal identities than for impressions of generic accents. Using functional connectivity analyses, we describe roles for these three sites in their interactions with the brain regions supporting speech planning and production. Our findings mark a significant step toward understanding the neural control of vocal identity, with wider implications for the cognitive control of voluntary motor acts.

  18. Effect of eight weeks of endurance exercise training on right and left ventricular volume and mass in untrained obese subjects: a longitudinal MRI study

    DEFF Research Database (Denmark)

    Vogelsang, T W; Hanel, B; Kristoffersen, U S

    2008-01-01

    The aim of the present investigation was to examine how 8 weeks of intense endurance training influenced right and left ventricular volumes and mass in obese untrained subjects. Ten overweight subjects (19-47 years; body mass index of 34+/-5 kg/m(2)) underwent intensive endurance training (rowing...

  19. Early Cardiac Involvement Affects Left Ventricular Longitudinal Function in Females Carrying α-Galactosidase A Mutation: Role of Hybrid Positron Emission Tomography and Magnetic Resonance Imaging and Speckle-Tracking Echocardiography.

    Science.gov (United States)

    Spinelli, Letizia; Imbriaco, Massimo; Nappi, Carmela; Nicolai, Emanuele; Giugliano, Giuseppe; Ponsiglione, Andrea; Diomiaiuti, Tommaso Claudio; Riccio, Eleonora; Duro, Giovanni; Pisani, Antonio; Trimarco, Bruno; Cuocolo, Alberto

    2018-04-01

    Hybrid 18 F-fluorodeoxyglucose (FDG) positron emission tomography and magnetic resonance imaging may differentiate mature fibrosis or scar from fibrosis associated to active inflammation in patients with Anderson-Fabry disease, even in nonhypertrophic stage. This study was designed to compare the results of positron emission tomography and magnetic resonance cardiac imaging with those of speckle-tracking echocardiography in heterozygous Anderson-Fabry disease females. Twenty-four heterozygous females carrying α-galactosidase A mutation and without left ventricular hypertrophy underwent cardiac positron emission tomography and magnetic resonance using 18 F-FDG for glucose uptake and 2-dimensional strain echocardiography. 18 F-FDG myocardial uptake was quantified by measuring the coefficient of variation (COV) of the standardized uptake value using a 17-segment model. Focal 18 F-FDG uptake with COV >0.17 was detected in 13 patients, including 2 patients with late gadolinium enhancement at magnetic resonance. COV was 0.30±0.14 in patients with focal 18 F-FDG uptake and 0.12±0.03 in those without ( P 0.17 compared with those with COV ≤0.17 (-18.5±2.7% versus -22.2±1.8%; P =0.024). For predicting COV >0.17, a global longitudinal strain >-19.8% had 77% sensitivity and 91% specificity and a value >2 dysfunctional segments 92% sensitivity and 100% specificity. In females carrying α-galactosidase A mutation, focal 18 F-FDG uptake represents an early sign of disease-related myocardial damage and is associated with impaired left ventricular longitudinal function. These findings support the hypothesis that inflammation plays an important role in glycosphingolipids storage disorders. © 2018 American Heart Association, Inc.

  20. Analysis of Short- and Long-term Outcomes of Patients With Surgically Treated Left-sided Infective Endocarditis: A 5-Year Longitudinal Follow-up Study.

    Science.gov (United States)

    Marushchak, Oksana; Cole, Holy; Hiebert, Brett; Lo, Evelyn; Keynan, Yoav; Tam, James; Shaikh, Nasir; Menkis, Alan H; Arora, Rakesh C; Shah, Pallav

    2017-01-01

    This study aims to analyze survival, repeat hospitalization, and risk factors for surgically treated left-sided endocarditis. Retrospective review of all 166 (114 native and 52 prosthetic) patients operated between January 2004 and March 2015 was performed. Long-term survival and repeat hospitalization data for 134 of 166 patients were obtained via linked clinical databases with the Manitoba Centre for Health Policy. Kaplan-Meier estimates of survival and hospital readmission and Cox multivariable regression analysis of factors influencing outcomes were performed. Survival at 1 and 5 years was 91% and 80%, respectively, and major adverse prosthesis-related event repeat hospitalization rates were 12% and 21%, respectively. Repeat hospitalization because of endocarditis was 7% and 11% at 1 and 5 years, respectively. Survival and repeat hospitalization were similar for aortic and mitral valves. Survival after surgically treated endocarditis was similar to survival for age-, sex-, and valve-matched surgical valve replacements for noninfectious indications (P = 0.53). Viridans Streptococci was the most common organism in native valve endocarditis, and culture negative endocarditis was most common in prosthetic valves. Prosthetic valve endocarditis (P hospital mortality and major postoperative adverse events. Diabetes and renal dysfunction were associated with poor long-term survival, functional survival, and repeat hospitalization. This analysis suggests that surgery remains a very effective tool in management of these complex patients in terms of survival and major adverse prosthesis-related event repeat hospitalization. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. [Tourette syndrome and reading disorder in a boy with left parietofrontal tract disruption].

    Science.gov (United States)

    Martín Fernández-Mayoralas, D; Fernández-Jaén, A; Gómez Herrera, J J; Jiménez de la Peña, M

    2014-01-01

    We present the case of a nine-year-old boy with Tourette syndrome and reading disorder with a history of a severe infectious process in the late neonatal period. Brain MRI showed a left parietal malacotic cavity and diffusion tensor imaging and tractography showed a striking disruption of the white matter bundle that joins the left parietal region with the ipsilateral frontal region with involvement of the left superior longitudinal fasciculus and of the left arcuate fasciculus. Although Tourette syndrome and reading disorder are fundamentally hereditary neuropsychiatric disorders, they can also occur secondary to cerebral alterations like those existing in this boy. The introduction of modern neuroimaging techniques in patients with neuropsychiatric disorders (or the risk of developing them) can be very useful in the diagnosis and prognosis in the future. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

  2. Individual structural differences in left inferior parietal area are associated with schoolchildrens’ arithmetic scores

    Directory of Open Access Journals (Sweden)

    Yongxin eLi

    2013-12-01

    Full Text Available Arithmetic skill is of critical importance for academic achievement, professional success and everyday life, and childhood is the key period to acquire this skill. Neuroimaging studies have identified that left parietal regions are a key neural substrate for representing arithmetic skill. Although the relationship between functional brain activity in left parietal regions and arithmetic skill has been studied in detail, it remains unclear about the relationship between arithmetic achievement and structural properties in left inferior parietal area in schoolchildren. The current study employed a combination of voxel-based morphometry (VBM for high-resolution T1-weighted images and fiber tracking on diffusion tensor imaging (DTI to examine the relationship between structural properties in the inferior parietal area and arithmetic achievement in 10-year-old schoolchildren. VBM of the T1-weighted images revealed that individual differences in arithmetic scores were significantly and positively correlated with the grey matter (GM volume in the left intraparietal sulcus (IPS. Fiber tracking analysis revealed that the forceps major, left superior longitudinal fasciculus (SLF, bilateral inferior longitudinal fasciculus (ILF and inferior fronto-occipital fasciculus (IFOF were the primary pathways connecting the left IPS with other brain areas. Furthermore, the regression analysis of the probabilistic pathways revealed a significant and positive correlation between the fractional anisotropy (FA values in the left SLF, ILF and bilateral IFOF and arithmetic scores. The brain structure-behavior correlation analyses indicated that the GM volumes in the left IPS and the FA values in the tract pathways connecting left IPS were both related to children’s arithmetic achievement. The present findings provide evidence that individual structural differences in the left IPS are associated with arithmetic scores in schoolchildren.

  3. Progressive gray matter reduction of the superior temporal gyrus during transition to psychosis.

    Science.gov (United States)

    Takahashi, Tsutomu; Wood, Stephen J; Yung, Alison R; Soulsby, Bridget; McGorry, Patrick D; Suzuki, Michio; Kawasaki, Yasuhiro; Phillips, Lisa J; Velakoulis, Dennis; Pantelis, Christos

    2009-04-01

    Longitudinal magnetic resonance imaging studies have shown progressive gray matter reduction in the superior temporal gyrus during the earliest phases of schizophrenia. It is unknown whether these progressive processes predate the onset of psychosis. To examine gray matter reduction of the superior temporal gyrus over time in individuals at risk for psychosis and in patients with first-episode psychosis. Cross-sectional and longitudinal comparisons. Personal Assessment and Crisis Evaluation Clinic and Early Psychosis Preventions and Intervention Centre. Thirty-five ultrahigh-risk individuals (of whom 12 later developed psychosis [UHRP] and 23 did not [UHRNP]), 23 patients with first-episode psychosis (FEP), and 22 control subjects recruited from the community. Volumes of superior temporal subregions (planum polare, Heschl gyrus, planum temporale, and rostral and caudal regions) were measured at baseline and follow-up (mean, 1.8 years) and were compared across groups. In cross-sectional comparisons, only the FEP group had significantly smaller planum temporale and caudal superior temporal gyrus than other groups at baseline, whereas male UHRP subjects also had a smaller planum temporale than controls at follow-up. In longitudinal comparison, UHRP and FEP patients showed significant gray matter reduction (approximately 2%-6% per year) in the planum polare, planum temporale, and caudal region compared with controls and/or UHRNP subjects. The FEP patients also exhibited progressive gray matter loss in the left Heschl gyrus (3.0% per year) and rostral region (3.8% per year), which were correlated with the severity of delusions at follow-up. A progressive process in the superior temporal gyrus precedes the first expression of florid psychosis. These findings have important implications for underlying neurobiologic features of emerging psychotic disorders and emphasize the importance of early intervention during or before the first episode of psychosis.

  4. Takotsubo cardiomyopathy in the case of 72-year-old teacher after work-related psychological stress. Evolution of left ventricular longitudinal strain - Delayed but complete recovery in automated function imaging (AFI).

    Science.gov (United States)

    Wierzbowska-Drabik, Karina; Marcinkiewicz, Andrzej; Hamala, Piotr; Trzos, Ewa; Lipiec, Piotr; Kurpesa, Małgorzata; Kręcki, Radosław; Plewka, Michał; Kasprzak, Jarosław D

    2017-06-19

    Takotsubo cardiomyopathy (TC) is related to a transient systolic dysfunction of left ventricle (LV), accompanied by clinical and electrocardiographic symptoms of myocardial ischemia in the absence of hemodynamically significant coronary artery disease. Takotsubo cardiomyopathy is usually provoked by a psychologically or/and physically stressful event which may be related to occupational activities. Although visually assessed evolution of LV function is well documented, the data concerning strain changes is sparse and various patterns of deformation abnormalities are suggested. We have described a 72-year-old woman with chest pain related to a lecture given at the meeting of the Senior University, fulfilling all the Mayo Clinic criteria of the TC. The longitudinal strain analysis with automated function imaging (AFI) documented severe impairment and stepwise recovery of regional and global LV contractility. The case described confirms that accurate diagnosis, treatment and documenting of functional improvement in takotsubo cardiomyopathy may enable the return to occupational activities even for elderly persons. Int J Occup Med Environ Health 2017;30(4):681-683. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  5. Is the Deep Inspiration Breath-Hold Technique Superior to the Free Breathing Technique in Cardiac and Lung Sparing while Treating both Left-Sided Post-Mastectomy Chest Wall and Supraclavicular Regions

    Directory of Open Access Journals (Sweden)

    Anupama Darapu

    2017-01-01

    Full Text Available Aims: To evaluate the efficacy of the deep inspirational breath-hold (DIBH technique and its dosimetric advantages over the free breathing (FB technique in cardiac (heart and left anterior descending artery [LAD] and ipsilateral lung sparing in left-sided post-mastectomy field-in-field conformal radiotherapy. DIBH is highly reproducible, and this study aims to find out its dosimetric benefits over FB. Materials and Methods: Nineteen left-sided mastectomy patients were immobilized using breast boards with both arms positioned above the head. All patients had 2 sets of planning CT images (one in FB and another in DIBH with a Biograph TruePoint HD CT scanner in the same setup. DIBH was performed by tracking the respiratory cycles using a Varian Real-Time Position Management system. The target (chest wall and supraclavicular region, organs at risk (OARs; ipsilateral lung, contralateral lung, heart, LAD, and contralateral breast, and other organs of interests were delineated as per the RTOG (Radiation Therapy Oncology Group contouring guidelines. The single-isocenter conformal fields in the field treatment plans were generated with the Eclipse Treatment Planning System (Varian Medical Systems for both FB and DIBH images, and the doses to the target and OARs were compared. The standard fractionation regimen of 50 Gy in 25 fractions over a period of 5 weeks was used for all patients in this study. Results and Discussion: The target coverage parameters (V95, V105, V107, and Dmean were found to be 97.8 ± 0.9, 6.1 ± 3.4, 0.2 ± 0.3, and 101.9 ± 0.5% in the FB plans and 98.1 ± 0.8, 6.1 ± 3.2, 0.2 ± 0.3, and 101.9 ± 0.4% in the DIBH plans, respectively. The plan quality indices (conformity index and homogeneity index also showed 1.3 ± 0.2 and 0.1 for the FB plans and 1.2 ± 0.3 and 0.1 for the DIBH plans, respectively. There was a significant reduction in dose to the heart in the DIBH plans compared to the FB plans, with p values of nearly 0 for the

  6. The CT appearance of the superior intercostal veins

    International Nuclear Information System (INIS)

    Lund, G.

    1982-01-01

    The CT appearance of the superior intercostal veins is described. The veins are more frequently seen on the right side. The right superior intercostal vein should not be misinterpreted as a paraspinal mass when it is large or bulges into the contour of the right lung. A case of stenosis of the left brachiocephalic vein is shown, where the left superior intercostal vein serves as a collateral. (orig.)

  7. Apraxia and spatial inattention dissociate in left hemisphere stroke.

    Science.gov (United States)

    Timpert, David C; Weiss, Peter H; Vossel, Simone; Dovern, Anna; Fink, Gereon R

    2015-10-01

    Theories of lateralized cognitive functions propose a dominance of the left hemisphere for motor control and of the right hemisphere for spatial attention. Accordingly, spatial attention deficits (e.g., neglect) are more frequently observed after right-hemispheric stroke, whereas apraxia is a common consequence of left-hemispheric stroke. Clinical reports of spatial attentional deficits after left hemisphere (LH) stroke also exist, but are often neglected. By applying parallel analysis (PA) and voxel-based lesion-symptom mapping (VLSM) to data from a comprehensive neuropsychological assessment of 74 LH stroke patients, we here systematically investigate the relationship between spatial inattention and apraxia and their neural bases. PA revealed that apraxic (and language comprehension) deficits loaded on one common component, while deficits in attention tests were explained by another independent component. Statistical lesion analyses with the individual component scores showed that apraxic (and language comprehension) deficits were significantly associated with lesions of the left superior longitudinal fascicle (SLF). Data suggest that in LH stroke spatial attention deficits dissociate from apraxic (and language comprehension) deficits. These findings contribute to models of lateralised cognitive functions in the human brain. Moreover, our findings strongly suggest that LH stroke patients should be assessed systematically for spatial attention deficits so that these can be included in their rehabilitation regime. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Involuntary switching into the native language induced by electrocortical stimulation of the superior temporal gyrus: a multimodal mapping study.

    Science.gov (United States)

    Tomasino, Barbara; Marin, Dario; Canderan, Cinzia; Maieron, Marta; Budai, Riccardo; Fabbro, Franco; Skrap, Miran

    2014-09-01

    We describe involuntary language switching from L2 to L1 evoked by electro-stimulation in the superior temporal gyrus in a 30-year-old right-handed Serbian (L1) speaker who was also a late Italian learner (L2). The patient underwent awake brain surgery. Stimulation of other portions of the exposed cortex did not cause language switching as did not stimulation of the left inferior frontal gyrus, where we evoked a speech arrest. Stimulation effects on language switching were selective, namely, interfered with counting behaviour but not with object naming. The coordinates of the positive site were combined with functional and fibre tracking (DTI) data. Results showed that the language switching site belonged to a significant fMRI cluster in the left superior temporal gyrus/supramarginal gyrus found activated for both L1 and L2, and for both the patient and controls, and did not overlap with the inferior fronto-occipital fasciculus (IFOF), the inferior longitudinal fasciculus (ILF) and the superior longitudinal fasciculus (SLF). This area, also known as Stp, has a role in phonological processing. Language switching phenomenon we observed can be partly explained by transient dysfunction of the feed-forward control mechanism hypothesized by the DIVA (Directions Into Velocities of Articulators) model (Golfinopoulos, E., Tourville, J. A., & Guenther, F. H. (2010). The integration of large-scale neural network modeling and functional brain imaging in speech motor control. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Impact of longitudinal myocardial deformation on the prognosis of chronic heart failure patients.

    Science.gov (United States)

    Nahum, Julien; Bensaid, Alexandre; Dussault, Caroline; Macron, Laurent; Clémence, Darrort; Bouhemad, Belaid; Monin, Jean-Luc; Rande, Jean-Luc Dubois; Gueret, Pascal; Lim, Pascal

    2010-05-01

    Longitudinal myocardial deformation indexes appear superior to left ventricular ejection fraction (LVEF) in assessing myocardial contractility. However, few studies have addressed the prognostic value of longitudinal motion markers (velocity, strain, and strain rate) in predicting outcome in heart failure patients. The study included 125 consecutive symptomatic heart failure patients (63+/-16 years, 77% male, LVEF=31+/-10%). All patients underwent a complete echocardiographic and clinical examination, and brain natriuretic peptide level was assessed in 93 patients. Longitudinal myocardial velocity by tissue Doppler imaging, global-epsilon, and strain rate by speckle tracking were computed from apical views (4-, 3-, and 2-chambers views) and compared with the occurrence of major adverse cardiac events. On the whole, peak longitudinal velocity, global-epsilon, and strain rate averaged 5+/-2 cm/s (range, 1 to 9), -8+/-3% (range, -3 to -18), and -0.33+/-0.16 s(-1) (range, -0.83 to -0.05), respectively. During the follow-up period (266+/-177 days), major adverse cardiac events occurred in 47 (38%) patients (15 deaths, 29 recurrent heart failure, and 4 heart transplantations). By univariable analysis using Cox model global-epsilon, strain rate, and LVEF were associated with the occurrence of major adverse cardiac events, whereas only global-epsilon remained independently predictive of outcome by multivariate analysis. In the heart failure population, longitudinal global strain by speckle tracking is superior to LVEF and other longitudinal markers in identifying patients with poor outcome.

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

    Directory of Open Access Journals (Sweden)

    Sesi

    2015-03-01

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

  11. High prevalence rate of left superior vena cava determined by ...

    African Journals Online (AJOL)

    2013-10-08

    Oct 8, 2013 ... persistent LSVC (6). There was a similar high prevalence, in the current study, of persistent LSVC in patients with tetralogy of. Fallot and coarctation of the aorta when compared to other studies (6, 8). This can be explained by the fact that the patient sample in the current study with these lesions was small.

  12. Persistent left superior vena cava in cardiac congenital surgery

    OpenAIRE

    Giuliani-Poncini, C.

    2013-01-01

    La persistance d'une veine cave supérieure gauche (VCSG) est une entité relativement fréquente dans le cadre des malformations cardiaques congénitales. Le but de cette étude est d'analyser à quel moment le diagnostic de la persistance de la VCSG est effectué, à quel moment le diagnostic des éventuelles anomalies du sinus coronarien associées est effectué, et de l'impact global de la persistance d'une VCSG sur la mortalité et la morbidité des patients après chirurgie cardiaque pour une malform...

  13. Absent right superior caval vein in situs solitus

    DEFF Research Database (Denmark)

    Lytzen, Rebekka; Sundberg, Karin; Vejlstrup, Niels

    2015-01-01

    Introduction In up to 0.07% of the general population, the right anterior cardinal vein obliterates and the left remains open, creating an absent right superior caval vein and a persistent left superior caval vein. Absent right superior caval vein is associated with additional congenital heart...... disease in about half the patients. We wished to study the consequences of absent right superior caval vein as an incidental finding on prenatal ultrasonic malformation screening. Material and methods This is a retrospective case series study of all foetuses diagnosed with absent right superior caval vein...... at the national referral hospital, Rigshospitalet, Denmark, from 2009 to 2012. RESULTS: In total, five cases of absent right superior caval vein were reviewed. No significant associated cardiac, extra-cardiac, or genetic anomalies were found. Postnatal echocardiographies confirmed the diagnosis and there were...

  14. Superior repair: A useful approach for some anatomic variants of ...

    African Journals Online (AJOL)

    retrospectively reviewed.Three patients had long narrow venous stalk connecting the coronary sinus to venous confl uence; two had the right pulmonary veins draining to superior vena cava (SVC) and left pulmonary veins to left lateral wall of SVC and one had an obstruction at entrance of Pulmonary Vein into venous confl ...

  15. ARE LEFT HANDED SURGEONS LEFT OUT?

    OpenAIRE

    SriKamkshi Kothandaraman; Balasubramanian Thiagarajan

    2012-01-01

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

  16. White-matter microstructure and language lateralization in left-handers: a whole-brain MRI analysis.

    Science.gov (United States)

    Perlaki, Gabor; Horvath, Reka; Orsi, Gergely; Aradi, Mihaly; Auer, Tibor; Varga, Eszter; Kantor, Gyongyi; Altbäcker, Anna; John, Flora; Doczi, Tamas; Komoly, Samuel; Kovacs, Norbert; Schwarcz, Attila; Janszky, Jozsef

    2013-08-01

    Most people are left-hemisphere dominant for language. However the neuroanatomy of language lateralization is not fully understood. By combining functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI), we studied whether language lateralization is associated with cerebral white-matter (WM) microstructure. Sixteen healthy, left-handed women aged 20-25 were included in the study. Left-handers were targeted in order to increase the chances of involving subjects with atypical language lateralization. Language lateralization was determined by fMRI using a verbal fluency paradigm. Tract-based spatial statistics analysis of DTI data was applied to test for WM microstructural correlates of language lateralization across the whole brain. Fractional anisotropy and mean diffusivity were used as indicators of WM microstructural organization. Right-hemispheric language dominance was associated with reduced microstructural integrity of the left superior longitudinal fasciculus and left-sided parietal lobe WM. In left-handed women, reduced integrity of the left-sided language related tracts may be closely linked to the development of right hemispheric language dominance. Our results may offer new insights into language lateralization and structure-function relationships in human language system. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Bathymetry of Lake Superior

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Bathymetry of Lake Superior has been compiled as a component of a NOAA project to rescue Great Lakes lake floor geological and geophysical data and make it more...

  18. Superior Hiking Trail

    Data.gov (United States)

    Minnesota Department of Natural Resources — Superior Hiking Trail main trail, spurs, and camp spurs for completed trail throughout Cook, Lake, St. Louis and Carlton counties. These data were collected with...

  19. Alternate superior Julia sets

    International Nuclear Information System (INIS)

    Yadav, Anju; Rani, Mamta

    2015-01-01

    Alternate Julia sets have been studied in Picard iterative procedures. The purpose of this paper is to study the quadratic and cubic maps using superior iterates to obtain Julia sets with different alternate structures. Analytically, graphically and computationally it has been shown that alternate superior Julia sets can be connected, disconnected and totally disconnected, and also fattier than the corresponding alternate Julia sets. A few examples have been studied by applying different type of alternate structures

  20. Compression syndrome of the left renal vein

    Energy Technology Data Exchange (ETDEWEB)

    Justich, E.

    1982-04-01

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

  1. Longitudinal changes in cortical thickness in autism and typical development

    Science.gov (United States)

    Prigge, Molly B. D.; Nielsen, Jared A.; Froehlich, Alyson L.; Abildskov, Tracy J.; Anderson, Jeffrey S.; Fletcher, P. Thomas; Zygmunt, Kristen M.; Travers, Brittany G.; Lange, Nicholas; Alexander, Andrew L.; Bigler, Erin D.; Lainhart, Janet E.

    2014-01-01

    The natural history of brain growth in autism spectrum disorders remains unclear. Cross-sectional studies have identified regional abnormalities in brain volume and cortical thickness in autism, although substantial discrepancies have been reported. Preliminary longitudinal studies using two time points and small samples have identified specific regional differences in cortical thickness in the disorder. To clarify age-related trajectories of cortical development, we examined longitudinal changes in cortical thickness within a large mixed cross-sectional and longitudinal sample of autistic subjects and age- and gender-matched typically developing controls. Three hundred and forty-five magnetic resonance imaging scans were examined from 97 males with autism (mean age = 16.8 years; range 3–36 years) and 60 males with typical development (mean age = 18 years; range 4–39 years), with an average interscan interval of 2.6 years. FreeSurfer image analysis software was used to parcellate the cortex into 34 regions of interest per hemisphere and to calculate mean cortical thickness for each region. Longitudinal linear mixed effects models were used to further characterize these findings and identify regions with between-group differences in longitudinal age-related trajectories. Using mean age at time of first scan as a reference (15 years), differences were observed in bilateral inferior frontal gyrus, pars opercularis and pars triangularis, right caudal middle frontal and left rostral middle frontal regions, and left frontal pole. However, group differences in cortical thickness varied by developmental stage, and were influenced by IQ. Differences in age-related trajectories emerged in bilateral parietal and occipital regions (postcentral gyrus, cuneus, lingual gyrus, pericalcarine cortex), left frontal regions (pars opercularis, rostral middle frontal and frontal pole), left supramarginal gyrus, and right transverse temporal gyrus, superior parietal lobule, and

  2. Longitudinal changes in cortical thickness in autism and typical development.

    Science.gov (United States)

    Zielinski, Brandon A; Prigge, Molly B D; Nielsen, Jared A; Froehlich, Alyson L; Abildskov, Tracy J; Anderson, Jeffrey S; Fletcher, P Thomas; Zygmunt, Kristen M; Travers, Brittany G; Lange, Nicholas; Alexander, Andrew L; Bigler, Erin D; Lainhart, Janet E

    2014-06-01

    The natural history of brain growth in autism spectrum disorders remains unclear. Cross-sectional studies have identified regional abnormalities in brain volume and cortical thickness in autism, although substantial discrepancies have been reported. Preliminary longitudinal studies using two time points and small samples have identified specific regional differences in cortical thickness in the disorder. To clarify age-related trajectories of cortical development, we examined longitudinal changes in cortical thickness within a large mixed cross-sectional and longitudinal sample of autistic subjects and age- and gender-matched typically developing controls. Three hundred and forty-five magnetic resonance imaging scans were examined from 97 males with autism (mean age = 16.8 years; range 3-36 years) and 60 males with typical development (mean age = 18 years; range 4-39 years), with an average interscan interval of 2.6 years. FreeSurfer image analysis software was used to parcellate the cortex into 34 regions of interest per hemisphere and to calculate mean cortical thickness for each region. Longitudinal linear mixed effects models were used to further characterize these findings and identify regions with between-group differences in longitudinal age-related trajectories. Using mean age at time of first scan as a reference (15 years), differences were observed in bilateral inferior frontal gyrus, pars opercularis and pars triangularis, right caudal middle frontal and left rostral middle frontal regions, and left frontal pole. However, group differences in cortical thickness varied by developmental stage, and were influenced by IQ. Differences in age-related trajectories emerged in bilateral parietal and occipital regions (postcentral gyrus, cuneus, lingual gyrus, pericalcarine cortex), left frontal regions (pars opercularis, rostral middle frontal and frontal pole), left supramarginal gyrus, and right transverse temporal gyrus, superior parietal lobule, and

  3. Superior memorizers employ different neural networks for encoding and recall.

    Science.gov (United States)

    Mallow, Johannes; Bernarding, Johannes; Luchtmann, Michael; Bethmann, Anja; Brechmann, André

    2015-01-01

    Superior memorizers often employ the method of loci (MoL) to memorize large amounts of information. The MoL, known since ancient times, relies on a complex process where information to be memorized is bound to landmarks along mental routes in a previously memorized environment. However, functional magnetic resonance imaging data on groups of trained superior memorizer are rare. Based on the memorizing strategy reported by superior memorizers, we developed a scheme of the processes successively employed during memorizing and recalling digits and relate these to brain activation that is specific for the encoding and recall period. In the examined superior memorizers several regions, suggested to be involved in mental navigation and digit-to-word processing, were specifically activated during encoding: bilateral early visual cortex, retrosplenial cortex, left parahippocampus, left visual cortex, and left superior parietal cortex. Although the scheme suggests that some steps during encoding and recall seem to be analog, none of the encoding areas were specifically activated during the recall. Instead, we found strong activation in left anterior superior temporal gyrus, which we relate to recalling the sequential order of the digits, and right motor cortex that may be related to reciting the digits.

  4. Isolated abscess in superior rectus muscle in a child

    Directory of Open Access Journals (Sweden)

    Sushank Ashok Bhalerao

    2015-01-01

    Full Text Available Pyomyositis is a primary bacterial infection of striated muscles nearly always caused by Staphylococcus aureus. Development of the intramuscular abscess involving the extra-ocular muscles (EOMs remains an extremely rare process. We herein present a case of isolated EOM pyomyositis involving superior rectus muscle in a 2-year male child who was referred with complaints of swelling in left eye (LE and inability to open LE since last 1-month. Orbital computed tomography (CT scan showed a well-defined, hypo-dense, peripheral rim-enhancing lesion in relation to left superior rectus muscle suggestive of left superior rectus abscess. The abscess was drained through skin approach. We concluded that pyomyositis of EOM should be considered in any patient presenting with acute onset of orbital inflammation and characteristic CT or magnetic resonance imaging features. Management consists of incision and drainage coupled with antibiotic therapy.

  5. Traumatic superior orbital fissure syndrome: a rare case report

    OpenAIRE

    Eskitascioglu, Teoman; Yontar, Yalcin; Aydin, Ahmet; Tucer, Bulent

    2017-01-01

    Superior orbital fissure syndrome is a severe clinical entity characterized by injuries of neurovascular structures passing through the superior orbital fissure. A 38-year-old male patient admitted to outpatient clinic with left upper eyelid ptosis, ecchymosis, mydriasis, hypoesthesia in upper eyelid and frontal region, blepharoptosis, restriction of ocular movements in all directions, loss of accommodation reflex and absence of direct pupillary reflex. Three-dimensional computed tomography s...

  6. Superior facet syndrome

    International Nuclear Information System (INIS)

    Kubo, Yoshichika; Igarashi, Seishi; Koyama, Tsunemaro

    1985-01-01

    Sciatica caused by root entrapment in the lateral recess was named superior facet syndrome by Epstein in 1972. Few reports on this subject based on large numbers of cases have been documented to date. Of the patients with sciatica, 32 patients were diagnosed to have root entrapment at the lateral recess L 5 or/and S 1 lumbar spine. Out of 32 patients, 20 patients were operated on and the lateral entrapment was recognized in all of surgical cases. Neuroradiological findings, especially of metrizamide CT (met. CT), were documented in detail. Thirty two patients were classified in three types according to radiological findings. They were congenital or developmental, degenerative, and combined type, respectively, Fourteen cases belonged to the congenital type, 13 to the degenerative and 5 to the combined type. Each group had the mean ages of 23.4, 53.8, and 36.8 years old, respectively. Of 32 cases the entrapment occured in 47 L 5 roots and 11 S 1 roots. There was no remarkable laterality. In operation the unroofing of the lateral recess were done and the sciatica subsided postoperatively in all of surgical cases. Met. CT revealed extreme medial protrusion of the superior articular joint in 18 of 24 cases(75%) and none filling of the root in the lateral recess in 21 of 24 cases (87.5%). In the degenerative type, met. CT showed some degenerative changes that were hypertrophy or deformity of the articular joints and spur formation of the vertebral body. In contrast to met. CT, metrizamide myelography revealed only slight changes, which were poor filling of the root before it turned out the pedicle of lateral compression of the root. In plain films or lumbar spine articular joints at Lsub(4/5) were formed in coronal plane in 69% of cases of the L 5 root entrapment. Met. CT using ReView technique was of great diagnostic value in superior facet syndrome. (author)

  7. Potential spaces of superior mediastinum on CT for space-occupying lesions

    International Nuclear Information System (INIS)

    Sone, Shusuke; Higashihara, Tokuo; Morimoto, Shizuo; Ikezoe, Junpei; Arisawa, Jun

    1982-01-01

    The available potential space for the expansion of the space-occupying lesion in the superior mediastinum and the available routes for its extension to the neighbouring areas are illustrated based on CT images obtained following pneumomediastinography: The superior mediastinum can be conveniently subdivided into three compartmentalized areas; 1) the prevascular region, 2) the right (superior) paratracheal region, and 3) the left (superior) paratracheoesophageal region. And some anatomic points of each subdivided compartment are described in several selected cases with mediastinal pathology. (author)

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    PURPOSE: To assess the acute effect of triggered left ventricular pacing (tLVp) on left ventricular performance and contraction pattern in patients with heart failure, left bundle branch block (LBBB), and cardiac resynchronization therapy (CRT). METHODS: Twenty-three patients with pre-implant QRS...... complex >150 ms, QRS complex narrowing under CRT, and sinus rhythm were included ≥3 months after CRT implantation. Echocardiographic assessment of left ventricular ejection fraction (LVEF), global peak systolic longitudinal strain (GLS), and contraction pattern by 2D strain was performed during intrinsic......V pacing. CONCLUSIONS: The acute effect of tLVp on LV systolic function and contraction pattern is significantly lower than the effect of BiV pacing and not different from intrinsic conduction in patients with LBBB and CRT....

  9. Sobredentadura total superior implantosoportada

    Directory of Open Access Journals (Sweden)

    Luis Orlando Rodríguez García

    2010-06-01

    Full Text Available Se presenta un caso de un paciente desdentado total superior, rehabilitado en la consulta de implantología de la Clínica "Pedro Ortiz" del municipio Habana del Este en Ciudad de La Habana, Cuba, en el año 2009, mediante prótesis sobre implantes osteointegrados, técnica que se ha incorporado a la práctica estomatológica en Cuba como alternativa al tratamiento convencional en los pacientes desdentados totales. Se siguió un protocolo que comprendió una fase quirúrgica, procedimiento con o sin realización de colgajo y carga precoz o inmediata. Se presenta un paciente masculino de 56 años de edad, que acudió a la consulta multidisciplinaria, preocupado, porque se le habían elaborado tres prótesis en los últimos dos años y ninguna reunía los requisitos de retención que él necesitaba para sentirse seguro y cómodo con las mismas. El resultado final fue la satisfacción total del paciente, con el mejoramiento de la calidad estética y funcional.

  10. Anterior superior iliac spine avulsion in a young soccer player.

    Science.gov (United States)

    Bendeddouche, I; Jean-Luc, B B; Poiraudeau, S; Nys, A

    2010-11-01

    Avulsion fractures of the anterior superior iliac spine are rare. They usually occur in teenagers during sport activities. Cases concerning adults are very uncommon. We report here the case of a 23-year-old man who was admitted for recent pain of the left hip that worsened while kicking a ball in a soccer match eight days earlier. The examination found pain when moving the left hip in extension. Radiographs showed an avulsion fracture of the left anterior superior iliac spine, which was confirmed by computer tomography. The treatment was conservative consisting in rest and non-weight bearing with releasing of pain a few weeks later. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  11. Left atrial volume index

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  12. Structural connectivity in spatial attention network: reconstruction from left hemispatial neglect.

    Science.gov (United States)

    Hattori, Takaaki; Ito, Kenji; Nakazawa, Chika; Numasawa, Yoshiyuki; Watanabe, Mayumi; Aoki, Shigeki; Mizusawa, Hidehiro; Ishiai, Sumio; Yokota, Takanori

    2018-04-01

    Left hemispatial neglect (neglect) is an impaired state of spatial attention. We aimed to reconstruct structural connectivity in the spatial attention network and to identify disconnection patterns underlying neglect. We enrolled 59 right-handed patients who had their first-ever infarction in the right hemisphere and classified them into neglect group (34 patients with neglect) and control group (25 patients without neglect). The neglect group was further subcategorized into 6 subgroups based on infarcted vascular territories. Diffusion tensor imaging data were obtained from all patients. Fractional anisotropy maps were compared between neglect group/subgroups and the control group by using non-parametric voxel-based analysis, generating a lesion path mask. Probabilistic tractography analysis using the lesion path mask reconstructed the following structural connectivity in the spatial attention network, which is specifically damaged in neglect patients: (1) superior longitudinal fasciculus (SLF) I connecting the superior parietal lobule/intraparietal sulcus with the superior frontal gyrus/frontal eye field (SFG/FEF) (dorsal attention network); (2) SLF III/the arcuate fasciculus (AF) and the extreme capsule/inferior fronto-occipital fasciculus (IFOF) connecting the right inferior parietal lobule/temporoparietal junction/superior temporal gyrus (IPL/TPJ/STG) with the middle frontal gyrus/inferior frontal gyrus (ventral attention network); (3) the thalamic radiations to the spatial attention-related cortices; and (4) SLF II and IFOF interconnecting dorsal and ventral attention networks. Individual analysis indicated that isolated damage in SLF I, SLF II, SLF III/AF or the thalamic radiations to IPL/TPJ/STG due to posterior cerebral artery infarction, or simultaneous damage in four thalamic radiations due to anterior choroidal artery infarction, underlies different phenotypes of neglect.

  13. An MRI Study of Superior Temporal Gyrus Volume in Women With Schizotypal Personality Disorder

    OpenAIRE

    Dickey, Chandlee C.; McCarley, Robert William; Voglmaier, Martina M.; Niznikiewicz, Margaret A.; Seidman, Larry Joel; Demeo, Susan; Frumin, Melissa; Shenton, Martha Elizabeth

    2003-01-01

    Objective: An abnormal superior temporal gyrus has figured prominently in schizophrenia research, and left superior temporal gyrus volume has been shown to be smaller in male subjects with schizotypal personality disorder. This is the first structural magnetic resonance imaging study to examine a group of female subjects with schizotypal personality disorder. Method: The superior temporal gyrus was drawn on coronal images acquired from female subjects recruited from the community (schizotypal...

  14. Tratamento da síndrome da veia cava superior Treatment of superior vena cava syndrome

    Directory of Open Access Journals (Sweden)

    Luís Marcelo Inaco Cirino

    2005-12-01

    Full Text Available A veia cava superior é formada pela união das duas veias inominadas, direita e esquerda, e localiza-se no mediastino médio, à direita da artéria aorta e anteriormente à traquéia. A síndrome da veia cava superior representa um conjunto de sinais (dilatação das veias do pescoço, pletora facial, edema de membros superiores, cianose e sintomas (cefaléia, dispnéia, tosse, edema de membro superior, ortopnéia e disfagia decorrentes da obstrução do fluxo sanguíneo através da veia cava superior em direção ao átrio direito. A obstrução pode ser causada por compressão extrínseca, invasão tumoral, trombose ou por dificuldade do retorno venoso ao coração secundária a doenças intra-atriais ou intraluminais. Aproximadamente 73% a 97% dos casos de síndrome da veia cava superior ocorrem durante a evolução de processos malignos intratorácicos. A maioria dos pacientes com a síndrome secundária a neoplasias malignas é tratada sem necessidade de cirurgia, através de radioterapia ou quimioterapia, ou através da colocação de stents endoluminais. Quando a síndrome é de etiologia benigna, o tratamento é feito através de medidas clínicas (anticoagulação, elevação da cabeça, etc. ou, em casos refratários, através de angioplastia, colocação de stents endoluminais e cirurgia.The superior vena cava is formed by the union of the right and left brachiocephalic veins. It is located in the middle mediastinum, to the right of the aorta and anterior to the trachea. Superior vena cava syndrome consists of a group of signs (dilation of the veins in the neck, facial swelling, edema of the upper limbs, and cyanosis and symptoms (headache, dyspnea, cough, orthopnea and dysphagia caused by the obstruction of blood flow through the superior vena cava to the right atrium. This obstruction can be caused by extrinsic compression, tumor invasion or thrombosis. Such obstruction may also occur as a result of insufficient venous return

  15. Simultaneous Idiopathic Dissections of the Coronary and Superior Mesenteric Arteries

    Science.gov (United States)

    Nishi, Masato; Sueta, Daisuke; Miyazaki, Takashi; Sakamoto, Kenji; Yamamoto, Eiichiro; Izumiya, Yasuhiro; Tsujita, Kenichi; Kojima, Sunao; Kaikita, Koichi; Ikeda, Osamu; Yamashita, Yasuyuki; Hokimoto, Seiji

    2017-01-01

    A 49-year-old man complained of sudden upper abdominal pain but was not given a definitive diagnosis. The day after he was discharged, he noticed left chest pain. An in-depth electrocardiogram indicated acute myocardial infarction, and emergent coronary angiography revealed 99% stenosis of his left coronary artery. An intravascular ultrasound revealed spontaneous coronary artery dissection (SCAD), and the lesion was successfully stented. In an atherosclerosis screening, superior mesenteric artery dissection (SMAD) was confirmed, after which the lesion was successfully stented. This case suggests that SCAD and SMAD might have similar pathological backgrounds. PMID:28566599

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

    Science.gov (United States)

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

    2008-10-01

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

  17. Left heart catheterization

    Science.gov (United States)

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

  18. The compression syndrome of the left renal vein

    International Nuclear Information System (INIS)

    Justich, E.

    1982-01-01

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

  19. Longitudinal Stent Deformation at Aneurysm Site: Flexibility at the Expense of Longitudinal Integrity.

    Science.gov (United States)

    Shah, Bhupesh R

    2017-07-01

    Longitudinal stent deformation is a recently described complication of percutaneous coronary intervention. Novel stents with thin struts and reduced number of fixed links between cells improve flexibility and deliverability but in certain cases it may reduce longitudinal strength and thereby increase the risk of longitudinal deformation. Although longitudinal deformation of coronary stents is an infrequent finding, it requires clinical attention as it may lead to catastrophic clinical outcomes. We report a case of longitudinal deformation of coronary stent observed at our institution while treating ostial lesion and aneurysm of left anterior descending artery. Longitudinal deformation was identified during the procedure and treated with the deployment of another stent. Three-month follow-up of the patient was found satisfactory without any incidence of stent thrombosis.

  20. Pseudoaneurysm of the superior gluteal artery following polytrauma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dennis [Vancouver General Hospital, University of British Columbia and Department of Radiology, Vancouver, BC (Canada); Legiehn, Gerald M. [Vancouver General Hospital, Interventional Radiology, University of British Columbia and Department of Radiology, Vancouver, BC (Canada); Munk, Peter L. [Vancouver General Hospital, MSK Section, University of British Columbia and Department of Radiology, Vancouver, BC (Canada)

    2007-09-15

    Gluteal artery aneurysms are rare and often secondary to pelvic fractures, blunt or penetrating trauma. We describe a case of a superior gluteal artery pseudoaneurysm that presented as back pain with numbness and weakness of the lower extremities. Diagnosis was confirmed by color Doppler sonography and angiography. A proximal and distal control was obtained over the aneurysm neck via coil embolization with excellent hemostasis within the pseudoaneurysm and maintenance of perfusion to the left pelvis. (orig.)

  1. Pseudoaneurysm of the superior gluteal artery following polytrauma

    International Nuclear Information System (INIS)

    Lee, Dennis; Legiehn, Gerald M.; Munk, Peter L.

    2007-01-01

    Gluteal artery aneurysms are rare and often secondary to pelvic fractures, blunt or penetrating trauma. We describe a case of a superior gluteal artery pseudoaneurysm that presented as back pain with numbness and weakness of the lower extremities. Diagnosis was confirmed by color Doppler sonography and angiography. A proximal and distal control was obtained over the aneurysm neck via coil embolization with excellent hemostasis within the pseudoaneurysm and maintenance of perfusion to the left pelvis. (orig.)

  2. Reproducibilidad del strain longitudinal global del ventrículo izquierdo por ecocardiografía bidimensional speckle tracking: Estudio Longitudinal de Salud del Adulto (ELSA-Brasil

    Directory of Open Access Journals (Sweden)

    Wilson Cañon-Montañez

    2017-11-01

    Full Text Available Resumen: Introducción: Se han propuesto técnicas ecocardiográficas avanzadas como el strain longitudinal global por ecocardiografía bidimensional speckle tracking para la detección de alteraciones precoces de la función sistólica del ventrículo izquierdo. La evaluación de la reproducibilidad del strain longitudinal global es fundamental para su aplicación clínica en diferentes escenarios. Objetivo: Estimar la reproducibilidad del strain longitudinal global del ventrículo izquierdo en individuos de un estudio de cohorte del Brasil. Métodos: La reproducibilidad del strain longitudinal global del ventrículo izquierdo fue evaluada mediante lectura y análisis de imágenes de ecocardiografía de una muestra aleatoria de 50 participantes de la línea de base del Estudio Longitudinal de Salud del Adulto (ELSA-Brasil. Resultados: Los participantes tenían una edad promedio de 49,7 ± 7,3 años, 54% eran mujeres y la media del strain longitudinal global fue –19,5% ± 1,9%. La reproducibilidad interobservador de la medida del strain longitudinal global mostró un coeficiente de variación de 7,4% y un coeficiente de correlación intraclase de 0,76 (IC 95%: 0,61, 0,86. El análisis del acuerdo interobservador de las medidas del strain longitudinal global mediante el método de Bland & Altman evidenció un promedio de diferencias de 0,1% ± 1,4% y unos límites de acuerdo superior de 2,9 e inferior de –2,7. Conclusiones: Hubo una reproducibilidad adecuada de las medidas del strain longitudinal global del ventrículo izquierdo en participantes del ELSA-Brasil y los valores fueron similares a los reportados en otros estudios epidemiológicos longitudinales. Los hallazgos refuerzan la utilidad del strain longitudinal global como un índice clínico de deformación miocárdica, capaz de detectar alteraciones subclínicas de la contractilidad mioc

  3. Interventional embolectomy for acute superior mesenteric artery embolism

    International Nuclear Information System (INIS)

    Li Xuan; Ouyang Qiang; Xiao Xiangsheng

    2006-01-01

    Objective: To evaluate the effects of percutaneous embolectomy for treatment of acute superior mesenteric artery embolism. Methods: 34 cases (atrial fibrillation 14 cases; left atrium myxoma 2 cases; SMA thrombosis 15 cases and chronic mesenteric ischemia 3 cases) of acute mesenteric artery embolism were treated with percutaneous embolectomy using long sheath aspiration method and/or thrombolysis via catheterization of the SMA. Results: Successful recanalizations were achieved in all of the 34 superior mesenteric arterial embolism including recovery in 31 cases, laparotomy for 2 cases, and 1 died within 24 hours. Conclusions: Percutaneous embolectomy using long sheath aspiration is a simple and effective method for treatment of acute superior mesenteric artery embolism. A correct pathogenetic diagnosis is the key to improve the curative effect and avoid the severe complication. (authors)

  4. Vena cava superior izquierda persistente

    Directory of Open Access Journals (Sweden)

    Gustavo Restrepo

    2014-04-01

    Full Text Available La vena cava superior izquierda persistente es la anomalía más común del drenaje venoso del tórax y con frecuencia acompaña a otras anomalías congénitas. Generalmente, su hallazgo es incidental durante la inserción de catéteres venosos centrales. Su diagnóstico puede hacerse por medio de múltiples técnicas de imagen. El principal hallazgo ecocardiográfico es un seno coronario dilatado que sugiere la presencia de vena cava superior izquierda persistente. Cuando ésta drena en la aurícula izquierda, urge la corrección del defecto. Aunque habitualmente tiene un curso benigno, siempre que se documente vena cava superior izquierda conviene buscar otras anomalías congénitas.

  5. [Recurrent left atrial myxoma].

    Science.gov (United States)

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

    2003-01-01

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

  6. Plasticity of left perisylvian white-matter tracts is associated with individual differences in math learning.

    Science.gov (United States)

    Jolles, Dietsje; Wassermann, Demian; Chokhani, Ritika; Richardson, Jennifer; Tenison, Caitlin; Bammer, Roland; Fuchs, Lynn; Supekar, Kaustubh; Menon, Vinod

    2016-04-01

    Plasticity of white matter tracts is thought to be essential for cognitive development and academic skill acquisition in children. However, a dearth of high-quality diffusion tensor imaging (DTI) data measuring longitudinal changes with learning, as well as methodological difficulties in multi-time point tract identification have limited our ability to investigate plasticity of specific white matter tracts. Here, we examine learning-related changes of white matter tracts innervating inferior parietal, prefrontal and temporal regions following an intense 2-month math tutoring program. DTI data were acquired from 18 third grade children, both before and after tutoring. A novel fiber tracking algorithm based on a White Matter Query Language (WMQL) was used to identify three sections of the superior longitudinal fasciculus (SLF) linking frontal and parietal (SLF-FP), parietal and temporal (SLF-PT) and frontal and temporal (SLF-FT) cortices, from which we created child-specific probabilistic maps. The SLF-FP, SLF-FT, and SLF-PT tracts identified with the WMQL method were highly reliable across the two time points and showed close correspondence to tracts previously described in adults. Notably, individual differences in behavioral gains after 2 months of tutoring were specifically correlated with plasticity in the left SLF-FT tract. Our results extend previous findings of individual differences in white matter integrity, and provide important new insights into white matter plasticity related to math learning in childhood. More generally, our quantitative approach will be useful for future studies examining longitudinal changes in white matter integrity associated with cognitive skill development.

  7. Left atrial appendage occlusion

    Directory of Open Access Journals (Sweden)

    Ahmad Mirdamadi

    2013-01-01

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

  8. Hypoplastic left heart syndrome

    Directory of Open Access Journals (Sweden)

    Thiagarajan Ravi

    2007-05-01

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

  9. White matter lesional predictors of chronic visual neglect: a longitudinal study

    Science.gov (United States)

    Lunven, Marine; Thiebaut De Schotten, Michel; Bourlon, Clémence; Duret, Christophe; Migliaccio, Raffaella; Rode, Gilles

    2015-01-01

    Chronic visual neglect prevents brain-damaged patients from returning to an independent and active life. Detecting predictors of persistent neglect as early as possible after the stroke is therefore crucial to plan the relevant interventions. Neglect signs do not only depend on focal brain lesions, but also on dysfunction of large-scale brain networks connected by white matter bundles. We explored the relationship between markers of axonal degeneration occurring after the stroke and visual neglect chronicity. A group of 45 patients with unilateral strokes in the right hemisphere underwent cognitive testing for neglect twice, first at the subacute phase (1 year). For each patient, magnetic resonance imaging including diffusion sequences was performed at least 4 months after the stroke. After masking each patient’s lesion, we used tract-based spatial statistics to obtain a voxel-wise statistical analysis of the fractional anisotropy data. Twenty-seven patients had signs of visual neglect at initial testing. Only 10 of these patients had recovered from neglect at follow-up. When compared with patients without neglect, the group including all subacute neglect patients had decreased fractional anisotropy in the second (II) and third (III) branches of the right superior longitudinal fasciculus, as well as in the splenium of the corpus callosum. The subgroup of chronic patients showed reduced fractional anisotropy in a portion the splenium, the forceps major, which provides interhemispheric communication between regions of the occipital lobe and of the superior parietal lobules. The severity of neglect correlated with fractional anisotropy values in superior longitudinal fasciculus II/III for subacute patients and in its caudal portion for chronic patients. Our results confirm a key role of fronto-parietal disconnection in the emergence and chronic persistence of neglect, and demonstrate an implication of caudal interhemispheric disconnection in chronic neglect

  10. White Matter Microstructural Changes Following Quadrato Motor Training: A Longitudinal Study

    Directory of Open Access Journals (Sweden)

    Claudia Piervincenzi

    2017-12-01

    Full Text Available Diffusion tensor imaging (DTI is an important way to characterize white matter (WM microstructural changes. While several cross-sectional DTI studies investigated possible links between mindfulness practices and WM, only few longitudinal investigations focused on the effects of these practices on WM architecture, behavioral change, and the relationship between them. To this aim, in the current study, we chose to conduct an unbiased tract-based spatial statistics (TBSS analysis (n = 35 healthy participants to identify longitudinal changes in WM diffusion parameters following 6 and 12 weeks of daily Quadrato Motor Training (QMT, a whole-body mindful movement practice aimed at improving well-being by enhancing attention, coordination, and creativity. We also investigated the possible relationship between training-induced WM changes and concomitant changes in creativity, self-efficacy, and motivation. Our results indicate that following 6 weeks of daily QMT, there was a bilateral increase of fractional anisotropy (FA in tracts related to sensorimotor and cognitive functions, including the corticospinal tracts, anterior thalamic radiations, and uncinate fasciculi, as well as in the left inferior fronto-occipital, superior and inferior longitudinal fasciculi. Interestingly, significant FA increments were still present after 12 weeks of QMT in most of the above WM tracts, but only in the left hemisphere. FA increase was accompanied by a significant decrease of radial diffusivity (RD, supporting the leading role of myelination processes in training-related FA changes. Finally, significant correlations were found between training-induced diffusion changes and increased self-efficacy as well as creativity. Together, these findings suggest that QMT can improve WM integrity and support the existence of possible relationships between training-related WM microstructural changes and behavioral change.

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

    Science.gov (United States)

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

    2015-12-01

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

  12. Left Ventricular Assist Devices

    Directory of Open Access Journals (Sweden)

    Khuansiri Narajeenron

    2017-04-01

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

  13. Prosopomorphic vessels from Moesia Superior

    Directory of Open Access Journals (Sweden)

    Nikolić Snežana

    2008-01-01

    Full Text Available The prosopomorphic vessels from Moesia Superior had the form of beakers varying in outline but similar in size. They were wheel-thrown, mould-made or manufactured by using a combination of wheel-throwing and mould-made appliqués. Given that face vessels are considerably scarcer than other kinds of pottery, more than fifty finds from Moesia Superior make an enviable collection. In this and other provinces face vessels have been recovered from military camps, civilian settlements and necropolises, which suggests that they served more than one purpose. It is generally accepted that the faces-masks gave a protective role to the vessels, be it to protect the deceased or the family, their house and possessions. More than forty of all known finds from Moesia Superior come from Viminacium, a half of that number from necropolises. Although tangible evidence is lacking, there must have been several local workshops producing face vessels. The number and technological characteristics of the discovered vessels suggest that one of the workshops is likely to have been at Viminacium, an important pottery-making centre in the second and third centuries.

  14. Pensamiento Superior y Desarrollo Territorial

    Directory of Open Access Journals (Sweden)

    Víctor Manuel Racancoj Alonzo

    2015-04-01

    Full Text Available Esta reflexión pretende explicar el papel, fundamental, que juega el pensamiento superior, en la formulación y la práctica de modelos de desarrollo territorial local; para que contribuyan de forma sustantiva, en la transformación de las condiciones socioeconómicas adversas que hoy viven comunidades indígenas y rurales de muchos países, como Guatemala, situación que puede resumirse en altos índices de pobreza y desnutrición. Pero, el pensamiento superior, debe ser competencia de la población con pertenencia a lo local, pues si y solo si esta condición existe, se dará validez y viabilidad al desarrollo territorial. Para alcanzar competencias de pensamiento superior, en los espacios locales, se tiene que superar obstáculos en el modelo de universidad, que hoy estamos familiarizados a ver y pensar; modelos que tienen las características de: herencia colonial, disfunción con la problemática económica, cultural, social y política de la sociedad y la negación de los saberes ancestrales.

  15. Superior mediastinal syndrome: emergency management.

    Science.gov (United States)

    Jain, Richa; Bansal, Deepak; Marwaha, R K; Singhi, Sunit

    2013-01-01

    Superior Vena Cava Syndrome (SVCS) refers to signs and symptoms caused by obstruction of the superior vena cava. Superior mediastinal syndrome (SMS) is the term used when SVCS coexists with obstruction of trachea. In children, a mediastinal pathology causing SVCS generally results in SMS as well, due to the limited chest volume. Hence, the two terms are often used interchangeably in children. SMS is a medical emergency that can be challenging, albeit often rewarding to manage. The common causes in a patient presenting to pediatric emergency room include non-Hodgkin lymphoma and acute lymphoblastic leukemia. Patients with SMS are at a very high risk for adverse cardio-respiratory events in case they are administered any kind of anesthetic agents, anxiolytics or sedatives. Investigations, including tissue diagnosis are desirable, though not mandatory, before initiating emergency management. The patient's clinical condition should dictate the speed, requirement and sequence of investigations and the specific treatment. The least invasive procedure should be performed to confirm the diagnosis. As the most common cause of SMS in children is lymphoma/leukemia, the administration of systemic steroids is often the front line therapy. Diagnosis, monitoring and management of SMS in relevance to the pediatric emergency room are outlined.

  16. The Superior Transverse Scapular Ligament in Fetuses

    Directory of Open Access Journals (Sweden)

    José Aderval Aragão

    2013-01-01

    Full Text Available Introduction. The superior transverse scapular ligament (STSL links the margins of the suprascapular notch and converts it into a foramen, through which, the suprascapular nerve and, on some rare occasions, the suprascapular vessels pass. This conversion often results from partial or complete ossification of the STSL and may produce compressive symptoms in the suprascapular nerve. Material and Method. Twenty shoulders from human fetuses were dissected without the aid of optical instruments and, using a digital pachymeter of precision 0.01 millimeters, length measurements and thickness measurements were made. The fetal age was from 21 to 33 weeks of gestation, with a mean of 27.6±4.14 weeks. Results. There was no statistically significant difference in STSL length or any difference in the thicknesses at the medial and lateral extremities between the halves of the body (P≥0.05. However, in the left half of the body, the medial extremity of the STSL was significantly thinner than the lateral extremity (P≤0.05. Conclusion. Anatomical and morphometric details about the STSL were described in human fetuses. These findings, in fetuses, may encourage the pursuit of further studies to understand the morphofunctional role and meaning of this small ligament.

  17. High Frequency rTMS over the Left Parietal Lobule Increases Non-Word Reading Accuracy

    Science.gov (United States)

    Costanzo, Floriana; Menghini, Deny; Caltagirone, Carlo; Oliveri, Massimiliano; Vicari, Stefano

    2012-01-01

    Increasing evidence in the literature supports the usefulness of Transcranial Magnetic Stimulation (TMS) in studying reading processes. Two brain regions are primarily involved in phonological decoding: the left superior temporal gyrus (STG), which is associated with the auditory representation of spoken words, and the left inferior parietal lobe…

  18. 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".

  19. Left Ventricular Pseudoaneurysm Perceived as a Left Lung Mass

    Directory of Open Access Journals (Sweden)

    Ugur Gocen

    2013-02-01

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

  20. Right ventricular dysfunction affects survival after surgical left ventricular restoration.

    Science.gov (United States)

    Couperus, Lotte E; Delgado, Victoria; Palmen, Meindert; van Vessem, Marieke E; Braun, Jerry; Fiocco, Marta; Tops, Laurens F; Verwey, Harriëtte F; Klautz, Robert J M; Schalij, Martin J; Beeres, Saskia L M A

    2017-04-01

    Several clinical and left ventricular parameters have been associated with prognosis after surgical left ventricular restoration in patients with ischemic heart failure. The aim of this study was to determine the prognostic value of right ventricular function. A total of 139 patients with ischemic heart failure (62 ± 10 years; 79% were male; left ventricular ejection fraction 27% ± 7%) underwent surgical left ventricular restoration. Biventricular function was assessed with echocardiography before surgery. The independent association between all-cause mortality and right ventricular fractional area change, tricuspid annular plane systolic excursion, and right ventricular longitudinal peak systolic strain was assessed. The additive effect of multiple impaired right ventricular parameters on mortality also was assessed. Baseline right ventricular fractional area change was 42% ± 9%, tricuspid annular plane systolic excursion was 18 ± 3 mm, and right ventricular longitudinal peak systolic strain was -24% ± 7%. Within 30 days after surgery, 15 patients died. Right ventricular fractional area change (hazard ratio, 0.93; 95% confidence interval, 0.88-0.98; P right ventricular longitudinal peak systolic strain (hazard ratio, 1.15; 95% confidence interval, 1.05-1.26; P Right ventricular function was impaired in 21%, 20%, and 27% of patients on the basis of right ventricular fractional area change, tricuspid annular plane systolic excursion, and right ventricular longitudinal peak systolic strain, respectively. Any echocardiographic parameter of right ventricular dysfunction was present in 39% of patients. The coexistence of several impaired right ventricular parameters per patient was independently associated with increased 30-day mortality (hazard ratio, 2.83; 95% confidence interval, 1.64-4.87, P right ventricular systolic dysfunction is independently associated with increased mortality in patients with ischemic heart failure undergoing surgical left

  1. Percutaneous Mechanical Thrombectomy Treatment of Acute Superior Mesenteric Artery Embolism

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    Z. Zhang

    Full Text Available : Objective/Background: This report presents a superior mesenteric artery (SMA embolism managed by percutaneous mechanical thrombectomy (PMT. Methods: A 61 year old woman diagnosed with SMA embolism was admitted. Emboli were found in the middle and distal segments of the SMA on abdominal computed tomography angiography. Under local anaesthesia, a 6 F Rotarex system was used to remove the emboli via left brachial artery access. Emboli were successfully removed and patency was restored to the SMA and its branches. Results: Post-operatively, the patient's symptoms were significantly relieved. No post-operative complications were observed and no discomfort was documented during follow-up. Conclusion: Endovascular treatment of SMA embolism using PMT is a feasible and alternative option. Keywords: Acute mesenteric ischaemia, Embolism, Endovascular treatment, Percutaneous mechanical thrombectomy, Superior mesenteric artery

  2. The sentence superiority effect revisited.

    Science.gov (United States)

    Snell, Joshua; Grainger, Jonathan

    2017-11-01

    A sentence superiority effect was investigated using post-cued word-in-sequence identification with the rapid parallel visual presentation (RPVP) of four horizontally aligned words. The four words were presented for 200ms followed by a post-mask and cue for partial report. They could form a grammatically correct sentence or were formed of the same words in a scrambled agrammatical sequence. Word identification was higher in the syntactically correct sequences, and crucially, this sentence superiority effect did not vary as a function of the target's position in the sequence. Cloze probability measures for words at the final, arguably most predictable position, revealed overall low values that did not interact with the effects of sentence context, suggesting that these effects were not driven by word predictability. The results point to a level of parallel processing across multiple words that enables rapid extraction of their syntactic categories. These generate a sentence-level representation that constrains the recognition process for individual words, thus facilitating parallel word processing when the sequence is grammatically sound. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Why Dora Left

    DEFF Research Database (Denmark)

    Gammelgård, Judy

    2017-01-01

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

  4. Surgery for gliomas involving the left inferior parietal lobule: new insights into the functional anatomy provided by stimulation mapping in awake patients.

    Science.gov (United States)

    Maldonado, Igor Lima; Moritz-Gasser, Sylvie; de Champfleur, Nicolas Menjot; Bertram, Luc; Moulinié, Gérard; Duffau, Hugues

    2011-10-01

    Surgery in the left dominant inferior parietal lobule (IPL) is challenging because of a high density of somatosensory and language structures, both in the cortex and white matter. In the present study, on the basis of the results provided by direct cerebral stimulation in awake patients, the authors revisit the anatomofunctional aspects of surgery within the left IPL. Fourteen consecutive patients underwent awake craniotomy for a glioma involving the left IPL. Intraoperative motor, sensory, and language mapping was performed before and during the tumor removal, at both the cortical and subcortical levels, to optimize the extent of resection, which was determined based on functional boundaries. Anatomofunctional correlations were performed by combining the results of intraoperative mapping and those provided by pre- and postoperative MR imaging. At the cortical level, the primary somatosensory area (retrocentral gyrus) limited the resection anteriorly in all cases, at least partially. Less frequently, speech arrest or articulatory problems were observed within the parietal operculum (4 cases). The lateral limit was determined by language sites that were variably distributed. Anomia was the most frequent response (9 cases) at the posterior third of the superior (and/or middle) temporal gyrus. Posteriorly, less reproducible reorganized language sites were seldom observed in the posterior portion of the angular gyrus (2 cases). At the subcortical level, in addition to somatosensory responses due to stimulation of the thalamocortical pathways, articulatory disturbances were induced by stimulation of white matter in the anterior and lateral part of the surgical cavity (11 cases). This tract anatomically corresponds to the horizontal portion of the lateral segment of the superior longitudinal fascicle (SLF III). Deeper and superiorly, phonemic paraphasia was the main language disturbance (12 cases), elicited by stimulation of the posterosuperior portion of the arcuate

  5. superior en México

    Directory of Open Access Journals (Sweden)

    César Mureddu Torres

    2008-01-01

    Full Text Available El presente artículo desarrolla algunos de los retos que ha traído consigo el acceso a la información existente en la red de Internet y lo que ello supone. Se abordan principalmente las consecuencias de la presencia actual de una sociedad llamada del conocimiento, si se mantiene la confusión entre conocimiento e información. Por ello, la sola gestión de la información no puede ser tomada como definitoria respecto a la función de educación superior confiada a las universidades. Hacerlo sería cometer un error aún más grave que la confusión teórica entre los términos mencionados.

  6. Left-handedness in professional and amateur tennis.

    Directory of Open Access Journals (Sweden)

    Florian Loffing

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

  7. Childhood Music Training Induces Change in Micro and Macroscopic Brain Structure: Results from a Longitudinal Study.

    Science.gov (United States)

    Habibi, Assal; Damasio, Antonio; Ilari, Beatriz; Veiga, Ryan; Joshi, Anand A; Leahy, Richard M; Haldar, Justin P; Varadarajan, Divya; Bhushan, Chitresh; Damasio, Hanna

    2017-11-08

    Several studies comparing adult musicians and nonmusicians have shown that music training is associated with structural brain differences. It is not been established, however, whether such differences result from pre-existing biological traits, lengthy musical training, or an interaction of the two factors, or if comparable changes can be found in children undergoing music training. As part of an ongoing longitudinal study, we investigated the effects of music training on the developmental trajectory of children's brain structure, over two years, beginning at age 6. We compared these children with children of the same socio-economic background but either involved in sports training or not involved in any systematic after school training. We established at the onset that there were no pre-existing structural differences among the groups. Two years later we observed that children in the music group showed (1) a different rate of cortical thickness maturation between the right and left posterior superior temporal gyrus, and (2) higher fractional anisotropy in the corpus callosum, specifically in the crossing pathways connecting superior frontal, sensory, and motor segments. We conclude that music training induces macro and microstructural brain changes in school-age children, and that those changes are not attributable to pre-existing biological traits. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  8. 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

  9. Applied longitudinal analysis

    CERN Document Server

    Fitzmaurice, Garrett M; Ware, James H

    2012-01-01

    Praise for the First Edition "". . . [this book] should be on the shelf of everyone interested in . . . longitudinal data analysis.""-Journal of the American Statistical Association   Features newly developed topics and applications of the analysis of longitudinal data Applied Longitudinal Analysis, Second Edition presents modern methods for analyzing data from longitudinal studies and now features the latest state-of-the-art techniques. The book emphasizes practical, rather than theoretical, aspects of methods for the analysis of diverse types of lo

  10. Sustained attention is associated with right superior longitudinal fasciculus and superior parietal white matter microstructure in children

    DEFF Research Database (Denmark)

    Klarborg, Brith; Skak Madsen, Kathrine; Vestergaard, Martin

    2013-01-01

    Sustained attention develops during childhood and has been linked to the right fronto-parietal cortices in functional imaging studies; however, less is known about its relation to white matter (WM) characteristics. Here we investigated whether the microstructure of the WM underlying and connectin...

  11. Mechanical discordance between left atrium and left atrial appendage

    Directory of Open Access Journals (Sweden)

    Arash Khamooshian

    2018-01-01

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

  12. [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.

  13. Escuela Superior de Palos Verdes

    Directory of Open Access Journals (Sweden)

    Neutra, Richard J.

    1965-02-01

    Full Text Available Before initiating the building operations for the «Palos Verdes» School, the site was divided into two large horizontal surfaces, at different levels. The lower one served to accommodate the playing fields, a car park, the physical training building, and shop and ancillary buildings. On the higher of these two surfaces, and to the West of the access road, there is a car park and also the building and plot of ground devoted to agricultural technology, as well as the literary studies and general purpose buildings. As a complement to these, there is a series of blocks, arranged in parallel rows, which house the administrative offices, the art school, the craft's school, the general classrooms, and those devoted to higher education. The fascinating aspect of this school is the outstanding penetration of the architect's mind into the essential function of the project. Its most evident merit is the sense of comradeship and harmony that permeates the whole architectural manifold.Antes de construir el complejo escolar «Palos Verdes» se comenzó por crear, en el terreno, dos grandes mesetas a niveles diferentes. Sobre el inferior se organizaron: los campos de juegos, de deportes, un aparcamiento, el edificio para educación física y los destinados a tiendas y servicios. Sobre la meseta superior, al oeste de la vía de acceso, se dispuso un aparcamiento y el edificio y campo para adiestramiento agrícola; al este, otro aparcamiento, el edificio dedicado a materias literarias, y el destinado a usos múltiples. Completan las instalaciones de la escuela una serie de bloques paralelos: la administración, la escuela de arte, las clases de trabajos manuales, las aulas de enseñanzas generales, y las de los cursos superiores. Lo fascinante de este complejo escolar es la perfecta y magistral compenetración del arquitecto con el tema proyectado, y su mayor mérito, la sensación de cordialidad y armonía con el ambiente.

  14. Imaging network level language recovery after left PCA stroke.

    Science.gov (United States)

    Sebastian, Rajani; Long, Charltien; Purcell, Jeremy J; Faria, Andreia V; Lindquist, Martin; Jarso, Samson; Race, David; Davis, Cameron; Posner, Joseph; Wright, Amy; Hillis, Argye E

    2016-05-11

    The neural mechanisms that support aphasia recovery are not yet fully understood. Our goal was to evaluate longitudinal changes in naming recovery in participants with posterior cerebral artery (PCA) stroke using a case-by-case analysis. Using task based and resting state functional magnetic resonance imaging (fMRI) and detailed language testing, we longitudinally studied the recovery of the naming network in four participants with PCA stroke with naming deficits at the acute (0 week), sub acute (3-5 weeks), and chronic time point (5-7 months) post stroke. Behavioral and imaging analyses (task related and resting state functional connectivity) were carried out to elucidate longitudinal changes in naming recovery. Behavioral and imaging analysis revealed that an improvement in naming accuracy from the acute to the chronic stage was reflected by increased connectivity within and between left and right hemisphere "language" regions. One participant who had persistent moderate naming deficit showed weak and decreasing connectivity longitudinally within and between left and right hemisphere language regions. These findings emphasize a network view of aphasia recovery, and show that the degree of inter- and intra- hemispheric balance between the language-specific regions is necessary for optimal recovery of naming, at least in participants with PCA stroke.

  15. Impact of videogame play on the brain's microstructural properties: cross-sectional and longitudinal analyses.

    Science.gov (United States)

    Takeuchi, H; Taki, Y; Hashizume, H; Asano, K; Asano, M; Sassa, Y; Yokota, S; Kotozaki, Y; Nouchi, R; Kawashima, R

    2016-12-01

    Videogame play (VGP) has been associated with numerous preferred and non-preferred effects. However, the effects of VGP on the development of microstructural properties in children, particularly those associated with negative psychological consequences of VGP, have not been identified to date. The purpose of this study was to investigate this issue through cross-sectional and longitudinal prospective analyses. In the present study of humans, we used the diffusion tensor imaging mean diffusivity (MD) measurement to measure microstructural properties and examined cross-sectional correlations with the amount of VGP in 114 boys and 126 girls. We also assessed correlations between the amount of VGP and longitudinal changes in MD that developed after 3.0±0.3 (s.d.) years in 95 boys and 94 girls. After correcting for confounding factors, we found that the amount of VGP was associated with increased MD in the left middle, inferior and orbital frontal cortex; left pallidum; left putamen; left hippocampus; left caudate; right putamen; right insula; and thalamus in both cross-sectional and longitudinal analyses. Regardless of intelligence quotient type, higher MD in the areas of the left thalamus, left hippocampus, left putamen, left insula and left Heschl gyrus was associated with lower intelligence. We also confirmed an association between the amount of VGP and decreased verbal intelligence in both cross-sectional and longitudinal analyses. In conclusion, increased VGP is directly or indirectly associated with delayed development of the microstructure in extensive brain regions and verbal intelligence.

  16. Cross-sectional and longitudinal voxel-based grey matter asymmetries in Huntington's disease

    Directory of Open Access Journals (Sweden)

    Lora Minkova

    2018-01-01

    Full Text Available Huntington's disease (HD is a progressive neurodegenerative disorder that can be genetically confirmed with certainty decades before clinical onset. This allows the investigation of functional and structural changes in HD many years prior to disease onset, which may reveal important mechanistic insights into brain function, structure and organization in general. While regional atrophy is present at early stages of HD, it is still unclear if both hemispheres are equally affected by neurodegeneration and how the extent of asymmetry affects domain-specific functional decline. Here, we used whole-brain voxel-based analysis to investigate cross-sectional and longitudinal hemispheric asymmetries in grey matter (GM volume in 56 manifest HD (mHD, 83 pre-manifest HD (preHD, and 80 healthy controls (HC. Furthermore, a regression analysis was used to assess the relationship between neuroanatomical asymmetries and decline in motor and cognitive measures across the disease spectrum. The cross-sectional analysis showed striatal leftward-biased GM atrophy in mHD, but not in preHD, relative to HC. Longitudinally, no net 36-month change in GM asymmetries was found in any of the groups. In the regression analysis, HD-related decline in quantitative-motor (Q-Motor performance was linked to lower GM volume in the left superior parietal cortex. These findings suggest a stronger disease effect targeting the left hemisphere, especially in those with declining motor performance. This effect did not change over a period of three years and may indicate a compensatory role of the right hemisphere in line with recent functional imaging studies.

  17. A tensor based morphometry study of longitudinal gray matter contraction in FTD

    Science.gov (United States)

    Brambati, Simona M.; Renda, Natasha C.; Rankin, Katherine P.; Rosen, Howard J.; Seeley, William W.; Ashburner, John; Weiner, Michael W.; Miller, Bruce L.; Gorno-Tempini, Maria Luisa

    2008-01-01

    Frontotemporal dementia (FTD) is a neurodegenerative disease characterized by progressive behavioural abnormalities and frontotemporal atrophy. Here we used tensor based morphometry (TBM) to identify regions of longitudinal progression of gray matter atrophy in FTD compared to controls. T1-weighted MRI images were acquired at presentation and 1-year follow-up from 12 patients with mild to moderate FTD and 12 healthy controls. Using TBM as implemented in SPM2, a voxel-wise estimation of regional tissue volume change was derived from the deformation field required to warp a subject’s late to early anatomical images. A whole brain analysis was performed, in which a level of significance of pBased on prior studies, a region of interest (ROI) analysis was also performed, including in the search area bilateral medial and orbital frontal regions, anterior cingulate gyrus, insula, amygdala and hippocampus. Within this ROI a level of significance of p<0.001 uncorrected was accepted. In the whole brain analysis, the anterior cingulate/paracingulate gyri were the only regions that showed significant atrophy change over 1 year. In the ROI analysis, the left ventro-medial frontal cortex, right medial superior frontal gyrus, anterior insulae and left amygdala/hippocampus showed significant longitudinal changes. In conclusion, limbic and paralimbic regions showed detectable gray matter contraction over 1 year in FTD, confirming the susceptibility of these regions to the disease and the consistency with their putative role in causing typical presenting behaviours. These results suggest that TBM might be useful in tracking progression of regional atrophy in FTD. PMID:17350290

  18. A Longitudinal Assessment of Structural and Chemical Alterations in Mixed Martial Arts Fighters.

    Science.gov (United States)

    Mayer, Andrew R; Ling, Josef M; Dodd, Andrew B; Gasparovic, Charles; Klimaj, Stefan D; Meier, Timothy B

    2015-11-15

    Growing evidence suggests that temporally proximal acute concussions and repetitive subconcussive head injuries may lead to long-term neurological deficits. However, the underlying mechanisms of injury and their relative time-scales are not well documented in human injury models. The current study therefore investigated whether biomarkers of brain chemistry (magnetic resonance [MR] spectroscopy: N-acetylaspartate [NAA], combined glutamate and glutamine [Glx], total creatine [Cre], choline compounds [Cho], and myo-inositol [mI]) and structure (cortical thickness, white matter [WM]/subcortical volume) differed between mixed martial artists (MMA; n = 13) and matched healthy controls (HC) without a history of contact sport participation (HC; n = 14). A subset of participants (MMA = 9; HC = 10) returned for follow-up visits, with MMA (n = 3) with clinician-documented acute concussions also scanned serially. As expected, MMA self-reported a higher incidence of previous concussions and significantly more cognitive symptoms during prior concussion recovery. Fighters also exhibited reduced memory and processing speed relative to controls on neuropsychological testing coupled with cortical thinning in the left posterior cingulate gyrus and right occipital cortex at baseline assessment. Over a 1-year follow-up period, MMA experienced a significant decrease in both WM volume and NAA concentration, as well as relative thinning in the left middle and superior frontal gyri. These longitudinal changes did not correlate with self-reported metrics of injury (i.e., fight diary). In contrast, HC did not exhibit significant longitudinal changes over a 4-month follow-up period (p > 0.05). Collectively, current results provide preliminary evidence of progressive changes in brain chemistry and structure over a relatively short time period in individuals with high exposure to repetitive head hits. These findings require replication in independent samples.

  19. Emission computer tomography of the left ventricle

    Energy Technology Data Exchange (ETDEWEB)

    Semmler, W.; Felix, R.; Calder, D.; Golde, G.; Botsch, H.

    1983-10-01

    Tomographic studies and time-dependent tomograms on phantoms and patients were carried out using a 7-pinhole collimator in order to study the clinical value of ECG-triggered tomographic radionuclid ventriculography. A suitable computer programme has been developed. The results have shown that it is possible to evaluate local contraction abnormalities by this method. Using a left oblique position of the collimator (LAO (45/sup 0/) - cranial (15/sup 0/)), emission computer tomography is aligned with the longitudinal axis for the heart. In this way, a single projection is sufficient to show the montility of the anterior and posterior walls and of the septum. Hypokinesis, akinesis or dyskinesis can be recognised visually. The localisation and extent of the defect can be determined through the 7-pinhole collimator. Reconstructed images of the triggered radionuclide scintigrams show excellent marginal definition. In the RAO projection the left ventricle can be seen without superimposition and images obtained which equal those of a first-pass technique.

  20. Sobredentadura total superior implantosoportada Superior total overdenture on implants

    Directory of Open Access Journals (Sweden)

    Luis Orlando Rodríguez García

    2010-06-01

    Full Text Available Se presenta un caso de un paciente desdentado total superior, rehabilitado en la consulta de implantología de la Clínica "Pedro Ortiz" del municipio Habana del Este en Ciudad de La Habana, Cuba, en el año 2009, mediante prótesis sobre implantes osteointegrados, técnica que se ha incorporado a la práctica estomatológica en Cuba como alternativa al tratamiento convencional en los pacientes desdentados totales. Se siguió un protocolo que comprendió una fase quirúrgica, procedimiento con o sin realización de colgajo y carga precoz o inmediata. Se presenta un paciente masculino de 56 años de edad, que acudió a la consulta multidisciplinaria, preocupado, porque se le habían elaborado tres prótesis en los últimos dos años y ninguna reunía los requisitos de retención que él necesitaba para sentirse seguro y cómodo con las mismas. El resultado final fue la satisfacción total del paciente, con el mejoramiento de la calidad estética y funcional.This is the case of a total maxilla edentulous patient seen in consultation of the "Pedro Ortíz" Clinic Implant of Habana del Este municipality in 2009 and con rehabilitation by prosthesis over osteointegration implants added to stomatology practice in Cuba as an alternative to conventional treatment in patients totally edentulous. We follow a protocol including a surgery or surgical phase, technique without or with flap creation and early or immediate load. This is a male patient aged 56 came to our multidisciplinary consultation worried because he had three prostheses in last two years and any fulfilled the requirements of retention to feel safe and comfortable with prostheses. The final result was the total satisfaction of rehabilitated patient improving its aesthetic and functional quality.

  1. Migration of central lines from the superior vena cava to the azygous vein

    Energy Technology Data Exchange (ETDEWEB)

    Haygood, T.M., E-mail: tamara.haygood@mdanderson.org [University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1475, Houston, TX 77030 (United States); Malhotra, K., E-mail: kmalhotra@mdanderson.org [University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1475, Houston, TX 77030 (United States); Ng, C., E-mail: cng@mdanderson.org [University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1475, Houston, TX 77030 (United States); Chasen, B., E-mail: beth.chasen@mdanderson.org [University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1475, Houston, TX 77030 (United States); McEnery, K.W., E-mail: kmcenery@mdanderson.org [University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1475, Houston, TX 77030 (United States); Chasen, M., E-mail: mchasen@mdanderson.org [University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1475, Houston, TX 77030 (United States)

    2012-01-15

    Aim: To report 11 cases of central venous access catheters migrating from the superior vena cava to the azygos vein in order to raise radiologists' awareness of this possibility. Materials and methods: This is a retrospective review of the clinical history and imaging of 11 patients whose central line migrated from the superior vena cava to the azygos vein. The time course of migration, access route of the catheters, outcome, and depth of placement in the superior vena cava were evaluated. Results: All of these catheters were placed from the left; six through the subclavian vein, four as PICC lines, and one from the left internal jugular vein. Seven of the catheters were originally positioned in the superior vena cava. Four of the catheters were originally positioned in the azygos vein and were repositioned into the superior vena cava at the time of placement. The time to migration ranged from 2 to 126 days, average 43 days. In three cases, the migration was not reported at the first opportunity, resulting in a delay in diagnosis ranging from 10 to 27 days. All but one of the catheters extended at least 3.5 cm (range 1.8-7 cm) below the top of the right mainstem bronchus when in the superior vena cava. Conclusion: Risk factors for migration into the azygos vein include placement from a left-sided approach and original positioning in the azygos vein with correction at placement. The depth of placement in the superior vena cava was not a protective factor. It is important to recognize migration because of the elevated risk of complications when central lines are placed in the azygos vein.

  2. Migration of central lines from the superior vena cava to the azygous vein

    International Nuclear Information System (INIS)

    Haygood, T.M.; Malhotra, K.; Ng, C.; Chasen, B.; McEnery, K.W.; Chasen, M.

    2012-01-01

    Aim: To report 11 cases of central venous access catheters migrating from the superior vena cava to the azygos vein in order to raise radiologists’ awareness of this possibility. Materials and methods: This is a retrospective review of the clinical history and imaging of 11 patients whose central line migrated from the superior vena cava to the azygos vein. The time course of migration, access route of the catheters, outcome, and depth of placement in the superior vena cava were evaluated. Results: All of these catheters were placed from the left; six through the subclavian vein, four as PICC lines, and one from the left internal jugular vein. Seven of the catheters were originally positioned in the superior vena cava. Four of the catheters were originally positioned in the azygos vein and were repositioned into the superior vena cava at the time of placement. The time to migration ranged from 2 to 126 days, average 43 days. In three cases, the migration was not reported at the first opportunity, resulting in a delay in diagnosis ranging from 10 to 27 days. All but one of the catheters extended at least 3.5 cm (range 1.8–7 cm) below the top of the right mainstem bronchus when in the superior vena cava. Conclusion: Risk factors for migration into the azygos vein include placement from a left-sided approach and original positioning in the azygos vein with correction at placement. The depth of placement in the superior vena cava was not a protective factor. It is important to recognize migration because of the elevated risk of complications when central lines are placed in the azygos vein.

  3. Myxoma of the Left Ventricle

    Science.gov (United States)

    Novoa, José; Delgado, Antonio; Alonso, Ana

    2014-01-01

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

  4. Left ventricular hypertrophy in athletes.

    Science.gov (United States)

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

    1997-11-15

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

  5. The Left-Handed Writer.

    Science.gov (United States)

    Bloodsworth, James Gaston

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

  6. Two Lefts in Latin America?

    DEFF Research Database (Denmark)

    Christensen, Steen Fryba

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

  7. A Giant Left Atrial Myxoma

    Directory of Open Access Journals (Sweden)

    Medhat F. Zaher

    2014-01-01

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

  8. CBCT volumetric coverage extension using a pair of complementary circular scans with complementary kV detector lateral and longitudinal offsets

    International Nuclear Information System (INIS)

    Yang, Deshan; Li, H Harold; Goddu, S Murty; Tan, Jun

    2014-01-01

    Onboard cone-beam CT (CBCT) has been widely used in image guided radiation therapy. However, the longitudinal coverage is only 15.5 cm in the pelvis scan mode. As a result, a single CBCT scan cannot cover the planning target volume in the longitudinal direction for over 80% of the patients. The common approach is to use double- or multiple-circular scans and then combine multiple CBCT volumes after reconstruction. However it raises concerns regarding doubled imaging dose at the imaging beam junctions due to beam divergence. In this work, we present a new method, DSCS (Dual Scan with Complementary Shifts), to address the CBCT coverage problem using a pair of complementary circular scans. In DSCS, two circular scans were performed at 39.5 cm apart longitudinally. In the superior scan, the detector panel was offset by 16 cm to the left, 15 cm to the inferior. In the inferior scan, the detector panel was shifted 16 cm to the right and 15 cm to the superior. The effective imaging volume is 39.5 cm longitudinally with a 45 cm lateral field-of-view (FOV). Half beam blocks were used to confine the imaging radiation inside the volume of interest. A new image reconstruction algorithm was developed, based on the Feldkamp–Davis–Kress cone-beam CT reconstruction algorithm, to support the DSCS scanning geometry. Digital phantom simulations were performed to demonstrate the feasibility of DSCS. Physical phantom studies were performed using an anthropomorphic phantom on a commercial onboard CBCT system. With basic scattering corrections, the reconstruction results were acceptable. Other issues, including the discrepancy in couch vertical at different couch longitudinal positions, and the inaccuracy in couch table longitudinal movement, were manually corrected during the reconstruction process. In conclusion, the phantom studies showed that, using DSCS, a 39.5 cm longitudinal coverage with a 45 cm FOV was accomplished. The efficiency of imaging dose usage

  9. CBCT volumetric coverage extension using a pair of complementary circular scans with complementary kV detector lateral and longitudinal offsets

    Science.gov (United States)

    Yang, Deshan; Li, H. Harold; Goddu, S. Murty; Tan, Jun

    2014-10-01

    Onboard cone-beam CT (CBCT) has been widely used in image guided radiation therapy. However, the longitudinal coverage is only 15.5 cm in the pelvis scan mode. As a result, a single CBCT scan cannot cover the planning target volume in the longitudinal direction for over 80% of the patients. The common approach is to use double- or multiple-circular scans and then combine multiple CBCT volumes after reconstruction. However it raises concerns regarding doubled imaging dose at the imaging beam junctions due to beam divergence. In this work, we present a new method, DSCS (Dual Scan with Complementary Shifts), to address the CBCT coverage problem using a pair of complementary circular scans. In DSCS, two circular scans were performed at 39.5 cm apart longitudinally. In the superior scan, the detector panel was offset by 16 cm to the left, 15 cm to the inferior. In the inferior scan, the detector panel was shifted 16 cm to the right and 15 cm to the superior. The effective imaging volume is 39.5 cm longitudinally with a 45 cm lateral field-of-view (FOV). Half beam blocks were used to confine the imaging radiation inside the volume of interest. A new image reconstruction algorithm was developed, based on the Feldkamp-Davis-Kress cone-beam CT reconstruction algorithm, to support the DSCS scanning geometry. Digital phantom simulations were performed to demonstrate the feasibility of DSCS. Physical phantom studies were performed using an anthropomorphic phantom on a commercial onboard CBCT system. With basic scattering corrections, the reconstruction results were acceptable. Other issues, including the discrepancy in couch vertical at different couch longitudinal positions, and the inaccuracy in couch table longitudinal movement, were manually corrected during the reconstruction process. In conclusion, the phantom studies showed that, using DSCS, a 39.5 cm longitudinal coverage with a 45 cm FOV was accomplished. The efficiency of imaging dose usage was

  10. The Left Atrio-Vertebral Ratio: a new simple means for assessing left atrial enlargement on Computed Tomography.

    Science.gov (United States)

    Montillet, Marie; Baqué-Juston, Marie; Tasu, Jean-Pierre; Bertrand, Sandra; Berthier, Frédéric; Zarqane, Naïma; Brunner, Philippe

    2018-03-01

    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. • Left atrial enlargement is a frequent condition associated with poor cardiac outcome. • Left atrial enlargement is highly time-consuming to diagnose on CT. • The left atrio-vertebral ratio quickly assesses left atrial enlargement. • A left atrial area > three times vertebral area is highly specific.

  11. Superior Electrical Contractors Inc. Information Sheet

    Science.gov (United States)

    Superior Electrical Contractors Inc. (the Company) is located in Boise, Idaho. The settlement involves renovation activities conducted at a property constructed prior to 1978, located in Boise, Idaho.

  12. Validation of semi-automatic segmentation of the left atrium

    Science.gov (United States)

    Rettmann, M. E.; Holmes, D. R., III; Camp, J. J.; Packer, D. L.; Robb, R. A.

    2008-03-01

    Catheter ablation therapy has become increasingly popular for the treatment of left atrial fibrillation. The effect of this treatment on left atrial morphology, however, has not yet been completely quantified. Initial studies have indicated a decrease in left atrial size with a concomitant decrease in pulmonary vein diameter. In order to effectively study if catheter based therapies affect left atrial geometry, robust segmentations with minimal user interaction are required. In this work, we validate a method to semi-automatically segment the left atrium from computed-tomography scans. The first step of the technique utilizes seeded region growing to extract the entire blood pool including the four chambers of the heart, the pulmonary veins, aorta, superior vena cava, inferior vena cava, and other surrounding structures. Next, the left atrium and pulmonary veins are separated from the rest of the blood pool using an algorithm that searches for thin connections between user defined points in the volumetric data or on a surface rendering. Finally, pulmonary veins are separated from the left atrium using a three dimensional tracing tool. A single user segmented three datasets three times using both the semi-automatic technique as well as manual tracing. The user interaction time for the semi-automatic technique was approximately forty-five minutes per dataset and the manual tracing required between four and eight hours per dataset depending on the number of slices. A truth model was generated using a simple voting scheme on the repeated manual segmentations. A second user segmented each of the nine datasets using the semi-automatic technique only. Several metrics were computed to assess the agreement between the semi-automatic technique and the truth model including percent differences in left atrial volume, DICE overlap, and mean distance between the boundaries of the segmented left atria. Overall, the semi-automatic approach was demonstrated to be repeatable within

  13. Left-handedness and health

    Directory of Open Access Journals (Sweden)

    Milenković Sanja

    2010-01-01

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

  14. Left ventricular wall stress compendium.

    Science.gov (United States)

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

    2012-01-01

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

  15. Restoration of longitudinal images.

    Science.gov (United States)

    Hu, Y; Frieden, B R

    1988-01-15

    In this paper, a method of restoring longitudinal images is developed. By using the transfer function for longitudinal objects, and inverse filtering, a longitudinal image may be restored. The Fourier theory and sampling theorems for transverse images cannot be used directly in the longitudinal case. A modification and reasonable approximation are introduced. We have numerically established a necessary relationship between just-resolved longitudinal separation (after inverse filtering), noise level, and the taking conditions of object distance and lens diameter. An empirical formula is also found to well-fit the computed results. This formula may be of use for designing optical systems which are to image longitudinal details, such as in robotics or microscopy.

  16. Prostate-specific antigen superior serum marker for prostatic carcinoma

    International Nuclear Information System (INIS)

    Heaney, J.A.; Allen, M.A.; Keane, T.; Duffy, J.J.

    1987-01-01

    A new immunoradiometric assay based on dual monoclonal antibody reaction system (Hybritech-TANDEM R ) was used to measure serum levels of prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP) in 39 patients with prostatic carcinoma (CaP), in 57 with benign prostatic hyperplasia (BPH) and in 14 without prostatic disease. Serum PSA was elevated in 82% of patients with CaP while PAP was elevated in only 54%. In this and other studies, PSA is superior to conventional serum markers in sensitivity, prediction of CaP stage and in longitudinal monitoring of disease. A 16% false positive rate precludes PSA as a screening test. The assay used was found to be simple and reliable. (author)

  17. 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.

  18. Paso superior en una ladera

    Directory of Open Access Journals (Sweden)

    Bender, O.

    1965-07-01

    Full Text Available The Redwood highway, through the Californian forest, runs on a viaduct, as it crosses a mountain slope of about 45° inclination. The firm ground is fairly deep, and as an additional constructional difficulty, it was necessary to respect the natural beauty of the countryside. A structure of portal frames were built, forming a number of short spans. These spans were bridged with metal girders, on which a 19 m wide deck was placed. The columns are hollow and have a transversal cross beam, to join each pair. There was difficulty in excavating the foundations for the columns, as it was necessary to dig through the soft top soil, and also prevent this soil from hurting the trunks of the forest trees. Another significant difficulty in the construction of this viaduct was the access to the working site, since there were no suitable platforms from which to operate the appropriate machinery. This made it necessary to do a lot of the work by manual operation. As one of the edges of the deck is very close to the mountain side, a supporting beam was erected on this side. It was made of concrete, on metal piles. The formwork for the deck structure was placed on the concrete stems of the supporting piles.La autopista denominada Redwood (California salva, con un paso superior, la ladera de un bosque cuya pendiente es del 1/1. El terreno firme se halla a bastante profundidad, añadiéndose, a los naturales problemas de la construcción, el imperativo de respetar la belleza agreste del paraje. La solución adoptada consiste en una estructura porticada, con varios tramos de pequeñas luces, salvados con vigas metálicas, sobre los que se coloca la losa del tablero, de 19 m de anchura total. Los soportes están constituidos por pórticos de dos montantes huecos (con bases de hormigón en masa por debajo del suelo, hasta el firme coronados por un cabezal. La perforación de pozos para el hormigonado de los montantes presentaba la dificultad de atravesar el terreno

  19. Intracranially protruded bilateral posterior and superior SCCs with multiple dehiscences in a patient with positional vertigo: CT and MR imaging findings and review of literature

    Directory of Open Access Journals (Sweden)

    Nischal G Kundaragi

    2014-01-01

    Full Text Available We report a rare case of intracranially protruded posterior and superior semicircular canals beyond the margins of temporal bone with bony roof dehiscence in bilateral posterior and left superior semicircular canals in a patient with benign paroxysmal positional vertigo (BPPV.

  20. Left-right cortical asymmetries of regional cerebral blood flow during listening to words

    DEFF Research Database (Denmark)

    Nishizawa, Y; Olsen, T S; Larsen, B

    1982-01-01

    1. Regional cerebral blood flow (rCBF) was measured during rest and during listening to simple words. The xenon-133 intracarotid technique was used and results were obtained from 254 regions of seven right hemispheres and seven left hemispheres. The measurements were performed just after carotid...... of the entire hemisphere. The focal rCBF increases were localized to the superior part of the temporal regions, the prefrontal regions, the frontal eye fields, and the orbitofrontal regions. Significant asymmetries were found in particular in the superior temporal region with the left side showing a more...

  1. Left main percutaneous coronary intervention.

    Science.gov (United States)

    Teirstein, Paul S; Price, Matthew J

    2012-10-23

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

  2. Left 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...

  3. Dabigatran for left ventricular thrombus

    Directory of Open Access Journals (Sweden)

    Satishkumar Kolekar

    2015-09-01

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

  4. Burlington Northern Taconite Transshipment Facility, Duluth-Superior Harbor, Superior Wisconsin. Environmental Assessment Report.

    Science.gov (United States)

    1975-03-01

    unsuitable for potable and even some industrial uses. 2.250 Water Use. The city of Superior presently obtains its entire municipal water supply from a...53, which will link Duluth-Superior to Eau Claire and Madison, Wisconsin, and to Chicago, Illinois. Duluth and Superior combined have more than 6,000

  5. Left ventricular diastolic function is associated with symptom status in severe aortic valve stenosis

    DEFF Research Database (Denmark)

    Dahl, Jordi S; Christensen, Nicolaj L; Videbæk, Lars

    2014-01-01

    BACKGROUND: In aortic valve stenosis (AS), the occurrence of heart failure symptoms does not always correlate with severity of valve stenosis and left ventricular (LV) function. Therefore, we tested the hypothesis that symptomatic patients with AS have impaired diastolic, longitudinal systolic...... atrial volume index, and deceleration time were still associated with the presence of symptoms. CONCLUSIONS: The present study demonstrates that symptomatic status in severe AS is associated with impaired diastolic function, LV hypertrophy, concentric remodeling, and left atrial dilatation when corrected...

  6. 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

  7. 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)

  8. Left Main Coronary Artery Aneurysm

    Directory of Open Access Journals (Sweden)

    Hossein Doustkami

    2016-07-01

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

  9. 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.

  10. Longitudinal categorical data analysis

    CERN Document Server

    Sutradhar, Brajendra C

    2014-01-01

    This is the first book in longitudinal categorical data analysis with parametric correlation models developed based on dynamic relationships among repeated categorical responses. This book is a natural generalization of the longitudinal binary data analysis to the multinomial data setup with more than two categories. Thus, unlike the existing books on cross-sectional categorical data analysis using log linear models, this book uses multinomial probability models both in cross-sectional and longitudinal setups. A theoretical foundation is provided for the analysis of univariate multinomial responses, by developing models systematically for the cases with no covariates as well as categorical covariates, both in cross-sectional and longitudinal setups. In the longitudinal setup, both stationary and non-stationary covariates are considered. These models have also been extended to the bivariate multinomial setup along with suitable covariates. For the inferences, the book uses the generalized quasi-likelihood as w...

  11. Superiority in value and the repugnant conclusion

    DEFF Research Database (Denmark)

    Jensen, Karsten Klint

    2007-01-01

    superiority does not amount to a radical value difference at all. I then spell out the consequences of these results for different interpretations of Griffin's suggestion regarding population ethics. None of them comes out very successful, but perhaps they nevertheless retain some interest.......James Griffin has considered a weak form of superiority in value a possible remedy to the Repugnant Conclusion. In this paper, I demonstrate that, in a context where value is additive, this weaker form collapses into a stronger form of superiority. And in a context where value is non-additive, weak...

  12. Three-dimensional Speckle Tracking Echocardiography in Light Chain Cardiac Amyloidosis: Examination of Left and Right Ventricular Myocardial Mechanics Parameters.

    Science.gov (United States)

    Urbano-Moral, Jose Angel; Gangadharamurthy, Dakshin; Comenzo, Raymond L; Pandian, Natesa G; Patel, Ayan R

    2015-08-01

    The study of myocardial mechanics has a potential role in the detection of cardiac involvement in patients with amyloidosis. This study aimed to characterize 3-dimensional-speckle tracking echocardiography-derived left and right ventricular myocardial mechanics in light chain amyloidosis and examine their relationship with brain natriuretic peptide. In patients with light chain amyloidosis, left ventricular longitudinal and circumferential strain (n=40), and right ventricular longitudinal strain and radial displacement (n=26) were obtained by 3-dimensional-speckle tracking echocardiography. Brain natriuretic peptide levels were determined. All myocardial mechanics measurements showed differences when compared by brain natriuretic peptide level tertiles. Left and right ventricular longitudinal strain were highly correlated (r=0.95, P<.001). Left ventricular longitudinal and circumferential strain were reduced in patients with cardiac involvement (-9±4 vs -16±2; P<.001, and -24±6 vs -29±4; P=.01, respectively), with the most prominent impairment at the basal segments. Right ventricular longitudinal strain and radial displacement were diminished in patients with cardiac involvement (-9±3 vs -17±3; P<.001, and 2.7±0.8 vs 3.8±0.3; P=.002). On multivariate analysis, left ventricular longitudinal strain was associated with the presence of cardiac involvement (odds ratio = 1.6; 95% confidence interval, 1.04 to 2.37; P=.03) independent of the presence of brain natriuretic peptide and troponin I criteria for cardiac amyloidosis. Three-dimensional-speckle tracking echocardiography-derived left and right ventricular myocardial mechanics are increasingly altered as brain natriuretic peptide increases in light chain amyloidosis. There appears to be a strong association between left ventricular longitudinal strain and cardiac involvement, beyond biomarkers such as brain natriuretic peptide and troponin I. Copyright © 2015 Sociedad Española de Cardiología. Published by

  13. Aphasia following left thalamic hemorrhage

    International Nuclear Information System (INIS)

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

    1984-01-01

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

  14. 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.

  15. Enlarged right superior temporal gyrus in children and adolescents with autism.

    Science.gov (United States)

    Jou, Roger J; Minshew, Nancy J; Keshavan, Matcheri S; Vitale, Matthew P; Hardan, Antonio Y

    2010-11-11

    The superior temporal gyrus has been implicated in language processing and social perception. Therefore, anatomical abnormalities of this structure may underlie some of the deficits observed in autism, a severe neurodevelopmental disorder characterized by impairments in social interaction and communication. In this study, volumes of the left and right superior temporal gyri were measured using magnetic resonance imaging obtained from 18 boys with high-functioning autism (mean age=13.5±3.4years; full-scale IQ=103.6±13.4) and 19 healthy controls (mean age=13.7±3.0years; full-scale IQ=103.9±10.5), group-matched on age, gender, and handedness. When compared to the control group, right superior temporal gyral volumes was significantly increased in the autism group after controlling for age and total brain volume. There was no significant difference in the volume of the left superior temporal gyrus. Post-hoc analysis revealed a significant increase of the right posterior superior temporal gyral volume in the autism group, before and after controlling for age and total brain volume. Examination of the symmetry index for the superior temporal gyral volumes did not yield statistically significant between-group differences. Findings from this preliminary investigation suggest the existence of volumetric alterations in the right superior temporal gyrus in children and adolescents with autism, providing support for a neuroanatomical basis of the social perceptual deficits characterizing this severe neurodevelopmental disorder. Copyright © 2010 Elsevier B.V. All rights reserved.

  16. Superior mesenteric artery syndrome causing growth retardation

    Directory of Open Access Journals (Sweden)

    Halil İbrahim Taşcı

    2013-03-01

    Full Text Available Superior mesenteric artery syndrome is a rare and lifethreateningclinical condition caused by the compressionof the third portion of the duodenum between the aortaand the superior mesenteric artery’s proximal part. Thiscompression may lead to chronic intermittent, acute totalor partial obstruction. Sudden weight-loss and the relateddecrease in the fat tissue are considered to be the etiologicalreason of acute stenosis. Weight-loss accompaniedby nausea, vomiting, anorexia, epigastric pain, andbloating are the leading complaints. Barium radiographs,computerized tomography, conventional angiography,tomographic and magnetic resonance angiography areused in the diagnosis. There are medical and surgical approachesto treatment. We hereby present the case ofa patient with superior mesenteric artery syndrome withdelayed diagnosis.Key words: superior mesenteric artery syndrome, nausea-vomiting, anorexia

  17. Endovascular treatment of superior vena cava syndrome

    DEFF Research Database (Denmark)

    Duvnjak, Stevo; Andersen, Poul Erik

    2011-01-01

    Abstract AIM: The aim of this study was to report our experience with palliative stent treatment of superior vena cava syndrome. METHODS: Between January 2008 and December 2009, 30 patients (mean age 60.7 years) were treated with stents because of stenosed superior vena cava. All patients presented...... clinically with superior vena cava syndrome and according caval stenosis confirmed by computed tomography. The causes of stenoses were non-small cell carcinoma in 22 patients and small cell carcinoma in 8 patients. RESULTS: In all patients the stents were placed as intended in all patients....... All patients were followed clinically till death and the median follow-up period was 2.8 months (15-420 days). During follow-up three cases of stent thrombosis (one complete and two partial thrombosis) were observed. CONCLUSION: Palliative care with stent implantation for superior vena cava syndrome...

  18. Radiation induced myxoma of superior vena cava origin presenting as a right atrial mass.

    Science.gov (United States)

    Sabzi, F; Faraji, R

    2014-01-01

    Myxomas are the most common benign cardiac tumors. Myxomas are more common in the left heart chamber than the right side chamber. An extracardiac origin presenting as a right atrial mass is very rare. Right-sided tumors are considerably less common than left-sided tumors, and however myxoma of great vessels origin presenting as right atrial masses are rare but radiation induced villous myxoma in superior vena cava (SVC) is exceedingly rare tumor. A case of radiation induced myxoma originating in a previously undescribed location and presenting as a right atrial mass is reported.

  19. Eficacia educativa: avances de un modelo para la educación superior

    Directory of Open Access Journals (Sweden)

    Rafael Hernández-González

    2008-01-01

    Full Text Available Se analizó un modelo de eficacia educativa que permite al controlar el factor socioeconómico, determinar el valor agregado que las instituciones del Subsistema de Universidades Tecnológicas proporcionan a sus estudiantes. Es un estudio multinivel, longitudinal con resultados de 8,522 estudiantes de 38 universidades en 19 estados que sustentaron el examen nacional de ingreso a la educación superior (EXANI-II y el examen para el egreso de técnico superior universitario- Sistemas Informáticos (EGETSU-SI del Centro Nacional de Evaluación para la Educación Superior [CENEVAL] durante 2000-2006. El modelo identifica la eficacia de las instituciones y facilita la construcción de indicadores de calidad educativa.

  20. Superiorization: an optimization heuristic for medical physics.

    Science.gov (United States)

    Herman, Gabor T; Garduno, Edgar; Davidi, Ran; Censor, Yair

    2012-09-01

    To describe and mathematically validate the superiorization methodology, which is a recently developed heuristic approach to optimization, and to discuss its applicability to medical physics problem formulations that specify the desired solution (of physically given or otherwise obtained constraints) by an optimization criterion. The superiorization methodology is presented as a heuristic solver for a large class of constrained optimization problems. The constraints come from the desire to produce a solution that is constraints-compatible, in the sense of meeting requirements provided by physically or otherwise obtained constraints. The underlying idea is that many iterative algorithms for finding such a solution are perturbation resilient in the sense that, even if certain kinds of changes are made at the end of each iterative step, the algorithm still produces a constraints-compatible solution. This property is exploited by using permitted changes to steer the algorithm to a solution that is not only constraints-compatible, but is also desirable according to a specified optimization criterion. The approach is very general, it is applicable to many iterative procedures and optimization criteria used in medical physics. The main practical contribution is a procedure for automatically producing from any given iterative algorithm its superiorized version, which will supply solutions that are superior according to a given optimization criterion. It is shown that if the original iterative algorithm satisfies certain mathematical conditions, then the output of its superiorized version is guaranteed to be as constraints-compatible as the output of the original algorithm, but it is superior to the latter according to the optimization criterion. This intuitive description is made precise in the paper and the stated claims are rigorously proved. Superiorization is illustrated on simulated computerized tomography data of a head cross section and, in spite of its generality

  1. Phlegmonous gastritis secondary to superior mesenteric artery syndrome.

    Science.gov (United States)

    Nomura, Kosuke; Iizuka, Toshiro; Yamashita, Satoshi; Kuribayashi, Yasutaka; Toba, Takahito; Yamada, Akihiro; Furuhata, Tsukasa; Kikuchi, Daisuke; Matsui, Akira; Mitani, Toshifumi; Ogawa, Osamu; Hoteya, Shu; Inoshita, Naoko; Kaise, Mitsuru

    2015-01-01

    We herein report a case of phlegmonous gastritis secondary to superior mesenteric artery syndrome. An 80-year-old woman visited the hospital emergency department with the chief complaints of epigastric pain and vomiting. She was hospitalized urgently following the diagnosis of superior mesenteric artery syndrome based on abdominal computed tomography findings. Conservative therapy was not effective, and phlegmonous gastritis was diagnosed based on the findings of upper gastrointestinal endoscopy and biopsy performed on the 12th day of the disease. Undernutrition and reduced physical activity were observed on hospital admission, and proactive nutritional therapy with enteral nutrition was started. An upper gastrointestinal series, performed approximately 1 month later, confirmed the persistence of strictures and impaired gastric emptying. Because conservative therapy was unlikely to improve oral food intake, open total gastrectomy was performed on the 94th day of the disease. Examination of surgically resected specimens revealed marked inflammation and fibrosis, especially in the body of the stomach. Following a good postoperative recovery, the patient was able to commence oral intake and left our hospital on foot approximately 1 month after surgery.

  2. Phlegmonous gastritis secondary to superior mesenteric artery syndrome

    Directory of Open Access Journals (Sweden)

    Kosuke Nomura

    2015-12-01

    Full Text Available We herein report a case of phlegmonous gastritis secondary to superior mesenteric artery syndrome. An 80-year-old woman visited the hospital emergency department with the chief complaints of epigastric pain and vomiting. She was hospitalized urgently following the diagnosis of superior mesenteric artery syndrome based on abdominal computed tomography findings. Conservative therapy was not effective, and phlegmonous gastritis was diagnosed based on the findings of upper gastrointestinal endoscopy and biopsy performed on the 12th day of the disease. Undernutrition and reduced physical activity were observed on hospital admission, and proactive nutritional therapy with enteral nutrition was started. An upper gastrointestinal series, performed approximately 1 month later, confirmed the persistence of strictures and impaired gastric emptying. Because conservative therapy was unlikely to improve oral food intake, open total gastrectomy was performed on the 94th day of the disease. Examination of surgically resected specimens revealed marked inflammation and fibrosis, especially in the body of the stomach. Following a good postoperative recovery, the patient was able to commence oral intake and left our hospital on foot approximately 1 month after surgery.

  3. Evaluation of superior oblique weakening procedures.

    Science.gov (United States)

    Sharma, P; Khokhar, S; Thanikachalam

    1999-01-01

    To evaluate two superior oblique weakening procedures, silicon expander (SE), and translational recession (TR), and their effects on correction of "A" pattern, vertical deviation in adduction and dorsoadduction, superior oblique overaction, and torsion. In a prospective, institution-based study, 32 eyes of 16 patients having bilateral superior oblique overaction with significant "A" pattern (>10 prism diopters [delta]) were evaluated. The parameters studied were: change in "A" pattern; effect on vertical deviation in adduction and dorsoadduction; superior oblique overaction; and torsion. 95% reduction in "A" pattern with SE and 92% reduction with TR, indicating equal effect in collapse of "A" phenomenon (p=0.78). The extorsion produced by TR was more than that produced by SE (p=0.001). Both the SE and TR procedures offered controlled weakening of the superior oblique and caused a 95% and 92% reduction in the "A" pattern. The latter procedure caused a marked extorsional change, three times that which resulted from SE. Both the procedures leave residual superior oblique overaction.

  4. The way to "left" Piazza del Popolo: damage to white matter tracts in representational neglect for places.

    Science.gov (United States)

    Boccia, Maddalena; Di Vita, Antonella; Palermo, Liana; Committeri, Giorgia; Piccardi, Laura; Guariglia, Cecilia

    2018-02-13

    The ability of seeing with the mind's eye, the visual mental imagery, is peculiarly compromised in patients with representational neglect. Representational neglect affects the processing of the left side of a mental image and may selectively concern the ability to imagine places and/or objects. Right-brain damaged patients with representational neglect for places (RN+) lose the ability to imagine themselves within a familiar place and fail in transforming an egocentric representation of the environment into an allocentric one and vice-versa. A peak region located at the posterior junction between the parietal and temporal lobes has emerged as pivotal in determining representational neglect for places. Here we aimed at verifying whether white matter disconnections affecting parietal lobe, by preventing the integration of egocentric information with the allocentric one, play a role in representational neglect for places. A track-wise statistical analysis on 58 right brain damaged patients, with and without extrapersonal perceptual neglect and/or representational neglect for places, suggests that the disconnection of the superior longitudinal fasciculus and that of the posterior arcuate segment, together with the disconnection of a fronto-parietal u-shaped tract, may be crucial in determining the representational neglect for places. These results suggest that representational neglect for places emerges from a complex pattern of lesion location and disconnection that involves parietal, temporal and frontal lobes.

  5. Successful treatment of a spontaneous rupture of the left external iliac vein in a man.

    Science.gov (United States)

    Sadaghianloo, Nirvana; Jean-Baptiste, Elixine; Haudebourg, Pierre; Declemy, Serge; Mousnier, Aurdlien; Hassen-Khodja, Rida

    2014-02-01

    Spontaneous rupture of the external iliac vein associated with a May-Thurner syndrome is infrequent, particularly in men. We report a case of previously healthy 73-year-old man with a left iliac vein thrombosis, who presented a large lower left abdominal hematoma of sudden-unset. Emergent laparotomy revealed a 3-cm longitudinal tear in the left external iliac vein, which was repaired primarily. Patient's recovery was uneventful. Possible etiological factors have been identified as venous hypertension due to iliac vein thrombosis associated with Cockett syndrome, as well as inflammatory venous wall. Some other estrogenic factors could explain female preponderance of the event.

  6. Superior canal dehiscence syndrome associated with scuba diving.

    Science.gov (United States)

    Kitajima, Naoharu; Sugita-Kitajima, Akemi; Kitajima, Seiji

    2017-06-01

    A 28-year-old female diver presented with dizziness and difficulty clearing her left ear whilst scuba diving. Her pure-tone audiometry and tympanometry were normal. Testing of Eustachian tube function revealed tubal stenosis. Video-oculography revealed a predominantly torsional nystagmus while the patient was in the lordotic position. Fistula signs were positive. High-resolution computed tomography (HRCT) of the temporal bone revealed a diagnosis of bilateral superior semicircular canal dehiscence (SCDS). Cervical vestibular-evoked myogenic potential (cVEMP) testing showed that the amplitude of the cVEMP measured from her left ear was larger than that from the right. In electronystagmography (ENG), nose-pinched Valsalva manoeuvres caused eye movements to be mainly directed counterclockwise with a vertical component. Tullio phenomenon was also positive for both ears. SCDS patients tend to be misdiagnosed and misunderstood; common misdiagnoses in these cases are alternobaric vertigo (AV), inner ear barotrauma, and inner-ear decompression sickness. It is difficult to diagnose vertigo attacks after scuba diving as SCDS; however, when the patient develops sound- and/or pressure-induced vertical-torsional nystagmus, HRCT should be conducted to confirm a diagnosis of SCDS.

  7. 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.

  8. Collateral veins in left renal vein stenosis demonstrated via CT

    International Nuclear Information System (INIS)

    Lien, H.H.; Lund, G.; Talle, K.

    1983-01-01

    Twelve patients with left renal vein stenosis from tumor compression were studied with CT. All had distended collateral veins in the perirenal space which either formed a radiating or a cobweb pattern or appeared as marked longitudinal veins. Inferior phrenic vein branches were seen in seven patients and were considerably enlarged in two. Other major veins possibly taking part in collateral circulation could not be recognized due to obliteration of fat planes. The renal fascia was thickened in eleven patients, probably due to edema. A close study of the perirenal space with CT may give valuable information about collateral development. (orig.)

  9. Changes in Fetal Left and Right Ventricular Strain Mechanics during Normal Pregnancy.

    NARCIS (Netherlands)

    Kapusta, L.; Mainzer, G.; Weiner, Z.; Deutsch, L.; Khoury, A.; Haddad, S.; Lorber, A.

    2013-01-01

    BACKGROUND: The aim of this study was to detect normal changes in fetal two-dimensional speckle-tracking echocardiography-derived values for global and regional longitudinal left and right ventricular strain, strain rate, and time to peak (T2P) global strain during pregnancy. METHODS: Forty-four

  10. The effects of sports participation on the development of left ventricular mass in adolescent boys

    NARCIS (Netherlands)

    Valente-Dos-Santos, Joao; Coelho-E-Silva, Manuel J.; Castanheira, Joaquim; Machado-Rodrigues, Aristides M.; Cyrino, Edilson S.; Sherar, Lauren B.; Esliger, Dale W.; Elferink-Gemser, Marije T.; Malina, Robert M.

    2015-01-01

    ObjectivesTo examine the contribution of body size, biological maturation, and nonelite sports participation to longitudinal changes of left ventricular mass (LVM) in healthy boys. MethodsOne hundred and ten boys (11.0-14.5 years at baseline) were assessed biannually for 2 years. Stature, body mass,

  11. Lingual and fusiform gyri in visual processing: a clinico-pathologic study of superior altitudinal hemianopia.

    OpenAIRE

    Bogousslavsky, J; Miklossy, J; Deruaz, J P; Assal, G; Regli, F

    1987-01-01

    A macular-sparing superior altitudinal hemianopia with no visuo-psychic disturbance, except impaired visual learning, was associated with bilateral ischaemic necrosis of the lingual gyrus and only partial involvement of the fusiform gyrus on the left side. It is suggested that bilateral destruction of the lingual gyrus alone is not sufficient to affect complex visual processing. The fusiform gyrus probably has a critical role in colour integration, visuo-spatial processing, facial recognition...

  12. Effect of eye rotation on visual-field map onto superior colliculus and visual cortex.

    Science.gov (United States)

    Gordon, B; Moran, J; Presson, J

    1983-09-01

    We used multiunit recording to assess the effect of rotating one eye approximately 90 degrees at about the time of normal eye opening. Rotation of the eye did not alter the topography of the retinal maps onto visual cortex or superior colliculus. The intorted eye drove cells at most recording points in the contralateral visual cortex and superior colliculus. In its ipsilateral colliculus the intorted eye drove cells at about 10% of the recording points; that is, the temporal retina of this eye was quite ineffective in driving collicular cells. In its ipsilateral cortex the intorted eye drove cells at about 30% of the recording sites. The unoperated eye drove cells at all locations in both colliculus and cortex on both sides of the brain. The effects of extorsion were studied only in the superior colliculus. Extorsion and intorsion produced similar results except that extorsion produced a less severe deficit in the ability of the temporal retina to drive cells in its ipsilateral colliculus. Cutting all the extraocular muscles without eye rotation was studied only in the colliculus and produced results similar to those produced by intorsion and extorsion. However, the temporal retina of the operated eye was more effective after muscle cut alone than after intorsion or extorsion. Forcing the animal to use the rotated right eye alone on alternate days during the first 3 mo of life did not decrease the deficits. Almost all recording sites in the right colliculus were driven only by the unoperated left eye. If the left eye was sutured when the right eye was rotated, only the right eye drove cells in the left colliculus, but the two eyes were about equally effective in the right colliculus; however, rather few sites in the right colliculus were binocularly driven. We conclude that both extraocular muscle section and eye rotation reduce the effectiveness of the uncrossed input from the operated eye to the superior colliculus and visual cortex. The effects on the superior

  13. Longitudinal Magnification Drawing Mistake

    Science.gov (United States)

    Rabal, Héctor; Cap, Nelly; Trivi, Marcelo

    2004-01-01

    Lateral magnification in image formation by positive lenses, mirrors, and dioptrics is usually appropriately developed in most optics textbooks.1-9 However, the image of a three-dimensional object occupies a three-dimensional region of space. The optical system affects both the transverse and the longitudinal dimensions of the object and, in general, does it in different ways. The magnification in the direction of the optical axis (the longitudinal magnification) is seldom treated. In several texts, the concept of longitudinal magnification is not even considered. Symmetrical objects (such as arrows) are used and their images appear laterally inverted. It is not shown how a longitudinally nonsymmetric object is imaged. One of the few books where this subject is well treated is in the textbook by Hecht.10 We have repeatedly verified in our classes that there is some confusion related to this subject. Students tend to believe that the image is longitudinally symmetric with respect to the lens optic center. Some prestigious texts commit the same mistake. In addition, a very nice optics book,11 a catalogue of optical hardware,12 a worldwide scientific magazine,13 a paper in an optics journal,14 and a Spanish encyclopedia,15 for example, have also been found to contain this error in drawing the image of a three-dimensional object formed by a positive lens. In this paper we suggest that the teaching of longitudinal magnification should be done with some care and we include a figure showing a properly drawn image.

  14. Superior Semicircular Canal Ampullae Dehiscence As Part of the Spectrum of the Third Window Abnormalities: A Case Study

    Directory of Open Access Journals (Sweden)

    Eugen Constant Ionescu

    2017-12-01

    Full Text Available A 60-year-old man was referred to the ENT department for intense episodic vertigo triggered by loud sounds. Pure tone audiometry and otoneurological assessment, including videonystagmography using auditory stimulation and cervical vestibular evoked myogenic potential measures, conducted to the hypothesis of a third window syndrome in the left ear. Results from the high-resolution computed tomography of the petrous bone confirmed the hypothesis and revealed the presence of a submillimeter semicircular canal dehiscence, located between the left lateral and superior semicircular canal ampullae on the left side.

  15. Mental Number Line Disruption in a Right-Neglect Patient after a Left-Hemisphere Stroke

    Science.gov (United States)

    Pia, Lorenzo; Corazzini, Luca Latini; Folegatti, Alessia; Gindri, Patrizia; Cauda, Franco

    2009-01-01

    A right-neglect patient with focal left-hemisphere damage to the posterior superior parietal lobe was assessed for numerical knowledge and tested on the bisection of numerical intervals and visual lines. The semantic and verbal knowledge of numbers was preserved, whereas the performance in numerical tasks that strongly emphasize the visuo-spatial…

  16. Left Activism, Succour and Selfhood

    DEFF Research Database (Denmark)

    Hughes, Celia Penelope

    2014-01-01

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

  17. Anatomical variations in the origins of the celiac axis and the superior mesenteric artery: MDCT angiographic findings and their probable embryological mechanisms

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yi; Cheng, Cheng; Wang, Lu; Li, Ran; Chen, Jin-hua; Gong, Shui-gen [Institute of Surgery Research, Daping Hospital, Third Military Medical University, Department of Radiology, Chongqing (China)

    2014-08-15

    To identify the spectrum and prevalence of anatomical variations in the origin of the celiac axis (CA), the superior mesenteric artery (SMA) and their major branches by using multidetector computed tomographic (MDCT) angiography. A retrospective evaluation was carried out on 1,500 abdominal MDCT angiography images. The aortic origins of the CA, the SMA and their major branch patterns were investigated. Normal aortic origins of CA and SMA were noted in 1,347 (89.8 %) patients. Seven types of CA and SMA origin variants were identified in 153 (10.2 %) patients. The three most common variations were hepatomesenteric trunk (67 patients, 4.47 %), celiomesenteric trunk (CMT) (51 patients, 3.4 %) and splenomesenteric trunk (18 patients, 1.2 %). An evaluation of CMT was classified as long (34 patients, 66.7 %) or short (17 patients, 33.3 %) subtypes, compared with the length of the common trunk. Further CMT classification was based on the origin of the left gastric artery: subtype I, 26 patients (53.1 %); subtype II, 5 patients (10.2 %); subtype III, 15 patients (30.6 %); subtype IV, 3 patients (6.1 %). Dislocation interruption, incomplete interruption and persistence of the longitudinal anastomosis could be the embryological mechanisms of the variant origins of the CA, the SMA and their major branches. (orig.)

  18. Anatomical variations in the origins of the celiac axis and the superior mesenteric artery: MDCT angiographic findings and their probable embryological mechanisms

    International Nuclear Information System (INIS)

    Wang, Yi; Cheng, Cheng; Wang, Lu; Li, Ran; Chen, Jin-hua; Gong, Shui-gen

    2014-01-01

    To identify the spectrum and prevalence of anatomical variations in the origin of the celiac axis (CA), the superior mesenteric artery (SMA) and their major branches by using multidetector computed tomographic (MDCT) angiography. A retrospective evaluation was carried out on 1,500 abdominal MDCT angiography images. The aortic origins of the CA, the SMA and their major branch patterns were investigated. Normal aortic origins of CA and SMA were noted in 1,347 (89.8 %) patients. Seven types of CA and SMA origin variants were identified in 153 (10.2 %) patients. The three most common variations were hepatomesenteric trunk (67 patients, 4.47 %), celiomesenteric trunk (CMT) (51 patients, 3.4 %) and splenomesenteric trunk (18 patients, 1.2 %). An evaluation of CMT was classified as long (34 patients, 66.7 %) or short (17 patients, 33.3 %) subtypes, compared with the length of the common trunk. Further CMT classification was based on the origin of the left gastric artery: subtype I, 26 patients (53.1 %); subtype II, 5 patients (10.2 %); subtype III, 15 patients (30.6 %); subtype IV, 3 patients (6.1 %). Dislocation interruption, incomplete interruption and persistence of the longitudinal anastomosis could be the embryological mechanisms of the variant origins of the CA, the SMA and their major branches. (orig.)

  19. Regional Longitudinal Deformation Improves Prediction of Ventricular Tachyarrhythmias in Patients With Heart Failure With Reduced Ejection Fraction

    DEFF Research Database (Denmark)

    Biering-Sørensen, Tor; Knappe, Dorit; Pouleur, Anne-Catherine

    2017-01-01

    BACKGROUND: Left ventricular dysfunction is a known predictor of ventricular arrhythmias. We hypothesized that measures of regional longitudinal deformation by speckle-tracking echocardiography predict ventricular tachyarrhythmias and provide incremental prognostic information over clinical and c...

  20. Left ventricular diastolic performance of left ventricular hypertrophy

    Energy Technology Data Exchange (ETDEWEB)

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

    1987-02-01

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

  1. Assessment of Left Ventricular Mechanics in Patients with Ischemic Heart Disease

    Directory of Open Access Journals (Sweden)

    Gladkikh Natalia

    2016-01-01

    Full Text Available The paper presents new ultrasound technology for assessment of left ventricular (LV strain in the longitudinal, radial, and circumferential directions and the LV area strain at rest and during dobutamine stressechocardiography in patients with intermediate pretest probability of ischemic heart disease (IHD. Analysis was performed for the first time using real-time three-dimensional echocardiography (4D Strain. It was shown that in patients with single-artery left anterior descending artery (LAD and left circumflex coronary artery (LCX stenosis of 50% and more, the decreases in the global LV strain in the longitudinal, radial, and circumferential directions as well as in the LV strain area were observed at peak dobutamine stress in 4D Strain mode. Assessment of global LV strain in 4D Strain mode during dobutamine test had low sensitivity, specificity, and diagnostic accuracy in diagnosing single-vessel coronary artery disease.

  2. Lake Superior Aquatic Invasive Species Complete Prevention Plan

    Science.gov (United States)

    The Lake Superior Aquatic Invasive Species Complete Prevention Plan is an expression of the best professional judgment of the members of the Lake Superior Task Force as to what is necessary to protect Lake Superior from new aquatic invasive species.

  3. Vena cava superior syndrome associated with sarcoidosis

    International Nuclear Information System (INIS)

    Wurm, K.; Walz, M.; Reidemeister, J.C.; Donhuijsen, K.

    1988-01-01

    We report the first observation of clinical manifestations of vena cava superior syndrome (VCSS) associated with sarcoidosis. Twenty-four years after the first signs of the disease had been noted, mediastinal lymphomas penetrating the wall of the vena cava superior caused complete obstruction. It is most unusual for the vessel wall to be destroyed in this way, which explains why VCSS is often missed in sarcoidosis. The obstructed vessel was resected and successfully replaced by a Gore-Tex prosthesis. The importance of VCSS for the differential diagnosis is pointed out. Two further peculiarities are the simultaneous occurrence of elevated intraocular pressure and VCSS, and the familial incidence. (orig.) [de

  4. Superior mesenteric vein thrombosis complicating appendicular masses

    International Nuclear Information System (INIS)

    Echitibi, Salma S.; Bashir, Masoud O.; Ahmad, Misba U.

    2003-01-01

    Mesenteric vein thrombosis (MVT) is rare. Its diagnosis is usually difficult and delayed. We report two patients who developed MVT as a complication of an appendicular mass. One of them had appendectomy and developed fever 10 days postoperatively. The other was treated conservatively. An abdominal computerized tomography(CT) scan with intravenous contrast was helpful in diagnosing superior MVT in both patients, which were not suspected. Intravenous contrast should be used when performing CT of an appendicular mass. Special interest should be directed at studying the superior mesenteric vein. Early diagnosis of our patients helped to start early medical treatment with anticoagulation. (author)

  5. Superior oblique luxation and trochlear luxation as new concepts in superior oblique muscle weakening surgery

    NARCIS (Netherlands)

    Mombaerts, I.; Koornneef, L.; Everhard-Halm, Y. S.; Hughes, D. S.; Maillette de Buy Wenniger-Prick, L. J.

    1995-01-01

    We used superior oblique luxation and trochlear luxation as new surgical procedures to treat acquired Brown's syndrome and superior oblique muscle overaction. We studied nine patients (11 eyes) who underwent trochlear surgery between 1988 and 1993. Four patients had acquired Brown's syndrome and

  6. Compensating for Missing Data from Longitudinal Studies Using WinBUGS

    Directory of Open Access Journals (Sweden)

    Gretchen Carrigan

    2007-06-01

    Full Text Available Missing data is a common problem in survey based research. There are many packages that compensate for missing data but few can easily compensate for missing longitudinal data. WinBUGS compensates for missing data using multiple imputation, and is able to incorporate longitudinal structure using random effects. We demonstrate the superiority of longitudinal imputation over cross-sectional imputation using WinBUGS. We use example data from the Australian Longitudinal Study on Women’s Health. We give a SAS macro that uses WinBUGS to analyze longitudinal models with missing covariate date, and demonstrate its use in a longitudinal study of terminal cancer patients and their carers.

  7. Producing The New Regressive Left

    DEFF Research Database (Denmark)

    Crone, Christine

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

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

    Directory of Open Access Journals (Sweden)

    Król Wojciech

    2016-12-01

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

  9. Millian superiorities and the repugnant conclusion

    DEFF Research Database (Denmark)

    Jensen, Karsten Klint

    2008-01-01

    . And in a context where value is non-additive, weak superiority does not amount to a radical value difference at all. These results are applied on one of Larry Temkin's cases against transitivity. I demonstrate that Temkin appeals to two conflicting notions of aggregation. I then spell out the consequences...

  10. the pedicled superior gluteal artery perforator flap

    African Journals Online (AJOL)

    lieved pressure on tissue over the sacral area, with shear, friction, moisture and malnutrition as contributing ... To report the use of the pedicled superior gluteal artery perforator (SGAP) fasciocutaneous flap as a ... et al. reported the sliding gluteus maximus flap, whereby structural and functional integrity of the muscle was ...

  11. Perturbation resilience and superiorization of iterative algorithms

    International Nuclear Information System (INIS)

    Censor, Y; Davidi, R; Herman, G T

    2010-01-01

    Iterative algorithms aimed at solving some problems are discussed. For certain problems, such as finding a common point in the intersection of a finite number of convex sets, there often exist iterative algorithms that impose very little demand on computer resources. For other problems, such as finding that point in the intersection at which the value of a given function is optimal, algorithms tend to need more computer memory and longer execution time. A methodology is presented whose aim is to produce automatically for an iterative algorithm of the first kind a 'superiorized version' of it that retains its computational efficiency but nevertheless goes a long way toward solving an optimization problem. This is possible to do if the original algorithm is 'perturbation resilient', which is shown to be the case for various projection algorithms for solving the consistent convex feasibility problem. The superiorized versions of such algorithms use perturbations that steer the process in the direction of a superior feasible point, which is not necessarily optimal, with respect to the given function. After presenting these intuitive ideas in a precise mathematical form, they are illustrated in image reconstruction from projections for two different projection algorithms superiorized for the function whose value is the total variation of the image

  12. Mammographic varicosities indicative of a superior mediastinal ...

    African Journals Online (AJOL)

    In addition, an abnormal calibre of the superficial veins can reflect not only underrying breast pathology, but a collateral venous return resulting from an upper mediastinal obstruction. A case mammographically demonstrating mammary varicosities resulting from a superior mediastinal syndrome is described. S. Afr. Med.

  13. Tratamento cirúrgico da síndrome da veia cava superior causado por timoma invasivo Surgical treatment of superior vena cava syndrome caused by invasive thymoma

    Directory of Open Access Journals (Sweden)

    George Ronald Soncini da Rosa

    2010-06-01

    Full Text Available Paciente do sexo masculino, branco, 57 anos, portador de síndrome da veia cava superior havia 3 meses, devido a timoma invasivo em mediastino médio e anterior, levando a comprometimento da veia cava superior intrínseca e extrinsecamente. Após avaliação por tomografia computadorizada e angiorressonância magnética de tórax, o paciente foi submetido à ressecção radical do timoma - derivação venosa da veia subclávia esquerda para átrio direito, com tubo de PTFE (politetrafluoroetileno. Relevante caso de timoma invasivo ocasionando a oclusão da veia cava superior. A evolução clínica, após 7 meses, foi considerada satisfatória.We report on a case of a 57 years-old white male, patient, who presented superior vena cava syndrome (SVC for 3 months, derived from an invasive thymoma in the medium and anterior mediastinum, compromising intrinsic and extrinsic to the SVC. After evaluation by computed tomography and magnetic angioresonance of the thorax, the patient underwent radical resection of the thymoma - bypass from left subclavian vein to right atrium, using polytetrafluoroethylene tube. Relevant case of invasive thymoma causing the occlusion of SVC. The clinic evolution of the patient after 7 months was considered satisfactory.

  14. Longitudinal changes in resting-state fMRI from age 5 to age 6years covary with language development.

    Science.gov (United States)

    Xiao, Yaqiong; Friederici, Angela D; Margulies, Daniel S; Brauer, Jens

    2016-03-01

    Resting-state functional magnetic resonance imaging is a powerful technique to study the whole-brain neural connectivity that underlies cognitive systems. The present study aimed to define the changes in neural connectivity in their relation to language development. Longitudinal resting-state functional data were acquired from a cohort of preschool children at age 5 and one year later, and changes in functional connectivity were correlated with language performance in sentence comprehension. For this, degree centrality, a voxel-based network measure, was used to assess age-related differences in connectivity at the whole-brain level. Increases in connectivity with age were found selectively in a cluster within the left posterior superior temporal gyrus and sulcus (STG/STS). In order to further specify the connection changes, a secondary seed-based functional connectivity analysis on this very cluster was performed. The correlations between resting-state functional connectivity (RSFC) and language performance revealed developmental effects with age and, importantly, also dependent on the advancement in sentence comprehension ability over time. In children with greater advancement in language abilities, the behavioral improvement was positively correlated with RSFC increase between left posterior STG/STS and other regions of the language network, i.e., left and right inferior frontal cortex. The age-related changes observed in this study provide evidence for alterations in the language network as language develops and demonstrates the viability of this approach for the investigation of normal and aberrant language development. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  15. LIA longitudinal coupling impedance

    International Nuclear Information System (INIS)

    Faltens, A.

    1980-01-01

    The beam generated fields enter into the problems of waveform generation and longitudinal stability. In the former, provision must be made for the longitudinally defocusing forces due to the space charge and the beam loading effects on the accelerating voltage due to the current of a presumably known bunch. In the latter, the concern is for the growth of unintentional perturbations to unacceptably large values through the interaction of the charge and current fluctuations with the rest of the beam and the surrounding structures. These beam generated electric fields may be related to the beam current through a coupling impedance

  16. 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...

  17. Reading without the left ventral occipito-temporal cortex

    Science.gov (United States)

    Seghier, Mohamed L.; Neufeld, Nicholas H.; Zeidman, Peter; Leff, Alex P.; Mechelli, Andrea; Nagendran, Arjuna; Riddoch, Jane M.; Humphreys, Glyn W.; Price, Cathy J.

    2012-01-01

    The left ventral occipito-temporal cortex (LvOT) is thought to be essential for the rapid parallel letter processing that is required for skilled reading. Here we investigate whether rapid written word identification in skilled readers can be supported by neural pathways that do not involve LvOT. Hypotheses were derived from a stroke patient who acquired dyslexia following extensive LvOT damage. The patient followed a reading trajectory typical of that associated with pure alexia, re-gaining the ability to read aloud many words with declining performance as the length of words increased. Using functional MRI and dynamic causal modelling (DCM), we found that, when short (three to five letter) familiar words were read successfully, visual inputs to the patient’s occipital cortex were connected to left motor and premotor regions via activity in a central part of the left superior temporal sulcus (STS). The patient analysis therefore implied a left hemisphere “reading-without-LvOT” pathway that involved STS. We then investigated whether the same reading-without-LvOT pathway could be identified in 29 skilled readers and whether there was inter-subject variability in the degree to which skilled reading engaged LvOT. We found that functional connectivity in the reading-without-LvOT pathway was strongest in individuals who had the weakest functional connectivity in the LvOT pathway. This observation validates the findings of our patient’s case study. Our findings highlight the contribution of a left hemisphere reading pathway that is activated during the rapid identification of short familiar written words, particularly when LvOT is not involved. Preservation and use of this pathway may explain how patients are still able to read short words accurately when LvOT has been damaged. PMID:23017598

  18. The superior vena cava syndrome caused by malignant disease

    International Nuclear Information System (INIS)

    Eren, Suat; Karaman, Adem; Okur, Adnan

    2006-01-01

    Objective: The superior vena cava (SVC) obstruction by malignant diseases is either by direct invasion and compression or by tumour thrombus of the SVC. Whatever is its cause, obstruction of the SVC causes elevated pressure in the veins draining into the SVC and increased or reversed blood flow through collateral vessels. Severity of the syndrome depends on the collateral vascular system development. Therefore, imaging of the collateral veins with variable location and connection is important in determining the extension and management of the disease. Our aims are to describe collateral vessels of the superior vena cava syndrome (SVCS) related with the malignant diseases and to assess the ability of multi-detector row CT with multiplanar and 3D volume rendering techniques in determining and describing collateral circulations. Materials and methods: We present CT angiography findings of seven patients with small cell carcinoma of the lung (n = 2), squamous cell carcinoma of the lung (n = 3), Hodgkin disease of the thorax (n = 1), and squamous cell carcinoma of the oesophagus (n = 1). The patients received contrast-enhanced CT scans of the chest and abdomen on a multi-detector row CT during breath holding at suspended inspiration. Results: CT images revealed the cause and level of the SVC obstruction in all patients with axial and multiplanar reconstructed images. The SVC showed total obstruction in five patients and partial obstruction in two patients. The most common experienced collateral vessels were azygos vein (6), intercostal veins (6), mediastinal veins (6), paravertebral veins (5), hemiazygos vein (5), thoracoepigastric vein (5), internal mammary vein (5), thoracoacromioclavicular venous plexus (5), and anterior chest wall veins (5). While one case showed the portal-systemic shunt, V. cordis media and sinus coronarius with phrenic veins were enlarged in two cases, and the left adrenal vein was enlarged in a patient. In one case, the azygos vein with reversed

  19. Simultaneous thrombosis of superior mesenteric artery and superior mesenteric vein following chemotherapy: MDCT findings.

    Science.gov (United States)

    Olgun, Deniz Cebi; Bakan, Selim; Samanci, Cesur; Tutar, Onur; Demiryas, Suleyman; Korkmazer, Bora; Kantarci, Fatih

    2014-02-01

    A case of acute mesenteric ischemia due to thrombosis of superior mesenteric artery and vein in a 44-year-old woman following chemotherapy for invasive laryngeal carcinoma was diagnosed on a multi-detector CT scan. Although the link between malignancy and thromboembolism is widely recognized in patients with cancer, chemotherapy further elevates the risk of thrombosis. Acute mesenteric ischemia associated or not associated with chemotherapy rarely occurs in patients with cancer. Moreover, co-occurrence of superior mesenteric artery and superior mesenteric vein thrombosis is reported for the first time.

  20. Rebuilding the US Health Left

    Directory of Open Access Journals (Sweden)

    Victor W. Sidel, MD

    2010-02-01

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

  1. Pitx2 confers left morphological, molecular, and functional identity to the sinus venosus myocardium.

    Science.gov (United States)

    Ammirabile, Grazia; Tessari, Alessandra; Pignataro, Viviana; Szumska, Dorota; Sutera Sardo, Fabio; Benes, Jiri; Balistreri, Mariangela; Bhattacharya, Shoumo; Sedmera, David; Campione, Marina

    2012-02-01

    The sinus venous myocardium, comprising the sinoatrial node (SAN) and sinus horns (SH), is a region subject to congenital malformations and cardiac arrhythmias. It differentiates from symmetric bilateral mesenchymal precursors, but morphological, molecular, and functional left/right differences are progressively established through development. The role of the laterality gene Pitx2 in this process is unknown. We aimed to elucidate the molecular events driving left/right patterning in the sinus venosus (SV) myocardium by using a myocardial Pitx2 knockout mouse. We generated a myocardial specific Pitx2 knockout model (cTP mice). cTP embryos present several features of Pitx2 null, including right atrial isomerism with bilateral SANs and symmetric atrial entrance of the systemic veins. By in situ hybridization and optical mapping analysis, we compared throughout development the molecular and functional properties of the SV myocardium in wt and mutant embryos. We observed that Pitx2 prevents the expansion of the left-SAN primordium at the onset of its differentiation into myocardium; Pitx2 promotes expansion of the left SH through development; Pitx2 dose-dependently represses the autorhythmic properties of the left SV myocardium at mid-gestation (E14.5); Pitx2 modulates late foetal gene expression at the left SH-derived superior caval vein. Pitx2 drives left/right patterning of the SV myocardium through multiple developmental steps. Overall, Pitx2 plays a crucial functional role by negatively modulating a nodal-type programme in the left SV myocardium.

  2. Longitudinal joint specifications and performance.

    Science.gov (United States)

    2012-08-01

    Deterioration of longitudinal joints is widely recognized as one of the major factors contributing to failure of asphalt pavements. Finding : ways to improve the durability of longitudinal joints will lead to improved service lives and lower life cyc...

  3. Superior-subordinate relations as organizational processes

    DEFF Research Database (Denmark)

    Asmuss, Birte; Aggerholm, Helle Kryger; Oshima, Sae

    Since the emergence of the practice turn in social sciences (Golsorkhi et al. 2010), studies have shown a number of institutionally relevant aspects as achievements across time and by means of various resources (human and non-human) (Taylor & van Every 2000, Cooren et al. 2006). Such a process view...... superior-subordinate relations in a specific institutionalized setting: performance appraisal interviews (PAIs). While one main task of PAIs is to manage and integrate organizational and employee performance (Fletcher, 2001:473), PAIs are also organizational practices where superior-subordinate relations...... the participants’ different orientations to “standardized” and “non-standardized” assessments (Maynard, 2003). In our data, “non-standardized” assessments are frequently oriented to as doing the work of "real" evaluations, whereas “standardized” assessments are oriented to as topic closure implicative. Accordingly...

  4. Aneurysm of the superior mesenteric artery

    International Nuclear Information System (INIS)

    Gebauer, A.

    1984-01-01

    This is a report about 4 patients with aneurysms of the superior mesenteric artery of arteriosclerotic, mycotic and probably congenital etiology together with a review of the literature as to the etiology, diagnostic possibilities and therapy. Arteriography is the method of choice even though a diagnosis may be possible by sonography or CT in special cases. Even though an aneurysm of the superior mesenteric artery is rare, it has to be considered in the differential diagnosis of persisting abdominal problems of unknown origin. This is especially true for patients with a predisposing history such as previous or existing endocarditis, sepsis, arteriosclerosis and hypertension. Because of the possibility of rupture followed by life threating bleeding an adequate diagnostic step such as arteriography has to be considered finally. (orig.) [de

  5. Reperfusion hemorrhage following superior mesenteric artery stenting.

    LENUS (Irish Health Repository)

    Moore, Michael

    2012-02-03

    Percutaneous transluminal angioplasty and stent placement is now an established treatment option for chronic mesenteric ischemia and is associated with low mortality and morbidity rates. We present a case of reperfusion hemorrhage complicating endovascular repair of superior mesenteric artery stenosis. Although a recognized complication following repair of carotid stenosis, hemorrhage has not previously been reported following mesenteric endovascular reperfusion. We describe both spontaneous cessation of bleeding and treatment with coil embolization.

  6. Superior mesenteric vein thrombosis: a case report

    International Nuclear Information System (INIS)

    Costa Praxedes, Marcia da; Malheiros, Noemia Reis; Machado, Dianne Melo; Carvalho, Ana Alice Vidal de; Marchiori, Edson; Universidade Federal, Rio de Janeiro, RJ; Santos, Alair Augusto S.M.

    1995-01-01

    A case of superior mesenteric mesenteric vein thrombosis diagnosed by computed tomography in 29 year-old man with abdominal pain, without any predisposing pathologic disorders is reported. This patient had a chronic evolution, had not resulting in mesenteric infarction. He was treated conservatively with anticoagulant therapy and recanalization of the involved vessels was demonstrated by another computed tomography. The patient is asymptomatic now. (author). 8 refs., 3 figs

  7. [Neuromolecular mechanism of the superiority illusion].

    Science.gov (United States)

    Yamada, Makiko

    2014-01-01

    The majority of individuals evaluate themselves as above average. This is a cognitive bias called "the superiority illusion". This illusory self-evaluation helps us to have hopes for the future, and has been central to the process of human evolution. Possessing this illusion is also important for mental health, as depressed people appear to have a more realistic perception of themselves, dubbed "depressive realism". Our recent study revealed the spontaneous brain activity and central dopaminergic neurotransmission that generate this illusion, using resting-state fMRI and PET. A functional connectivity between the frontal cortex and striatum, regulated by inhibitory dopaminergic neurotransmission, determines individual levels of the superiority illusion. We further revealed that blocking the dopamine transporter, which enhanced the level of dopamine, increased the degree of the superiority illusion. These findings suggest that dopamine acts on striatal dopamine receptors to suppress fronto-striatal functional connectivity, leading to disinhibited, heuristic, approaches to positive self-evaluation. These findings help us to understand how this key aspect of the human mind is biologically determined, and will suggest treatments for depressive symptoms by targeting specific molecules and neural circuits.

  8. [Surface ECG characteristics of right and left atrial flutter].

    Science.gov (United States)

    Rostock, Thomas; Konrad, Torsten; Sonnenschein, Sebastian; Mollnau, Hanke; Ocete, Blanca Quesada; Bock, Karsten; Spittler, Raphael; Huber, Carola; Theis, Cathrin

    2015-09-01

    Atrial tachycardia in virtually all areas of both atria has become more important in the clinical management of patients with previous complex atrial fibrillation ablation. Accurate interpretation of surface electrocardiogram (ECG) characteristics is of paramount importance to localize the origin of atrial tachycardia, particularly for planning interventional treatment. This article highlights the ECG features of different types of right and left atrial tachycardia. Typical right atrial flutter through the cavotricuspid isthmus conducts septally in a cranial direction and demonstrates sawtooth-like flutter waves which start negative in II, III and aVF and then show a steep slope upwards to the isoelectric line. The flutter rate typically ranges between 240-250 beats/min. In contrast, right atrial flutter in a clockwise rotation, flutter around the vena cava inferior or superior and around a scar (e.g. after cardiac surgery) show positive or biphasic flutter waves (lower or upper loop reentry). Left atrial flutter waves (e.g. around the mitral valve or around the pulmonary veins) are very heterogeneous and are typically positive in V1 as the left atrium is located in the posterior mediastinum. Specific knowledge of flutter wave morphology in surface ECG facilitates planning and performance of the ablation strategy.

  9. Superior temporal gyrus thickness correlates with cognitive performance in multiple sclerosis.

    Science.gov (United States)

    Achiron, Asaf; Chapman, Joab; Tal, Sigal; Bercovich, Eran; Gil, Hararai; Achiron, Anat

    2013-07-01

    Decreased cortical thickness that signifies gray matter pathology and its impact on cognitive performance is a research field with growing interest in relapsing-remitting multiple sclerosis (RRMS) and needs to be further elucidated. Using high-field 3.0 T MRI, three-dimensional T1-FSPGR (voxel size 1 × 1 × 1 mm) cortical thickness was measured in 82 regions in the left hemisphere (LH) and right hemisphere (RH) in 20 RRMS patients with low disease activity and in 20 age-matched healthy subjects that in parallel underwent comprehensive cognitive evaluation. The correlation between local cortical atrophy and cognitive performance was examined. We identified seven regions with cortical tissue loss that differed between RRMS and age-matched healthy controls. These regions were mainly located in the frontal and temporal lobes, specifically within the gyrus rectus, inferior frontal sulcus, orbital gyrus, parahippocampal gyrus, and superior temporal gyrus, with preferential left asymmetry. Increased cortical thickness was identified in two visual sensory regions, the LH inferior occipital gyrus, and the RH cuneus, implicating adaptive plasticity. Correlation analysis demonstrated that only the LH superior temporal gyrus thickness was associated with cognitive performance and its thickness correlated with motor skills (r = 0.65, p = 0.003), attention (r = 0.45, p = 0.042), and information processing speed (r = 0.50, p = 0.025). Our findings show that restricted cortical thinning occurs in RRMS patients with mild disease and that LH superior temporal gyrus atrophy is associated with cognitive dysfunction.

  10. Left-handed Children in Singapore.

    Science.gov (United States)

    Gan, Linda

    1998-01-01

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

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

    Science.gov (United States)

    Costas, Elaine Fowler

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

  12. Mondini-like malformation mimicking otosclerosis and superior semicircular canal dehiscence.

    Science.gov (United States)

    Karlberg, M; Annertz, M; Magnusson, M

    2006-05-01

    In 2003, it was reported that superior semicircular canal dehiscence can mimic otosclerosis because of low-frequency bone conduction hearing gain and dissipation of air-conducted acoustic energy through the dehiscence. We report the case of a 17-year-old girl with left-sided combined hearing loss thought to be due to otosclerosis. Bone conduction thresholds were -10 dB at 250 and 500 Hz and she had a 40 dB air-bone gap at 250 Hz. When a tuning fork was placed at her ankle she heard it in her left ear. Acoustic reflexes and vestibular evoked myogenic potentials could be elicited bilaterally. Imaging of the temporal bones showed no otosclerosis, superior semicircular canal dehiscence or large vestibular aqueduct, but a left-sided, Mondini-like dysplasia of the cochlea with a modiolar deficiency could be seen. Mondini-like cochlear dysplasia should be added to the causes of inner-ear conductive hearing loss.

  13. Muon cooling: longitudinal compression.

    Science.gov (United States)

    Bao, Yu; Antognini, Aldo; Bertl, Wilhelm; Hildebrandt, Malte; Khaw, Kim Siang; Kirch, Klaus; Papa, Angela; Petitjean, Claude; Piegsa, Florian M; Ritt, Stefan; Sedlak, Kamil; Stoykov, Alexey; Taqqu, David

    2014-06-06

    A 10  MeV/c positive muon beam was stopped in helium gas of a few mbar in a magnetic field of 5 T. The muon "swarm" has been efficiently compressed from a length of 16 cm down to a few mm along the magnetic field axis (longitudinal compression) using electrostatic fields. The simulation reproduces the low energy interactions of slow muons in helium gas. Phase space compression occurs on the order of microseconds, compatible with the muon lifetime of 2  μs. This paves the way for the preparation of a high-quality low-energy muon beam, with an increase in phase space density relative to a standard surface muon beam of 10^{7}. The achievable phase space compression by using only the longitudinal stage presented here is of the order of 10^{4}.

  14. Effect of training on left ventricular structure and functioning of the normotensive and the hypertensive subject.

    Science.gov (United States)

    Fagard

    1997-10-01

    OBJECTIVE: To review the literature on the effects of training on left ventricular structure and functioning of the normotensive and the hypertensive subject. METHOD AND RESULTS: Meta-analytical techniques were applied to selected echocardiographic reports on the effects of exercise training on the heart of normotensive subjects. The combined analysis of studies revealed that the hearts of competitive athletes may differ from those of nonathletes. Long-distance runners develop predominantly eccentric left ventricular hypertrophy, strength athletes predominantly concentric hypertrophy and cyclists a mixed type of hypertrophy. Relative to their respective controls, left ventricular mass was larger by 64% (P athletes. There were no differences in left ventricular systolic and diastolic function at rest. The meta-analyses of longitudinal studies in which athletes or nonathletes were assessed in active and inactive periods showed that physical training per se can affect cardiac structure. The few reports concerning hypertensive patients suggest that dynamic physical training seems to reduce rather than increase left ventricular mass, in which effect the reduction in blood pressure might play a part. CONCLUSION: Cross-sectional and longitudinal studies indicate that physical training may increase heart size in the normotensive subject. In contrast, heart size in the hypertensive patient may decrease in response to dynamic training.

  15. Biomass fuel smoke exposure was associated with adverse cardiac remodeling and left ventricular dysfunction in Peru.

    Science.gov (United States)

    Burroughs Peña, M S; Velazquez, E J; Rivera, J D; Alenezi, F; Wong, C; Grigsby, M; Davila-Roman, V G; Gilman, R H; Miranda, J J; Checkley, W

    2017-07-01

    While household air pollution from biomass fuel combustion has been linked to cardiovascular disease, the effects on cardiac structure and function have not been well described. We sought to determine the association between biomass fuel smoke exposure and cardiac structure and function by transthoracic echocardiography. We identified a random sample of urban and rural residents living in the high-altitude region of Puno, Peru. Daily biomass fuel use was self-reported. Participants underwent transthoracic echocardiography. Multivariable linear regression was used to examine the relationship of biomass fuel use with echocardiographic measures of cardiac structure and function, adjusting for age, sex, height, body mass index, diabetes, physical activity, and tobacco use. One hundred and eighty-seven participants (80 biomass fuel users and 107 non-users) were included in this analysis (mean age 59 years, 58% women). After adjustment, daily exposure to biomass fuel smoke was associated with increased left ventricular internal diastolic diameter (P=.004), left atrial diameter (P=.03), left atrial area (four-chamber) (P=.004) and (two-chamber) (P=.03), septal E' (P=.006), and lateral E' (P=.04). Exposure to biomass fuel smoke was also associated with worse global longitudinal strain in the two-chamber view (P=.01). Daily biomass fuel use was associated with increased left ventricular size and decreased left ventricular systolic function by global longitudinal strain. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Flavoured Dark Matter moving left

    Science.gov (United States)

    Blanke, Monika; Das, Satrajit; Kast, Simon

    2018-02-01

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

  17. A Programmed Procedure of Prosthetic Reconstruction of the Superior Vena Cava 
for Thoracic Tumors via Median Thoracotomy

    Directory of Open Access Journals (Sweden)

    Shijie ZHANG

    2017-11-01

    Full Text Available Background and objective The involvement of superior vena cava is a common condition in locally advanced thoracic tumors. Patients may benefit from the high risk operation. This study proposed a programmed procedure to optimize surgical techniques, which can facilitate the safety of operation via median thoracotomy. Methods A total of 35 patients with thoracic disease involved superior vena cava underwent prosthetic vascular reconstruction via median thoracotomy. All patients were confirmed locally advanced without distant metastasis including 16 pulmonary neoplasm and 19 mediastinal disease. The operations proceed from left to right with one direction manner. The initial part of the left innominate vein was dissected, then cut off, so as to lift tumor, the pericardium was opened, and the left innominate vein and the right artrium were bridged with prosthetic vascular. The proximal end of the superior vena cava which not invaded was dissected and the tumor was pulled to the caudal side, the right mediastinal pleura was opened and the right inner mammary vascular was ligated and the right innominate vein was fully revealed. Stretch the tumor to left top, cut azygos vein on above the hilum, then block the right innominate vein and superior vena cava, removed involved part of blood vessels, the right innominate vein and superior vena cava was connected with prosthetic vascular. With these procedures the superior vena cava was reconstructed completely. Results The operation was completed successfully in all cases. Postoperative complications included 6 cases with arrhythmia, 5 cases with hypoxemia, 1 case with myasthenia crisis, 1 case with cardiac hernia, and 2 cases with fungal infection. 2 patients died of myocardial infarction and lung infection respectively with a mortality rate of 5.12%. The remaining 33 cases were discharged successfully. The average postoperative hospital stay was 15 days. Of the 10 patients with superior vena cava syndrome

  18. [A Programmed Procedure of Prosthetic Reconstruction of the Superior Vena Cava 
for Thoracic Tumors via Median Thoracotomy].

    Science.gov (United States)

    Zhang, Shijie; Liu, Xiangzheng; Huang, Weiming; Li, Jian

    2017-11-20

    The involvement of superior vena cava is a common condition in locally advanced thoracic tumors. Patients may benefit from the high risk operation. This study proposed a programmed procedure to optimize surgical techniques, which can facilitate the safety of operation via median thoracotomy. A total of 35 patients with thoracic disease involved superior vena cava underwent prosthetic vascular reconstruction via median thoracotomy. All patients were confirmed locally advanced without distant metastasis including 16 pulmonary neoplasm and 19 mediastinal disease. The operations proceed from left to right with one direction manner. The initial part of the left innominate vein was dissected, then cut off, so as to lift tumor, the pericardium was opened, and the left innominate vein and the right artrium were bridged with prosthetic vascular. The proximal end of the superior vena cava which not invaded was dissected and the tumor was pulled to the caudal side, the right mediastinal pleura was opened and the right inner mammary vascular was ligated and the right innominate vein was fully revealed. Stretch the tumor to left top, cut azygos vein on above the hilum, then block the right innominate vein and superior vena cava, removed involved part of blood vessels, the right innominate vein and superior vena cava was connected with prosthetic vascular. With these procedures the superior vena cava was reconstructed completely. The operation was completed successfully in all cases. Postoperative complications included 6 cases with arrhythmia, 5 cases with hypoxemia, 1 case with myasthenia crisis, 1 case with cardiac hernia, and 2 cases with fungal infection. 2 patients died of myocardial infarction and lung infection respectively with a mortality rate of 5.12%. The remaining 33 cases were discharged successfully. The average postoperative hospital stay was 15 days. Of the 10 patients with superior vena cava syndrome preoperatively, 8 patients had symptoms relief except 2 cases

  19. Superior Venacava Thrombus-A Case Report

    Directory of Open Access Journals (Sweden)

    Bijay Sah

    2016-03-01

    Full Text Available Superior venacava (SVC thrombus is a condition requiring immediate diagnosis and treatment. SVC thrombus causes obstruction of blood flow through the SVC resulting in severe decrease in venous return from the head, neck and upper extremity to the heart. The presenting symptoms of SVC obstruction include headache, hoarseness of voice, dyspnea, and laryngeal edema, dizziness, swelling of face, neck, and upper extremity. We hereby present a case of SVC thrombus who presented to the casualty department of COMS-TH with features of SVC syndrome which was diagnosed and managed promptly.JCMS Nepal. 2016;12(1:33-5.

  20. Endovascular treatment of superior vena cava syndrome

    DEFF Research Database (Denmark)

    Duvnjak, Stevo; Andersen, Poul Erik

    2011-01-01

    there was an immediate clinical improvement with considerable reduction in the edema of upper extremities and head. There was, however, continous dyspnea in five patients (17%) and two patients (7%) had persistent visible collateral venous circulations on the upper chest. There were no stent associated complications....... All patients were followed clinically till death and the median follow-up period was 2.8 months (15-420 days). During follow-up three cases of stent thrombosis (one complete and two partial thrombosis) were observed. CONCLUSION: Palliative care with stent implantation for superior vena cava syndrome...

  1. Superior labrum anterior-to-posterior tear.

    Science.gov (United States)

    Sum, Jonathan C; Omid, Reza

    2012-12-01

    The patient was a 25-year-old male college student with a chief complaint of right shoulder pain. The patient was initially diagnosed with bicipital tendinitis by his physician and had been treated for 4 weeks by a physical therapist. However, his symptoms did not improve and he was unable to return to his preinjury activity levels, so he sought the services of another physical therapist for a second opinion. Due to concern for a labrum tear, the physical therapist referred the patient to an orthopaedic surgeon. Magnetic resonance arthrography revealed findings consistent with a superior labrum anterior-to-posterior tear.

  2. Spontaneous Dissection of the Superior Mesenteric Artery

    International Nuclear Information System (INIS)

    Sheldon, Patrick J.; Esther, James B.; Sheldon, Elana L.; Sparks, Steven R.; Brophy, David P.; Oglevie, Steven B.

    2001-01-01

    Spontaneous dissection of the superior mesenteric artery (SMA) is a rare occurrence, especially when not associated with aortic dissection. Currently, only 28 cases appear to have been reported. Due to the scarcity of cases in the literature, the natural history of isolated, spontaneous SMA dissection is unclear. CT has been reported to be useful for the initial diagnosis of SMA dissection [2-5]. We present two recent cases of spontaneous SMA dissection in which enhanced spiral CT was instrumental in following the disease process and guiding clinical decision making

  3. Continuity and change in children's longitudinal neural responses to numbers.

    Science.gov (United States)

    Emerson, Robert W; Cantlon, Jessica F

    2015-03-01

    Human children possess the ability to approximate numerical quantity nonverbally from a young age. Over the course of early childhood, children develop increasingly precise representations of numerical values, including a symbolic number system that allows them to conceive of numerical information as Arabic numerals or number words. Functional brain imaging studies of adults report that activity in bilateral regions of the intraparietal sulcus (IPS) represents a key neural correlate of numerical cognition. Developmental neuroimaging studies indicate that the right IPS develops its number-related neural response profile more rapidly than the left IPS during early childhood. One prediction that can be derived from previous findings is that there is longitudinal continuity in the number-related neural responses of the right IPS over development while the development of the left IPS depends on the acquisition of numerical skills. We tested this hypothesis using fMRI in a longitudinal design with children ages 4 to 9. We found that neural responses in the right IPS are correlated over a 1-2-year period in young children whereas left IPS responses change systematically as a function of children's numerical discrimination acuity. The data are consistent with the hypothesis that functional properties of the right IPS in numerical processing are stable over early childhood whereas the functions of the left IPS are dynamically modulated by the development of numerical skills. © 2014 John Wiley & Sons Ltd.

  4. Borders of left gastric lymph node area in 124 patients with esophageal and gastric cardia carcinoma

    International Nuclear Information System (INIS)

    Qian Pudong; Guo Yesong; Li Jianzhong; Wang Yufen; Feng Chunwei; Lv Hong; Fei Wenlong

    2006-01-01

    Objective: To measure and define the distribution of left gastric lymph nodes. Methods: From Jan. 2004 to Apr. 2005, silver clips were set around the root of the left gastric artery in 124 patients with esophageal and gastric cardia carcinoma, X-ray films at 0 degree and 90 degree simulator gantry in the radio- therapeutic position were taken. Then, the data of the superior, lower, left, right, anterior and posterior bor- der in each patient was recorded. With SAS 8.02 software, data of minimum area which covered the left gastric lymph node in different incidences were obtained. Results: According to the analysis of Shapiro-Wilk, Kolmogorov-Smimov, Cramervon Mises and Anderson-Darling tests, each border' was of normal distribution, with equal frequency in the male and female, despite the actual results in different genders. Pearson Correlation Coefficients analysis did not suggest a significant relationship between the border and height, weight and size of vertebrae, which formed the minimum area covering the left gastric area at frequency of 100%, 95%, 90% and 85%, which were drawn out through the calculation. Conclusions: Aiming at completely identifying the normal distribution of the left gastric lymph node, more patients are required to be in the pool. For the time being, location in the left gastric area can be obtained from details of the results in the present study. (authors)

  5. Superior temporal gyrus volume reduction and P300 in schizophrenia prior to treatment

    International Nuclear Information System (INIS)

    Hirayasu, Akira; Hokama, Hiroto; Ogura, Chikara; Ohta, Hirokazu; Arakaki, Hajime; Asato, Naohiko; Yamaguchi, Keiichiro

    1998-01-01

    Authors measured the superior temporal gyrus volume by 3D MRI imaging for the schizophrenics and simultaneously recorded the P300 component during the auditory odd-ball exercise. Subjects were 8 cases of schizophrenics and the sex- and age-matched healthy control adults. In schizophrenics, the superior temporal gyrus volume reduction was found. When the superior temporal gyrus was divided into two parts, the anterior part containing the primary auditory area, and the posterior part containing the planum temporale and the Wernicle speech area, the volume reduction of left side in the posterior part was remarkable. There was no difference in the latent time and the P300 amplitude between schizophrenics and healthy controls, suggesting that the superior temporal gyrus abnormalities will appear prior to P300 abnormalities. We could not find any correlation between findings of MRI and P300 and psychic symptoms. We discuss the possible contribution on the elucidation of the pathogenesis of the schizophrenia by simultaneous recordings of 3D MRI imaging and the event-related potentials. (K.H.)

  6. Acute superior vena caval syndrome with airway obstruction following elective mediastinoscopy.

    LENUS (Irish Health Repository)

    Power, C K

    2012-02-03

    A 47-year-old female patient had a subclinical superior vena caval syndrome which developed into the \\'full blown\\' acute condition when she was placed into the left lateral position after mediastinoscopy. She developed airway obstruction requiring urgent re-intubation and subsequent admission to the intensive care unit. This subclinical condition might have been suspected pre-operatively if closer attention had been paid to the history, physical examination and review of the computerised axial tomography scan: she had a history of intermittent dysponea, wheeze and cough which was worse on waking and improved as the day progressed, she had a positive Pemberton\\'s sign and the computerised axial tomography scan showed that the lesion was encroaching on the superior vena cava.

  7. Thrombolytics for late superior caval vein thrombus in a patient with tricuspid atresia and single-lung Glenn anastomosis.

    Science.gov (United States)

    Bonnel, Alexander R; Paruchuri, Vijayapraveena; Franklin, Wayne J

    2016-01-01

    Those with cyanotic heart disease have an elevated bleeding risk but also are hypercoaguable. Treating haemodynamically significant thrombi in this unique cohort poses a monumental challenge. Case A 29-year-old women with tricuspid atresia and left pulmonary artery atresia presented with superior caval vein syndrome. She had a right modified Blalock-Taussig shunt as a neonate. A left modified Blalock-Taussig shunt performed later failed to establish flow to her left lung. At age 5, she had a Fontan procedure to the right lung but could not tolerate the physiology and had a low cardiac output syndrome. The Fontan was taken down and she was left with a Glenn anastamosis to the right pulmonary artery. She did well for years until she had dyspnea, upper extremity oedema and "facial fullness". On examination she was tachycardic, hypotensive, and more desaturated than baseline. She also had facial plethora. Decision-making Echocardiogram showed a large 9 × 3 mm nearly occlusive thrombus in the superior caval vein at the bifurcation of the left and right innominate veins. An emergent venogram confirmed the location and size of the thrombus. Given the thrombus burden and potential for distal embolisation through the Glenn to the single functional lung, we chose to treat the patient with thrombolytics. She had uncomplicated ICU course and was sent home on warfarin. Follow-up echocardiogram showed complete resolution of clot. This case shows the importance of history and physical exam in caring for this complex cohort of adult patients with CHD.

  8. Binocular cyclotorsion in superior vestibular neuritis.

    Science.gov (United States)

    Lapenna, R; Pellegrino, A; Ricci, G; Cagini, C; Faralli, M

    2017-11-30

    Conjugated cyclotorsion of the eyes toward the affected side can commonly be observed in vestibular neuritis. The aim of this study was to assess the differences in cyclotorsion between the ipsi- and contralesional eye during selective involvement of the superior branch of the vestibular nerve. We studied binocular cyclotorsion through ocular fundus photographs in 10 patients affected by acute superior vestibular neuritis (SVN). Cyclotorsion was also studied in 20 normal subjects. All SVN patients showed an ipsilesional cycloversion of the eyes. Normal subjects exhibited a constant mild excyclovergence (6.42 ± 2.34°). In SVN patients, contralateral incyclotorsion (8.4 ± 8.14°) was lower and not normally distributed compared to ipsilateral eye excyclotorsion (17.9 ± 4.36°) with no correlation between them. The interocular difference in cyclodeviation could be related to the starting physiological excyclovergence, to different tonic effects on the extraocular muscles of the two eyes and to the different influence of spontaneous nystagmus on cyclodeviation in the two eyes. We recommend referring only to ipsilateral excyclotorsion in the evaluation of utricular function during SVN and its subsequent compensation. Further studies are required to determine the binocular cyclotorsion in the case of other kinds of selective involvement of the vestibular nerve. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale.

  9. Premissas para o ensino superior do design

    Directory of Open Access Journals (Sweden)

    André Luis Marques da Silveira

    2016-12-01

    Full Text Available Este artigo aborda a temática da Educação Superior e objetivo identificar premissas para o Ensino em Design no Brasil. Para tanto, efetua um estudo dos conteúdos das comunicações da área em periódicos e livros quanto ao assunto. O método de investigação utilizado foi a análise de conteúdo e observou as seguintes etapas de investigação: registro de dados, interpretação inferencial e categorização. Num primeiro momento, identifica a frequência do aparecimento de índices lexicais quanto ao relato de problemas no processo de Ensino-aprendizagem do Design e as proposições para o seu enfrentamento. Procede uma interpretação inferencial destes dados e, por fim, propõe como resultado, um conjunto de doze premissas que devem ser observadas quanto ao Ensino Superior em Design, a saber: 1 Incentivar o empreendedorismo; 2 Nivelar a Formação; 3 Desenvolver estrategistas; 4 Pensar a ética na atuação profissional; 5 Educar para o social; 6 Valorizar os ideias humanistas; 7 Repensar as estruturas acadêmicas; 8 Focar na aprendizagem baseada em problemas; 9 Aceitar os novos paradigmas; 10 Fomentar o pensamento crítico reflexivo; 11 Estimular a transdisciplinaridade; 12 Focar nas economias emergentes.

  10. Premissas para o Ensino Superior do Design

    Directory of Open Access Journals (Sweden)

    André Luis Marques da Silveira

    2016-12-01

    Full Text Available Este artigo aborda a temática da Educação Superior e objetivo identificar premissas para o Ensino em Design no Brasil. Para tanto, efetua um estudo dos conteúdos das comunicações da área em periódicos e livros quanto ao assunto. O método de investigação utilizado foi a análise de conteúdo e observou as seguintes etapas de investigação: registro de dados, interpretação inferencial e categorização. Num primeiro momento, identifica a frequência do aparecimento de índices lexicais quanto ao relato de problemas no processo de Ensino-aprendizagem do Design e as proposições para o seu enfrentamento. Procede uma interpretação inferencial destes dados e, por fim, propõe como resultado, um conjunto de doze premissas que devem ser observadas quanto ao Ensino Superior em Design, a saber: 1 Incentivar o empreendedorismo; 2 Nivelar a Formação; 3 Desenvolver estrategistas; 4 Pensar a ética na atuação profissional; 5 Educar para o social; 6 Valorizar os ideias humanistas; 7 Repensar as estruturas acadêmicas; 8 Focar na aprendizagem baseada em problemas; 9 Aceitar os novos paradigmas; 10 Fomentar o pensamento crítico reflexivo; 11 Estimular a transdisciplinaridade; 12 Focar nas economias emergentes.

  11. [Reversibility of cardiomyopathy after therapy of incessant left ventricular tachycardia with radiofrequency ablation in a newborn infant].

    Science.gov (United States)

    Benito Bartolomé F; Sánchez Fernández-Bernal C

    2000-08-01

    We present a 15-month-old infant with tachycardia-induced cardiomyopathy secondary to idiopathic left ventricular tachycardia, which was incessant despite medical treatment. In the electrocardiogram, the tachycardia showed right bundle branch morphology and left superior axis deviation and was successfully ablated with the application of radiofrequency in the inferior apical septal region of the left ventricle. One week after the procedure the shortening fraction increased from 12% to 30% and at 18 months of follow-up the patient is tachycardia-free.

  12. Left ventricular biomechanics in professional football players.

    Science.gov (United States)

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

    2018-01-01

    Chronic exercise induces adaptive changes of left ventricular (LV) ejection and filling capacities which may be detected by novel speckle-tracking echocardiography (STE) and tissue Doppler imaging (TDI)-based techniques. A total of 103 consecutive male elite Norwegian soccer players and 46 age-matched healthy controls underwent echocardiography at rest. STE was used to assess LV torsional mechanics and LV systolic longitudinal strain (LS). Diastolic function was evaluated by trans-mitral blood flow, mitral annular velocities by TDI, and LV inflow propagation velocity by color M-mode. Despite similar global LS, players displayed lower basal wall and higher apical wall LS values vs controls, resulting in an incremental base-to-apex gradient of LS. Color M-mode and TDI-derived data were similar in both groups. Peak systolic twist rate (TWR) was significantly lower in players (86.4±2.8 vs controls 101.9±5.2 deg/s, P<.01). Diastolic untwisting rate (UTWR) was higher in players (-124.5±4.2 vs -106.9±6.7 deg/s) and peaked earlier during the cardiac cycle (112.7±0.8 vs 117.4±2.4% of systole duration, both P<.05). Untwisting/twisting ratio (-1.48±0.05 vs -1.11±0.08; P<.001) and untwisting performance (=UTR/TW; -9.25±0.34 vs -7.38±0.40 s -1 , P<.01) were increased in players. Augmented diastolic wall strain (DWS), a novel measure of LV compliance in players, was associated with improved myocardial mechanical efficiency. The described myocardial biomechanics may underlie augmented exertional cardiac function in athletes and may have a potential role to characterize athlete's heart by itself or to distinguish it from hypertensive or hypertrophic cardiomyopathy. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Superior repair: A useful approach for some anatomic variants of total anomalous pulmonary venous connection

    Directory of Open Access Journals (Sweden)

    Kelechi E Okonta

    2013-01-01

    Full Text Available Background: Total anomalous pulmonary venous connection (TAPVC occurs when all the four pulmonary veins drain to the right atrium or to tributaries of the systemic veins. There have been various published techniques for the repair but none has been agreed on for the different anatomical variants that may be encountered during surgery. Patients and Methods: Between January 2005 and June 2010 the data of 6 of 18 patients who had surgical repair using the superior approach were retrospectively reviewed.Three patients had long narrow venous stalk connecting the coronary sinus to venous confluence; two had the right pulmonary veins draining to superior vena cava (SVC and left pulmonary veins to left lateral wall of SVC and one had an obstruction at entrance of Pulmonary Vein into venous confluence. Results: Five patients initially had the superior approach while one had transatrial with unroofing of the coronary sinus. Two had a concomitant Wardens procedure. The mean aortic cross clamping was 87.5 (60-125 min, the mean cardiopulmonary bypass time should have min as unit of 127.8 (100-180, the mean Intensive Care Unit (ICU stay of 2.5 (2-4 days and the mean hospital stay 8.2 (7-9 days. One patient died at early post-operation from low cardiac outputand five had an uneventful post-operative course and had remained stable until date. Conclusion: In our experience, the superior approach was an effective alternative approach for some anatomic variants of TAPVC that may be unexpectedly encountered during operation and also useful surgical approach for older children.

  14. Echocardiographic evaluation of left ventricle mechanical parameters in infants of the first year of life

    Directory of Open Access Journals (Sweden)

    Yu. S. Sinelnikov

    2017-11-01

    Full Text Available Aim. The study focused on the analysis of the measurement range of left ventricle mechanics (strain, strain rate, rotation, rotation rate, twisting, untwisting, torsion in healthy infants of the first year of life to obtain their baseline values.Methods. The study included 125 healthy infants aged 5 days to 12 months (average 5.9±3.9 months. The Аcuson S 2000 machine (Siemens Medical Systems, Mountain View, CA, USA was used to perform echocardiography. The indicators of left ventricle longitudinal strain (% and strain rate (s–1, radial strain and strain rate (% and s–1, circumferential strain and strain rate (% and s–1, basal and apical rotation in systole and diastole (° and rotation rate (°/s, twisting (°, untwisting (°, twisting and unwinding rate (°/s and torsion (°/cm were measured and analyzed. Results. It was found out that the values of the longitudinal strain and strain rate inversely correlate with the pumping function (stroke volume index and diastolic function (filling pressures and the untwisting rate. The parameters of the circular and radial strain tended to depend on the left ventricle mass index, interventricular septum/left ventricle posterior wall thicknesses. Left ventricle twisting and untwisting would increase in healthy infants from the newborn period to the first year of life. Left ventricle torsion range was determined by the twist values and not by left ventricular geometry.Conclusion. The obtained data on the values of longitudinal, circumferential and radial left ventricle strain and strain rate can be used as reference ranges to evaluate the mechanical left ventricular function in infants of the first year of life.Received 27 January 2017. Accepted 15 June 2017.Funding: The study did not have sponsorship.Conflict of interest: The authors declare no conflict of interest.Author contributionsConception and study design: Yu.S. Sinelnikov, E.N. OrekhovaData collection and analysis: M.A. Polevshikova, T

  15. Papilledema secondary to a superior sagittal sinus thrombosis. Mantle cell lymphoma paraneoplastic syndrome.

    Science.gov (United States)

    Platas-Moreno, I; Antón-Benito, A; Pérez-Cid-Rebolleda, M T; Rosado Sierra, M B

    2016-01-01

    A 46 year old patient presented with visual loss in the left eye during the previous months. Ophthalmoscopic examination and magnetic resonance angiography found the presence of papilledema due to thrombosis in superior sagittal sinus. The examination findings revealed a mantle cell lymphoma. Cerebral venous thrombosis is an unusual cause of papilledema. This type of thrombosis may be secondary to hyper-viscosity within a context of a paraneoplastic syndrome. Copyright © 2015 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  16. Superior Mesenteric Artery Syndrome—Believe in it! Report of a Case

    Directory of Open Access Journals (Sweden)

    Sante Capitano

    2012-01-01

    Full Text Available We present a case of a man with amyotrophic lateral sclerosis who developed superior mesenteric artery syndrome (SMAS following the confection of feeding jejunostomy. He was successfully managed by conservative treatment. Left lateral positioning during enteral feeding allowed quick resolution of the occlusive state. Various surgical interventions have been associated with SMAS, directly or indirectly, by reducing the width of the aortomesenteric angle. The operative stress was probably what triggered symptomatology in our patient thus to conclude that the surgical stress should be considered as a causal factor triggering the SMAS in a context of other predisposing factors.

  17. Superior canal dehiscence in a patient with three failed stapedectomy operations for otosclerosis: a case report

    Directory of Open Access Journals (Sweden)

    Sudhoff Holger H

    2011-02-01

    Full Text Available Abstract Introduction This case illustrates that superior semicircular canal dehiscence syndrome can be associated with a "pseudo"-conductive hearing loss, a symptom that overlaps with the clinical appearance of otosclerosis. Case presentation We present the case of a 48-year-old German Caucasian woman presenting with hearing loss on the left side and vertigo. She had undergone three previous stapedectomies for hearing improvement. Reformatted high-resolution computed tomographic scanning and the patient's history confirmed the diagnosis of concurrent canal dehiscence syndrome. Conclusion Failure of hearing improvement after otosclerosis surgery may indicate an alternative underlying diagnosis which should be explored by further appropriate evaluation.

  18. Cochlear implant outcomes in patients with superior canal dehiscence

    NARCIS (Netherlands)

    Puram, Sidharth V.; Roberts, Daniel S.; Niesten, Marlien E F; Dilger, Amanda E.; Lee, Daniel J.

    2015-01-01

    Objective: To determine whether adult cochlear implant (CI) users with superior canal dehiscence syndrome (SCDS) or asymptomatic superior semicircular canal dehiscence (SCD) have different surgical, vestibular, and audiologic outcomes when compared to CI users with normal temporal bone anatomy.

  19. Left ventricular assist device therapy in advanced heart failure

    DEFF Research Database (Denmark)

    Gustafsson, Finn; Rogers, Joseph G

    2017-01-01

    when deciding on LVAD implantation such as age, co-morbidity, and cardiac pathophysiology. Complications to LVAD therapy are reviewed. It is concluded that while complications with LVAD therapy are not uncommon, most are manageable, and current outcomes clearly justify use of LVADs in advanced HF....... to shortage of donor organs. Implantable left ventricular assist device (LVAD) technology has improved considerably, and the currently used continuous flow devices may last >10 years in a patient. LVADs are being used increasingly both as bridge-to-transplantation and as destination therapy. Current studies...... report 1- and 2-year survival after LVAD implantation of 80% and 70%, respectively. Outcome after LVAD implantation in stable patients is superior to that of 'crash and burn' patients or patients sliding on inotropes, favouring early referral and implantation. This review summarizes factors to consider...

  20. The left fusiform gyrus hosts trisensory representations of manipulable objects

    DEFF Research Database (Denmark)

    Kassuba, Tanja; Klinge, Corinna; Hölig, Cordula

    2011-01-01

    During object manipulation the brain integrates the visual, auditory, and haptic experience of an object into a unified percept. Previous brain imaging studies have implicated for instance the dorsal part of the lateral occipital complex in visuo-tactile and the posterior superior temporal sulcus....... In the first experiment, we identified brain regions which were consistently activated by unimodal visual, auditory, and haptic processing of manipulable objects relative to non-object control stimuli presented in the same modality. In the second experiment, we assessed regional brain activations when...... participants had to match object-related information that was presented simultaneously in two or all three modalities. Only a well-defined region in left fusiform gyrus (FG) showed an object-specific activation during unisensory processing in the visual, auditory, and tactile modalities. The same region...

  1. A longitudinal study

    OpenAIRE

    Kristen, Astrid

    2010-01-01

    Does playing violent video games increase aggressive behavior over time or is it aggressive children who increasingly seek out (and play) these violent video games? To study such long-term effects a longitudinal design is necessary. Within a field study in a large German city (Kinder, Computer, Hobby, Lernen – KUHL, Freie Universtität Berlin) about 115 elementary school boys attending in the beginning (t1) classrooms of the third and fourth grade and twelve months later (t2) classrooms of the...

  2. The difficulties of a randomized study in superior vena caval obstruction.

    Science.gov (United States)

    Wilson, Paula; Bezjak, Andrea; Asch, Murray; Barton, Rachael; Wong, Rebecca; Levin, Wilfred; Kane, Gabrielle; Kirkbride, Peter

    2007-06-01

    Superior vena caval obstruction (SVCO) is a not uncommon complication of malignant disease. Treatment may consist of radiation (RT) to the mediastinum, systemic therapy for chemosensitive tumors, and supportive measures such as oxygen and steroids. Advances in interventional radiology have allowed the introduction of expandable stents into the superior vena cava (SVC), with the theoretical advantage of providing symptom relief within hours, rather than the days and weeks over which RT exerts its effect. Although small case series have supported the use of stents in SVCO, there are no randomized data. We set up a randomized study at Princess Margaret Hospital, Toronto. Patients were randomized to receive palliative RT to the mediastinum or immediate stenting of the SVC and then mediastinal RT within a week. The aim of the study was to compare symptom response between the two treatment arms. A second study, a prospective longitudinal study, was also set up to obtain information on symptom response and outcome regardless of the treatment given. In a 12-month period, we were unable to accrue any patients in the randomized study; of the 19 patients approached, 13 have agreed to participate in the longitudinal study. In this report, we present the problems that we have encountered with these studies.

  3. Superior vena cava syndrome as tumour presentation

    Directory of Open Access Journals (Sweden)

    Nuno Filipe Pires

    2010-01-01

    Full Text Available Superior vena cava syndrome (SVCS is characterised by gradual and insidious compression/obstruction of the superior vena cava (SVC. Upper chest and neck ingurgitation, plethoric face and oedema are the common symptoms/signs. It generally means the presence of neoplasm, namely lung cancer. Aim: Retrospective analysis of the patients admitted to S. João Hospital, Porto, Portugal, January 1995-December 2006 with SVCS without previous diagnosis. Patients, tumour characteristics and prognostic factors were studied. Material and methods: Data was collected by consulting the clinical files of 60 SVCS patients without previous diagnosis. Data was gathered on the patients’ demographic characteristics (age, gender, smoking habits, performance status, histology, staging, treatment and overall survival. Results: Lung cancer was observed in 87% of the patients. Small-cell lung cancer (SCLC was the most frequent histological type; 41% of the patients. It is noticeable that 10% were diagnosed with non-Hodgkin's lymphoma. In terms of prognostic factors analysed, the absence of metastasis, the lymphoma's histological diagnosis, good performance status and non-smoker status were positively correlated with the survival rate. On the contrary SCLC was significantly correlated with a worse survival. Conclusions: In our analysis we concluded that SCLC, smokers and a poorer performance status as well as metastatic disease were unfavourable prognostic factors to SVCS as tumour presentation. Resumo: A síndroma da veia cava superior (SVCS é causada por uma obstrução/compressão gradual e insidiosa da veia cava superior, caracterizando-se por fácies pletórica, edema e ingurgitamento vascular do pescoço e parte superior do tronco. É geralmente tradutora de neoplasia, sendo o cancro do pulmão a sua causa mais comum. Objectivo: Estudo retrospectivo dos internamentos no Hospital de S. João entre Janeiro de 1995 e Dezembro de 2006 por

  4. Superior Canal Dehiscence Syndrome Affecting 3 Families.

    Science.gov (United States)

    Heidenreich, Katherine D; Kileny, Paul R; Ahmed, Sameer; El-Kashlan, Hussam K; Melendez, Tori L; Basura, Gregory J; Lesperance, Marci M

    2017-07-01

    Superior canal dehiscence syndrome (SCDS) is an increasingly recognized cause of hearing loss and vestibular symptoms, but the etiology of this condition remains unknown. To describe 7 cases of SCDS across 3 families. This retrospective case series included 7 patients from 3 different families treated at a neurotology clinic at a tertiary academic medical center from 2010 to 2014. Patients were referred by other otolaryngologists or were self-referred. Each patient demonstrated unilateral or bilateral SCDS or near dehiscence. Clinical evaluation involved body mass index calculation, audiometry, cervical vestibular evoked myogenic potential testing, electrocochleography, and multiplanar computed tomographic (CT) scan of the temporal bones. Zygosity testing was performed on twin siblings. The diagnosis of SCDS was made if bone was absent over the superior semicircular canal on 2 consecutive CT images, in addition to 1 physiologic sign consistent with labyrinthine dehiscence. Near dehiscence was defined as absent bone on only 1 CT image but with symptoms and at least 1 physiologic sign of labyrinthine dehiscence. A total of 7 patients (5 female and 2 male; age range, 8-49 years) from 3 families underwent evaluation. Family A consisted of 3 adult first-degree relatives, of whom 2 were diagnosed with SCDS and 1 with near dehiscence. Family B included a mother and her child, both of whom were diagnosed with unilateral SCDS. Family C consisted of adult monozygotic twins, each of whom was diagnosed with unilateral SCDS. For all cases, dehiscence was located at the arcuate eminence. Obesity alone did not explain the occurrence of SCDS because 5 of the 7 cases had a body mass index (calculated as weight in kilograms divided by height in meters squared) less than 30.0. Superior canal dehiscence syndrome is a rare, often unrecognized condition. This report of 3 multiplex families with SCDS provides evidence in support of a potential genetic contribution to the etiology

  5. Superiority of Bessel function over Zernicke polynomial as base ...

    Indian Academy of Sciences (India)

    Abstract. Here we describe the superiority of Bessel function as base function for radial expan- sion over Zernicke polynomial in the tomographic reconstruction technique. The causes for the superiority have been described in detail. The superiority has been shown both with simulated data for Kadomtsev's model for ...

  6. Multiplicativity of left centralizers forcing additivity

    Directory of Open Access Journals (Sweden)

    Mohammad Sayed Tammam El-Sayiad

    2014-01-01

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

  7. Exploring the word superiority effect using TVA

    DEFF Research Database (Denmark)

    Starrfelt, Randi

    for perception of words, or a higher speed of processing for words than letters. We have investigated the WSE using methods based on a Theory of Visual Attention. In an experiment using single stimuli (words or letters) presented centrally, we show that the classical WSE is specifically reflected in perceptual......Words are made of letters, and yet sometimes it is easier to identify a word than a single letter. This word superiority effect (WSE) has been observed when written stimuli are presented very briefly or degraded by visual noise. It is unclear, however, if this is due to a lower threshold...... simultaneously we find a different pattern: In a whole report experiment with six stimuli (letters or words), letters are perceived more easily than words, and this is reflected both in perceptual processing speed and short term memory capacity....

  8. Superior vena cava syndrome in hemodialysis patient

    Directory of Open Access Journals (Sweden)

    Azeb Molhem

    2011-01-01

    Full Text Available Obstruction of blood flow in the superior vena cava (SVC results in symptoms and signs of SVC syndrome. SVC obstruction can be caused either by invasion or external compression of the SVC by contagious pathologic processes involving the right lung, lymph nodes, and other mediastinal structures, or by thrombosis of blood within the SVC. Occasionally, both mechanisms co-exist. We hereby report a case of a 28-year-old male, Saudi patient who was diagnosed with end-stage renal disease and was maintained on regular hemodiaysis via right jugular vein dual lumen catheter for ten months. Three years later, the patient presented with signs and symptoms suggestive of SVC obstruction that was successfully managed with SVC stenting.

  9. Lightning activity during the 1999 Superior derecho

    Science.gov (United States)

    Price, Colin G.; Murphy, Brian P.

    2002-12-01

    On 4 July 1999, a severe convective windstorm, known as a derecho, caused extensive damage to forested regions along the United States/Canada border, west of Lake Superior. There were 665,000 acres of forest destroyed in the Boundary Waters Canoe Area Wilderness (BWCAW) in Minnesota and Quetico Provincial Park in Canada, with approximately 12.5 million trees blown down. This storm resulted in additional severe weather before and after the occurrence of the derecho, with continuous cloud-to-ground (CG) lightning occurring for more than 34 hours during its path across North America. At the time of the derecho the percentage of positive cloud-to-ground (+CG) lightning measured by the Canadian Lightning Detection Network (CLDN) was greater than 70% for more than three hours, with peak values reaching 97% positive CG lightning. Such high ratios of +CG are rare, and may be useful indicators of severe weather.

  10. Have the Guests Perceived Superior Value?

    Directory of Open Access Journals (Sweden)

    Levyda Levyda

    2017-11-01

    Full Text Available This research aimed to describe guests’ perceived value by using a multidimensional approach. From previous research, guests’ perceived value consisted of some functional value, emotional value, and social value. Based on guest experience, and functional value consisted of physical evidence, guest room, food and beverage, hotel staff, and price. This research was conducted in four-star hotels in Jakarta. The respondents were the guests who had stayed in four-star hotels. The number of the respondent was 405. The data were obtained by using self-administered questionnaires. This research shows that guests have not perceived superior value. Some of the values and the necessary efforts need to be improved.

  11. Superior Mesenteric Artery Syndrome or Wilkie Syndrome

    International Nuclear Information System (INIS)

    Castano Llano, Rodrigo; Chams Anturi, Abraham; Arango Vargas, Paula

    2009-01-01

    We described three cases of superior mesenteric artery (SMA) syndrome, also known as Wilkie's syndrome, chronic duodenal ileus, or cast syndrome. This syndrome occurs when the third portion of the duodenum is compressed between the SMA and the aorta. The major risk factors for development of SMA syndrome are rapid weight loss and surgical correction of spinal deformities. The clinical presentation of SMA syndrome is variable and nonspecific, including nausea, vomiting, abdominal pain, and weight loss. The diagnosis is based on endoscopic, radiographic and tomographic findings of duodenal compression by the SMA. The treatment of SMA syndrome is aimed at the precipitating factor, which usually is related to weight loss. Therefore, conservative therapy with nutritional supplementation is the initial approach, and surgery is reserved for those who do not respond to nutritional therapy.

  12. Radiotherapy of superior vena cava syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kawanami, Shoko; Imada, Hajime; Terashima, Hiromi; Nakata, Hajime [University of Occupational and Environmental Health, Kitakyushu, Fukuoka (Japan)

    1996-10-01

    The records of 38 patients with superior vena cava syndrome (SVC syndrome) due to malignancy and who received radiation therapy were retrospectively reviewed. The majority were lung cancers, constituting 28 of the 38 cases (73.7%). All patients were treated with conventional radiation doses ranging from 20 to 70 Gy and good symptomatic response was observed in 31 cases (81.6% ). The response appeared within 1.7{+-}0.9 weeks on average (3 days-4 weeks;), and performance status also improved in 50% of the patients. The median survival was 6.6 months. Long term survivors were seen mostly in patients with thymoma, and only one patient ever showed a recurrence of SVC syndrome. We conclude that radiotherapy can be an effective therapeutic modality for SVC syndrome and that it improves the quality of life in most patients. (author)

  13. Feeling superior is a bipartisan issue: extremity (not direction) of political views predicts perceived belief superiority.

    Science.gov (United States)

    Toner, Kaitlin; Leary, Mark R; Asher, Michael W; Jongman-Sereno, Katrina P

    2013-12-01

    Accusations of entrenched political partisanship have been launched against both conservatives and liberals. But is feeling superior about one's beliefs a partisan issue? Two competing hypotheses exist: the rigidity-of-the-right hypothesis (i.e., conservatives are dogmatic) and the ideological-extremism hypothesis (i.e., extreme views on both sides predict dogmatism). We measured 527 Americans' attitudes about nine contentious political issues, the degree to which they thought their beliefs were superior to other people's, and their level of dogmatism. Dogmatism was higher for people endorsing conservative views than for people endorsing liberal views, which replicates the rigidity-of-the-right hypothesis. However, curvilinear effects of ideological attitude on belief superiority (i.e., belief that one's position is more correct than another's) supported the ideological-extremism hypothesis. Furthermore, responses reflecting the greatest belief superiority were obtained on conservative attitudes for three issues and liberal attitudes for another three issues. These findings capture nuances in the relationship between political beliefs and attitude entrenchment that have not been revealed previously.

  14. Kompetisi Stasiun Televisi Swasta Nasional Berdasarkan Superiority Direction dan Superiority Magnitude

    Directory of Open Access Journals (Sweden)

    Anastasia Winanti Riesardhy

    2013-11-01

    Full Text Available Abstract: Uses and gratification theory is employed particularly as the teoritical frame of the research to examine the extent to which ten national television stations compete to satisfy Indonesian audiences. In particular, two main concepts of that theory namely audiences “gratification sought and gratifications obtained, are broken down and counted based on superiority direction and superiority magnitude. In general, the findings show that those televisions have satisfied their audiences, although in terms of gratifications to dispersal motives, they haven’t satisfied as much as it was expected. Significant competition occurs between TRANSTV and TRANS7, RCTI and SCTV, and TVONE and METROTV. TVONE become the most satisfiyng television station. Abstrak: Teori Uses & Gratification menjadi dasar penelitian ini untuk mengukur bagaimana kompetisi yang terjadi di antara sepuluh stasiun televisi yang bersiaran secara nasional di Indonesia. Aplikasi dari teori tersebut dimunculkan dalam konsep kepuasan yang diharapkan dan kepuasan yang diperoleh ketika menonton acara televisi dan didasarkan pada penghitungan superiority direction dan superiority magnitude. Sepuluh stasiun televisi yang diteliti telah dapat memuaskan audiensnya, meskipun untuk kepuasan atas motif pengalihan masih belum dapat melampaui kepuasan yang diharapkan. Kompetisi yang signifikan terjadi antara TRANSTV dengan TRANS7, RCTI dengan SCTV serta TVONE dengan METROTV. TVONE menjadi stasiun televisi yang menduduki peringkat pertama dalam memberikan kepuasan tertinggi kepada audiens.

  15. Anarchy, socialism and a Darwinian left.

    Science.gov (United States)

    Clarke, Ellen

    2006-03-01

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

  16. What is Beyond Right/Left?

    DEFF Research Database (Denmark)

    Dyrberg, Torben Bech

    2009-01-01

    The article looks at New Labour's move beyond right/left in the mid/late 1990s, which is an occasion to spell out the nature of right/left and what it means for democracy. In contrast to both defenders and critics of this move I argue in the first part that right/left is not an empty label bound up...... right/left. I argue that the new hegemonic orientation is that of front/back, which designs political renewal as a response to the social changes cutting across the outdated lines of contestation of partisan politics. The democratic problem of this move lies in squeezing politics between technocratic...

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

    DEFF Research Database (Denmark)

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

    2008-01-01

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

  18. Regional vulnerability of longitudinal cortical association connectivity

    Directory of Open Access Journals (Sweden)

    Rafael Ceschin

    2015-01-01

    Full Text Available Preterm born children with spastic diplegia type of cerebral palsy and white matter injury or periventricular leukomalacia (PVL, are known to have motor, visual and cognitive impairments. Most diffusion tensor imaging (DTI studies performed in this group have demonstrated widespread abnormalities using averaged deterministic tractography and voxel-based DTI measurements. Little is known about structural network correlates of white matter topography and reorganization in preterm cerebral palsy, despite the availability of new therapies and the need for brain imaging biomarkers. Here, we combined novel post-processing methodology of probabilistic tractography data in this preterm cohort to improve spatial and regional delineation of longitudinal cortical association tract abnormalities using an along-tract approach, and compared these data to structural DTI cortical network topology analysis. DTI images were acquired on 16 preterm children with cerebral palsy (mean age 5.6 ± 4 and 75 healthy controls (mean age 5.7 ± 3.4. Despite mean tract analysis, Tract-Based Spatial Statistics (TBSS and voxel-based morphometry (VBM demonstrating diffusely reduced fractional anisotropy (FA reduction in all white matter tracts, the along-tract analysis improved the detection of regional tract vulnerability. The along-tract map-structural network topology correlates revealed two associations: (1 reduced regional posterior–anterior gradient in FA of the longitudinal visual cortical association tracts (inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, optic radiation, posterior thalamic radiation correlated with reduced posterior–anterior gradient of intra-regional (nodal efficiency metrics with relative sparing of frontal and temporal regions; and (2 reduced regional FA within frontal–thalamic–striatal white matter pathways (anterior limb/anterior thalamic radiation, superior longitudinal fasciculus and cortical spinal tract

  19. Impact of technique of left ventricular aneurysm repair on clinical outcomes: current best available evidence.

    Science.gov (United States)

    Raja, Shahzad G; Salehi, Salim; Bahrami, Toufan T

    2009-01-01

    Postinfarction left ventricular aneurysm is a serious disorder that can lead to congestive heart failure, lethal ventricular arrhythmia, and premature death. Surgical treatment is indicated in established cases of congestive heart failure, angina pectoris, malignant ventricular arrhythmia, or recurrent embolization from the left ventricle. The goal of surgical intervention is to correct the size and geometry of the left ventricle, reduce wall tension and paradoxical movement, and improve systolic function. Surgical techniques for repair of left ventricular aneurysm have evolved over the last five decades. Aneurysmectomy and linear repair of the left ventricle was introduced by Cooley and colleagues in 1958 and remained the standard procedure until the late 1980s. Endoventricular patch plasty (EVPP) was then introduced as a more physiologic repair than the linear closure technique, especially when the aneurysm extends into the septum. However, there is still controversy whether EVPP is superior to simple linear resection in terms of impact on early and late clinical outcomes. In the current era of evidence-based medicine, the best strategy to resolve a controversy is through the explicit and conscientious assessment of current best evidence. This review article attempts to evaluate the current best available evidence on the impact of technique of left ventricular aneurysm repair on postoperative clinical outcomes.

  20. Longitudinal Assessment of Left Ventricular Structure and Function in Adolescents with Developmental Coordination Disorder

    Science.gov (United States)

    Chirico, Daniele; O'Leary, Deborah; Cairney, John; Haluka, Karen; Coverdale, Nicole S.; Klentrou, Panagiota; Hay, John; Faught, Brent E.

    2012-01-01

    Children with developmental coordination disorder (DCD) are more likely to develop cardiovascular disease (CVD) risk factors such as obesity and reduced cardio-respiratory fitness. It has also been shown that adolescents with probable DCD (p-DCD) have elevated cardiac output (CO) and stroke volume (SV) compared to typically developing (TD)…

  1. LEIR longitudinal studies

    CERN Document Server

    Albright, S; Hancock, S

    2017-01-01

    Towards the end of 2015 and during 2016 there were exten-sive studies of longitudinal beam dynamics in LEIR aimedat improving extracted intensities. As the driving source oflosses early in the ramp was shown to be transverse spacecharge tune spread a significant improvement came fromflattening the beam profile to increase the bunching factorby offsetting the RF frequency from the beam revolution fre-quency. Further benefits were provided by modulating theRF frequency during capture, leading to emittance blow-upand improved reproducibility. The use of two RF cavitiesduring operation was studied to try and further increase thecaptured emittance, however after careful alignment of theRF it was found that a hard limit in the bunch heigh of approx-imately 7 MeV exists. Due to the acceptance limit there wasno operational benefit to using both cavities simultaneously

  2. 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...

  3. Malignant phyllodes tumor of the left atrium

    Directory of Open Access Journals (Sweden)

    Anupam Bhambhani

    2014-03-01

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

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

    African Journals Online (AJOL)

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

  5. Leptogenesis with left-right domain walls

    Indian Academy of Sciences (India)

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

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

    African Journals Online (AJOL)

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

  7. Recognition of emotion in hemifaces presented to the left and right visual fields.

    Science.gov (United States)

    Wedding, D; Cyrus, P

    1986-09-01

    Thirty-two right-handed subjects (16 males and 16 females) participated in a choice reaction time experiment replicating two previous studies which demonstrated the superiority of the left hemisphere in rapidly identifying facial emotion as either positive or negative. Slides of hemifaces split along the vertical axis, showing either positive (happiness, surprise) or negative (anger, disgust, or sadness) affect were presented tachistoscopically to either the left or right visual field. A 2 X 2 X 2 mixed ANOVA revealed main effects for visual field and type of affect. In contrast to earlier studies which presented full face stimuli, presentation of hemifaces produced a strong left visual field advantage and, as expected, positive faces produced faster reaction times than negative faces.

  8. Loading Conditions and Longitudinal Strength

    DEFF Research Database (Denmark)

    Sørensen, Herman

    1995-01-01

    Methods for the calculation of the lightweight of the ship.Loading conditions satisfying draught, trim and intact stability requirements and analysis of the corresponding stillwater longitudinal strength.......Methods for the calculation of the lightweight of the ship.Loading conditions satisfying draught, trim and intact stability requirements and analysis of the corresponding stillwater longitudinal strength....

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

    Science.gov (United States)

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

    2014-06-01

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

  10. Longitudinal Observations of Infants' Daily Arrivals at a Day Care Center.

    Science.gov (United States)

    Willis, E. Anne; Ricciuti, Henry N.

    This longitudinal study was concerned with infants' reactions to being greeted by a caregiver upon arrival at the nursery, being left by the parent with the caregiver, and to reunion with the parents. Observations were made twice weekly in the natural setting of the nursery foyer where parents normally arrive with their infants. An affectivity…

  11. Left Atrial Enlargement on Transthoracic Echocardiography Predicts Left Atrial Thrombus on Transesophageal Echocardiography in Ischemic Stroke Patients

    Directory of Open Access Journals (Sweden)

    James Anaissie

    2016-01-01

    Full Text Available Background. Transesophageal echocardiogram (TEE is superior to transthoracic echocardiogram (TTE in detecting left atrial thrombus (LAT, a risk factor for stroke, but is costly and invasive, carrying a higher risk for complications. Aims. To determine the utility of using left atrial enlargement (LAE on TTE to predict LAT on TEE. Methods. AIS patients who presented in 06/2008–7/2013 and underwent both TTE and TEE were identified from our prospective stroke registry. Analysis consisted of multivariate logistic regression with propensity score adjustment and receiver operating characteristic (ROC area under the curve (AUC analyses. Results. 219 AIS patients underwent both TTE and TEE. LAE on TTE was detected in 113 (51.6% of AIS patients. Patients with LAE on TTE had higher proportion of LAT on TEE (8.4% versus 1.0%, p=0.018. LAE on TTE predicted increased odds of LAT on TEE (OR=8.83, 95% CI 1.04–74.83, p=0.046. The sensitivity and specificity for LAT on TEE by LAE on TEE were 88.89% and 52.20%, respectively (AUC=0.7054, 95% CI 0.5906–0.8202. Conclusions. LAE on TTE can predict LAT detected on TEE in nearly 90% of patients. This demonstrates the utility of LAE on TTE as a potential screening tool for LAT, potentially limiting unneeded costs and complications associated with TEE.

  12. Left Atrial Enlargement on Transthoracic Echocardiography Predicts Left Atrial Thrombus on Transesophageal Echocardiography in Ischemic Stroke Patients.

    Science.gov (United States)

    Anaissie, James; Monlezun, Dominique; Seelochan, A; Siegler, James E; Chavez-Keatts, Maria; Tiu, Jonathan; Pineda, Denise; George, Alexander; Shaban, Amir; Abi Rafeh, Nidal; Schluter, Laurie; Martin-Schild, Sheryl; El Khoury, Ramy

    2016-01-01

    Background. Transesophageal echocardiogram (TEE) is superior to transthoracic echocardiogram (TTE) in detecting left atrial thrombus (LAT), a risk factor for stroke, but is costly and invasive, carrying a higher risk for complications. Aims. To determine the utility of using left atrial enlargement (LAE) on TTE to predict LAT on TEE. Methods. AIS patients who presented in 06/2008-7/2013 and underwent both TTE and TEE were identified from our prospective stroke registry. Analysis consisted of multivariate logistic regression with propensity score adjustment and receiver operating characteristic (ROC) area under the curve (AUC) analyses. Results. 219 AIS patients underwent both TTE and TEE. LAE on TTE was detected in 113 (51.6%) of AIS patients. Patients with LAE on TTE had higher proportion of LAT on TEE (8.4% versus 1.0%, p = 0.018). LAE on TTE predicted increased odds of LAT on TEE (OR = 8.83, 95% CI 1.04-74.83, p = 0.046). The sensitivity and specificity for LAT on TEE by LAE on TEE were 88.89% and 52.20%, respectively (AUC = 0.7054, 95% CI 0.5906-0.8202). Conclusions. LAE on TTE can predict LAT detected on TEE in nearly 90% of patients. This demonstrates the utility of LAE on TTE as a potential screening tool for LAT, potentially limiting unneeded costs and complications associated with TEE.

  13. Grey Matter Changes Associated with Heavy Cannabis Use: A Longitudinal sMRI Study.

    Directory of Open Access Journals (Sweden)

    Laura Koenders

    Full Text Available Cannabis is the most frequently used illicit drug worldwide. Cross-sectional neuroimaging studies suggest that chronic cannabis exposure and the development of cannabis use disorders may affect brain morphology. However, cross-sectional studies cannot make a conclusive distinction between cause and consequence and longitudinal neuroimaging studies are lacking. In this prospective study we investigate whether continued cannabis use and higher levels of cannabis exposure in young adults are associated with grey matter reductions. Heavy cannabis users (N = 20, age baseline M = 20.5, SD = 2.1 and non-cannabis using healthy controls (N = 22, age baseline M = 21.6, SD = 2.45 underwent a comprehensive psychological assessment and a T1- structural MRI scan at baseline and 3 years follow-up. Grey matter volumes (orbitofrontal cortex, anterior cingulate cortex, insula, striatum, thalamus, amygdala, hippocampus and cerebellum were estimated using the software package SPM (VBM-8 module. Continued cannabis use did not have an effect on GM volume change at follow-up. Cross-sectional analyses at baseline and follow-up revealed consistent negative correlations between cannabis related problems and cannabis use (in grams and regional GM volume of the left hippocampus, amygdala and superior temporal gyrus. These results suggests that small GM volumes in the medial temporal lobe are a risk factor for heavy cannabis use or that the effect of cannabis on GM reductions is limited to adolescence with no further damage of continued use after early adulthood. Long-term prospective studies starting in early adolescence are needed to reach final conclusions.

  14. Grey Matter Changes Associated with Heavy Cannabis Use: A Longitudinal sMRI Study

    Science.gov (United States)

    Cousijn, Janna; Vingerhoets, Wilhelmina A. M.; van den Brink, Wim; Wiers, Reinout W.; Meijer, Carin J.; Machielsen, Marise W. J.; Veltman, Dick J.; Goudriaan, Anneke E.; de Haan, Lieuwe

    2016-01-01

    Cannabis is the most frequently used illicit drug worldwide. Cross-sectional neuroimaging studies suggest that chronic cannabis exposure and the development of cannabis use disorders may affect brain morphology. However, cross-sectional studies cannot make a conclusive distinction between cause and consequence and longitudinal neuroimaging studies are lacking. In this prospective study we investigate whether continued cannabis use and higher levels of cannabis exposure in young adults are associated with grey matter reductions. Heavy cannabis users (N = 20, age baseline M = 20.5, SD = 2.1) and non-cannabis using healthy controls (N = 22, age baseline M = 21.6, SD = 2.45) underwent a comprehensive psychological assessment and a T1- structural MRI scan at baseline and 3 years follow-up. Grey matter volumes (orbitofrontal cortex, anterior cingulate cortex, insula, striatum, thalamus, amygdala, hippocampus and cerebellum) were estimated using the software package SPM (VBM-8 module). Continued cannabis use did not have an effect on GM volume change at follow-up. Cross-sectional analyses at baseline and follow-up revealed consistent negative correlations between cannabis related problems and cannabis use (in grams) and regional GM volume of the left hippocampus, amygdala and superior temporal gyrus. These results suggests that small GM volumes in the medial temporal lobe are a risk factor for heavy cannabis use or that the effect of cannabis on GM reductions is limited to adolescence with no further damage of continued use after early adulthood. Long-term prospective studies starting in early adolescence are needed to reach final conclusions. PMID:27224247

  15. Gray matter deficits and altered resting-state connectivity in the superior temporal gyrus among individuals with problematic hypersexual behavior.

    Science.gov (United States)

    Seok, Ji-Woo; Sohn, Jin-Hun

    2018-04-01

    Neuroimaging studies on the characteristics of hypersexual disorder have been accumulating, yet alternations in brain structures and functional connectivity in individuals with problematic hypersexual behavior (PHB) has only recently been studied. This study aimed to investigate gray matter deficits and resting-state abnormalities in individuals with PHB using voxel-based morphometry and resting-state connectivity analysis. Seventeen individuals with PHB and 19 age-matched healthy controls participated in this study. Gray matter volume of the brain and resting-state connectivity were measured using 3T magnetic resonance imaging. Compared to healthy subjects, individuals with PHB had significant reductions in gray matter volume in the left superior temporal gyrus (STG) and right middle temporal gyrus. Individuals with PHB also exhibited a decrease in resting-state functional connectivity between the left STG and left precuneus and between the left STG and right caudate. The gray matter volume of the left STG and its resting-state functional connectivity with the right caudate both showed significant negative correlations with the severity of PHB. The findings suggest that structural deficits and resting-state functional impairments in the left STG might be linked to PHB and provide new insights into the underlying neural mechanisms of PHB. Copyright © 2018 Elsevier B.V. All rights reserved.

  16. Text legibility and the letter superiority effect.

    Science.gov (United States)

    Sheedy, James E; Subbaram, Manoj V; Zimmerman, Aaron B; Hayes, John R

    2005-01-01

    Effects of font design and electronic display parameters upon text legibility were determined using a threshold size method. Participants' visual acuity (inverse of the minimum detection size, representing the threshold legibility for each condition) was measured using upper- and lowercase letters and lowercase words in combinations of 6 fonts, 3 font-smoothing modes, 4 font sizes, 10 pixel heights, and 4 stroke widths. Individual lowercase letters were 10% to 20% more legible than lowercase words (i.e., lowercase words must be 10%-20% larger to have the same threshold legibility). This letter superiority effect suggests that individual letters play a large role and word shape plays a smaller role, if any, in word identification at threshold. Pixel height, font, stroke width, and font smoothing had significant main effects on threshold legibility. Optimal legibility was attained at 9 pixels (10 points). Verdana and Arial were the most legible fonts; Times New Roman and Franklin were least legible. Subpixel rendering (ClearType) improved threshold legibility for some fonts and, in combination with Verdana, was the most legible condition. Increased stroke width (bold) improved threshold legibility but only at the thinnest width tested. Potential applications of this research include optimization of font design for legibility and readability.

  17. Superior wear resistance of aggregated diamond nanorods.

    Science.gov (United States)

    Dubrovinskaia, Natalia; Dub, Sergey; Dubrovinsky, Leonid

    2006-04-01

    The hardness of single-crystal diamond is superior to all other known materials, but its performance as a superabrasive is limited because of its low wear resistance. This is the consequence of diamond's low thermal stability (it graphitizes at elevated temperature), low fracture toughness (it tends to cleave preferentially along the octahedral (111) crystal plains), and large directional effect in polishing (some directions appear to be "soft", i.e., easy to abrade, because diamond is anisotropic in many of its physical properties). Here we report the results of measurements of mechanical properties (hardness, fracture toughness, and Young's modulus) of aggregated diamond nanorods (ADNRs) synthesized as a bulk sample. Our investigation has shown that this nanocrystalline material has the fracture toughness 11.1 +/- 1.2 MPa.m(0.5), which exceeds that of natural and synthetic diamond (that varies from 3.4 to 5.0 MPa.m(0.5)) by 2-3 times. At the same time, having a hardness and Young's modulus comparable to that of natural diamond and suppressed because of the random orientation of nanorods "soft" directions, ADNR samples show the enhancement of wear resistance up to 300% in comparison with commercially available polycrystalline diamonds (PCDs). This makes ADNRs extremely prospective materials for applications as superabrasives.

  18. Lake Superior Coastal Wetland Fish Assemblages and ...

    Science.gov (United States)

    The role of the coastal margin and the watershed context in defining the ecology of even very large lakes is increasingly being recognized and examined. Coastal wetlands are both important contributors to the biodiversity and productivity of large lakes and important mediators of the lake-basin connection. We explored wetland-watershed connections and their relationship to wetland function and condition using data collected from 37 Lake Superior wetlands spanning a substantial geographic and geomorphic gradient. While none of these wetlands are particularly disturbed, there were nevertheless clear relationships between watershed landuse and wetland habitat and biota, and these varied consistently across wetland type categories that reflected the strength of connection to the watershed. For example, water clarity and vegetation structure complexity declined with decreasing percent natural land cover, and these effects were strongest in riverine wetlands (having generally large watersheds and tributary-dominated hydrology) and weakest in lagoon wetlands (having generally small watersheds and lake-dominate hydrology). Fish abundance and species richness both increased with decreasing percent natural land cover while species diversity decreased, and again the effect was strongest in riverine wetlands. Lagoonal wetlands, which lack any substantial tributary, consistently harbored the fewest species of fish and a composition different from the more watershed-lin

  19. Superior mesenteric vein thrombosis: a case report; Trombose da veia mesenterica superior: relato de um caso

    Energy Technology Data Exchange (ETDEWEB)

    Costa Praxedes, Marcia da; Malheiros, Noemia Reis; Machado, Dianne Melo; Carvalho, Ana Alice Vidal de [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia; Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia]|[Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina; Santos, Alair Augusto S.M. [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Inst. Biomedico

    1995-09-01

    A case of superior mesenteric mesenteric vein thrombosis diagnosed by computed tomography in 29 year-old man with abdominal pain, without any predisposing pathologic disorders is reported. This patient had a chronic evolution, had not resulting in mesenteric infarction. He was treated conservatively with anticoagulant therapy and recanalization of the involved vessels was demonstrated by another computed tomography. The patient is asymptomatic now. (author). 8 refs., 3 figs.

  20. Masked bilateral superior oblique muscle paresis. A simple overcorrection phenomenon?

    Science.gov (United States)

    Ellis, F J; Stein, L A; Guyton, D L

    1998-03-01

    This study aimed to determine a mechanism by which the masked bilateral superior oblique muscle paresis phenomenon may be explained. A retrospective study of the authors' patients with the preoperative diagnosis of a unilateral superior oblique muscle paresis was performed. Patients in whom an apparent contralateral superior oblique muscle paresis developed after surgery (masked bilateral superior oblique muscle paresis) were compared with those patients in whom this condition did not develop. One hundred eight patients participated. Of the 108 patients studied, 30 (27.7%) patients had signs of an apparent superior oblique muscle paresis develop in the contralateral eye after surgery. In comparing those patients in whom an apparent contralateral superior oblique muscle paresis did develop after surgery with those patients in whom this finding did not develop, no significant differences were found in the age at surgery; etiology (traumatic vs. nontraumatic); average hyperdeviations in primary gaze, ipsilateral and contralateral gazes, and ipsilateral and contralateral head tilts; average V pattern; inferior and superior oblique muscle function; extorsion on double Maddox rod testing; and objective fundus extorsion. Analysis of the authors' data showed that a surgical overcorrection of a unilateral superior oblique muscle paresis can masquerade as an apparent contralateral superior oblique muscle paresis. This is caused by a persistence of the head tilt and side gaze misalignment pattern from the original superior oblique muscle paresis.

  1. Elements of the Modern Left-Wing European Politics into the Horizon of the European Union’s Construction

    Directory of Open Access Journals (Sweden)

    Flavia-Tania Stefan

    2014-12-01

    Full Text Available This paper is about the importance of modern left-wing European politics in the process of construction of European Union. In our paper, we have tried to discern the main elements of the contemporary European left-wing, focusing on that which may currently be considered the essence of the offer of the left-wing political parties: the European societal model. The European societal model lies at the heart of most European, but also Transatlantic, intellectual debates. It is an ongoing process, which is still quite far from the final agreement stage. The European Socialists (Social- Democrats claim the avant-garde of the construction and modernization of the European societal model. This model constitutes an important political and even ideological bet – in a global context – for the European left-wing. Political, as the left-wing desires to prove the superiority of their pan- European views in relation to the Neo-liberals and the non-Conservatives who either oppose integration or promote incoherent projects. Ideological in a global context, as the European left-wing desires to prove the superiority of the European societal model/European model of life over the North American one, symbol of the neo-liberal mundialization.

  2. Electrocorticography of Spatial Shifting and Attentional Selection in Human Superior Parietal Cortex

    Directory of Open Access Journals (Sweden)

    Maarten Schrooten

    2017-05-01

    Full Text Available Spatial-attentional reorienting and selection between competing stimuli are two distinct attentional processes of clinical and fundamental relevance. In the past, reorienting has been mainly associated with inferior parietal cortex. In a patient with a subdural grid covering the upper and lower bank of the left anterior and middle intraparietal sulcus (IPS and the superior parietal lobule (SPL, we examined the involvement of superior parietal cortex using a hybrid spatial cueing paradigm identical to that previously applied in stroke and in healthy controls. In SPL, as early as 164 ms following target onset, an invalidly compared to a validly cued target elicited a positive event-related potential (ERP and an increase in intertrial coherence (ITC in the theta band, regardless of the direction of attention. From around 400–650 ms, functional connectivity [weighted phase lag index (wPLI analysis] between SPL and IPS briefly inverted such that SPL activity was driving IPS activity. In contrast, the presence of a competing distracter elicited a robust change mainly in IPS from 300 to 600 ms. Within superior parietal cortex reorienting of attention is associated with a distinct and early electrophysiological response in SPL while attentional selection is indexed by a relatively late electrophysiological response in the IPS. The long latency suggests a role of IPS in working memory or cognitive control rather than early selection.

  3. Social aspects of left-handedness

    Directory of Open Access Journals (Sweden)

    Belojević Goran

    2010-01-01

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

  4. Longitudinal and Seasonal Variation of Lunar tide strength

    Science.gov (United States)

    Yizengaw, E.; Pacheco, E. E.; Valladares, C. E.

    2012-12-01

    It has been known since many decades that lunar tide, which manifests itself as a semi-diurnal wave that precesses through all local times within one lunar month, has been identified as a significant force that can produce a notable influence on the longitudinal equatorial density distribution and equatorial electrojet (EEJ). However, there has never been a comprehensive study, except some statistical analysis using the satellite based in-situ observations, of the lunar tide effect on a global scale. This left several questions, like the longitudinal and solar flux dependence of the lunar tide, the tidal wave strength difference between new and full moon phases, remained unanswered. The proximity of the Earth/Moon system to the Sun, proximity of a New/Full Moon to one of the nodes of the lunar orbit, and the proximity of a New/Full Moon to the perigee of the lunar orbit are among the main factors that can affect the seasonal variability of lunar tide strength. With the indications of lunar tide influence on the strength of dayside EEJ, enhancing EEJ's strength shortly after new and full moon, we utilize the ground-based magnetometer fourteen years (1998 - 2012) data and investigate the various aspects of lunar tide effects on the EEJ at three different longitudinal sectors. The equatorial magnetometers located at Jicamarca for American sector, Addis Ababa for African sector, and Tirunelveli for Indian sector are used for this comprehensive study. Simultaneously, using the GPS TEC data, we examined the lunar tide impacts on the equatorial density irregularities and bubble formations at different longitudinal sectors. We found surprising strong longitudinal dependence in the lunar tide strength and its influence on EEJ and density bubble formation. Significant solar flux and seasonal dependences in lunar tide strength have also been observed at all longitudinal sectors. Finally, we investigated the lunar tide strength difference between new moon and full moon phases.

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

    Science.gov (United States)

    de Micheli, A; Medrano, G A

    1979-01-01

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

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

    Science.gov (United States)

    Paik, Peter; Arukala, Sanjay K

    2018-01-01

    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. PMID:29541565

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

    Science.gov (United States)

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

    2013-12-10

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

  8. Corporate Foresight and its Impact on Firm Performance: A Longitudinal Analysis

    DEFF Research Database (Denmark)

    Rohrbeck, René; Kum, Menes Etingue

    2018-01-01

    Corporate foresight is applied with the expectation that it will help firms to break away from path dependency, help decision makers to define superior courses of action, and ultimately enable superior firm performance. To empirically test this assumption, we developed a model that judges a firm......’s future preparedness (FP) by assessing the need for corporate foresight (CF) and comparing it to the maturity of its CF practices. We apply a longitudinal research design in which we measure future preparedness in 2008 and its impact on firm performance in 2015. The results indicated future preparedness...... to be a powerful predictor for becoming an outperformer in the industry, for attaining superior profitability, and for gaining superior market capitalization growth. In the article, we also calculate the average bonus/discount that can be expected by sufficiently/insufficiently future-prepared firms....

  9. A superior mesenteric vein thrombosis associated with in vitro fertilization.

    Science.gov (United States)

    Dorais, Jessie; Jones, Kirtly; Hammoud, Ahmad; Gibson, Mark; Johnstone, Erica; Peterson, C Matthew

    2011-02-01

    To describe a case of superior mesenteric vein thrombosis associated with IVF. Case report. University teaching hospital. A 33-year-old female developed progressive abdominal pain several days after ET in her first IVF cycle. A computed tomography scan 12 days after ET showed a superior mesenteric vein thrombosis. Therapeutic anticoagulation. Resolution of the superior mesenteric vein thrombosis with therapeutic anticoagulation. Early diagnosis and treatment of a superior mesenteric vein thrombosis associated with IVF led to a favorable outcome. Endocrine alterations consequent to controlled ovarian hyperstimulation for IVF place patients at risk for thromboembolic events. Thromboembolic events may occur during an IVF cycle in the absence of overt ovarian hyperstimulation, an inherited thrombophilia, or pregnancy. Early diagnosis and treatment of superior mesenteric vein thrombosis can lead to a favorable outcome. Treatment guidelines for superior mesenteric vein thrombosis in setting of IVF are discussed. Published by Elsevier Inc.

  10. Physiological models of the lateral superior olive.

    Directory of Open Access Journals (Sweden)

    Go Ashida

    2017-12-01

    Full Text Available In computational biology, modeling is a fundamental tool for formulating, analyzing and predicting complex phenomena. Most neuron models, however, are designed to reproduce certain small sets of empirical data. Hence their outcome is usually not compatible or comparable with other models or datasets, making it unclear how widely applicable such models are. In this study, we investigate these aspects of modeling, namely credibility and generalizability, with a specific focus on auditory neurons involved in the localization of sound sources. The primary cues for binaural sound localization are comprised of interaural time and level differences (ITD/ILD, which are the timing and intensity differences of the sound waves arriving at the two ears. The lateral superior olive (LSO in the auditory brainstem is one of the locations where such acoustic information is first computed. An LSO neuron receives temporally structured excitatory and inhibitory synaptic inputs that are driven by ipsi- and contralateral sound stimuli, respectively, and changes its spike rate according to binaural acoustic differences. Here we examine seven contemporary models of LSO neurons with different levels of biophysical complexity, from predominantly functional ones ('shot-noise' models to those with more detailed physiological components (variations of integrate-and-fire and Hodgkin-Huxley-type. These models, calibrated to reproduce known monaural and binaural characteristics of LSO, generate largely similar results to each other in simulating ITD and ILD coding. Our comparisons of physiological detail, computational efficiency, predictive performances, and further expandability of the models demonstrate (1 that the simplistic, functional LSO models are suitable for applications where low computational costs and mathematical transparency are needed, (2 that more complex models with detailed membrane potential dynamics are necessary for simulation studies where sub

  11. The Business Value of Superior Energy Performance

    Energy Technology Data Exchange (ETDEWEB)

    McKane, Aimee; Scheihing, Paul; Evans, Tracy; Glatt, Sandy; Meffert, William

    2015-08-04

    Industrial facilities participating in the U.S. Department of Energy’s (US DOE) Superior Energy Performance (SEP) program are finding that it provides them with significant business value. This value starts with the implementation of ISO 50001-Energy management system standard, which provides an internationally-relevant framework for integration of energy management into an organization’s business processes. The resulting structure emphasizes effective use of available data and supports continual improvement of energy performance. International relevance is particularly important for companies with a global presence or trading interests, providing them with access to supporting ISO standards and a growing body of certified companies representing the collective knowledge of communities of practice. This paper examines the business value of SEP, a voluntary program that builds on ISO 50001, inviting industry to demonstrate an even greater commitment through third-party verification of energy performance improvement to a specified level of achievement. Information from 28 facilities that have already achieved SEP certification will illustrate key findings concerning both the value and the challenges from SEP/ISO 50001 implementation. These include the facilities’ experience with implementation, internal and external value of third-party verification of energy performance improvement; attractive payback periods and the importance of SEP tools and guidance. US DOE is working to bring the program to scale, including the Enterprise-Wide Accelerator (SEP for multiple facilities in a company), the Ratepayer-Funded Program Accelerator (supporting tools for utilities and program administrators to include SEP in their program offerings), and expansion of the program to other sectors and industry supply chains.

  12. Auditory attention enhances processing of positive and negative words in inferior and superior prefrontal cortex.

    Science.gov (United States)

    Wegrzyn, Martin; Herbert, Cornelia; Ethofer, Thomas; Flaisch, Tobias; Kissler, Johanna

    2017-11-01

    Visually presented emotional words are processed preferentially and effects of emotional content are similar to those of explicit attention deployment in that both amplify visual processing. However, auditory processing of emotional words is less well characterized and interactions between emotional content and task-induced attention have not been fully understood. Here, we investigate auditory processing of emotional words, focussing on how auditory attention to positive and negative words impacts their cerebral processing. A Functional magnetic resonance imaging (fMRI) study manipulating word valence and attention allocation was performed. Participants heard negative, positive and neutral words to which they either listened passively or attended by counting negative or positive words, respectively. Regardless of valence, active processing compared to passive listening increased activity in primary auditory cortex, left intraparietal sulcus, and right superior frontal gyrus (SFG). The attended valence elicited stronger activity in left inferior frontal gyrus (IFG) and left SFG, in line with these regions' role in semantic retrieval and evaluative processing. No evidence for valence-specific attentional modulation in auditory regions or distinct valence-specific regional activations (i.e., negative > positive or positive > negative) was obtained. Thus, allocation of auditory attention to positive and negative words can substantially increase their processing in higher-order language and evaluative brain areas without modulating early stages of auditory processing. Inferior and superior frontal brain structures mediate interactions between emotional content, attention, and working memory when prosodically neutral speech is processed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Longitudinal Research with Latent Variables

    CERN Document Server

    van Montfort, Kees; Satorra, Albert

    2010-01-01

    This book combines longitudinal research and latent variable research, i.e. it explains how longitudinal studies with objectives formulated in terms of latent variables should be carried out, with an emphasis on detailing how the methods are applied. Because longitudinal research with latent variables currently utilizes different approaches with different histories, different types of research questions, and different computer programs to perform the analysis, the book is divided into nine chapters. Starting from some background information about the specific approach, short history and the ma

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

    Science.gov (United States)

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

    2017-07-01

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

  15. Tendencias mundiales que afectan la educación superior.

    Directory of Open Access Journals (Sweden)

    Orlando Salinas Gómez

    2010-05-01

    Full Text Available La globalización y la creciente importancia de la sociedad del conocimiento son, hoy día, factores primordiales en el contexto mundial de la educación superior. Su impacto en las instituciones de educación superior es tal que las ha forzado a cambiar su rumbo, para determinar sus oportunidades y amenazas. Como consecuencia, el presente ensayo plantea la discusión actual sobre las tendencias mundiales que afectan la educación superior y sus efectos en el direccionamiento de las instituciones de educación superior colombianas.

  16. Superior Mesenteric Artery Syndrome: An Infrequent Complication of Scoliosis Surgery

    Directory of Open Access Journals (Sweden)

    Metin Keskin

    2014-01-01

    Full Text Available Superior mesenteric artery syndrome is a rare condition that causes a proximal small intestinal obstruction due to contraction of the angle between the superior mesenteric artery and the aorta. Scoliosis surgery is one of the 15 reasons for superior mesenteric artery syndrome, which can present with acute or chronic manifestations. Although conservative treatment is usually possible, surgical treatment is required in certain cases that cannot be treated using conservative methods. In this paper, we describe a patient who developed superior mesenteric artery syndrome after scoliosis surgery and was treated with duodenojejunostomy due to failure and complications of conservative treatment.

  17. Information Superiority: Outsourcing an Air Force Core Competency?

    National Research Council Canada - National Science Library

    McTerman, Hugh

    1997-01-01

    .... This thesis explores the perceived relationship between the core competency requirements for information superiority and the tasks defined for the Air Force communication, computer, and information career field...

  18. Involvement of the dorsolateral prefrontal cortex and superior temporal sulcus in impaired social perception in schizophrenia.

    Science.gov (United States)

    Shin, Jung Eun; Choi, Soo-Hee; Lee, Hyeongrae; Shin, Young Seok; Jang, Dong-Pyo; Kim, Jae-Jin

    2015-04-03

    Schizophrenia is a mental disorder characterized by impairments in diverse thinking and emotional responses, which are related to social perception dysfunction. This fMRI study was designed to investigate a neurobiological basis of social perception deficits of patients with schizophrenia in various social situations of daily life and their relationship with clinical symptoms and social dysfunction. Seventeen patients and 19 controls underwent functional magnetic resonance imaging, during which participants performed a virtual social perception task, containing an avatar's speech with positive, negative or neutral emotion in a virtual reality space. Participants were asked to determine whether or not the avatar's speech was appropriate to each situation. The significant group×appropriateness interaction was seen in the left dorsolateral prefrontal cortex (DLPFC), resulting from lower activity in patients in the inappropriate condition, and left DLPFC activity was negatively correlated with the severity of negative symptoms and positively correlated with the level of social functioning. The significant appropriateness×emotion interaction observed in the left superior temporal sulcus (STS) was present in controls, but absent in patients, resulting from the existence and absence of a difference between the inappropriate positive and negative conditions, respectively. These findings indicate that dysfunction of the DLPFC-STS network may underlie patients' abnormal social perception in various social situations of daily life. Abnormal functioning of this network may contribute to increases of negative symptoms and decreases of social functioning. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Beware the left-sided gallbladder

    African Journals Online (AJOL)

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

  20. 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)

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

    African Journals Online (AJOL)

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

  2. Normal left ventricular mechanics by two-dimensional speckle-tracking echocardiography. Reference values in healthy adults.

    Science.gov (United States)

    Kocabay, Gonenc; Muraru, Denisa; Peluso, Diletta; Cucchini, Umberto; Mihaila, Sorina; Padayattil-Jose, Seena; Gentian, Denas; Iliceto, Sabino; Vinereanu, Dragos; Badano, Luigi P

    2014-08-01

    Two-dimensional speckle-tracking echocardiography is a novel tool to assess myocardial function. The purpose of this study was to evaluate left ventricular myocardial strain and rotation parameters by two-dimensional speckle-tracking echocardiography in a large group of healthy adults across a wide age range to establish their reference values and to assess the influence of age, sex, and hemodynamic factors. Transthoracic echocardiograms were acquired in 247 healthy volunteers (139 women, 44 years [standard deviation, 16 years old] (range, 18-80 years). We measured longitudinal, circumferential, and radial peak systolic strain values, and left ventricular rotation and twist. Average values of global longitudinal, radial, and circumferential strain were -21.5% (standard deviation, 2.0%), 40.1% (standard deviation, 11.8%) and -22.2% (standard deviation, 3.4%), respectively. Longitudinal strain was significantly more negative in women, whereas radial and circumferential strain and rotational parameters were similar in both sexes. Accordingly, lower limits of normality for the strain components were -16.9% in men and -18.5% in women for longitudinal strain, and -15.4% for circumferential and 24.6% for radial strain, irrespective of sex. Longitudinal strain values were more negative at the base than at apical segments. Mean rotational values were -6.9° (standard deviation, 3.5°) for the base, 13.0° (standard deviation, 6.5°) for apical rotation, and 20.0° (standard deviation, 7.3°) for net twist. We report the comprehensive assessment of normal myocardial deformation and rotational mechanics in a large cohort of healthy volunteers. We found that women have more negative longitudinal strain, accounting for their higher left ventricular ejection fraction. Availability of reference values for these parameters may foster their implementation in the clinical routine. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  3. Neural evidence for the use of digit-image mnemonic in a superior memorist: an fMRI study.

    Science.gov (United States)

    Yin, Li-Jun; Lou, Yu-Ting; Fan, Ming-Xia; Wang, Zhao-Xin; Hu, Yi

    2015-01-01

    Some superior memorists demonstrated exceptional memory for reciting a large body of information. The underlying neural correlates, however, are seldom addressed. C.L., the current holder of Guinness World Record for reciting 67,890 digits in π, participated in this functional magnetic resonance imaging (fMRI) study. Thirteen participants without any mnemonics training were included as controls. Our previous studies suggested that C.L. used a digit-image mnemonic in studying and recalling lists of digits, namely associating 2-digit groups of "00" to "99" with images and generating vivid stories out of them (Hu et al., 2009). Thus, 2-digit condition was included, with 1-digit numbers and letters as control conditions. We hypothesized that 2-digit condition in C.L. should elicit the strongest activity in the brain regions which are associated with his mnemonic. Functional MRI results revealed that bilateral frontal poles (FPs, BA10), left superior parietal lobule (SPL), left premotor cortex (PMC), and left dorsolateral prefrontal cortex (DLPFC), were more engaged in both the study and recall phase of 2-digit condition for C.L. relative to controls. Moreover, the left middle/inferior frontal gyri (M/IFG) and intraparietal sulci (IPS) were less engaged in the study phase of 2-digit condition for C.L. (vs. controls). These results suggested that C.L. relied more on brain regions that are associated with episodic memory other than verbal rehearsal while he used his mnemonic strategies. This study supported theoretical accounts of restructured cognitive mechanisms for the acquisition of superior memory performance.

  4. Neural evidence for the use of digit-image mnemonic in a superior memorist: An fMRI study

    Directory of Open Access Journals (Sweden)

    Li-Jun eYin

    2015-03-01

    Full Text Available Some superior memorists demonstrated exceptional memory for reciting a large body of information. The underlying neural correlates, however, are seldom addressed. C.L., the current holder of Guinness World Record for reciting 67,890 digits in π, participated in this functional magnetic resonance imaging (fMRI study. Thirteen participants without any mnemonics training were included as controls. Our previous studies suggested that C.L. used a digit-image mnemonic in studying and recalling lists of digits, namely associating 2-digit groups of ‘00’ to ‘99’ with images and generating vivid stories out of them (Hu, Ericsson, Yang & Lu, 2009. Thus, 2-digit condition was included, with 1-digit numbers and letters as control conditions. We hypothesized that 2-digit condition in C.L. should elicit the strongest activity in the brain regions which are associated with his mnemonic. Functional MRI results revealed that bilateral frontal poles (FPs, BA10, left superior parietal lobule (SPL, left premotor cortex (PMC, and left dorsolateral prefrontal cortex (DLPFC, were more engaged in both the study and recall phase of 2-digit condition for C.L. relative to controls. Moreover, the left middle/inferior frontal gyri (M/IFG and intraparietal sulci (IPS were less engaged in the study phase of 2-digit condition for C.L. (vs. controls. These results suggested that C.L. relied more on brain regions that are associated with episodic memory other than verbal rehearsal while he used his mnemonic strategies. This study supported theoretical accounts of restructured cognitive mechanisms for the acquisition of superior memory performance.

  5. Neural evidence for the use of digit-image mnemonic in a superior memorist: an fMRI study

    Science.gov (United States)

    Yin, Li-Jun; Lou, Yu-Ting; Fan, Ming-Xia; Wang, Zhao-Xin; Hu, Yi

    2015-01-01

    Some superior memorists demonstrated exceptional memory for reciting a large body of information. The underlying neural correlates, however, are seldom addressed. C.L., the current holder of Guinness World Record for reciting 67,890 digits in π, participated in this functional magnetic resonance imaging (fMRI) study. Thirteen participants without any mnemonics training were included as controls. Our previous studies suggested that C.L. used a digit-image mnemonic in studying and recalling lists of digits, namely associating 2-digit groups of “00” to “99” with images and generating vivid stories out of them (Hu et al., 2009). Thus, 2-digit condition was included, with 1-digit numbers and letters as control conditions. We hypothesized that 2-digit condition in C.L. should elicit the strongest activity in the brain regions which are associated with his mnemonic. Functional MRI results revealed that bilateral frontal poles (FPs, BA10), left superior parietal lobule (SPL), left premotor cortex (PMC), and left dorsolateral prefrontal cortex (DLPFC), were more engaged in both the study and recall phase of 2-digit condition for C.L. relative to controls. Moreover, the left middle/inferior frontal gyri (M/IFG) and intraparietal sulci (IPS) were less engaged in the study phase of 2-digit condition for C.L. (vs. controls). These results suggested that C.L. relied more on brain regions that are associated with episodic memory other than verbal rehearsal while he used his mnemonic strategies. This study supported theoretical accounts of restructured cognitive mechanisms for the acquisition of superior memory performance. PMID:25798098

  6. No Child Left Inside Week: Pilot Program

    OpenAIRE

    Clark, Jamie C.

    2013-01-01

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

  7. Radiation therapy for superior vena cava syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Hee [Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2005-06-15

    We studied the effect of such variables as the symptom improvement rate, survival and prognostic factors on the treatment results of radiation therapy for Superior Vena Cava Syndrome (SVCS). From 1988 to 2003, seventy two patients with SVCS were treated with radiation therapy at the Department of Radiation Oncology, Keimyung University Dongsan Medical Center. The patients' ages ranged from 10 to 83 years old with the median age being 61, and sixty four patients were male. For the causes of the SVCS, 64 patients had lung cancer, four had metastatic lung cancer, two had malignant lymphoma and two had thymoma. The radiotherapy was delivered with 6-MV X-ray and all patients received above 900 cGy up to 6,600 cGy, with the median dose being 4,000 cGy. The follow-up periods were from 1 to 180 months with a median of 5.6 months. The main clinical manifestations were dyspnea (84.7%), facial edema (81.9%), arm edema (22.2%), neck vein distension (25%), hoarseness (12.5%) and facial plethora (5.6%). Eighty percent of patients achieved excellent to good symptom improvement and 19.4% experienced minimal improvement. The median survival period was 5.1 months, and overall survival rates were 17.7% at 2 years (2YOS) and 14.8% at five years (5YOS) for all the patients. The median survival period, the two and five year disease free survival rates were 4.3 months, 16.7% and 13.4% for the lung cancer patients, respectively. The total tumor dose was a statistically significant survival factor on the univariate analysis for the patients with lung cancer (2YSR; > 30 Gy, 25.6%, {<=} 30 Gy 6.7%, {rho} < 0.01). On the multivariated analysis, a higher total tumor dose ({rho} < 0.01) and younger age ({rho} < 0.05) were statistically significant factors of survival for the lung cancer patients. Patients with NSCLC showed better survival than did the patients with SCLC, but this was not statistically significant ({rho} > 0.05). Radiation therapy for the patients with SVCS due to

  8. [Catheter in the superior vena cava for hemodialysis as a last resort in superior hemithorax].

    Science.gov (United States)

    Restrepo Valencia, C A; Buritica Barragán, C M; Arango, A

    2010-01-01

    We report four patients with chronic kidney disease undergoing haemodialysis therapy, which had exhausted conventional venous access (internal jugular, subclavian) and non-conventional access (axillary, innominate) in the upper hemithorax for haemodialysis. This was primarily due to thrombosis of these veins caused by previous catheterisation. These patients did not qualify for peritoneal dialysis. Using the technique recommended by Archundia et al., 4 indwelling catheters were implanted directly in the superior vena cava in each of the patients with subsequent subcutaneous tunneling. The catheters operated correctly and are currently permeable after being used for an average of 19 months.

  9. Quasielastic Scattering from Relativistic Bound Nucleons: Transverse-Longitudinal Response

    Energy Technology Data Exchange (ETDEWEB)

    Udias, J. M. [Instituto de Estructura de la Materia, CSIC Serrano 123, E-28006 Madrid, (Spain); Departamento de Fisica Atomica, Molecular y Nuclear, Universidad Complutense de Madrid, E-28040 Madrid, (Spain); Caballero, J. A. [Instituto de Estructura de la Materia, CSIC Serrano 123, E-28006 Madrid, (Spain); Departamento de Fisica Atomica, Molecular y Nuclear, Universidad de Sevilla, E-41080 Sevilla, (Spain); Moya de Guerra, E. [Instituto de Estructura de la Materia, CSIC Serrano 123, E-28006 Madrid, (Spain); Amaro, J. E. [Departamento de Fisica Moderna, Universidad de Granada, E-18071 Granada, (Spain); Donnelly, T. W. [Center for Theoretical Physics, Laboratory for Nuclear Science and Department of Physics, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139 (United States)

    1999-12-27

    Predictions for electron induced proton knockout from p{sub 1/2} and p{sub 3/2} shells in {sup 16}O are presented using various approximations for the relativistic nucleonic current. Results for differential cross section, transverse-longitudinal response (R{sub TL} ), and left-right asymmetry A{sub TL} are compared at |Q{sup 2}|=0.8(GeV/c){sup 2} . We show that there are important dynamical and kinematical relativistic effects which can be tested by experiment. (c) 1999 The American Physical Society.

  10. Pediatric Acute Longitudinal Extensive Transverse Myelitis Secondary to Neuroborreliosis

    Directory of Open Access Journals (Sweden)

    Sana Khan

    2015-07-01

    Full Text Available Lyme neuroborreliosis has several different clinical manifestations in children, of which facial nerve palsies, meningitis and radiculopathies are the most common. Transverse myelitis (TM secondary to Lyme disease has been reported in rare occasions, typically presenting with severe weakness, sensory abnormalities and autonomic dysfunction. We present the case of a 16-year-old male who developed acute left peripheral facial palsy and longitudinal extensive TM secondary to Lyme disease. Remarkably, the patient reported only mild symptoms with severe back pain in the absence of profound signs of myelopathy. We reviewed the medical literature and analyzed the clinical features of pediatric patients with Borrelia burgdorferi-related TM.

  11. Functional characteristics of developmental dyslexia in left-hemispheric posterior brain regions predate reading onset.

    Science.gov (United States)

    Raschle, Nora Maria; Zuk, Jennifer; Gaab, Nadine

    2012-02-07

    Individuals with developmental dyslexia (DD) show a disruption in posterior left-hemispheric neural networks during phonological processing. Additionally, compensatory mechanisms in children and adults with DD have been located within frontal brain areas. However, it remains unclear when and how differences in posterior left-hemispheric networks manifest and whether compensatory mechanisms have already started to develop in the prereading brain. Here we investigate functional networks during phonological processing in 36 prereading children with a familial risk for DD (n = 18, average age = 66.50 mo) compared with age and IQ-matched controls (n = 18; average age = 65.61 mo). Functional neuroimaging results reveal reduced activation in prereading children with a family-history of DD (FHD(+)), compared with those without (FHD(-)), in bilateral occipitotemporal and left temporoparietal brain regions. This finding corresponds to previously identified hypoactivations in left hemispheric posterior brain regions for school-aged children and adults with a diagnosis of DD. Furthermore, left occipitotemporal and temporoparietal brain activity correlates positively with prereading skills in both groups. Our results suggest that differences in neural correlates of phonological processing in individuals with DD are not a result of reading failure, but are present before literacy acquisition starts. Additionally, no hyperactivation in frontal brain regions was observed, suggesting that compensatory mechanisms for reading failure are not yet present. Future longitudinal studies are needed to determine whether the identified differences may serve as neural premarkers for the early identification of children at risk for DD.

  12. LONGITUDINAL IONIZATION COOLING WITHOUT WEDGES

    International Nuclear Information System (INIS)

    BERG, J.S.

    2001-01-01

    The emittance of a muon beam must be reduced very rapidly due to the finite lifetime of the muons. The most effective known way to accomplish this is ionization cooling. It is straightforward to reduce transverse emittance through ionization cooling, but the reducing the longitudinal emittance is more challenging. Longitudinal cooling is necessary for a muon collider, and would be helpful for a neutrino factory. The method traditionally proposed for longitudinal cooling is emittance exchange involving wedges of absorber material: the longitudinal emittance is reduced at the cost of increased transverse emittance. The larger transverse emittance can then be reduced straightforwardly. An alternative method is proposed here, which does not require wedges of material but instead makes slight modifications to the standard transverse cooling lattice. We demonstrate a lattice which is a slight modification to a standard Super FOFO transverse cooling lattice, which has linear eigenvalues all of which have magnitude less than one

  13. Longitudinal data driven study design.

    Science.gov (United States)

    Hund, Hauke; Gerth, Sven; Lossnitzer, Dirk; Fegeler, Christian

    2014-01-01

    In this paper we present a method for processing EHR data into a longitudinal data model and examples for using this model to identify patients cross-sectionally and longitudinally as well as testing study designs retrospectively. Our data model describes measurements on four dimensions: the associated patient, observed feature, data source and time of survey. The transformation of structured source data into our model is defined by rules written in XML. To showcase the flexibility of the proposed longitudinal data model, we present an evolution of a retrospective study design as well as an example for interpreting biomarkers in emergency situations. With the proposed longitudinal data model complex queries can be performed, study designs tested and optimized.

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

    Science.gov (United States)

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

    2007-11-01

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

  15. Bimanual proprioceptive performance differs for right- and left-handed individuals.

    Science.gov (United States)

    Han, Jia; Waddington, Gordon; Adams, Roger; Anson, Judith

    2013-05-10

    It has been proposed that asymmetry between the upper limbs in the utilization of proprioceptive feedback arises from functional differences in the roles of the preferred and non-preferred hands during bimanual tasks. The present study investigated unimanual and bimanual proprioceptive performance in right- and left-handed young adults with an active finger pinch movement discrimination task. With visual information removed, participants were required to make absolute judgments about the extent of pinch movements made to physical stops, either by one hand, or by both hands concurrently, with the sequence of presented movement extents varied randomly. Discrimination accuracy scores were derived from participants' responses using non-parametric signal detection analysis. Consistent with previous findings, a non-dominant hand/hemisphere superiority effect was observed, where the non-dominant hands of right- and left-handed individuals performed overall significantly better than their dominant hands. For all participants, bimanual movement discrimination scores were significantly lower than scores obtained in the unimanual task. However, the magnitude of the performance reduction, from the unimanual to the bimanual task, was significantly greater for left-handed individuals. The effect whereby bimanual proprioception was disproportionately affected in left-handed individuals could be due to enhanced neural communication between hemispheres in left-handed individuals leading to less distinctive separation of information obtained from the two hands in the cerebral cortex. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  16. Sample size determination for mediation analysis of longitudinal data.

    Science.gov (United States)

    Pan, Haitao; Liu, Suyu; Miao, Danmin; Yuan, Ying

    2018-03-27

    Sample size planning for longitudinal data is crucial when designing mediation studies because sufficient statistical power is not only required in grant applications and peer-reviewed publications, but is essential to reliable research results. However, sample size determination is not straightforward for mediation analysis of longitudinal design. To facilitate planning the sample size for longitudinal mediation studies with a multilevel mediation model, this article provides the sample size required to achieve 80% power by simulations under various sizes of the mediation effect, within-subject correlations and numbers of repeated measures. The sample size calculation is based on three commonly used mediation tests: Sobel's method, distribution of product method and the bootstrap method. Among the three methods of testing the mediation effects, Sobel's method required the largest sample size to achieve 80% power. Bootstrapping and the distribution of the product method performed similarly and were more powerful than Sobel's method, as reflected by the relatively smaller sample sizes. For all three methods, the sample size required to achieve 80% power depended on the value of the ICC (i.e., within-subject correlation). A larger value of ICC typically required a larger sample size to achieve 80% power. Simulation results also illustrated the advantage of the longitudinal study design. The sample size tables for most encountered scenarios in practice have also been published for convenient use. Extensive simulations study showed that the distribution of the product method and bootstrapping method have superior performance to the Sobel's method, but the product method was recommended to use in practice in terms of less computation time load compared to the bootstrapping method. A R package has been developed for the product method of sample size determination in mediation longitudinal study design.

  17. Bayesian semiparametric mixture Tobit models with left censoring, skewness, and covariate measurement errors.

    Science.gov (United States)

    Dagne, Getachew A; Huang, Yangxin

    2013-09-30

    Common problems to many longitudinal HIV/AIDS, cancer, vaccine, and environmental exposure studies are the presence of a lower limit of quantification of an outcome with skewness and time-varying covariates with measurement errors. There has been relatively little work published simultaneously dealing with these features of longitudinal data. In particular, left-censored data falling below a limit of detection may sometimes have a proportion larger than expected under a usually assumed log-normal distribution. In such cases, alternative models, which can account for a high proportion of censored data, should be considered. In this article, we present an extension of the Tobit model that incorporates a mixture of true undetectable observations and those values from a skew-normal distribution for an outcome with possible left censoring and skewness, and covariates with substantial measurement error. To quantify the covariate process, we offer a flexible nonparametric mixed-effects model within the Tobit framework. A Bayesian modeling approach is used to assess the simultaneous impact of left censoring, skewness, and measurement error in covariates on inference. The proposed methods are illustrated using real data from an AIDS clinical study. . Copyright © 2013 John Wiley & Sons, Ltd.

  18. Temporal versus Superior Limbal Incision: Any difference in visual ...

    African Journals Online (AJOL)

    Dr. C. Pedro-Egbe

    Department of Ophthalmology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria. ABSTRACT. Aim: To compare the visual outcome of a superiorly placed limbal incision ..... Roman SJ, Auclin FX, Chong-Sit DA, Ullern MM. Surgically induced astigmatism with superior and temporal incisions in cases of ...

  19. Superior mesenteric artery syndrome: case report | Jani | East ...

    African Journals Online (AJOL)

    Superior Mesenteric Artery Syndrome (SMAS) is caused by trapping of the third part of the duodenum between Superior Mesenteric Artery (SMA) and aorta as result of narrowing of the angle between the two vessels due to acute loss of mesenteric fat which is secondary to rapid weight loss. A fifteen year old caucasian ...

  20. Evaluation and management of superior canal dehiscence syndrome

    NARCIS (Netherlands)

    Niesten, M.E.F.

    2014-01-01

    Superior canal dehiscence (SCD) syndrome is a rare disorder involving the inner ear that was first described by Lloyd Minor in 1998. Patients with SCD syndrome can present with a range of auditory and/or vestibular signs and symptoms that are associated with a bony defect of one or both superior

  1. Superior dislocation hip with anterior column acetabular fracture ...

    African Journals Online (AJOL)

    Superior variety of anterior dislocation of the hip is a rare injury. Its occurrence with acetabular fractures has been documented infrequently. We report a case of superior dislocation of the hip with anterior column acetabular fracture. Open reduction of the hip and internal fixation of the fracture was carried out using a twin ...

  2. Retrograde superior mesenteric artery stenting for acute mesenteric arterial thrombosis.

    Science.gov (United States)

    Do, Natalie; Wisniewski, Paul; Sarmiento, Jose; Vo, Trung; Aka, Paul K; Hsu, Jeffrey H; Tayyarah, Majid

    2010-08-01

    Retrograde superior mesenteric artery stenting (ROMS) represents a significant development in the treatment of acute mesenteric ischemia. Compared to traditional surgical mesenteric bypass, ROMS is a less invasive technique that avoids many complications associated with emergent mesenteric bypass. This case report illustrates that retrograde superior mesenteric artery (SMA) stenting is an option for the treatment of acute mesenteric ischemia for patients in extremis.

  3. Superior sagittal sinus thrombosis: a rare complication of nephrotic syndrome.

    Directory of Open Access Journals (Sweden)

    Tullu M

    1999-10-01

    Full Text Available A two and half year-old-male child, known case of steroid responsive nephrotic syndrome presented with fever and vomiting of acute onset. He was diagnosed to have superior sagittal sinus thrombosis on a contrast computerised tomographic scan of brain. Recovery was complete without anticoagulant therapy. Superior sagittal sinus thrombosis is an extremely rare complication of nephrotic syndrome.

  4. Superior vena cava obstruction caused by radiation induced venous fibrosis

    NARCIS (Netherlands)

    Van Putten, JWG; Schlosser, NJJ; Vujaskovic, Z; Van der Leest, AHD; Groen, HJM

    Superior vena cava syndrome is most often caused by lung carcinoma. Two cases are described in whom venous obstruction in the superior mediastinum was caused by local vascular fibrosis due to radiotherapy five and seven years earlier. The development of radiation injury to greater vessels is

  5. Detection and characterization of left Ventricular Thrombi by MRT compared to Transthoracic Echocardiography

    International Nuclear Information System (INIS)

    Bruder, O.; Jochims, M.; Sabin, G.V.; Waltering, K.U.; Hunhold, P.; Narin, B.; Barkhausen, J.

    2005-01-01

    Purpose: Transthoracic echocardiography is the routine diagnostic procedure in assessing patients with left ventricular thrombi, but is limited by the acoustic window and poor contrast between thrombus and adjacent myocardium. This study evaluates the role of cardiac MRI in the detection of left ventricular thrombi in patients with chronic myocardial infarction compared to standard transthoracic echocardiography. Materials and Methods: In 82 patients (55 men and 27 women, age 36 to 79 years, median 59±11 years) who suffered a myocardial infarction more than 6 months earlier, transthoracic echocardiography and MRI were performed. The MRI protocol included steady state cine imaging (true FISP: TR 3.0 ms, TE 1.5 ms, FA 65 ) in standard long and short axis orientation and contrast-enhanced imaging using a 3D IR-FLASH sequence with long inversion time (TR 4 ms; TE 1.43 ms, FA 10 , TI 300 ms) early, and a 2D IR-FLASH sequence with optimized inversion time (TR 8 ms, TE 4.3 ms, FA 20 , TI 180-280 ms) late after administration of gadolinium. Results: Transthoracic echocardiography depicted 12 thrombi. Contrast-enhanced MRI confirmed these 12 thrombi and detected 23 additional thrombi. With the exception of 2 very small apical thrombi only visible on contrast-enhanced MRI images, spherical thrombi were diagnosed by both techiques, whereas only contrast-enhanced MRI was able to visualize mural thrombi. Left ventricular thrombi were more frequently diagnosed in patients with moderate to severe impairment of the left ventricular systolic function, 32/42 (76%), or in patients with left ventricular aneurysms, 21/24 (84%). Conclusion: Contrast-enhanced MRI is mostly superior to transthoracic echocardiography in diagnosing mural left ventricular thrombi in patients who had suffered a myocardial infarction. Intracavitray thrombi are mor frequently found in patients with impaired regional and global left ventricular function. (orig.)

  6. Morphologic expression of the left coronary artery in pigs. An approach in relation to human heart

    Directory of Open Access Journals (Sweden)

    Fabian Alejandro Gómez

    2014-04-01

    Full Text Available Introduction: In spite of its importance as an experimental model, the information on the left coronary artery in pigs is sparse. Objective: To determine the morphologic features of the left coronary artery in pigs. Methods: We evaluated 158 pig hearts. The left coronary artery was perfused with synthetic resin after their ostia had been catheterized. Diameters and courses of the vascular beds were measured with an electronic caliper (Mitutoyo(r. Results: The diameter of left coronary artery was 6.98 ± 1.56 mm and its length was 3.51±0.99 mm. It was found to end up by bifurcating itself into the anterior interventricular artery and the circumflex artery in 79% of the cases, and by trifurcating in 21% of the cases, with the presence of the diagonal artery. The anterior interventricular artery ended up at the apex in 79.7% of the cases, and the circumflex artery at the posterior aspect of the left ventricle in 64% of the case, this artery never reached the posterior interventricular sulcus. An anastomosis between the terminal branches of the anterior interventricular artery and the posterior interventricular artery was found in 7.6% of the specimens. The antero-superior branch of the anterior interventricular artery occurred in 89.9% of the hearts. A left marginal branch was observed in 87.9% of the cases with a diameter of 2.25±0.55 mm. Conclusion: Compared with humans, pigs have shorter left coronary artery trunks and branches; even the circumflex artery never reaches the posterior interventricular sulcus. Our findings are useful for the design of experimental hemodynamic and procedural models.

  7. LEFT ATRIAL FUNCTION: MODERN ASSESSMENT METHODS AND CLINICAL SIGNIFICANCE

    Directory of Open Access Journals (Sweden)

    E. N. Pavlyukova

    2017-01-01

    Full Text Available Assessment of the left atrial (LA function is important aspect of comprehensive cardiovascular system estimation. Many cardiac diseases make an impact to LA work either by direct affect on myocardium or hemodynamic condition changing. It is considered, LA and left ventricle diastolic pressure is interrelated, thus without mitral valve disease LA expanding is a sign of LV filling pressure augmentation. Examination of LA size and function by analysis of atrial reservoir, conduit, and booster pump can predict cardiovascular outcomes in patients with cardiomyopathy, ischemic heart disease and valvular heart disease. The last two decades gave new technologies to accurate and comprehensive LA mechanics estimation, in the first place related to tissue Doppler imaging. Atrial strain and strain rate obtained using two-dimensional speckle-tracking echocardiography have proved to be feasible and reproducible techniques to evaluate LA mechanics.In physiological settings, LA is a highly expandable chamber with relatively low pressures. However in the presence of acute and chronic injury, LA wall stretches. LA stretching is a hallmark of structure changing with myocardial fibrosis and has influence on LA strain and strain rate. LA strain estimation could be useful in the prediction of sinus rhythm restoration and maintenance after cardioversion and catheter ablation. Low values of global longitudinal LA strain indicate irreversible LA remodeling and are related to the atrial fibrillation progression from paroxysmal to permanent forms. The most interesting in these circumstances is the potential contribution of echocardiography to thromboembolic risk stratification in atrial fibrillation and invasive procedures such as atrial ablation. Therefore, at present, the main task is to understand the ways of clinical application of data  obtained during the LA study.

  8. ASSESSMENT OF LEFT VENTRICULAR FUNCTION USING TISSUE DOPPLER IMAGING

    Directory of Open Access Journals (Sweden)

    Martin Tretjak

    2004-09-01

    Full Text Available Background. Objective evidence of cardiac dysfunction is one of the diagnostic criteria for heart failure. It is often hard to assess systolic function and assessing diastolic dysfunction is even harder because there are no generally accepted echocardiographic criteria. Tissue Doppler imaging (TDI enables analysis of the mitral annular descent velocity for detection of left ventricular diastolic dysfunction along the longitudinal axis.Methods. 30 patients with heart failure and 30 healthy participants were enrolled in the study. Pulsed wave tissue Doppler imaging velocities of septal and lateral mitral annulus borders were recorded in systole (Sm and early diastole (Em. Velocities in both groups were compared. The correlations between Sm velocity and LVEF and Em velocity and age were studied.Results. Patients with heart failure had significantly decreased Sm and Em velocities compared with healthy participants (5.3 ± 1.6 cm/s vs. 8.4 ± 1 cm/s, P < 0.001, for Sm velocity and 5 ± 1.4 cm/s vs. 8.7 ± 1.6 cm/s, P < 0.001, for Em velocity. The correlation between Sm velocity and LVEF in all participants was very good and highly significant (r = 0.91, P < 0.001. The Sm velocity ≥ 6.4 cm/s was 91% sensitive and 95% specific for LVEF ≥ 0.45. There was a good correlation between age and Em velocity (r = -0.84, P < 0.001. The Em velocity < 7 cm/s had a sensitivity of 90% and specificity of 97% for diagnosing heart failure.Conclusions. Pulsed wave tissue Doppler imaging of mitral annulus enables simple, fast and precise assessment of systolic and diastolic left ventricular function. It can replace some other more time consuming echocardiographic measurements.

  9. Impact of reading habit on white matter structure: Cross-sectional and longitudinal analyses.

    Science.gov (United States)

    Takeuchi, Hikaru; Taki, Yasuyuki; Hashizume, Hiroshi; Asano, Kohei; Asano, Michiko; Sassa, Yuko; Yokota, Susumu; Kotozaki, Yuka; Nouchi, Rui; Kawashima, Ryuta

    2016-06-01

    Psychological studies showed the quantity of reading habit affects the development of their reading skills, various language skills, and knowledge. However, despite a vast amount of literature, the effects of reading habit on the development of white matter (WM) structures critical to language and reading processes have never been investigated. In this study, we used the fractional anisotropy (FA) measure of diffusion tensor imaging to measure WM microstructural properties and examined cross-sectional and longitudinal correlations between reading habit and FA of the WM bundles in a large sample of normal children. In both cross-sectional and longitudinal analyses, we found that greater strength of reading habit positively affected FA in the left arcuate fasciculus (AF), in the left inferior fronto-occipital fasciculus (IFOF), and in the left posterior corona radiata (PCR). Consistent with previous studies, we also confirmed the significance or a tendency for positive correlation between the strength of reading habit and the Verbal Comprehension score in cross-sectional and longitudinal analyses. These cross-sectional and longitudinal findings indicate that a healthy reading habit may be directly or indirectly associated with the advanced development of WM critical to reading and language processes. Future intervention studies are needed to determine the causal effects of reading habits on WM in normal children. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Left Right Patterning, Evolution and Cardiac Development

    Directory of Open Access Journals (Sweden)

    Iain M. Dykes

    2014-04-01

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

  11. Left behind radiological investigations: An inherent problem

    Directory of Open Access Journals (Sweden)

    Giridhar A Govindswamy

    2011-01-01

    Full Text Available Objectives: To assess the number of investigations left behind by patients in radiology department, their cost, and the possible methods of reducing the problem. Materials and Methods: A total of 1424 radiographs, 160 computed tomography (CT scans, 300 ultrasonography (USG reports, and 46 Doppler reports were left behind by patients in one financial year. The total cost of these left behind investigations was calculated and the reports were categorized into normal and abnormal for each modality. Results: Of the radiographs left behind 658 were abnormal, with 211 among these being radiographs of postoperative patients. Thirty-seven percent of CT scans had positive findings. Sixty-eight percent of USG reports had positive findings while 46% of Doppler reports were abnormal. Conclusion: We believe that the cost and number of these left behind investigations over a period of time would definitely be significant for the health care system in a developing country. It is time to think of the possible reasons and methods for containing this problem.

  12. Left atrial laceration with epicardial ligation device.

    Science.gov (United States)

    Keating, Vincent P; Kolibash, Christopher P; Khandheria, Bijoy K; Bajwa, Tanvir; Sra, Jasbir; Kress, David C

    2014-01-01

    Many new devices and techniques are being developed to attempt a reduction in embolic stroke risk for patients with atrial fibrillation who are either unable or unwilling to maintain long-term anticoagulation. One of these new devices (LARIAT®, SentreHEART Inc., Redwood City, California, USA) employs delivery of an epicardial suture to ligate the left atrial appendage after percutaneous pericardial and transseptal access. This series presents three clinical cases that demonstrate a serious and recurrent complication of left atrial laceration and cardiac tamponade shortly following delivery of an epicardial suture ligation to the left atrial appendage. Three clinical cases are described in detail with pre- and postprocedure angiography and echocardiography as well as illustrations reflecting the surgeon's findings on direct visualization of the left atrial lacerations postligation. Potential hypotheses of each injury are examined in light of the case timelines and findings at sternotomy. There was no suggestion that tamponade was related to pericardial or transseptal access, but rather a complication with device delivery. These three patients quickly progressed to clinical cardiac tamponade despite attempted drainage, stressing the importance of cardiovascular surgery backup, including a cardiopulmonary bypass pump, when delivering novel, percutaneous ligation devices for the left atrial appendage.

  13. The effects of sports participation on the development of left ventricular mass in adolescent boys.

    Science.gov (United States)

    Valente-Dos-Santos, João; Coelho-E-Silva, Manuel J; Castanheira, Joaquim; Machado-Rodrigues, Aristides M; Cyrino, Edilson S; Sherar, Lauren B; Esliger, Dale W; Elferink-Gemser, Marije T; Malina, Robert M

    2015-01-01

    To examine the contribution of body size, biological maturation, and nonelite sports participation to longitudinal changes of left ventricular mass (LVM) in healthy boys. One hundred and ten boys (11.0-14.5 years at baseline) were assessed biannually for 2 years. Stature, body mass, and four skinfolds were measured. Lean body mass (LBM) was estimated. Biological maturation was assessed as years from age at peak height velocity (APHV). Sports participation was assessed by questionnaire. LVM was obtained from M-mode echocardiograms using two-dimensional images. To account for the repeated measures within individual nature of longitudinal data, multilevel random effects regression analyses were used in the analysis. LVM increased on average 42 ± 18 g from 11 to 15 years (P sports participation were not associated with greater LVM. © 2015 Wiley Periodicals, Inc.

  14. Enlargement of the superior rectus and superior oblique muscles causes intorsion in Graves' eye disease.

    Science.gov (United States)

    Wei, Yan; Kang, Xiao Li; Del Monte, Monte A

    2016-09-01

    To review the prevalence of preoperative and postoperative intorsion in patients with strabismus and Graves' eye disease (GED), and to correlate the intorsion with coexisting superior rectus (SR) and superior oblique (SO) muscle enlargement as a possible mechanism causing intorsion in these patients. Charts of consecutive patients with GED who underwent strabismus surgery between 1 January 2010 and 1 April 2013 were retrospectively reviewed. Of these, patients with orbital CT or MRI scan were identified for further analysis. Clinical characteristics documented included age, gender, horizontal and vertical deviation, subjective torsional deviation, specific extraocular muscles (EOMs) operated upon, EOM enlargement on CT/MRI scans and width and thickness of SO, SR group and inferior rectus (IR). Charts of 45 patients (14 males and 31 females) were reviewed. Mean age was 56.8±12.5 years. Of these, seven (15.6%) patients demonstrated intorsion, and 38 (84.4%) patients demonstrated extorsion preoperatively. But after strabismus surgery, 15 (39.5%) of the 38 patients with preoperative extorsion demonstrated postoperative intorsion and 23 (60.5%) patients continued to show postoperative extorsion. On analysis of CT/MRI scans in these patients, only an increase in the thickness of SR group and the thickness/width of SO muscle were significantly associated with preoperative and postoperative intorsion; while age, gender, preoperative horizontal or vertical deviation and IR recession were unrelated to preoperative or postoperative intorsion. Postoperative intorsion was also associated with smaller degrees of preoperative extorsion (extorsion (<3.5°) in the presence of tight IRs should be carefully evaluated for possible SR and/or SO involvement by CT or MRI scan to predict those at risk for and plan for prevention/treatment of postoperative intorsion. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please

  15. Síndrome de Deiscência de Canal Semicircular Superior Superior Canal Dehiscence Syndrome

    Directory of Open Access Journals (Sweden)

    Suzane da Cunha Ferreira

    2006-06-01

    Full Text Available A Síndrome de Deiscência de Canal Semicircular Superior (SDCSS, primeiramente descrita em 1998 por Minor et al., caracteriza-se por vertigem associada à presença de nistagmo, relacionados à exposição a estímulos sonoros intensos ou a modificações de pressão dentro da orelha média ou intracraniana. Disacusia, em sua maioria de padrão condutivo à audiometria tonal, também pode estar presente. Nesta revisão da literatura objetivou-se abordar a SDCSS, com seus principais sinais e sintomas, achados diagnósticos e tratamento, assim como enfatizar a importância de sua inclusão dentre as causas de vertigem, visto tratar-se de acometimento ainda pouco conhecido até mesmo entre especialistas. O diagnóstico correto, além de possibilitar seu tratamento, impede que abordagens diagnósticas e terapêuticas inapropriadas sejam realizadas.The Superior Canal Dehiscence Syndrome (SCDS was first reported by Minor at. Al. (1998, and has been characterized by vertigo and vertical-torsional eye movements related to loud sounds or stimuli that change middle ear or intracranial pressure. Hearing loss, for the most part with conductive patterns on audiometry, may be present in this syndrome. We performed a literature survey in order to to present symptoms, signs, diagnostic and therapeutic approaches to the SCDS, also aiming at stressing the great importance of including this syndrome among the tractable cause of vertigo. We should emphasize that this is a recent issue, still unknown by some specialists. The Correct SCDS diagnosis, besides enabling patient treatment, precludes misdiagnosis and inadequate therapeutic approaches.

  16. Automated processes in tennis: do left-handed players benefit from the tactical preferences of their opponents?

    Science.gov (United States)

    Loffing, Florian; Hagemann, Norbert; Strauss, Bernd

    2010-02-01

    Previous research on laterality in sport suggests an over-representation of left-handers in interactive sports such as tennis and cricket. These findings potentially reflect left-handers' advantage over their right-handed competitors in those sports. Although considered crucial for successful performance, the tactical component of their superiority has yet to be analysed. Two studies were conducted to test for a side bias in tennis players' tactical preferences. In the first study, 108 right- and left-handed players of varying skill watched rallies on a computer screen and had to indicate where they would place the ball in the opposing half. The results showed the tactical preference of players to place more balls on a left-handed opponent's mostly stronger forehand side compared with when faced with a right-hander. In the second study, 54 professional tennis matches involving right- and left-handers were analysed with respect to ball placement frequencies on the opponent's backhand side. Significantly fewer balls were hit to the backhand side of a left-handed opponent, thus replicating the findings of Study 1 in on-court situations. Both studies indicate players' preference to place shots to their right irrespective of their opponent's handedness. Findings support the assumption that left-handers might enjoy a strategic advantage in tennis.

  17. 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.

  18. Left atrial deformation and phasic function determined by 2-dimensional speckle tracking echocardiography in healthy dogs.

    Science.gov (United States)

    Caivano, D; Rishniw, M; Patata, V; Giorgi, M E; Birettoni, F; Porciello, F

    2016-06-01

    Feasibility, intra- and inter-observer variability of measuring left atrial (LA) longitudinal strain and strain rate (SR) variables using speckle tracking echocardiography (STE) have not been reported in the dog. Reference intervals for these variables which can be useful to estimate LA function have been provided. Forty-eight healthy adult dogs. Left atrial longitudinal deformation was evaluated in each dog by STE, and different combinations of STE variables were used to describe the 3 phases (reservoir, conduit and booster pump phase) of the LA function. Left atrial STE was possible in 40/48 dogs (83%). Strain and SR curves in healthy dogs were characterized, and reference intervals for several strain and SR variables are provided. Intra- and inter-observer variability, expressed as percent difference between observations or observers, was 3.58%-10.8% for indices of the LA reservoir function, 10.48%-15.82% for indices of the LA conduit function and 14.1%-34% for indices of the LA contractile function. Strain rate in early diastole and strain rate at atrial contraction variables were correlated significantly with age. No other relationships (body weight, heart rate or LA size) with any STE variables could be identified. Speckle tracking echocardiography provides quantitative measurements of LA longitudinal deformation and can be used to assess LA phasic function in healthy dogs. Further studies of these variables in dogs with cardiac diseases are needed to determine the clinical applicability and utility. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. Tailored Panel Management: A Theory-Based Approach to Building and Maintaining Participant Commitment to a Longitudinal Study

    Science.gov (United States)

    Estrada, Mica; Woodcock, Anna; Schultz, P. Wesley

    2014-01-01

    Many psychological processes unfold over time, necessitating longitudinal research designs. Longitudinal research poses a host of methodological challenges, foremost of which is participant attrition. Building on Dillman’s work, we provide a review of how social influence and relationship research informs retention strategies in longitudinal studies. Objective: We introduce the tailored panel management (TPM) approach, which is designed to establish communal norms that increase commitment to a longitudinal study, and this commitment, in turn, increases response rates and buffers against attrition. Specifically, we discuss practices regarding compensation, communication, consistency, and credibility that increase longer term commitment to panel participation. Research design: Throughout the article, we describe how TPM is being used in a national longitudinal study of undergraduate minority science students. TheScienceStudy is a continuing panel, which has 12 waves of data collected across 6 academic years, with response rates ranging from 70% to 92%. Although more than 90% of participants have either left or graduated from their undergraduate degree program, this highly mobile group of people remains engaged in the study. TheScienceStudy has usable longitudinal data from 96% of the original panel. Conclusion: This article combines social psychological theory, current best practice, and a detailed case study to illustrate the TPM approach to longitudinal data collection. The approach provides guidance for other longitudinal researchers, and advocates for empirical research into longitudinal research methodologies. PMID:24590918

  20. Tailored Panel Management: A Theory-Based Approach to Building and Maintaining Participant Commitment to a Longitudinal Study.

    Science.gov (United States)

    Estrada, Mica; Woodcock, Anna; Schultz, P Wesley

    2014-02-01

    Many psychological processes unfold over time, necessitating longitudinal research designs. Longitudinal research poses a host of methodological challenges, foremost of which is participant attrition. Building on Dillman's work, we provide a review of how social influence and relationship research informs retention strategies in longitudinal studies. Objective: We introduce the tailored panel management (TPM) approach, which is designed to establish communal norms that increase commitment to a longitudinal study, and this commitment, in turn, increases response rates and buffers against attrition. Specifically, we discuss practices regarding compensation, communication, consistency, and credibility that increase longer term commitment to panel participation. Research design: Throughout the article, we describe how TPM is being used in a national longitudinal study of undergraduate minority science students. TheScienceStudy is a continuing panel, which has 12 waves of data collected across 6 academic years, with response rates ranging from 70% to 92%. Although more than 90% of participants have either left or graduated from their undergraduate degree program, this highly mobile group of people remains engaged in the study. TheScienceStudy has usable longitudinal data from 96% of the original panel. Conclusion: This article combines social psychological theory, current best practice, and a detailed case study to illustrate the TPM approach to longitudinal data collection. The approach provides guidance for other longitudinal researchers, and advocates for empirical research into longitudinal research methodologies. © The Author(s) 2014.

  1. Left ventricular markers of mortality and ventricular arrhythmias in heart failure patients with cardiac resynchronization therapy.

    Science.gov (United States)

    Hasselberg, Nina E; Haugaa, Kristina H; Bernard, Anne; Ribe, Margareth P; Kongsgaard, Erik; Donal, Erwan; Edvardsen, Thor

    2016-03-01

    Cardiac resynchronization therapy (CRT) reduces morbidity and mortality in heart failure. However, prediction of the outcome remains difficult. We aimed to investigate for echocardiographic predictors of ventricular arrhythmias and fatal outcome and to explore how myocardial function is changed by biventricular pacing in heart failure. We prospectively included 170 heart failure patients (66 ± 10 years, New York Heart Association class 2.8 ± 0.5, 48% ischaemic cardiomyopathy) and recorded ventricular arrhythmias and fatal end point defined as death, heart transplantation, or left ventricular assist device implantation during 2 years. Two-dimensional echocardiography was performed before and 6 months after CRT implantation. CRT response was defined as ≥15% reduction in end-systolic volume at 6 months. Speckle-tracking technique was performed to assess longitudinal and circumferential left ventricular function, defined as global longitudinal (GLS) and circumferential strain (GCS), and to assess mechanical dyssynchrony, defined as mechanical dispersion. GLS before CRT was a predictor of fatal end point independently of CRT response [hazard ratio, HR 1.14 (1.02-1.27), P = 0.02]. Patients with GLS better than -8.3% showed event-free survival benefit (log rank, P heart failure patients with CRT, worse longitudinal function before CRT was an important predictor of fatal outcome during 2 years, independently of CRT response. Mechanical dispersion at 6 months was a strong predictor of ventricular arrhythmias. CRT response by reverse remodelling was dependent on improvement of both longitudinal and circumferential function. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Cardiology.

  2. Marcapasso bi-atrial epicárdico subxifóide na obstrução da veia cava superior Bi-atrial subxiphoid epicardial pacemaker in superior vena cava syndrome

    Directory of Open Access Journals (Sweden)

    Roberto Costa

    2006-10-01

    Full Text Available Um paciente portador de marcapasso definitivo bi-atrial-ventricular por fibrilação atrial paroxística e bradicardia sinusal, em uso crônico de anticoagulante oral, apresentou sinais clínicos da síndrome da veia cava superior. A venografia por subtração digital mostrou obstrução total do tronco braquiocefálico venoso direito e grande dificuldade de fluxo sangüíneo da veia inominada para a veia cava superior. A abordagem terapêutica constou da remoção completa do sistema transvenoso seguida de reimplante do sistema bi-atrial-ventricular por técnica epimiocárdica pela via subxifóide assistida por fluoroscopia.A patient with a bi-atrial-ventricular permanent pacemaker due to paroxystic atrial fibrillation associated to sinus bradycardia, in chronic use of oral anticoagulant, presented clinical signs of superior vena cava syndrome. Digital subtraction venography showed total obstruction of the right brachiocephalic venous trunk and severe stenosis of the connection of the left trunk to the superior vena cava. The therapeutic approach consisted of complete removal of transvenous system followed by re-implant of the bi-atrial-ventricular system using an epicardial subxiphoid access with fluoroscopic assistance

  3. 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.)

  4. Echocardiographic study of left atrial myxoma

    Directory of Open Access Journals (Sweden)

    Dalal J

    1979-01-01

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

  5. “Getting the Left Right”

    DEFF Research Database (Denmark)

    Klinke, Marianne E.; Zahavi, Dan; Hjaltason, Haukur

    2015-01-01

    experience was captured in the overarching theme, “getting the left right,” which encompasses the two subthemes of (a) surreal awareness of the left and (b) emergence of a different world. Patients had unclear perceptions of their own body and surroundings, their attention was brittle, and they encountered...... bewildering reactions from other people. They simultaneously pursued the ineffable neglected space and searched for coherence. The vulnerability, loss, and conflicting perceptions that patients with neglect face should be acknowledged and alleviation sought. Facilitating methods should provide additional...

  6. 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...

  7. Left paraduodenal hernias; Hernias paraduodenales izquierdas

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-07-01

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

  8. [Difficulties in face identification after lesion in the left hemisphere].

    Science.gov (United States)

    Verstichel, P; Chia, L

    1999-11-01

    A 82 year-old right-handed man, without any intellectual impairment, suffered from an acute neurological deficit consisting in letter-by-letter reading, right superior quadrant hemianopia with achromatopia in the lower quadrant, and anomia. Cerebral MRI showed an infarct involving the ventral structures of the left hemisphere sparing the splenium of the corpus callosum and the thalamus. Neuropsychological examination revealed that the patient easily identified the objects, the animals and the famous places he could not name: his comments attested normal visual recognition. Conversely, when he was presented with famous faces, he always had a strong feeling of familiarity, but could not provide accurate information about the corresponding individual. Biographic information about personalities was not impaired in the semantic-biographic store, because it could be accessed from the names. Activation of face recognition units (where the visual description provided by the structural encoding and the stored sets of descriptions of familiar faces are compared), was effective, since the patient could distinguish famous faces from unknown ones. In a modular-sequential model of face recognition, this deficit is interpreted as a disconnection between face recognition units and person identity nodes (which are considered to contain semantic-biographic information about individuals). This kind of disturbance differs from classic prosopagnosia in which, characteristically, the patients are unable to experience a feeling of familiarity when viewing famous faces, and to perform a categorization between famous and unknown faces. Right hemisphere has a preponderant role in structural analysis of faces and in activation of face recognition units. The integrity of this hemisphere in this patient could explain the preservation of these two steps of processing. Left-hemisphere specific function in facial recognition enabled access to semantic-biographic store in a conscious, verbal and

  9. Parametric Modeling of the Mouse Left Ventricular Myocardial Fiber Structure.

    Science.gov (United States)

    Merchant, Samer S; Gomez, Arnold David; Morgan, James L; Hsu, Edward W

    2016-09-01

    Magnetic resonance diffusion tensor imaging (DTI) has greatly facilitated detailed quantifications of myocardial structures. However, structural patterns, such as the distinctive transmural rotation of the fibers, remain incompletely described. To investigate the validity and practicality of pattern-based analysis, 3D DTI was performed on 13 fixed mouse hearts and fiber angles in the left ventricle were transformed and fitted to parametric expressions constructed from elementary functions of the prolate spheroidal spatial variables. It was found that, on average, the myocardial fiber helix angle could be represented to 6.5° accuracy by the equivalence of a product of 10th-order polynomials of the radial and longitudinal variables, and 17th-order Fourier series of the circumferential variable. Similarly, the fiber imbrication angle could be described by 10th-order polynomials and 24th-order Fourier series, to 5.6° accuracy. The representations, while relatively concise, did not adversely affect the information commonly derived from DTI datasets including the whole-ventricle mean fiber helix angle transmural span and atlases constructed for the group. The unique ability of parametric models for predicting the 3D myocardial fiber structure from finite number of 2D slices was also demonstrated. These findings strongly support the principle of parametric modeling for characterizing myocardial structures in the mouse and beyond.

  10. 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.

  11. Noise management to achieve superiority in quantum information systems

    Science.gov (United States)

    Nemoto, Kae; Devitt, Simon; Munro, William J.

    2017-06-01

    Quantum information systems are expected to exhibit superiority compared with their classical counterparts. This superiority arises from the quantum coherences present in these quantum systems, which are obviously absent in classical ones. To exploit such quantum coherences, it is essential to control the phase information in the quantum state. The phase is analogue in nature, rather than binary. This makes quantum information technology fundamentally different from our classical digital information technology. In this paper, we analyse error sources and illustrate how these errors must be managed for the system to achieve the required fidelity and a quantum superiority. This article is part of the themed issue 'Quantum technology for the 21st century'.

  12. Magnetic resonance tomography of superior vena caval obstruction

    International Nuclear Information System (INIS)

    Weiss, T.; Loddenkemper, R.; Bittner, R.; Sander, B.; Husen-Weiss, E.; Mitsch, E.; Trempenau, B.; Kaiser, D.; Krankenhaus Zehlendorf, Berlin

    1987-01-01

    The potential of magnetic resonance tomography (MRT) to demonstrate the mediastinal veins was evaluated retrospectively in 6 patients with superior vena caval ostruction. In each instance, MRT provided detailed information about the extent of venous obstruction and the precise site of the causative oncological pathology. Transaxial images most clearly and unequivocally depicted obstructed superior vena cavas. MRT was also able to indicate some secondary effects of superior vena cavals obstruction such as slow intravenous flow the latter could be demonstrated by a significant increase of signal intensity within venous structures proximal to the obstruction. Peripheral venous collaterals in the chest wall were better seen with contrast enhanced computed tomography scans. (orig.) [de

  13. The radiology of the right superior intercostal vein

    International Nuclear Information System (INIS)

    Catalano, D.; Pagliari, U.; Lapiccirella, G.

    1989-01-01

    The right superior intercostal vein is visualised on CT examination as a circular opacity laterally at the right aspect of the vertebral body at the T 4 -T 5 level. In venographic examination the RSIV appears to be formed by the confluence of the venous channels, the right second third and fourth intercostal veins. In superior vena cava obstruction the RSIV is an important collateral pathway: the flow through the vein depends on the site of the obstruction, anterograde if the obstruction is superior or parallel to the level of the vena azygos, and retrograde if the obstruction is below the vena azygos. (orig.) [de

  14. Ruptured superior gluteal artery pseudoaneurysm with hemorrhagic shock: Case report

    Directory of Open Access Journals (Sweden)

    Kerem Seref Corbacioglu

    2016-03-01

    Full Text Available Pseudoaneurysm of the superior gluteal artery (SGA is very rare and the most common causes are blunt or penetrating pelvic traumas. Although pseudoaneurysm can be asymptomatic at the time of initial trauma, it can be symptomatic weeks, months, even years after initial trauma. We present a case of a ruptured superior gluteal artery pseudoaneurysm with hemorrhagic shock twenty days after a bomb injury in the Syria civil war. In addition, we review the anatomy of the SGA, clinical presentation and pitfalls of pseudoaneurysm, and imaging and treatment options. Keywords: Pseudoaneurysm, Superior gluteal artery, Pitfall, Angiography

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

    Science.gov (United States)

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

    2017-11-06

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

  16. Fulminant superior ophthalimic vein and cavermous sinus thrombophlebitis with intracranial extensions: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Ji Sun; Hong, Hyun Sook; Park, Ji Sang; Lee, A Leum; Choo, Eun Ju; Chang, Kee Hyun [Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of)

    2015-06-15

    Cavernous sinus thrombophlebitis (CST) is a rare and life-threatening disease without prompt diagnosis and treatment. Two cases of fulminant superior ophthalmic vein (SOV) and CST caused by maxillary periodontitis and sphenoid sinusitis are described. A 65-year-old woman presented with right proptosis, headache, and fever. A 74-year-old woman presented with left periorbital swelling. In both patients, MRI with gadolinium showed expansion of the bilateral cavernous sinus and diffuse dilatation of the SOV with non-enhancement of central thrombus, which indicated CST. The condition was complicated by brain abscess, meningitis, and ischemic stroke. These conditions were improved by antibiotic treatment, but one patient underwent exenteration of the orbit due to orbital rupture during hospitalization.

  17. Myxoma of the Superior Vena Cava Origin Presented as a Right Atrial Mass

    Directory of Open Access Journals (Sweden)

    Feridoun Sabzi

    2015-10-01

    Full Text Available Myxomas are the most common benign cardiac tumors. Myxomas are more common in the left heart chamber than the right side chamber. An extracardiac origin presenting as a right atrial mass is very rare. We present a case of myxoma originating in the superior vena cava (SVC in a 24-year-old man, who underwent surgical resection. Preoperative two-dimensional echocardiography demonstrated a mass in the right atrium. Intraoperatively, the tumor was found to have originated from the SVC orifice. The tumor was excised from the SVC by opening the one-third proximal portion of the SVC. Pathological examination revealed a myxoma, and one-year follow-up showed no evidence of the recurrence of any tumors in the SVC.

  18. Summary of longitudinal instabilities workshop

    Energy Technology Data Exchange (ETDEWEB)

    Chasman, R.

    1976-01-01

    A five-day ISABELLE workshop on longitudinal instabilities was held at Brookhaven, August 9-13, 1976. About a dozen outside accelerator experts, both from Europe and the U.S.A., joined the local staff for discussions of longitudinal instabilities in ISABELLE. An agenda of talks was scheduled for the first day of the workshop. Later during the week, a presentation was given on the subject ''A more rigorous treatment of Landau damping in longitudinal beam instabilities''. A few progress meetings were held in which disagreements regarding calculations of coupling impedances were clarified. A summary session was held on the last day. Heavy emphasis was put on single bunched beam instabilities in the microwave region extending above the cut-off frequency of the ISABELLE vacuum chamber.

  19. Current cardiac imaging techniques for detection of left ventricular mass

    Directory of Open Access Journals (Sweden)

    Celebi Aksuyek S

    2010-06-01

    Full Text Available Abstract Estimation of left ventricular (LV mass has both prognostic and therapeutic value independent of traditional risk factors. Unfortunately, LV mass evaluation has been underestimated in clinical practice. Assessment of LV mass can be performed by a number of imaging modalities. Despite inherent limitations, conventional echocardiography has fundamentally been established as most widely used diagnostic tool. 3-dimensional echocardiography (3DE is now feasible, fast and accurate for LV mass evaluation. 3DE is also superior to conventional echocardiography in terms of LV mass assessment, especially in patients with abnormal LV geometry. Cardiovascular magnetic resonance (CMR and cardiovascular computed tomography (CCT are currently performed for LV mass assessment and also do not depend on cardiac geometry and display 3-dimensional data, as well. Therefore, CMR is being increasingly employed and is at the present standard of reference in the clinical setting. Although each method demonstrates advantages over another, there are also disadvantages to receive attention. Diagnostic accuracy of methods will also be increased with the introduction of more advanced systems. It is also likely that in the coming years new and more accurate diagnostic tests will become available. In particular, CMR and CCT have been intersecting hot topic between cardiology and radiology clinics. Thus, good communication and collaboration between two specialties is required for selection of an appropriate test.

  20. Superiority of the dominant and nondominant hands in static strength and controlled force exertion.

    Science.gov (United States)

    Noguchi, Takanori; Demura, Shinichi; Aoki, Hiroki

    2009-10-01

    The dominant hand can be defined in such a way that Oldfield's Handedness Inventory may not identify the superior hand, i.e., the hand with more strength and/or more force control. The dominant and nondominant hands were compared for two different grip force-exertion tests. 50 healthy young men (M age = 21.1 yr.) performed two tests with each hand: a maximal grip strength test and a controlled force-exertion test with dynamic demand. In the latter test, the participants matched their submaximal grip force to the changing demand values with real-time feedback. The total sum of the differences between the demand value and grip force value for 25 sec. was used as an evaluation parameter for the test (unit: %). Mean maximal grip force values in the right and left hands were 439.9 N (SD = 59.1) and 405.6 N (SD = 59.3), respectively. Mean controlled force-exertion test values in the right and left hands were 610.3% (SD = 150.2) and 722.6% (SD = 147.8), respectively. In both tests, the dominant hand was significantly stronger and controlled dynamic force better. The relationship between the two hands was very high. Based on this study's criteria, the dominant hand was stronger in 34% (n = 17) of participants during the maximal grip strength test and more controlled in 54% (n = 27) of participants during the controlled force-exertion test. Thus, the dynamic force control test showed that for significantly more people the dominant hand is stronger and controls force better. Controlled force exertion may be a better test for identifying the superior hand.

  1. Superior Intraparietal Sulcus Controls the Variability of Visual Working Memory Precision.

    Science.gov (United States)

    Galeano Weber, Elena M; Peters, Benjamin; Hahn, Tim; Bledowski, Christoph; Fiebach, Christian J

    2016-05-18

    Limitations of working memory (WM) capacity depend strongly on the cognitive resources that are available for maintaining WM contents in an activated state. Increasing the number of items to be maintained in WM was shown to reduce the precision of WM and to increase the variability of WM precision over time. Although WM precision was recently associated with neural codes particularly in early sensory cortex, we have so far no understanding of the neural bases underlying the variability of WM precision, and how WM precision is preserved under high load. To fill this gap, we combined human fMRI with computational modeling of behavioral performance in a delayed color-estimation WM task. Behavioral results replicate a reduction of WM precision and an increase of precision variability under high loads (5 > 3 > 1 colors). Load-dependent BOLD signals in primary visual cortex (V1) and superior intraparietal sulcus (IPS), measured during the WM task at 2-4 s after sample onset, were modulated by individual differences in load-related changes in the variability of WM precision. Although stronger load-related BOLD increase in superior IPS was related to lower increases in precision variability, thus stabilizing WM performance, the reverse was observed for V1. Finally, the detrimental effect of load on behavioral precision and precision variability was accompanied by a load-related decline in the accuracy of decoding the memory stimuli (colors) from left superior IPS. We suggest that the superior IPS may contribute to stabilizing visual WM performance by reducing the variability of memory precision in the face of higher load. This study investigates the neural bases of capacity limitations in visual working memory by combining fMRI with cognitive modeling of behavioral performance, in human participants. It provides evidence that the superior intraparietal sulcus (IPS) is a critical brain region that influences the variability of visual working memory precision between and

  2. Quantitative and Computed Tomography Anatomic Analysis of Glenoid Fixation for Superior Capsule Reconstruction: A Cadaveric Study.

    Science.gov (United States)

    Schon, Jason M; Katthagen, J Christoph; Dupre, Cameron N; Mitchell, Justin J; Turnbull, Travis Lee; Adams, Christopher R; Denard, Patrick J; Millett, Peter J

    2017-06-01

    To investigate glenoid fixation for superior capsule reconstruction (SCR) and evaluate anchor positions, intraosseous trajectories, and proximity to the suprascapular nerve (SSN) and glenoid fossa. The secondary purpose was to provide technical pearls and pitfalls for anchor insertion on the superior glenoid during SCR. Three beath pins were arthroscopically inserted into 12 (n = 12) nonpaired human cadaveric shoulders through Neviaser, anterior, and posterior portals to simulate anchor placement on the superior glenoid during SCR. Computed tomography scans were performed to evaluate anchor positioning and insertion trajectories. Specimens were then dissected to delineate the anatomic relations of the beath pins to the SSN and glenoid fossa. The superior glenoid anchor position was a mean 15.0 ± 4.0 mm to the SSN and 6.5 ± 1.7 mm to the glenoid fossa. The posterior glenoid anchor position was a mean 11.8 ± 2.1 mm to the SSN and 2.9 ± 2.9 mm to the glenoid fossa. On average, the superior pin was placed at 12:30 ± 0:30 (left-sided glenoid clock face) and inserted at 19° ± 9° with respect to the sagittal plane of the glenoid, the anterior pin was placed at 11:00 ± 0:30 and inserted 40° ± 17° off the glenoid, and the posterior pin was placed at 3:00 ± 1:00 and inserted at 52° ± 12° off the glenoid. The results of the present cadaveric study showed that glenoid fixation was safe with respect to the SSN and delineated technical guidelines and trajectories for inserting 3 anchors into the glenoid. This study shows that 3 anchors can be inserted into the glenoid without a risk of SSN damage and delineates technical guidelines for anchor insertion. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  3. Passive longitudinal phase space linearizer

    Directory of Open Access Journals (Sweden)

    P. Craievich

    2010-03-01

    Full Text Available We report on the possibility to passively linearize the bunch compression process in electron linacs for the next generation x-ray free electron lasers. This can be done by using the monopole wakefields in a dielectric-lined waveguide. The optimum longitudinal voltage loss over the length of the bunch is calculated in order to compensate both the second-order rf time curvature and the second-order momentum compaction terms. Thus, the longitudinal phase space after the compression process is linearized up to a fourth-order term introduced by the convolution between the bunch and the monopole wake function.

  4. Longitudinal dynamics in storage rings

    International Nuclear Information System (INIS)

    Colton, E.P.

    1986-01-01

    The single-particle equations of motion are derived for charged particles in a storage ring. Longitudinal space charge is included in the potential assuming an infinitely conducting circular beam pipe with a distributed inductance. The framework uses Hamilton's equations with the canonical variables phi and W. The Twiss parameters for longitudinal motion are also defined for the small amplitude synchrotron oscillations. The space-charge Hamiltonian is calculated for both parabolic bunches and ''matched'' bunches. A brief analysis including second-harmonic rf contributions is also given. The final sections supply calculations of dynamical quantities and particle simulations with the space-charge effects neglected

  5. A radial global dyssynchrony index as predictor of left ventricular reverse remodeling after cardiac resynchronization therapy.

    Science.gov (United States)

    Ascione, Luigi; Iengo, Raffaele; Accadia, Maria; Rumolo, Salvatore; Celentano, Eduardo; D'Andrea, Antonello; De Michele, Mario; Muto, Carmine; Carreras, Giovanni; Maglione, Marco; Tuccillo, Bernardino; Roelandt, Jos

    2008-07-01

    Cardiac mechanical efficiency requires that opposing left ventricular regions are coupled both in shortening and lengthening during the same phase of cardiac cycle. Aim of this study was to evaluate whether global measures of mechanical dyssynchrony are able to predict reverse remodeling of the left ventricle in patients receiving cardiac resynchronization therapy (CRT). Sixty-two patients underwent a clinical examination, including New York Heart Association class evaluation and 6-minute walking distance and both echocardiographic study before and 6 months after CRT. Intraventricular dyssynchrony was evaluated by two-dimensional strain echocardiography, measuring the amount of uncoordinated contraction and relaxation between septum and free wall for both longitudinal and radial function and was presented as the longitudinal global dyssynchrony index (LGDI) and the radial global dyssynchrony index (RGDI). Reverse remodeling was defined by a left ventricular end systolic volume reduction >or= 15%. After CRT 39 patients showed reverse remodeling. In this group, RGDI (0.74 +/- 0.26 vs 0.32 +/- 0.30; P = 0.0001) and LGDI (0.52 +/- 0.28 vs 0.30 +/- 0.24; P = 0.002) were significantly higher than in nonresponders. A receiver-operating characteristic curve analysis showed that RGDI >0.47 and LGDI >0.34 had a sensitivity and a specificity to predict reverse remodeling of 87% and 74%, 82%, and 74%, respectively. Stepwise forward multiple logistic regression analysis showed that RGDI (O.R.:13.4; 95%C.I.:4.2-120.5; P < 0.0001) was an independent determinant of a positive response to CRT. A radial global dyssynchrony index predicts left ventricular reverse remodeling after CRT.

  6. 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

  7. Left ventricular mass: Myxoma or thrombus?

    Directory of Open Access Journals (Sweden)

    Monish S Raut

    2015-01-01

    Full Text Available Patient with embolic episode should always be evaluated for cardiac mass. Mass in left ventricular can be a myxoma or thrombus even in a normal functioning heart . In either case, mobile mass with embolic potential should be surgically resected.

  8. Left atrial myxoma with biventricular dysfunction

    Directory of Open Access Journals (Sweden)

    Monish S. Raut

    2016-09-01

    Full Text Available Occurrence of left atrial myxoma with severe ventricular dysfunction without any obstructive coronary artery disease, as presented in our case, is very rare. It may be due to undiagnosed concomitant dilated cardiomyopathy or unknown cardiodepressant effect of myxoma which warrants further research.

  9. Left atrial myxoma with biventricular dysfunction.

    Science.gov (United States)

    Raut, Monish S; Shad, Sujay; Maheshwari, Arun

    2016-09-01

    Occurrence of left atrial myxoma with severe ventricular dysfunction without any obstructive coronary artery disease, as presented in our case, is very rare. It may be due to undiagnosed concomitant dilated cardiomyopathy or unknown cardiodepressant effect of myxoma which warrants further research. Copyright © 2016 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  10. Vergisson 4: a left-handed Neandertal.

    Science.gov (United States)

    Condemi, Silvana; Monge, Janet; Quertelet, Sylvain; Frayer, David W; Combier, Jean

    2017-01-01

    Handedness is an important marker for lateralization of humans in the modern and fossil record. For the most part, Neandertals and their ancestors are strongly right-handed. We describe a single tooth from a Neandertal level at Vergisson 4 (Vg 4-83). This left upper central incisor shows all the features typical of Neandertal incisors. It also exhibits a predominance of left-handed striations. Striations on the incisor's labial surface were mapped at 20x magnification using Photoshop. Angulations of the striations were determined from their deviation from the maximum mesio-distal line and were analyzed using NIH's freeware, Image J. Of the 60 labial surface striations, Vg 4-83 shows a strong predominance of left-handed striations (46; 76.7%), which are statistically significantly different (p handed striations. The identification of another left-handed Neandertal adds to our understanding about handedness variation in this fossil hominin. Given the high frequency of right-handed Neandertals, the 90: 10 modern ratio is still preserved in this group. © 2016 Wiley Periodicals, Inc.

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

    African Journals Online (AJOL)

    1983-01-01

    Jan 1, 1983 ... sniper with an Armourlite assault rifle in Ireland. He had received a single bullet injury to the left ... His history negated any cardiovascular impairment, angina or limitation in effort tolerance. He plays ... In view of the patient's age, history and the cardiovascular findings, we would like to postulate that the ...

  12. Radiative left-right Dirac neutrino mass

    Science.gov (United States)

    Ma, Ernest; Sarkar, Utpal

    2018-01-01

    We consider the conventional left-right gauge extension of the standard model of quarks and leptons without a scalar bidoublet. We study systematically how one-loop radiative Dirac neutrino masses may be obtained. In addition to two well-known cases from almost 30 years ago, we find two new scenarios with verifiable predictions.

  13. Giant melanoma of the left thumb

    NARCIS (Netherlands)

    Zeebregts, CJAM; Schraffordt Koops, H.

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

  14. Submitral Left Ventricular Aneurysm Associated with Thrombus

    African Journals Online (AJOL)

    2018-01-01

    Jan 1, 2018 ... She was given drugs for management of heart failure and ... treatment abroad. KEYWORDS: Ethiopia, heart failure, submitral aneurysm, thrombus. INTRODUCTION. Submitral left ventricle aneurysm is a rare cardiovascular disorder worldwide, but ... grade 2 pulmonary edema, and bilateral pleural effusion.

  15. Left-Right Symmetry at LHC

    CERN Document Server

    Maiezza, Alessio; Nesti, Fabrizio; Senjanovic, Goran

    2010-01-01

    We revisit the issue of the limit on the scale of Left-Right symmetry breaking. We focus on the minimal SU(2)_L x SU(2)_R x U(1)_B-L gauge theory with the seesaw mechanism and discuss the two possibilities of defining Left-Right symmetry as parity or charge conjugation. In the commonly adopted case of parity, we perform a complete numerical study of the quark mass matrices and the associated left and right mixing matrices without any assumptions usually made in the literature about the ratio of vacuum expectation values. We find that the usual lower limit on the mass of the right-handed gauge boson from the K mass difference, M_WR>2.5TeV, is subject to a possible small reduction due to the difference between right and left Cabibbo angles. In the case of charge conjugation the limit on M_WR is somewhat more robust. However, the more severe bounds from CP-violating observables are absent in this case. In fact, the free phases can also resolve the present mild discrepancy between the Standard Model and CP-violat...

  16. Left Dislocation: a typological overview | Westbury | Stellenbosch ...

    African Journals Online (AJOL)

    The Left Dislocation construction is a typologically universal phenomenon that has received detailed analysis, from both formal and functional perspectives, in a number of genetically and areally diverse languages. The present paper aims to provide a general overview of this cross-linguistic research with a concentration ...

  17. Left-forbidding cooperating distributed grammar systems

    Czech Academy of Sciences Publication Activity Database

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

    2010-01-01

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

  18. Left Ventricular Thrombus among patients undergoing Transthoracic ...

    African Journals Online (AJOL)

    Objective: Left Ventricular Thrombus (LVT) is a well recognized complication of various cardiac conditions, particularly following an acute anterior myocardial infarction and in those with systolic congestive heart failure. Transthoracic echocardiography (TTE) remains the most common imaging modality to make the diagnosis ...

  19. Modern Democratic Left and Economic Crisis

    Directory of Open Access Journals (Sweden)

    Dubravko Radošević

    2011-01-01

    Full Text Available Political left, notably social democracy, implies acceptance of market economy and parliamentary democracy, as a political framework within which the interests of large sections of the population could be preserved. Does the modern political left have a chance to revive, after the global economic crisis? We believe it does. The core idea of social democracy is the idea of equality. It is the growing inequality that could help the return of social democracy. In Croatia, during transition, there was predominantly the process of neoliberalization, and the democratic left accepted a neoliberal economic agenda. Currently Croatia has a structural economic problem and deep recession. Due to the global crisis, the democratic left in Croatia should abandon economic neoliberalism. Macroeconomic policy decision-makers in Croatia should reject orthodox policies, and it is necessary to implement heterodox economic policies. There is an urgent need to achieve a new (postKeynesian consensus, a new combination of post-Keynesian economics and social democracy

  20. 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

  1. First Evidence of Cardiac Stem Cells From the Left Ventricular Apical Tip in Patients With Left Ventricular Assist Device Implantation.

    Science.gov (United States)

    Cameli, M; Righini, F M; Sparla, S; Tacchini, D; Dokollari, A; Sassi, C G; Di Tommaso, C; Curci, V; Censini, S; Incampo, E; Cassano, F; Droandi, G; Bernazzali, S; Focardi, M; Ietta, F; Sartiani, L; Romagnoli, R; Marotta, G; Mugelli, A; Paulesu, L; Sani, G; Tanganelli, P; Maccherini, M; Mondillo, S

    2016-03-01

    Recent studies have challenged the dogma that the adult heart is a postmitotic organ and raise the possibility of the existence of resident cardiac stem cells (CSCs). Our study aimed to explore if these CSCs are present in the "ventricular tip" obtained during left ventricular assist device (LVAD) implantation from patients with end-stage heart failure (HF) and the relationship with LV dysfunctional area extent. Four consecutive patients with ischemic cardiomyopathy and end-stage HF submitted to LVAD implantation were studied. The explanted "ventricular tip" was used as a sample of apical myocardial tissue for the pathological examination. Patients underwent clinical and echocardiographic examination, both standard transthoracic echocardiography (TTE) and speckle tracking echocardiography (STE), before LVAD implantation. All patients presented severe apical dysfunction, with apical akinesis/diskinesis and very low levels of apical longitudinal strain (-3.5 ± 2.9%). Despite this, the presence of CSCs was demonstrated in pathological myocardial samples of "ventricular tip" in all 4 of the patients. It was found to be a mean of 6 c-kit cells in 10 fields magnification 40×. Cardiac stem cells can be identified in the LV apical segment of patients who have undergone LVAD implantation despite LV apical fibrosis. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Significance of force transfer in mitral valve-left ventricular interaction: in vivo assessment.

    Science.gov (United States)

    Askov, Jesper B; Honge, Jesper L; Jensen, Morten O; Nygaard, Hans; Hasenkam, J Michael; Nielsen, Sten L

    2013-06-01

    The objective of this study was to assess the combined force transfer from the papillary muscle tips to the mitral valve through the chordae tendineae in vivo, and thereby quantify the force transmitted through the papillary-chordal complex to augment left ventricular ejection. In an acute porcine model (n = 8), force transfer between papillary muscles and the mitral valve was recorded on the anterior and posterior papillary muscle tip using dedicated force transducers. Ultrasound sonomicrometry was utilized to record and calculate left ventricular long-axis shortening and mitral annular geometry. The closing force acting on the mitral valve leaflets was calculated as mitral annular area multiplied by the transmitral pressure difference throughout systole. Mitral valve competence was verified before measurements with color Doppler ultrasound. Peak force in the anterior and posterior papillary muscle was 5.9 ± 0.6 N and 5.8 ± 0.7 N (mean ± standard error of the mean), respectively, and peak closing force was 6.8 ± 0.3 N all at a transmitral pressure of 90 mm Hg. Peak rate of left ventricular contraction coincided with peak papillary muscle force. This study is the first to assess the magnitude and time course of the longitudinal force transmitted through the papillary-chordal complex to the left ventricular wall during ejection. The study also demonstrates a significant force transfer to the closing force acting on the mitral valve leaflets that constitutes an essential component of valvular-ventricular interaction to enhance left ventricular systolic pump performance. The magnitude of the combined papillary muscle force component emphasizes the crucial role of preserving mitral valve-left ventricular continuity in mitral valve surgery. Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  3. Analysis of the Lake Superior Watershed Seasonal Snow Cover

    National Research Council Canada - National Science Library

    Daly, Steven F; Baldwin, Timothy B; Weyrick, Patricia

    2007-01-01

    Daily estimates of the snow water equivalent (SWE) distribution for the period from 1 December through 30 April for each winter season from 1979 80 through 2002 03 were calculated for the entire Lake Superior watershed...

  4. 2010 Great Lakes Restoration Initiative Bathymetric Lidar: Lake Superior

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The data contained in this file contain hydrographic and topographic data collected by the Fugro LADS Mk II system along the Lake Superior coast of Minnessota,...

  5. Treatment of superior mesentery arterial embolism with transcatheterizing thrombolysis

    International Nuclear Information System (INIS)

    Wu Qinghai

    2008-01-01

    Objective: To discuss the treatment of superior mesenteric arterial thrombo-embolism through superior mesenteric arterial angiography and transcatheterizing thrombolysis. Methods: After diagnosis of superior mesenteric arterial thrombo-embolism through percutaneous transluminal angiography, the embolism was cleared out and then the inner tip of catheter was implanted within embolus for slow continuously thrombolysis with the outer tip of catheter connected to the infusion pump. Result: Four cases succeeded with thrombolysis; 3 cases were performed with partial small intestinal excision with necrosis. Two cases healed. One case died of heart failure postoperatively and another case died of massive digestive tract hemorrhage. Conclusions: Angiography can help to confirm the position of superior mesentery arterial thrombosis and the extent of intestinal ischemia. Early intrathrombus catheterization for clear out and thrombolysis can obtain satisfactory prognosis. (authors)

  6. Left atrial deformation: Useful index for early detection of cardiac damage in chronic mitral regurgitation.

    Science.gov (United States)

    Cameli, M; Incampo, E; Mondillo, S

    2017-12-01

    In chronic mitral regurgitation (MR) left atrium is one of the first cardiac structures that is involved in remodeling and ultrastructural changes for a progressive volume overload. Severe left atrial (LA) dilation on echocardiography and new onset of atrial fibrillation in asymptomatic patients with preserved Left Ventricular (LV) function, appeared as a Class IIb recommendation for consideration for surgical mitral valve repair in the actual guidelines. However, before atrial dilatation and dysfunction, several ultrastructural changes appear in the atrial muscle tissue that are difficult to identify with the standard echocardiography. Speckle tracking echocardiography (STE) can analyze LA function: it has been showed that it can indirectly identify structural tissue modifications from excessive atrial effort in the early stages of MR up to the full depression of atrial function in the late stages where there are advanced ultrastructural alterations. This review aims to summarize current knowledge on the role of atrial strain identifying early structural alterations of the atrial tissue in the rising stages of MR considering that Left Atrial Peak Longitudinal Strain (PALS) considered useful parameter for a more extensive evaluation of MR patients.

  7. Superior Semicircular Canal Dehiscence Syndrome without Vestibular Symptoms

    OpenAIRE

    Teixeira,Emidio Oliveira; Fonseca,Marconi Teixeira

    2014-01-01

    Introduction Superior semicircular canal dehiscence syndrome is mainly characterized by vestibular symptoms induced by intense sound stimuli or pressure changes, which occur because of dehiscence of the bony layer covering the superior semicircular canal. Case Report Here, we report a case of the syndrome with pulsatile tinnitus and ear fullness, in the absence of vestibular symptoms. Discussion Signs and symptoms of the syndrome are rarely obvious, leading to the requirement for a min...

  8. Spontaneous Rupture of a Superior Gluteal Artery Mycotic Aneurysm

    OpenAIRE

    George, Neal; Abdelghany, Mahmoud; Stark, Owen; Joshi, Medha

    2015-01-01

    Gluteal artery aneurysms are uncommon among all aneurysms and are usually a result of trauma. Streptococcus viridans bacteremia has been described in rare cases of extracranial mycotic aneurysms. Despite a variable clinical presentation, mycotic aneurysms of the superior gluteal artery could be the cause in patients with unexplained sciatica pain. Here we report a very rare case of spontaneous rupture of a superior gluteal artery mycotic aneurysm in a patient with underlying infective endocar...

  9. Left dorsal speech stream components and their contribution to phonological processing.

    Science.gov (United States)

    Murakami, Takenobu; Kell, Christian A; Restle, Julia; Ugawa, Yoshikazu; Ziemann, Ulf

    2015-01-28

    Models propose an auditory-motor mapping via a left-hemispheric dorsal speech-processing stream, yet its detailed contributions to speech perception and production are unclear. Using fMRI-navigated repetitive transcranial magnetic stimulation (rTMS), we virtually lesioned left dorsal stream components in healthy human subjects and probed the consequences on speech-related facilitation of articulatory motor cortex (M1) excitability, as indexed by increases in motor-evoked potential (MEP) amplitude of a lip muscle, and on speech processing performance in phonological tests. Speech-related MEP facilitation was disrupted by rTMS of the posterior superior temporal sulcus (pSTS), the sylvian parieto-temporal region (SPT), and by double-knock-out but not individual lesioning of pars opercularis of the inferior frontal gyrus (pIFG) and the dorsal premotor cortex (dPMC), and not by rTMS of the ventral speech-processing stream or an occipital control site. RTMS of the dorsal stream but not of the ventral stream or the occipital control site caused deficits specifically in the processing of fast transients of the acoustic speech signal. Performance of syllable and pseudoword repetition correlated with speech-related MEP facilitation, and this relation was abolished with rTMS of pSTS, SPT, and pIFG. Findings provide direct evidence that auditory-motor mapping in the left dorsal stream causes reliable and specific speech-related MEP facilitation in left articulatory M1. The left dorsal stream targets the articulatory M1 through pSTS and SPT constituting essential posterior input regions and parallel via frontal pathways through pIFG and dPMC. Finally, engagement of the left dorsal stream is necessary for processing of fast transients in the auditory signal. Copyright © 2015 the authors 0270-6474/15/351411-12$15.00/0.

  10. 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

  11. Superior mesenteric arterial branch occlusion causing partial jejunal ischemia: a case report

    Directory of Open Access Journals (Sweden)

    Van De Winkel Nele

    2012-02-01

    Full Text Available Abstract Introduction Ischemic bowel disease comprises both mesenteric ischemia and colonic ischemia. Mesenteric ischemia can be divided into acute and chronic ischemia. These are two separate entities, each with their specific clinical presentation and diagnostic and therapeutic modalities. However, diagnosis may be difficult due to the vague symptomatology and subtle signs. Case presentation We report the case of a 68-year-old Caucasian woman who presented with abdominal discomfort, anorexia, melena and fever. A physical examination revealed left lower quadrant tenderness and an irregular pulse. Computed tomography of her abdomen as well as computed tomography enterography, enteroscopy, angiography and small bowel enteroclysis demonstrated an ischemic jejunal segment caused by occlusion of a branch of the superior mesenteric artery. The ischemic segment was resected and an end-to-end anastomosis was performed. The diagnosis of segmental small bowel ischemia was confirmed by histopathological study. Conclusion Mesenteric ischemia is a pathology well-known by surgeons, gastroenterologists and radiologists. Acute and chronic mesenteric ischemia are two separate entities with their own specific clinical presentation, radiological signs and therapeutic modalities. We present the case of a patient with symptoms and signs of chronic mesenteric ischemia despite an acute etiology. To the best of our knowledge, this is the first report presenting a case of acute mesenteric ischemia with segmental superior mesenteric artery occlusion.

  12. Speech-specific tuning of neurons in human superior temporal gyrus.

    Science.gov (United States)

    Chan, Alexander M; Dykstra, Andrew R; Jayaram, Vinay; Leonard, Matthew K; Travis, Katherine E; Gygi, Brian; Baker, Janet M; Eskandar, Emad; Hochberg, Leigh R; Halgren, Eric; Cash, Sydney S

    2014-10-01

    How the brain extracts words from auditory signals is an unanswered question. We recorded approximately 150 single and multi-units from the left anterior superior temporal gyrus of a patient during multiple auditory experiments. Against low background activity, 45% of units robustly fired to particular spoken words with little or no response to pure tones, noise-vocoded speech, or environmental sounds. Many units were tuned to complex but specific sets of phonemes, which were influenced by local context but invariant to speaker, and suppressed during self-produced speech. The firing of several units to specific visual letters was correlated with their response to the corresponding auditory phonemes, providing the first direct neural evidence for phonological recoding during reading. Maximal decoding of individual phonemes and words identities was attained using firing rates from approximately 5 neurons within 200 ms after word onset. Thus, neurons in human superior temporal gyrus use sparse spatially organized population encoding of complex acoustic-phonetic features to help recognize auditory and visual words. © The Author 2013. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  13. Differential diagnosis of cervical radiculopathy and superior pulmonary sulcus tumor.

    Science.gov (United States)

    Gu, Rui; Kang, Ming-Yang; Gao, Zhong-Li; Zhao, Jian-Wu; Wang, Jin-Cheng

    2012-08-01

    The result would be disastrous if the superior pulmonary sulcus tumor (Pancoast tumor) was misdiagnosed as degenerative cervical spine diseases. The aim of this study was to investigate the differential diagnosis methods of cervical radiculopathy and superior pulmonary sulcus tumor. Clinical manifestations, physical, and radiological findings of 10 patients, whose main complaints were radiating shoulder and arm pain and later were diagnosed with superior pulmonary sulcus tumor, were reviewed and compared with those of cervical radiculopathy. Superior pulmonary sulcus tumor patients have shorter mean history and fewer complaints of neck pain or limitation of neck movement. Physical examination showed almost normal cervical spine range of motion. Spurling's neck compression test was negative in all patients. Anteroposterior cervical radiographs showed the lack of pulmonary air at the top of the affected lung in all cases and first rib encroachment in one case. The diagnosis of superior pulmonary sulcus tumor can be further confirmed by CT and MRI. By the method of combination of history, physical examination, and radiological findings, superior pulmonary sulcus tumor can be efficiently differentiated from cervical radiculopathy. Normal motion range of the cervical spine, negative Spurling's neck compression test, and the lack of pulmonary air at the top of the affected lung in anteroposterior cervical radiographs should be considered as indications for further chest radiograph examinations.

  14. Gray and white matter distribution in dyslexia: a VBM study of superior temporal gyrus asymmetry.

    Directory of Open Access Journals (Sweden)

    Marjorie Dole

    Full Text Available In the present study, we investigated brain morphological signatures of dyslexia by using a voxel-based asymmetry analysis. Dyslexia is a developmental disorder that affects the acquisition of reading and spelling abilities and is associated with a phonological deficit. Speech perception disabilities have been associated with this deficit, particularly when listening conditions are challenging, such as in noisy environments. These deficits are associated with known neurophysiological correlates, such as a reduction in the functional activation or a modification of functional asymmetry in the cortical regions involved in speech processing, such as the bilateral superior temporal areas. These functional deficits have been associated with macroscopic morphological abnormalities, which potentially include a reduction in gray and white matter volumes, combined with modifications of the leftward asymmetry along the perisylvian areas. The purpose of this study was to investigate gray/white matter distribution asymmetries in dyslexic adults using automated image processing derived from the voxel-based morphometry technique. Correlations with speech-in-noise perception abilities were also investigated. The results confirmed the presence of gray matter distribution abnormalities in the superior temporal gyrus (STG and the superior temporal Sulcus (STS in individuals with dyslexia. Specifically, the gray matter of adults with dyslexia was symmetrically distributed over one particular region of the STS, the temporal voice area, whereas normal readers showed a clear rightward gray matter asymmetry in this area. We also identified a region in the left posterior STG in which the white matter distribution asymmetry was correlated to speech-in-noise comprehension abilities in dyslexic adults. These results provide further information concerning the morphological alterations observed in dyslexia, revealing the presence of both gray and white matter distribution

  15. Selective involvement of superior frontal cortex during working memory for shapes.

    Science.gov (United States)

    Yee, Lydia T S; Roe, Katherine; Courtney, Susan M

    2010-01-01

    A spatial/nonspatial functional dissociation between the dorsal and ventral visual pathways is well established and has formed the basis of domain-specific theories of prefrontal cortex (PFC). Inconsistencies in the literature regarding prefrontal organization, however, have led to questions regarding whether the nature of the dissociations observed in PFC during working memory are equivalent to those observed in the visual pathways for perception. In particular, the dissociation between dorsal and ventral PFC during working memory for locations versus object identities has been clearly present in some studies but not in others, seemingly in part due to the type of objects used. The current study compared functional MRI activation during delayed-recognition tasks for shape or color, two object features considered to be processed by the ventral pathway for perceptual recognition. Activation for the shape-delayed recognition task was greater than that for the color task in the lateral occipital cortex, in agreement with studies of visual perception. Greater memory-delay activity was also observed, however, in the parietal and superior frontal cortices for the shape than for the color task. Activity in superior frontal cortex was associated with better performance on the shape task. Conversely, greater delay activity for color than for shape was observed in the left anterior insula and this activity was associated with better performance on the color task. These results suggest that superior frontal cortex contributes to performance on tasks requiring working memory for object identities, but it represents different information about those objects than does the ventral frontal cortex.

  16. Superior cortical screw in osteoporotic lumbar vertebrae: A biomechanics and microstructure-based study.

    Science.gov (United States)

    Yu, Tianming; Zhang, Xuyang; Liu, Junhui; Li, Shengyun; Shan, Zhi; Fan, Shunwu; Zhao, Fengdong

    2018-01-31

    Osteoporosis reduces the bone-screw purchase, potentially reducing pullout strength and other biomechanical properties. However, the existing pedicle screw approach may not compensate for the detrimental effects of decreased vertebral bone mineral density. Two methods of screw insertion were performed in thirteen cadaveric osteoporotic lumbar vertebrae: Magerl's method in the left pedicle, and superior cortical screw method in the right (its entry point located vertically 3 mm above Magerl's point). Before screw fixations, the pedicle and its corresponding vertebral body were divided into six equal layers from cranial to caudal by performing micro-CT and tested for microstructure properties, such as bone mineral density, trabecular bone volume fraction, trabecular thickness, trabecular separation and trabecular number. Further, pedicle was horizontally divided into three regions and tested. After screw fixations, microstructure properties of the bone surrounding the screws were analyzed. Finally, the screw pullout strength was tested biomechanically. The bone structure is denser in the upper third of the pedicle and its corresponding vertebral body. A similar microstructure is seen within the pedicle. This study reveals that the pullout strength is significantly correlated to the bone mineral density, trabecular bone volume fraction and trabecular thickness. Biomechanical test showed pullout strength in the superior cortical screw group with mean 613.3 N (SD 200.4) was 22.4% higher than that in the Magerl group with mean 501.2 N (SD 256.6). The superior cortical screw method can be a reliable alternative, to provide better pullout strength for posterior lumbar instrumentation, especially in osteoporotic patients. Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. Gray and white matter distribution in dyslexia: a VBM study of superior temporal gyrus asymmetry.

    Science.gov (United States)

    Dole, Marjorie; Meunier, Fanny; Hoen, Michel

    2013-01-01

    In the present study, we investigated brain morphological signatures of dyslexia by using a voxel-based asymmetry analysis. Dyslexia is a developmental disorder that affects the acquisition of reading and spelling abilities and is associated with a phonological deficit. Speech perception disabilities have been associated with this deficit, particularly when listening conditions are challenging, such as in noisy environments. These deficits are associated with known neurophysiological correlates, such as a reduction in the functional activation or a modification of functional asymmetry in the cortical regions involved in speech processing, such as the bilateral superior temporal areas. These functional deficits have been associated with macroscopic morphological abnormalities, which potentially include a reduction in gray and white matter volumes, combined with modifications of the leftward asymmetry along the perisylvian areas. The purpose of this study was to investigate gray/white matter distribution asymmetries in dyslexic adults using automated image processing derived from the voxel-based morphometry technique. Correlations with speech-in-noise perception abilities were also investigated. The results confirmed the presence of gray matter distribution abnormalities in the superior temporal gyrus (STG) and the superior temporal Sulcus (STS) in individuals with dyslexia. Specifically, the gray matter of adults with dyslexia was symmetrically distributed over one particular region of the STS, the temporal voice area, whereas normal readers showed a clear rightward gray matter asymmetry in this area. We also identified a region in the left posterior STG in which the white matter distribution asymmetry was correlated to speech-in-noise comprehension abilities in dyslexic adults. These results provide further information concerning the morphological alterations observed in dyslexia, revealing the presence of both gray and white matter distribution anomalies and the

  18. Assessment of stiffness of the hypertrophied left ventricle of bicyclists using left ventricular inflow Doppler velocimetry.

    Science.gov (United States)

    Fagard, R; Van den Broeke, C; Bielen, E; Vanhees, L; Amery, A

    1987-06-01

    Sixteen male bicyclists and 16 control subjects were studied to assess whether the left ventricular hypertrophy of athletes is associated with changes in diastolic left ventricular function. The cyclists had a larger left ventricular internal diameter on echocardiography (55.2 versus 47.9 mm; p less than 0.001) and a disproportionate increase in wall thickness relative to the internal diameter (0.48 versus 0.41; p less than 0.01), indicating a mixed eccentric-concentric type of hypertrophy. Left ventricular inflow Doppler velocimetry showed similar results in athletes and control subjects for peak flow velocities in the atrial contraction phase (30 versus 32 cm/s; p = NS) and in the early diastolic rapid filling phase (71 versus 67 cm/s; p = NS). The similar ratio of both velocities, that is, 0.43 in the cyclists and 0.49 in the control subjects, suggests that left ventricular distensibility is unaltered in cyclists. It is concluded that the left ventricular hypertrophy observed in cyclists is not associated with changes in ventricular stiffness, as estimated from left ventricular inflow Doppler velocimetry.

  19. Longitudinal health effects of disasters.

    NARCIS (Netherlands)

    Yzermans, C.J.

    2004-01-01

    Background: We carry out prospective, longitudinal studies on the possible health effects of two disasters in the Netherlands: the explosion of fireworks depot in a residential area (Enschede) and a fire in discotheque in Volendam. Learning from the chaotic aftermath previous disasters, the Dutch

  20. Longitudinal heritability of childhood aggression

    NARCIS (Netherlands)

    Porsch, R.M.P.; Middeldorp, C.M.; Cherny, S.S.; Krapohl, E.; van Beijsterveldt, C.E.M.; Loukola, A.; Korhonen, T.; Pulkkinen, L.; Corley, R.P.; Rhee, S.; Kaprio, J.; Rose, R.; Hewitt, J.K.; Sham, P.; Plomin, R.; Boomsma, D.I.; Bartels, M.

    2016-01-01

    The genetic and environmental contributions to the variation and longitudinal stability in childhood aggressive behavior were assessed in two large twin cohorts, the Netherlands Twin Register (NTR), and the Twins Early Development Study (TEDS; United Kingdom). In NTR, maternal ratings on aggression

  1. Students dance longitudinal standing waves

    Science.gov (United States)

    Ruiz, Michael J.

    2017-05-01

    A demonstration is presented that involves students dancing longitudinal standing waves. The resulting kinaesthetic experience and visualization both contribute towards an understanding of the natural modes of vibrations in open and closed pipes. A video of this fun classroom activity is provided (http://mjtruiz.com/ped/dance/).

  2. Cardiac resynchronization therapy by multipoint pacing improves response of left ventricular mechanics and fluid dynamics: a three-dimensional and particle image velocimetry echo study.

    Science.gov (United States)

    Siciliano, Mariachiara; Migliore, Federico; Badano, Luigi; Bertaglia, Emanuele; Pedrizzetti, Gianni; Cavedon, Stefano; Zorzi, Alessandro; Corrado, Domenico; Iliceto, Sabino; Muraru, Denisa

    2017-11-01

    To characterize the effect of multipoint pacing (MPP) compared to biventricular pacing (BiV) on left ventricle (LV) mechanics and intraventricular fluid dynamics by three-dimensional echocardiography (3DE) and echocardiographic particle imaging velocimetry (Echo-PIV). In 11 consecutive patients [8 men; median age 65 years (57-75)] receiving cardiac resynchronization therapy (CRT) with a quadripolar LV lead (Quartet,St.Jude Medical,Inc.), 3DE and Echo-PIV data were collected for each pacing configuration (CRT-OFF, BiV, and MPP) at follow-up after 6 months. 3DE data included LV volumes, LV ejection fraction (LVEF), strain, and systolic dyssynchrony index (SDI). Echo-PIV was used to evaluate the directional distribution of global blood flow momentum, ranging from zero, when flow force is predominantly along the base-apex direction, up to 90° when it becomes transversal. MPP resulted in significant reduction in end-diastolic and end-systolic volumes compared with both CRT-OFF (P = 0.02; P = 0.008, respectively) and BiV (P = 0.04; P = 0.03, respectively). LVEF and cardiac output were significant superior in MPP compared with CRT-OFF, but similar between MPP and BiV. Statistical significant differences when comparing global longitudinal and circumferential strain and SDI with MPP vs. CRT-OFF were observed (P = 0.008; P = 0.008; P = 0.01, respectively). There was also a trend towards improvement in strain between BiV and MPP that did not reach statistical significance. MPP reflected into a significant reduction of the deviation of global blood flow momentum compared with both CRT-OFF and BiV (P = 0.002) indicating a systematic increase of longitudinal alignment from the base-apex orientation of the haemodynamic forces. These preliminary results suggest that MPP resulted in significant improvement of LV mechanics and fluid dynamics compared with BiV. However, larger studies are needed to confirm this hypothesis. © Crown copyright 2016.

  3. PICTORIAL ESSAY Is anomalous origin of the left vertebral artery ...

    African Journals Online (AJOL)

    The incidence of anomalous origin of the left vertebral artery from the aortic arch ranges between 1% and 5.8%.1,2 This anomaly has important implications for thoracic surgery and interventional procedures. The left vertebral artery may originate from: • the left common carotid artery. • the root of the left subclavian artery ...

  4. Positive symptoms associate with cortical thinning in the superior temporal gyrus via the ENIGMA Schizophrenia consortium.

    Science.gov (United States)

    Walton, E; Hibar, D P; van Erp, T G M; Potkin, S G; Roiz-Santiañez, R; Crespo-Facorro, B; Suarez-Pinilla, P; Van Haren, N E M; de Zwarte, S M C; Kahn, R S; Cahn, W; Doan, N T; Jørgensen, K N; Gurholt, T P; Agartz, I; Andreassen, O A; Westlye, L T; Melle, I; Berg, A O; Mørch-Johnsen, L; Faerden, A; Flyckt, L; Fatouros-Bergman, H; Jönsson, E G; Hashimoto, R; Yamamori, H; Fukunaga, M; Preda, A; De Rossi, P; Piras, F; Banaj, N; Ciullo, V; Spalletta, G; Gur, R E; Gur, R C; Wolf, D H; Satterthwaite, T D; Beard, L M; Sommer, I E; Koops, S; Gruber, O; Richter, A; Krämer, B; Kelly, S; Donohoe, G; McDonald, C; Cannon, D M; Corvin, A; Gill, M; Di Giorgio, A; Bertolino, A; Lawrie, S; Nickson, T; Whalley, H C; Neilson, E; Calhoun, V D; Thompson, P M; Turner, J A; Ehrlich, S

    2017-05-01

    Based on the role of the superior temporal gyrus (STG) in auditory processing, language comprehension and self-monitoring, this study aimed to investigate the relationship between STG cortical thickness and positive symptom severity in schizophrenia. This prospective meta-analysis includes data from 1987 individuals with schizophrenia collected at seventeen centres around the world that contribute to the ENIGMA Schizophrenia Working Group. STG thickness measures were extracted from T1-weighted brain scans using FreeSurfer. The study performed a meta-analysis of effect sizes across sites generated by a model predicting left or right STG thickness with a positive symptom severity score (harmonized SAPS or PANSS-positive scores), while controlling for age, sex and site. Secondary models investigated relationships between antipsychotic medication, duration of illness, overall illness severity, handedness and STG thickness. Positive symptom severity was negatively related to STG thickness in both hemispheres (left: β std = -0.052; P = 0.021; right: β std = -0.073; P = 0.001) when statistically controlling for age, sex and site. This effect remained stable in models including duration of illness, antipsychotic medication or handedness. Our findings further underline the important role of the STG in hallmark symptoms in schizophrenia. These findings can assist in advancing insight into symptom-relevant pathophysiological mechanisms in schizophrenia. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. The Neuroanatomical Basis for Posterior Superior Parietal Lobule Control Lateralization of Visuospatial Attention.

    Science.gov (United States)

    Wu, Yan; Wang, Jiaojian; Zhang, Yun; Zheng, Dingchen; Zhang, Jinfeng; Rong, Menglin; Wu, Huawang; Wang, Yinyan; Zhou, Ke; Jiang, Tianzi

    2016-01-01

    The right hemispheric dominance in visuospatial attention in human brain has been well established. Converging evidence has documented that ventral posterior parietal cortex (PPC) plays an important role in visuospatial attention. The role of dorsal PPC subregions, especially the superior parietal lobule (SPL) in visuospatial attention is still controversial. In the current study, we used repetitive transcranial magnetic stimulation (rTMS) and diffusion magnetic resonance imaging (MRI) techniques to test the role of posterior SPL in visuospatial attention and to investigate the potential neuroanatomical basis for right hemisphere dominance in visuospatial function. Transcranial magnetic stimulation (TMS) results unraveled that the right SPL predominantly mediated visuospatial attention compared to left SPL. Anatomical connections analyses between the posterior SPL and the intrahemispheric frontal subregions and the contralateral PPC revealed that right posterior SPL has stronger anatomical connections with the ipsilateral middle frontal gyrus (MFG), with the ipsilateral inferior frontal gyrus (IFG), and with contralateral PPC than that of the left posterior SPL. Furthermore, these asymmetric anatomical connections were closely related to behavioral performances. Our findings indicate that SPL plays a crucial role in regulating visuospatial attention, and dominance of visuospatial attention results from unbalanced interactions between the bilateral fronto-parietal networks and the interhemispheric parietal network.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-09-15

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

  7. Intestinal malrotation in patients with situs anomaly: Implication of the relative positions of the superior mesenteric artery and vein

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Kyu Sung [Department of Radiology, Seoul National University Hospital (Korea, Republic of); Choi, Young Hun, E-mail: iater@snu.ac.kr [Department of Radiology, Seoul National University Hospital (Korea, Republic of); Department of Radiology, Seoul National University College of Medicine (Korea, Republic of); Cheon, Jung-Eun; Kim, Woo Sun; Kim, In One [Department of Radiology, Seoul National University Hospital (Korea, Republic of); Department of Radiology, Seoul National University College of Medicine (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Medical Research Center (Korea, Republic of)

    2016-10-15

    Purpose: To assess the usefulness of the relative position of the superior mesenteric artery (SMA) and superior mesenteric vein (SMV) in diagnosing intestinal malrotation in situs anomaly. Materials and methods: From January 2004 to April 2015, 33 patients with situs anomalies were enrolled in this study who underwent abdominal USG, CT or MRI as well as upper gastrointestinal series (UGIS) or surgery: situs inversus (n = 16), left isomerism (n = 10), and right isomerism (n = 7); age 21.2 ± 23.2 years (mean ± standard deviation), range 0–72 years. The intestinal malrotation was confirmed with UGIS and/or operation in 16 patients. Relative positions of the SMV to the SMA were classified into four groups by reviewing abdominal USG, CT, or MRI: right sided, left sided, ventral sided, and dorsal sided. The incidence of malrotation was analyzed for each group. Results: In 16 patients with situs inversus, there was reversed SMA-SMV relationship: left sided (n = 11) or ventral sided (n = 5). One situs inversus patient with ventral sided SMV had intestinal malrotation (6.25%). 17 patients with situs ambiguus showed various SMA-SMV relationships (ventral sided, n = 7; left sided, n = 5; right sided, n = 4; dorsal sided, n = 1). Among them, 15 patients (88.2%) had intestinal malrotation. Two patients with normal rotation had either right sided or dorsal sided SMV. Conclusion: Situs ambiguus was commonly associated with intestinal malrotation with a variable SMA-SMV relationship. Reversal of the mesenteric vascular relationship was observed in situs inversus with normal rotation, not excluding the possibility of intestinal malrotation.

  8. Impact of overweight on left ventricular function in type 2 diabetes mellitus.

    Science.gov (United States)

    Suto, Makiko; Tanaka, Hidekazu; Mochizuki, Yasuhide; Mukai, Jun; Takada, Hiroki; Soga, Fumitaka; Dokuni, Kumiko; Hatani, Yutaka; Hatazawa, Keiko; Matsuzoe, Hiroki; Sano, Hiroyuki; Shimoura, Hiroyuki; Ooka, Junichi; Matsumoto, Kensuke; Hirota, Yushi; Ogawa, Wataru; Hirata, Ken-Ichi

    2017-11-09

    Coexistence of left ventricular (LV) longitudinal myocardial systolic dysfunction with LV diastolic dysfunction could lead to heart failure with preserved ejection fraction (HFpEF). Diabetes mellitus (DM) is known as a significant factor associated with HFpEF. Although the mechanisms of DM-related LV myocardial injury are complex, it has been postulated that overweight contributes to the development of LV myocardial injury in type 2 diabetes mellitus (T2DM) patients. However, the precise impact of overweight on LV longitudinal myocardial systolic function in T2DM patients remains unclear. We studied 145 asymptomatic T2DM patients with preserved LV ejection fraction (LVEF) without coronary artery disease. LV longitudinal myocardial systolic function was assessed by global longitudinal strain (GLS), which was defined as the average peak strain of 18-segments obtained from standard apical views. Overweight was defined as body mass index (BMI) ≥ 25 kg/m 2 . Ninety age-, gender- and LVEF-matched healthy volunteers served as controls. GLS of overweight T2DM patients was significantly lower than that of non-overweight patients (17.9 ± 2.4% vs. 18.9 ± 2.6%, p overweight and non-overweight controls was similar (19.8 ± 1.3% vs. 20.4 ± 2.1%, p = 0.38). Furthermore, multiple regression analysis revealed that for T2DM patients, BMI was the independent determinant parameters for GLS as well as LV mass index. Overweight has a greater effect on LV longitudinal myocardial systolic function in T2DM patients than on that in non-DM healthy subjects. Our finding further suggests that the strict control of overweight in T2DM patients may be associated with prevention of the development of HFpEF.

  9. Global Longitudinal Strain Is a Superior Predictor of All-Cause Mortality in Heart Failure With Reduced Ejection Fraction

    DEFF Research Database (Denmark)

    Sengeløv, Morten; Jørgensen, Peter Godsk; Jensen, Jan Skov

    2015-01-01

    failure clinic. The echocardiographic images were analyzed, and conventional and novel echocardiographic parameters were obtained. RESULTS: Many of the conventional echocardiographic parameters proved to be predictors of mortality. However, GLS remained an independent predictor of mortality...

  10. Evaluation of longitudinal joint tie bar system.

    Science.gov (United States)

    2011-09-01

    "An adequate longitudinal joint tie bar system is essential in the overall performance of concrete pavement. Excessive : longitudinal joint openings are believed to be caused by either inadequate tie bar size or spacing or improper tie bar : installa...

  11. Analysis of Regional Left Ventricular Strain in Patients with Chagas Disease and Normal Left Ventricular Systolic Function.

    Science.gov (United States)

    Gomes, Victor Augusto M; Alves, Gabriel F; Hadlich, Marcelo; Azevedo, Clerio F; Pereira, Iane M; Santos, Carla Renata F; Brasil, Pedro Emmanuel A A; Sangenis, Luiz Henrique C; Cunha, Ademir B; Xavier, Sergio S; Saraiva, Roberto M

    2016-07-01

    Chagas heart disease has a high socioeconomic burden, and any strategy to detect early myocardial damage is welcome. Speckle-tracking echocardiography assesses global and segmental left ventricular (LV) systolic function, yielding values of two-dimensional strain (ε). The aim of this study was to determine if patients with chronic Chagas disease and normal LV ejection fractions present abnormalities in global and segmental LV ε. In this prospective study, patients with Chagas disease with no evidence of cardiac involvement (group I; n = 83) or at stage A of the cardiac form (i.e., with changes limited to the electrocardiogram) (group A; n = 42) and 43 control subjects (group C) underwent evaluation of global and segmental LV ε by speckle-tracking echocardiography. A subset of randomly selected patients in group A underwent cardiac magnetic resonance imaging and repeated echocardiography 3.5 ± 0.8 years after the first evaluation. Mean age, chamber dimensions, and LV ejection fraction were similar among the groups. Global longitudinal (group C, -19 ± 2%; group I, -19 ± 2%; group A, -19 ± 2%), circumferential (group C, -19 ± 3%; group I, -20 ± 3%; group A, -19 ± 3%), and radial (group C, 46 ± 10%; group I, 45 ± 13%; group A, 42 ± 14%) LV ε were similar among the groups. Segmental longitudinal, circumferential, and radial LV ε were similar across the studied groups. Seven of 14 patients had areas of fibrosis on cardiac magnetic resonance imaging. Patients with fibrosis had lower global longitudinal (-15 ± 2% vs -18 ± 2%, P = .004), circumferential (-14 ± 2% vs -19 ± 2%, P = .002), and radial LV ε (36 ± 13% vs 54 ± 12%, P = .02) than those without cardiac fibrosis despite similar LV ejection fractions. Patients with fibrosis had lower radial LV ε in the basal inferoseptal wall than patients without cardiac fibrosis (27 ± 17% vs 60 ± 15%, P = .04). Patients with chronic Chagas disease and normal

  12. [Cerebellar infarction in vascular teritorry of arteria cerebelli superior].

    Science.gov (United States)

    Savić, Dejan; Savić, Ljiljana

    2010-01-01

    Cerebellar vascular diseases are focal cerebrovascular diseases in posterior circulation--vertebrobasilar system. The cerebellum is supplied by three main arteries arising from the vertebrobasilar system: arteria cerebelli inferior posterior, arteria cerebelli inferior anterior and arteria cerebelli superior. Cerebelar infarctions are rare but unpredictable disorders. The aim of this study was determination of main risk factors, clinical presentation and prognosis of the cerebellar infarctions in distal vascular teritorry of the arteria cerebelli superior. We evaluated 60 patients hospitalized after acute cerebellar infarction among other hospitalized patients in five year period. In 18 patients computerized tomography demonstrated infarction in distal vascular teritorry of the arteria cerebelli superior. All patients underwent clinical and other diagnostic investigations (computerized tomography, electrocardyography and standard blood tests) and were questioned by phone after finishing hospital treatment. Cerebellar infarcts in distal vascular teritorry of arteria cerebell superior was 30% of all cerebellar infarcts. The most frequent risk factor was hypertension (66.7%). Symptomatology and clinical signs were heterogenous but the most frequent were instability (77.8%), vertigo (72.2%) and vomiting (55.6%) followed by ataxia of the limbs (77.8%) and the body (61.1%), nystagmus (55.6%) and disarthria (33.3%) in clinical presentation. All patients had good recovery in hospital and one year afterwards. Infarctions in distribution of arteria cerebelli superior are rare and have multiple risk factors and various clinical features in majority of other studies as in this one. Mass effects are present in several studies but none in this one which reflects contraversions present in other published investigations. Cerebellar infarctions in vascular teritorry of arteria cerebelli superior have multiple risk factors, mostly heterogenous clinical presentations with

  13. 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.

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

    Directory of Open Access Journals (Sweden)

    S. Bhattacharyya

    2014-01-01

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

  15. Left ventricular non-compaction cardiomyopathy and left ventricular assist device: a word of caution.

    Science.gov (United States)

    Kornberger, A; Stock, U A; Risteski, P; Beiras Fernandez, A

    2016-07-15

    In patients with left ventricular non-compaction (LVNC), implantation of a left ventricular assist device (LVAD) may be performed as a bridge to transplantation. In this respect, the particular characteristics of the left ventricular myocardium may represent a challenge. We report a patient with LVNC who required urgent heart transplantation for inflow cannula obstruction nine months after receiving a LVAD. LVAD parameters, echocardiography and examination of the explanted heart suggested changes of left ventricular configuration brought about by LVAD support as the most likely cause of inflow cannula obstruction. We conclude that changes experienced by non-compacted myocardium during LVAD support may give rise to inflow cannula obstruction and flow reduction. Presence of LVNC mandates tight surveillance for changes in LV configuration and LVAD flow characteristics and may justify urgent transplantation listing status.

  16. Relationship between longitudinal strain and symptomatic status in aortic stenosis.

    Science.gov (United States)

    Attias, David; Macron, Laurent; Dreyfus, Julien; Monin, Jean-Luc; Brochet, Eric; Lepage, Laurent; Hekimian, Guillaume; Iung, Bernard; Vahanian, Alec; Messika-Zeitoun, David

    2013-08-01

    Global longitudinal strain (GLS) and basal longitudinal strain (BLS) assessed using two-dimensional speckle-tracking imaging have been proposed as subtle markers of left ventricular (LV) systolic dysfunction with potential prognostic value in patients with aortic stenosis (AS). The aim of this study was to evaluate the relationship between longitudinal strain and symptomatic status in patients with AS. GLS and BLS were measured in 171 patients with pure, isolated, at least mild AS prospectively enrolled at two institutions. The population was divided into four groups: asymptomatic nonsevere AS (n = 55), asymptomatic severe AS with preserved LV ejection fraction (LVEF; ≥50%) (n = 37), symptomatic severe AS with preserved LVEF (n = 60), and severe AS with reduced LVEF (<50%) (n = 19). GLS was significantly different among the four groups (P < .0001), but the difference was due mainly to patients with reduced LVEFs. In addition, there was an important overlap among the groups, and in multivariate analysis, after adjustment for age, gender, AS severity, and LVEF, GLS was not an independent predictor of symptomatic status (P = .07). BLS was also significantly different among the four groups (P < .0001) but in contrast was independently associated with symptomatic status (P < .0001). However, as for GLS, there was an important overlap between groups and differences were close to intraobserver or interobserver variability (1.3 ± 1.1% and 2.0 ± 1.6%, respectively). In this prospective multicenter cohort of patients with wide ranges of AS severity, symptoms, and LVEFs, BLS but not GLS was independently associated with symptomatic status. However, there was an important overlap among groups, and differences were close to measurements' reproducibility, raising caution regarding the use of longitudinal strain, at least as a single criterion, in the decision-making process for patients with severe asymptomatic AS. Copyright © 2013. Published by Mosby, Inc.

  17. [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.

  18. Left-right symmetric electroweak models

    International Nuclear Information System (INIS)

    Olness, F.I.

    1989-10-01

    We present a critical analysis of the spontaneous symmetry breaking and the Higgs sector of the conventional SU(2) L circle-times SU(2) R circle-times U(1) B-L left-right symmetric theory involving bi-doublet and triplet Higgs fields. We examine the phenomenological constraints imposed on the minimization of the Higgs potential arising from experimental observations, and explore the resulting consequences including the problem of ''fine- tuning'' arising from the hierarchy of mass scales involved. We show that it is non-trivial to satisfy all of these constraints. We contrast the benefits of this general class left-right models against the required ''fine-tuning'' necessary to force the phenomenology to conform to experimental fact. 17 refs., 1 fig

  19. 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.

  20. Total agenesis of the left pericardium

    Directory of Open Access Journals (Sweden)

    J. Glauco Lobo Fº

    1999-09-01

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