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Sample records for left-sided network comprising

  1. Insights into Intrinsic Brain Networks based on Graph Theory and PET in right- compared to left-sided Temporal Lobe Epilepsy.

    Science.gov (United States)

    Vanicek, Thomas; Hahn, Andreas; Traub-Weidinger, Tatjana; Hilger, Eva; Spies, Marie; Wadsak, Wolfgang; Lanzenberger, Rupert; Pataraia, Ekaterina; Asenbaum-Nan, Susanne

    2016-06-28

    The human brain exhibits marked hemispheric differences, though it is not fully understood to what extent lateralization of the epileptic focus is relevant. Preoperative [(18)F]FDG-PET depicts lateralization of seizure focus in patients with temporal lobe epilepsy and reveals dysfunctional metabolic brain connectivity. The aim of the present study was to compare metabolic connectivity, inferred from inter-regional [(18)F]FDG PET uptake correlations, in right-sided (RTLE; n = 30) and left-sided TLE (LTLE; n = 32) with healthy controls (HC; n = 31) using graph theory based network analysis. Comparing LTLE and RTLE and patient groups separately to HC, we observed higher lobar connectivity weights in RTLE compared to LTLE for connections of the temporal and the parietal lobe of the contralateral hemisphere (CH). Moreover, especially in RTLE compared to LTLE higher local efficiency were found in the temporal cortices and other brain regions of the CH. The results of this investigation implicate altered metabolic networks in patients with TLE specific to the lateralization of seizure focus, and describe compensatory mechanisms especially in the CH of patients with RTLE. We propose that graph theoretical analysis of metabolic connectivity using [(18)F]FDG-PET offers an important additional modality to explore brain networks.

  2. Insights into Intrinsic Brain Networks based on Graph Theory and PET in right- compared to left-sided Temporal Lobe Epilepsy

    OpenAIRE

    Thomas Vanicek; Andreas Hahn; Tatjana Traub-Weidinger; Eva Hilger; Marie Spies; Wolfgang Wadsak; Rupert Lanzenberger; Ekaterina Pataraia; Susanne Asenbaum-Nan

    2016-01-01

    The human brain exhibits marked hemispheric differences, though it is not fully understood to what extent lateralization of the epileptic focus is relevant. Preoperative [18F]FDG-PET depicts lateralization of seizure focus in patients with temporal lobe epilepsy and reveals dysfunctional metabolic brain connectivity. The aim of the present study was to compare metabolic connectivity, inferred from inter-regional [18F]FDG PET uptake correlations, in right-sided (RTLE; n?=?30) and left-sided TL...

  3. Beware the left-sided gallbladder

    African Journals Online (AJOL)

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

  4. 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

  5. A disappearing left-sided neck mass.

    Science.gov (United States)

    Lutwak, Nancy; Dill, Curt

    2012-07-04

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

  6. A Study of Clinicopathological Differences Between Right-sided and Left-sided Colon Cancers

    OpenAIRE

    芳賀, 駿介; 遠藤, 俊吾; 加藤, 博之; 高橋, 直樹; 吉松, 和彦; 橋本, 雅彦; 石橋, 敬一郎; 梅原, 有弘; 横溝, 肇; 梶原, 哲郎; Shunsuke, HAGA; Shungo, ENDO; Hiroyuki, KATO; Naoki, TAKAHASHI; Kazuhiko, YOSHIMATSU

    1996-01-01

    The present study was aimed to determine the clinicopathological features of cancers of the right-sided colon (cecum, ascending colon, transverse colon) and left-sided colon (descending colon, sigmoid colon) in order to help improve the efficacy of their treatment. Excluding multiple cancer cases, 364 patients with primary colon cancer underwent surgey at our department between 1974 and 1994; they comprised 171 individuals with right-sided colon cancer and 193 with left-sided colon cancer. A ...

  7. Left-sided congenital heart lesions in mosaic Turner syndrome.

    Science.gov (United States)

    Bouayed Abdelmoula, Nouha; Abdelmoula, Balkiss; Smaoui, Walid; Trabelsi, Imen; Louati, Rim; Aloulou, Samir; Aloulou, Wafa; Abid, Fatma; Kammoun, Senda; Trigui, Khaled; Bedoui, Olfa; Denguir, Hichem; Mallek, Souad; Ben Aziza, Mustapha; Dammak, Jamila; Kaabi, Oldez; Abdellaoui, Nawel; Turki, Fatma; Kaabi, Asma; Kamoun, Wafa; Jabeur, Jihen; Ltaif, Wided; Chaker, Kays; Fourati, Haytham; M'rabet, Samir; Ben Ameur, Hedi; Gouia, Naourez; Mhiri, Mohamed Nabil; Rebai, Tarek

    2018-04-01

    In the era of the diseasomes and interactome networks, linking genetics with phenotypic traits in Turner syndrome should be studied thoroughly. As a part of this stratagem, mosaicism of both X and Y chromosome which is a common finding in TS and an evaluation of congenital heart diseases in the different situations of mosaic TS types, can be helpful in the identification of disturbed sex chromosomes, genes and signaling pathway actors. Here we report the case of a mosaic TS associated to four left-sided CHD, including BAV, COA, aortic aneurysms and dissections at an early age. The mosaicism included two cell lines, well-defined at the cytogenetic and molecular levels: a cell line which is monosomic for Xp and Xq genes (45,X) and another which is trisomic for pseudoautosomal genes that are present on the X and Y chromosomes and escape X inactivation: 45,X[8]/46,X,idic(Y)(pter→q11.2::q11.2→pter)[42]. This case generates two hypotheses about the contribution of genes linked to the sex chromosomes and the signaling pathways involving these genes, in left-sided heart diseases. The first hypothesis suggests the interaction between X chromosome and autosomal genes or loci of aortic development, possibly dose-dependent, and which could be in the framework of TGF-β-SMAD signaling pathways. The second implies that left-sided congenital heart lesions involve sex chromosomes loci. The reduced dosage of X chromosome gene(s), escaping X inactivation during development, contributes to this type of CHD. Regarding our case, these X chromosome genes may have homologues at the Y chromosome, but the process of inactivation of the centromeres of the isodicentric Y spreads to the concerned Y chromosome genes. Therefore, this case emerges as an invitation to consider the mosaics of Turner syndrome and to study their phenotypes in correlation with their genotypes to discover the underlying developmental and genetic mechanisms, especially the ones related to sex chromosomes.

  8. Left-sided gall bladder: Report of two cases

    Directory of Open Access Journals (Sweden)

    Chrungoo R

    2007-01-01

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

  9. Left-sided native valve Staphylococcus aureus endocarditis

    NARCIS (Netherlands)

    Slabbekoorn, M.; Horlings, H. M.; van der Meer, J. T. M.; Windhausen, A.; Van der Sloot, J. A. P.; Lagrand, W. K.

    2010-01-01

    Despite improved diagnostic tools and expanded treatment options, left-sided native valve endocarditis caused by Staphylococcus aureus infection remains a serious and destructive disease. The high morbidity and mortality, however, can be reduced by early recognition, correct diagnosis, and

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

    Science.gov (United States)

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

    2013-06-01

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

  11. Fallopian Tube Herniation through Left Sided Abdominal Drain Site.

    Science.gov (United States)

    Hussain, Khalid; Masood, Jovaria

    2016-06-01

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

  12. Prevalence of left-sided melanomas in an Irish population.

    LENUS (Irish Health Repository)

    de Blacam, C

    2012-02-01

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

  13. Prevalence of left-sided melanomas in an Irish population.

    LENUS (Irish Health Repository)

    de Blacam, C

    2011-04-17

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

  14. Oral antibiotic treatment of left-sided infectious endocarditis verified by 16S-PCR

    DEFF Research Database (Denmark)

    Bruun, Louise E; Tønder, Niels; Hansen, Thomas Fritz

    2011-01-01

    Treatment of infectious endocarditis (IE) comprises intravenously administered antibiotic medications given at high doses for 4-6 weeks--sometimes even longer. Approximately 50% of patients referred to tertiary care centres require additional surgical intervention. At present there are few papers...... describing the effects of oral antibiotic treatment in IE, and only in patients with right-sided endocarditis. In this case report we present a patient with left-sided Streptococcus endocarditis successfully treated with oral antibiotic drugs....

  15. Intraoperative colonic irrigation in the management of left sided ...

    African Journals Online (AJOL)

    Objectives: To evaluate the safety and benefits of antegrade intraoperative colonic irrigation (lavage) and primary anastomosis, after colonic resection, in the treatment of left sided large bowel emergencies. Design: A prospective descriptive study. Setting: Jos University Teaching Hospital, Jos, Nigeria. Participants: Thirty ...

  16. Anosognosia for hemiparesis after left-sided stroke.

    Science.gov (United States)

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

    2014-12-01

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

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

    Science.gov (United States)

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

    2017-01-19

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

  18. Emergency Management of Malignant Acute Left-Sided Colonic Obstruction

    Science.gov (United States)

    Trompetas, Vasileios

    2008-01-01

    INTRODUCTION The management of acute left-sided colonic obstruction still remains a challenging problem despite significant progress. METHODS A literature search was undertaken using PubMed and the Cochrane Library regarding the options in emergency management of left-sided colonic obstruction focusing on outcomes such as mortality, morbidity, long-term prognosis and cost effectiveness. DISCUSSION Colonic stenting is the best option either for palliation or as a bridge to surgery. It reduces morbidity and mortality rate and the need for colostomy formation. Stenting is likely to be cost effective, but data are variable depending on the individual healthcare system. Nevertheless, surgical management remains relevant as colonic stenting has a small rate of failure, and it is not always available. There are various surgical options. One-stage primary resection and anastomosis is the preferred choice for low-risk patients. Intra-operative colonic irrigation has no proven benefit. Subtotal colectomy is useful in cases of proximal bowel damage or synchronous tumours. Hartmann's procedure should be reserved for high-risk patients. Simple colostomy has no role other than for use in very ill patients who are not fit for any other procedure. PMID:18430330

  19. Electrode material comprising graphene-composite materials in a graphite network

    Science.gov (United States)

    Kung, Harold H.; Lee, Jung K.

    2017-08-08

    A durable electrode material suitable for use in Li ion batteries is provided. The material is comprised of a continuous network of graphite regions integrated with, and in good electrical contact with a composite comprising graphene sheets and an electrically active material, such as silicon, wherein the electrically active material is dispersed between, and supported by, the graphene sheets.

  20. Difference between right and left side in total knee and unicondylar knee replacement: An interesting observation

    Directory of Open Access Journals (Sweden)

    Vasudevan Thirumal Selvan

    2005-02-01

    Full Text Available We report an observation made about the differences between right and left side in case of total knee and unicondylar knee replacement. It was found that unicondylar knee replacement was performed more commonly on the left side (66%, as compared to only 34% on right side, where as total knee replacement was more common on the right side (64% as compared to 36% on left side. The exact clinical utility of this difference is yet to be known.

  1. Detection of Left-Sided and Right-Sided Hearing Loss via Fractional Fourier Transform

    Directory of Open Access Journals (Sweden)

    Shuihua Wang

    2016-05-01

    Full Text Available In order to detect hearing loss more efficiently and accurately, this study proposed a new method based on fractional Fourier transform (FRFT. Three-dimensional volumetric magnetic resonance images were obtained from 15 patients with left-sided hearing loss (LHL, 20 healthy controls (HC, and 14 patients with right-sided hearing loss (RHL. Twenty-five FRFT spectrums were reduced by principal component analysis with thresholds of 90%, 95%, and 98%, respectively. The classifier is the single-hidden-layer feed-forward neural network (SFN trained by the Levenberg–Marquardt algorithm. The results showed that the accuracies of all three classes are higher than 95%. In all, our method is promising and may raise interest from other researchers.

  2. The differential effects of acute right- vs. left-sided vestibular failure on brain metabolism.

    Science.gov (United States)

    Becker-Bense, Sandra; Dieterich, Marianne; Buchholz, Hans-Georg; Bartenstein, Peter; Schreckenberger, Mathias; Brandt, Thomas

    2014-07-01

    The human vestibular system is represented in the brain bilaterally, but it has functional asymmetries, i.e., a dominance of ipsilateral pathways and of the right hemisphere in right-handers. To determine if acute right- or left-sided unilateral vestibular neuritis (VN) is associated with differential patterns of brain metabolism in areas representing the vestibular network and the visual-vestibular interaction, patients with acute VN (right n = 9; left n = 13) underwent resting state (18)F-FDG PET once in the acute phase and once 3 months later after central vestibular compensation. The contrast acute vs. chronic phase showed signal differences in contralateral vestibular areas and the inverse contrast in visual cortex areas, both more pronounced in VN right. In VN left additional regions were found in the cerebellar hemispheres and vermis bilaterally, accentuated in severe cases. In general, signal changes appeared more pronounced in patients with more severe vestibular deficits. Acute phase PET data of patients compared to that of age-matched healthy controls disclosed similarities to these patterns, thus permitting the interpretation that the signal changes in vestibular temporo-parietal areas reflect signal increases, and in visual areas, signal decreases. These data imply that brain activity in the acute phase of right- and left-sided VN exhibits different compensatory patterns, i.e., the dominant ascending input is shifted from the ipsilateral to the contralateral pathways, presumably due to the missing ipsilateral vestibular input. The visual-vestibular interaction patterns were preserved, but were of different prominence in each hemisphere and more pronounced in patients with right-sided failure and more severe vestibular deficits.

  3. Neglecting the Left Side of a City Square but Not the Left Side of Its Clock: Prevalence and Characteristics of Representational Neglect

    Science.gov (United States)

    Guariglia, Cecilia; Palermo, Liana; Piccardi, Laura; Iaria, Giuseppe; Incoccia, Chiara

    2013-01-01

    Representational neglect, which is characterized by the failure to report left-sided details of a mental image from memory, can occur after a right hemisphere lesion. In this study, we set out to verify the hypothesis that two distinct forms of representational neglect exist, one involving object representation and the other environmental representation. As representational neglect is considered rare, we also evaluated the prevalence and frequency of its association with perceptual neglect. We submitted a group of 96 unselected, consecutive, chronic, right brain-damaged patients to an extensive neuropsychological evaluation that included two representational neglect tests: the Familiar Square Description Test and the O'Clock Test. Representational neglect, as well as perceptual neglect, was present in about one-third of the sample. Most patients neglected the left side of imagined familiar squares but not the left side of imagined clocks. The present data show that representational neglect is not a rare disorder and also support the hypothesis that two different types of mental representations (i.e. topological and non-topological images) may be selectively damaged in representational neglect. PMID:23874416

  4. Chromosomal abnormalities and copy number variations in fetal left-sided congenital heart defects.

    Science.gov (United States)

    Jansen, Fenna A R; Hoffer, Mariette J V; van Velzen, Christine L; Plati, Stephani Klingeman; Rijlaarsdam, Marry E B; Clur, Sally-Ann B; Blom, Nico A; Pajkrt, Eva; Bhola, Shama L; Knegt, Alida C; de Boer, Marion A; Haak, Monique C

    2016-02-01

    To demonstrate the spectrum of copy number variants (CNVs) in fetuses with isolated left-sided congenital heart defects (CHDs), and analyse genetic content. Between 2003 and 2012, 200 fetuses were identified with left-sided CHD. Exclusion criteria were chromosomal rearrangements, 22q11.2 microdeletion and/or extra-cardiac malformations (n = 64). We included cases with additional minor anomalies (n = 39), such as single umbilical artery. In 54 of 136 eligible cases, stored material was available for array analysis. CNVs were categorized as either (likely) benign, (likely) pathogenic or of unknown significance. In 18 of the 54 isolated left-sided CHDs we found 28 rare CNVs (prevalence 33%, average 1.6 CNV per person, size 10.6 kb-2.2 Mb). Our interpretation yielded clinically significant CNVs in two of 54 cases (4%) and variants of unknown significance in three other cases (6%). In left-sided CHDs that appear isolated, with normal chromosome analysis and 22q11.2 FISH analysis, array analysis detects clinically significant CNVs. When counselling parents of a fetus with a left-sided CHD it must be taken into consideration that aside from the cardiac characteristics, the presence of extra-cardiac malformations and chromosomal abnormalities influence the treatment plan and prognosis. © 2015 John Wiley & Sons, Ltd.

  5. Comparison between the incidence of right and left sided congenital torticollis

    International Nuclear Information System (INIS)

    Aslam, S.; Bashir, M.S.; Hussain, S.I.

    2013-01-01

    Congenital torticollis is an intriguing condition of unknown origin, characterized by unilateral shortening and tightness of the sternocleidomastoid muscle. Patients usually present with head tilt, facial asymmetry and plagiocephaly. A sternomastoid mass or tumor may or may not be clinically apparent. Untreated, cervical function and facial cosmesis may be severely compromised. Objective: My study is aimed at establishing a comparison between the incidence of right versus left sided congenital torticollis. Method: This observational study included 30 patients of congenital torticollis that completed the questionnaire. The data was collected from patients coming to the Physiotherapy and Orthopedic departments of Children Hospital, Lahore. Results: Results showed that right side was involved in 19 (63.3%) patients and left side was involved in 11 (36.7%) patients. Out of 30 patients, 14 (46.7%) were male, of which 8 had right sided congenital torticollis and 6 had left sided congenital torticollis, and 16 (53.3%) were female, of which right sided congenital torticollis and 5 had left sided congenital torticollis. Conclusion: Hence it is concluded that incidence of right sided congenital torticollis is more common than left sided congenital torticollis. The incidence of con-genital torticollis is higher in females than in males. (author)

  6. Minimally invasive radical pancreatectomy for left-sided pancreatic cancer: Current status and future perspectives

    Science.gov (United States)

    Kang, Chang Moo; Lee, Sung Hwan; Lee, Woo Jung

    2014-01-01

    Minimally invasive distal pancreatectomy with splenectomy has been regarded as a safe and effective treatment for benign and borderline malignant pancreatic lesions. However, its application for left-sided pancreatic cancer is still being debated. The clinical evidence for radical antegrade modular pancreatosplenectomy (RAMPS)-based minimally invasive approaches for left-sided pancreatic cancer was reviewed. Potential indications and surgical concepts for minimally invasive RAMPS were suggested. Despite the limited clinical evidence for minimally invasive distal pancreatectomy in left-sided pancreatic cancer, the currently available clinical evidence supports the use of laparoscopic distal pancreatectomy under oncologic principles in well-selected left sided pancreatic cancers. A pancreas-confined tumor with an intact fascia layer between the pancreas and left adrenal gland/kidney positioned more than 1 or 2 cm away from the celiac axis is thought to constitute a good condition for the use of margin-negative minimally invasive RAMPS. The use of minimally invasive (laparoscopic or robotic) anterior RAMPS is feasible and safe for margin-negative resection in well-selected left-sided pancreatic cancer. The oncologic feasibility of the procedure remains to be determined; however, the currently available interim results indicate that even oncologic outcomes will not be inferior to those of open radical distal pancreatosplenectomy. PMID:24605031

  7. Incidence of Important Hemobilia Following Transhepatic Biliary Drainage: Left-Sided Versus Right-Sided Approaches

    International Nuclear Information System (INIS)

    Rivera-Sanfeliz, G. M.; Assar, O. S. A.; LaBerge, J. M.; Wilson, M. W.; Gordon, R. L.; Ring, E. J.; Kerlan, R. K. Jr.

    2004-01-01

    Our purpose here is to describe our experience with important hemobilia following PTBD and to determine whether left-sided percutaneous transhepatic biliary drainage (PTBD) is associated with an increased incidence of important hemobilia compared to right-sided drainages. We reviewed 346 transhepatic biliary drainages over a four-year period and identified eight patients (2.3%) with important hemobilia requiring transcatheter embolization. The charts and radiographic files of these patients were reviewed. The side of the PTBD (left versus right), and the order of the biliary ductal branch entered (first, second, or third) were recorded. Of the 346 PTBDs, 269 were right-sided and 77 were left-sided. Of the eight cases of important hemobilia requiring transcatheter embolization, four followed right-sided and four followed left-sided PTBD, corresponding to a bleeding incidence of 1.5% (4/269) for right PTBD and 5.2% (4/77) for left PTBD. The higher incidence of hemobilia associated with left-sided PTBD approached, but did not reach the threshold of statistical significance (p = 0.077). In six of the eight patients requiring transcatheter embolization, first or second order biliary branches were accessed by catheter for PTBD. All patients with left-sided bleeding had first or proximal second order branches accessed by biliary drainage catheters. In conclusion, a higher incidence of hemobilia followed left- versus right-sided PTBD in this study, but the increased incidence did not reach statistical significance

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1983-03-01

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

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

    International Nuclear Information System (INIS)

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

    1983-01-01

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

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

    Science.gov (United States)

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

    2017-09-01

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

  11. Incidence and factors associated with infective endocarditis in patients undergoing left-sided heart valve replacement

    DEFF Research Database (Denmark)

    Østergaard, Lauge; Valeur, Nana; Ihlemann, Nikolaj

    2018-01-01

    Aims: Patients with left-sided heart valve replacement are considered at high-risk of infective endocarditis (IE). However, data on the incidence and risk factors associated with IE are sparse. Methods and results: Through Danish administrative registries, we identified patients who underwent left.......35-2.15), and cardiac implantable electronic device (CIED) (HR = 1.57, 95% CI 1.19-2.06) were among factors associated with an increased risk of IE. Conclusion: Infective endocarditis after left-sided heart valve replacement is not uncommon and occurs in about 1/20 over 10 years. Male, bioprosthetic valve, and heart...

  12. Guidelines of diagnostics and treatment of acute left-sided colonic diverticulitis

    NARCIS (Netherlands)

    Andeweg, Caroline S.; Mulder, Irene M.; Felt-Bersma, Richelle J. F.; Verbon, Annelies; van der Wilt, Gert Jan; van Goor, Harry; Lange, Johan F.; Stoker, Jaap; Boermeester, Marja A.; Bleichrodt, Robert P.

    2013-01-01

    The incidence of acute left-sided colonic diverticulitis (ACD) is increasing in the Western world. To improve the quality of patient care, a guideline for diagnosis and treatment of diverticulitis is needed. A multidisciplinary working group, representing experts of relevant specialties, was

  13. Left-sided approach for cardiac procedure and thoracoplasty in a patient with Marfan syndrome.

    Science.gov (United States)

    Shimamura, J; Kubota, H; Sudo, K

    2012-02-01

    We present a case of a 20-year-old female in whom we successfully performed a simultaneous Bentall procedure and thoracoplasty by initially removing only the left side of the costal cartilages. This modified sternal elevation technique offered chest stability and an excellent surgical view, and the postoperative course was satisfactory. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  14. Dissecting aneurysm of arch and descending thoracic aorta presenting as a left sided hemorrhagic pleural effusion

    Directory of Open Access Journals (Sweden)

    Shamim Shelley

    2010-01-01

    Full Text Available The most common cause of massive hemorrhagic effusion is malignancy. Herein we present a case of dissecting aneurysm of descending thoracic aorta presenting initially with shortness of breath due to left sided massive pleural effusion. Effusion was hemorrhagic in nature with high hematocrit value. CT scan of thorax with CT angiogram was done and that revealed the diagnosis.

  15. Surgical management of colonic diverticular disease: discrepancy between right- and left-sided diseases.

    Science.gov (United States)

    Oh, Heung-Kwon; Han, Eon Chul; Ha, Heon-Kyun; Choe, Eun Kyung; Moon, Sang Hui; Ryoo, Seung-Bum; Jeong, Seung-Yong; Park, Kyu Joo

    2014-08-07

    To compare the outcome of the surgical management of left-sided and right-sided diverticular disease. The medical records of 77 patients who were surgically treated for diverticular disease between 1999 and 2010 in a tertiary referral hospital were retrospectively reviewed. The study population was limited to cases wherein the surgical specimen was confirmed as diverticulosis by pathology. Right-sided diverticula were classified as those arising from the cecum, ascending colon, and transverse colon, and those from the descending colon, sigmoid colon, and rectum were classified as left-sided diverticulosis. To assess the changing trend of occurrence of diverticulosis, data were compared with two previous studies of 51 patients. The proportion of left-sided disease cases was significantly increased compared to the results of our previous studies in 1994 and 2001, (27.5% vs 48.1%, P disease. However, patients with right-sided disease were significantly younger (50.9 year vs 64.0 year, P disease was significantly associated with a higher incidence of complicated diverticulitis (89.2% vs 57.5%, P diverticular disease, the incidence of left-sided disease in Korea has increased since 2001 and is associated with worse surgical outcomes.

  16. Perceptual expertise: can sensorimotor experience change holistic processing and left-side bias?

    Science.gov (United States)

    Tso, Ricky Van-yip; Au, Terry Kit-fong; Hsiao, Janet Hui-wen

    2014-09-01

    Holistic processing and left-side bias are both behavioral markers of expert face recognition. By contrast, expert recognition of characters in Chinese orthography involves left-side bias but reduced holistic processing, although faces and Chinese characters share many visual properties. Here, we examined whether this reduction in holistic processing of Chinese characters can be better explained by writing experience than by reading experience. Compared with Chinese nonreaders, Chinese readers who had limited writing experience showed increased holistic processing, whereas Chinese readers who could write characters fluently showed reduced holistic processing. This result suggests that writing and sensorimotor experience can modulate holistic-processing effects and that the reduced holistic processing observed in expert Chinese readers may depend mostly on writing experience. However, both expert writers and writers with limited experience showed similarly stronger left-side bias than novices did in processing mirror-symmetric Chinese characters; left-side bias may therefore be a robust expertise marker for object recognition that is uninfluenced by sensorimotor experience. © The Author(s) 2014.

  17. Mean size estimation yields left-side bias: Role of attention on perceptual averaging.

    Science.gov (United States)

    Li, Kuei-An; Yeh, Su-Ling

    2017-11-01

    The human visual system can estimate mean size of a set of items effectively; however, little is known about whether information on each visual field contributes equally to the mean size estimation. In this study, we examined whether a left-side bias (LSB)-perceptual judgment tends to depend more heavily on left visual field's inputs-affects mean size estimation. Participants were instructed to estimate the mean size of 16 spots. In half of the trials, the mean size of the spots on the left side was larger than that on the right side (the left-larger condition) and vice versa (the right-larger condition). Our results illustrated an LSB: A larger estimated mean size was found in the left-larger condition than in the right-larger condition (Experiment 1), and the LSB vanished when participants' attention was effectively cued to the right side (Experiment 2b). Furthermore, the magnitude of LSB increased with stimulus-onset asynchrony (SOA), when spots on the left side were presented earlier than the right side. In contrast, the LSB vanished and then induced a reversed effect with SOA when spots on the right side were presented earlier (Experiment 3). This study offers the first piece of evidence suggesting that LSB does have a significant influence on mean size estimation of a group of items, which is induced by a leftward attentional bias that enhances the prior entry effect on the left side.

  18. Echocardiographic 3D-guided 2D planimetry in quantifying left-sided valvular heart disease.

    Science.gov (United States)

    Argulian, Edgar; Seetharam, Karthik

    2018-02-08

    Echocardiographic 3D-guided 2D planimetry can improve the accuracy of valvular disease assessment. Acquisition of 3D pyramidal dataset allows subsequent multiplanar reconstruction with accurate orthogonal plane alignment to obtain the correct borders of an anatomic orifice or flow area. Studies examining the 3D-guided 2D planimetry approach in left-sided valvular heart disease were identified and reviewed. The strongest evidence exists for estimating mitral valve area in patients with rheumatic mitral valve stenosis and vena contracta area in patients with mitral regurgitation (both primary and secondary). 3D-guided approach showed excellent feasibility and reproducibility in most studies, as well as time efficiency and good correlation with reference and comparator methods. Therefore, 3D-guided 2D planimetry can be used as an important clinical tool in quantifying left-sided valvular heart disease, especially mitral valve disorders. © 2018 Wiley Periodicals, Inc.

  19. Anterior subcarinal node dissection on the left side using video thoracoscopy: an easier technique.

    Science.gov (United States)

    Baste, Jean-Marc; Haddad, Laura; Melki, Jean; Peillon, Christophe

    2015-04-01

    Lobectomy for lung carcinoma is usually associated with complete node dissection, but it is often difficult to perform using video thoracoscopy, especially on the left side. In this case, our team uses an anterior technique for subcarinal lymphadenectomy. After left lobectomy, we lift the bronchial stump by its anterior face to open and dissect the subcarinal space. Exposure is difficult using the more usual technique of posterior subcarinal lymphadenectomy, and the different techniques (often requiring retractors) remain complex because some vessels might be injured. We recommend using anterior lymphadenectomy, which should facilitate video thoracoscopy for lymphadenectomy on the left side. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Transcriptional analysis of left-sided colitis, pancolitis, and ulcerative colitis-associated dysplasia

    DEFF Research Database (Denmark)

    Bjerrum, Jacob T; Nielsen, Ole H; Riis, Lene B

    2014-01-01

    to identify potential biomarkers and transcripts of importance for the carcinogenic behavior of chronic inflammation. METHODS: The Affymetrix GeneChip Human Genome U133 Plus 2.0 was applied on colonic biopsies from UC patients with left-sided UC, pancolitis, dysplasia, and controls. Reverse transcription...... polymerase chain reaction and immunohistochemistry were performed for validating selected transcripts in the initial cohort and in 2 independent cohorts of patients with UC. Microarray data were analyzed by principal component analysis, and reverse transcription polymerase chain reaction...... and immunohistochemistry data by the Wilcoxon's rank-sum test. RESULTS: The principal component analysis results revealed separate clusters for left-sided UC, pancolitis, dysplasia, and controls. Close clustering of dysplastic and pancolitic samples indicated similarities in gene expression. Indeed, 101 and 656 parallel...

  1. Left-Sided Patent Ductus Arteriosus in a Right-Sided Aortic Arch

    Directory of Open Access Journals (Sweden)

    Ming-Yen Ng

    2014-01-01

    Full Text Available We present a 31-year-old female with repaired tetralogy of Fallot (TOF and right-sided aortic arch (RAA with left-sided patent ductus arteriosus (PDA originating from the left brachiocephalic artery. This is a rare finding but most common site for a PDA in TOF and a RAA. To the best of our knowledge, this is the first demonstration of this rare finding on MRI in the literature.

  2. A missing link between RON expression and oncological outcomes in resected left-sided pancreatic cancer.

    Science.gov (United States)

    Han, Dai Hoon; Kang, Chang Moo; Lee, Sung Whan; Hwang, Ho Kyoung; Lee, Woo Jung

    2017-10-01

    Alteration and activation of recepteur d'origine nantais (RON) expression is known to be associated with cancer progression and decreased survival in various types of human cancer, including pancreatic cancer. Therefore, in the present study, RON expression levels were determined in resected left-sided pancreatic cancer to evaluate the potential oncological role of RON in the clinical setting of distal pancreatic cancer. From January 2005 to December 2011, a total of 57 patients underwent radical distal pancreatectomy for left-sided pancreatic cancer. Ductal adenocarcinoma was confirmed in all patients. Among these patients, 17 patients who received preoperative neoadjuvant treatment and 7 patients without available paraffin-embedded tissue blocks were excluded from the present study. RON expression in a the pancreatic cancer cell lines ASPC-1, BxPC-3, MiaPaCa-3 and Panc-1, as well as in resected left-sided pancreatic cancer specimens was determined by Western blot analysis. RON and vascular endothelial growth factor (VEGF) overexpression in resected left-sided pancreatic cancer was also evaluated by immunohistochemistry using pre-diluted anti-RON and anti-VEGF antibodies. An association was identified between the oncological outcome and RON overexpression. Increased levels of RON expression were observed in two pancreatic cancer cell lines, AsPC-1 and BxPC-3. RON overexpression was detected in specimens from 15/33 patients (45.5%) using immunohistochemistry. No significant association was identified between RON overexpression and VEGF overexpression (25.5 vs. 87.9%; P=0.667). No significant differences in disease-free survival or disease-specific survival associated with RON overexpression were identified. Although the results of previous studies have suggested that RON is a potential target for the treatment of pancreatic cancer, in the present study no association between RON overexpression and any adverse oncological effect was identified.

  3. Guenther Tulip Filter Retrieval from a Left-sided Inferior Vena Cava

    International Nuclear Information System (INIS)

    Brountzos, Elias N.; Kaufman, John A.; Lakin, Paul L.

    2004-01-01

    Optional (retrievable) inferior cava filters (IVC) may have advantages over permanent filters in a certain subset of patients, especially in view of recent concerns about the long-term thrombotic complications of the latter. Retrieval of the Guenther Tulip Filter (GTF), an optional filter, has been reported in a total of 76 patients. We present the first description of GTF retrieval from a left-sided IVC using the right internal jugular approach

  4. Complicated left-sided native valve endocarditis in adults: risk classification for mortality.

    Science.gov (United States)

    Hasbun, Rodrigo; Vikram, Holenarasipur R; Barakat, Lydia A; Buenconsejo, Joan; Quagliarello, Vincent J

    2003-04-16

    Complicated left-sided native valve endocarditis causes significant morbidity and mortality in adults. Lack of valid data regarding estimation of prognosis makes management of this condition difficult. To derive and externally validate a prognostic classification system for adults with complicated left-sided native valve endocarditis. Retrospective observational cohort study conducted from January 1990 to January 2000 at 7 Connecticut hospitals among 513 patients older than 16 years who experienced complicated left-sided native valve endocarditis and who were divided into derivation (n = 259) and validation (n = 254) cohorts. All-cause mortality at 6 months after baseline. In the derivation and validation cohorts, the 6-month mortality rates were 25% and 26%, respectively. Five baseline features were independently associated with 6-month mortality (comorbidity [P =.03], abnormal mental status [P =.02], moderate to severe congestive heart failure [P =.01], bacterial etiology other than viridans streptococci [Pclassification system. In the derivation cohort, patients were classified into 4 groups with increasing risk for 6-month mortality: 5%, 15%, 31%, and 59% (Pendocarditis can be accurately risk stratified using baseline features into 4 groups of prognostic severity. This prognostic classification system might be useful for facilitating management decisions.

  5. Infection of the left sided gallbladder simulating liver abscess and gastric antral tumor

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Woo; Ahn, Jae Sung [St Mary' s Hospital Catholic Medical College, Seoul (Korea, Republic of)

    1972-12-15

    The left sided gallbladder, being a rare occurrence, may create diagnostic problem especially when it becomes infected. Recently, we have experienced 2 cases of infection of left sided gallbladder at the Department of Radiology, St Mary's Hospital, Catholic Medical College. Case I was a 32-year-old housewife with dyspepsia, epigastric pain and recurring bouts of high fever of 2 months duration. Under the provisional diagnosis of liver abscess liver scan was performed which revealed well defined cold area in the left lobe supporting the provisional diagnosis. Tender cystic mass was aspirated and pus was drained. The injected air at the occasion of aspiration outlined well defined cystic structure. Because aspiration failed to control the symptoms, laparotomy was performed. Surgeon found a left sided gallbladder which was empyematous. Case II was a 38 year old business man admitted to the hospital because of tender ill defined mass in mid epigastrium. The patient was febrile (39.4 .deg. C) and anemic. An upper GI series disclosed an irregular filling defect involving the antrum of the stomach. The mass was primarily extrinsic but was closely fixed to the gastric wall. Surgical intervention revealed chronic cholecystitis and pericholecystitis with thick adhesion to the distal stomach.

  6. Left-sided and duplicate inferior vena cava: a case series and review.

    Science.gov (United States)

    Ang, Wee Choen; Doyle, Terry; Stringer, Mark D

    2013-11-01

    Left-sided and duplicate inferior vena cava (IVC) are two major anatomical variants within the spectrum of IVC malformations, both of which are developmental abnormalities of the supracardinal veins. Four clinical cases are described to highlight the computed tomographic appearances of these vascular malformations and provide novel data on venous dimensions. A systematic review of the recent literature (2000-2011) was conducted focusing on the anatomy, demographics, and associated pathology (congenital and acquired) of isolated left-sided and duplicate IVC. A total of 73 relevant articles were retrieved, consisting of case reports and small case series. The prevalence of left-sided IVC is about 0.1-0.4% and that for duplicate IVC about 0.3-0.4%; both anomalies show a slight male preponderance. In each condition, there are documented variations in the course and tributaries of the IVC. The clinical importance of these anomalies lies in three principal areas: the potential for misdiagnosis on imaging; technical difficulties during retroperitoneal surgery (particularly abdominal aortic aneurysm repair and live donor nephrectomy); and their significance in relation to the etiology and management of venous thromboembolism. Copyright © 2012 Wiley Periodicals, Inc.

  7. Differences between right- and left-sided colon cancer in patient characteristics, cancer morphology and histology.

    Science.gov (United States)

    Nawa, Toru; Kato, Jun; Kawamoto, Hirofumi; Okada, Hiroyuki; Yamamoto, Hiroshi; Kohno, Hiroyuki; Endo, Hisayuki; Shiratori, Yasushi

    2008-03-01

    Recently, the clinical and biological differences between right- and left-sided colon cancers have been widely debated. However, close analyses of these clinical differences, based on large-scale studies, have been scarcely reported. A total of 3552 consecutive Japanese colorectal cancer cases were examined and the clinical differences between right- and left-sided colon cancer cases were investigated. The proportion of right-sided colon cancer was relatively high in patients aged less than 40 years (33%) and more than 80 years (43%). The proportion of right-sided colon cancer in patients aged 40-59 years was relatively low (male 22% and female 29%). In male patients the proportion increased in the 70-79 years age group (30%), while in female patients the proportion increased in the 60-69 years age group (39%). Right-sided colon cancer was more likely to be detected at an advanced stage (T1 stage; left 22%, right 15%) (P cancer was dominant in the left colon (left 59%; right 40%) (P cancer in the right colon was significantly higher than that in the left colon (left 25%; right 44%) (P colon cancer was observed and the difference between male and female patients was highlighted. Other clinical features also differed between right- and left-sided colon cancer, suggesting that different mechanisms may be at work during right and left colon carcinogenesis.

  8. Left-sided incarcerated Amyand’s hernia with cecum and terminal ileum: a case report

    Directory of Open Access Journals (Sweden)

    Bekele K

    2017-10-01

    Full Text Available Kebebe Bekele,1 Desalegn Markos2 1Department of Surgery, School of Medicine, Madda Walabu University, Bale Robe, Ethiopia; 2Unit of Neonatology Nursing, St Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia Background: Amyand’s hernia, which is the presence of a normal or pathological appendix as a part of an inguinal hernia, is a rare clinical entity. We are reporting a very rare case of left-sided incarcerated Amyand’s hernia with cecum and terminal ileum involvement. Case presentation: A 4-year-old male child with left inguinal swelling of 2-year duration presented to Goba Referral Hospital. Two days before the patient visited our hospital, the swelling had become irreducible and caused severe groin pain. He had abdominal cramps, bilious vomiting, and mild abdominal distention, but passed feces. With the diagnosis of left-sided incarcerated inguinal hernia, the patient was investigated and prepared for surgical management. During the operative procedure, we identified the presence of appendix, cecum, and terminal ileum in the scrotum as the herniated component. After the sack was dissected, since there was also appendicitis, an appendectomy was performed. Then, high ligation of sack was done after cecum and ileum were reduced. After 3 uneventful postoperative days in the hospital, the patient was discharged. The patient was followed-up for 6 months, and he did not develop any complications. Conclusion: Left-sided incarcerated Amyand’s hernia with cecum and terminal ileum involvement is a rare clinical entity. Even though it is not common, appendicitis is one of the comorbidities that can be seen in patients with left-sided incarcerated Amyand’s hernia with cecum and terminal ileum. Surgeons should have a high index of clinical suspicion and be aware of the potential involvement of appendix, cecum, and ileum as part of an incarcerated hernia during surgery, even in the left inguinal region. In this case, left-sided

  9. Characterization of the Left-Sided Substrate in Arrhythmogenic Right Ventricular Cardiomyopathy.

    Science.gov (United States)

    Berte, Benjamin; Denis, Arnaud; Amraoui, Sana; Yamashita, Seigo; Komatsu, Yuki; Pillois, Xavier; Sacher, Frédéric; Mahida, Saagar; Wielandts, Jean-Yves; Sellal, Jean-Marc; Frontera, Antonio; Al Jefairi, Nora; Derval, Nicolas; Montaudon, Michel; Laurent, François; Hocini, Mélèze; Haïssaguerre, Michel; Jaïs, Pierre; Cochet, Hubert

    2015-12-01

    The correlates of left ventricular (LV) substrate in arrhythmogenic right ventricular (RV) cardiomyopathy are largely unknown. Thirty-two patients with arrhythmogenic RV cardiomyopathy (47±14 years; 6 women) were included. RV and LV dysplasia were defined from multidetector computed tomography and cardiac magnetic resonance imaging. Arrhythmias were characterized as right-sided or left-sided on 12-lead ECG recordings at baseline and during isoproterenol testing. In 14 patients, the imaging substrate was compared with voltage mapping and local abnormal ventricular activity. Imaging abnormalities were found in 32 (100%) and 21 (66%) patients on the RV and LV, respectively, intramyocardial fat on multidetector computed tomography being the most sensitive feature. LV involvement related to none of the Task Force criteria. Right-sided arrhythmias were more frequent than left-sided arrhythmias (P=0.003) although the latter were more frequent in case of LV involvement (P=0.02). The agreement between low voltage and fat on multidetector computed tomography was high on the RV when using either endocardial unipolar or epicardial bipolar data (κ=0.82 and κ=0.78, respectively) but lower on the LV (κ=0.54 for epicardial bipolar). LV local abnormal ventricular activity was found in all patients with LV involvement, and none of the others. The density of local abnormal ventricular activity within fat areas was similar between the RV and LV (P=0.57). LV substrate is frequent in arrhythmogenic RV cardiomyopathy, but poorly identified by current diagnostic strategies. Left-sided arrhythmias are more frequent in case of LV involvement. LV fat hosts the same density of local abnormal ventricular activity as RV fat, but is less efficiently detected by voltage mapping. These results support the need for alternative diagnostic strategies to identify LV dysplasia. © 2015 American Heart Association, Inc.

  10. [Left-sided endocarditis due to gram-negative bacilli: epidemiology and clinical characteristics].

    Science.gov (United States)

    Noureddine, Mariam; de la Torre, Javier; Ivanova, Radka; Martínez, Francisco José; Lomas, Jose María; Plata, Antonio; Gálvez, Juan; Reguera, Jose María; Ruiz, Josefa; Hidalgo, Carmen; Luque, Rafael; García-López, María Victoria; de Alarcón, Arístides

    2011-04-01

    The aim of this study is to describe the epidemiological, clinical characteristics, and outcome of patients with left-side endocarditis caused by gram-negative bacteria. Prospective multicenter study of left-sided infective endocarditis reported in the Andalusian Cohort for the Study of Cardiovascular Infections between 1984 and 2008. Among the 961 endocarditis, 24 (2.5%) were caused by gram-negative bacilli. The most common pathogens were Escherichia coli, Pseudomonas aeruginosa and Salmonella enterica. Native valves (85.7%) were mainly affected, most of them with previous valve damage (57%). Comorbidity was greater (90% vs 39%; P=.05) than in endocarditis due to other microorganism, the most frequent being, diabetes, hepatic cirrhosis and neoplasm. A previous manipulation was found in 47.6% of the cases, and 37% were considered hospital-acquired. Renal failure (41%), central nervous system involvement (33%) and ventricular dysfunction (45%) were the most frequent complications. Five cases (21%) required cardiac surgery, mostly due to ventricular dysfunction. More than 50% of cases were treated with aminoglycosides, but this did not lead to a better outcome or prognosis. Mortality (10 patients) was higher than that reported with other microorganisms (41% vs 35%; P=.05). Left-sided endocarditis due to gram-negative bacilli is a rare disease, which affects patients with major morbidities and often with a previous history of hospital manipulations. Cardiac, neurological and renal complications are frequent and associated with a high mortality. The association of aminoglycosides in the antimicrobial treatment did not involve a better outcome or prognosis. Copyright © 2010 Elsevier España, S.L. All rights reserved.

  11. Early experience of the compression anastomosis ring (CARTM 27) in left-sided colon resection

    Science.gov (United States)

    Lee, Jung-Yeon; Woo, Jin-Hee; Choi, Hong-Jo; Park, Ki-Jae; Roh, Young-Hoon; Kim, Ki-Han; Lee, Hak-Yoon

    2011-01-01

    AIM: To evaluate clinical validity of the compression anastomosis ring (CAR™ 27) anastomosis in left-sided colonic resection. METHODS: A non-randomized prospective data collection was performed for patients undergoing an elective left-sided colon resection, followed by an anastomosis using the CAR™ 27 between November 2009 and January 2011. Eligibility criteria of the use of the CAR™ 27 were anastomoses between the colon and at or above the intraperitoneal rectum. The primary short-term clinical endpoint, rate of anastomotic leakage, and other clinical outcomes, including intra- and postoperative complications, length of operation time and hospital stay, and the ring elimination time were evaluated. RESULTS: A total of 79 patients (male, 43; median age, 64 years) underwent an elective left-sided colon resection, followed by an anastomosis using the CAR™ 27. Colectomy was performed laparoscopically in 70 patients, in whom two patients converted to open procedure (2.9%). There was no surgical mortality. As an intraoperative complication, total disruption of the anastomosis occurred by premature enforced tension on the proximal segment of the anastomosis in one patient. The ring was removed and another new CAR™ 27 anastomosis was constructed. One patient with sigmoid colon cancer showed postoperative anastomotic leakage after 6 d postoperatively and temporary diverting ileostomy was performed. Exact date of expulsion of the ring could not be recorded because most patients were not aware that the ring had been expelled. No patients manifested clinical symptoms of anastomotic stricture. CONCLUSION: Short-term evaluation of the CAR™ 27 anastomosis in elective left colectomy suggested it to be a safe and efficacious alternative to the standard hand-sewn or stapling technique. PMID:22147979

  12. Early experience of the compression anastomosis ring (CAR™ 27) in left-sided colon resection.

    Science.gov (United States)

    Lee, Jung-Yeon; Woo, Jin-Hee; Choi, Hong-Jo; Park, Ki-Jae; Roh, Young-Hoon; Kim, Ki-Han; Lee, Hak-Yoon

    2011-11-21

    To evaluate clinical validity of the compression anastomosis ring (CAR™ 27) anastomosis in left-sided colonic resection. A non-randomized prospective data collection was performed for patients undergoing an elective left-sided colon resection, followed by an anastomosis using the CAR™ 27 between November 2009 and January 2011. Eligibility criteria of the use of the CAR™ 27 were anastomoses between the colon and at or above the intraperitoneal rectum. The primary short-term clinical endpoint, rate of anastomotic leakage, and other clinical outcomes, including intra- and postoperative complications, length of operation time and hospital stay, and the ring elimination time were evaluated. A total of 79 patients (male, 43; median age, 64 years) underwent an elective left-sided colon resection, followed by an anastomosis using the CAR™ 27. Colectomy was performed laparoscopically in 70 patients, in whom two patients converted to open procedure (2.9%). There was no surgical mortality. As an intraoperative complication, total disruption of the anastomosis occurred by premature enforced tension on the proximal segment of the anastomosis in one patient. The ring was removed and another new CAR™ 27 anastomosis was constructed. One patient with sigmoid colon cancer showed postoperative anastomotic leakage after 6 d postoperatively and temporary diverting ileostomy was performed. Exact date of expulsion of the ring could not be recorded because most patients were not aware that the ring had been expelled. No patients manifested clinical symptoms of anastomotic stricture. Short-term evaluation of the CAR™ 27 anastomosis in elective left colectomy suggested it to be a safe and efficacious alternative to the standard hand-sewn or stapling technique.

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

    Science.gov (United States)

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

    2014-09-01

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

  14. Chylous ascites as a complication of left sided robot-assisted laparoscopic partial nephrectomy

    Directory of Open Access Journals (Sweden)

    Gaurav Pahouja

    2016-10-01

    Full Text Available Objective: The aim of the study was to present a case series of the sparsely reported complication of chylous ascites (CA after left sided robot-assisted laparoscopic partial nephrectomy (RALPN, identify possible risk factors for the development of postoperative CA, and explore current recommendations for identification, management and prevention of CA. Material and methods: A retrospective review of patients that were treated with a RALPN during a one year time period (August 2012 to August 2013 by one surgeon at our institution was conducted. A total of 12 patients were included in the study. Demographics, tumor characteristics, and perioperative outcomes were assessed. Results: Three patients in the study experienced postoperative CA. All three patients had left sided surgery. The initial clinical suspicion for CA was raised due to complaints of abdominal pain with increased milky appearance of JP fluid. JP triglycerides were elevated in all three patients. The patients responded to conservative measures, with two patients treated with medium chain triglyceride diets and one patient treated with total parenteral nutrition (TPN. Among the patients treated with RALPN, the group that was diagnosed with postoperative CA (CA group was found to have a statistically significant lower average body mass index (BMI as compared to the group that did not have CA (non-CA group (24.67 kg/m2 in the CA group versus 31.77 kg/m2 in the non-CA group; P = 0.026. Other demographic data, tumor characteristics, and perioperative outcomes were similar in both groups. Conclusions: CA as a result of RALPN is a newly reported and rare postoperative complication. As utilization of RALPN continues to increase, urologists should be aware of this possible complication and be adept at diagnosing and managing CA. We suggest that left sided retroperitoneal surgery and a lower BMI preoperatively be considered risk factors for developing this complication.

  15. Midgut malrotation presenting with left-sided acute appendicitis and CT inversion sign

    Science.gov (United States)

    Çağlar, Emrah; Arıbaş, Bilgin; Tiken, Ramazan; Keskin, Suat

    2014-01-01

    In patients presenting with abdominal pain, appendicitis is the most common surgical disorder. Appendicitis causing pain in the left lower quadrant is extremely rare and can occur with congenital abnormalities that include true left-sided appendix or as an atypical presentation of right-sided long appendix, which projects into the left lower quadrant. We report a case of a 69-year-old man showing midgut malrotation with acute appendicitis presenting as left lower quadrant abdominal pain. PMID:24682135

  16. Two Young Women with Left-sided Pneumothorax Due to Thoracic Endometriosis.

    Science.gov (United States)

    Yukumi, Shungo; Suzuki, Hideaki; Morimoto, Masamitsu; Shigematsu, Hisayuki; Okazaki, Mikio; Abe, Masahiro; Kitazawa, Sohei; Nakamura, Kenji; Sano, Yoshifumi

    Pneumothorax associated with thoracic endometriosis (TE) generally occurs in women around 30 years old and it usually affects the right pleural cavity. We herein report two cases of TE associated with left-sided pneumothorax in young women. The prevalence of TE in younger patients may be underestimated if these cases are treated as spontaneous pneumothorax. Pneumothorax occurring in younger patients has not been reported to show laterality. TE-related or catamenial pneumothorax in young women must therefore represent a different clinical entity from the condition seen in older patients.

  17. Missed diagnosis of atresia of the right pulmonary artery in woman with left-sided pneumothorax

    DEFF Research Database (Denmark)

    Dagnegård, Hanna; Ryom, Philip

    2016-01-01

    Isolated pulmonary atresia is an uncommon condition, which can go undiagnosed for a long time in asymptomatic patients. Sometimes, diagnosis can be made at pregnancy due to respiratory symptoms. There is no known increased risk of pneumothorax. We here present a case where a second-time pregnant...... woman with an unknown atresia of the right pulmonary artery received a left-sided pneumothorax. The diagnosis was initially missed in spite of adequate imaging and the condition progressed to respiratory stop. We describe the course of diagnostics and the chosen strategy of treatment....

  18. Warfarin therapy and incidence of cerebrovascular complications in left-sided native valve endocarditis

    DEFF Research Database (Denmark)

    Snygg-Martin, U; Rasmussen, Rasmus Vedby; Hassager, C

    2011-01-01

    Anticoagulant therapy has been anticipated to increase the risk of cerebrovascular complications (CVC) in native valve endocarditis (NVE). This study investigates the relationship between ongoing oral anticoagulant therapy and the incidence of symptomatic CVC in left-sided NVE. In a prospective...... factors for CVC, while warfarin on admission (aOR 0.26, 95% CI 0.07-0.94), history of congestive heart failure (adjusted OR 0.22, 95% CI 0.1-0.52) and previous endocarditis (aOR 0.1, 95% CI 0.01-0.79) correlated with lower CVC frequency....

  19. Convergent and divergent functional connectivity patterns in patients with long-term left-sided and right-sided deafness.

    Science.gov (United States)

    Zhang, Yanyang; Mao, Zhiqi; Feng, Shiyu; Wang, Wenxin; Zhang, Jun; Yu, Xinguang

    2018-02-05

    Cortical reorganization may be induced in long-term single-sided deafness (SD); however, the influence of the deafness side on the functional changes remains poorly understood. Here, we investigated whole-brain functional connectivity patterns in long-term SD patients. The normalized voxel-based functional connectivity strength (FCS) was determined using resting-state fMRI (rs-fMRI) in 17 left-sided deafness (LD) patients, 21 right-sided deafness (RD) patients and 21 healthy controls (HCs). Relative to the HCs, both the LD and RD patients exhibited a reduction in the FCS in the ipsilateral visual cortex. However, compared to that in the HCs, a significantly higher FCS was observed in some regions in the salience and default-mode networks in the RD patients, but this FCS alternation pattern was not observed in the LD patients. A direct comparison of the two patient groups revealed a significantly increased FCS in the supplemental motor area in the LD group. Altogether, the long-term SD groups with LD and RD exhibited convergent and divergent functional connectivity patterns in whole-brain networks, providing promising evidence that the functional changes in long-term SD are highly deafness-side-dependent. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Enhanced Lithium- and Sodium-Ion Storage in an Interconnected Carbon Network Comprising Electronegative Fluorine.

    Science.gov (United States)

    Hong, Seok-Min; Etacheri, Vinodkumar; Hong, Chulgi Nathan; Choi, Seung Wan; Lee, Ki Bong; Pol, Vilas G

    2017-06-07

    Fluorocarbon (C x F y ) anode materials were developed for lithium- and sodium-ion batteries through a facile one-step carbonization of a single precursor, polyvinylidene fluoride (PVDF). Interconnected carbon network structures were produced with doped fluorine in high-temperature carbonization at 500-800 °C. The fluorocarbon anodes derived from the PVDF precursor showed higher reversible discharge capacities of 735 mAh g -1 and 269 mAh g -1 in lithium- and sodium-ion batteries, respectively, compared to the commercial graphitic carbon. After 100 charge/discharge cycles, the fluorocarbon showed retentions of 91.3% and 97.5% in lithium (at 1C) and sodium (at 200 mA g -1 ) intercalation systems, respectively. The effects of carbonization temperature on the electrochemical properties of alkali metal ion storage were thoroughly investigated and documented. The specific capacities in lithium- and sodium-ion batteries were dependent on the fluorine content, indicating that the highly electronegative fluorine facilitates the insertion/extraction of lithium and sodium ions in rechargeable batteries.

  1. Does concomitant tricuspid annuloplasty increase perioperative mortality and morbidity when correcting left-sided valve disease?

    Science.gov (United States)

    Zhu, Tie-Yuan; Wang, Jian-Gang; Meng, Xu

    2015-01-01

    A best evidence topic in adult valvular surgery was written according to a structured protocol. The question addressed was 'Does concomitant tricuspid annuloplasty increase the perioperative mortality and morbidity when correcting left-sided valve disease?' A total of 561 papers were found using the reported search, of which 12 presented the best evidence to answer the clinical question. The authors, country, journal, date of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Among these 12 papers, there were nine retrospective studies, two cohort studies and one randomized controlled trial (RCT). Overall, additional tricuspid valve (TV) repair takes more time during operations, particularly with a ring annuloplasty method. The mean aortic cross-clamping times were 57-83 min without associated tricuspid repair and 62-100 min with, and cardiopulmonary bypass times without and with repair were 82-124 and 90-174 min, respectively. A study of 624 patients who had undergone isolated mitral valve (MV) surgery and MV surgery plus TV repair showed more female and atrial fibrillation patients in the tricuspid valve plasty (TVP) group, but no increase in the 30-day mortality was found. One RCT, presenting similar patient baseline characteristics, also found no difference in the hospital mortality rates between the TVP group and the non-TVP group. Another 10 studies also demonstrated no statistically significant differences in perioperative mortality. In a cohort study of 311 patients undergoing MV repair with or without tricuspid annuloplasty, postoperative complications, such as bleeding, stroke, pacemaker, haemofiltration and myocardial infarction, all showed no statistically significant differences in the two groups. One study retrospectively analysed a large number of patients undergoing either isolated left-sided valve surgery or a concomitant TV repair, and there were no statistically significant differences

  2. [Comparison of ablation of left-sided accessory pathway by atrial septal and retrograde arterial approach].

    Science.gov (United States)

    Zhu, J G; Bao, Z Y; Gu, X

    2017-03-07

    Objective: To compare the advantages and disadvantages of radiofrequency ablation of left-sided accessory pathways by via atrial septal approach with retrograde through aortic approach. Methods: A total of 184 patients of left-side accessory pathways were treated in Taizhou People's Hospital and the Subei People's Hospital from March 2012 to August 2015.A total of 103 cases were treated by aortic retrograde approach as through arterial group, 81 cases were treated by punctured atrial septal to left atrial for mapping and ablation as through atrial septal group.Comparison of ablation procedure time, total and pathways of different parts(subgroup) at instant success and relapse rates, safety (serious complications), and statistics other complications in operation and postoperative. Results: Through arterial group and through atrial septal group were no significant difference ( P >0.05) in the ablation procedure time((25±18 ) vs (22±15)min ), instant success(98.1% vs 97.5%) and relapse rates(1.0% vs 1.2%), security(1 vs 0 case). There was no statistical difference in septal part subgroups (all P >0.05) in the ablation procedure time((22±18)vs (25±19)min), instant success(91.7% vs 89.9 %) and relapse rates(0 vs 11.1%); posterior wall subgroup had no statistical difference in the ablation procedure time((18±15)vs (16±12)min), instant success(100% vs 100 %) and relapse rates(0 vs 0)(all P >0.05); side wall subgroup had no statistical difference in the ablation procedure time((29±20)vs (21±18) min), instant success (98.3% vs 98.1%)and relapse rates(1.7% vs 0%)(all P >0.05). Conclusion: Ablation of left-sided accessory pathways by transseptal approach and transaortic approach has no statistical difference in the procedure time, instant success and relapse rates, security.In a particular case, there is a certain complementarity between the two methods.

  3. [Left-sided native valve endocarditis by coagulase-negative staphylococci: an emerging disease].

    Science.gov (United States)

    Haro, Juan Luis; Lomas, José M; Plata, Antonio; Ruiz, Josefa; Gálvez, Juan; de la Torre, Javier; Hidalgo-Tenorio, Carmen; Reguera, José M; Márquez, Manuel; Martínez-Marcos, Francisco; de Alarcón, Arístides

    2008-05-01

    To describe the epidemiological, clinical, and prognostic characteristics of patients with left-sided native valve endocarditis (LNVE) caused by coagulase-negative staphylococci (CoNS). Prospective multicenter study of endocarditis cases reported in the Andalusian Cohort for the Study of Cardiovascular Infections between 1984 and 2005. Among 470 cases of LNVE, 39 (8.3%) were caused by CoNS, a number indicating a 30% increase in the incidence of this infection over the last decade. The mean age of affected patients was 58.32 +/- 15 years and 27 (69.2%) were men. Twenty-one patients (53.8%) had previous known valve disease and half the episodes were considered nosocomial (90% of them from vascular procedures). Median time interval from the onset of symptoms to diagnosis was 14 days (range: 1-120). Renal failure (21 cases, 53.8%), intracardiac damage (11 cases, 28.2%), and central nervous system involvement (10 cases, 25.6%) were the most frequent complications. There were only 3 cases (7.7%) of septic shock. Surgery was performed in 18 patients (46.2%). Nine patients (23.1%) died, overall. Factors associated with higher mortality in the univariate analysis were acute renal failure (P = 0.023), left-sided ventricular failure (P = 0.047), and time prior to diagnosis less than 21 days (P = 0.018). As compared to LNVE due to other microorganisms, the patients were older (P = 0.018), had experienced previous nosocomial manipulation as the source of bacteremia (P < 0.001), and developed acute renal failure more frequently (P = 0.001). Mortality of LNVE due to CoNS was lower than mortality in Staphylococcus aureus infection, but higher than in Streptococcus viridans infection. Left-sided native valve endocarditis due to CoNS is now increasing because of the ageing of the population. This implies more frequent invasive procedures (mainly vascular) as a consequence of the concomitant disease. Nonetheless, the mortality associated with LNVE due to CoNS does not seem to be

  4. Losing the left side of the world: rightward shift in human spatial attention with sleep onset.

    Science.gov (United States)

    Bareham, Corinne A; Manly, Tom; Pustovaya, Olga V; Scott, Sophie K; Bekinschtein, Tristan A

    2014-05-28

    Unilateral brain damage can lead to a striking deficit in awareness of stimuli on one side of space called Spatial Neglect. Patient studies show that neglect of the left is markedly more persistent than of the right and that its severity increases under states of low alertness. There have been suggestions that this alertness-spatial awareness link may be detectable in the general population. Here, healthy human volunteers performed an auditory spatial localisation task whilst transitioning in and out of sleep. We show, using independent electroencephalographic measures, that normal drowsiness is linked with a remarkable unidirectional tendency to mislocate left-sided stimuli to the right. The effect may form a useful healthy model of neglect and help in understanding why leftward inattention is disproportionately persistent after brain injury. The results also cast light on marked changes in conscious experience before full sleep onset.

  5. Isolated left-sided pulmonary artery agenesis with left lung hypoplasia: A report of two cases

    Directory of Open Access Journals (Sweden)

    V Govindaraj

    2017-01-01

    Full Text Available Unilateral absence of pulmonary artery or pulmonary artery agenesis (UAPA is a rare congenital malformation that can present as an isolated lesion or in association with other cardiac anomalies. Though congenital, presentation in adults are also reported. Most common presentation in adults is of exercise intolerance. The developing lung on the affected side is hypoplastic. Diagnosis of UAPA is established by imaging methods like CT and MRI . There is no specific treatment for this condition. Treatment depends on patients symptomatology, presence of pulmonary hypertension and collateral circulation. Presence of pulmonary hypertension carries a bad prognosis. We present two adult patients with isolated left sided unilateral pulmonary artery agenesis with ipsilateral lung hypoplasia. The diagnosis was confirmed by CT chest and perfusion scan.

  6. Left-Sided Catamenial Pneumothorax with Thoracic Endometriosis and Bullae in the Alveolar Wall.

    Science.gov (United States)

    Takahashi, Ryo; Kurihara, Masatoshi; Mizobuchi, Teruaki; Ebana, Hiroki; Yamanaka, Sumitaka

    2017-04-20

    Catamenial pneumothorax (CP) is generally caused by intraperitoneal air leaking from the uterus into the thoracic cavity via a defect in the endometrial tissue of the diaphragm and is usually detected in the right thorax. We report a case of left-sided CP caused by endometriosis in the visceral pleura and with no abnormal findings in the diaphragm. A 33-year-old female patient presented at the end of a course of low-dose contraceptive pills for pelvic endometriosis, with spontaneous pneumothorax in the left chest. Chest CT revealed a bulla in the left upper lung lobe. The patient underwent partial resection of the lung. Immunohistochemistry confirmed the presence of endometrial stromal tissue in the visceral pleura and confirmed this as the cause of pneumothorax since there were no observable abnormalities in the diaphragm. This case suggests that immunohistochemical examination of patients with spontaneous pneumothorax can detect alternative endometrial lesions.

  7. Rare combination of left-sided congenital diaphragmatic hernia and omphalocele.

    Science.gov (United States)

    Chee, Yuet Yee; Wong, Siu Chun Mabel; Wong, Ming Sum Rosanna

    2017-08-07

    We reported a rare case of left-sided posterolateral congenital diaphragmatic hernia (CDH) and omphalocele, which is not associated with chromosomal abnormalities or other syndromes. Omphalocele was detected antenatally (CDH was not detected in antenatal ultrasound). The patient suffered from respiratory failure secondary to severe pulmonary hypertension. As the combination of CDH and omphalocele is rare and with the abdominal content herniating into the omphalocele instead of the thorax, antenatal diagnosis of such condition can be difficult. Unlike other reported cases in the literature, our patient's respiratory condition has been improving with time and is surviving beyond the infancy period. We believe this to be the first such survival case reported in the literature. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. VMAT techniques for lymph node-positive left sided breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Pasler, Marlies; Lutterbach, Johannes; Bjoernsgard, Mari; Reichmann, Ursula; Bartelt, Susanne [Lake Constance Radiation Oncology Center Singen, Friedrichshafen (Germany); Georg, Dietmar [Medical Univ. Vienna/AKH Vienna (Austria). Dept. of Radiooncology; Medical Univ. Vienna (Austria). Christian Doppler Lab. for Medical Radiation Research for Radiation Oncology

    2015-09-01

    To investigate the plan quality of two different volumetric modulated arc therapy (VMAT) techniques for lymph node-positive left-sided breast cancer. Two VMAT plans were generated for 10 lymph node-positive left-sided breast cancer patients: one plan using one single segment of a full rotation, typically an arc segment of 230 (1s-VMAT); and a second plan consisting of 2 small tangential arc segments of about 50 (2s-VMAT). For plan comparison, various dose and dose volume metrics (D{sub mean}, D{sub 98%}, D{sub 2%} for target volumes, D{sub 2%}, D{sub mean} and V{sub x%} for organs at risk (OAR)) were evaluated. Both techniques fulfilled both clinical target dose and OAR goals. 1s-VMAT achieved a slightly better homogeneity and better target coverage (D{sub 2%} = 54.2 ± 0.7 Gy, D{sub 98%} = 30.3 ± 1.8 Gy) compared to 2s-VMAT (D{sub 2%} = 55.0 ± 1.1 Gy, D{sub 98%} = 29.9 ± 1.7 Gy). For geometrical reasons, OAR sparing was noticeable but not significant better using 2s-VMAT, particularly heart and contralateral breast. The heart received a mean dose of 4.4 ± 0.8 Gy using 1s-VMAT and 3.3 ± 1.0 Gy using 2s-VMAT; the contralateral breast received 1.5 ± 0.3 Gy and 0.9 ± 0.3 Gy, respectively. A VMAT technique based on two small tangential arc segments enables improved OAR sparing; the differences between the two techniques in target coverage and homogeneity are minor. Patient age and -anatomy must be considered for each individual case when deciding which technique to be used.

  9. VMAT techniques for lymph node-positive left sided breast cancer

    International Nuclear Information System (INIS)

    Pasler, Marlies; Lutterbach, Johannes; Bjoernsgard, Mari; Reichmann, Ursula; Bartelt, Susanne; Georg, Dietmar; Medical Univ. Vienna

    2015-01-01

    To investigate the plan quality of two different volumetric modulated arc therapy (VMAT) techniques for lymph node-positive left-sided breast cancer. Two VMAT plans were generated for 10 lymph node-positive left-sided breast cancer patients: one plan using one single segment of a full rotation, typically an arc segment of 230 (1s-VMAT); and a second plan consisting of 2 small tangential arc segments of about 50 (2s-VMAT). For plan comparison, various dose and dose volume metrics (D mean , D 98% , D 2% for target volumes, D 2% , D mean and V x% for organs at risk (OAR)) were evaluated. Both techniques fulfilled both clinical target dose and OAR goals. 1s-VMAT achieved a slightly better homogeneity and better target coverage (D 2% = 54.2 ± 0.7 Gy, D 98% = 30.3 ± 1.8 Gy) compared to 2s-VMAT (D 2% = 55.0 ± 1.1 Gy, D 98% = 29.9 ± 1.7 Gy). For geometrical reasons, OAR sparing was noticeable but not significant better using 2s-VMAT, particularly heart and contralateral breast. The heart received a mean dose of 4.4 ± 0.8 Gy using 1s-VMAT and 3.3 ± 1.0 Gy using 2s-VMAT; the contralateral breast received 1.5 ± 0.3 Gy and 0.9 ± 0.3 Gy, respectively. A VMAT technique based on two small tangential arc segments enables improved OAR sparing; the differences between the two techniques in target coverage and homogeneity are minor. Patient age and -anatomy must be considered for each individual case when deciding which technique to be used.

  10. Respiration Induced Heart Motion and Indications of Gated Delivery for Left-Sided Breast Irradiation

    International Nuclear Information System (INIS)

    Qi, X. Sharon; Hu, Angela; Wang Kai; Newman, Francis; Crosby, Marcus; Hu Bin; White, Julia; Li, X. Allen

    2012-01-01

    Purpose: To investigate respiration-induced heart motion for left-sided breast irradiation using a four-dimensional computed tomography (4DCT) technique and to determine novel indications to assess heart motion and identify breast patients who may benefit from a gated treatment. Methods and Materials: Images of 4DCT acquired during free breathing for 20 left-sided breast cancer patients, who underwent whole breast irradiation with or without regional nodal irradiation, were analyzed retrospectively. Dose distributions were reconstructed in the phases of 0%, 20%, and 50%. The intrafractional heart displacement was measured in three selected transverse CT slices using D LAD (the distance from left ascending aorta to a fixed line [connecting middle point of sternum and the body] drawn on each slice) and maximum heart depth (MHD, the distance of the forefront of the heart to the line). Linear regression analysis was used to correlate these indices with mean heart dose and heart dose volume at different breathing phases. Results: Respiration-induced heart displacement resulted in observable variations in dose delivered to the heart. During a normal free-breathing cycle, heart-induced motion D LAD and MHD changed up to 9 and 11 mm respectively, resulting in up to 38% and 39% increases of mean doses and V 25.2 for the heart. MHD and D LAD were positively correlated with mean heart dose and heart dose volume. Respiratory-adapted gated treatment may better spare heart and ipsilateral-lung compared with the conventional non-gated plan in a subset of patients with large D LAD or MHD variations. Conclusion: Proposed indices offer novel assessment of heart displacement based on 4DCT images. MHD and D LAD can be used independently or jointly as selection criteria for respiratory gating procedure before treatment planning. Patients with great intrafractional MHD variations or tumor(s) close to the diaphragm may particularly benefit from the gated treatment.

  11. Intraoperative colonic pulse oximetry in left-sided colorectal surgery: can it predict anastomotic leak?

    Science.gov (United States)

    Salusjärvi, Johannes M; Carpelan-Holmström, Monika A; Louhimo, Johanna M; Kruuna, Olli; Scheinin, Tom M

    2018-03-01

    An anastomotic leak is a fairly common and a potentially lethal complication in colorectal surgery. Objective methods to assess the viability and blood circulation of the anastomosis could help in preventing leaks. Intraoperative pulse oximetry is a cheap, easy to use, fast, and readily available method to assess tissue viability. Our aim was to study whether intraoperative pulse oximetry can predict the development of an anastomotic leak. The study was a prospective single-arm study conducted between the years 2005 and 2011 in Helsinki University Hospital. Patient material consisted of 422 patients undergoing elective left-sided colorectal surgery. The patients were operated by one of the three surgeons. All of the operations were partial or total resections of the left side of the colon with a colorectal anastomosis. The intraoperative colonic oxygen saturation was measured with pulse oximetry from the colonic wall, and the values were analyzed with respect to post-operative complications. 2.3 times more operated anastomotic leaks occurred when the colonic StO 2 was ≤ 90% (11/129 vs 11/293). The mean colonic StO 2 was 91.1 in patients who developed an operated anastomotic leak and 93.0 in patients who did not. With logistic regression analysis, the risk of operated anastomotic leak was 4.2 times higher with StO 2 values ≤ 90%. Low intraoperative colonic StO 2 values are associated with the occurrence of anastomotic leak. Despite its handicaps, the method seems to be useful in assessing anastomotic viability.

  12. Right- vs. Left-Sided Metastatic Colorectal Cancer: Differences in Tumor Biology and Bevacizumab Efficacy

    Directory of Open Access Journals (Sweden)

    Paola Ulivi

    2017-06-01

    Full Text Available There is evidence of a different response to treatment with regard to the primary tumor localization (right-sided or left-sided in patients with metastatic colorectal cancer (mCRC. We analyzed the different outcomes and biomolecular characteristics in relation to tumor localization in 122 of the 370 patients with metastatic colorectal cancer enrolled onto the phase III prospective multicenter “Italian Trial in Advanced Colorectal Cancer (ITACa”, randomized to receive first-line chemotherapy (CT or CT plus bevacizumab (CT + B. RAS and BRAF mutations; baseline expression levels of circulating vascular endothelial growth factor (VEGF, endothelial nitric oxide synthase (eNOS, cyclooxygenase-2 (COX2, ephrin type-B receptor 4 (EPHB4, hypoxia-inducible factor 1-alpha (HIF-1α, lactate dehydrogenase (LDH, and high-sensitivity C reactive protein (hs-CRP; and inflammatory indexes such as the neutrophil-to-lymphocyte ratio, platelet-lymphocyte rate and systemic immune-inflammation index were evaluated. Patients with right-sided tumors showed a longer median progression-free survival in the CT + B arm than in the CT group (12.6 vs. 9.0 months, respectively, p = 0.017. Baseline inflammatory indexes were significantly higher in left-sided tumors, whereas eNOS and EPHB4 expression was significantly higher and BRAF mutation more frequent in right-sided tumors. Our data suggest a greater efficacy of the CT + B combination in right-sided mCRC, which might be attributable to the lower inflammatory status and higher expression of pro-angiogenic factors that appear to characterize these tumors.

  13. Factors affecting colonoscope insertion time in patients with or without a colostomy after left-sided colorectal resection.

    Science.gov (United States)

    Jang, Hui Won; Kim, Yoon Nam; Nam, Chung Mo; Lee, Hyun Jung; Park, Soo Jung; Hong, Sung Pil; Kim, Tae Il; Kim, Won Ho; Cheon, Jae Hee

    2012-12-01

    We examined whether the insertion time for colonoscopies performed after left-sided resection was different in patients with a colostomy from that in patients without a colostomy and identified factors that could impact colonoscopy performance. We included consecutive patients who underwent colonoscopy between July 2005 and March 2011 after left-sided colorectal resection for colorectal cancer. We classified surgical methods according to the presence or absence of a colostomy and evaluated colonoscope insertion time retrospectively. Furthermore, we analyzed factors that might affect insertion time. A total of 1,041 patients underwent colonoscopy after left-sided colorectal resection during the study period. The colonoscopy completion rate was 98.6 %, and the mean insertion time was 6.1 ± 4.6 min (median 4.7 min, range 0.3-35.8 min). A shorter resection length of colon, the presence of a colostomy, and a lower endoscopist case volume were found to be independent factors associated with prolonged insertion time in patients with left-sided colorectal resection. Among experienced colonoscopists, no colonoscopy-associated or clinical factors were found to affect insertion time. However, a shorter resection length of colon, the presence of a colostomy, and poor bowel preparation were associated with prolonged insertion time among inexperienced endoscopists. We identified three factors that affect colonoscope insertion time after left-sided colorectal resection, including the presence of a colostomy. Inexperienced endoscopists were much more affected by the presence of a colostomy after left-sided colorectal resection. These findings have implications for the practice and teaching of colonoscopy after left-sided colorectal resection.

  14. Preliminary investigation of orally administered benazepril in horses with left-sided valvular regurgitation.

    Science.gov (United States)

    Afonso, T; Giguère, S; Brown, S A; Barton, M H; Rapoport, G; Barba, M; Dembek, K A; Toribio, R E; Coleman, A E

    2017-10-17

    Despite the paucity of data available, orally administered angiotensin-converting enzyme (ACE) inhibitors are empirically used in horses with valvular regurgitation. Evaluate the echocardiographic and hormonal changes in response to oral benazepril in horses with left-sided valvular regurgitation. Prospective, randomised double-blind, placebo-controlled trial. Horses with mitral valve (MR) and/or aortic valve regurgitation (AR) received oral benazepril (n = 6) at a dosage of 1 mg/kg q 12 h or a placebo (n = 5) for 28 days. Echocardiography was performed before drug administration and after 28 days of treatment. Plasma renin activity, serum ACE activity, angiotensin II concentration, aldosterone concentration and biochemical variables were measured before drug administration and after 7 and 28 days of treatment. Relative to baseline, horses treated with benazepril had statistically significant reduction in left ventricular internal diameter in systole (mean difference between groups = -0.97 cm; 95% CI = -1.5 to -0.43 cm), aortic sinus diameter (-0.31 cm; -0.54 to -0.07 cm), and percentage of the aortic annulus diameter occupied by the base of the AR jet (-17.05%; -31.17 to -2.93%) compared with horses receiving a placebo. In addition, horses treated with benazepril had a significantly greater increase in cardiac output (11.95 L/min; 1.17-22.73 L/min) and fractional shortening (7.59%; 3.3-11.88%) compared with horses receiving a placebo. Despite profound serum ACE inhibition, renin activity and concentrations of angiotensin II and aldosterone were not significantly different between treatment groups or among time points. Very small sample size and short treatment period. Treatment with oral benazepril resulted in statistically significant echocardiographic changes that might indicate reduced cardiac afterload in horses with left-sided valvular regurgitation. Additional studies with a larger sample size will be necessary to determine if administration of benazepril is

  15. Respiration Induced Heart Motion and Indications of Gated Delivery for Left-Sided Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Qi, X. Sharon, E-mail: xiangrong.qi@ucdenver.edu [Department of Radiation Oncology, University of Colorado Denver, Aurora, CO (United States); Hu, Angela [Department of Radiation Oncology, University of Colorado Denver, Aurora, CO (United States); Wang Kai [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States); Newman, Francis [Department of Radiation Oncology, University of Colorado Denver, Aurora, CO (United States); Crosby, Marcus; Hu Bin; White, Julia; Li, X. Allen [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States)

    2012-04-01

    Purpose: To investigate respiration-induced heart motion for left-sided breast irradiation using a four-dimensional computed tomography (4DCT) technique and to determine novel indications to assess heart motion and identify breast patients who may benefit from a gated treatment. Methods and Materials: Images of 4DCT acquired during free breathing for 20 left-sided breast cancer patients, who underwent whole breast irradiation with or without regional nodal irradiation, were analyzed retrospectively. Dose distributions were reconstructed in the phases of 0%, 20%, and 50%. The intrafractional heart displacement was measured in three selected transverse CT slices using D{sub LAD} (the distance from left ascending aorta to a fixed line [connecting middle point of sternum and the body] drawn on each slice) and maximum heart depth (MHD, the distance of the forefront of the heart to the line). Linear regression analysis was used to correlate these indices with mean heart dose and heart dose volume at different breathing phases. Results: Respiration-induced heart displacement resulted in observable variations in dose delivered to the heart. During a normal free-breathing cycle, heart-induced motion D{sub LAD} and MHD changed up to 9 and 11 mm respectively, resulting in up to 38% and 39% increases of mean doses and V{sub 25.2} for the heart. MHD and D{sub LAD} were positively correlated with mean heart dose and heart dose volume. Respiratory-adapted gated treatment may better spare heart and ipsilateral-lung compared with the conventional non-gated plan in a subset of patients with large D{sub LAD} or MHD variations. Conclusion: Proposed indices offer novel assessment of heart displacement based on 4DCT images. MHD and D{sub LAD} can be used independently or jointly as selection criteria for respiratory gating procedure before treatment planning. Patients with great intrafractional MHD variations or tumor(s) close to the diaphragm may particularly benefit from the gated

  16. Massive Left-sided Congestive Colitis Due to Idiopathic Inferior Mesenteric Arteriovenous Malformation

    Directory of Open Access Journals (Sweden)

    Laura Martí Gelonch

    2017-01-01

    Full Text Available Arteriovenous malformations (AVM of the inferior mesenteric artery are rare. They may be primary (congenital or idiopathic or secondary (acquired after trauma or of iatrogenic origin. Of the abdominal AVM, the inferior mesenteric trunk is the least commonly involved. Most reported cases are of iatrogenic origin, resulting from colon surgery. Only 17 cases have been described and published in the literature. The objective of this work is to make known a case treated in our center. We present a case of 73-year old male, who came to the emergency service with symptoms of abdominal distension, pain lasting 48 hours along with months of diarrhoea. CT scan and an abdominal CT angiography showed a massive left-sided congestive colitis due to idiopathic inferior mesenteric arteriovenous malformation. In our case, the decision was to carry out the treatment in two stages. Embolisation was performed in the first stage in order to decrease the blood flow and the risk of intraoperative bleeding, followed by resective surgery of the affected colon.

  17. An unusual case of metastasis to the left side of the heart: a case report

    Directory of Open Access Journals (Sweden)

    Boyars Michael

    2011-01-01

    Full Text Available Abstract Introduction Cardiac metastases are found in six to 20% of autopsies of patients with malignant neoplasm. The most common neoplasms that metastasize to the heart are malignant melanoma, lymphoma, and leukemia, but the relative numbers are greater with breast and lung cancers, reflecting the most common incidence of these cancers. Case presentation A 60-year-old Hispanic man presented to our hospital after being transferred from an outside hospital for workup and evaluation of an adrenal mass of the abdomen and pelvis, found on computed tomography. His chief complaint upon admission was altered mental status. Physical examination was unremarkable. He was alert and oriented and had a dry and non-erythematous oropharynx, and bilateral diffuse wheezing on lung examination. Computed tomography of the chest showed multiple hypodense lesions in the left ventricular myocardium, suggestive of metastases. There were also tiny sub-centimeter nodular densities in the right upper and lower lobes. Adrenal glands contained hypodense lesions, which showed characteristic adenocarcinomatous malignant cells. Conclusion Cancers which have metastasized to the heart are found in six to 20% of patients with malignant neoplasms. The right side of the heart is more commonly involved in metastasis. This study is unusual in that a tumor of an unknown primary origin had metastasized to the left side of the heart.

  18. Reduced-dose abdominopelvic CT using hybrid iterative reconstruction in suspected left-sided colonic diverticulitis

    Energy Technology Data Exchange (ETDEWEB)

    Laqmani, Azien; Dulz, Simon; Behzadi, Cyrus; Schmidt-Holtz, Jakob; Wassenberg, Felicia; Adam, Gerhard; Regier, Marc [University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg (Germany); Veldhoen, Simon [University Medical Center Wuerzburg, Department of Diagnostic and Interventional Radiology, Wuerzburg (Germany); Derlin, Thorsten [Hannover Medical School, Department of Nuclear Medicine, Hannover (Germany); Sehner, Susanne [University Medical Center Hamburg-Eppendorf, Department of Medical Biometry and Epidemiology, Hamburg (Germany); Nagel, Hans-Dieter [Scientific and Application-oriented Studies and Consulting in Radiology (SASCRAD), Buchholz (Germany)

    2016-01-15

    To assess the effect of hybrid iterative reconstruction (HIR) and filtered back projection (FBP) on abdominopelvic CT with reduced-dose (RD-APCT) in the evaluation of acute left-sided colonic diverticulitis (ALCD). Twenty-five consecutive patients with suspected ALCD who underwent RD-APCT (mean CTDIvol 11.2 ± 4.2 mGy) were enrolled in this study. Raw data were reconstructed using FBP and two increasing HIR levels, L4 and L6. Two radiologists assessed image quality, image noise and reviewer confidence in interpreting findings of ALCD, including wall thickening, pericolic fat inflammation, pericolic abscess, and contained or free extraluminal air. Objective image noise (OIN) was measured. OIN was reduced up to 54 % with HIR compared to FBP. Subjective image quality of HIR images was superior to FBP; subjective image noise was reduced. The detection rate of extraluminal air was higher with HIR L6. Reviewer confidence in interpreting CT findings of ALCD significantly improved with application of HIR. RD-APCT with HIR offers superior image quality and lower image noise compared to FBP, allowing a high level of reviewer confidence in interpreting CT findings in ALCD. HIR facilitates detection of ALCD findings that may be missed with the FBP algorithm. (orig.)

  19. Left-sided appendicitis: review of 95 published cases and a case report.

    Science.gov (United States)

    Akbulut, Sami; Ulku, Abdullah; Senol, Ayhan; Tas, Mahmut; Yagmur, Yusuf

    2010-11-28

    To give an overview of the literature on left-sided acute appendicitis (LSAA) associated with situs inversus totalis (SIT) and midgut malrotation (MM). We present a new case of LSAA with SIT and a literature review of studies published in the English language on LSAA, accessed via PubMed and Google Scholar databases. Ninety-five published cases of LSAA were evaluated and a 25-year-old female, who presented to our clinic with left lower abdominal pain caused by LSAA, is reported. In the reviewed literature, fifty-seven patients were male and 38 were female with an age range of 8 to 82 years and a median age of 29.1 ± 15.9 years. Sixty-six patients had SIT, 23 had MM, three had cecal malrotation, and two had a previously unnoted congenital abnormality. Fifty-nine patients had presented to the hospital with left lower, 14 with right lower and seven with bilateral lower quadrant pain, and seven subjects complained of left upper quadrant pain. The diagnosis was established preoperatively in 49 patients, intraoperatively in 19, and during the postoperative period in five; 14 patients were aware of having this anomaly. The data of eight patients were not unavailable. Eleven patients underwent laparoscopic appendectomy, which was combined with cholecystectomy in two cases. Histopathological examination of the appendix specimens revealed adenocarcinoma in only two of 95 patients. The diagnosis of left lower quadrant pain is based on well-established clinical symptoms, physical examination and physician's experience.

  20. Quantitative assessment of left-sided valvular regurgitation using the fourier amplitude ratio

    International Nuclear Information System (INIS)

    Kosuda, Shigeru; Satoh, Jinsei; Yonahara, Yoshio; Asato, Tetsuyoshi; Naito, Masahito; Nishiguchi, Iku; Ogawa, Koichi; Kubo, Atsushi; Hashimoto, Shozo.

    1985-01-01

    Since the amplitude value of a pixel is proportional to the stroke counts of the pixel, the total amplitude value of each ventricle would reflect its own stroke volume. Stroke count ratio (SCR) and ventricular amplitude ratio (VAR) values were simultaneously calculated and compared in 43 subjects, including 13 subjects with valvular regurgitation, after multigated equilibrium scintigraphy was performed. Mean values of SCR in 13 subjects with valvular regurgitation and 30 control subjects were 2.22+-1.11, 1.24+-0.41, respectively (p<0.005). Mean values of VAR were 2.52+-0.87, 1.36+-0.39, respectively (p<0.0005). The VAR method was independent of the tilting angles of the detector, and showed excellent intra-observer and inter-observer reproducibilities (r=0.95, r=0.91). The VAR method derived from the Fourier amplitude image is a noninvasive technique, is suitable for serial studies, and appears to be a relatively reliable means of assessing the severity of left-sided valvular regurgitation. (author)

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

    Directory of Open Access Journals (Sweden)

    Mark Gorman

    2015-01-01

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

  2. Insight into the da Vinci® Xi - technical notes for single-docking left-sided colorectal procedures.

    Science.gov (United States)

    Ngu, James Chi-Yong; Sim, Sarah; Yusof, Sulaiman; Ng, Chee-Yung; Wong, Andrew Siang-Yih

    2017-12-01

    The adoption of robot-assisted laparoscopic colorectal surgery has been hampered by issues with docking, operative duration, technical difficulties in multi-quadrant access, and cost. The da Vinci® Xi has been designed to overcome some of these limitations. We describe our experience with the system and offer technical insights to its application in left-sided colorectal procedures. Our initial series of left-sided robotic colorectal procedures was evaluated. Patient demographics and operative outcomes were recorded prospectively using a predefined database. Between March 2015 and April 2016, 54 cases of robot-assisted laparoscopic left-sided colorectal procedures were successfully completed with no cases of conversion. The majority were low anterior resections for colorectal malignancies. Using the da Vinci® Xi Surgical System, multi-quadrant surgery involving dissection from the splenic flexure to the pelvis was possible without redocking. The da Vinci® Xi simplifies the docking procedure and makes single-docking feasible for multi-quadrant left-sided colorectal procedures. Copyright © 2016 John Wiley & Sons, Ltd.

  3. Deviating colostomy construction versus stent placement as bridge to surgery for malignant left-sided colonic obstruction

    NARCIS (Netherlands)

    Amelung, F.J.; Borg, F. ter; Consten, E.C.; Siersema, P.D.; Draaisma, W.A.

    2016-01-01

    BACKGROUND: Acute colonic decompression using a deviating colostomy (DC) or a self-expandable metal stent (SEMS) has been shown to lead to fewer complications and permanent stomas compared to acute resection in elderly patients with malignant left-sided colonic obstruction (LSCO). However, no

  4. Is Diversion with Ileostomy Non-inferior to Hartmann Resection for Left-sided Colorectal Anastomotic Leak?

    Science.gov (United States)

    Stafford, Caitlin; Francone, Todd D; Marcello, Peter W; Roberts, Patricia L; Ricciardi, Rocco

    2018-03-01

    Treatment of left-sided colorectal anastomotic leaks often requires fecal stream diversion for prevention of further septic complications. To manage anastomotic leak, it is unclear if diverting ileostomy provides similar outcomes to Hartmann resection with colostomy. We identified all patients who developed anastomotic leak following left-sided colorectal resections from 1/2012 through 12/2014 using the American College of Surgeons National Surgical Quality Improvement Program. Then, we examined the risk of mortality and abdominal reoperation in patients treated with diverting ileostomy as compared to Hartmann resection. There were 1745 patients who experienced an anastomotic leak in a cohort of 63,748 patients (3.7%). Two hundred thirty-five patients had a reoperation for anastomotic leak involving the formation of a diverting ileostomy (n = 77) or Hartmann resection (n = 158). There was no difference in mortality or abdominal reoperation in patients treated with diverting ileostomy (3.9, 7.8%) versus Hartmann resection (3.8, 6.3%) (p = 0.8). There was no difference in the outcomes of mortality or need for second abdominal reoperation in patients treated with diverting ileostomy as compared to Hartmann resection for left-sided colorectal anastomotic leak. Thus, select patients with left-sided colorectal anastomotic leaks may be safely managed with diverting ileostomy.

  5. Combined atresia of one left-sided and one right-sided cardiac valve in a premature newborn.

    Science.gov (United States)

    Roberts, William C; Sing, Alan C; Guileyardo, Joseph M

    2017-10-01

    Described herein is the heart of a 2-day-old newborn, the product of a 25-week gestation, with atresia of two cardiac valves, one on the right side and one on the left side, apparently a previously undescribed entity.

  6. [Analysis of clinicopathologic and survival characteristics in patients with right-or left-sided colon cancer].

    Science.gov (United States)

    Hu, Junjie; Zhou, Zhixiang; Liang, Jianwei; Zhou, Haitao; Wang, Zheng; Zhang, Xingmao; Zeng, Weigen

    2015-07-28

    This study aimed to clarify the clinical and histological parameters, and survival difference between right- and left-sided colon cancer. We retrospectively analyzed the medical records (2006.1-2009.12) of 1 088 consecutive colon cancer patients who received surgery at our hospital. Right- and left-sided colon cancers were compared regarding the clinical and histological parameters. The survival analysis was performed by the Kaplan-Meier method, and the log-rank test was used to determine the statistical significance of differences. Right-sided colon cancer was associated with older age, a more advanced state, and poorly differentiated and undifferentiated adenocarcinoma (25.2% vs 13.2%), mucinous adenocarcinoma (33.5% vs 17.3%) and vascular invasion (9.9% vs 3.9%) were more commonly seen in right-sided colon cancer compared with right-sided colon cancer, and all these differences were statistically significant. Median overall survival was right, 67 months; and left, 68 months. The five-years overall survival of right- and left-sided colon cancer was I/II stage, 91.4% vs 88.6% (P = 0.819); III stage, 66.1% vs 75.4% (P = 0.010); and IV stage, 27.8% vs 38.5% (P = 0.020) respectively. Right- and left-sided colon cancers are significantly different regarding clinical and histological parameters. Right-sided colon cancers in stage III and IV have a worse prognosis.

  7. A nationwide Danish cohort study challenging the categorisation into right-sided and left-sided colon cancer

    DEFF Research Database (Denmark)

    Jess, Per; Hansen, Iben Onsberg; Gamborg, Michael

    2013-01-01

    The categorisation of colon cancer (CC) into right-sided (RCC) and left-sided (LCC) disease may not capture more subtle variances in aetiology and prognosis. In a nationwide study, we investigated differences in clinical characteristics and survival of RCC versus LCC and of the complete range of CC...

  8. Intensity modulated radiotherapy with fixed collimator jaws for locoregional left-sided breast cancer irradiation.

    Science.gov (United States)

    Wang, Juanqi; Yang, Zhaozhi; Hu, Weigang; Chen, Zhi; Yu, Xiaoli; Guo, Xiaomao

    2017-05-16

    The purpose of this study is to evaluate the intensity modulated radiotherapy (IMRT) with the fixed collimator jaws technique (FJT) for the left breast and regional lymph node. The targeted breast tissue and the lymph nodes, and the normal tissues were contoured for 16 left-sided breast cancer patients previously treated with radiotherapy after lumpectomy. For each patient, treatment plans using different planning techniques, i.e., volumetric modulated arc therapy (VMAT), tangential IMRT (tangential-IMRT), and IMRT with FJT (FJT-IMRT) were developed for dosimetric comparisons. A dose of 50Gy was prescribed to the planning target volume. The dose-volume histograms were generated, and the paired t-test was used to analyze the dose differences. FJT-IMRT had similar mean heart volume receiving 30Gy (V30 Gy) with tangential-IMRT (1.5% and 1.6%, p = 0.41), but inferior to the VMAT (0.8%, p < 0.001). In the average heart mean dose comparison, FJT-IMRT had the lowest value, and it was 0.6Gy lower than that for the VMAT plans (p < 0.01). A significant dose increase in the contralateral breast and lung was observed in VMAT plans. Compared with tangential-IMRT and VMAT plans, FJT-IMRT reduced the mean dose of thyroid, humeral head and cervical esophageal by 47.6% (p < 0.01) and 45.7% (p < 0.01), 74.3% (p =< 0.01) and 73% (p =< 0.01), and 26.7% (p =< 0.01) and 29.2% (p =< 0.01). In conclusion, compared with tangential-IMRT and VMAT, FJT-IMRT plan has the lowest thyroid, humeral head and cervical esophageal mean dose and it can be a reasonable treatment option for a certain subgroup of patients, such as young left-breast cancer patients and/or patients with previous thyroid disease.

  9. Positron emission tomographic localization of left-sided unilateral spatial agnosia

    International Nuclear Information System (INIS)

    Tagawa, Koichi; Nagata, Ken; Shishido, Fumio; Uemura, Kazuo

    1986-01-01

    Positron emission tomography (PET) was used to clarify the localization and the underlying mechanisms of left-sided unilateral spatial agnosia (LUSA). Eleven right-handed patients with cerebral infarction in the territory of the right middle cerebral artery who had LUSA were included in this study. Cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRO 2 ) were measured with PET using 15 O steady state method. Sixteen right-handed patients with cerebral infarction who did not exhibit LUSA served as a control group. The mean local values of CBF and CMRO 2 in the control group were 37.4 ml/100 ml tissue/min and 2.66 ml/100 ml tissue/min, respectively. By contrast, those values of CBF and CMRO 2 in the patients with LUSA were 21.7 ml/100 ml tissue/min and 1.43 ml/100 ml tissue/min, respectively. Both CBF and CMRO 2 in the right posterior parietal region were significantly lower in the patients with LUSA as compared with the control group (p 2 between 1.8 and 2.2 ml/100 ml tissue/min. These ranges of CBF and CMRO 2 in the right parietal region were considered to include the threshold level producing LUSA. The CMRO 2 values were more stabilized in the course of cerebral infarction as compared with the CBF values which may be variable on account of luxury perfusion syndrome. The right posterior parietal CMRO 2 values less than 2.0 ml/100 ml tissue/min was considered to be critical in causing LUSA. The above results may suggest that severe damages of CBF and metabolism in the posterior part of the right parietal lobe play an important role in the occurrence of LUSA. (J.P.N.)

  10. Efficacy of loop colostomy construction for acute left-sided colonic obstructions: a cohort analysis.

    Science.gov (United States)

    Amelung, Femke J; Mulder, Charlotte L J; Broeders, Ivo A M J; Consten, Esther C J; Draaisma, Werner A

    2017-03-01

    Acute primary resection as treatment for left-sided colonic obstruction (LSCO) is notorious for its high morbidity and mortality rates. Both stenting and loop colostomy construction can serve as a bridge to surgery, hereby avoiding the high morbidity and mortality rates associated with emergency resections. This study aims to investigate the safety of a loop colostomy in patients presenting with acute LSCO. Retrospective analysis of all patients that received a loop colostomy for LSCO between 2003 and 2015 was performed. Primary outcomes were mortality, major morbidity (Clavien-Dindo grades III-IV) and minor morbidity (Clavien-Dindo grades I-II). One hundred forty-six patients presenting with acute LSCO received a diverting colostomy. After colostomy construction, mortality occurred in four patients (2.7%) and major complications were reported in 20 patients (13.7%). In 61 patients, the diverting colostomy served as a palliative measure, because of metastatic disease or unfitness for major surgery. The remaining 85 patients all underwent delayed resection, resulting in an overall mortality, major morbidity and minor morbidity of 6.9% (n = 6), 14.0% (n = 12) and 26.7% (n = 23), respectively. Diverting colostomy construction is a minimally invasive and safe treatment option for LSCO. It can serve as a definite palliative measure, as well as a bridge to elective surgery. A diverting colostomy as a bridge to surgery might even be a valid alternative for emergency resections, since mortality and morbidity rates following colostomy construction and delayed resection appear lower than reported outcomes following primary resection.

  11. Epidermal growth factor enemas for induction of remission in left-sided ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Hugo Nodarse-Cuní

    2013-03-01

    Full Text Available Introduction: ulcerative colitis is a little known chronic inflammatory disease in colonic mucosa. The positive effect of epidermal growth factor was shown in a previous report, with enema use for treatment of mild to moderate left-sided manifestation of the disease. This evidence provided the basis for evaluating the efficacy and safety profile of a viscous solution of this product. Methods: thirty-one patients were randomized to three groups for daily medications during 14 days. Twelve received one 10 mg enema of epidermal growth factor dissolved in 100 mL of viscous solution whereas nine were treated with placebo enema; both groups also received 1.2 g of oral mesalamine per day. The other group included ten patients with 3 g / 100 mL of mesalamine enema. Primary end point was clinical responses after two weeks of treatment, defined as a decreased of, at least three points from baseline, the Disease Activity Index and endoscopic or histological evidences of improvement. Results: remission of disease was observed in all patients in the epidermal growth factor group, and six in both, mesalamine enema and placebo group. All the comparisons between groups showed statistically significant superiority for epidermal growth factor, the only product with significant reduction in disease activity index as well as the presence and intensity of digestive symptoms in patients after treatment. None adverse event was reported. Conclusions: the results agree with previous molecular and clinical evidences, indicating that the epidermal growth factor is effective to reduce disease activity and to induce remission. A new study involving more patients should be conducted to confirm the efficacy of the epidermal growth factor enemas.

  12. Left-sided breast cancer irradiation using rotational and fixed-field radiotherapy

    International Nuclear Information System (INIS)

    Qi, X. Sharon; Liu, Tian X.; Liu, Arthur K.; Newman, Francis; Rabinovitch, Rachel; Kavanagh, Brian; Hu, Y. Angie

    2014-01-01

    The 3-dimensional conformal radiotherapy (3DCRT) technique is the standard for breast cancer radiotherapy. During treatment planning, not only the coverage of the planning target volume (PTV) but also the minimization of the dose to critical structures, such as the lung, heart, and contralateral breast tissue, need to be considered. Because of the complexity and variations of patient anatomy, more advanced radiotherapy techniques are sometimes desired to better meet the planning goals. In this study, we evaluated external-beam radiation treatment techniques for left breast cancer using various delivery platforms: fixed-field including TomoDirect (TD), static intensity-modulated radiotherapy (sIMRT), and rotational radiotherapy including Elekta volumetric-modulated arc therapy (VMAT) and tomotherapy helical (TH). A total of 10 patients with left-sided breast cancer who did or did not have positive lymph nodes and were previously treated with 3DCRT/sIMRT to the entire breast were selected, their treatment was planned with Monaco VMAT, TD, and TH. Dosimetric parameters including PTV coverage, organ-at-risk (OAR) sparing, dose-volume histograms, and target minimum/maximum/mean doses were evaluated. It is found that for plans providing comparable PTV coverage, the Elekta VMAT plans were generally more inhomogeneous than the TH and TD plans. For the cases with regional node involvement, the average mean doses administered to the heart were 9.2 (± 5.2) and 8.8 (± 3.0) Gy in the VMAT and TH plans compared with 11.9 (± 6.4) and 11.8 (± 9.2) Gy for the 3DCRT and TD plans, respectively, with slightly higher doses given to the contralateral lung or breast or both. On average, the total monitor units for VMAT plans are 11.6% of those TH plans. Our studies have shown that VMAT and TH plans offer certain dosimetric advantages over fixed-field IMRT plans for advanced breast cancer requiring regional nodal treatment. However, for early-stage breast cancer fixed

  13. Image-Guided Radiotherapy for Left-Sided Breast Cancer Patients: Geometrical Uncertainty of the Heart

    International Nuclear Information System (INIS)

    Topolnjak, Rajko; Borst, Gerben R.; Nijkamp, Jasper; Sonke, Jan-Jakob

    2012-01-01

    Purpose: To quantify the geometrical uncertainties for the heart during radiotherapy treatment of left-sided breast cancer patients and to determine and validate planning organ at risk volume (PRV) margins. Methods and Materials: Twenty-two patients treated in supine position in 28 fractions with regularly acquired cone-beam computed tomography (CBCT) scans for offline setup correction were included. Retrospectively, the CBCT scans were reconstructed into 10-phase respiration correlated four-dimensional scans. The heart was registered in each breathing phase to the planning CT scan to establish the respiratory heart motion during the CBCT scan (σ resp ). The average of the respiratory motion was calculated as the heart displacement error for a fraction. Subsequently, the systematic (Σ), random (σ), and total random (σ tot =√(σ 2 +σ resp 2 )) errors of the heart position were calculated. Based on the errors a PRV margin for the heart was calculated to ensure that the maximum heart dose (D max ) is not underestimated in at least 90% of the cases (M heart = 1.3Σ-0.5σ tot ). All analysis were performed in left-right (LR), craniocaudal (CC), and anteroposterior (AP) directions with respect to both online and offline bony anatomy setup corrections. The PRV margin was validated by accumulating the dose to the heart based on the heart registrations and comparing the planned PRV D max to the accumulated heart D max . Results: For online setup correction, the cardiac geometrical uncertainties and PRV margins were ∑ = 2.2/3.2/2.1 mm, σ = 2.1/2.9/1.4 mm, and M heart = 1.6/2.3/1.3 mm for LR/CC/AP, respectively. For offline setup correction these were ∑ = 2.4/3.7/2.2 mm, σ = 2.9/4.1/2.7 mm, and M heart = 1.6/2.1/1.4 mm. Cardiac motion induced by breathing was σ resp = 1.4/2.9/1.4 mm for LR/CC/AP. The PRV D max underestimated the accumulated heart D max for 9.1% patients using online and 13.6% patients using offline bony anatomy setup correction, which validated

  14. Echocardiographic findings predict in-hospital and 1-year mortality in left-sided native valve Staphylococcus aureus endocarditis

    DEFF Research Database (Denmark)

    Lauridsen, Trine K.; Park, Lawrence; Tong, Steven Y C

    2015-01-01

    BACKGROUND: Staphylococcus aureus left-sided native valve infective endocarditis (LNVIE) has higher complication and mortality rates compared with endocarditis from other pathogens. Whether echocardiographic variables can predict prognosis in S aureus LNVIE is unknown. METHODS AND RESULTS......: Consecutive patients with LNVIE, enrolled between January 2000 and September 2006, in the International Collaboration on Endocarditis were identified. Subjects without S aureus IE were matched to those with S aureus IE by the propensity of having S aureus. Survival differences were determined using log...

  15. Growth Patterns of Fetal Lung Volumes in Healthy Fetuses and Fetuses With Isolated Left-Sided Congenital Diaphragmatic Hernia.

    Science.gov (United States)

    Ruano, Rodrigo; Britto, Ingrid Schwach Werneck; Sananes, Nicolas; Lee, Wesley; Sangi-Haghpeykar, Haleh; Deter, Russell L

    2016-06-01

    To evaluate fetal lung growth using 3-dimensional sonography in healthy fetuses and those with congenital diaphragmatic hernia (CDH). Right and total lung volumes were serially evaluated by 3-dimensional sonography in 66 healthy fetuses and 52 fetuses with left-sided CDH between 20 and 37 weeks' menstrual age. Functions fitted to these parameters were compared for 2 groups: (1) healthy versus those with CDH; and (2) fetuses with CHD who survived versus those who died. Fetal right and total lung volumes as well as fetal observed-to-expected right and total lung volume ratios were significantly lower in fetuses with CDH than healthy fetuses (Pvolume ratios did not vary with menstrual age in healthy fetuses or in those with CDH (independent of outcome). Lung volume rates were lower in fetuses with left-sided CDH compared to healthy fetuses, as well as in fetuses with CDH who died compared to those who survived. The observed-to-expected right and total lung volume ratios were relatively constant throughout menstrual age in fetuses with left-sided CDH, suggesting that the origin of their lung growth abnormalities occurred before 20 weeks and did not progress. The observed-to-expected ratios may be useful in predicting the outcome in fetuses with CDH independent of menstrual age. © 2016 by the American Institute of Ultrasound in Medicine.

  16. Oral antibiotic treatment of left-sided infectious endocarditis verified by 16S-PCR

    DEFF Research Database (Denmark)

    Bruun, Louise E; Tønder, Niels; Hansen, Thomas Fritz

    2011-01-01

    Treatment of infectious endocarditis (IE) comprises intravenously administered antibiotic medications given at high doses for 4-6 weeks--sometimes even longer. Approximately 50% of patients referred to tertiary care centres require additional surgical intervention. At present there are few papers...

  17. Long-term mortality from cardiac causes after adjuvant hypofractionated vs. conventional radiotherapy for localized left-sided breast cancer.

    Science.gov (United States)

    Chan, Elisa K; Woods, Ryan; Virani, Sean; Speers, Caroline; Wai, Elaine S; Nichol, Alan; McBride, Mary L; Tyldesley, Scott

    2015-01-01

    Ongoing concern remains regarding cardiac injury with hypofractionated whole breast/chest-wall radiotherapy (HF-WBI) compared to conventional radiotherapy (CF-WBI) in left-sided breast cancer patients. The purpose was to determine if cardiac mortality increases with HF-WBI relative to CF-WBI. Between 1990 and 1998, 5334 women with early-stage breast cancer received post-operative radiotherapy to the breast/chest wall alone. A population-based database recorded baseline patient, tumor and treatment factors. Baseline cardiovascular risk factors were identified from hospital administrative records. A propensity-score model balanced risk factors between radiotherapy groups. Cause of death was coded as breast cancer, cardiac or other cause. Cumulative mortality from each cause after radiotherapy was estimated using a competing risk approach. For left-sided cases, median follow-up was 14.2 years. 485 women received CF-WBI, 2221 women received HF-WBI. There was no difference in 15-year mortality from cardiac causes: 4.8% with HF-WBI and 4.2% with CF-WBI (p=0.74), even after propensity-score adjustment (p=0.45). There was no difference in breast cancer mortality or other cause mortality. For right-sided cases, there was no difference in mortality for the three causes of death. At 15-years follow-up, cardiac mortality is not statistically different among left-sided breast cancer patients treated with HF-WBI or CF-WBI. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Node-positive left-sided breast cancer. Does VMAT improve treatment plan quality with respect to IMRT?

    Energy Technology Data Exchange (ETDEWEB)

    Pasler, M.; Bartelt, S.; Lutterbach, J. [Lake Constance Radiation Oncology Center Singen, Friedrichshafen (Germany); Georg, D. [Medical University Vienna/AKH Wien, Vienna (Austria). Dept. of Radiooncology; Medical University Vienna (Austria). Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology

    2013-05-15

    Purpose: The aim of the present work was to explore plan quality and dosimetric accuracy of intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) for lymph node-positive left-sided breast cancer. Methods: VMAT and IMRT plans were generated with the Pinnacle{sup 3} V9.0 treatment planning system for 10 lymph node-positive left-sided breast cancer patients. VMAT plans were created using a single arc and IMRT was performed with 4 beams using 6, 10, and 15 MV photon energy, respectively. Plans were evaluated both manually and automatically using ArtiView trademark. Dosimetric plan verification was performed with a 2D ionization chamber array placed in a full scatter phantom. Results: Photon energy had no significant influence on plan quality for both VMAT and IMRT. Large variability in low doses to the heart was found due to patient anatomy (range V{sub 5} {sub Gy} 26.5-95 %). Slightly more normal tissue dose was found for VMAT (e.g., V{sub Tissue30%} = 22 %) than in IMRT (V{sub Tissue30%} = 18 %). The manual and ArtiView trademark plan evaluation coincided very accurately for most dose metrics (difference < 1 %). In VMAT, 96.7 % of detector points passed the 3 %/3 mm gamma criterion; marginally better accuracy was found in IMRT (98.3 %). Conclusion: VMAT for node-positive left-sided breast cancer retains target homogeneity and coverage when compared to IMRT and allows maximum doses to organs at risk to be reduced. ArtiView trademark enables fast and accurate plan evaluation. (orig.)

  19. Association Between Tangential Beam Treatment Parameters and Cardiac Abnormalities After Definitive Radiation Treatment for Left-Sided Breast Cancer

    International Nuclear Information System (INIS)

    Correa, Candace R.; Das, Indra J.; Litt, Harold I.; Ferrari, Victor; Hwang, W.-T.; Solin, Lawrence J.; Harris, Eleanor E.

    2008-01-01

    Purpose: To examine the association between radiation treatment (RT) parameters, cardiac diagnostic test abnormalities, and clinical cardiovascular diagnoses among patients with left-sided breast cancer after breast conservation treatment with tangential beam RT. Methods and Materials: The medical records of 416 patients treated between 1977 and 1995 with RT for primary left-sided breast cancer were reviewed for myocardial perfusion imaging and echocardiograms. Sixty-two patients (62/416, 15%) underwent these cardiac diagnostic tests for cardiovascular symptoms and were selected for further study. Central lung distance and maximum heart width and length in the treatment field were determined for each patient. Medical records were reviewed for cardiovascular diagnoses and evaluation of cardiac risk factors. Results: At a median of 12 years post-RT the incidence of cardiac diagnostic test abnormalities among symptomatic left-sided irradiated women was significantly higher than the predicted incidence of cardiovascular disease in the patient population, 6/62 (9%) predicted vs. 24/62 (39%) observed, p 0.001. As compared with patients with normal tests, patients with cardiac diagnostic test abnormalities had a larger median central lung distance (2.6 cm vs. 2.2 cm, p = 0.01). Similarly, patients with vs. without congestive heart failure had a larger median central lung distance (2.8 cm vs. 2.3 cm, p = 0.008). Conclusions: Contemporary RT for early breast cancer may be associated with a small, but potentially avoidable, risk of cardiovascular morbidity that is associated with treatment technique

  20. Long-term mortality from cardiac causes after adjuvant hypofractionated vs. conventional radiotherapy for localized left-sided breast cancer

    International Nuclear Information System (INIS)

    Chan, Elisa K.; Woods, Ryan; Virani, Sean; Speers, Caroline; Wai, Elaine S.; Nichol, Alan; McBride, Mary L.; Tyldesley, Scott

    2015-01-01

    Background and purpose: Ongoing concern remains regarding cardiac injury with hypofractionated whole breast/chest-wall radiotherapy (HF-WBI) compared to conventional radiotherapy (CF-WBI) in left-sided breast cancer patients. The purpose was to determine if cardiac mortality increases with HF-WBI relative to CF-WBI. Materials and methods: Between 1990 and 1998, 5334 women with early-stage breast cancer received post-operative radiotherapy to the breast/chest wall alone. A population-based database recorded baseline patient, tumor and treatment factors. Baseline cardiovascular risk factors were identified from hospital administrative records. A propensity-score model balanced risk factors between radiotherapy groups. Cause of death was coded as breast cancer, cardiac or other cause. Cumulative mortality from each cause after radiotherapy was estimated using a competing risk approach. Results: For left-sided cases, median follow-up was 14.2 years. 485 women received CF-WBI, 2221 women received HF-WBI. There was no difference in 15-year mortality from cardiac causes: 4.8% with HF-WBI and 4.2% with CF-WBI (p = 0.74), even after propensity-score adjustment (p = 0.45). There was no difference in breast cancer mortality or other cause mortality. For right-sided cases, there was no difference in mortality for the three causes of death. Conclusions: At 15-years follow-up, cardiac mortality is not statistically different among left-sided breast cancer patients treated with HF-WBI or CF-WBI

  1. Left-Sided Congenital Diaphragmatic Hernia with Multiple Congenital Cardiac Anomalies, Hernia Sac, and Microscopic Hepatic Heterotopia: A Case Report

    Directory of Open Access Journals (Sweden)

    Maria Arafah

    2011-01-01

    Full Text Available Congenital diaphragmatic hernia is a common congenital anomaly of uncertain etiology. Its association with multiple congenital anomalies in various organs is well recognized and antenatal radiological evidence of congenital diaphragmatic hernia warrants thorough evaluation to detect other anomalies, some of which can be life threatening. Rarely, heterotopic hepatic tissue is identified in the hernia, a rare pathological finding, exhibiting more than one macroscopic and microscopic characteristics, and always associated with cardiac congenital anomalies. Herein, we report a case of left-sided microscopic heterotopic hepatic tissue in a congenital diaphragmatic hernia in an infant with multiple cardiac congenital anomalies, but with preserved pericardium.

  2. Segmental omental infarction in childhood: an unusual case of left-sided location with extension into the pelvis

    International Nuclear Information System (INIS)

    Foscolo, Sylvain; Mandry, Damien; Galloy, Marie-Agnes; Claudon, Michel; Champigneulles, Jacqueline; Miscault, Godefroy de

    2007-01-01

    Segmental omental infarction (OI) is a rare cause of abdominal pain in children. It generally occurs in the right lower and upper quadrants of the abdomen and only a few cases of other locations have been described in adults. We report a unique paediatric case of OI with an unusual left-sided location extending into the pelvis in a 6-year-old non-obese girl. The diagnosis was suspected on US and CT based on imaging patterns previously described in adults and children. Laparoscopic resection should be balanced with nonsurgical management. (orig.)

  3. Familial Screening for Left-Sided Congenital Heart Disease: What Is the Evidence? What Is the Cost?

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    Daniel J. Perry

    2017-12-01

    Full Text Available Since the American Heart Association’s recommendation for familial screening of adults with congenital heart disease for bicuspid aortic valve, similar recommendations for other left-sided heart defects, such as hypoplastic left heart syndrome (HLHS, have been proposed. However, defining at-risk populations for these heart defects based on genetics is less straightforward due to the wide variability of inheritance patterns and non-genetic influences such as environmental and lifestyle factors. We discuss whether there is sufficient evidence to standardize echocardiographic screening for first-degree relatives of children diagnosed with HLHS. Due to variations in the inclusion of cardiac anomalies linked to HLHS and the identification of asymptomatic individuals with cardiac malformations, published studies are open to interpretation. We conclude that familial aggregation of obstructive left-sided congenital heart lesions in families with history of HLHS is not supported and recommend that additional screening should adopt a more conservative definition of what truly constitutes this heart defect. More thorough consideration is needed before embracing familial screening recommendations of families of patients with HLHS, since this could inflict serious costs on healthcare infrastructure and further burden affected families both emotionally and financially.

  4. Imaging analysis of heart movement for improving the respiration-gated radiotherapy in patients with left sided breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Abdelhamid, Rania; Farrag, A.; Khalifa, A. [Clinical Oncology Department, Assiut University (Egypt); Block, Andreas [Institut fuer Medizinische Strahlenphysik und Strahlenschutz, Klinikum Dortmund (Germany)

    2012-07-01

    Respiration induced heart movement during radiotherapy exposes the heart to the inevitable risks of radio-exposure, and hence radiation injury, in cases of Lt. sided breast cancer. The impact of such a risk is additionally aggravated by the use of radiotherapy in combination with cardiotoxic chemotherapeutic agents. Radio-oncologists pay special attention to the coronary arteries that might be included in this small part of the heart exposed to radiation. The aim of this study was to include the internal heart movement for improving respiration-gated radiotherapy of left sided breast cancer. For 70 patients, all females left sided breast cancer, two planning CT's in inspiration and expiration, and one free breathing scan are performed. The heart motion was analyzed with the clinic-developed software ORAT in the simulator sequence for acquiring information of the cranio-caudal amplitude of heart movements in free breathing (respiration-induced amplitude) and a 15 seconds breath-hold phase (inherent amplitude). The role of inherent heart movement varies from one patient to another which should be taken in consideration during defining the parameters of respiration-gated radiotherapy. The inherent amplitude of the heart motion is the physiological lower limit of the respiration-gating window.

  5. EDUCATIONAL PECULIARITIES AND DIFFICULTIES OF CHILDREN WITH LEFT-SIDED LATERALITY: THE TECHNOLOGICAL SOLUTION OF THE PROBLEM

    Directory of Open Access Journals (Sweden)

    Maria Sitnikova

    2011-09-01

    Full Text Available Nowadays there is a significant increase of the incidence of left-handedness and sinistrality among schoolchildren. Theydemonstrate a large number of left-sided motor and sensory preferences which are considered as external markers offunctional hemispheric asymmetry of the brain. The purposes of this study are to investigate gender peculiarities and specificityof age-related dynamics of laterality pattern’s formation in junior schoolchildren and to find out educational peculiarities anddifficulties of left-handed children. The findings show that left-handers differ greatly in their mental development by havingsome peculiarities of intelligence, world’s perception and prevailing thinking strategies, ways of memorization, specificity ofemotional-affective expression. The main problems of left-handed children in school performance are academic failure, lack ofperseverance, anxiety neurosis, and extreme emotional lability. Integrated development of the left hemisphere and the righthemisphere thinking of left-handed schoolchildren is a favorable condition for harmonious personal and intellectualdevelopment and effective mastering of various modules of the school curriculum. The technological solution of the problem ofteaching the children with left-sided laterality is to include in educational programs some special exercises to developimagination, emotional sensitivity, integrity of perception, global view to the problems, creativeness, and original approachesto tasks’ solving. So a complex program for the intensive development of the right hemisphere of children who demonstrateleft-sided laterality to overcome the possible failure at primary school is proposed in this paper.

  6. Helical Tomotherapy Planning for Left-Sided Breast Cancer Patients With Positive Lymph Nodes: Comparison to Conventional Multiport Breast Technique

    International Nuclear Information System (INIS)

    Goddu, S. Murty; Chaudhari, Summer; Mamalui-Hunter, Maria; Pechenaya, Olga L.; Pratt, David; Mutic, Sasa; Zoberi, Imran; Jeswani, Sam; Powell, Simon N.; Low, Daniel A.

    2009-01-01

    Purpose: To evaluate the feasibility of using helical tomotherapy for locally advanced left-sided breast cancer. Methods and Materials: Treatment plans were generated for 10 left-sided breast cancer patients with positive lymph nodes comparing a multiport breast (three-dimensional) technique with the tomotherapy treatment planning system. The planning target volumes, including the chest wall/breast, supraclavicular, axillary, and internal mammary lymph nodes, were contoured. The treatment plans were generated on the tomotherapy treatment planning system to deliver 50.4 Gy to the planning target volume. To spare the contralateral tissues, directional blocking was applied to the right breast and right lung. The optimization goals were to protect the lungs, heart, and right breast. Results: The tomotherapy plans increased the minimal dose to the planning target volume (minimal dose received by 99% of target volume = 46.2 ± 1.3 Gy vs. 27.9 ± 17.1 Gy) while improving the dose homogeneity (dose difference between the minimal dose received by 5% and 95% of the planning target volume = 7.5 ± 1.8 Gy vs. 37.5 ± 26.9 Gy). The mean percentage of the left lung volume receiving ≥20 Gy in the tomotherapy plans decreased from 32.6% ± 4.1% to 17.6% ± 3.5%, while restricting the right-lung mean dose to <5 Gy. However, the mean percentage of volume receiving ≥5 Gy for the total lung increased from 25.2% ± 4.2% for the three-dimensional technique to 46.9% ± 8.4% for the tomotherapy plan. The mean volume receiving ≥35 Gy for the heart decreased from 5.6% ± 4.8% to 2.2% ± 1.5% in the tomotherapy plans. However, the mean heart dose for tomotherapy delivery increased from 7.5 ± 3.4 Gy to 12.2 ± 1.8 Gy. Conclusion: The tomotherapy plans provided better dose conformity and homogeneity than did the three-dimensional plans for treatment of left-sided breast tumors with regional lymph node involvement, while allowing greater sparing of the heart and left lung from doses

  7. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-07-01

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

  9. Sleeping and resting respiratory rates in dogs and cats with medically-controlled left-sided congestive heart failure.

    Science.gov (United States)

    Porciello, F; Rishniw, M; Ljungvall, I; Ferasin, L; Haggstrom, J; Ohad, D G

    2016-01-01

    Sleeping and resting respiratory rates (SRR and RRR, respectively) are commonly used to monitor dogs and cats with left-sided cardiac disease and to identify animals with left-sided congestive heart failure (L-CHF). Dogs and cats with subclinical heart disease have SRRmean values dogs and cats with CHF that is well controlled with medical therapy. In this study, SRR and RRR were measured by the owners of 51 dogs and 22 cats with stable, well-controlled CHF. Median canine SRRmean was 20 breaths/min (7-39 breaths/min); eight dogs were ≥25 breaths/min and one dog only was ≥30 breaths/min. Canine SRRmean was unrelated to pulmonary hypertension or diuretic dose. Median feline SRRmean was 20 breaths/min (13-31 breaths/min); four cats were ≥25 breaths/min and only one cat was ≥30 breaths/min. Feline SRRmean was unrelated to diuretic dose. SRR remained stable during collection in both species with little day-to-day variability. The median canine RRRmean was 24 breaths/min (12-44 breaths/min), 17 were ≥25 breaths/min, seven were ≥30 breaths/min, two were >40 breaths/min. Median feline RRRmean was 24 breaths/min (15-45 breaths/min); five cats had RRRmean ≥25 breaths/min; one had ≥30 breaths/min, and two had ≥40 breaths/min. These data suggest that most dogs and cats with CHF that is medically well-controlled and stable have SRRmean and RRRmean dogs and cats. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Volumetric modulated arc therapy and breath-hold in image-guided locoregional left-sided breast irradiation

    International Nuclear Information System (INIS)

    Osman, Sarah O.S.; Hol, Sandra; Poortmans, Philip M.; Essers, Marion

    2014-01-01

    Purpose: To investigate the effects of using volumetric modulated arc therapy (VMAT) and/or voluntary moderate deep inspiration breath-hold (vmDIBH) in the radiation therapy (RT) of left-sided breast cancer including the regional lymph nodes. Materials and methods: For 13 patients, four treatment combinations were compared; 3D-conformal RT (i.e., forward IMRT) in free-breathing 3D-CRT(FB), 3D-CRT(vmDIBH), 2 partial arcs VMAT(FB), and VMAT(vmDIBH). Prescribed dose was 42.56 Gy in 16 fractions. For 10 additional patients, 3D-CRT and VMAT in vmDIBH only were also compared. Results: Dose conformity, PTV coverage, ipsilateral and total lung doses were significantly better for VMAT plans compared to 3D-CRT. Mean heart dose (D mean,heart ) reduction in 3D-CRT(vmDIBH) was between 0.9 and 8.6 Gy, depending on initial D mean,heart (in 3D-CRT(FB) plans). VMAT(vmDIBH) reduced the D mean,heart further when D mean,heart was still >3.2 Gy in 3D-CRT(vmDIBH). Mean contralateral breast dose was higher for VMAT plans (2.7 Gy) compared to 3DCRT plans (0.7 Gy). Conclusions: VMAT and 3D-CRT(vmDIBH) significantly reduced heart dose for patients treated with locoregional RT of left-sided breast cancer. When D mean,heart exceeded 3.2 Gy in 3D-CRT(vmDIBH) plans, VMAT(vmDIBH) resulted in a cumulative heart dose reduction. VMAT also provided better target coverage and reduced ipsilateral lung dose, at the expense of a small increase in the dose to the contralateral breast

  11. Comparison of right and left side heart functions in patients with thalassemia major, patients with thalassemia intermedia, and control group.

    Science.gov (United States)

    Noori, Noormohammad; Mohamadi, Mehdi; Keshavarz, Kambiz; Alavi, Seyed Mostafa; Mahjoubifard, Maziar; Mirmesdagh, Yalda

    2013-01-01

    Heart disease is the main cause of mortality and morbidity in patients with beta thalassemia, rendering its early diagnosis vital. We studied and compared echocardiographic findings in patients with beta thalassemia major, patients with beta thalassemia intermedia, and a control group. Eighty asymptomatic patients with thalassemia major and 22 asymptomatic cases with thalassemia intermedia (8-25 years old) were selected from those referred to Ali Asghar Hospital (Zahedan-Iran) between June 2008 and June 2009. Additionally, 80 healthy individuals within the same age and sex groups were used as controls. All the individuals underwent echocardiography, the data of which were analyzed with the Student t-test. The mean value of the pre-ejection period/ejection time ratio of the left ventricle during systole, the diameter of the posterior wall of the left ventricle during diastole, the left and right isovolumic relaxation times, and the right myocardial performance index in the patients with beta thalassemia major and intermedia increased significantly compared to those of the controls, but the other parameters were similar between the two patient groups. The mean values of the left and right pre-ejection periods, left ventricular end systolic dimension, and left isovolumic contraction time in the patients with thalassemia intermedia increased significantly compared to those of the controls. In the left side, myocardial performance index, left ventricular mass index, isovolumic contraction time, and deceleration time exhibited significant changes between the patients with thalassemia major and those with thalassemia intermedia, whereas all the echocardiographic parameters of the right side were similar between these two groups. The results showed that the systolic and diastolic functions of the right and left sides of the heart would be impaired in patients with thalassemia major and thalassemia intermedia. Consequently, serial echocardiography is suggested in

  12. Right- and left-sided colon cancer - clinical and pathological differences of the disease entity in one organ.

    Science.gov (United States)

    Mik, Michal; Berut, Maciej; Dziki, Lukasz; Trzcinski, Radzislaw; Dziki, Adam

    2017-02-01

    Some researchers suggest that cancers located in the right vs. the left side of the colon are different and they can be regarded as distinct disease entities. The aim of this study was to analyze differences in clinical, epidemiological and pathological features of patients with right-sided (RCC) and left-sided (LCC) colon cancer. One thousand two hundred and twenty-four patients were operated on due to colorectal cancer. A group of 477 patients (254 women, mean age 65.5 ±11 for the whole group) with colon cancer was included (212 RCC vs. 265 LCC). Right colon cancer patients were older (67.8 ±11.3 vs. 63.2 ±11.2; p = 0.0087). Left colon cancer patients underwent surgery for urgent indications more often (17.0% vs. 8.5%; p = 0006). Tumor diameter was greater in the RCC group (55 ±60 mm vs. 38 ±21 mm; p = 0.0003). Total number of removed lymph nodes was higher in the RCC group (11.7 ±6 vs. 8.3 ±5; p = 0.0001). Lymph node ratio was higher in the LCC group (0.45 ±0.28 vs. 0.30 ±0.25; p = 0.0063). We found a strong positive correlation between tumor diameter and the number of removed lymph nodes in the LCC group ( r = 0.531). These differences may result from the fact that RCC patients are diagnosed at an older age. The smaller number of removed lymph nodes in LCC patients may result in incorrect staging. It is still necessary to find other biological dissimilarities of adenocarcinoma located on different sides of the colon.

  13. Calcitriol Supplementation Causes Decreases in Tumorigenic Proteins and Different Proteomic and Metabolomic Signatures in Right versus Left-Sided Colon Cancer.

    Science.gov (United States)

    Schroll, Monica M; Ludwig, Katelyn R; Bauer, Kerry M; Hummon, Amanda B

    2018-01-11

    Vitamin D deficiency is a common problem worldwide. In particular, it is an issue in the Northern Hemisphere where UVB radiation does not penetrate the atmosphere as readily. There is a correlation between vitamin D deficiency and colorectal cancer incidence and mortality. Furthermore, there is strong evidence that cancer of the ascending (right side) colon is different from cancer of the descending (left side) colon in terms of prognosis, tumor differentiation, and polyp type, as well as at the molecular level. Right-side tumors have elevated Wnt signaling and are more likely to relapse, whereas left-side tumors have reduced expression of tumor suppressor genes. This study seeks to understand both the proteomic and metabolomic changes resulting from treatment of the active metabolite of vitamin D, calcitriol, in right-sided and left-sided colon cancer. Our results show that left-sided colon cancer treated with calcitriol has a substantially greater number of changes in both the proteome and the metabolome than right-sided colon cancer. We found that calcitriol treatment in both right-sided and left-sided colon cancer causes a downregulation of ribosomal protein L37 and protein S100A10. Both of these proteins are heavily involved in tumorigenesis, suggesting a possible mechanism for the correlation between low vitamin D levels and colon cancer.

  14. Calcitriol Supplementation Causes Decreases in Tumorigenic Proteins and Different Proteomic and Metabolomic Signatures in Right versus Left-Sided Colon Cancer

    Directory of Open Access Journals (Sweden)

    Monica M. Schroll

    2018-01-01

    Full Text Available Vitamin D deficiency is a common problem worldwide. In particular, it is an issue in the Northern Hemisphere where UVB radiation does not penetrate the atmosphere as readily. There is a correlation between vitamin D deficiency and colorectal cancer incidence and mortality. Furthermore, there is strong evidence that cancer of the ascending (right side colon is different from cancer of the descending (left side colon in terms of prognosis, tumor differentiation, and polyp type, as well as at the molecular level. Right-side tumors have elevated Wnt signaling and are more likely to relapse, whereas left-side tumors have reduced expression of tumor suppressor genes. This study seeks to understand both the proteomic and metabolomic changes resulting from treatment of the active metabolite of vitamin D, calcitriol, in right-sided and left-sided colon cancer. Our results show that left-sided colon cancer treated with calcitriol has a substantially greater number of changes in both the proteome and the metabolome than right-sided colon cancer. We found that calcitriol treatment in both right-sided and left-sided colon cancer causes a downregulation of ribosomal protein L37 and protein S100A10. Both of these proteins are heavily involved in tumorigenesis, suggesting a possible mechanism for the correlation between low vitamin D levels and colon cancer.

  15. Myocardial perfusion changes in patients irradiated for left-sided breast cancer and correlation with coronary artery distribution

    International Nuclear Information System (INIS)

    Lind, Pehr A.; Pagnanelli, Robert; Marks, Lawrence B.; Borges-Neto, Salvador; Hu, Caroline; Zhou, S.-M.; Light, Kim; Hardenbergh, Patricia H.

    2003-01-01

    Purpose: To evaluate postradiation regional heart perfusion changes with single photon emission tomography (SPECT) myocardial perfusion imaging in 69 patients treated with tangential photon beams radiation therapy (RT) for left-sided breast cancer. To correlate SPECT changes with percent irradiated left ventricle (LV) volume and risk factors for coronary artery disease (CAD). Methods and Materials: Rest SPECT of the LV was acquired pre-RT and at 6-month intervals post-RT. The extent of defects (%) with a severity > 1.5 standard deviations below the mean was quantitatively analyzed for the distributions of the left anterior descending (LAD) artery, left circumflex (LCX) artery, and right coronary artery (RCA) based on computer assisted polar map reconstruction (i.e., bull's-eye-view). Changes in perfusion were correlated with percent irradiated LV receiving > 25 Gy (range 0-32%). Data on patient- and treatment-related factors were collected prospectively (e.g., cardiac premorbidity, risk factors for CAD, chemotherapy, and hormonal treatment). Results: In the LAD distribution, there were increased perfusion defects at 6 months (median 11%; interquartile range 2-23) compared with baseline (median 5%; interquartile range 1-14) (p<0.001). There were no increases in perfusion defects in the LCX or RCA distributions. In multivariate analysis, the SPECT perfusion changes in the LAD distribution at 6 months were independently associated with percent irradiated LV (p<0.001), hormonal therapy (p=0.005), and pre-RT hypercholesterolemia (p=0.006). The SPECT defects in the LAD distribution at 12 and 18 months were not statistically different from those at 6 months. The perfusion defects in the LAD distribution were limited essentially to the regions of irradiated myocardium. Conclusion: Tangential photon beam RT in patients with left-sided breast cancer was associated with short-term SPECT defects in the vascular distribution corresponding to the radiation portals. Factors

  16. Emergency surgery for obstructing colonic cancer: a comparison between right-sided and left-sided lesions.

    Science.gov (United States)

    Faucheron, J-L; Paquette, B; Trilling, B; Heyd, B; Koch, S; Mantion, G

    2018-02-01

    Few studies compare management and outcomes of obstructive colonic cancer, depending on the tumor site. We aim to evaluate the differences in patient characteristics, tumor characteristics, and outcomes of emergency surgery for obstructive right-sided versus left-sided colonic cancers. Between 2000 and 2009, 71 consecutive patients had an emergency colectomy following strict and clear definition of obstruction in a single institution. We retrospectively analyzed pre, per, and postoperative data that were prospectively collected. There were 31 and 40 patients in the right and left group, respectively. Patients aged over 80 were more frequent in the right group (p = 0.03). At operation, ileocecal valve was less often competent in the right group (p = 0.03). The one-stage strategy was more frequent in the right group (p = 0.008). Patients in the right group had a higher rate of nodes invasion (p = 0.04). One- and two-year mortality rate in the right group had a tendency to be higher. Patients presenting with a right obstructive colonic cancer are older, have a more advanced locoregional disease, and are more often treated in a one-stage strategy than patients with a left obstructive tumor.

  17. Intraoperative bowel irrigation improves anastomotic collagen metabolism in the left-sided colonic obstruction but not covering colostomy.

    Science.gov (United States)

    Duraker, N; Bender, O; Memişoğlu, K; Yalçiner, A

    1998-01-01

    This study investigated the effects of intraoperative colonic irrigation and proximal diverting end colostomy after segmental bowel resection in experimental left-colonic obstruction on anastomotic healing. Simple obstruction of descending colon was performed in male Sprague-Dawley rats. After 24 h we performed segmental colonic resection and anastomosis in the control group (n = 15); resection, anastomosis, and covering colostomy in the colostomy group (n = 14); resection and anastomosis after antegrade colonic lavage through cecum by using isotonic saline solution in the irrigation group (n = 13). In rats that were killed 7 days later anastomotic dehiscence and bursting pressure and tissue hydroxyproline concentration at the anastomosis were measured. No significant differences were observed between groups in terms of anastomotic dehiscence, bursting site, or pressure. The hydroxyproline concentration was significantly higher in the irrigation group than the control group (P = 0.025) and the colostomy group (P = 0.029), but no difference was noted between the control group and the colostomy group. These findings suggest that intraoperative antegrade colonic irrigation in the acute left-sided colonic obstruction positively affects collagen metabolism at the anastomotic site; if the anastomosis is performed without bowel cleansing, covering colostomy does not improve collagen metabolism.

  18. Clinical application of self-expanding metallic stent in the management of acute left-sided colorectal malignant obstruction

    Institute of Scientific and Technical Information of China (English)

    You-Ben Fan; Ying-Sheng Cheng; Ni-Wei Chen; Hui-Min Xu; Zhe Yang; Yue Wang; Yu-Yao Huang; Qi Zheng

    2006-01-01

    AIM: To summarize our experience with the application of self-expanding metallic stent (SEMS) in the management of acute left-sided colorectal malignant obstruction.METHODS: A retrospective chart review of all patients undergoing placement of SEMS between April 2000 and January 2004 was performed.RESULTS: Insertion of SEMS was attempted in 26patients under fluoroscopic guidance with occasional endoscopic assistance. The sites of lesions were located in splenic flexure of two patients, left colon of seven patients, sigmoid colon of eight patients and rectum of nine patients. The intended uses of SEMS were for palliation in 7 patients and as a bridge to elective surgery in 19 patients. In the latter group, placement of SEMS allowed for preoperative systemic and bowel preparation and the following one-stage anastomosis. Successful stent placement was achieved in 22 (85%) of the 26patients. The clinical bowel obstruction resolved 24 hours after successful stent placement in 21 (95%) patients.Three SEMS-related minor complications occurred, two stents migrated and one caused anal pain.CONCLUSION: SEMS represents an effective and safe tool in the management of acute malignant colorectal obstruction. As a bridge to surgery, SEMS can provide time for systematic support and bowel preparation and obviate the need for fecal diversion or on-table lavage.As a palliative measure, SEMS can eliminate the need for emergent colostomy.

  19. A diagnostic dilemma: Left-sided appendicitis in a 10 year old boy with previously undiagnosed intestinal malrotation. A case report

    Directory of Open Access Journals (Sweden)

    Ashvini Shekhar

    2015-01-01

    Conclusion: Left sided acute appendicitis is a diagnostic dilemma, thus often leading to management delays. It is pertinent to remember that malrotation of the gut is more common than previously thought, and not just a disease of infancy. It is advisable to consider imaging studies while balancing the risk-benefit-ratio of radiation exposure, especially in paediatric cases to cinch the diagnosis.

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

    NARCIS (Netherlands)

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

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

  1. Acute resection versus bridge to surgery with diverting colostomy for patients with acute malignant left sided colonic obstruction : Systematic review and meta-analysis

    NARCIS (Netherlands)

    Amelung, Femke J.; Mulder, C.L.J.; Verheijen, P.M.; Draaisma, W. A.; Siersema, P.D.; Consten, E. C J

    2015-01-01

    Background Currently, no consensus exists on the best treatment strategy for acute malignant left-sided colonic obstruction. This systematic review and meta-analysis aims to compare the outcomes following the two surgical treatment options; primary resection versus colostomy creation as bridge to

  2. Acute resection versus bridge to surgery with diverting colostomy for patients with acute malignant left sided colonic obstruction: Systematic review and meta-analysis

    NARCIS (Netherlands)

    Amelung, F.J.; Mulder, C.L.; Verheijen, P.M.; Draaisma, W.A.; Siersema, P.D.; Consten, E.C.

    2015-01-01

    BACKGROUND: Currently, no consensus exists on the best treatment strategy for acute malignant left-sided colonic obstruction. This systematic review and meta-analysis aims to compare the outcomes following the two surgical treatment options; primary resection versus colostomy creation as bridge to

  3. An Outflow Event on the Left Side of Harvey: Erosion of Barrier Sand and Seaward Transport Through Aransas Pass

    Science.gov (United States)

    Goff, J.; Swartz, J. M.; Gulick, S. P. S.

    2017-12-01

    Barrier islands provide critical support and protection for coastal communities and ecosystems, but are potentially vulnerable to net losses of sand during major storms. Evidence from satellite imagery, ground observations and tide stations indicates that Hurricane Harvey in 2017 caused a large outflow event of waters moving from the bays out towards the sea in the Port Aransas, Texas region. Rather than just an ebb of a storm surge, this event may have been driven by seaward-directed winds on the left side of storm. Less than a month after landfall, we conducted a swath mapping and sampling survey in Lydia Ann Channel and Aransas Pass, where we had earlier mapped in 2009 and 2012 as part of the UT marine geology and geophysical field course. These waterways are important conduits linking Corpus Christi and Aransas bays to the Gulf of Mexico. This multi-year record allows us to gauge the impact of the outflow event on these waterways in the context of "normal" coastal processes. Both satellite imagery and sonar mapping reveal that the outflow event caused significant erosion, both on land and beneath the water, along the edges of Lydia Ann Channel and Corpus Christi ship channel. It also caused seaward-directed flow and erosion through breaches in the foredunes along southern San Jose Island, from waters that overtopped Lydia Ann Channel. Much of the sand that was transported seaward settled in Lydia Ann Channel and Aransas Pass (up to 6.5 m accumulation), possibly during the waning stages of the event. However, a likely large (but unknown) quantity of barrier and estuarine sand could have been transported well out to sea, beyond the jetties, at the peak of the event. If so, it would have resulted in a net loss of sand from the barrier island system.

  4. Metropolitian area network services comprised of virtual local area networks running over hybrid fiber-coax and asynchronous transfer mode technologies

    Science.gov (United States)

    Biedron, William S.

    1995-11-01

    Since 1990 there has been a rapid increase in the demand for communication services, especially local and wide area network (LAN/WAN) oriented services. With the introduction of the DFB laser transmitter, hybrid-fiber-coax (HFC) cable plant designs, ATM transport technologies and rf modems, new LAN/WAN services can now be defined and marketed to residential and business customers over existing cable TV systems. The term metropolitan area network (MAN) can be used to describe this overall network. This paper discusses the technical components needed to provision these services as well as provides some perspectives on integration issues. Architecture at the headend and in the backbone is discussed, as well as specific service definitions and the technology issues associated with each. The TCP/IP protocol is suggested as a primary protocol to be used throughout the MAN.

  5. Quality of life differences in patients with right- versus left-sided facial paralysis: Universal preference of right-sided human face recognition.

    Science.gov (United States)

    Ryu, Nam Gyu; Lim, Byung Woo; Cho, Jae Keun; Kim, Jin

    2016-09-01

    We investigated whether experiencing right- or left-sided facial paralysis would affect an individual's ability to recognize one side of the human face using hybrid hemi-facial photos by preliminary study. Further investigation looked at the relationship between facial recognition ability, stress, and quality of life. To investigate predominance of one side of the human face for face recognition, 100 normal participants (right-handed: n = 97, left-handed: n = 3, right brain dominance: n = 56, left brain dominance: n = 44) answered a questionnaire that included hybrid hemi-facial photos developed to determine decide superiority of one side for human face recognition. To determine differences of stress level and quality of life between individuals experiencing right- and left-sided facial paralysis, 100 patients (right side:50, left side:50, not including traumatic facial nerve paralysis) answered a questionnaire about facial disability index test and quality of life (SF-36 Korean version). Regardless of handedness or hemispheric dominance, the proportion of predominance of the right side in human face recognition was larger than the left side (71% versus 12%, neutral: 17%). Facial distress index of the patients with right-sided facial paralysis was lower than that of left-sided patients (68.8 ± 9.42 versus 76.4 ± 8.28), and the SF-36 scores of right-sided patients were lower than left-sided patients (119.07 ± 15.24 versus 123.25 ± 16.48, total score: 166). Universal preference for the right side in human face recognition showed worse psychological mood and social interaction in patients with right-side facial paralysis than left-sided paralysis. This information is helpful to clinicians in that psychological and social factors should be considered when treating patients with facial-paralysis. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  6. Whole exome sequencing in 342 congenital cardiac left sided lesion cases reveals extensive genetic heterogeneity and complex inheritance patterns

    Directory of Open Access Journals (Sweden)

    Alexander H. Li

    2017-10-01

    Full Text Available Abstract Background Left-sided lesions (LSLs account for an important fraction of severe congenital cardiovascular malformations (CVMs. The genetic contributions to LSLs are complex, and the mutations that cause these malformations span several diverse biological signaling pathways: TGFB, NOTCH, SHH, and more. Here, we use whole exome sequence data generated in 342 LSL cases to identify likely damaging variants in putative candidate CVM genes. Methods Using a series of bioinformatics filters, we focused on genes harboring population-rare, putative loss-of-function (LOF, and predicted damaging variants in 1760 CVM candidate genes constructed a priori from the literature and model organism databases. Gene variants that were not observed in a comparably sequenced control dataset of 5492 samples without severe CVM were then subjected to targeted validation in cases and parents. Whole exome sequencing data from 4593 individuals referred for clinical sequencing were used to bolster evidence for the role of candidate genes in CVMs and LSLs. Results Our analyses revealed 28 candidate variants in 27 genes, including 17 genes not previously associated with a human CVM disorder, and revealed diverse patterns of inheritance among LOF carriers, including 9 confirmed de novo variants in both novel and newly described human CVM candidate genes (ACVR1, JARID2, NR2F2, PLRG1, SMURF1 as well as established syndromic CVM genes (KMT2D, NF1, TBX20, ZEB2. We also identified two genes (DNAH5, OFD1 with evidence of recessive and hemizygous inheritance patterns, respectively. Within our clinical cohort, we also observed heterozygous LOF variants in JARID2 and SMAD1 in individuals with cardiac phenotypes, and collectively, carriers of LOF variants in our candidate genes had a four times higher odds of having CVM (odds ratio = 4.0, 95% confidence interval 2.5–6.5. Conclusions Our analytical strategy highlights the utility of bioinformatic resources, including human

  7. Deviating colostomy construction versus stent placement as bridge to surgery for malignant left-sided colonic obstruction.

    Science.gov (United States)

    Amelung, Femke J; Ter Borg, Frank; Consten, Esther C J; Siersema, Peter D; Draaisma, Werner A

    2016-12-01

    Acute colonic decompression using a deviating colostomy (DC) or a self-expandable metal stent (SEMS) has been shown to lead to fewer complications and permanent stomas compared to acute resection in elderly patients with malignant left-sided colonic obstruction (LSCO). However, no consensus exists on which decompression method is superior, especially in patients treated with curative intend. This retrospective study therefore aimed to compare both decompression methods in potentially curable LSCO patients. All LSCO patients treated with curative intent between 2004 and 2013 in two teaching hospitals were retrospectively identified. In one institution, a DC was the standard of care, whereas in the other all patients were treated with SEMS. In total, 88 eligible LSCO patients with limited disease and curative treatment options were included; 51 patients had a SEMS placed and 37 patients a DC constructed. All patients eventually underwent a subsequent elective resection. In sum, 235 patients were excluded due to benign or inoperable disease. No significant differences were found for hospital stay, morbidity, disease-free and overall survival and mortality. Major complications were seen in 13/51 (25.5 %) patients in the SEMS group and were mostly due to stent dysfunction (n = 7). Also, one stent-related perforation occurred. Major complications occurred in 4/37 (10.8 %) patients in the DC group, including abdominal sepsis (n = 3) and wound dehiscence (n = 1). Long-term complication rate was significantly higher in the DC group (29.7 vs. 9.8 %, p = 0.01), mainly due to a high incisional hernia rate. Fewer patients had a temporary colostomy following elective resection after SEMS placement (62.2 vs. 17.6 %, p colostomy rate was not significantly different. SEMS and DC are both effective decompression methods for curable LSCO patients with comparable short- and long-term oncological outcomes; however, more surgical procedures are performed after DC due to an

  8. Left-sided breast cancer and risks of secondary lung cancer and ischemic heart disease. Effects of modern radiotherapy techniques

    Energy Technology Data Exchange (ETDEWEB)

    Corradini, Stefanie; Ballhausen, Hendrik; Weingandt, Helmut; Freislederer, Philipp; Schoenecker, Stephan; Niyazi, Maximilian; Belka, Claus [University Hospital, LMU Munich, Department of Radiation Oncology, Munich (Germany); Simonetto, Cristoforo; Eidemueller, Markus [Helmholtz Zentrum Muenchen, Institute of Radiation Protection, Neuherberg (Germany); Ganswindt, Ute [University Hospital, LMU Munich, Department of Radiation Oncology, Munich (Germany); Medical University, Department of Radiation Oncology, Innsbruck (Austria)

    2018-03-15

    Modern breast cancer radiotherapy techniques, such as respiratory-gated radiotherapy in deep-inspiration breath-hold (DIBH) or volumetric-modulated arc radiotherapy (VMAT) have been shown to reduce the high dose exposure of the heart in left-sided breast cancer. The aim of the present study was to comparatively estimate the excess relative and absolute risks of radiation-induced secondary lung cancer and ischemic heart disease for different modern radiotherapy techniques. Four different treatment plans were generated for ten computed tomography data sets of patients with left-sided breast cancer, using either three-dimensional conformal radiotherapy (3D-CRT) or VMAT, in free-breathing (FB) or DIBH. Dose-volume histograms were used for organ equivalent dose (OED) calculations using linear, linear-exponential, and plateau models for the lung. A linear model was applied to estimate the long-term risk of ischemic heart disease as motivated by epidemiologic data. Excess relative risk (ERR) and 10-year excess absolute risk (EAR) for radiation-induced secondary lung cancer and ischemic heart disease were estimated for different representative baseline risks. The DIBH maneuver resulted in a significant reduction of the ERR and estimated 10-year excess absolute risk for major coronary events compared to FB in 3D-CRT plans (p = 0.04). In VMAT plans, the mean predicted risk reduction through DIBH was less pronounced and not statistically significant (p = 0.44). The risk of radiation-induced secondary lung cancer was mainly influenced by the radiotherapy technique, with no beneficial effect through DIBH. VMAT plans correlated with an increase in 10-year EAR for radiation-induced lung cancer as compared to 3D-CRT plans (DIBH p = 0.007; FB p = 0.005, respectively). However, the EARs were affected more strongly by nonradiation-associated risk factors, such as smoking, as compared to the choice of treatment technique. The results indicate that 3D-CRT plans in DIBH pose the lowest

  9. Patterns of intrafractional motion and uncertainties of treatment setup reference systems in accelerated partial breast irradiation for right- and left-sided breast cancer.

    Science.gov (United States)

    Yue, Ning J; Goyal, Sharad; Kim, Leonard H; Khan, Atif; Haffty, Bruce G

    2014-01-01

    This study investigated the patterns of intrafractional motion and accuracy of treatment setup strategies in 3-dimensional conformal radiation therapy of accelerated partial breast irradiation (APBI) for right- and left-sided breast cancers. Sixteen right-sided and 17 left-sided breast cancer patients were enrolled in an institutional APBI trial in which gold fiducial markers were strategically sutured to the surgical cavity walls. Daily pre- and postradiation therapy kV imaging were performed and were matched to digitally reconstructed radiographs based on bony anatomy and fiducial markers, respectively, to determine the intrafractional motion. The positioning differences of the laser-tattoo and the bony anatomy-based setups with respect to the marker-based setup (benchmark) were determined to evaluate their accuracy. Statistical differences were found between the right- and left-sided APBI treatments in vector directions of intrafractional motion and treatment setup errors in the reference systems, but less in their overall magnitudes. The directional difference was more pronounced in the lateral direction. It was found that the intrafractional motion and setup reference systems tended to deviate in the right direction for the right-sided breast treatments and in the left direction for the left-sided breast treatments. It appears that the fiducial markers placed in the seroma cavity exhibit side dependent directional intrafractional motion, although additional data may be needed to further validate the conclusion. The bony anatomy-based treatment setup improves the accuracy over laser-tattoo. But it is inadequate to rely on bony anatomy to assess intrafractional target motion in both magnitude and direction. Copyright © 2014 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  10. Model-based approach for quantitative estimates of skin, heart, and lung toxicity risk for left-side photon and proton irradiation after breast-conserving surgery.

    Science.gov (United States)

    Tommasino, Francesco; Durante, Marco; D'Avino, Vittoria; Liuzzi, Raffaele; Conson, Manuel; Farace, Paolo; Palma, Giuseppe; Schwarz, Marco; Cella, Laura; Pacelli, Roberto

    2017-05-01

    Proton beam therapy represents a promising modality for left-side breast cancer (BC) treatment, but concerns have been raised about skin toxicity and poor cosmesis. The aim of this study is to apply skin normal tissue complication probability (NTCP) model for intensity modulated proton therapy (IMPT) optimization in left-side BC. Ten left-side BC patients undergoing photon irradiation after breast-conserving surgery were randomly selected from our clinical database. Intensity modulated photon (IMRT) and IMPT plans were calculated with iso-tumor-coverage criteria and according to RTOG 1005 guidelines. Proton plans were computed with and without skin optimization. Published NTCP models were employed to estimate the risk of different toxicity endpoints for skin, lung, heart and its substructures. Acute skin NTCP evaluation suggests a lower toxicity level with IMPT compared to IMRT when the skin is included in proton optimization strategy (0.1% versus 1.7%, p < 0.001). Dosimetric results show that, with the same level of tumor coverage, IMPT attains significant heart and lung dose sparing compared with IMRT. By NTCP model-based analysis, an overall reduction in the cardiopulmonary toxicity risk prediction can be observed for all IMPT compared to IMRT plans: the relative risk reduction from protons varies between 0.1 and 0.7 depending on the considered toxicity endpoint. Our analysis suggests that IMPT might be safely applied without increasing the risk of severe acute radiation induced skin toxicity. The quantitative risk estimates also support the potential clinical benefits of IMPT for left-side BC irradiation due to lower risk of cardiac and pulmonary morbidity. The applied approach might be relevant on the long term for the setup of cost-effectiveness evaluation strategies based on NTCP predictions.

  11. [Comparison of clinicopathological features and prognosis between left-sided colon cancer and right-sided colon cancer].

    Science.gov (United States)

    Gao, Xianhua; Yu, Guanyu; Liu, Peng; Hao, Liqiang; Liu, Lianjie; Zhang, Wei

    2017-06-25

    To compare the clinicopathological features and prognosis between left-sided colon cancer (LC) and right-sided colon cancer (RC). Clinicopathological and follow-up data of 2 174 colon carcinoma cases undergoing resection at Shanghai Changhai Hospital of The Second Military Medical University from January 2000 to December 2010 were retrospectively analyzed. Patients with transverse colon cancer, overlapping position, unknown location, recurrent cancer, multiple primary cancer, concomitant malignant tumors, preoperative chemotherapy, local resection, incomplete clinical data and missed follow up were excluded. Finally, a total of 1 036 patients, whose primary tumors were radically removed, were enrolled, with 563 patients in LC group (including carcinoma in cecum, ascending colon and hepatic flexure) and 473 in RC group (including carcinoma in splenic flexure, descending colon and sigmoid colon). The clinicopathological features and survival, including median overall survival, 5-year overall survival rate, tumor specific median overall survival, cancer specific 5-year overall survival rate, were compared between LC and RC groups. Tumor specific overall survival was defined as the period between operation date to the date of death caused by cancer progression. Multivariate Cox regression analysis was used to analyze the influencing factors of survival. Propensity score matching was carried out to balance the clinicopathological factors between the two groups with the SAS 9.3, taking the following parameters into consideration (age, gender, gross appearance, tumor diameter, invasion depth, lymph node metastasis, distant metastasis, TNM stages, differentiation, CEA and CA199-9). Patients in RC group and LC group were matched according to the propensity scores and the clinicopathological characteristics and prognosis of two groups were compared again. No significant differences were identified between the two groups in age, distant metastasis and serum CEA level

  12. SU-E-T-317: The Development of a DIBH Technique for Left Sided Breast Patients Undergoing Radiation Therapy Utilizing Varians RPM System in a Community Hospital

    International Nuclear Information System (INIS)

    Hasson, B; Young, M; Workie, D; Geraghty, C

    2014-01-01

    Purpose: To develop and implement a Deep Inhalation Breath Hold program (DIBH) for treatment of patients with Left-sided breast cancer in a community hospital. Methods: All patients with left sided breast cancer underwent a screening free breathing CT. Evaluation of the conventional tangent treatment fields and the heart was conducted. If the heart would not be excluded using tangents, the patient then received DIBH breathe coaching. The patients returned for a 4D CT simulation. The patients breathing cycle was monitored using the Varian Real-Time position ManagementTM (RPM) system to assess duration of DIBH, amplitude, phase and recovery time to normal breathing. Then a DIBH CT was obtained at the desired amplitude. Duplicate plans were developed for both free breathing and DIBH on the Eclipse planning system and comparison DVH's were created. The plan that provided the prescribed treatment coverage and the least doses to the OAR (heart, Lt. Lung) was determined. Those patients selected to receive treatment with DIBH were set up for treatment, and breathing was monitored using the RPM system. Practice trials were used to confirm that the amplitude, phase and recovery were consistent with findings from simulation. Results: 10 patients have been treated using the DIBH procedure in our clinic. The DIBH patients had an average increase of 80% lung volume on DIBH, decreased lung volume receiving 50% of the dose, and decreases in the V20 dose. Significant reduction in the maximum and mean dose to the heart, as well as the dose to 1CC of the volume for the DIBH plans. Conclusion: Using the RPM system already available in the clinic, staff training, and patient coaching a simple DIBH program was setup. The use of DIBH has shown promise in reducing doses to the critical organs while maintaining PTV coverage for left sided breast treatments

  13. SU-E-T-317: The Development of a DIBH Technique for Left Sided Breast Patients Undergoing Radiation Therapy Utilizing Varians RPM System in a Community Hospital

    Energy Technology Data Exchange (ETDEWEB)

    Hasson, B; Young, M; Workie, D; Geraghty, C [Anne Arundel Medical Center, Annapolis, MD (United States)

    2014-06-01

    Purpose: To develop and implement a Deep Inhalation Breath Hold program (DIBH) for treatment of patients with Left-sided breast cancer in a community hospital. Methods: All patients with left sided breast cancer underwent a screening free breathing CT. Evaluation of the conventional tangent treatment fields and the heart was conducted. If the heart would not be excluded using tangents, the patient then received DIBH breathe coaching. The patients returned for a 4D CT simulation. The patients breathing cycle was monitored using the Varian Real-Time position ManagementTM (RPM) system to assess duration of DIBH, amplitude, phase and recovery time to normal breathing. Then a DIBH CT was obtained at the desired amplitude. Duplicate plans were developed for both free breathing and DIBH on the Eclipse planning system and comparison DVH's were created. The plan that provided the prescribed treatment coverage and the least doses to the OAR (heart, Lt. Lung) was determined. Those patients selected to receive treatment with DIBH were set up for treatment, and breathing was monitored using the RPM system. Practice trials were used to confirm that the amplitude, phase and recovery were consistent with findings from simulation. Results: 10 patients have been treated using the DIBH procedure in our clinic. The DIBH patients had an average increase of 80% lung volume on DIBH, decreased lung volume receiving 50% of the dose, and decreases in the V20 dose. Significant reduction in the maximum and mean dose to the heart, as well as the dose to 1CC of the volume for the DIBH plans. Conclusion: Using the RPM system already available in the clinic, staff training, and patient coaching a simple DIBH program was setup. The use of DIBH has shown promise in reducing doses to the critical organs while maintaining PTV coverage for left sided breast treatments.

  14. A case of left-sided unilateral spatial neglect owing to the cerebral infarction in the distribution of the right posterior cerebral artery

    International Nuclear Information System (INIS)

    Odagaki, Yuji; Oka, Iori; Kon, Yutaka; Asano, Yutaka

    1985-01-01

    We report a case of left-sided unilateral spatial neglect (USN) induced by the cerebral infarction in the distribution of right posterior cerebral artery (PCA). A 69-year-old, right-handed man, who had had a sudden onset of left hemiparesis in August 1983, was admitted to our hospital on January 16, 1984, because of nocturnal delirium. He became alert a few days after admission, but was euphoric and sometimes irritable. Neurologic examination disclosed left homonymous hemianopsia, dysarthria, left central facial weakness, spastic left hemiparesis, hyperactive reflexes on the left with no Babinski sign, left hemisensory loss, and left thalamic pain. On neuropsychologic examination it was revealed that he had a tendency to neglect the left half of his extrapersonal space. When asked to locate cities on a blank map of Japan, he located most of them not only on the right side of the map but also incorrectly. He also had a severe acalculia. There was gradual improvement in these neuropsychologic symptoms. CT demonstrated an area of decreased density in the territory of the right PCA, posterolateral portion of the right thalamus, and the posterior limb of right internal capsule, sparing parietal and temporal lobes. Single-photon emission computed tomography (SPECT) using the Xenon-133 inhalation method showed, however, diminished regional cerebral blood flow (rCBF) in an area larger than the area of infarction demonstrated by CT, including the right parieto-temporo-occipital junctional area, which has been considerd to be responsible for left-sided USN. The authors ascribed the patient's left-sided USN to the lesion of this area that was revealed not morphologically by CT but functionally by SPECT, although the possibility that the lesions of the medial portion of the right occipital lobe and/or subcortical lesions of such areas as the thalamus and the internal capsule more or less influenced the neuropsychologic symptoms could not be excluded. (author)

  15. Long-term outcomes after resection of para-aortic lymph node metastasis from left-sided colon and rectal cancer.

    Science.gov (United States)

    Nakai, Nozomu; Yamaguchi, Tomohiro; Kinugasa, Yusuke; Shiomi, Akio; Kagawa, Hiroyasu; Yamakawa, Yushi; Numata, Masakatsu; Furutani, Akinobu

    2017-07-01

    Para-aortic lymph node (PALN) metastasis from colorectal cancer is rare and often not suitable for surgery. However, in selected patients, radical resection may bring about longer survival. The aim of this study was to evaluate long-term outcomes of resection of left-sided colon or rectal cancer with simultaneous PALN metastasis. The study included 2122 patients with left-sided colon or rectal cancer (30 patients with and 2092 patients without PALN metastasis) who underwent resection with curative intent between 2002 and 2013. Clinicopathological characteristics, long-term outcomes of resection, and factors related to poor postoperative survival in patients with PALN metastasis were investigated. Of a total of 2122 total patients, 16 of 50 patients (32.0%) with lymph node metastasis at the root of the inferior mesenteric artery had PALN metastasis. The 5-year overall survival rates for 18 patients who underwent R0 resection and 12 patients who did not were 29.1 and 10.4%, respectively (p = 0.017). Factors associated with poor postoperative survival among patients who underwent R0 resection were presence of conversion therapy, lack of adjuvant chemotherapy, carcinoembryonic antigen >20 ng/mL, and lateral lymph node metastasis in rectal cancer patients. The 5-year recurrence-free survival rate was 14.8%. Although recurrence was frequent, R0 resection for left-sided colon or rectal cancer with PALN metastasis was associated with longer survival than R1/R2 resection. Furthermore, the 5-year overall survival rate in the R0 group was relatively favorable for stage IV. Therefore, R0 resection may prolong survival compared with chemotherapy alone in selected patients.

  16. A fully electronic intensity-modulated radiation therapy quality assurance (IMRT QA) process implemented in a network comprised of independent treatment planning, record and verify, and delivery systems

    International Nuclear Information System (INIS)

    Bailey, Daniel W; Kumaraswamy, Lalith; Podgorsak, Matthew B

    2010-01-01

    The purpose of this study is to implement an electronic method to perform and analyze intensity-modulated radiation therapy quality assurance (IMRT QA) using an aSi megavoltage electronic portal imaging device in a network comprised of independent treatment planning, record and verify (R&V), and delivery systems. A verification plan was generated in the treatment planning system using the actual treatment plan of a patient. After exporting the treatment fields to the R&V system, the fields were delivered in QA mode with the aSi imager deployed. The resulting dosimetric images are automatically stored in a DICOM-RT format in the delivery system treatment console computer. The relative dose density images are subsequently pushed to the R&V system. The absolute dose images are then transferred electronically from the treatment console computer to the treatment planning system and imported into the verification plan in the dosimetry work space for further analysis. Screen shots of the gamma evaluation and isodose comparison are imported into the R&V system as an electronic file (e.g. PDF) to be reviewed prior to initiation of patient treatment. A relative dose image predicted by the treatment planning system can also be sent to the R&V system to be compared with the relative dose density image measured with the aSi imager. Our department does not have integrated planning, R&V, and delivery systems. In spite of this, we are able to fully implement a paperless and filmless IMRT QA process, allowing subsequent analysis and approval to be more efficient, while the QA document is directly attached to its specific patient chart in the R&V system in electronic form. The calculated and measured relative dose images can be compared electronically within the R&V system to analyze the density differences and ensure proper dose delivery to patients. In the absence of an integrated planning, verifying, and delivery system, we have shown that it is nevertheless possible to develop a

  17. Inverted Nutcracker Syndrome: A Case of Persistent Hematuria and Pain in the Presence of a Left-Sided Inferior Vena Cava

    Directory of Open Access Journals (Sweden)

    Obi Ekwenna

    2011-01-01

    Full Text Available Nutcracker syndrome is described as the symptomatic compression of left renal vein between the aorta and the superior mesenteric artery, resulting in outflow congestion of the left kidney. We present the case of a 51-year-old male with a left-sided inferior vena cava, resulting in compression of the right renal vein by the superior mesenteric artery. Secondary to this anatomic anomaly, the patient experienced a many-year history of flank pain and intermittent gross hematuria. We have termed this unusual anatomic finding and its associated symptoms as the “inverted nutcracker syndrome”, and describe its successful management with nephrectomy and autotransplantation.

  18. Colonic stenting as bridge to surgery versus emergency surgery for management of acute left-sided malignant colonic obstruction: a multicenter randomized trial (Stent-in 2 study

    Directory of Open Access Journals (Sweden)

    Scholten Pieter

    2007-07-01

    Full Text Available Abstract Background Acute left-sided colonic obstruction is most often caused by malignancy and the surgical treatment is associated with a high mortality and morbidity rate. Moreover, these operated patients end up with a temporary or permanent stoma. Initial insertion of an enteral stent to decompress the obstructed colon, allowing for surgery to be performed electively, is gaining popularity. In uncontrolled studies stent placement before elective surgery has been suggested to decrease mortality, morbidity and number of colostomies. However stent perforation can lead to peritoneal tumor spill, changing a potentially curable disease in an incurable one. Therefore it is of paramount importance to compare the outcomes of colonic stenting followed by elective surgery with emergency surgery for the management of acute left-sided malignant colonic obstruction in a randomized multicenter fashion. Methods/design Patients with acute left-sided malignant colonic obstruction eligible for this study will be randomized to either emergency surgery (current standard treatment or colonic stenting as bridge to elective surgery. Outcome measurements are effectiveness and costs of both strategies. Effectiveness will be evaluated in terms of quality of life, morbidity and mortality. Quality of life will be measured with standardized questionnaires (EORTC QLQ-C30, EORTC QLQ-CR38, EQ-5D and EQ-VAS. Morbidity is defined as every event leading to hospital admission or prolonging hospital stay. Mortality will be analyzed as total mortality as well as procedure-related mortality. The total costs of treatment will be evaluated by counting volumes and calculating unit prices. Including 120 patients on a 1:1 basis will have 80% power to detect an effect size of 0.5 on the EORTC QLQ-C30 global health scale, using a two group t-test with a 0.05 two-sided significance level. Differences in quality of life and morbidity will be analyzed using mixed-models repeated measures

  19. Successful management of a complicated clinical crisis: A patient with left-sided endocarditis and secondary hemophagocytic lymphohistiocytosis: a rare case report and literature review.

    Science.gov (United States)

    Xu, Peipei; Zeng, Hui; Zhou, Min; Ouyang, Jian; Chen, Bing; Zhang, Qiguo

    2017-12-01

    Hemophagocytic lymphohistiocytosis (HLH) secondary to methicillin-resistant Staphylococcus epidermidis (MRSE)-related left-sided infectious endocarditis had never been reported before. In the last decade, daptomycin, a novel lipopeptide antibiotic, showed its excellent role in anti-Gram-positive bacteria, including soft tissue infection, bloodstream and deep tissueinfection. An Asian women under sever condition due to the cooccurrence of HLH and MRSE-related endocarditis while also be allergic to vancomycin. The patient was cured by high-dose daptomycin monotheraphy, HLH-2004 protocol and cardiothoracic surgery to remove the valve at last, and was obviously benefit from the endeavor of a multidisciplinary team (MDT) strategy. IE was made on March 27according to the modified Duke criteria. HLH was diagnosed too. The patient was cured by high-dose daptomycin monotheraphy, HLH-2004 protocol and cardiothoracic surgery to remove the valve at last, and was obviously benefit from the endeavor of a multidisciplinary team (MDT) strategy. The patient was healthy andstable when we published this case. This case proves high-dose daptomycin monotheraphy could be used as an effective alternative regimen for vancomycin in treating MRSE-related left-sided endocarditis and highlight the importance of early diagnosis and appropriate management for HLH. Furthermore, our work suggests an MDT model as a practical strategy in managing similar clinical situation. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  20. Lung volumes, ventricular function and pulmonary arterial flow in children operated on for left-sided congenital diaphragmatic hernia: long-term results

    Energy Technology Data Exchange (ETDEWEB)

    Abolmaali, Nasreddin; Koch, Arne [Dresden University of Technology, OncoRay - Molecular and Biological Imaging, Medical Faculty Carl Gustav Carus, Dresden (Germany); Goetzelt, Knut; Vogelberg, Christian [University Clinics Carl Gustav Carus, Dresden University of Technology, Clinic and Policlinic for Pediatrics - Pediatric Pulmonology, Dresden (Germany); Hahn, Gabriele [University Clinics Carl Gustav Carus, Dresden University of Technology, Institute and Policlinic for Radiology - Pediatric Radiology, Dresden (Germany); Fitze, Guido [University Clinics Carl Gustav Carus, Dresden University of Technology, Clinic and Policlinic for Pediatric Surgery, Dresden (Germany)

    2010-07-15

    To compare MRI-based functional pulmonary and cardiac measurements in the long-term follow-up of children operated on for left-sided congenital diaphragmatic hernia (CDH) with age- and body size-matched healthy controls. Twelve children who received immediate postnatal surgery for closure of isolated left-sided CDH were included and received basic medical examinations, pulmonary function testing and echocardiography. MRI included measurement of lung volume, ventricular function assessment and velocity-encoded imaging of the pulmonary arteries and was compared with the data for 12 healthy children matched for age and body size. While patients' clinical test results were not suspicious, comparison between the MRI data for patients and those for healthy controls revealed significant differences. In patients, the volumes of the left lungs were increased and the tidal volume was larger on the right side. While the stroke volumes of both ventricles were reduced, heart rate and ejection fraction were increased. Flow, acceleration time and cross-sectional area of the left pulmonary artery were reduced. Functional MRI detected pulmonary and cardiac findings in the late follow-up of CDH children which may be missed by standard clinical methods and might be relevant for decisions regarding late outcome and treatment. (orig.)

  1. Lung volumes, ventricular function and pulmonary arterial flow in children operated on for left-sided congenital diaphragmatic hernia: long-term results.

    Science.gov (United States)

    Abolmaali, Nasreddin; Koch, Arne; Götzelt, Knut; Hahn, Gabriele; Fitze, Guido; Vogelberg, Christian

    2010-07-01

    To compare MRI-based functional pulmonary and cardiac measurements in the long-term follow-up of children operated on for left-sided congenital diaphragmatic hernia (CDH) with age- and body size-matched healthy controls. Twelve children who received immediate postnatal surgery for closure of isolated left-sided CDH were included and received basic medical examinations, pulmonary function testing and echocardiography. MRI included measurement of lung volume, ventricular function assessment and velocity-encoded imaging of the pulmonary arteries and was compared with the data for 12 healthy children matched for age and body size. While patients' clinical test results were not suspicious, comparison between the MRI data for patients and those for healthy controls revealed significant differences. In patients, the volumes of the left lungs were increased and the tidal volume was larger on the right side. While the stroke volumes of both ventricles were reduced, heart rate and ejection fraction were increased. Flow, acceleration time and cross-sectional area of the left pulmonary artery were reduced. Functional MRI detected pulmonary and cardiac findings in the late follow-up of CDH children which may be missed by standard clinical methods and might be relevant for decisions regarding late outcome and treatment.

  2. Lung volumes, ventricular function and pulmonary arterial flow in children operated on for left-sided congenital diaphragmatic hernia: long-term results

    International Nuclear Information System (INIS)

    Abolmaali, Nasreddin; Koch, Arne; Goetzelt, Knut; Vogelberg, Christian; Hahn, Gabriele; Fitze, Guido

    2010-01-01

    To compare MRI-based functional pulmonary and cardiac measurements in the long-term follow-up of children operated on for left-sided congenital diaphragmatic hernia (CDH) with age- and body size-matched healthy controls. Twelve children who received immediate postnatal surgery for closure of isolated left-sided CDH were included and received basic medical examinations, pulmonary function testing and echocardiography. MRI included measurement of lung volume, ventricular function assessment and velocity-encoded imaging of the pulmonary arteries and was compared with the data for 12 healthy children matched for age and body size. While patients' clinical test results were not suspicious, comparison between the MRI data for patients and those for healthy controls revealed significant differences. In patients, the volumes of the left lungs were increased and the tidal volume was larger on the right side. While the stroke volumes of both ventricles were reduced, heart rate and ejection fraction were increased. Flow, acceleration time and cross-sectional area of the left pulmonary artery were reduced. Functional MRI detected pulmonary and cardiac findings in the late follow-up of CDH children which may be missed by standard clinical methods and might be relevant for decisions regarding late outcome and treatment. (orig.)

  3. SU-E-T-483: Treatment Planning Study of Volumetric Modulated Arc Therapy for Left-Sided Breast and Chestwall Cancers

    Energy Technology Data Exchange (ETDEWEB)

    Xu, H [Department of Radiation Oncology, Dalhousie University, Halifax, NS (Canada); Cape Breton Cancer Centre, Sydney, NS (Australia)

    2014-06-01

    Purpose: To perform the comparison of dose distributions and dosevolume- histograms generated by VMAT and conventional field-in-field technique for left-sided breast and chestwall cancers; to determine whether VMAT offers more dosimetric benefits than does the field-in-field technique. Methods: All VMAT and field-in-filed plans were produced in Eclipse(version 10). Five plans were generated for left-sided breast and leftsided chestwall with supraclavicular nodes, respectively. A clockwise arc (CW) and a counter-clockwise arc (CCW) were used with start and stop angles being 310o±10o and 140o±10o. Collimator angles were 30o for CW and 330o for CCW. The conformity index (CI) is the ratio of V95% over PTV. The homogeneity index (HI) is the ratio of the difference between D2% and D98% over the prescribed dose. The V5, as an indicator of low dose bath to organs-at-risk, was used for ipsilateral lung, heart, contralateral lung, and contralateral breast. The V20, as an indicator of radiation pneumonitis, was used for ipsilateral lung. Results: Breast/chestwall VMAT delivers much higher low dose bath to ipsilateral lung, contralateral lung and contralateral breast/chestwall for both intact breast and chestwall with nodes. V5 for heart is increased in VMAT plans. V20 for ipsilateral lung is lower in VMAT plans. PTV coverage is similar for both techniques. For one particular chestwall patient with supraclavicular and internal mammary nodes, VMAT offers superior dose coverage of PTVs with slightly more low-dose-wash to heart, contralateral lung and contralateral breast. Conclusion: This study indicates that there is generally no benefit using VMAT for left-sided intact breast, due to large low-dose-bath (5Gy) to normal tissues with insignificant improvement in PTV coverage. Dosimetric benefits will be seen in VMAT plans for some chestwall patients with large size, and/or internal mammary nodes, etc. Whether a chestwall patient is treated with VMAT should be carefully

  4. Anterior Myocardial Territory May Replace the Heart as Organ at Risk in Intensity-Modulated Radiotherapy for Left-Sided Breast Cancer

    International Nuclear Information System (INIS)

    Tan Wenyong; Liu Dong; Xue Chenbin; Xu Jiaozhen; Li Beihui; Chen Zhengwang; Hu Desheng; Wang Xionghong

    2012-01-01

    Purpose: We investigated whether the heart could be replaced by the anterior myocardial territory (AMT) as the organ at risk (OAR) in intensity-modulated radiotherapy (IMRT) of the breast for patients with left-sided breast cancer. Methods and Materials: Twenty-three patients with left-sided breast cancer who received postoperative radiation after breast-conserving surgery were studied. For each patient, we generated five IMRT plans including heart (H), left ventricle (LV), AMT, LV+AMT, and H+LV as the primary OARs, respectively, except both lungs and right breast, which corresponded to IMRT(H), IMRT(LV), IMRT(AMT), IMRT(LV+AMT), and IMRT(H+LV). For the planning target volumes and OARs, the parameters of dose–volume histograms were compared. Results: The homogeneity index, conformity index, and coverage index were not compromised significantly in IMRT(AMT), IMRT(LV) and IMRT(LV+ AMT), respectively, when compared with IMRT(H). The mean dose to the heart, LV, and AMT decreased 5.3–21.5% (p < 0.05), 19.9–29.5% (p < 0.05), and 13.3–24.5% (p < 0.05), respectively. Similarly, the low (e.g., V5%), middle (e.g., V20%), and high (e.g., V30%) dose-volume of the heart, LV, and AMT decreased with different levels. The mean dose and V10% of the right lung increased by 9.2% (p < 0.05) and 27.6% (p < 0.05), respectively, in IMRT(LV), and the mean dose and V5% of the right breast decreased significantly in IMRT(AMT) and IMRT(LV+AMT). IMRT(AMT) was the preferred plan and was then compared with IMRT(H+LV); the majority of dose–volume histogram parameters of OARs including the heart, LV, AMT, both lungs, and the right breast were not statistically different. However, the low dose-volume of LV increased and the middle dose-volume decreased significantly (p < 0.05) in IMRT(AMT). Also, those of the right lung (V10%, V15%) and right breast (V5%, V10%) decreased significantly (p < 0.05). Conclusions: The AMT may replace the heart as the OAR in left-sided breast IMRT after breast

  5. Cardiac dose reduction with deep inspiration breath hold for left-sided breast cancer radiotherapy patients with and without regional nodal irradiation.

    Science.gov (United States)

    Yeung, Rosanna; Conroy, Leigh; Long, Karen; Walrath, Daphne; Li, Haocheng; Smith, Wendy; Hudson, Alana; Phan, Tien

    2015-09-22

    Deep inspiration breath hold (DIBH) reduces heart and left anterior descending artery (LAD) dose during left-sided breast radiation therapy (RT); however there is limited information about which patients derive the most benefit from DIBH. The primary objective of this study was to determine which patients benefit the most from DIBH by comparing percent reduction in mean cardiac dose conferred by DIBH for patients treated with whole breast RT ± boost (WBRT) versus those receiving breast/chest wall plus regional nodal irradiation, including internal mammary chain (IMC) nodes (B/CWRT + RNI) using a modified wide tangent technique. A secondary objective was to determine if DIBH was required to meet a proposed heart dose constraint of Dmean irradiation.

  6. Reduction of cardiac and coronary artery doses in irradiation of left-sided breast cancer during inspiration breath hold. A planning study

    Energy Technology Data Exchange (ETDEWEB)

    Schoenecker, S.; Heinz, C.; Soehn, M.; Haimerl, W.; Corradini, S.; Pazos, M.; Belka, C.; Scheithauer, H. [University Hospital of Ludwig-Maximilian-University, Department of Radiation Oncology, Munich (Germany)

    2016-11-15

    The radiation dose received by the heart during adjuvant left-sided breast irradiation plays a crucial role in development of late toxicity. Although the absolute risk of cardiotoxicity can be reduced with modern irradiation techniques, cardiotoxic chemotherapy increases the risk of late damage. Thus, the radiation dose to the heart should be minimized. This study evaluated the influence of different amplitudes of inspiration breath hold (IBH) during simulated left-sided breast irradiation on cardiac doses compared to free breathing (FB). CT data of 11 lung cancer patients were retrospectively used as left-sided pseudo-breast cancer cases. Two CT scans were used, one during IBH and one during FB, and two treatment plans were generated. Relevant heart, lung, and left anterior descending artery (LAD) parameters were derived from dose-volume histograms. The normal tissue complication probabilities (NTCPs) for the heart were calculated based on the relative seriality model. Inspiration depth was quantified using chest volume and diameter, and correlated thereafter to a possible sparing of heart tissue. Mean reduction of heart dose for IBH compared to FB was 40 % (1.65 vs. 0.99 Gy; p = 0.007). Maximum dose to the heart and LAD could be decreased by 33 % (p = 0.011) and 43 % (p = 0.024), respectively. The mean anteroposterior shift was 5 mm (range 0.9-9.5 mm). Significant negative correlations between the relative change in LAD mean dose and the mean thoracic diameter and volume change, as well as with the absolute change in thoracic diameter were seen. The NTCP for cardiac mortality could be decreased by about 78 % (p = 0.017). For left-sided breast cancer patients, cardiac doses can be significantly decreased with tangential irradiation and IBH. (orig.) [German] Die Herzdosisbelastung spielt eine entscheidende Rolle in der Entwicklung einer kardialen Spaettoxizitaet nach der adjuvanten Strahlentherapie von linksseitigem Brustkrebs. Obwohl moderne strahlentherapeutische

  7. Comparison of conventional inserts and an add-on electron MLC for chest wall irradiation of left-sided breast cancer

    International Nuclear Information System (INIS)

    Vatanen, Tero; Lahtinen, Tapani; Traneus, Erik

    2009-01-01

    Background. Collimation of irregularly shaped clinical electron beams is currently based on electron inserts made of low melting point alloys. The present investigation compares a conventional electron applicator with insert and add-on eMLC-based dose distributions in the postoperative chest wall irradiation of left-sided breast cancer. Material and methods. Voxel Monte Carlo++ (VMC++) calculated dose distributions related to electron fields were compared with 10 left-sided breast cancer patients after radical mastectomy. The prescription dose was 50 Gy at a build-up maximum. The same dose was prescribed for the ipsilateral axillary, parasternal and supraclavicular lymph nodes that were treated with photons and calculated with a pencil beam algorithm. The insert beams were shaped with 1.5 cm thick Wood's metal electron inserts in an electron applicator of a Varian 2100 C/D linac. Doses for the eMLC-shaped beams were calculated for an eMLC prototype with 2 cm thick and 5 mm wide steel leaves. The same collimator-to-surface distance (CSD) of 5.8 cm was used for both collimators. Results. The mean PTV dose was slightly higher for the eMLC plans (50.7 vs 49.5 Gy, p<0.001, respectively). The maximum doses assessed by D5% for the eMLC and insert were 60.9 and 59.1 Gy (p<0.001). The difference was due to the slightly higher doses near the field edges for the eMLC. The left lung V20 volumes were 34.5% and 34.0% (p<0.001). There was only a marginal difference in heart doses. Discussion: Despite a slight increase of maximum dose in PTV the add-on electron MLC for chest wall irradiation results in practically no differences in dose distributions compared with the present insert-based collimation

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

    Science.gov (United States)

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

    2017-10-01

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

  9. Voluntary Deep Inspiration Breath-hold Reduces the Heart Dose Without Compromising the Target Volume Coverage During Radiotherapy for Left-sided Breast Cancer.

    Science.gov (United States)

    Al-Hammadi, Noora; Caparrotti, Palmira; Naim, Carole; Hayes, Jillian; Rebecca Benson, Katherine; Vasic, Ana; Al-Abdulla, Hissa; Hammoud, Rabih; Divakar, Saju; Petric, Primoz

    2018-03-01

    During radiotherapy of left-sided breast cancer, parts of the heart are irradiated, which may lead to late toxicity. We report on the experience of single institution with cardiac-sparing radiotherapy using voluntary deep inspiration breath hold (V-DIBH) and compare its dosimetric outcome with free breathing (FB) technique. Left-sided breast cancer patients, treated at our department with postoperative radiotherapy of breast/chest wall +/- regional lymph nodes between May 2015 and January 2017, were considered for inclusion. FB-computed tomography (CT) was obtained and dose-planning performed. Cases with cardiac V25Gy ≥ 5% or risk factors for heart disease were coached for V-DIBH. Compliant patients were included. They underwent additional CT in V-DIBH for planning, followed by V-DIBH radiotherapy. Dose volume histogram parameters for heart, lung and optimized planning target volume (OPTV) were compared between FB and BH. Treatment setup shifts and systematic and random errors for V-DIBH technique were compared with FB historic control. Sixty-three patients were considered for V-DIBH. Nine (14.3%) were non-compliant at coaching, leaving 54 cases for analysis. When compared with FB, V-DIBH resulted in a significant reduction of mean cardiac dose from 6.1 +/- 2.5 to 3.2 +/- 1.4 Gy (p FB and V-DIBH, respectively (p FB- and V-DIBH-derived mean lung dose (11.3 +/- 3.2 vs. 10.6 +/- 2.6 Gy), lung V20Gy (20.5 +/- 7 vs. 19.5 +/- 5.1 Gy) and V95% for the OPTV (95.6 +/- 4.1 vs. 95.2 +/- 6.3%) were non-significant. V-DIBH-derived mean shifts for initial patient setup were ≤ 2.7 mm. Random and systematic errors were ≤ 2.1 mm. These results did not differ significantly from historic FB controls. When compared with FB, V-DIBH demonstrated high setup accuracy and enabled significant reduction of cardiac doses without compromising the target volume coverage. Differences in lung doses were non-significant.

  10. SU-F-T-204: A Preliminary Approach of Reducing Contralateral Breast and Heart Dose in Left Sided Whole Breast Cancer Patients Utilizing Proton Beams

    Energy Technology Data Exchange (ETDEWEB)

    Islam, M; Algan, O; Jin, H; Ahmad, S; Hossain, S [University of Oklahoma Health Sciences Center, Oklahoma City, OK (United States)

    2016-06-15

    Purpose: To investigate the plan quality and feasibility of a hybrid plan utilizing proton and photon fields for superior coverage in the internal mammary (IM) and supraclavicular (S/C) regions while minimizing heart and contralateral breast dose for the left-sided whole breast cancer patient treatment. Methods: This preliminary study carried out on single left-sided intact breast patient involved IM and S/C nodes. The IM and S/C node fields of the 5-Field 3DCRT photon-electron base plan were replaced by two proton fields. These two along with two Field-in-Field tangential photon fields were optimized for comparable dose coverage. The treatment plans were done using Eclipse TPS for the total dose of 46Gy in 23 fractions with 95% of the prescription dose covering 95% of the RTOG PTV. The 3DCRT photon-electron and 4-Field photon-proton hybrid plans were compared for the PTV dose coverage as well as dose to OARs. Results: The overall RTOG PTV coverage for proton-hybrid and 3DCRT plan was comparable (95% of prescription dose covers 95% PTV volume). In proton-hybrid plan, 99% of IM volume received 100% dose whereas in 3DCRT only 77% received 100% dose. For S/C regions, 97% and 77% volume received 100% prescription dose in proton-hybrid and 3DCRT plans, respectively. The heart mean dose, V3Gy(%), and V5Gy(%) was 2.2Gy, 14.4%, 9.8% for proton-hybrid vs. 4.20 Gy, 21.5%, and 39% for 3DCRT plan, respectively. The maximum dose to the contralateral breast was 39.75Gy for proton-hybrid while 56.87Gy for 3DCRT plan. The mean total lung dose, V20Gy(%), and V30Gy(%) was 5.68Gy, 11.3%, 10.5% for proton-hybrid vs. 5.90Gy, 9.8%, 7.2% for 3DCRT, respectively. Conclusion: The protonhybrid plan can offer better dose coverage to the involved lymphatic tissues while lower doses to the heart and contralateral breast. More treatment plans are currently in progress before being implemented clinically.

  11. SU-E-T-532: Left-Sided Breast Cancer Irradiation Using Volumatric Modulated Arc Therapy: An Evaluation of Multiple Commercial Systems

    International Nuclear Information System (INIS)

    Liu, R; Liu, T; Qi, S

    2015-01-01

    Purposes: There has been growing interest in treating breast cancer using VMAT technique. Our goal is to compare the dosimetry and treatment delivery parameters for the left-sided breast cancer treatment using various VMAT platforms from commercially available planning systems. Methods: Five consecutive left-sided breast cancer patients initially treated with conventional 3D-conformal radiotherapy (3DCRT) were selected. Four VMAT plans using most popular treatment planning systems, including Eclipse (Version 11, Varian), Pinnacle (Version 9.8, Philips), Monaco (Version 2.03, Elekta) and helical Tomotherapy (V4.0, Accuray). The same structure set and same planning goals were used for all VMAT plans. The dosimetric parameters including target coverage and minimum/maximum/mean, dose-volume endpoints for the selected normal structures: the heart, ipsilateral-/contralateral lung and breast, were evaluated. Other dosimetric indices including heterogeneity index (HI) were evaluated. The treatment delivery parameters, such as monitor unit (MUs) and delivery time were also compared. Results: VMAT increases dose homogeneity to the treated volume and reduces the irradiated heart and left-lung volumes. Compared to the 3DCRT technique, all VMAT plans offer better heart and left-lung dose sparing; the mean heart doses were 4.5±1.6(Monaco), 1.2±0.4(Pinnacle), 1.3± (Eclipse) and 5.6±4.4(Tomo), the mean left-lung doses were 5.9±1.5(Monaco), 3.7±0.7(Pinnacle), 1.4± (Eclipse) and 5.2±1.6 (Tomo), while for the 3DCRT plan, the mean heart and left-Lung doses were 2.9±2.0, and 6.8±4.4 (Gy) respectively. The averaged contralateral-breast and lung mean doses were higher in VMAT plans than the 3DCRT plans but were not statistically significant. Among all the VMAT plans, the Pinnacle plans often yield the lowest right-lung/breast mean doses, and slightly better heterogeneity indices that are similar to Tomotherapy plans. Treatment delivery time of the VMAT plans (except helical

  12. Preoperative intestinal stent decompression with primary laparoscopic surgery to treat left-sided colorectal cancer with obstruction: a report of 21 cases

    International Nuclear Information System (INIS)

    Zheng, Chao; Wu, Yu-Lian; Li, Qing

    2013-01-01

    This work aimed to study the safety and efficacy of preoperative intestinal stent decompression combined with laparoscopic surgery to treat left-sided colorectal cancer with obstruction (LCCO). Retrospective analysis was conducted on data obtained from 21 LCCO patients admitted to The First Affiliated Hospital of Zhejiang Chinese Medicine University during March 2008 and December 2011. To remove the intestinal obstruction, preoperative intestinal stent placement under colonoscopic guidance was performed. Approximately 7 to 10 days after the operation, laparoscopic radical surgery of colorectal cancer was conducted. Among the 21 cases studied, laparoscopic surgery was successful in 20 patients. Emergent laparotomy was conducted in one patient because of tumor invasion in the ureter. The duration of the operation ranged from 180 to 320 min, and the average time was 220 min. The recovery time for bowel function ranged from 2 to 5 days with an average time of 3 days. Postoperative infection of the incision occurred in one case. No anastomotic leakage was observed in any of the cases. Preoperative intestinal stent decompression, combined with primary stage laparoscopic surgery, is a safe and effective method for the treatment of LCCO

  13. A 58-Year-Old Woman with Left-Sided Weakness and a History of a Pediatric Brain Tumor: A Case Report

    Directory of Open Access Journals (Sweden)

    Shaakir Hasan

    2018-03-01

    Full Text Available Background: An uncommon but well-established complication of cranial irradiation is secondary neoplasm. This case presentation documents a radiation-induced malignant glioma 55 years after being diagnosed with “cerebral sarcoma,” now defined as atypical meningioma. This not only represents the longest reported latency period for a patient initially receiving over 30 Gy, but also provides a valuable historical perspective of neuro-oncology. Clinical Presentation: A 58-year-old female presenting with progressive left-sided upper and lower extremity weakness with a past medical history significant for “cerebral sarcoma” was diagnosed with glioblastoma multiforme. This patient had previously been treated with resection and adjuvant radiation therapy via a 280-kVP orthovoltage machine and received 3,390 rad to the posterior three-quarters of the skull for “cerebral sarcoma.” Conclusion: A comprehensive investigation of the past medical history helped uncover a mysterious pediatric diagnosis, helped drive the management 5 decades later, and serves as a reminder that seemingly safe interventions may still cause harm.

  14. Comparison of oncological outcomes of right-sided colon cancer versus left-sided colon cancer after curative resection: Which side is better outcome?

    Science.gov (United States)

    Lim, Dae Ro; Kuk, Jung Kul; Kim, Taehyung; Shin, Eung Jin

    2017-10-01

    There are embryological origins, anatomical, histological, genetic, and immunological differences between right-sided colon cancer (RCC) and left-sided colon cancer (LCC). Many studies have sought to determine the survival and prognosis according to tumor location. This study aimed to analyze outcomes between RCC and LCC. Between January 2000 and December 2012, data on 414 patients who underwent curative resection for RCC and LCC were retrieved from a retrospective database. Propensity score matching (1:1) was performed and RCC was identified in 207 and LCC in 207 patients. On average, RCC exhibited a more advanced N stage, increased tumor size, more frequently poorly differentiated tumors, more harvested lymph nodes, and more positivity of lymphovascular invasion than LCC. With a median follow-up of 66.7 months, the 5-year overall survival (OS) rates for RCC and LCC were 82.1% and 88.7%, respectively, (P cancers, the DFS rates were 61.1% (RCC) and 81.9% (LCC; P colon cancer is needed.

  15. Cerebral and Renal Oxygen Saturation Are Not Compromised in the Presence of Retrograde Blood Flow in either the Ascending or Descending Aorta in Term or Near-Term Infants with Left-Sided Obstructive Lesions

    NARCIS (Netherlands)

    van der Laan, Michelle E.; Mebius, Mirthe J.; Roofthooft, Marcus T. R.; Bos, Arend F.; Berger, Rolf M. F.; Kooi, Elisabeth M. W.

    2017-01-01

    Background: In infants with left-sided obstructive lesions (LSOL), the presence of retrograde blood flow in either the ascending or descending aorta may lead to diminished cerebral and renal blood flow, respectively. Objectives: Our aim was to compare cerebral and renal tissue oxygen saturation

  16. SU-E-J-62: Breath Hold for Left-Sided Breast Cancer: Visually Monitored Deep Inspiration Breath Hold Amplitude Evaluated Using Real-Time Position Management

    Energy Technology Data Exchange (ETDEWEB)

    Conroy, L; Quirk, S; Smith, WL [The University of Calgary, Calgary, AB (Canada); Tom Baker Cancer Centre, Calgary, AB (Canada); Yeung, R; Phan, T [The University of Calgary, Calgary, AB (Canada); Hudson, A [Tom Baker Cancer Centre, Calgary, AB (Canada)

    2015-06-15

    Purpose: We used Real-Time Position Management (RPM) to evaluate breath hold amplitude and variability when gating with a visually monitored deep inspiration breath hold technique (VM-DIBH) with retrospective cine image chest wall position verification. Methods: Ten patients with left-sided breast cancer were treated using VM-DIBH. Respiratory motion was passively collected once weekly using RPM with the marker block positioned at the xiphoid process. Cine images on the tangent medial field were acquired on fractions with RPM monitoring for retrospective verification of chest wall position during breath hold. The amplitude and duration of all breath holds on which treatment beams were delivered were extracted from the RPM traces. Breath hold position coverage was evaluated for symmetric RPM gating windows from ± 1 to 5 mm centered on the average breath hold amplitude of the first measured fraction as a baseline. Results: The average (range) breath hold amplitude and duration was 18 mm (3–36 mm) and 19 s (7–34 s). The average (range) of amplitude standard deviation per patient over all breath holds was 2.7 mm (1.2–5.7 mm). With the largest allowable RPM gating window (± 5 mm), 4 of 10 VM-DIBH patients would have had ≥ 10% of their breath hold positions excluded by RPM. Cine verification of the chest wall position during the medial tangent field showed that the chest wall was greater than 5 mm from the baseline in only 1 out of 4 excluded patients. Cine images verify the chest wall/breast position only, whether this variation is acceptable in terms of heart sparing is a subject of future investigation. Conclusion: VM-DIBH allows for greater breath hold amplitude variability than using a 5 mm gating window with RPM, while maintaining chest wall positioning accuracy within 5 mm for the majority of patients.

  17. Does inverse-planned intensity-modulated radiation therapy have a role in the treatment of patients with left-sided breast cancer?

    International Nuclear Information System (INIS)

    Stillie, Alison L.; Chua, Boon; Kron, Tomas; Cramb, Jim; Herschtal, Alan; Hornby, Colin; Sullivan, Kelly

    2011-01-01

    The purpose of the study was to determine if multi-field inverse-planned intensity-modulated radiation therapy (IMRT) improves on the sparing of organs at risk (heart, lungs and contralateral breast) when compared with field-in-field forward-planned RT (FiF). The planning CT scans of 10 women with left-sided breast cancer previously treated with whole-breast RT on an inclined breast board with both arms supported above the head were retrieved. The whole breast planning target volume (PTV) was defined by clinical mark-up and contoured on all relevant CT slices as were the organs at risk. For each patient, three plans were generated using FiF, five- and nine-field inverse-planned IMRT, all to a total dose of 50 Gy to the whole breast. Mean and maximum doses to the organs at risk and the homogeneity index (HI) of the whole-breast PTV were compared. The mean heart dose for the FiF plans was 2.63 Gy compared with 4.04 Gy for the five-field and 4.30 Gy for the nine-field IMRT plans, with no significant differences in the HI of the whole-breast PTV in all plans. The FiF plans resulted in a mean contralateral breast dose of 0.58 Gy compared with 0.70 and 2.08 Gy for the five- and nine-field IMRT plans, respectively. FiF resulted in a lower mean heart and contralateral breast dose with comparable HI of the whole-breast PTV in comparison with inverse-planned IMRT using five or nine fields.

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

    Science.gov (United States)

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

    2017-10-01

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

  19. SU-G-BRC-13: Model Based Classification for Optimal Position Selection for Left-Sided Breast Radiotherapy: Free Breathing, DIBH, Or Prone

    Energy Technology Data Exchange (ETDEWEB)

    Lin, H; Liu, T; Xu, X [Rensselaer Polytechnic Institute, Troy, NY (United States); Shi, C [Saint Vincent Medical Center, Bridgeport, CT (United States); Petillion, S; Kindts, I [University Hospitals Leuven, Leuven, Vlaams-Brabant (Belgium); Tang, X [Memorial Sloan Kettering Cancer Center, West Harrison, NY (United States)

    2016-06-15

    Purpose: There are clinical decision challenges to select optimal treatment positions for left-sided breast cancer patients—supine free breathing (FB), supine Deep Inspiration Breath Hold (DIBH) and prone free breathing (prone). Physicians often make the decision based on experiences and trials, which might not always result optimal OAR doses. We herein propose a mathematical model to predict the lowest OAR doses among these three positions, providing a quantitative tool for corresponding clinical decision. Methods: Patients were scanned in FB, DIBH, and prone positions under an IRB approved protocol. Tangential beam plans were generated for each position, and OAR doses were calculated. The position with least OAR doses is defined as the optimal position. The following features were extracted from each scan to build the model: heart, ipsilateral lung, breast volume, in-field heart, ipsilateral lung volume, distance between heart and target, laterality of heart, and dose to heart and ipsilateral lung. Principal Components Analysis (PCA) was applied to remove the co-linearity of the input data and also to lower the data dimensionality. Feature selection, another method to reduce dimensionality, was applied as a comparison. Support Vector Machine (SVM) was then used for classification. Thirtyseven patient data were acquired; up to now, five patient plans were available. K-fold cross validation was used to validate the accuracy of the classifier model with small training size. Results: The classification results and K-fold cross validation demonstrated the model is capable of predicting the optimal position for patients. The accuracy of K-fold cross validations has reached 80%. Compared to PCA, feature selection allows causal features of dose to be determined. This provides more clinical insights. Conclusion: The proposed classification system appeared to be feasible. We are generating plans for the rest of the 37 patient images, and more statistically significant

  20. Acute resection versus bridge to surgery with diverting colostomy for patients with acute malignant left sided colonic obstruction: Systematic review and meta-analysis.

    Science.gov (United States)

    Amelung, Femke J; Mulder, Charlotte L J; Verheijen, Paul M; Draaisma, Werner A; Siersema, Peter D; Consten, Esther C J

    2015-12-01

    Currently, no consensus exists on the best treatment strategy for acute malignant left-sided colonic obstruction. This systematic review and meta-analysis aims to compare the outcomes following the two surgical treatment options; primary resection versus colostomy creation as bridge to surgery. This systematic review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to minimize risk of bias. Pubmed, Embase and Cochrane Library were searched for all relevant literature. Methodological quality of included studies was assessed using the MINORS criteria. Pooled odds ratios with 95% confidence intervals (95%CI) were calculated using random effects models. Eight comparative studies were included, reporting on 2424 patients; 1973 patients were treated with primary resection and 451 patients with colostomy construction followed by elective resection. Meta-analysis showed no significant differences between both treatment groups regarding 30-day mortality and morbidity (OR = 0.77, 95%CI 0.3-1.96 and OR = 0.76, 95%CI 0.51-1.13, respectively). However, patients treated with a colostomy followed by elective resection had significantly more primary anastomoses constructed and were less likely to be left with a permanent colostomy (OR = 0.17, 95%CI 0.11-0.26 and OR = 0.22, 95%CI 0.11-0.46, respectively). This systematic review provides an overview of all available literature on primary resection versus colostomy creation as bridge to surgery in patients with acute LSCO. Keeping the limitations of this study in mind, we conclude that a diverting colostomy as bridge to surgery is a safe and valid alternative for primary resection. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Deep inspiration breath-hold (DIBH) radiotherapy in left-sided breast cancer. Dosimetrical comparison and clinical feasibility in 20 patients

    International Nuclear Information System (INIS)

    Hepp, Rodrigo; Ammerpohl, Mark; Morgenstern, Christina; Erichsen, Patricia; Nielinger, Lisa; Abdallah, Abdallah; Galalae, Razvan

    2015-01-01

    Adjuvant radiotherapy after breast-conserving surgery (BCS) for breast cancer (BC) is a well-established indication. The risk of ischaemic heart disease after radiotherapy for BC increases linearly with the heart mean dose with no apparent threshold. Radiotherapy to the left breast in deep inspiration breath-hold (DIBH) reduces the dose to the heart. A new linac system with an integrated surface scanner (SS) for DIBH treatments was recently installed in our department. We tested it for potential benefits, safety, patients' acceptance/compliance and associated additional workload. Twenty consecutive patients following BCS for breast carcinoma of the left side were enrolled in our institutional DIBH protocol. We compared dose to the heart and ipsilateral lung (IL) between plans in DIBH and free breathing (FB) using standard defined parameters: mean dose, maximal dose to a volume of 2 cm 3 (D 2 cm 3 ), volume receiving ≥ 5 Gy (V 5 ), 10 Gy (V 10 ), 15 Gy (V 15 ) and 20 Gy (V 20 ). Comparison of median calculated dose values was performed using a two-tailed Wilcoxon signed rank test. DIBH was associated with a statistically significant reduction (p < 0.001) in all studied parameters for the heart and the IL. In 16 of 20 patients the heart D 2 cm 3 was less than 42 Gy in DIBH. In FB the heart D 2 cm 3 was ≥ 42 Gy in 17 of 20 patients. The median daily treatment time was 9 min. Radiotherapy of the left breast in DIBH using a SS could easily be incorporated into daily routine and is associated with significant dose reduction to the heart and IL. (orig.) [de

  2. Cardiac risk index as a simple geometric indicator to select patients for the heart-sparing radiotherapy of left-sided breast cancer

    International Nuclear Information System (INIS)

    Sung, KiHoon; Choi, Young Eun; Lee, Kyu Chan

    2017-01-01

    This is a dosimetric study to identify a simple geometric indicator to discriminate patients who meet the selection criterion for heart-sparing radiotherapy (RT). The authors proposed a cardiac risk index (CRI), directly measurable from the CT images at the time of scanning. Treatment plans were regenerated using the CT data of 312 consecutive patients with left-sided breast cancer. Dosimetric analysis was performed to estimate the risk of cardiac mortality using cardiac dosimetric parameters, such as the relative heart volumes receiving ≥25 Gy (heart V 25 ). For each CT data set, in-field heart depth (HD) and in-field heart width (HW) were measured to generate the geometric parameters, including maximum HW (HW max ) and maximum HD (HD max ). Seven geometric parameters were evaluated as candidates for CRI. Receiver operating characteristic (ROC) curve analyses were used to examine the overall discriminatory power of the geometric parameters to select high-risk patients (heart V 25 ≥ 10%). Seventy-one high-risk (22.8%) and 241 low-risk patients (77.2%) were identified by dosimetric analysis. The geometric and dosimetric parameters were significantly higher in the high-risk group. Heart V 25 showed the strong positive correlations with all geometric parameters examined (r > 0.8, p < 0.001). The product of HD max and HW max (CRI) revealed the largest area under the curve (AUC) value (0.969) and maintained 100% sensitivity and 88% specificity at the optimal cut-off value of 14.58 cm 2 . Cardiac risk index proposed as a simple geometric indicator to select high-risk patients provides useful guidance for clinicians considering optimal implementation of heart-sparing RT.

  3. Utility of Deep Inspiration Breath Hold for Left-Sided Breast Radiation Therapy in Preventing Early Cardiac Perfusion Defects: A Prospective Study

    Energy Technology Data Exchange (ETDEWEB)

    Zagar, Timothy M., E-mail: zagar@med.unc.edu [Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina (United States); Kaidar-Person, Orit [Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina (United States); Tang, Xiaoli [Memorial Sloan Kettering Cancer Center, West Harrison, New York (United States); Jones, Ellen E.; Matney, Jason; Das, Shiva K.; Green, Rebecca L. [Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina (United States); Sheikh, Arif [Department of Radiology, Columbia University, New York, New York (United States); Khandani, Amir H.; McCartney, William H.; Oldan, Jorge Daniel; Wong, Terence Z. [Department of Radiology, University of North Carolina, Chapel Hill, North Carolina (United States); Marks, Lawrence B. [Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina (United States)

    2017-04-01

    Purpose: To evaluate early cardiac single photon computed tomography (SPECT) findings after left breast/chest wall postoperative radiation therapy (RT) in the setting of deep inspiration breath hold (DIBH). Methods and Materials: We performed a prospective single-institution single-arm study of patients who were planned for tangential RT with DIBH to the left breast/chest wall (± internal mammary nodes). The DIBH was done by use of a controlled surface monitoring technique (AlignRT, Vision RT Ltd, London, UK). The RT was given with tangential fields and a heart block. Radiation-induced cardiac perfusion and wall motion changes were assessed by pre-RT and 6-month post-RT SPECT scans. A cumulative SPECT summed-rest score was used to quantify perfusion in predefined left ventricle segments. The incidence of wall motion abnormalities was assessed in each of these same segments. Results: A total of 20 patients with normal pre-RT scans were studied; their median age was 56 years (range, 39-72 years). Seven (35%) patients also received irradiation to the left internal mammary chain, and 5 (25%) received an additional RT field to supraclavicular nodes. The median heart dose was 94 cGy (range, 56-200 cGy), and the median V25{sub Gy} was zero (range, 0-0.1). None of the patients had post-RT perfusion or wall motion abnormalities. Conclusions: Our results suggest that DIBH and conformal cardiac blocking for patients receiving tangential RT for left-sided breast cancer is an effective means to avoid early RT-associated cardiac perfusion defects.

  4. Cardiac dose reduction with deep inspiration breath hold for left-sided breast cancer radiotherapy patients with and without regional nodal irradiation

    International Nuclear Information System (INIS)

    Yeung, Rosanna; Conroy, Leigh; Long, Karen; Walrath, Daphne; Li, Haocheng; Smith, Wendy; Hudson, Alana; Phan, Tien

    2015-01-01

    Deep inspiration breath hold (DIBH) reduces heart and left anterior descending artery (LAD) dose during left-sided breast radiation therapy (RT); however there is limited information about which patients derive the most benefit from DIBH. The primary objective of this study was to determine which patients benefit the most from DIBH by comparing percent reduction in mean cardiac dose conferred by DIBH for patients treated with whole breast RT ± boost (WBRT) versus those receiving breast/chest wall plus regional nodal irradiation, including internal mammary chain (IMC) nodes (B/CWRT + RNI) using a modified wide tangent technique. A secondary objective was to determine if DIBH was required to meet a proposed heart dose constraint of D mean < 4 Gy in these two cohorts. Twenty consecutive patients underwent CT simulation both free breathing (FB) and DIBH. Patients were grouped into two cohorts: WBRT (n = 11) and B/CWRT + RNI (n = 9). 3D-conformal plans were developed and FB was compared to DIBH for each cohort using Wilcoxon signed-rank tests for continuous variables and McNemar’s test for discrete variables. The percent relative reduction conferred by DIBH in mean heart and LAD dose, as well as lung V 20 were compared between the two cohorts using Wilcox rank-sum testing. The significance level was set at 0.05 with Bonferroni correction for multiple testing. All patients had comparable target coverage on DIBH and FB. DIBH statistically significantly reduced mean heart and LAD dose for both cohorts. Percent reduction in mean heart and LAD dose with DIBH was significantly larger in the B/CWRT + RNI cohort compared to WBRT group (relative reduction in mean heart and LAD dose: 55.9 % and 72.1 % versus 29.2 % and 43.5 %, p < 0.02). All patients in the WBRT group and five patients (56 %) in the B/CWBRT + RNI group met heart D mean <4 Gy with FB. All patients met this constraint with DIBH. All patients receiving WBRT met D mean Heart < 4 Gy on FB, while only slightly over

  5. BALLISTIC RESISTANT ARTICLES COMPRISING TAPES

    NARCIS (Netherlands)

    VAN DER EEM, JORIS; HARINGS, JULES; JANSE, GERARDUS; TJADEN, HENDRIK

    2015-01-01

    The invention pertains to a ballistic-resistant moulded article comprising a compressed stack of sheets comprising reinforcing tapes having a tensile strength of at least 1.0 GPa, a tensile modulus of at least 40 GPa, and a tensile energy-to-break of at least 15 J/g, the direction of the tapes

  6. A case report of percutaneous endoscopic gastrostomy left-side gastropexy to resolve a recurrent gastric dilatation in a dog previously treated with right-side gastropexy for gastric dilatation volvulus.

    Science.gov (United States)

    Spinella, Giuseppe; Cinti, Filippo; Pietra, Marco; Capitani, Ombretta; Valentini, Simona

    2014-12-01

    A 6-year-old, large-breed, female dog was evaluated for gastric dilatation (GD). The dog was affected by GD volvulus, which had been surgically treated with gastric derotation and right incisional gastropexy. Recurrence of GD appeared 36 hours after surgery. The dilatation was immediately treated with an orogastric probe but still recurred 4 times. Therefore, a left-side gastropexy by percutaneous endoscopic gastrostomy (PEG) was performed to prevent intermittent GD. After PEG tube placement, the patient recovered rapidly without side effects. Several techniques of gastropexy have been described as a prophylactic method for gastric dilatation volvulus, but to the authors' knowledge, this is the first report of left-sided PEG gastropexy performed in a case of canine GD recurrence after an incisional right gastropexy. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Deep inspiration breath-hold (DIBH) radiotherapy in left-sided breast cancer. Dosimetrical comparison and clinical feasibility in 20 patients

    Energy Technology Data Exchange (ETDEWEB)

    Hepp, Rodrigo; Ammerpohl, Mark; Morgenstern, Christina; Erichsen, Patricia [Evangelische Kliniken Gelsenkirchen, Klinik fuer Strahlentherapie und Radioonkologie, Gelsenkirchen (Germany); Nielinger, Lisa [Evangelische Kliniken Gelsenkirchen, Klinik fuer Strahlentherapie und Radioonkologie, Gelsenkirchen (Germany); Hochschule Hamm-Lippstadt, Lippstadt (Germany); Abdallah, Abdallah [Evangelische Kliniken Gelsenkirchen, Klinik fuer Senologie, Gelsenkirchen (Germany); Galalae, Razvan [Evangelische Kliniken Gelsenkirchen, Klinik fuer Strahlentherapie und Radioonkologie, Gelsenkirchen (Germany); Christian-Albrechts-Universitaet zu Kiel, Medizinische Fakultaet, Kiel (Germany)

    2015-09-15

    Adjuvant radiotherapy after breast-conserving surgery (BCS) for breast cancer (BC) is a well-established indication. The risk of ischaemic heart disease after radiotherapy for BC increases linearly with the heart mean dose with no apparent threshold. Radiotherapy to the left breast in deep inspiration breath-hold (DIBH) reduces the dose to the heart. A new linac system with an integrated surface scanner (SS) for DIBH treatments was recently installed in our department. We tested it for potential benefits, safety, patients' acceptance/compliance and associated additional workload. Twenty consecutive patients following BCS for breast carcinoma of the left side were enrolled in our institutional DIBH protocol. We compared dose to the heart and ipsilateral lung (IL) between plans in DIBH and free breathing (FB) using standard defined parameters: mean dose, maximal dose to a volume of 2 cm{sup 3} (D{sub 2} {sub cm} {sup 3}), volume receiving ≥ 5 Gy (V{sub 5}), 10 Gy (V{sub 10}), 15 Gy (V{sub 15}) and 20 Gy (V{sub 20}). Comparison of median calculated dose values was performed using a two-tailed Wilcoxon signed rank test. DIBH was associated with a statistically significant reduction (p < 0.001) in all studied parameters for the heart and the IL. In 16 of 20 patients the heart D{sub 2} {sub cm} {sup 3} was less than 42 Gy in DIBH. In FB the heart D{sub 2} {sub cm} {sup 3} was ≥ 42 Gy in 17 of 20 patients. The median daily treatment time was 9 min. Radiotherapy of the left breast in DIBH using a SS could easily be incorporated into daily routine and is associated with significant dose reduction to the heart and IL. (orig.) [German] Die adjuvante Strahlentherapie nach brusterhaltener Operation (BCS) bei Brustkrebs (BC) ist eine seit langem anerkannte Behandlungsform. Das postradiogene Risiko einer kardialen Ischaemie steigt linear ohne erkennbaren Schwellenwert mit der mittleren Herzdosis. Die Bestrahlung der linken Brust in tiefer Inspiration unter Anhalten der

  8. Ionic liquids comprising heteraromatic anions

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, William F.; Brennecke, Joan F.; Maginn, Edward J.; Mindrup, Elaine; Gurkan, Burcu; Price, Erica; Goodrich, Brett

    2018-04-24

    Some embodiments described herein relate to ionic liquids comprising an anion of a heteraromatic compound such as optionally substituted pyrrolide, optionally substituted pyrazolide, optionally substituted indolide, optionally substituted phospholide, or optionally substituted imidazolide. Methods and devices for gas separation or gas absorption related to these ionic liquids are also described herein.

  9. Arteriovenous renal replacement therapy in end-stage left-sided heart failure patients has a detrimental effect on patients with impaired right ventricular function

    Directory of Open Access Journals (Sweden)

    Evangelos Repasos, MD

    2017-07-01

    Conclusion: In patients with end-stage HF, the creation of AVC for intermittent RRT was followed by a significant increase in morbidity and mortality in comparison to the safe and effective placement of permanent central venous catheters. Patients with elevated PVR seem to comprise a group at high risk for adverse outcomes after central catheter insertion.

  10. Re-evaluation of lung to thorax transverse area ratio immediately before birth in predicting postnatal short-term outcomes of fetuses with isolated left-sided congenital diaphragmatic hernia: A single center analysis.

    Science.gov (United States)

    Kido, Saki; Hidaka, Nobuhiro; Sato, Yuka; Fujita, Yasuyuki; Miyoshi, Kina; Nagata, Kouji; Taguchi, Tomoaki; Kato, Kiyoko

    2018-05-01

    We aimed to investigate whether the lung-to-thorax transverse area ratio (LTR) immediately before birth is of diagnostic value for the prediction of postnatal short-term outcomes in cases of isolated left-sided congenital diaphragmatic hernia (CDH). We retrospectively reviewed the cases of fetal isolated left-sided CDH managed at our institution between April 2008 and July 2016. We divided the patients into two groups based on LTR immediately before birth, using a cut-off value of 0.08. We compared the proportions of subjects within the two groups who survived until discharge using Fisher's exact test. Further, using Spearman's rank correlation, we assessed whether LTR was correlated with length of stay, duration of mechanical ventilation, and supplemental oxygen. Twenty-nine subjects were included (five with LTR < 0.08, and 24 with LTR ≥ 0.08). The proportion of subjects surviving until discharge was 40% (2/5) for patients with LTR < 0.08, as compared with 96% (23/24) for those with LTR ≥ 0.08. LTR measured immediately before birth was negatively correlated with the postnatal length of stay (Spearman's rank correlation coefficient, rs = -0.486), and the duration of supplemental oxygen (rs = -0.537). Further, the duration of mechanical ventilation was longer in patients with a lower LTR value. LTR immediately before birth is useful for the prediction of postnatal short-term outcomes in fetuses with isolated left-sided CDH. In particular, patients with prenatal LTR value less than 0.08 are at increased risk of postnatal death. © 2017 Japanese Teratology Society.

  11. Is it possible for knowledge-based planning to improve intensity modulated radiation therapy plan quality for planners with different planning experiences in left-sided breast cancer patients?

    Science.gov (United States)

    Wang, Juanqi; Hu, Weigang; Yang, Zhaozhi; Chen, Xiaohui; Wu, Zhiqiang; Yu, Xiaoli; Guo, Xiaomao; Lu, Saiquan; Li, Kaixuan; Yu, Gongyi

    2017-05-22

    Knowledge-based planning (KBP) is a promising technique that can improve plan quality and increase planning efficiency. However, no attempts have been made to extend the domain of KBP for planners with different planning experiences so far. The purpose of this study was to quantify the potential gains for planners with different planning experiences after implementing KBP in intensity modulated radiation therapy (IMRT) plans for left-sided breast cancer patients. The model libraries were populated with 80 expert clinical plans from treated patients who previously received left-sided breast-conserving surgery and IMRT with simultaneously integrated boost. The libraries were created on the RapidPlan TM . 6 planners with different planning experiences (2 beginner planners, 2 junior planners and 2 senior planners) generated manual and KBP optimized plans for additional 10 patients, similar to those included in the model libraries. The plan qualities were compared between manual and KBP plans. All plans were capable of achieving the prescription requirement. There were almost no statistically significant differences in terms of the planning target volume (PTV) coverage and dose conformality. It was demonstrated that the doses for most of organs-at-risk (OARs) were on average lower or equal in KBP plans compared to manual plans except for the senior planners, where the very small differences were not statistically significant. KBP data showed a systematic trend to have superior dose sparing at most parameters for the heart and ipsilateral lung. The observed decrease in the doses to these OARs could be achieved, particularly for the beginner and junior planners. Many differences were statistically significant. It is feasible to generate acceptable IMRT plans after implementing KBP for left-sided breast cancer. KBP helps to effectively improve the quality of IMRT plans against the benchmark of manual plans for less experienced planners without any manual intervention. KBP

  12. Three-Catheter Technique for Ablation of Left-Sided Accessory Pathways in Wolff-Parkinson-White is Less Expensive and Equally Successful When Compared to a Five-Catheter Technique.

    Science.gov (United States)

    Capone, Christine A; Ceresnak, Scott R; Nappo, Lynn; Gates, Gregory J; Schechter, Clyde B; Pass, Robert H

    2015-12-01

    To compare the efficacy, safety, and cost-effectiveness of a three-catheter approach with a conventional five-catheter approach for the mapping and ablation of supraventricular tachycardia in pediatric patients with Wolff-Parkinson-White Syndrome (WPW) and concealed accessory pathways (APs). A retrospective review from 2008 to 2012 of patients less than 21 years with WPW who underwent a three-catheter radiofrequency (RF) ablation of a left-sided AP (ablation, right ventricular [RV] apical, and coronary sinus [CS] decapolar catheters) was performed. The three-catheter group was compared to a control group who underwent a standard five-catheter (ablation, RV apical, CS decapolar, His catheter, and right atrial catheter) ablation for the treatment of left-sided WPW or concealed AP. Demographics, ablation outcomes, and costs were compared between groups. Twenty-eight patients met inclusion criteria with 28 control patients. The groups did not differ in gender, age, weight, or body surface area. Locations of the AP on the mitral annulus were similar between the groups. All patients were ablated via transseptal approach. Note that 28 of 28 in the three-catheter group (100%) and 27 of 28 (96%) controls were acutely successfully ablated (P = 0.31). No complications were encountered. There was no difference in procedural time, time to loss of AP conduction, or number of RF applications. Use of the three-catheter technique resulted in a total savings of $2,465/case, which includes the $680 savings from using fewer catheters as well as the savings from a shortened procedure time. Ablation in patients with WPW and a left-sided AP can be performed using three catheters with similar efficacy and safety while offering significant cost savings compared to a conventional five-catheter approach. © 2015 Wiley Periodicals, Inc.

  13. Positive pressure ventilation in a patient with a right upper lobar bronchocutaneous fistula: right upper bronchus occlusion using the cuff of a left-sided double lumen endobronchial tube.

    Science.gov (United States)

    Omori, Chieko; Toyama, Hiroaki; Takei, Yusuke; Ejima, Yutaka; Yamauchi, Masanori

    2017-08-01

    In patients with a bronchocutaneous fistula, positive pressure ventilation leads to air leakage and potential hypoxemia. A male patient with a right upper bronchocutaneous fistula was scheduled for esophageal reconstruction. His preoperative chest computed tomography image revealed aeration in the right middle and lower lobe, a large bulla in the left upper lobe, and pleural effusion and pneumonia in the left lower lobe. Therefore, left one-lung ventilation was considered to result in hypoxemia. Before anesthesia induction, the bronchocutaneous fistula was covered with gauze and film to prevent air leakage. After anesthesia induction, mask ventilation was performed with a peak positive pressure of 10 cmH 2 O. A left-sided double lumen endobronchial tube (DLT) was then inserted into the right main bronchus for occluding only the right superior bronchus, and two-lung ventilation was performed to minimize airway pressure and maintain oxygenation, which did not cause air leakage through the fistula. During anesthesia, no ventilation-related difficulty was faced. The method of inserting a left-sided DLT into the right main bronchus and occluding the right upper bronchus selectively by bronchial cuff is considered to be an option for mechanical ventilation in patients with a right upper bronchial fistula, as demonstrated in the present case.

  14. Dielectric electroactive polymers comprising an ionic supramolecular structure

    DEFF Research Database (Denmark)

    2014-01-01

    The present invention relates to an ionic interpenetrating polymer network comprising at least one elastomer and an ionic supramolecular structure comprising the reaction product of at least two chemical compounds wherein each of said compounds has at least two functional groups and wherein said ...... compounds are able to undergo Lewis acid-base reactions. The interpenetrating polymer network may be used as dielectric electroactive polymers (DEAPs) having a high dielectric permittivity....

  15. Analysis of the asymmetrically expressed Ablim1 locus reveals existence of a lateral plate Nodal-independent left sided signal and an early, left-right independent role for nodal flow

    Directory of Open Access Journals (Sweden)

    Hilton Helen

    2010-05-01

    Full Text Available Abstract Background Vertebrates show clear asymmetry in left-right (L-R patterning of their organs and associated vasculature. During mammalian development a cilia driven leftwards flow of liquid leads to the left-sided expression of Nodal, which in turn activates asymmetric expression of the transcription factor Pitx2. While Pitx2 asymmetry drives many aspects of asymmetric morphogenesis, it is clear from published data that additional asymmetrically expressed loci must exist. Results A L-R expression screen identified the cytoskeletally-associated gene, actin binding lim protein 1 (Ablim1, as asymmetrically expressed in both the node and left lateral plate mesoderm (LPM. LPM expression closely mirrors that of Nodal. Significantly, Ablim1 LPM asymmetry was detected in the absence of detectable Nodal. In the node, Ablim1 was initially expressed symmetrically across the entire structure, resolving to give a peri-nodal ring at the headfold stage in a flow and Pkd2-dependent manner. The peri-nodal ring of Ablim1 expression became asymmetric by the mid-headfold stage, showing stronger right than left-sided expression. Node asymmetry became more apparent as development proceeded; expression retreated in an anticlockwise direction, disappearing first from the left anterior node. Indeed, at early somite stages Ablim1 shows a unique asymmetric expression pattern, in the left lateral plate and to the right side of the node. Conclusion Left LPM Ablim1 is expressed in the absence of detectable LPM Nodal, clearly revealing existence of a Pitx2 and Nodal-independent left-sided signal in mammals. At the node, a previously unrecognised action of early nodal flow and Pkd2 activity, within the pit of the node, influences gene expression in a symmetric manner. Subsequent Ablim1 expression in the peri-nodal ring reveals a very early indication of L-R asymmetry. Ablim1 expression analysis at the node acts as an indicator of nodal flow. Together these results make

  16. Arteriovenous renal replacement therapy in end-stage left-sided heart failure patients has a detrimental effect on patients with impaired right ventricular function.

    Science.gov (United States)

    Repasos, Evangelos; Kaldara, Elisabeth; Pantsios, Christos; Kapelios, Chris; Nana, Emmeleia; Vernadakis, Spiridon; Melexopoulou, Christina; Malliaras, Konstantinos; Boletis, John; Nanas, John N

    Chronic intermittent renal replacement therapy(RRT) is an alternate method of decongestion for patients presenting with diuretic-resistant, end-stage heart failure(HF) and cardiorenal syndrome. The optimal method of vascular access has not been confirmed. This study investigated the 6-month outcomes of patients with end-stage HF after the creation of arteriovenous communications (AVC) compared with other means of RRT. We treated 40 patients with chronic, intermittent, ambulatory RRT, of whom 15 (37.5%; Group A) underwent creation of AVC, and 25 (62.5%; Group B) received intraperitoneal (n=6) or internal jugular catheters (n=19) with the goal of achieving body weight stabilization and relief from congestion. The characteristics of the two groups were similar. According to Cox regression analysis, the 6-month rate of death or re-hospitalization for HF was significantly higher in Group A (73%) than in Group B (44%); hazard ratio (HR): 2.58; 95% confidence interval (CI) 1.2-6.2; P=0.02. Over a 6-month follow-up, the cumulative survival was significantly shorter (P=0.03) in Group A (13.8±10 weeks) than in Group B (20.7±7 weeks). In the 15 patients who received AVC, the only independent predictor of adverse outcome at 6 months was serum total bilirubin concentration (HR 2.5; 95% CI 1.1-5.7, p=0.02), whereas in the 25 patients who underwent other means of RRT, pulmonary vascular resistance (PVR) was identified as a risk factor for hospitalization or death at 1-year follow-up (HR 1.26; 95% CI 1.1-1.57, p=0.04). In patients with end-stage HF, the creation of AVC for intermittent RRT was followed by a significant increase in morbidity and mortality in comparison to the safe and effective placement of permanent central venous catheters. Patients with elevated PVR seem to comprise a group at high risk for adverse outcomes after central catheter insertion. Copyright © 2016 Hellenic Society of Cardiology. Published by Elsevier B.V. All rights reserved.

  17. Self-Expandable Metallic Stent for the Palliative Treatment of Obstructing Left-Sided Colorectal Cancer under Fluoroscopic Guidance: A Comparison of the Clinical Results according to Stent Diameter

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Pyeong Guk; Hong, Hyun Pyo; Choi, Yoon Jung; Lee, Min Hee; Park, Hae Won; Chung, Eun Chul [Kangbuk Samsung Hospital, Seoul (Korea, Republic of); Kim, Sam Soo [Kangwon National University College of Medicine, Chuncheon (Korea, Republic of)

    2010-03-15

    To evaluate the feasibility, effectiveness, and safety of self-expandable metallic stent for the palliative treatment of obstructing left-sided colorectal cancer under fluoroscopic guidance, and to compare results according to the stent diameter. Under fluoroscopic guidance, 31 self-expandable metallic stents were placed into 25 patients for palliative purposes. The rates of technical success, clinical success, complications associated with stent insertion, patient survival, and primary stent patency were evaluated. The results were also compared between two groups: 13 patients using stents with a diameter of 22 mm and 12 patients using stents with a diameter of 26 mm. The technical and clinical success rates were 93.5 and 90.3%, respectively. The complications included severe abdominal pain (6.5%), minor rectal bleeding (9.7%), stent migration (9.7%), and tumor ingrowth or overgrowth (9.7%). No statistical differences in technical were detected between the two groups for the clinical success rate and complication rates. The mean survival time was 5.5 +- 1.4 months. The primary stent patency rates were 91.3% at 5 months, 85.2% at 10 months, and 77.4% at 15 months. The mean period of stent patency was 12.4 +- 2.6 months. The mean period of primary stent patency was 16.4 +- 2.6 months in the 26 mm stent group, and significantly higher than 5.4 +- 1.4 months in the 22 mm stent group (p=0.031). A self-expandable metallic stent under fluoroscopic guidance, for the palliative treatment of obstructing left-sided colorectal cancer, was feasible and effective, and yielded good clinical results. The period of primary stent patency of the 26 mm stent group was longer than the 22 mm stent group, and the complication rate was not significantly different between the two stent groups

  18. Self-Expandable Metallic Stent for the Palliative Treatment of Obstructing Left-Sided Colorectal Cancer under Fluoroscopic Guidance: A Comparison of the Clinical Results according to Stent Diameter

    International Nuclear Information System (INIS)

    Kang, Pyeong Guk; Hong, Hyun Pyo; Choi, Yoon Jung; Lee, Min Hee; Park, Hae Won; Chung, Eun Chul; Kim, Sam Soo

    2010-01-01

    To evaluate the feasibility, effectiveness, and safety of self-expandable metallic stent for the palliative treatment of obstructing left-sided colorectal cancer under fluoroscopic guidance, and to compare results according to the stent diameter. Under fluoroscopic guidance, 31 self-expandable metallic stents were placed into 25 patients for palliative purposes. The rates of technical success, clinical success, complications associated with stent insertion, patient survival, and primary stent patency were evaluated. The results were also compared between two groups: 13 patients using stents with a diameter of 22 mm and 12 patients using stents with a diameter of 26 mm. The technical and clinical success rates were 93.5 and 90.3%, respectively. The complications included severe abdominal pain (6.5%), minor rectal bleeding (9.7%), stent migration (9.7%), and tumor ingrowth or overgrowth (9.7%). No statistical differences in technical were detected between the two groups for the clinical success rate and complication rates. The mean survival time was 5.5 ± 1.4 months. The primary stent patency rates were 91.3% at 5 months, 85.2% at 10 months, and 77.4% at 15 months. The mean period of stent patency was 12.4 ± 2.6 months. The mean period of primary stent patency was 16.4 ± 2.6 months in the 26 mm stent group, and significantly higher than 5.4 ± 1.4 months in the 22 mm stent group (p=0.031). A self-expandable metallic stent under fluoroscopic guidance, for the palliative treatment of obstructing left-sided colorectal cancer, was feasible and effective, and yielded good clinical results. The period of primary stent patency of the 26 mm stent group was longer than the 22 mm stent group, and the complication rate was not significantly different between the two stent groups

  19. Impact of patient-specific factors, irradiated left ventricular volume, and treatment set-up errors on the development of myocardial perfusion defects after radiation therapy for left-sided breast cancer

    International Nuclear Information System (INIS)

    Evans, Elizabeth S.; Prosnitz, Robert G.; Yu Xiaoli; Zhou Sumin; Hollis, Donna R.; Wong, Terence Z.; Light, Kim L.; Hardenbergh, Patricia H.; Blazing, Michael A.; Marks, Lawrence B.

    2006-01-01

    Purpose: The aim of this study was to assess the impact of patient-specific factors, left ventricle (LV) volume, and treatment set-up errors on the rate of perfusion defects 6 to 60 months post-radiation therapy (RT) in patients receiving tangential RT for left-sided breast cancer. Methods and Materials: Between 1998 and 2005, a total of 153 patients were enrolled onto an institutional review board-approved prospective study and had pre- and serial post-RT (6-60 months) cardiac perfusion scans to assess for perfusion defects. Of the patients, 108 had normal pre-RT perfusion scans and available follow-up data. The impact of patient-specific factors on the rate of perfusion defects was assessed at various time points using univariate and multivariate analysis. The impact of set-up errors on the rate of perfusion defects was also analyzed using a one-tailed Fisher's Exact test. Results: Consistent with our prior results, the volume of LV in the RT field was the most significant predictor of perfusion defects on both univariate (p = 0.0005 to 0.0058) and multivariate analysis (p = 0.0026 to 0.0029). Body mass index (BMI) was the only significant patient-specific factor on both univariate (p = 0.0005 to 0.022) and multivariate analysis (p = 0.0091 to 0.05). In patients with very small volumes of LV in the planned RT fields, the rate of perfusion defects was significantly higher when the fields set-up 'too deep' (83% vs. 30%, p = 0.059). The frequency of deep set-up errors was significantly higher among patients with BMI ≥25 kg/m 2 compared with patients of normal weight (47% vs. 28%, p = 0.068). Conclusions: BMI ≥25 kg/m 2 may be a significant risk factor for cardiac toxicity after RT for left-sided breast cancer, possibly because of more frequent deep set-up errors resulting in the inclusion of additional heart in the RT fields. Further study is necessary to better understand the impact of patient-specific factors and set-up errors on the development of RT

  20. GAS SEPARATION MEMBRANES COMPRISING PERMEABILITY ENHANCING ADDITIVES

    NARCIS (Netherlands)

    Wessling, Matthias; Sterescu, D.M.; Stamatialis, Dimitrios

    2007-01-01

    The present invention relates to polymer compositions comprising a (co)polymer comprising (a) an arylene oxide moiety and (b) a dendritic (co)polymer, a hyperbranched (co)polymer or a mixture thereof, and the use of these polymer compositions as membrane materials for the separation of gases. The

  1. Cationic electrodepositable coating composition comprising lignin

    Science.gov (United States)

    Fenn, David; Bowman, Mark P; Zawacky, Steven R; Van Buskirk, Ellor J; Kamarchik, Peter

    2013-07-30

    A cationic electrodepositable coating composition is disclosed. The present invention in directed to a cationic electrodepositable coating composition comprising a lignin-containing cationic salt resin, that comprises (A) the reaction product of: lignin, an amine, and a carbonyl compound; (B) the reaction product of lignin, epichlorohydrin, and an amine; or (C) combinations thereof.

  2. Semiconductor device comprising a pn-heterojunction

    NARCIS (Netherlands)

    2007-01-01

    An electric device is disclosed comprising a pn-heterojunction ( 4 ) formed by a nanowire ( 3 ) of 111 -V semiconductor material and a semiconductor body ( 1 ) comprising a group IV semiconductor material. The nanowire ( 3 ) is positioned in direct contact with the surface ( 2 ) of the semiconductor

  3. Cerebral and Renal Oxygen Saturation Are Not Compromised in the Presence of Retrograde Blood Flow in either the Ascending or Descending Aorta in Term or Near-Term Infants with Left-Sided Obstructive Lesions.

    Science.gov (United States)

    van der Laan, Michelle E; Mebius, Mirthe J; Roofthooft, Marcus T R; Bos, Arend F; Berger, Rolf M F; Kooi, Elisabeth M W

    2017-01-01

    In infants with left-sided obstructive lesions (LSOL), the presence of retrograde blood flow in either the ascending or descending aorta may lead to diminished cerebral and renal blood flow, respectively. Our aim was to compare cerebral and renal tissue oxygen saturation (rSO2) between infants with LSOL with antegrade and retrograde blood flow in the ascending aorta and with and without diastolic backflow in the descending aorta. Based on 2 echocardiograms, the study group was categorized according to the direction of blood flow in the ascending and descending aorta. We measured cerebral and renal rSO2 using near-infrared spectroscopy and calculated fractional tissue oxygen extraction (FTOE). Nineteen infants with LSOL, admitted to the NICU between 0 and 28 days after birth, were included. Infants with antegrade blood flow (n = 12) and infants with retrograde blood flow in the ascending aorta (n = 7) had similar cerebral rSO2 and FTOE during both echocardiograms. Only during the first echocardiogram, infants with retrograde blood flow in the ascending aorta had lower renal FTOE (0.14 vs. 0.32, p = 0.04) and tended to have higher renal rSO2 (80 vs. 65%, p = 0.09). The presence of diastolic backflow in the descending aorta was not associated with cerebral or renal rSO2 and FTOE during the first (n = 8) as well as the second echocardiogram (n = 10). Retrograde blood flow in the ascending aorta was not associated with cerebral oxygenation, while diastolic backflow in the descending aorta was not associated with renal oxygenation in infants with LSOL. © 2017 S. Karger AG, Basel.

  4. Dosimetric Comparison of Intensity-Modulated Radiotherapy Plans, With or Without Anterior Myocardial Territory and Left Ventricle as Organs at Risk, in Early-Stage Left-Sided Breast Cancer Patients

    International Nuclear Information System (INIS)

    Tan Wenyong; Wang Xiaohong; Qiu Dasheng; Liu Dong; Jia Shaohui; Zeng Fanyu; Chen Zhengwang; Li Beihui; Xu Jiaozhen; Wei Lai; Hu Desheng

    2011-01-01

    Purpose: We evaluated heart sparing using an intensity-modulated radiotherapy (IMRT) plan with the left ventricle (LV) and/or the anterior myocardial territory (AMT) as additional organs at risk (OARs). Methods and Materials: A total of 10 patients with left-sided breast cancer were selected for dosimetric planning. Both lungs, the right breast, heart, LV, and AMT were defined as OARs. We generated one tangential field plan and four IMRT plans for each patient. We examined the dose–volume histogram parameters of the planning target volume and OARs. Results: Compared with the tangential field plan, the mean dose to the heart in the IMRT plans did not show significant differences; however, the dose to the AMT and LV decreased by 18.7–45.4% and 10.8–37.4%, respectively. The maximal dose to the heart decreased by 18.6–35.3%, to the AMT by 22.0–45.1%, and to the LV by 23.5–45.0%, And the relative volumes of the heart (V ≥12 ), AMT (V >11 ) and LV (V >10 ) decreased significantly with different levels, respectively. The volume of the heart, AMT, LV, both lungs, and right breast receiving ≥5 Gy showed a significant increase. Compared with the IMRT (H) plan, the mean dose to the heart, AMT, and LV decreased by 17.5–21.5%, 25.2–29.8%, and 22.8–29.8% and the maximal dose by 13.6–20.6%, 23.1–29.6%, and 17.3–29.1%, respectively. The IMRT plans for both lungs and the right breast showed no significant differences. Conclusions: The IMRT plans with the addition of the AMT and/or LV as OARs considerably increased heart sparing. We recommend including the LV as an additional OAR in such plans.

  5. Composition comprising lignin and antidi arrheal component

    DEFF Research Database (Denmark)

    2008-01-01

    The present invention relates to a composition comprising lignin and at least one compound selected from the group consisting of bromelain, papain, tannin, carvacrol, thymol, alliin, allicin, fenugreek seed, egg, poppy, poppy seeds, humic acid, roots, kaolin, catechu, cellulase, flavonoid...

  6. Dosimetric comparison for volumetric modulated arc therapy and intensity-modulated radiotherapy on the left-sided chest wall and internal mammary nodes irradiation in treating post-mastectomy breast cancer

    International Nuclear Information System (INIS)

    Zhang, Qian; Yu, Xiao Li; Hu, Wei Gang; Chen, Jia Yi; Wang, Jia Zhou; Ye, Jin Song; Guo, Xiao Mao

    2015-01-01

    The aim of the study was to evaluate the dosimetric benefit of applying volumetric modulated arc therapy (VMAT) on the post-mastectomy left-sided breast cancer patients, with the involvement of internal mammary nodes (IMN). The prescription dose was 50 Gy delivered in 25 fractions, and the clinical target volume included the left chest wall (CW) and IMN. VMAT plans were created and compared with intensity-modulated radiotherapy (IMRT) plans on Pinnacle treatment planning system. Comparative endpoints were dose homogeneity within planning target volume (PTV), target dose coverage, doses to the critical structures including heart, lungs and the contralateral breast, number of monitor units and treatment delivery time. VMAT and IMRT plans showed similar PTV dose homogeneity, but, VMAT provided a better dose coverage for IMN than IMRT (p = 0.017). The mean dose (Gy), V 30 (%) and V 10 (%) for the heart were 13.5 ± 5.0 Gy, 9.9% ± 5.9% and 50.2% ± 29.0% by VMAT, and 14.0 ± 5.4 Gy, 10.6% ± 5.8% and 55.7% ± 29.6% by IMRT, respectively. The left lung mean dose (Gy), V 20 (%), V 10 (%) and the right lung V 5 (%) were significantly reduced from 14.1 ± 2.3 Gy, 24.2% ± 5.9%, 42.4% ± 11.9% and 41.2% ± 12.3% with IMRT to 12.8 ± 1.9 Gy, 21.0% ± 3.8%, 37.1% ± 8.4% and 32.1% ± 18.2% with VMAT, respectively. The mean dose to the contralateral breast was 1.7 ± 1.2 Gy with VMAT and 2.3 ± 1.6 Gy with IMRT. Finally, VMAT reduced the number of monitor units by 24% and the treatment time by 53%, as compared to IMRT. Compared to 5-be am step-and-shot IMRT, VMAT achieves similar or superior target coverage and a better normal tissue sparing, with fewer monitor units and shorter delivery time

  7. Coating compositions comprising bismuth-alloyed zinc

    DEFF Research Database (Denmark)

    2008-01-01

    The present application discloses (i) a coating composition comprising a particulate zinc-based alloyed material, said material comprising 0.05-0.7% by weight of bismuth (Bi), the D50 of the particulate material being in the range of 2.5-30 µm; (ii) a coated structure comprising a metal structure...... having a first coating of the zinc-containing coating composition applied onto at least a part of the metal structure in a dry film thickness of 5-100 µm; and an outer coating applied onto said zinc-containing coating in a dry film thickness of 30-200 µm; (iii) a particulate zinc-based alloyed material......, wherein the material comprises 0.05-0.7%(w/w) of bismuth (Bi), and wherein the D50 of the particulate material is in the range of 2.5-30 µm; (iv) a composite powder consisting of at least 25%(w/w) of the particulate zinc-based alloyed material, the rest being a particulate material consisting of zinc...

  8. Biocatalytic material comprising multilayer enzyme coated fiber

    Science.gov (United States)

    Kim, Jungbae [Richland, WA; Kwak, Ja Hun [Richland, WA; Grate, Jay W [West Richland, WA

    2009-11-03

    The present invention relates generally to high stability, high activity biocatalytic materials and processes for using the same. The materials comprise enzyme aggregate coatings having high biocatalytic activity and stability useful in heterogeneous environment. These new materials provide a new biocatalytic immobilized enzyme system with applications in bioconversion, bioremediation, biosensors, and biofuel cells.

  9. Downhole transmission system comprising a coaxial capacitor

    Science.gov (United States)

    Hall, David R [Provo, UT; Pixton, David S [Lehi, UT; Johnson, Monte L [Orem, UT; Bartholomew, David B [Springville, UT; Hall, Jr., H. Tracy; Rawle, Michael [Springville, UT

    2011-05-24

    A transmission system in a downhole component comprises a plurality of data transmission elements. A coaxial cable having an inner conductor and an outer conductor is disposed within a passage in the downhole component such that at least one capacitor is disposed in the passage and having a first terminal coupled to the inner conductor and a second terminal coupled to the outer conductor. Preferably the transmission element comprises an electrically conducting coil. Preferably, within the passage a connector is adapted to electrically connect the inner conductor of the coaxial cable and the lead wire. The coaxial capacitor may be disposed between and in electrically communication with the connector and the passage. In another embodiment a connector is adapted to electrical connect a first and a second portion of the inner conductor of the coaxial cable and a coaxial capacitor is in electrical communication with the connector and the passage.

  10. Nanophosphor composite scintillators comprising a polymer matrix

    Science.gov (United States)

    Muenchausen, Ross Edward; Mckigney, Edward Allen; Gilbertson, Robert David

    2010-11-16

    An improved nanophosphor composite comprises surface modified nanophosphor particles in a solid matrix. The nanophosphor particle surface is modified with an organic ligand, or by covalently bonding a polymeric or polymeric precursor material. The surface modified nanophosphor particle is essentially charge neutral, thereby preventing agglomeration of the nanophosphor particles during formation of the composite material. The improved nanophosphor composite may be used in any conventional scintillator application, including in a radiation detector.

  11. Resonant power converter comprising adaptive dead-time control

    DEFF Research Database (Denmark)

    2017-01-01

    The invention relates in a first aspect to a resonant power converter comprising: a first power supply rail for receipt of a positive DC supply voltage and a second power supply rail for receipt of a negative DC supply voltage. The resonant power converter comprises a resonant network with an input...... terminal for receipt of a resonant input voltage from a driver circuit. The driver circuit is configured for alternatingly pulling the resonant input voltage towards the positive and negative DC supply voltages via first and second semiconductor switches, respectively, separated by intervening dead......-time periods in accordance with one or more driver control signals. A dead-time controller is configured to adaptively adjusting the dead-time periods based on the resonant input voltage....

  12. Fibrous composites comprising carbon nanotubes and silica

    Science.gov (United States)

    Peng, Huisheng [Shanghai, CN; Zhu, Yuntian Theodore [Cary, NC; Peterson, Dean E [Los Alamos, NM; Jia, Quanxi [Los Alamos, NM

    2011-10-11

    Fibrous composite comprising a plurality of carbon nanotubes; and a silica-containing moiety having one of the structures: (SiO).sub.3Si--(CH.sub.2).sub.n--NR.sub.1R.sub.2) or (SiO).sub.3Si--(CH.sub.2).sub.n--NCO; where n is from 1 to 6, and R.sub.1 and R.sub.2 are each independently H, CH.sub.3, or C.sub.2H.sub.5.

  13. Method of forming a nanocluster comprising dielectric layer and device comprising such a layer

    NARCIS (Netherlands)

    2009-01-01

    A method of forming a dielectric layer (330) on a further layer (114, 320) of a semiconductor device (300) is disclosed. The method comprises depositing a dielectric precursor compound and a further precursor compound over the further layer (114, 320), the dielectric precursor compound comprising a

  14. Electromagnetic radiation absorbers and modulators comprising polyaniline

    Science.gov (United States)

    Epstein, Arthur J.; Ginder, John M.; Roe, Mitchell G.; Hajiseyedjavadi, Hamid

    1992-01-01

    A composition for absorbing electromagnetic radiation, wherein said electromagnetic radiation possesses a wavelength generally in the range of from about 1000 Angstroms to about 50 meters, wherein said composition comprises a polyaniline composition of the formula ##STR1## where y can be equal to or greater than zero, and R.sup.1 and R.sup.2 are independently selected from the group containing of H, --OCH.sub.3, --CH.sub.3, --F, --Cl, --Br, --I, NR.sup.3 .sub.2, --NHCOR.sup.3, --OH, --O.sup.-, SR.sup.3, --OCOR.sup.3, --NO.sub.2, --COOH, --COOR.sup.3, --COR.sup.3, --CHO, and --CN, where R.sup.3 is a C.sub.1 to C.sub.8 alkyl, aryl or aralkyl group.

  15. Epidermal growth factor enemas for induction of remission in left-sided ulcerative colitis Enemas de factor de crecimiento epidérmico para inducir la remisión de la colitis ulcerosa izquierda

    Directory of Open Access Journals (Sweden)

    Hugo Nodarse-Cuní

    2013-03-01

    Full Text Available Introduction: ulcerative colitis is a little known chronic inflammatory disease in colonic mucosa. The positive effect of epidermal growth factor was shown in a previous report, with enema use for treatment of mild to moderate left-sided manifestation of the disease. This evidence provided the basis for evaluating the efficacy and safety profile of a viscous solution of this product. Methods: thirty-one patients were randomized to three groups for daily medications during 14 days. Twelve received one 10 mg enema of epidermal growth factor dissolved in 100 mL of viscous solution whereas nine were treated with placebo enema; both groups also received 1.2 g of oral mesalamine per day. The other group included ten patients with 3 g / 100 mL of mesalamine enema. Primary end point was clinical responses after two weeks of treatment, defined as a decreased of, at least three points from baseline, the Disease Activity Index and endoscopic or histological evidences of improvement. Results: remission of disease was observed in all patients in the epidermal growth factor group, and six in both, mesalamine enema and placebo group. All the comparisons between groups showed statistically significant superiority for epidermal growth factor, the only product with significant reduction in disease activity index as well as the presence and intensity of digestive symptoms in patients after treatment. None adverse event was reported. Conclusions: the results agree with previous molecular and clinical evidences, indicating that the epidermal growth factor is effective to reduce disease activity and to induce remission. A new study involving more patients should be conducted to confirm the efficacy of the epidermal growth factor enemas.Introducción: la colitis ulcerosa es una enfermedad inflamatoria crónica de etiología poco conocida, que afecta la mucosa del colon. El efecto positivo del factor de crecimiento epidérmico fue reportado en estudio previo con uso de

  16. Modeling superhydrophobic surfaces comprised of random roughness

    Science.gov (United States)

    Samaha, M. A.; Tafreshi, H. Vahedi; Gad-El-Hak, M.

    2011-11-01

    We model the performance of superhydrophobic surfaces comprised of randomly distributed roughness that resembles natural surfaces, or those produced via random deposition of hydrophobic particles. Such a fabrication method is far less expensive than ordered-microstructured fabrication. The present numerical simulations are aimed at improving our understanding of the drag reduction effect and the stability of the air-water interface in terms of the microstructure parameters. For comparison and validation, we have also simulated the flow over superhydrophobic surfaces made up of aligned or staggered microposts for channel flows as well as streamwise or spanwise ridge configurations for pipe flows. The present results are compared with other theoretical and experimental studies. The numerical simulations indicate that the random distribution of surface roughness has a favorable effect on drag reduction, as long as the gas fraction is kept the same. The stability of the meniscus, however, is strongly influenced by the average spacing between the roughness peaks, which needs to be carefully examined before a surface can be recommended for fabrication. Financial support from DARPA, contract number W91CRB-10-1-0003, is acknowledged.

  17. Compositions comprising free-standing two-dimensional nanocrystals

    Energy Technology Data Exchange (ETDEWEB)

    Barsoum, Michel W.; Gogotsi, Yury; Abdelmalak, Michael Naguib; Mashtalir, Olha

    2017-12-05

    The present invention is directed to methods of transferring urea from an aqueous solution comprising urea to a MXene composition, the method comprising contacting the aqueous solution comprising urea with the MXene composition for a time sufficient to form an intercalated MXene composition comprising urea.

  18. Artificial skin and patient simulator comprising the artificial skin

    NARCIS (Netherlands)

    2011-01-01

    The invention relates to an artificial skin (10, 12, 14), and relates to a patient simulator (100) comprising the artificial skin. The artificial skin is a layered structure comprising a translucent cover layer (20) configured for imitating human or animal skin, and comprising a light emitting layer

  19. Coated silicon comprising material for protection against environmental corrosion

    Science.gov (United States)

    Hazel, Brian Thomas (Inventor)

    2009-01-01

    In accordance with an embodiment of the invention, an article is disclosed. The article comprises a gas turbine engine component substrate comprising a silicon material; and an environmental barrier coating overlying the substrate, wherein the environmental barrier coating comprises cerium oxide, and the cerium oxide reduces formation of silicate glass on the substrate upon exposure to corrodant sulfates.

  20. Left Sided Trans-thoracic Esophagectomy for Resectable ...

    African Journals Online (AJOL)

    ADMIN

    Background: Surgery is the main stay of treatment for Esophageal Cancer but there is no .... patients and a nasogastric tube positioned in the gastric tube in all. .... infection, thorough drainage of the thoracic cavity, maintenance of nutrition and ...

  1. intraoperative colonic irrigation in the management of left sided ...

    African Journals Online (AJOL)

    hi-tech

    2000-11-01

    Nov 1, 2000 ... emergency resection of selected distal colonic lesions. INTRODUCTION ... constipation. Only five cases required further evaluation by plain x-rays to establish ... contamination and established peritonitis were lavaged with tetracycline ... The clinical course and post-operative complications were carefully ...

  2. Diagnostic evaluation of left-sided prosthetic heart valve dysfunction

    NARCIS (Netherlands)

    Habets, Jesse; Budde, Ricardo P.; Symersky, Petr; van den Brink, Renee B.; de Mol, Bas A.; Mali, Willem P.; van Herwerden, Lex A.; Chamuleau, Steven A.

    Prosthetic heart valve (PHV) dysfunction is a rare, but potentially life-threatening, complication. In clinical practice, PHV dysfunction poses a diagnostic dilemma. Echocardiography and fluoroscopy are the imaging techniques of choice and are routinely used in daily practice. However, these

  3. Diagnostic evaluation of left-sided prosthetic heart valve dysfunction

    NARCIS (Netherlands)

    Habets, Jesse; Budde, Ricardo P.; Symersky, Petr; van den Brink, Renee B.; de Mol, Bas A.; Mali, Willem P.; van Herwerden, Lex A.; Chamuleau, Steven A.

    2011-01-01

    Prosthetic heart valve (PHV) dysfunction is a rare, but potentially life-threatening, complication. In clinical practice, PHV dysfunction poses a diagnostic dilemma. Echocardiography and fluoroscopy are the imaging techniques of choice and are routinely used in daily practice. However, these

  4. Linezolid as rescue treatment for left-sided infective endocarditis

    DEFF Research Database (Denmark)

    Lauridsen, Trine Kiilerich; Bruun, Louise E; Rasmussen, R V

    2012-01-01

    The increasing number of resistant bacterial strains in infective endocarditis (IE) emphasizes the need for a constant development of antimicrobials. Linezolid is an oxazolidinone with an effect on Gram-positive cocci. Only a few casuistic reports describe its utilization in the treatment of IE...

  5. Compositions comprising enhanced graphene oxide structures and related methods

    Science.gov (United States)

    Kumar, Priyank Vijaya; Bardhan, Neelkanth M.; Belcher, Angela; Grossman, Jeffrey

    2016-12-27

    Embodiments described herein generally relate to compositions comprising a graphene oxide species. In some embodiments, the compositions advantageously have relatively high oxygen content, even after annealing.

  6. Zinc comprising coordination compounds as growth stimulants of cotton seeds

    International Nuclear Information System (INIS)

    Yusupov, Z.N.; Nurmatov, T.M.; Rakhimova, M.M.; Dzhafarov, M.I.; Nikolaeva, T.B.

    1991-01-01

    Present article is devoted to zinc comprising coordination compounds as growth stimulants of cotton seeds. The influence of zinc coordination compounds with physiologically active ligands on germinative energy and seed germination of cotton was studied. The biogical activity and effectiveness of zinc comprising coordination compounds at application them for humidification of cotton seeds was studied as well.

  7. Electrochemical energy storage devices comprising self-compensating polymers

    Science.gov (United States)

    Johnson, Paul; Bautista-Martinez, Jose Antonio; Friesen, Cody; Switzer, Elise

    2018-01-30

    The disclosed technology relates generally to devices comprising conductive polymers and more particularly to electrochemical devices comprising self-compensating conductive polymers. In one aspect, electrochemical energy storage device comprises a negative electrode comprising an active material including a redox-active polymer. The device additionally comprises a positive electrode comprising an active material including a redox-active polymer. The device further comprises an electrolyte material interposed between the negative electrode and positive electrode and configured to conduct mobile counterions therethrough between the negative electrode and positive electrode. At least one of the negative electrode redox-active polymer and the positive electrode redox-active polymer comprises a zwitterionic polymer unit configured to reversibly switch between a zwitterionic state in which the zwitterionic polymer unit has first and second charge centers having opposite charge states that compensate each other, and a non-zwitterionic state in which the zwitterionic polymer unit has one of the first and second charge centers whose charge state is compensated by mobile counterions.

  8. Printhead and inkjet printer comprising such a printhead

    NARCIS (Netherlands)

    2007-01-01

    The invention relates to a printhead comprising multiple substantially closed ink chambers (13), the ink chambers being mutually separated by at least one wall (12), wherein each of the chambers comprises an electro-mechanical converter (15), where actuation of the converter leads to a volume change

  9. A reconfigurable on-line learning spiking neuromorphic processor comprising 256 neurons and 128K synapses.

    Science.gov (United States)

    Qiao, Ning; Mostafa, Hesham; Corradi, Federico; Osswald, Marc; Stefanini, Fabio; Sumislawska, Dora; Indiveri, Giacomo

    2015-01-01

    Implementing compact, low-power artificial neural processing systems with real-time on-line learning abilities is still an open challenge. In this paper we present a full-custom mixed-signal VLSI device with neuromorphic learning circuits that emulate the biophysics of real spiking neurons and dynamic synapses for exploring the properties of computational neuroscience models and for building brain-inspired computing systems. The proposed architecture allows the on-chip configuration of a wide range of network connectivities, including recurrent and deep networks, with short-term and long-term plasticity. The device comprises 128 K analog synapse and 256 neuron circuits with biologically plausible dynamics and bi-stable spike-based plasticity mechanisms that endow it with on-line learning abilities. In addition to the analog circuits, the device comprises also asynchronous digital logic circuits for setting different synapse and neuron properties as well as different network configurations. This prototype device, fabricated using a 180 nm 1P6M CMOS process, occupies an area of 51.4 mm(2), and consumes approximately 4 mW for typical experiments, for example involving attractor networks. Here we describe the details of the overall architecture and of the individual circuits and present experimental results that showcase its potential. By supporting a wide range of cortical-like computational modules comprising plasticity mechanisms, this device will enable the realization of intelligent autonomous systems with on-line learning capabilities.

  10. Medical preparation container comprising microwave powered sensor assembly

    DEFF Research Database (Denmark)

    2016-01-01

    The present invention relates to a medical preparation container which comprises a microwave powered sensor assembly. The microwave powered sensor assembly comprises a sensor configured to measure a physical property or chemical property of a medical preparation during its heating in a microwave ...... oven. The microwave powered sensor assembly is configured for harvesting energy from microwave radiation emitted by the microwave oven and energize the sensor by the harvested microwave energy.......The present invention relates to a medical preparation container which comprises a microwave powered sensor assembly. The microwave powered sensor assembly comprises a sensor configured to measure a physical property or chemical property of a medical preparation during its heating in a microwave...

  11. Metal-polymer composites comprising nanostructures and applications thereof

    Science.gov (United States)

    Wang, Hsing-Lin [Los Alamos, NM; Jeon, Sea Ho [Dracut, MA; Mack, Nathan H [Los Alamos, NM

    2011-08-02

    Metal-polymer composites, and methods of making and use thereof, said composites comprising a thermally-cured dense polyaniline substrate; an acid dopant; and, metal nanostructure deposits wherein the deposits have a morphology dependent upon the acid dopant.

  12. Immunogenic compositions comprising human immunodeficiency virus (HIV) mosaic Nef proteins

    Science.gov (United States)

    Korber, Bette T [Los Alamos, NM; Perkins, Simon [Los Alamos, NM; Bhattacharya, Tanmoy [Los Alamos, NM; Fischer, William M [Los Alamos, NM; Theiler, James [Los Alamos, NM; Letvin, Norman [Boston, MA; Haynes, Barton F [Durham, NC; Hahn, Beatrice H [Birmingham, AL; Yusim, Karina [Los Alamos, NM; Kuiken, Carla [Los Alamos, NM

    2012-02-21

    The present invention relates to mosaic clade M HIV-1 Nef polypeptides and to compositions comprising same. The polypeptides of the invention are suitable for use in inducing an immune response to HIV-1 in a human.

  13. Compositions, methods, and systems comprising fluorous-soluble polymers

    Science.gov (United States)

    Swager, Timothy M.; Lim, Jeewoo; Takeda, Yohei

    2015-10-13

    The present invention generally relates to compositions, methods, and systems comprising polymers that are fluorous-soluble and/or organize at interfaces between a fluorous phase and a non-fluorous phase. In some embodiments, emulsions or films are provided comprising a polymer. The polymers, emulsions, and films can be used in many applications, including for determining, treating, and/or imaging a condition and/or disease in a subject. The polymer may also be incorporated into various optoelectronic device such as photovoltaic cells, organic light-emitting diodes, organic field effect transistors, or the like. In some embodiments, the polymers comprise pi-conjugated backbones, and in some cases, are highly emissive.

  14. Thermoacoustic refrigerators and engines comprising cascading stirling thermodynamic units

    Science.gov (United States)

    Backhaus, Scott; Swift, Greg

    2013-06-25

    The present invention includes a thermoacoustic assembly and method for improved efficiency. The assembly has a first stage Stirling thermal unit comprising a main ambient heat exchanger, a regenerator and at least one additional heat exchanger. The first stage Stirling thermal unit is serially coupled to a first end of a quarter wavelength long coupling tube. A second stage Stirling thermal unit comprising a main ambient heat exchanger, a regenerator, and at least one additional heat exchanger, is serially coupled to a second end of the quarter wavelength long coupling tube.

  15. DC-to-DC converter comprising a reconfigurable capacitor unit

    NARCIS (Netherlands)

    2008-01-01

    The present invention relates to a configurable trench multi-capacitor device comprising a trench in a semiconductor substrate. The trench has a lateral extension exceeding 10 micrometer and a trench filling includes a number of at least four electrically conductive capacitor-electrode layers. A

  16. Hot gas handling device and motorized vehicle comprising the device

    NARCIS (Netherlands)

    Klein Geltink, J.; Beukers, A.; Van Tooren, M.J.L.; Koussios, S.

    2012-01-01

    The invention relates to a device for handling hot exhaust gasses discharged from an internal combustion engine. The device comprises a housing (2), enclosing a space (3) for transporting the exhaust gasses. The housing (2) is provided with an entrance - opening (4) for the exhaust gasses discharged

  17. Non-cementitious compositions comprising vaterite and methods thereof

    Science.gov (United States)

    Devenney, Martin; Fernandez, Miguel; Morgan, Samuel O.

    2015-09-15

    Non-cementitious compositions and products are provided. The compositions of the invention include a carbonate additive comprising vaterite such as reactive vaterite. Additional aspects of the invention include methods of making and using the non-cementitious compositions and products.

  18. DC-to-DC converter comprising a reconfigurable capacitor unit

    NARCIS (Netherlands)

    Klootwijk, J.H.; Bergveld, H.J.; Roozeboom, F.; Reefman, D.; Ruigrok, J.

    2013-01-01

    The present invention relates to a configurable trench multi-capacitor device comprising a trench in a semiconductor substrate. The trench has a lateral extension exceeding 10 micrometer and a trench filling includes a number of at least four electrically conductive capacitor-electrode layers. A

  19. Recyclable organic solar cells on substrates comprising cellulose nanocrystals (CNC)

    Science.gov (United States)

    Kippelen, Bernard; Fuentes-Hernandez, Canek; Zhou, Yinhua; Moon, Robert; Youngblood, Jeffrey P

    2015-12-01

    Recyclable organic solar cells are disclosed herein. Systems and methods are further disclosed for producing, improving performance, and for recycling the solar cells. In certain example embodiments, the recyclable organic solar cells disclosed herein include: a first electrode; a second electrode; a photoactive layer disposed between the first electrode and the second electrode; an interlayer comprising a Lewis basic oligomer or polymer disposed between the photoactive layer and at least a portion of the first electrode or the second electrode; and a substrate disposed adjacent to the first electrode or the second electrode. The interlayer reduces the work function associated with the first or second electrode. In certain example embodiments, the substrate comprises cellulose nanocrystals that can be recycled. In certain example embodiments, one or more of the first electrode, the photoactive layer, and the second electrode may be applied by a film transfer lamination method.

  20. Thermal emitter comprising near-zero permittivity materials

    Science.gov (United States)

    Luk, Ting S.; Campione, Salvatore; Sinclair, Michael B.

    2017-10-25

    A novel thermal source comprising a semiconductor hyperbolic metamaterial provides control of the emission spectrum and the angular emission pattern. These properties arise because of epsilon-near-zero conditions in the semiconductor hyperbolic metamaterial. In particular, the thermal emission is dominated by the epsilon-near-zero effect in the doped quantum wells composing the semiconductor hyperbolic metamaterial. Furthermore, different properties are observed for s and p polarizations, following the characteristics of the strong anisotropy of hyperbolic metamaterials.

  1. Multilayer Electroactive Polymer Composite Material Comprising Carbon Nanotubes

    Science.gov (United States)

    Ounaies, Zoubeida (Inventor); Park, Cheol (Inventor); Harrison, Joycelyn S. (Inventor); Holloway, Nancy M. (Inventor); Draughon, Gregory K. (Inventor)

    2009-01-01

    An electroactive material comprises multiple layers of electroactive composite with each layer having unique dielectric, electrical and mechanical properties that define an electromechanical operation thereof when affected by an external stimulus. For example, each layer can be (i) a 2-phase composite made from a polymer with polarizable moieties and an effective amount of carbon nanotubes incorporated in the polymer for a predetermined electromechanical operation, or (ii) a 3-phase composite having the elements of the 2-phase composite and further including a third component of micro-sized to nano-sized particles of an electroactive ceramic incorporated in the polymer matrix.

  2. Networking

    OpenAIRE

    Rauno Lindholm, Daniel; Boisen Devantier, Lykke; Nyborg, Karoline Lykke; Høgsbro, Andreas; Fries, de; Skovlund, Louise

    2016-01-01

    The purpose of this project was to examine what influencing factor that has had an impact on the presumed increasement of the use of networking among academics on the labour market and how it is expressed. On the basis of the influence from globalization on the labour market it can be concluded that the globalization has transformed the labour market into a market based on the organization of networks. In this new organization there is a greater emphasis on employees having social qualificati...

  3. Photovoltaic device comprising compositionally graded intrinsic photoactive layer

    Science.gov (United States)

    Hoffbauer, Mark A; Williamson, Todd L

    2013-04-30

    Photovoltaic devices and methods of making photovoltaic devices comprising at least one compositionally graded photoactive layer, said method comprising providing a substrate; growing onto the substrate a uniform intrinsic photoactive layer having one surface disposed upon the substrate and an opposing second surface, said intrinsic photoactive layer consisting essentially of In.sub.1-xA.sub.xN,; wherein: i. 0.ltoreq.x.ltoreq.1; ii. A is gallium, aluminum, or combinations thereof; and iii. x is at least 0 on one surface of the intrinsic photoactive layer and is compositionally graded throughout the layer to reach a value of 1 or less on the opposing second surface of the layer; wherein said intrinsic photoactive layer is isothermally grown by means of energetic neutral atom beam lithography and epitaxy at a temperature of 600.degree. C. or less using neutral nitrogen atoms having a kinetic energy of from about 1.0 eV to about 5.0 eV, and wherein the intrinsic photoactive layer is grown at a rate of from about 5 nm/min to about 100 nm/min.

  4. HVDC Solution for Offshore Wind Park Comprising Turbines Equipped with Full-Range Converters

    DEFF Research Database (Denmark)

    Sharma, Ranjan; Rasmussen, Tonny Wederberg; Jensen, Kim Høj

    2010-01-01

    a voltage drop is created at the collection grid, the wind turbines go into fault-ride-through mode. The power output from each of the wind turbines is thus reduced to balance the system power. The detailed explanation of the strategy is presented in the paper. Matlab simulation model was prepared and some...... of a HVDC transmission system. The power system under study includes an offshore wind farm comprising turbines equipped with full range converters. The collection network is a local AC grid. Power transmission is done through HVDC system. The grid side VSC (voltage source converter) controls the DC voltage...

  5. Polythiophenes Comprising Conjugated Pendants for Polymer Solar Cells: A Review

    Directory of Open Access Journals (Sweden)

    Hsing-Ju Wang

    2014-03-01

    Full Text Available Polythiophene (PT is one of the widely used donor materials for solution-processable polymer solar cells (PSCs. Much progress in PT-based PSCs can be attributed to the design of novel PTs exhibiting intense and broad visible absorption with high charge carrier mobility to increase short-circuit current density (Jsc, along with low-lying highest occupied molecular orbital (HOMO levels to achieve large open circuit voltage (Voc values. A promising strategy to tailor the photophysical properties and energy levels via covalently attaching electron donor and acceptor pendants on PTs backbone has attracted much attention recently. The geometry, electron-donating capacity, and composition of conjugated pendants are supposed to be the crucial factors in adjusting the conformation, energy levels, and photovoltaic performance of PTs. This review will go over the most recent approaches that enable researchers to obtain in-depth information in the development of PTs comprising conjugated pendants for PSCs.

  6. Antimalarial activity of compounds comprising a primary benzene sulfonamide fragment.

    Science.gov (United States)

    Andrews, Katherine T; Fisher, Gillian M; Sumanadasa, Subathdrage D M; Skinner-Adams, Tina; Moeker, Janina; Lopez, Marie; Poulsen, Sally-Ann

    2013-11-15

    Despite the urgent need for effective antimalarial drugs with novel modes of action no new chemical class of antimalarial drug has been approved for use since 1996. To address this, we have used a rational approach to investigate compounds comprising the primary benzene sulfonamide fragment as a potential new antimalarial chemotype. We report the in vitro activity against Plasmodium falciparum drug sensitive (3D7) and resistant (Dd2) parasites for a panel of fourteen primary benzene sulfonamide compounds. Our findings provide a platform to support the further evaluation of primary benzene sulfonamides as a new antimalarial chemotype, including the identification of the target of these compounds in the parasite. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Solid polymer electrolyte composite membrane comprising laser micromachined porous support

    Science.gov (United States)

    Liu, Han [Waltham, MA; LaConti, Anthony B [Lynnfield, MA; Mittelsteadt, Cortney K [Natick, MA; McCallum, Thomas J [Ashland, MA

    2011-01-11

    A solid polymer electrolyte composite membrane and method of manufacturing the same. According to one embodiment, the composite membrane comprises a rigid, non-electrically-conducting support, the support preferably being a sheet of polyimide having a thickness of about 7.5 to 15 microns. The support has a plurality of cylindrical pores extending perpendicularly between opposing top and bottom surfaces of the support. The pores, which preferably have a diameter of about 5 microns, are made by laser micromachining and preferably are arranged in a defined pattern, for example, with fewer pores located in areas of high membrane stress and more pores located in areas of low membrane stress. The pores are filled with a first solid polymer electrolyte, such as a perfluorosulfonic acid (PFSA) polymer. A second solid polymer electrolyte, which may be the same as or different than the first solid polymer electrolyte, may be deposited over the top and/or bottom of the first solid polymer electrolyte.

  8. Solid polymer electrolyte composite membrane comprising plasma etched porous support

    Science.gov (United States)

    Liu, Han; LaConti, Anthony B.

    2010-10-05

    A solid polymer electrolyte composite membrane and method of manufacturing the same. According to one embodiment, the composite membrane comprises a rigid, non-electrically-conducting support, the support preferably being a sheet of polyimide having a thickness of about 7.5 to 15 microns. The support has a plurality of cylindrical pores extending perpendicularly between opposing top and bottom surfaces of the support. The pores, which preferably have a diameter of about 0.1 to 5 microns, are made by plasma etching and preferably are arranged in a defined pattern, for example, with fewer pores located in areas of high membrane stress and more pores located in areas of low membrane stress. The pores are filled with a first solid polymer electrolyte, such as a perfluorosulfonic acid (PFSA) polymer. A second solid polymer electrolyte, which may be the same as or different than the first solid polymer electrolyte, may be deposited over the top and/or bottom of the first solid polymer electrolyte.

  9. Asteroseismology of KIC 7107778: a binary comprising almost identical subgiants

    Science.gov (United States)

    Li, Yaguang; Bedding, Timothy R.; Li, Tanda; Bi, Shaolan; Murphy, Simon J.; Corsaro, Enrico; Chen, Li; Tian, Zhijia

    2018-05-01

    We analyse an asteroseismic binary system: KIC 7107778, a non-eclipsing, unresolved target, with solar-like oscillations in both components. We used Kepler short cadence time series spanning nearly 2 yr to obtain the power spectrum. Oscillation mode parameters were determined using Bayesian inference and a nested sampling Monte Carlo algorithm with the DIAMONDS package. The power profiles of the two components fully overlap, indicating their close similarity. We modelled the two stars with MESA and calculated oscillation frequencies with GYRE. Stellar fundamental parameters (mass, radius, and age) were estimated by grid modelling with atmospheric parameters and the oscillation frequencies of l = 0, 2 modes as constraints. Most l = 1 mixed modes were identified with models searched using a bisection method. Stellar parameters for the two sub-giant stars are MA = 1.42 ± 0.06 M⊙, MB = 1.39 ± 0.03 M⊙, RA = 2.93 ± 0.05 R⊙, RB = 2.76 ± 0.04 R⊙, tA = 3.32 ± 0.54 Gyr and tB = 3.51 ± 0.33 Gyr. The mass difference of the system is ˜1 per cent. The results confirm their simultaneous birth and evolution, as is expected from binary formation. KIC 7107778 comprises almost identical twins, and is the first asteroseismic sub-giant binary to be detected.

  10. Ecological network analysis for a virtual water network.

    Science.gov (United States)

    Fang, Delin; Chen, Bin

    2015-06-02

    The notions of virtual water flows provide important indicators to manifest the water consumption and allocation between different sectors via product transactions. However, the configuration of virtual water network (VWN) still needs further investigation to identify the water interdependency among different sectors as well as the network efficiency and stability in a socio-economic system. Ecological network analysis is chosen as a useful tool to examine the structure and function of VWN and the interactions among its sectors. A balance analysis of efficiency and redundancy is also conducted to describe the robustness (RVWN) of VWN. Then, network control analysis and network utility analysis are performed to investigate the dominant sectors and pathways for virtual water circulation and the mutual relationships between pairwise sectors. A case study of the Heihe River Basin in China shows that the balance between efficiency and redundancy is situated on the left side of the robustness curve with less efficiency and higher redundancy. The forestation, herding and fishing sectors and industrial sectors are found to be the main controllers. The network tends to be more mutualistic and synergic, though some competitive relationships that weaken the virtual water circulation still exist.

  11. A Re-configurable On-line Learning Spiking Neuromorphic Processor comprising 256 neurons and 128K synapses

    Directory of Open Access Journals (Sweden)

    Ning eQiao

    2015-04-01

    Full Text Available Implementing compact, low-power artificial neural processing systems with real-time on-line learning abilities is still an open challenge. In this paper we present a full-custom mixed-signal VLSI device with neuromorphic learning circuits that emulate the biophysics of real spiking neurons and dynamic synapses for exploring the properties of computational neuroscience models and for building brain-inspired computing systems. The proposed architecture allows the on-chip configuration of a wide range of network connectivities, including recurrent and deep networks with short-term and long-term plasticity. The device comprises 128 K analog synapse and 256 neuron circuits with biologically plausible dynamics and bi-stable spike-based plasticity mechanisms that endow it with on-line learning abilities. In addition to the analog circuits, the device comprises also asynchronous digital logic circuits for setting different synapse and neuron properties as well as different network configurations. This prototype device, fabricated using a 180 nm 1P6M CMOS process, occupies an area of 51.4 mm 2 , and consumes approximately 4 mW for typical experiments, for example involving attractor networks. Here we describe the details of the overall architecture and of the individual circuits and present experimental results that showcase its potential. By supporting a wide range of cortical-like computational modules comprising plasticity mechanisms, this device will enable the realization of intelligent autonomous systems with on-line learning capabilities.

  12. No disillusions in auditory extinction: perceiving a melody comprised of unperceived notes

    Directory of Open Access Journals (Sweden)

    Leon Y Deouell

    2008-03-01

    Full Text Available The formation of coherent percepts requires grouping together spatio-temporally disparate sensory inputs. Two major questions arise: (1 is awareness necessary for this process; and (2 can non-conscious elements of the sensory input be grouped into a conscious perceptµ To address this question, we tested two patients suffering from severe left auditory extinction following right hemisphere damage. In extinction, patients are unaware of the presence of left side stimuli when they are presented simultaneously with right side stimuli. We used the ‘scale illusion’ to test whether extinguished tones on the left can be incorporated into the content of conscious awareness. In the scale illusion, healthy listeners obtain the illusion of distinct melodies, which are the result of grouping of information from both ears into illusory auditory streams. We show that the two patients were susceptible to the scale illusion while being consciously unaware of the stimuli presented on their left. This suggests that awareness is not necessary for auditory grouping and non-conscious elements can be incorporated into a conscious percept.

  13. Multiple network interface core apparatus and method

    Science.gov (United States)

    Underwood, Keith D [Albuquerque, NM; Hemmert, Karl Scott [Albuquerque, NM

    2011-04-26

    A network interface controller and network interface control method comprising providing a single integrated circuit as a network interface controller and employing a plurality of network interface cores on the single integrated circuit.

  14. Lateralization effects on functional connectivity of the auditory network in patients with unilateral pulsatile tinnitus as detected by functional MRI.

    Science.gov (United States)

    Lv, Han; Zhao, Pengfei; Liu, Zhaohui; Liu, Xuehuan; Ding, Heyu; Liu, Liheng; Wang, Guopeng; Xie, Jing; Zeng, Rong; Chen, Yuchen; Yang, Zhenghan; Gong, Shusheng; Wang, Zhenchang

    2018-02-02

    Unilateral pulsatile tinnitus (PT) was proved to be a kind of disease with brain functional abnormalities within and beyond the auditory network (AN). However, changes in patterns of the lateralization effects of PT are yet to be established. Relationship between the AN and other brain networks in PT patients is also a scientific question need to be answered. In this study, we recruited 23 left-sided, 23 right-sided PT (LSPT, RSPT) patients and 23 normal controls (NC). We combined applied independent component analysis and seed-based functional connectivity (FC) analysis to investigate alteration feature of the FC of the AN by using resting-state functional magnetic resonance imaging (rs-fMRI). Compared with NC, LSPT patients demonstrated disconnected FC within the AN on both sides. Disrupted network integrity between AN and several brain functional networks, including executive control network, self-perceptual network and the limbic network, was also demonstrated in LSPT patient group bilaterally. In contrast, compared with NC, RSPT demonstrated decreased FC within the AN on the left side, but significant increased FC within the AN on the right side (symptomatic side). Enhanced FC between AN and executive control network, self-perceptual network and limbic network was also found mainly on the right side in patients with RSPT. Positive FC between the auditory network and the limbic network may be a reason to explain why RSPT patients are willing to be in the clinic. Briefly, LSPT exhibit disrupted network integrity in brain functional networks. But RSPT is featured by enhanced FC within AN and between networks, especially on the right (symptomatic) side. Corroboration of featured FC helps to reveal the pathophysiological changing process of the brain in patients with PT, providing imaging-based biomarker to distinguish PT from other kind of tinnitus. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. The obtaining of iron acetate from processed iron comprising catalyst of ammonia synthesis

    International Nuclear Information System (INIS)

    Mansurov, M.M.; Lugovenko, A.N.; Mirzoeva, M.M.

    1993-01-01

    Present article is devoted to obtaining of iron acetate from processed iron comprising catalyst of ammonia synthesis. The method of synthesis of iron acetate from processed iron comprising catalyst of ammonia synthesis was elaborated. The structure of complex was determined.

  16. Pneumatic stepper motor and device comprising at least one such pneumatic stepper motor

    NARCIS (Netherlands)

    Groenhuis, Vincent; Siepel, Françoise Jeanette; Stramigioli, Stefano

    2018-01-01

    The invention relates to a pneumatic stepper motor, comprising: - a housing, said housing accommodating at least part of: - a rack or geared axle comprising a plurality of gear elements; and - two pistons, each comprising at least two teeth, said pistons being arranged to cooperate with said rack or

  17. Energy Efficient Digital Networks

    Energy Technology Data Exchange (ETDEWEB)

    Lanzisera, Steven [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Brown, Richard [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2013-01-01

    Digital networks are the foundation of the information services, and play an expanding and indispensable role in our lives, via the Internet, email, mobile phones, etc. However, these networks consume energy, both through the direct energy use of the network interfaces and equipment that comprise the network, and in the effect they have on the operating patterns of devices connected to the network. The purpose of this research was to investigate a variety of technology and policy issues related to the energy use caused by digital networks, and to further develop several energy-efficiency technologies targeted at networks.

  18. Polymer coating comprising 2-methoxyethyl acrylate units synthesized by surface-initiated atom transfer radical polymerization

    DEFF Research Database (Denmark)

    2011-01-01

    Source: US2012184029A The present invention relates to preparation of a polymer coating comprising or consisting of polymer chains comprising or consisting of units of 2-methoxyethyl acrylate synthesized by Surface-Initiated Atom Transfer Radical Polymerization (SI ATRP) such as ARGET SI ATRP...

  19. Method for recovering aroma concentrate from a caffeine- or theobromine-comprising food base material

    NARCIS (Netherlands)

    Kattenberg, H.R.; Willemsen, J.H.A.; Starmans, D.A.J.; Hoving, H.D.; Winters, M.G.M.

    2002-01-01

    Described is a method for recovering aroma concentrate from a caffeine- or theobromine-comprising food base material, such as coffee or tea, and in particular cocoa, at least comprising the steps of: introducing the food base material into an aqueous extractant and incubating the food base material

  20. Molecular sleds comprising a positively -charged amino acid sequence and a molecular cargo and uses thereof

    NARCIS (Netherlands)

    Mangel, F Walter; Blainey, Paul C; Graziano, Vito; Herrmann, Andreas; McGrath, William J; van Oijen, Antonius Martinus; Xie, Xiaoliang Sunney

    2014-01-01

    The present invention relates to compositions which may comprise a molecular sled linked to cargo and uses thereof. In particular, the present invention relates to a non-naturally occurring or engineered composition which may comprise a molecular sled, linkers and a molecular cargo connected to the

  1. Ball bearings comprising nickel-titanium and methods of manufacture thereof

    Science.gov (United States)

    DellaCorte, Christopher (Inventor); Glennon, Glenn N. (Inventor)

    2012-01-01

    Disclosed herein is a friction reducing nickel-titanium composition. The nickel-titanium composition includes a first phase that comprises nickel and titanium in an atomic ratio of about 0.45:0.55 to about 0.55:0.45; a second phase that comprises nickel and titanium in an atomic ratio of about 0.70:0.30 to about 0.80:0.20; and a third phase that comprises nickel and titanium in an atomic ratio of about 0.52:0.48 to about 0.62:0.38. A bearing for reducing friction comprising a nickel-titanium composition comprising a first phase that comprises nickel and titanium in an atomic ratio of about 0.45:0.55 to about 0.55:0.45; a second phase that comprises nickel and titanium in an atomic ratio of about 0.70:0.30 to about 0.80:0.20; and a third phase that comprises nickel and titanium in an atomic ratio of about 0.52:0.48 to about 0.62:0.38; where the bearing is free from voids and pinholes.

  2. Alignment of Carbon Nanotubes Comprising Magnetically Sensitive Metal Oxides in Nanofluids

    Science.gov (United States)

    Hong, Haiping (Inventor); Peterson, G. P. " Bud" (Inventor)

    2016-01-01

    The present invention is a nanoparticle mixture or suspension or nanofluid comprising nonmagnetically sensitive nanoparticles, magnetically sensitive nanoparticles, and surfactant(s). The present invention also relates to methods of preparing and using the same.

  3. Combination Comprising Parthenolide For Use In The Treatment Of Alzheimer's Disease And Other Neurodegenerative Disorders

    KAUST Repository

    Bajic, Vladimir B.; Essack, Magbubah

    2015-01-01

    The present invention generally concerns particular methods and compositions for treatment of a neurodegenerative disease, such as Alzheimer's Disease. In particular embodiments, there is a composition comprising Parthenolide and a second agent

  4. Photodetection, photon event localization and position tomography device comprising a gammagraphy camera equipped wit such devices

    International Nuclear Information System (INIS)

    Jatteau, M.R.

    1984-01-01

    This device of photodetection and photon event (and noticeably scintillations) localization comprises at least a photomultiplier tube with unique photomultiplying structure and in front of this tube, a net of juxtaposed conduction metal wires excited by voltage pulses. This net comprises only 2n metallic wires to assure the localization of 2sup(2n) possible positions, and that is one of its characteristics [fr

  5. Falciform ligament abscess from left sided portal pyaemia following malignant obstructive cholangitis

    Directory of Open Access Journals (Sweden)

    Warren Leigh R

    2012-12-01

    Full Text Available Abstract Abscess formation of the falciform ligament is incredibly rare and perplexing when encountered for the first time. It is reported to occur in the setting of cholecystitis and cholangitis, but the pathophysiology is poorly understood. In this case report, we present a 73-year-old man with falciform ligament abscess following cholangitis from an obstructive ampullary carcinoma. The patient was referred to the Royal Adelaide Hospital from a country hospital, with progressive jaundice, anorexia and nausea. Prior to transfer, he deteriorated with cholangitis, dehydration and renal failure. On arrival, his abdomen was exquisitely tender along the course of the falciform ligament. His blood tests revealed an elevated white cell count of 14.9 x 103/μl, bilirubin of 291μmol/l and creatinine of 347 μmol/l. His CA 19-9 was markedly elevated at 35,000 kU/l. A non-contrast computed tomography (CT demonstrated gross biliary dilatation and a collection tracking along the path of the falciform ligament to the umbilicus. The patient was commenced on intravenous antibiotics and underwent an urgent endoscopic retrograde cholangiopancreatogram (ERCP with sphincterotomy and biliary stent drainage. Cholangiogram revealed a grossly dilated biliary tree, with abrupt transition at the ampulla, which on biopsy confirmed an obstructing ampullary carcinoma. Following ERCP, his jaundice and abdominal tenderness resolved. He was optimized over 4 weeks for an elective pancreaticoduodenectomy. At operation, we found abscess transformation of the falciform ligament. Copious amounts of pus and necrotic material was drained. Part of the round ligament was resected along the undersurface of the liver. Histology showed that there was prominent histiocytic inflammation with granular acellular eosinophilic components. The patient recovered slowly but uneventfully. A contrast CT scan undertaken 2 weeks post-operatively (approximately 7 weeks after the initial CT revealed left portal venous thrombosis, which was likely to be a delayed discovery and was managed conservatively. We present this patient’s operative images and radiographic findings, which may explain the pathophysiology behind this rare complication. We hypothesize that cholangitis, with secondary portal pyaemia and tracking via the paraumbilical veins, can cause infectious seeding of the falciform ligament, with consequent abscess formation.

  6. [Bilateral anophthalmia and left-sided orbital tumor : case of an eight-month-old infant].

    Science.gov (United States)

    Hundertmark, P; Dierks, P; Gottschalk, J; Kreusch, T; Wiegand, W

    2011-08-01

    An 8-month-old infant from Russia with bilateral anophthalmia presented with an expanding orbital tumor. The tumor was extirpated and the histological examination revealed a non-malignant pseudocystic process with residual neuro-ectodermal structures.

  7. Endoscopic Color Doppler Ultrasonographic Evaluation of GastricVarices Secondary to Left-Sided Portal Hypertension

    Science.gov (United States)

    Sato, Takahiro; Yamazaki, Katsu; Kimura, Mutsuumi; Toyota, Jouji; Karino, Yoshiyasu

    2014-01-01

    Gastric varices that arise secondary to the splenic vein occlusion can result in gastrointestinal hemorrhaging. Endoscopic color Doppler ultrasonography (ECDUS) was performed in 16 patients with gastric varices secondary to splenic vein occlusion. This study retrospectively evaluated the role of ECDUS in the diagnosis of gastric varices secondary to splenic vein occlusion. Thirteen patients had co-existing pancreatic diseases: 8 with chronic pancreatitis, 4 with cancer of the pancreatic body or tail and 1 with severe acute pancreatitis. Of the remaining 3 patients, 1 had myeloproliferative disease, 1 had advanced gastric cancer, and the third had splenic vein occlusion due to an obscure cause. The endoscopic findings of gastric varices were: variceal form (F) classified as enlarged tortuous (F2) in 12 cases and large, coil-shaped (F3) in 4 cases, and positive for erosion or red color sign of the variceal surface in 4 cases and negative in 12 cases. ECDUS color flow images of gastric variceal flow clearly depicted a round fundal region at the center, with varices expanding to the curvatura ventriculi major of the gastric body in all 16 cases. The velocities of F3 type gastric varices were significantly higher than those of the F2 type. The wall thickness of varices positive for erosion or red color sign was significantly less than the negative cases. I conclude that ECDUS color flow images of gastric variceal flow depicted specific findings of gastric varices secondary to splenic vein occlusion at the round fundal region at the center, with varices expanding to the curvatura ventriculi major of the gastric body. PMID:26852679

  8. Use of first-pass radionuclide angiography for evaluating left-sided heart regurgitation

    International Nuclear Information System (INIS)

    Mantel, J.; Freidin, M.; Willens, H.; Rubenfire, M.; Bahl, R.; Ruskin, R.; Cascade, P.

    1986-01-01

    The first-pass radionuclide technique can be used to evaluate valvular regurgitation. Sixty-three patients were studied with cardiac catheterization and first-pass radionuclide angiography. The degree of regurgitation by cardiac catheterization was evaluated by using a ranking scale of 0-4, where 4 is severe regurgitation. The results were as follows: for nine patients, rank = 0, and percentage of regurgitation (mean +- SD) = 3.6 +- 5; for five patients, rank = 1 and percentage regurgitation = 15.8 +- 3; for 13 patients, rank = 2 and percentage regurgitation = 28.5 +- 14; for 16 patients, rank = 3 and percentage regurgitation = 41.5 +- 10; and for 19 patients, rank = 4 and percentage regurgitation 54.9 +- 13. A correlation coefficient of .90 between cardiac catheterization and the first-pass technique was calculated. The authors conclude that first-pass radionuclide angiography can quantitate valvular regurgitation and accurately differentiate between no, minimal, moderate, and severe valvular regurgitation

  9. Radiation induced cardiotoxicity in left sided breast cancer - Where do we stand?

    Directory of Open Access Journals (Sweden)

    Pamela Alice Kingsley

    2015-01-01

    Full Text Available Breast cancer is the commonest cancer in women, with around a million new cases diagnosed each year worldwide. Adjuvant radiotherapy (RT is an important component of therapy for many women with early-stage breast cancer. With improving survival rates following breast cancer, patients are increasingly likely to die of other causes. As a result, long-term adverse effects of treatment are of major concern. To determine which treatment is optimal, clinician need to be aware of long-term risks and benefits of adjuvant therapies. An awareness of the potential cardiotoxicity of RT led to the application of improved RT techniques that minimize the irradiation to the heart. Although new techniques, including intensity-modulated RT combined with free breathing gating and helical tomotherapy may further reduce radiation-induced cardiac toxicities, the most important factors in limiting cardiac radiation are associated with the techniques used and the skill of the radiation oncologist.

  10. Accuracy of multidetector CT in detecting anastomotic leaks following stapled left-sided colonic anastomosis

    International Nuclear Information System (INIS)

    Kaur, P.; Karandikar, S.S.; Roy-Choudhury, S.

    2014-01-01

    Aims: To assess accuracy of multidetector computed tomography (MDCT) and individual radiological signs in the diagnosis of anastomotic leaks. Materials and methods: Patients undergoing anterior resection with a stapled anastomosis over a 2 year period were identified. Electronic and clinical records of these patients were reviewed. Unenhanced and/or enhanced MDCT was performed with intravenous and/or per-rectal contrast medium and read by a radiologist blinded to the patients' clinical details to determine the sensitivity and specificity of specific findings at MDCT for identifying leaks. Results: Seventeen percent (30/170) of the anterior resections were suspected to have an anastomotic leak. Ninety-three percent (28/30) of patients underwent MDCT. Seven point six percent (11+2/170) had a confirmed leak. Two patients underwent surgery without MDCT. A leak was confirmed by MDCT in 91% (10/11) of patients. The sensitivity, specificity, and positive and negative predictive values of MDCT in diagnosing a leak was 0.91, 1, 1, and 0.95, respectively. The sensitivity of peri-anastomotic air, peri-anastomotic collection, extravasation of rectal contrast medium, and staple line integrity was 0.81, 0.63, 0.54, and 0.72, respectively. Use of rectal contrast medium (8/11 cases) increased the subjective ease of diagnosis and was the only sign in one patient. Conclusions: Presence of peri-anastomotic air is a reliable marker of anastomotic leaks at MDCT. Leakage of rectal contrast medium is highly accurate and increases confidence of diagnosis. The appearance of the staple line itself is not accurate in assessing anastomotic integrity

  11. Absorption of wheat starch in patients resected for left-sided colonic cancer

    DEFF Research Database (Denmark)

    Nordgaard, I; Rumessen, J J; Nielsen, S A

    1992-01-01

    Bacterial fermentation of carbohydrate in the colon, producing short-chain fatty acids (SCFA)--and especially butyrate--has been shown possibly to impede cell proliferation and regulate cell differentiation of colonocytes. In patients with diverticular disease or benign polyps in the colon...... a hyperabsorption of potato starch in the small intestine has been found. We have investigated the absorption of wheat starch in 15 patients radically resected for cancer in the descending or sigmoid colon, and the results were compared with those of 15 healthy controls. The starch malabsorption was quantified...... also similar in patients and controls. The results do not support the theory that hyperabsorption of starch is characteristic of patients with malignant disease in the large intestine....

  12. Educational series in congenital heart disease:Congenital left-sided heart obstruction

    OpenAIRE

    Carr, Michelle; Curtis, Stephanie; Marek, Jan

    2018-01-01

    Congenital obstruction of the left ventricular outflow tract remains a significant problem and multilevel obstruction can often coexist. Obstruction can take several morphological forms and may involve the subvalvar, valvar or supravalvar portion of the aortic valve complex. Congenital valvar stenosis presenting in the neonatal period represents a spectrum of disorders ranging from the hypoplastic left heart syndrome to almost normal hearts. Treatment options vary dependent on the severity of...

  13. Infliximab-associated alveolitis after treatment for severe left-sided ulcerative colitis.

    LENUS (Irish Health Repository)

    Veerappan, Sundaram G

    2012-02-01

    Here we describe a patient with ulcerative colitis who developed alveolitis after infliximab therapy. With earlier case reports of development of alveolitis in rheumatoid arthritis patients after infliximab infusion, the temporal relationship between the infliximab therapy and the development of alveolitis in this case, raises the possibility that the two might be causally related. With an increasing trend towards treating moderate to severely active ulcerative colitis patients with infliximab as a rescue therapy, clinicians should be aware of this potentially serious complication.

  14. Is delayed surgery related to worse outcomes in native left-sided endocarditis?

    Science.gov (United States)

    Tepsuwan, Thitipong; Rimsukcharoenchai, Chartaroon; Tantraworasin, Apichat; Woragidpoonpol, Surin; Schuarattanapong, Suphachai; Nawarawong, Weerachai

    2016-05-01

    Timing of surgery in the management of infective endocarditis is controversial, and there is still no definite conclusion on how early the surgery should be performed. This study focuses on the outcomes of surgery during the active period of infective endocarditis in consideration of the duration after diagnosis. One hundred and thirty-four patients with active native valve infective endocarditis who underwent surgery from January 2006 to December 2013 were reviewed retrospectively. They were divided in 2 groups based on timing of surgery: early group (first week after diagnosis, n = 37) and delayed group (2 to 6 weeks after diagnosis, n = 97). Compared to the delayed group, the early group had significantly more patients in New York Heart Association class IV (81% vs. 43.3%), more mechanically ventilated (54.1% vs. 18.6%), more on inotropic support (62.2% vs. 38.1%), and hence a worse EuroSCORE II (14.8% vs. 8.8%). Operative mortality was comparable (5.4% vs. 10.3%) and 7-year survival was similar (77.4% vs. 74.6%). On multivariable regression analysis, delayed surgery did not impact on short- and long-term outcomes. Preoperative cardiac arrest and infection with Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, or Kingella were risk factors for higher operative mortality. Predictors of poor 7-year survival were diabetes mellitus and acute renal failure. Delayed surgery is not associated with worse outcomes. Both early and delayed approaches are safe and provide acceptable results. Timing of surgery should be tailored to each patient's clinical status, not based on duration of endocarditis alone. © The Author(s) 2016.

  15. Epidemics on interconnected networks

    Science.gov (United States)

    Dickison, Mark; Havlin, S.; Stanley, H. E.

    2012-06-01

    Populations are seldom completely isolated from their environment. Individuals in a particular geographic or social region may be considered a distinct network due to strong local ties but will also interact with individuals in other networks. We study the susceptible-infected-recovered process on interconnected network systems and find two distinct regimes. In strongly coupled network systems, epidemics occur simultaneously across the entire system at a critical infection strength βc, below which the disease does not spread. In contrast, in weakly coupled network systems, a mixed phase exists below βc of the coupled network system, where an epidemic occurs in one network but does not spread to the coupled network. We derive an expression for the network and disease parameters that allow this mixed phase and verify it numerically. Public health implications of communities comprising these two classes of network systems are also mentioned.

  16. Electric circuit breaker comprising a plurality of vacuum interrupters simultaneously operated by a common operator

    Science.gov (United States)

    Barkan, Philip; Imam, Imdad

    1980-01-01

    This circuit breaker comprises a plurality of a vacuum-type circuit interrupters, each having a movable contact rod. A common operating device for the interrupters comprises a linearly-movable operating member. The interrupters are mounted at one side of the operating member with their movable contact rods extending in a direction generally toward the operating member. Means is provided for mechanically coupling the operating member to the contact rods, and this means comprises a plurality of insulating operating rods, each connected at one end to the operating member and at its opposite end to one of the movable contact rods. The operating rods are of substantially equal length and have longitudinal axes that converge and intersect at substantially a common point.

  17. Solute transport in a single fracture involving an arbitrary length decay chain with rock matrix comprising different geological layers.

    Science.gov (United States)

    Mahmoudzadeh, Batoul; Liu, Longcheng; Moreno, Luis; Neretnieks, Ivars

    2014-08-01

    A model is developed to describe solute transport and retention in fractured rocks. It accounts for advection along the fracture, molecular diffusion from the fracture to the rock matrix composed of several geological layers, adsorption on the fracture surface, adsorption in the rock matrix layers and radioactive decay-chains. The analytical solution, obtained for the Laplace-transformed concentration at the outlet of the flowing channel, can conveniently be transformed back to the time domain by the use of the de Hoog algorithm. This allows one to readily include it into a fracture network model or a channel network model to predict nuclide transport through channels in heterogeneous fractured media consisting of an arbitrary number of rock units with piecewise constant properties. More importantly, the simulations made in this study recommend that it is necessary to account for decay-chains and also rock matrix comprising at least two different geological layers, if justified, in safety and performance assessment of the repositories for spent nuclear fuel. Copyright © 2014 Elsevier B.V. All rights reserved.

  18. Semipermeable thin-film membranes comprising siloxane, alkoxysilyl and aryloxysilyl oligomers and copolymers

    Science.gov (United States)

    Babcock, Walter C.; Friesen, Dwayne T.

    1988-01-01

    Novel semiperimeable membranes and thin film composite (TFC) gas separation membranes useful in the separation of oxygen, nitrogen, hydrogen, water vapor, methane, carbon dioxide, hydrogen sulfide, lower hydrocarbons, and other gases are disclosed. The novel semipermeable membranes comprise the polycondensation reaction product of two complementary polyfunctional compounds, each having at least two functional groups that are mutually reactive in a condensation polymerization reaction, and at least one of which is selected from siloxanes, alkoxsilyls and aryloxysilyls. The TFC membrane comprises a microporous polymeric support, the surface of which has the novel semipermeable film formed thereon, preferably by interfacial polymerization.

  19. Process for the separation of contaminant or mixture of contaminants from a Ch4-comprising gaseous feed streem

    NARCIS (Netherlands)

    2012-01-01

    The invention provides a process for the separation of a contaminant or mixture of contaminants from a CH4-comprising gaseous feed streem, comprising the subsequent steps of: a) passing a CH4-comprising gaseous feed streem comprising the contaminant or the mixture of contaminants in to and through a

  20. Instrument comprising a cable or tube provided provided with a propulsion device

    NARCIS (Netherlands)

    Breedveld, P.

    2006-01-01

    The invention relates to an instrument (1) comprising a cable or tube (3), at a distal end of which a propulsion device (4) is provided for moving the cable or tube in a hollow space, the propulsion device being shaped like a donut lying in a plane at right angles to the longitudinal direction of

  1. Optical device comprising a cantilever and method of fabrication and use thereof

    NARCIS (Netherlands)

    Iannuzzi, Davide; Deladi, S.; Elwenspoek, Michael Curt

    2008-01-01

    The present invention provides an optical device, comprising an optical fiber and a cantilever that is arranged on an end of the optical fiber; The cantilever may be an integral part of the optical fiber, and may have a length that is substantially equal to a diameter of the optical fiber.

  2. Optical device comprising a cantilever and method of fabrication and use thereof

    NARCIS (Netherlands)

    Iannuzzi, Davide; Deladi, S.; Elwenspoek, Michael Curt

    2011-01-01

    The present invention provides an optical device, comprising an optical fiber and a cantilever that is arranged on an end of the optical fiber; The cantilever may be an integral part of the optical fiber, and may have a length that is substantially equal to a diameter of the optical fiber.

  3. Photomlxer for terahertz electromagnetic wave emission comprising quantum dots in a laser cavity

    DEFF Research Database (Denmark)

    2013-01-01

    The present invention relates to a photomixer for generating terahertz electromagnetic radiation in response to illumination by a time-modulated optical signal. The photomixer (300) comprises a carrier substrate (310) with a plurality of quantum dots arranged in an emission region (308) thereof...

  4. Light source comprising a common substrate, a first led device and a second led device

    Science.gov (United States)

    Choong, Vi-En

    2010-02-23

    At least one stacked organic or polymeric light emitting diode (PLEDs) devices to comprise a light source is disclosed. At least one of the PLEDs includes a patterned cathode which has regions which transmit light. The patterned cathodes enable light emission from the PLEDs to combine together. The light source may be top or bottom emitting or both.

  5. Hydroformylation catalyst comprising a complex with ligands having a structure derived from bisphenol A

    NARCIS (Netherlands)

    2002-01-01

    Ethylenically unsaturated compounds are hydroformylated in the presence of a hydroformylation catalyst comprising at least one complex of a metal of transition group VIII with at least one phosphorus-containing compound as ligand, where this compound contains two groups which contain P atoms and are

  6. Structural and biophysical characterization of an antimicrobial peptide chimera comprised of lactoferricin and lactoferrampin

    NARCIS (Netherlands)

    Haney, E.F.; Nazmi, K.; Bolscher, J.G.M.; Vogel, H.J.

    2012-01-01

    Lactoferricin and lactoferrampin are two antimicrobial peptides found in the N-terminal lobe of bovine lactoferrin with broad spectrum antimicrobial activity against a range of Gram-positive and Gram-negative bacteria as well as Candida albicans. A heterodimer comprised of lactoferrampin joined to a

  7. Compositions and methods comprising cellulase variants with reduced affinity to non-cellulosic materials

    Energy Technology Data Exchange (ETDEWEB)

    Cascao-Pereira, Luis; Kaper, Thijs; Kelemen, Bradley R.; Liu, Amy D.

    2017-07-04

    The present disclosure relates to cellulase variants. In particular the present disclosure relates to cellulase variants having reduced binding to non-cellulosic materials. Also described are nucleic acids encoding the cellulase, compositions comprising said cellulase, methods of identifying cellulose variants and methods of using the compositions.

  8. Compositions and methods comprising cellulase variants with reduced affinity to non-cellulosic materials

    Science.gov (United States)

    Cascao-Pereira, Luis G.; Kaper, Thijs; Kelemen, Bradley R; Liu, Amy D.

    2012-08-07

    The present disclosure relates to cellulase variants. In particular the present disclosure relates to cellulase variants having reduced binding to non-cellulosic materials. Also described are nucleic acids encoding the cellulase, compositions comprising said cellulase, methods of identifying cellulose variants and methods of using the compositions.

  9. Compositions and methods comprising cellulase variants with reduced affinity to non-cellulosic materials

    Energy Technology Data Exchange (ETDEWEB)

    Cascao-Pereira, Luis G; Kaper, Thijs; Kelemen, Bradley R; Liu, Amy D

    2015-04-07

    The present disclosure relates to cellulase variants. In particular the present disclosure relates to cellulase variants having reduced binding to non-cellulosic materials. Also described are nucleic acids encoding the cellulase, compositions comprising said cellulase, methods of identifying cellulose variants and methods of using the compositions.

  10. Semiconductor sensor device, diagnostic instrument comprising such a device and method of manufacturing such a device

    NARCIS (Netherlands)

    2010-01-01

    The invention relates to a semiconductor sensor device (10) for sensing a substance comprising at least one mesa- shaped semiconductor region (11) which is formed on a surface of a semiconductor body (12) and which is connected at a first end to a first electrically conducting connection region (13)

  11. Nanoscale Cross-Point Resistive Switching Memory Comprising p-Type SnO Bilayers

    KAUST Repository

    Hota, Mrinal Kanti; Hedhili, Mohamed N.; Wang, Qingxiao; Melnikov, Vasily; Mohammed, Omar F.; Alshareef, Husam N.

    2015-01-01

    Reproducible low-voltage bipolar resistive switching is reported in bilayer structures of p-type SnO films. Specifically, a bilayer homojunction comprising SnOx (oxygen-rich) and SnOy (oxygen-deficient) in nanoscale cross-point (300 × 300 nm2

  12. X-ray diffraction device comprising cooling medium connections provided on the x-ray tube

    NARCIS (Netherlands)

    1996-01-01

    An X-ray diffraction device comprises a water-cooled X-ray tube which exhibits a line focus as well as, after rotation through 90 DEG , a point focus. Contrary to customary X-ray tubes, the cooling water is not supplied via the housing (12) in which the X-ray tube is mounted, but the cooling water

  13. Coordinated operation of a neighborhood of smart households comprising electric vehicles, energy storage and distributed generation

    NARCIS (Netherlands)

    Paterakis, N.G.; Erdinc, O.; Pappi, I.N.; Bakirtzis, A.G.; Catalao, J.P.S.

    2016-01-01

    In this paper, the optimal operation of a neighborhood of smart households in terms of minimizing the total energy procurement cost is analyzed. Each household may comprise several assets such as electric vehicles, controllable appliances, energy storage and distributed generation. Bi-directional

  14. Polymer foam comprising a polymer and nanoparticles, and nanoparticles for the manufacture of such foam.

    NARCIS (Netherlands)

    Vancso, Gyula J.; Duvigneau, Joost; Nederkoorn, P.H.J.; Wassing, T.

    2014-01-01

    A polymer foam is produced comprising a polymer and nanoparticles having a maximum dimensionof 750 nm, which foam has cells with an average cell size of at most 1 µm and a cell density of at least 1012 cells/ml, wherein polymeric grafts have been attached to the nanoparticles. The nanoparticles may

  15. Combination Comprising Parthenolide For Use In The Treatment Of Alzheimer's Disease And Other Neurodegenerative Disorders

    KAUST Repository

    Bajic, Vladimir B.

    2015-06-18

    The present invention generally concerns particular methods and compositions for treatment of a neurodegenerative disease, such as Alzheimer\\'s Disease. In particular embodiments, there is a composition comprising Parthenolide and a second agent, including an inhibitor of TLR4/MD-2/CD14, nAChR agonist, Resatorvid, Curcumin, Tilorone or a Tilorone analog, or a combination thereof.

  16. Method and device for fabricating dispersion fuel comprising fission product collection spaces

    Science.gov (United States)

    Shaber, Eric L; Fielding, Randall S

    2015-05-05

    A method of fabricating a nuclear fuel comprising a fissile material, one or more hollow microballoons, a phenolic resin, and metal matrix. The fissile material, phenolic resin and the one or more hollow microballoons are combined. The combined fissile material, phenolic resin and the hollow microballoons are heated sufficiently to form at least some fissile material carbides creating a nuclear fuel particle. The resulting nuclear fuel particle comprises one or more fission product collection spaces. In a preferred embodiment, the fissile material, phenolic resin and the one or more hollow microballoons are combined by forming the fissile material into microspheres. The fissile material microspheres are then overcoated with the phenolic resin and microballoon. In another preferred embodiment, the fissile material, phenolic resin and the one or more hollow microballoons are combined by overcoating the microballoon with the fissile material, and phenolic resin.

  17. Energy storage systems having an electrode comprising Li.sub.xS.sub.y

    Science.gov (United States)

    Xiao, Jie; Zhang, Jiguang; Graff, Gordon L.; Liu, Jun; Wang, Wei; Zheng, Jianming; Xu, Wu; Shao, Yuyan; Yang, Zhenguo

    2016-08-02

    Improved lithium-sulfur energy storage systems can utilizes Li.sub.xS.sub.y as a component in an electrode of the system. For example, the energy storage system can include a first electrode current collector, a second electrode current collector, and an ion-permeable separator separating the first and second electrode current collectors. A second electrode is arranged between the second electrode current collector and the separator. A first electrode is arranged between the first electrode current collector and the separator and comprises a first condensed-phase fluid comprising Li.sub.xS.sub.y. The energy storage system can be arranged such that the first electrode functions as a positive or a negative electrode.

  18. Lateral acoustic wave resonator comprising a suspended membrane of low damping resonator material

    Science.gov (United States)

    Olsson, Roy H.; El-Kady; , Ihab F.; Ziaei-Moayyed, Maryam; Branch; , Darren W.; Su; Mehmet F.,; Reinke; Charles M.,

    2013-09-03

    A very high-Q, low insertion loss resonator can be achieved by storing many overtone cycles of a lateral acoustic wave (i.e., Lamb wave) in a lithographically defined suspended membrane comprising a low damping resonator material, such as silicon carbide. The high-Q resonator can sets up a Fabry-Perot cavity in a low-damping resonator material using high-reflectivity acoustic end mirrors, which can comprise phononic crystals. The lateral overtone acoustic wave resonator can be electrically transduced by piezoelectric couplers. The resonator Q can be increased without increasing the impedance or insertion loss by storing many cycles or wavelengths in the high-Q resonator material, with much lower damping than the piezoelectric transducer material.

  19. Bacterial Artificial Chromosome Clones of Viruses Comprising the Towne Cytomegalovirus Vaccine

    Directory of Open Access Journals (Sweden)

    Xiaohong Cui

    2012-01-01

    Full Text Available Bacterial artificial chromosome (BAC clones have proven invaluable for genetic manipulation of herpesvirus genomes. BAC cloning can also be useful for capturing representative genomes that comprise a viral stock or mixture. The Towne live attenuated cytomegalovirus vaccine was developed in the 1970s by serial passage in cultured fibroblasts. Although its safety, immunogenicity, and efficacy have been evaluated in nearly a thousand human subjects, the vaccine itself has been little studied. Instead, genetic composition and in vitro growth properties have been inferred from studies of laboratory stocks that may not always accurately represent the viruses that comprise the vaccine. Here we describe the use of BAC cloning to define the genotypic and phenotypic properties of viruses from the Towne vaccine. Given the extensive safety history of the Towne vaccine, these BACs provide a logical starting point for the development of next-generation rationally engineered cytomegalovirus vaccines.

  20. Bacterial artificial chromosome clones of viruses comprising the towne cytomegalovirus vaccine.

    Science.gov (United States)

    Cui, Xiaohong; Adler, Stuart P; Davison, Andrew J; Smith, Larry; Habib, El-Sayed E; McVoy, Michael A

    2012-01-01

    Bacterial artificial chromosome (BAC) clones have proven invaluable for genetic manipulation of herpesvirus genomes. BAC cloning can also be useful for capturing representative genomes that comprise a viral stock or mixture. The Towne live attenuated cytomegalovirus vaccine was developed in the 1970s by serial passage in cultured fibroblasts. Although its safety, immunogenicity, and efficacy have been evaluated in nearly a thousand human subjects, the vaccine itself has been little studied. Instead, genetic composition and in vitro growth properties have been inferred from studies of laboratory stocks that may not always accurately represent the viruses that comprise the vaccine. Here we describe the use of BAC cloning to define the genotypic and phenotypic properties of viruses from the Towne vaccine. Given the extensive safety history of the Towne vaccine, these BACs provide a logical starting point for the development of next-generation rationally engineered cytomegalovirus vaccines.

  1. Ionizing device comprising a microchannel electron multiplier with secondary electron emission

    International Nuclear Information System (INIS)

    Chalmeton, Vincent.

    1974-01-01

    The present invention relates to a ionizing device comprising a microchannel electron multiplier involving secondary electron emission as a means of ionization. A system of electrodes is used to accelerate said electrons, ionize the gas and extract the ions from thus created plasma. Said ionizer is suitable for bombarding the target in neutron sources (target of the type of nickel molybdenum coated with tritiated titanium or with a tritium deuterium mixture) [fr

  2. Article comprising a garment or other textile structure for use in controlling body temperature

    Science.gov (United States)

    Butzer, Melissa J.

    2000-01-01

    There is disclosed an article for use in cooling body temperature which comprises a garment having a coat and pant, with each having a body section adapted to receive a portion of the torso of the wearer and extensions from the body section to receive the wearer's limbs. The garment includes a system for circulating temperature controlling fluid from a suitable source through patches removably received in pockets in each of body section and extensions.

  3. Class network routing

    Science.gov (United States)

    Bhanot, Gyan [Princeton, NJ; Blumrich, Matthias A [Ridgefield, CT; Chen, Dong [Croton On Hudson, NY; Coteus, Paul W [Yorktown Heights, NY; Gara, Alan G [Mount Kisco, NY; Giampapa, Mark E [Irvington, NY; Heidelberger, Philip [Cortlandt Manor, NY; Steinmacher-Burow, Burkhard D [Mount Kisco, NY; Takken, Todd E [Mount Kisco, NY; Vranas, Pavlos M [Bedford Hills, NY

    2009-09-08

    Class network routing is implemented in a network such as a computer network comprising a plurality of parallel compute processors at nodes thereof. Class network routing allows a compute processor to broadcast a message to a range (one or more) of other compute processors in the computer network, such as processors in a column or a row. Normally this type of operation requires a separate message to be sent to each processor. With class network routing pursuant to the invention, a single message is sufficient, which generally reduces the total number of messages in the network as well as the latency to do a broadcast. Class network routing is also applied to dense matrix inversion algorithms on distributed memory parallel supercomputers with hardware class function (multicast) capability. This is achieved by exploiting the fact that the communication patterns of dense matrix inversion can be served by hardware class functions, which results in faster execution times.

  4. Neurosensory and vascular function after 14 months of military training comprising cold winter conditions.

    Science.gov (United States)

    Carlsson, Daniel; Pettersson, Hans; Burström, Lage; Nilsson, Tohr; Wahlström, Jens

    2016-01-01

    This study aimed to examine the effects of 14 months of military training comprising cold winter conditions on neurosensory and vascular function in the hands and feet. Military conscripts (N=54) were assessed with quantitative sensory testing comprising touch, temperature, and vibration perception thresholds and finger systolic blood pressure (FSBP) after local cooling and a questionnaire on neurosensory and vascular symptoms at both baseline and follow-up. Ambient air temperature was recorded with body worn temperature loggers. The subjects showed reduced sensitivity to perception of touch, warmth, cold and vibrations in both the hands and feet except from vibrotactile perception in digit two of the right hand (right dig 2). Cold sensations, white fingers, and pain/discomfort when exposed to cold as well as pain increased in both prevalence and severity. There were no statistically significant changes in FSBP after local cooling. Fourteen months of winter military training comprising cold winter conditions reduced sensation from touch, warmth, cold, and vibrotactile stimulus in both hands and feet and increased the severity and prevalence of symptoms and pain. The vascular function in the hands, measured by FSBP after local cooling, was not affected.

  5. Alcohol dose dumping: The influence of ethanol on hot-melt extruded pellets comprising solid lipids.

    Science.gov (United States)

    Jedinger, N; Schrank, S; Mohr, S; Feichtinger, A; Khinast, J; Roblegg, E

    2015-05-01

    The objective of the present study was to investigate interactions between alcohol and hot-melt extruded pellets and the resulting drug release behavior. The pellets were composed of vegetable calcium stearate as matrix carrier and paracetamol or codeine phosphate as model drugs. Two solid lipids (Compritol® and Precirol®) were incorporated into the matrix to form robust/compact pellets. The drug release characteristics were a strong function of the API solubility, the addition of solid lipids, the dissolution media composition (i.e., alcohol concentration) and correspondingly, the pellet wettability. Pellets comprising paracetamol, which is highly soluble in ethanol, showed alcohol dose dumping regardless of the matrix composition. The wettability increased with increasing ethanol concentrations due to higher paracetamol solubilities yielding increased dissolution rates. For pellets containing codeine phosphate, which has a lower solubility in ethanol than in acidic media, the wettability was a function of the matrix composition. Dose dumping occurred for formulations comprising solid lipids as they showed increased wettabilities with increasing ethanol concentrations. In contrast, pellets comprising calcium stearate as single matrix component showed robustness in alcoholic media due to wettabilities that were not affected by the addition of ethanol. The results clearly indicate that the physico-chemical properties of the drug and the matrix systems are crucial for the design of ethanol-resistant dosage forms. Moreover, hydrophobic calcium stearate can be considered a suitable matrix system that minimizes the risk of ethanol-induced dose dumping for certain API's. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Composites comprising novel RTIL-based polymers, and methods of making and using same

    Science.gov (United States)

    Gin, Douglas; Carlisle, Trevor; Noble, Richard; Nicodemus, Garret; McDanel, William; Cowan, Matthew

    2017-06-27

    The invention includes compositions comprising curable imidazolium-functionalized poly(room-temperature ionic liquid) copolymers and homopolymers. The invention further includes methods of preparing and using the compositions of the invention. The invention further includes novel methods of preparing thin, supported, room-temperature ionic liquid-containing polymeric films on a porous support. In certain embodiments, the methods of the invention avoid the use of a gutter layer, which greatly reduces the overall gas permeance and selectivity of the composite membrane. In other embodiments, the films of the invention have increased gas selectivity and permeance over films prepared using methods described in the prior art.

  7. Palladium catalyst system comprising zwitterion and/or acid-​functionalized ionic liquid

    DEFF Research Database (Denmark)

    2011-01-01

    The present invention concerns a catalyst system in particular a catalyst system comprising Palladium (Pd), a zwitterion and/or an acid-functionalized ionic liquid, and one or more phosphine ligands, wherein the Pd catalyst can be provided by a complex precursor, such as Pd(CH3COO)2, PdCI2, Pd(CH3...... methyl methacrylate and/or methacrylic acid. Catalyst systems according to the invention are suitable for reactions forming separable product and catalyst phases and supported ionic liquid phase SILP applications....

  8. Possibility of sorption purification of chromium comprising waste waters of galvanic production by inorganic ion exchangers

    International Nuclear Information System (INIS)

    Khaynakov, S.A.; Likov, E.P.; Bortun, A.I.; Belyukov, V.N.

    1986-01-01

    Present work is devoted to possibilities of sorption purification of chromium comprising waste waters of galvanic production by inorganic ion exchangers. Thus, the comparative study of sorption of chromium ions on anion exchanger A B-17 and on inorganic ion exchangers on the basis of hydrated titanium and zirconium dioxides in static and dynamic conditions is conducted. The influence of chromium ions concentration, solutions acidity (ph=1÷12) and presence of base electrolyte on sorption is studied. The state of chromium ions sorbed by inorganic ion exchangers is studied by means of infrared spectroscopy and spectroscopy. It is defined that inorganic sorbents could be used for chromium extraction from different solutions.

  9. IDIOMS THAT COMPRISE THE PRESENCE OF TURKISH WORDS IN GREEK CYPRIOT LANGUAGE

    OpenAIRE

    Şevket ÖZNUR; Mahmut İSLÂMOĞLU

    2010-01-01

    In this communiqué again we preferred to present some examples from the effects of Turkish Cypriot Culture. For a few years, we have concentrated on our culture’s effect on other cultures in Cyprus. Bearing in mind that we have lived together for hundreds of years with other societies, we have seen fit to give examples of the cultural interaction between other cultures and Turkish Cypriot culture. Our communiqué mostly comprises the effects of Turkish Culture. We have found it convenient to p...

  10. Electrical characterization of MIM capacitor comprises an adamantane film at room temperature

    Energy Technology Data Exchange (ETDEWEB)

    Tiwari, Rajanish N., E-mail: rajanisht@gmail.com [Department of Physics and Astronomical Sciences, Central University of Himachal Pradesh, Dharmshala 176206 Kangra, H.P. India (India); Toyota Technological Institute, 2-12-1Hisakata, Tempaku-Ku, Nagoya 468-8511 (Japan); Yoshimura, Masamichi [Department of Physics and Astronomical Sciences, Central University of Himachal Pradesh, Dharmshala 176206 Kangra, H.P. India (India)

    2016-06-15

    We fabricated a new metal-insulator-metal capacitor at room temperature, comprising a ∼90 nm thin low–k adamantane film on a Si substrate. The surface morphology of deposited organic film was investigated by using scanning electron microscopy and Raman spectroscopy, which is confirmed that the adamantane thin film was uniformly distributed on the Si surface. The adamantane film exhibits a low leakage current density of 7.4 x 10{sup −7} A/cm{sup 2} at 13.5 V, better capacitance density of 2.14 fF/μm{sup 2} at 100 KHz.

  11. Anticonvection device for a narrow space comprised between two parallel walls

    International Nuclear Information System (INIS)

    Costes, Didier.

    1975-01-01

    The invention relates to an anticonvection device providing strong limitations against the convection currents inside a space submitted to a vertical thermal gradient and more especially the space enclosed between the inner wall of a vessel generally cyclindrical in shape and of vertical axis, intended for a nuclear reactor, and the outer wall of a plug fitted together with said vessel. To this effect, said device is characterized in that it comprises a packing of a material of open porosity and thickness-wise elasticity, in the form of threads, fibers, knitted-cloths or sheets separated by distances shorter than the thickness of stagnancy under the temperature conditions inside said space [fr

  12. Detection matrix of an electromagnetic radiation and radiological image intensifier comprising such a matrix

    International Nuclear Information System (INIS)

    Fraleux, Jean.

    1982-01-01

    This invention concerns a detection matrix comprising, in an electrode lattice of lines and columns, addressing means constituted of thin film technology MOS transistors and photoconductances which enable the number of unit module crossings to be halved and to bring about an increase in the effective detection area. This detection matrix is employed in radiological image intensifiers where it ensures the conversion of incident X photons into reading electric signals or only the detection of a visible radiation in the case where the incident X photons are converted into lesser energy photons by a scintillator. The scintillator is then formed of a panel brought into contact with the detector mosaic [fr

  13. Asynchronous networks: modularization of dynamics theorem

    Science.gov (United States)

    Bick, Christian; Field, Michael

    2017-02-01

    Building on the first part of this paper, we develop the theory of functional asynchronous networks. We show that a large class of functional asynchronous networks can be (uniquely) represented as feedforward networks connecting events or dynamical modules. For these networks we can give a complete description of the network function in terms of the function of the events comprising the network: the modularization of dynamics theorem. We give examples to illustrate the main results.

  14. A lung cancer risk classifier comprising genome maintenance genes measured in normal bronchial epithelial cells.

    Science.gov (United States)

    Yeo, Jiyoun; Crawford, Erin L; Zhang, Xiaolu; Khuder, Sadik; Chen, Tian; Levin, Albert; Blomquist, Thomas M; Willey, James C

    2017-05-02

    Annual low dose CT (LDCT) screening of individuals at high demographic risk reduces lung cancer mortality by more than 20%. However, subjects selected for screening based on demographic criteria typically have less than a 10% lifetime risk for lung cancer. Thus, there is need for a biomarker that better stratifies subjects for LDCT screening. Toward this goal, we previously reported a lung cancer risk test (LCRT) biomarker comprising 14 genome-maintenance (GM) pathway genes measured in normal bronchial epithelial cells (NBEC) that accurately classified cancer (CA) from non-cancer (NC) subjects. The primary goal of the studies reported here was to optimize the LCRT biomarker for high specificity and ease of clinical implementation. Targeted competitive multiplex PCR amplicon libraries were prepared for next generation sequencing (NGS) analysis of transcript abundance at 68 sites among 33 GM target genes in NBEC specimens collected from a retrospective cohort of 120 subjects, including 61 CA cases and 59 NC controls. Genes were selected for analysis based on contribution to the previously reported LCRT biomarker and/or prior evidence for association with lung cancer risk. Linear discriminant analysis was used to identify the most accurate classifier suitable to stratify subjects for screening. After cross-validation, a model comprising expression values from 12 genes (CDKN1A, E2F1, ERCC1, ERCC4, ERCC5, GPX1, GSTP1, KEAP1, RB1, TP53, TP63, and XRCC1) and demographic factors age, gender, and pack-years smoking, had Receiver Operator Characteristic area under the curve (ROC AUC) of 0.975 (95% CI: 0.96-0.99). The overall classification accuracy was 93% (95% CI 88%-98%) with sensitivity 93.1%, specificity 92.9%, positive predictive value 93.1% and negative predictive value 93%. The ROC AUC for this classifier was significantly better (p < 0.0001) than the best model comprising demographic features alone. The LCRT biomarker reported here displayed high accuracy and ease

  15. Nucleic acids encoding phloem small RNA-binding proteins and transgenic plants comprising them

    Science.gov (United States)

    Lucas, William J.; Yoo, Byung-Chun; Lough, Tony J.; Varkonyi-Gasic, Erika

    2007-03-13

    The present invention provides a polynucleotide sequence encoding a component of the protein machinery involved in small RNA trafficking, Cucurbita maxima phloem small RNA-binding protein (CmPSRB 1), and the corresponding polypeptide sequence. The invention also provides genetic constructs and transgenic plants comprising the polynucleotide sequence encoding a phloem small RNA-binding protein to alter (e.g., prevent, reduce or elevate) non-cell autonomous signaling events in the plants involving small RNA metabolism. These signaling events are involved in a broad spectrum of plant physiological and biochemical processes, including, for example, systemic resistance to pathogens, responses to environmental stresses, e.g., heat, drought, salinity, and systemic gene silencing (e.g., viral infections).

  16. Nanoscale Cross-Point Resistive Switching Memory Comprising p-Type SnO Bilayers

    KAUST Repository

    Hota, Mrinal Kanti

    2015-02-23

    Reproducible low-voltage bipolar resistive switching is reported in bilayer structures of p-type SnO films. Specifically, a bilayer homojunction comprising SnOx (oxygen-rich) and SnOy (oxygen-deficient) in nanoscale cross-point (300 × 300 nm2) architecture with self-compliance effect is demonstrated. By using two layers of SnO film, a good memory performance is obtained as compared to the individual oxide films. The memory devices show resistance ratio of 103 between the high resistance and low resistance states, and this difference can be maintained for up to 180 cycles. The devices also show good retention characteristics, where no significant degradation is observed for more than 103 s. Different charge transport mechanisms are found in both resistance states, depending on the applied voltage range and its polarity. The resistive switching is shown to originate from the oxygen ion migration and subsequent formation/rupture of conducting filaments.

  17. Palladium catalyst system comprising zwitterion and/or acid-functionalized ionic liquid

    DEFF Research Database (Denmark)

    2011-01-01

    The present invention concerns a catalyst system in particular a catalyst system comprising Palladium (Pd), a zwitterion and/or an acid-functionalized ionic liquid, and one or more phosphine ligands, wherein the Pd catalyst can be provided by a complex precursor, such as Pd(CH3COO)2, PdCI2, Pd(CH3......COCHCOCH3), Pd (CF3COO)2, Pd(PPh3)4 or Pd2(dibenzylideneacetone)3. Such catalyst systems can be used for e.g. alkoxycarbonylation reactions, carboxylation reactions, and/or in a co-polymerization reaction, e.g. in the production of methyl propionate and/or propanoic acid, optionally in processes forming...... methyl methacrylate and/or methacrylic acid. Catalyst systems according to the invention are suitable for reactions forming separable product and catalyst phases and supported ionic liquid phase SILP applications....

  18. PREPARATION AND CHARACTERIZATION OF COMPOSITES COMPRISING MODIFIED HARDWOOD AND WOOD POLYMERS/POLY(VINYL CHLORIDE

    Directory of Open Access Journals (Sweden)

    Ruxanda Bodîrlău

    Full Text Available Chemical modification of hardwood sawdust from ash-tree species was carried out with a solution of maleic anhydride in acetone. Wood polymers, lignin, and cellulose were isolated from the wood sawdust and modified by the same method. Samples were characterized by Fourier transform infrared spectroscopy (FTIR, providing evidence that maleic anhydride esterifies the free hydroxyl groups of the wood polymer components. Composites comprising chemically modified wood sawdust and wood polymers (cellulose, lignin-as variable weight percentages-, and poly (vinyl chloride were obtained and further characterized by using FTIR spectroscopy and scanning electron microscopy (SEM. The thermal behavior of composites was investigated by using the thermogravimetric analysis (TGA. In all cases, thermal properties were affected by fillers addition.

  19. Mycobacterium tuberculosis Lineage 4 comprises globally distributed and geographically restricted sublineages

    Science.gov (United States)

    Coscolla, Mireia; Liu, Qingyun; Trauner, Andrej; Fenner, Lukas; Rutaihwa, Liliana; Borrell, Sonia; Luo, Tao; Gao, Qian; Kato-Maeda, Midori; Ballif, Marie; Egger, Matthias; Macedo, Rita; Mardassi, Helmi; Moreno, Milagros; Tudo Vilanova, Griselda; Fyfe, Janet; Globan, Maria; Thomas, Jackson; Jamieson, Frances; Guthrie, Jennifer L.; Asante-Poku, Adwoa; Yeboah-Manu, Dorothy; Wampande, Eddie; Ssengooba, Willy; Joloba, Moses; Henry Boom, W.; Basu, Indira; Bower, James; Saraiva, Margarida; Vaconcellos, Sidra E. G.; Suffys, Philip; Koch, Anastasia; Wilkinson, Robert; Gail-Bekker, Linda; Malla, Bijaya; Ley, Serej D.; Beck, Hans-Peter; de Jong, Bouke C.; Toit, Kadri; Sanchez-Padilla, Elisabeth; Bonnet, Maryline; Gil-Brusola, Ana; Frank, Matthias; Penlap Beng, Veronique N.; Eisenach, Kathleen; Alani, Issam; Wangui Ndung’u, Perpetual; Revathi, Gunturu; Gehre, Florian; Akter, Suriya; Ntoumi, Francine; Stewart-Isherwood, Lynsey; Ntinginya, Nyanda E.; Rachow, Andrea; Hoelscher, Michael; Cirillo, Daniela Maria; Skenders, Girts; Hoffner, Sven; Bakonyte, Daiva; Stakenas, Petras; Diel, Roland; Crudu, Valeriu; Moldovan, Olga; Al-Hajoj, Sahal; Otero, Larissa; Barletta, Francesca; Jane Carter, E.; Diero, Lameck; Supply, Philip; Comas, Iñaki; Niemann, Stefan; Gagneux, Sebastien

    2016-01-01

    Generalist and specialist species differ in the breadth of their ecological niche. Little is known about the niche width of obligate human pathogens. Here we analyzed a global collection of Mycobacterium tuberculosis Lineage 4 clinical isolates, the most geographically widespread cause of human tuberculosis. We show that Lineage 4 comprises globally distributed and geographically restricted sublineages, suggesting a distinction between generalists and specialists. Population genomic analyses showed that while the majority of human T cell epitopes were conserved in all sublineages, the proportion of variable epitopes was higher in generalists. Our data further support a European origin for the most common generalist sublineage. Hence, the global success of Lineage 4 reflects distinct strategies adopted by different sublineages and the influence of human migration. PMID:27798628

  20. Apparatus comprising trace element dosage and method for treating raw water in biofilter

    DEFF Research Database (Denmark)

    2015-01-01

    the inlet (2) to the outlet (3) or in the reverse direction, - the trace element dosage device (13) is positioned upstream of the porous filter material and microbial biomass and is configured to dose trace element(s) to the water flowing through the filter. A method for treating raw water by microbial......Apparatus for treating raw water in a biofilter The present invention relates to an apparatus in which raw water is treated through microbial activity where microbial activity is controlled by nutrients and other parameters. Some of the nutrients controlling the microbial activity are trace...... elements such as certain metals (Cu, Co, Cr, Mo, Ni, W, Zn or a mixture thereof). The apparatus comprising - a volume provided with an inlet (2) for raw water and an outlet (3) for water having been subjected to microbial activity, a filter and a trace element dosage device (13) are placed in this volume...

  1. Functional Analysis of Genes Comprising the Locus of Heat Resistance in Escherichia coli.

    Science.gov (United States)

    Mercer, Ryan; Nguyen, Oanh; Ou, Qixing; McMullen, Lynn; Gänzle, Michael G

    2017-10-15

    The locus of heat resistance (LHR) is a 15- to 19-kb genomic island conferring exceptional heat resistance to organisms in the family Enterobacteriaceae , including pathogenic strains of Salmonella enterica and Escherichia coli The complement of LHR-comprising genes that is necessary for heat resistance and the stress-induced or growth-phase-induced expression of LHR-comprising genes are unknown. This study determined the contribution of the seven LHR-comprising genes yfdX1 GI , yfdX2 , hdeD GI , orf11 , trx GI , kefB , and psiE GI by comparing the heat resistances of E. coli strains harboring plasmid-encoded derivatives of the different LHRs in these genes. (Genes carry a subscript "GI" [genomic island] if an ortholog of the same gene is present in genomes of E. coli ) LHR-encoded heat shock proteins sHSP20, ClpK GI , and sHSP GI are not sufficient for the heat resistance phenotype; YfdX1, YfdX2, and HdeD are necessary to complement the LHR heat shock proteins and to impart a high level of resistance. Deletion of trx GI , kefB , and psiE GI from plasmid-encoded copies of the LHR did not significantly affect heat resistance. The effect of the growth phase and the NaCl concentration on expression from the putative LHR promoter p2 was determined by quantitative reverse transcription-PCR and by a plasmid-encoded p2:GFP promoter fusion. The expression levels of exponential- and stationary-phase E. coli cells were not significantly different, but the addition of 1% NaCl significantly increased LHR expression. Remarkably, LHR expression in E. coli was dependent on a chromosomal copy of evgA In conclusion, this study improved our understanding of the genes required for exceptional heat resistance in E. coli and factors that increase their expression in food. IMPORTANCE The locus of heat resistance (LHR) is a genomic island conferring exceptional heat resistance to several foodborne pathogens. The exceptional level of heat resistance provided by the LHR questions the

  2. Ion source using a hollow cathode discharge system and especially, particle accelerator comprising said source

    International Nuclear Information System (INIS)

    Mourier, Georges.

    1975-01-01

    An ion source provided with a hollow cathode discharge system is presented. The ion extraction system is designed in view of generating a beam directed towards a point of use located far from the point of ion production. Said source essentially comprises two cathodes facing each other, an anode at a continuous voltage with respect to the cathodes, a heated filament beyond the cathode on the path of the extracted beam, and a grid between said filament and cathode. The ion extraction is limited to a certain portion of the ions present inside the plasma, so as the discharge to continue to be sustained by itself. For that purpose pierced cathodes are used, with a transparency (the ratio of the hole area to the whole cathode area) not much higher than 50% [fr

  3. Position sensitive detector with semiconductor and image electron tube comprising such a detector

    International Nuclear Information System (INIS)

    Roziere, Guy.

    1977-01-01

    This invention concerns a position sensitive detector comprising a semiconducting substrate. It also concerns the electron tubes in which the detector may be incorporated in order to obtain an image formed at the tube input by an incident flux of particles or radiation. When a charged particle or group of such particles, electrons in particular, enter the space charge region of an inversely biased semiconductor diode, the energy supplied by these particles releases in the diode a certain number of electron-hole pairs which move in the field existing in the area towards the diode contacts. A corresponding current arises in the connections of this diode which constitutes the signal corresponding to the incident energy. Such a tube or chain of tubes is employed in nuclear medicine for observing parts of the human body, particularly by gamma radiation [fr

  4. Kinetic analysis of overlapping multistep thermal decomposition comprising exothermic and endothermic processes: thermolysis of ammonium dinitramide.

    Science.gov (United States)

    Muravyev, Nikita V; Koga, Nobuyoshi; Meerov, Dmitry B; Pivkina, Alla N

    2017-01-25

    This study focused on kinetic modeling of a specific type of multistep heterogeneous reaction comprising exothermic and endothermic reaction steps, as exemplified by the practical kinetic analysis of the experimental kinetic curves for the thermal decomposition of molten ammonium dinitramide (ADN). It is known that the thermal decomposition of ADN occurs as a consecutive two step mass-loss process comprising the decomposition of ADN and subsequent evaporation/decomposition of in situ generated ammonium nitrate. These reaction steps provide exothermic and endothermic contributions, respectively, to the overall thermal effect. The overall reaction process was deconvoluted into two reaction steps using simultaneously recorded thermogravimetry and differential scanning calorimetry (TG-DSC) curves by considering the different physical meanings of the kinetic data derived from TG and DSC by P value analysis. The kinetic data thus separated into exothermic and endothermic reaction steps were kinetically characterized using kinetic computation methods including isoconversional method, combined kinetic analysis, and master plot method. The overall kinetic behavior was reproduced as the sum of the kinetic equations for each reaction step considering the contributions to the rate data derived from TG and DSC. During reproduction of the kinetic behavior, the kinetic parameters and contributions of each reaction step were optimized using kinetic deconvolution analysis. As a result, the thermal decomposition of ADN was successfully modeled as partially overlapping exothermic and endothermic reaction steps. The logic of the kinetic modeling was critically examined, and the practical usefulness of phenomenological modeling for the thermal decomposition of ADN was illustrated to demonstrate the validity of the methodology and its applicability to similar complex reaction processes.

  5. The "All Sky Camera Network"

    Science.gov (United States)

    Caldwell, Andy

    2005-01-01

    In 2001, the "All Sky Camera Network" came to life as an outreach program to connect the Denver Museum of Nature and Science (DMNS) exhibit "Space Odyssey" with Colorado schools. The network is comprised of cameras placed strategically at schools throughout Colorado to capture fireballs--rare events that produce meteorites.…

  6. Magnetoresistance in single-electron transistors comprising a superconducting island with ferromagnetic leads

    Science.gov (United States)

    Mizugaki, Yoshinao; Takiguchi, Masashi; Tamura, Nobuyuki; Shimada, Hiroshi

    2018-03-01

    We report electric and magnetic field responses of single-electron transistors (SETs) comprising a superconducting island with ferromagnetic (FM) leads. We fabricated two SETs, one of which had relatively high resistance and the other had relatively low resistance. The SETs had two states for the gate charge: SET-ON or SET-OFF. They also had two states for the FM lead magnetization: parallel (P) or anti-parallel (AP) configuration. Current-voltage characteristics of four SET states (“P & SET-ON,” “P & SET-OFF,” “AP & SET-ON,” and “AP & SET-OFF”) were measured at approximately 0.1 K in a compact dilution refrigerator. Magnetoresistance ratio (MRR) values were obtained for the SET-ON and SET-OFF states, respectively. The higher-resistance SET1 exhibited positive MRR values for all measured bias voltages. The MRR enhancement was confirmed for the SET-OFF state, which agreed well with the co-tunneling model. The lower-resistance SET2, on the other hand, exhibited negative and positive MRR values for higher and lower bias voltage conditions, respectively. The bias voltage for the MRR polarity reversal was changed by the gate voltage. It was also confirmed that the co-tunneling model was partially valid for negative MRR values.

  7. Guided wave propagation and scattering in pipeworks comprising elbows: Theoretical and experimental results

    International Nuclear Information System (INIS)

    Bakkali, M El; Lhémery, A; Baronian, V; Chapuis, B

    2015-01-01

    Elastic guided waves (GW) are used to inspect pipeworks in various industries. Modelling tools for simulating GW inspection are necessary to understand complex scattering phenomena occurring at specific features (welds, elbows, junctions...). In pipeworks, straight pipes coexist with elbows. GW propagation in the former cases is well-known, but is less documented in the latter. Their scattering at junction of straight and curved pipes constitutes a complex phenomenon. When a curved part is joined to two straight parts, these phenomena couple and give rise to even more complex wave structures. In a previous work, the SemiAnalytic Finite Element method extended to curvilinear coordinates was used to handle GW propagation in elbows, combined with a mode matching method to predict their scattering at the junction with a straight pipe. Here, a pipework comprising an arbitrary number of elbows of finite length and of different curvature linking straight pipes is considered. A modal scattering matrix is built by cascading local scattering and propagation matrices. The overall formulation only requires meshing the pipe section to compute both the modal solutions and the integrals resulting from the mode-matching method for computing local scattering matrices. Numerical predictions using this approach are studied and compared to experiments

  8. Stability Assessment of a System Comprising a Single Machine and Inverter with Scalable Ratings

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Brian B [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Lin, Yashen [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Gevorgian, Vahan [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Purba, Victor [University of Minnesota; Dhople, Sairaj [University of Minnesota

    2017-09-28

    From the inception of power systems, synchronous machines have acted as the foundation of large-scale electrical infrastructures and their physical properties have formed the cornerstone of system operations. However, power electronics interfaces are playing a growing role as they are the primary interface for several types of renewable energy sources and storage technologies. As the role of power electronics in systems continues to grow, it is crucial to investigate the properties of bulk power systems in low inertia settings. In this paper, we assess the properties of coupled machine-inverter systems by studying an elementary system comprised of a synchronous generator, three-phase inverter, and a load. Furthermore, the inverter model is formulated such that its power rating can be scaled continuously across power levels while preserving its closed-loop response. Accordingly, the properties of the machine-inverter system can be assessed for varying ratios of machine-to-inverter power ratings and, hence, differing levels of inertia. After linearizing the model and assessing its eigenvalues, we show that system stability is highly dependent on the interaction between the inverter current controller and machine exciter, thus uncovering a key concern with mixed machine-inverter systems and motivating the need for next-generation grid-stabilizing inverter controls.

  9. Composite materials comprising two jonal functions and methods for making the same

    Science.gov (United States)

    Fareed, Ali Syed; Garnier, John Edward; Schiroky, Gerhard Hans; Kennedy, Christopher Robin; Sonuparlak, Birol

    2001-01-01

    The present invention generally relates to mechanisms for preventing undesirable oxidation (i.e., oxidation protection mechanisms) in composite bodies. The oxidation protection mechanisms include getterer materials which are added to the composite body which gather or scavenge undesirable oxidants which may enter the composite body. The getterer materials may be placed into at least a portion of the composite body such that any undesirable oxidant approaching, for example, a fiber reinforcement, would be scavenged by (e.g., reacted with) the getterer. The getterer materials) may form at least one compound which acts as a passivation layer, and/or is able to move by bulk transport (e.g., by viscous flow as a glassy material) to a crack, and sealing the crack, thereby further enhancing the oxidation protection of the composite body. One or more ceramic filler materials which serve as reinforcements may have a plurality of super-imposed coatings thereon, at least one of which coatings may function as or contain an oxidation protection mechanism. Specifically, a coating comprising boron nitride which has been engineered or modified to contain some silicon exhibits improved corrosion resistance, specifically to oxygen and moisture. The coated materials may be useful as reinforcing materials in high performance composites to provide improved mechanical properties such as fracture toughness. The present invention also relates to improved composites which incorporate these materials, and to their methods of manufacture.

  10. Strain gauge sensors comprised of carbon nanotube yarn: parametric numerical analysis of their piezoresistive response

    International Nuclear Information System (INIS)

    Abot, Jandro L; Kiyono, César Y; Thomas, Gilles P; Silva, Emílio C N

    2015-01-01

    Carbon nanotube (CNT) yarns are micron-size fibers that contain thousands of intertwined CNTs in their cross sections and exhibit piezoresistance characteristics that can be tapped for sensing purposes. Sensor yarns can be integrated into polymeric and composite materials to measure strain through resistance measurements without adding weight or altering the integrity of the host material. This paper includes the details of novel strain gauge sensor configurations comprised of CNT yarn, the numerical modeling of their piezoresistive response, and the parametric analysis schemes that determines the highest sensor sensitivity to mechanical loading. The effect of several sensor configuration parameters are discussed including the inclination and separation of the CNT yarns within the sensor, the mechanical properties of the CNT yarn, the direction and magnitude of the applied mechanical load, and the dimensions and shape of the sensor. The sensor configurations that yield the highest sensitivity are presented and discussed in terms of the mechanical and electrical properties of the CNT yarn. It is shown that strain gauge sensors consisting of CNT yarn are sensitive enough to measure strain, and could exhibit even higher gauge factors than those of metallic foil strain gauges. (paper)

  11. Implementation of a documentation model comprising nursing terminologies--theoretical and methodological issues.

    Science.gov (United States)

    von Krogh, Gunn; Nåden, Dagfinn

    2008-04-01

    To describe and discuss theoretical and methodological issues of implementation of a nursing services documentation model comprising NANDA nursing diagnoses, Nursing Intervention Classification and Nursing Outcome Classification terminologies. The model is developed for electronic patient record and was implemented in a psychiatric hospital on an organizational level and on five test wards in 2001-2005. The theory of Rogers guided the process of innovation, whereas the implementation procedure of McCloskey and Bulecheck combined with adult learning principals guided the test site implementation. The test wards managed in different degrees to adopt the model. Two wards succeeded fully, including a ward with high percentage of staff with interdisciplinary background. Better planning regarding the impact of the organization's innovative aptitude, the innovation strategies and the use of differentiated methods regarding the clinician's individual premises for learning nursing terminologies might have enhanced the adoption to the model. To better understand the nature of barriers and the importance of careful planning regarding the implementation of electronic patient record elements in nursing care services, focusing on nursing terminologies. Further to indicate how a theory and specific procedure can be used to guide the process of implementation throughout the different levels of management.

  12. Structural analysis and taste evaluation of γ-glutamyl peptides comprising sulfur-containing amino acids.

    Science.gov (United States)

    Amino, Yusuke; Wakabayashi, Hidehiko; Akashi, Satoko; Ishiwatari, Yutaka

    2018-03-01

    The structures, flavor-modifying effects, and CaSR activities of γ-glutamyl peptides comprising sulfur-containing amino acids were investigated. The chemical structures, including the linkage mode of the N-terminal glutamic acid, of γ-L-glutamyl-S-(2-propenyl)-L-cysteine (γ-L-glutamyl-S-allyl-L-cysteine) and its sulfoxide isolated from garlic were established by comparing their NMR spectra with those of authentic peptides prepared using chemical methods. Mass spectrometric analysis also enabled determination of the linkage modes in the glutamyl dipeptides by their characteristic fragmentation. In sensory evaluation, these peptides exhibited flavor-modifying effects (continuity) in umami solutions less pronounced but similar to that of glutathione. Furthermore, the peptides exhibited intrinsic flavor due to the sulfur-containing structure, which may be partially responsible for their flavor-modifying effects. In CaSR assays, γ-L-glutamyl-S-methyl-L-cysteinylglycine was most active, which indicates that the presence of a medium-sized aliphatic substituent at the second amino acid residue in γ-glutamyl peptides enhances CaSR activity.

  13. High-performance organic light-emitting diodes comprising ultrastable glass layers

    Science.gov (United States)

    Rodríguez-Viejo, Javier

    2018-01-01

    Organic light-emitting diodes (OLEDs) are one of the key solid-state light sources for various applications including small and large displays, automotive lighting, solid-state lighting, and signage. For any given commercial application, OLEDs need to perform at their best, which is judged by their device efficiency and operational stability. We present OLEDs that comprise functional layers fabricated as ultrastable glasses, which represent the thermodynamically most favorable and, thus, stable molecular conformation achievable nowadays in disordered solids. For both external quantum efficiencies and LT70 lifetimes, OLEDs with four different phosphorescent emitters show >15% enhancements over their respective reference devices. The only difference to the latter is the growth condition used for ultrastable glass layers that is optimal at about 85% of the materials’ glass transition temperature. These improvements are achieved through neither material refinements nor device architecture optimization, suggesting a general applicability of this concept to maximize the OLED performance, no matter which specific materials are used. PMID:29806029

  14. Novel Metabolic Attributes of the Genus Cyanothece, Comprising a Group of Unicellular Nitrogen-Fixing Cyanobacteria

    Science.gov (United States)

    Bandyopadhyay, Anindita; Elvitigala, Thanura; Welsh, Eric; Stöckel, Jana; Liberton, Michelle; Min, Hongtao; Sherman, Louis A.; Pakrasi, Himadri B.

    2011-01-01

    ABSTRACT The genus Cyanothece comprises unicellular cyanobacteria that are morphologically diverse and ecologically versatile. Studies over the last decade have established members of this genus to be important components of the marine ecosystem, contributing significantly to the nitrogen and carbon cycle. System-level studies of Cyanothece sp. ATCC 51142, a prototypic member of this group, revealed many interesting metabolic attributes. To identify the metabolic traits that define this class of cyanobacteria, five additional Cyanothece strains were sequenced to completion. The presence of a large, contiguous nitrogenase gene cluster and the ability to carry out aerobic nitrogen fixation distinguish Cyanothece as a genus of unicellular, aerobic nitrogen-fixing cyanobacteria. Cyanothece cells can create an anoxic intracellular environment at night, allowing oxygen-sensitive processes to take place in these oxygenic organisms. Large carbohydrate reserves accumulate in the cells during the day, ensuring sufficient energy for the processes that require the anoxic phase of the cells. Our study indicates that this genus maintains a plastic genome, incorporating new metabolic capabilities while simultaneously retaining archaic metabolic traits, a unique combination which provides the flexibility to adapt to various ecological and environmental conditions. Rearrangement of the nitrogenase cluster in Cyanothece sp. strain 7425 and the concomitant loss of its aerobic nitrogen-fixing ability suggest that a similar mechanism might have been at play in cyanobacterial strains that eventually lost their nitrogen-fixing ability. PMID:21972240

  15. Solvent exchange-induced in situ forming gel comprising ethyl cellulose-antimicrobial drugs.

    Science.gov (United States)

    Phaechamud, Thawatchai; Mahadlek, Jongjan

    2015-10-15

    Solvent-exchanged in situ forming gel is a drug delivery system which is in sol form before administration. When it contacts with the body fluid, then the water miscible organic solvent dissipates and water penetrates into the system, leading the polymer precipitation as in situ gel at the site of injection. The aim of this research was to study the parameters affecting the gel properties, drug release and antimicrobial activities of the in situ forming gels prepared from ethyl cellulose (EC) dissolved in N-methyl pyrrolidone (NMP) to deliver the antimicrobial agents (doxycycline hyclate, metronidazole and benzyl peroxide) for periodontitis treatment. The gel appearance, pH, viscosity, rheology, syringeability, gel formation, rate of water diffusion into the gels, in vitro degradation, drug release behavior and antimicrobial activities against Staphylococcus aureus, Escherichia coli, Candida albicans, Streptococcus mutans and Porphyrommonas gingivalis were determined. Increasing the amount of EC increased the viscosity of system while still exhibiting Newtonian flow and increased the work of syringeability whereas decreased the releasing of drug. The system transformed into the rigid gel formation after being injected into the simulated gingival crevicular fluid. The developed systems containing 5% w/w antimicrobial agent showed the antimicrobial activities against all test bacteria. Thus the developed solvent exchange-induced in situ forming gels comprising EC-antimicrobial drugs exhibited potential use for periodontitis treatment. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Characterization of the proteins comprising the integral matrix of Strongylocentrotus purpuratus embryonic spicules

    Science.gov (United States)

    Killian, C. E.; Wilt, F. H.

    1996-01-01

    In the present study, we enumerate and characterize the proteins that comprise the integral spicule matrix of the Strongylocentrotus purpuratus embryo. Two-dimensional gel electrophoresis of [35S]methionine radiolabeled spicule matrix proteins reveals that there are 12 strongly radiolabeled spicule matrix proteins and approximately three dozen less strongly radiolabeled spicule matrix proteins. The majority of the proteins have acidic isoelectric points; however, there are several spicule matrix proteins that have more alkaline isoelectric points. Western blotting analysis indicates that SM50 is the spicule matrix protein with the most alkaline isoelectric point. In addition, two distinct SM30 proteins are identified in embryonic spicules, and they have apparent molecular masses of approximately 43 and 46 kDa. Comparisons between embryonic spicule matrix proteins and adult spine integral matrix proteins suggest that the embryonic 43-kDa SM30 protein is an embryonic isoform of SM30. An adult 49-kDa spine matrix protein is also identified as a possible adult isoform of SM30. Analysis of the SM30 amino acid sequences indicates that a portion of SM30 proteins is very similar to the carbohydrate recognition domain of C-type lectin proteins.

  17. Saccharification of sunflower stalks using lignocellulases from a fungal consortium comprising Pholiota adiposa and Armillaria gemina.

    Science.gov (United States)

    Ramachandran, Priyadharshini; Kim, Tae-Su; Dhiman, Saurabh Sudha; Li, Jinglin; Park, Ji-Hyun; Choi, Joon-Ho; Kim, Jae Young; Kim, Dongwook; Lee, Jung-Kul

    2015-09-01

    Lignocellulases from Armillaria gemina and Pholiota adiposa are efficient in hydrolyzing aspen and poplar biomass, respectively. In the present study, lignocellulosic enzymes obtained from a fungal consortium comprising P. adiposa and A. gemina were used for the saccharification of sunflower stalks. Sunflower stalks were thermochemically pretreated using 2 % NaOH at 50 °C for 24 h. The saccharification process parameters including substrate concentration, enzyme loading, pH, and temperature were optimized using response surface methodology to improve the saccharification yield. The highest enzymatic hydrolysis (84.3 %) was obtained using the following conditions: enzyme loading 10 FPU/g-substrate, substrate 5.5 %, temperature 50 °C, and pH 4.5. The hydrolysis yield obtained using the enzymes from the fungal consortium was equivalent to that obtained using a mixture of commercial enzymes Celluclast and Novozyme β-glucosidase. Addition of up to 500 ppm of heavy metal ions (As, Cu, Fe, Mn, Ni, Pb, and Zn) during saccharification did not significantly affect the saccharification yield. Thus, the biomass grown for phytoremediation of heavy metals can be used for the production of reducing sugars followed by ethanol fermentation.

  18. Preparation of salted meat products, e.g. cured bacon - by injecting liquid comprising meat proteins hydrolysed with enzymes

    DEFF Research Database (Denmark)

    1997-01-01

    Preparation of salted meat products comprises the following:(1) meat is chopped into fine pieces and mixed with water to form a slurry; (2) enzymes hydrolyse proteins in the meat; (3) adding a culture to the resulting medium, which comprises short peptide chains or amino acids; (4) forming...... flavourings as the culture is growing, and (5) injecting the liquid into pieces of meat....

  19. Structural and biophysical characterization of an antimicrobial peptide chimera comprised of lactoferricin and lactoferrampin.

    Science.gov (United States)

    Haney, Evan F; Nazmi, Kamran; Bolscher, Jan G M; Vogel, Hans J

    2012-03-01

    Lactoferricin and lactoferrampin are two antimicrobial peptides found in the N-terminal lobe of bovine lactoferrin with broad spectrum antimicrobial activity against a range of Gram-positive and Gram-negative bacteria as well as Candida albicans. A heterodimer comprised of lactoferrampin joined to a fragment of lactoferricin was recently reported in which these two peptides were joined at their C-termini through the two amino groups of a single Lys residue (Bolscher et al., 2009, Biochimie 91(1):123-132). This hybrid peptide, termed LFchimera, has significantly higher antimicrobial activity compared to the individual peptides or an equimolar mixture of the two. In this work, the underlying mechanism behind the increased antibacterial activity of LFchimera was investigated. Differential scanning calorimetry studies demonstrated that all the peptides influenced the thermotropic phase behaviour of anionic phospholipid suspensions. Calcein leakage and vesicle fusion experiments with anionic liposomes revealed that LFchimera had enhanced membrane perturbing properties compared to the individual peptides. Peptide structures were evaluated using circular dichroism and NMR spectroscopy to gain insight into the structural features of LFchimera that contribute to the increased antimicrobial activity. The NMR solution structure, determined in a miscible co-solvent mixture of chloroform, methanol and water, revealed that the Lys linkage increased the helical content in LFchimera compared to the individual peptides, but it did not fix the relative orientations of lactoferricin and lactoferrampin with respect to each other. The structure of LFchimera provides insight into the conformation of this peptide in a membranous environment and improves our understanding of its antimicrobial mechanism of action. Copyright © 2011 Elsevier B.V. All rights reserved.

  20. Inadequate vitamin D status: does it contribute to the disorders comprising syndrome 'X'?

    Science.gov (United States)

    Boucher, B J

    1998-04-01

    Environmental factors are important in the aetiology of glucose intolerance, type II diabetes and IHD. The lack of vitamin D, which is necessary for adequate insulin secretion, relates demographically to increased risk of myocardial infarction. These disorders are connected, degenerative vascular disease increasing with glucose intolerance and diabetes and, with its risk factors, comprising syndrome 'X'. Evidence is presented suggesting that vitamin D deficiency may be an avoidable risk factor for syndrome 'X', adding another preventative measure to current recommendations which are aimed at reducing the worldwide epidemic of these disorders. Experimentally, vitamin D deficiency progressively reduces insulin secretion; glucose intolerance follows and becomes irreversible. Relationships between vitamin D status, glucose tolerance and 30 min insulin secretion during oral glucose tolerance tests are reported in British Asians; insulin secretion, but not glycaemia, improving with short-term supplementation. Studies showing reduction in blood pressure and in risk of heart attack and diabetes with exercise (usually outdoor), rarely consider the role of vitamin D status. Glycaemia and insulin secretion in elderly European men, however, relate to vitamin D status, independent of season or physical activity. Prolonged supplementation can improve glycaemia. Hypertension improves with vitamin D treatment with or without initial deficiency. Vitamin D status and climate are reviewed as risk factors for myocardial infarction; the risk reducing with altitude despite increasing cold. Glycaemia and fibrinogenaemia improve with insulin secretion increases in summer. Variation in vitamin D requirements could arise from genetic differences in vitamin D processing since bone density can vary with vitamin D-receptor genotype. Vitamin D receptors are present in islet beta cells and we report insulin secretion in healthy Asians differing profoundly with the Apa I genotype, being

  1. Modeling drag reduction and meniscus stability of superhydrophobic surfaces comprised of random roughness

    Science.gov (United States)

    Samaha, Mohamed A.; Tafreshi, Hooman Vahedi; Gad-el-Hak, Mohamed

    2011-01-01

    Previous studies dedicated to modeling drag reduction and stability of the air-water interface on superhydrophobic surfaces were conducted for microfabricated coatings produced by placing hydrophobic microposts/microridges arranged on a flat surface in aligned or staggered configurations. In this paper, we model the performance of superhydrophobic surfaces comprised of randomly distributed roughness (e.g., particles or microposts) that resembles natural superhydrophobic surfaces, or those produced via random deposition of hydrophobic particles. Such fabrication method is far less expensive than microfabrication, making the technology more practical for large submerged bodies such as submarines and ships. The present numerical simulations are aimed at improving our understanding of the drag reduction effect and the stability of the air-water interface in terms of the microstructure parameters. For comparison and validation, we have also simulated the flow over superhydrophobic surfaces made up of aligned or staggered microposts for channel flows as well as streamwise or spanwise ridges configurations for pipe flows. The present results are compared with theoretical and experimental studies reported in the literature. In particular, our simulation results are compared with work of Sbragaglia and Prosperetti, and good agreement has been observed for gas fractions up to about 0.9. The numerical simulations indicate that the random distribution of surface roughness has a favorable effect on drag reduction, as long as the gas fraction is kept the same. This effect peaks at about 30% as the gas fraction increases to 0.98. The stability of the meniscus, however, is strongly influenced by the average spacing between the roughness peaks, which needs to be carefully examined before a surface can be recommended for fabrication. It was found that at a given maximum allowable pressure, surfaces with random post distribution produce less drag reduction than those made up of

  2. Dutch Lung Surgery Audit: A National Audit Comprising Lung and Thoracic Surgery Patients.

    Science.gov (United States)

    Berge, Martijn Ten; Beck, Naomi; Heineman, David Jonathan; Damhuis, Ronald; Steup, Willem Hans; van Huijstee, Pieter Jan; Eerenberg, Jan Peter; Veen, Eelco; Maat, Alexander; Versteegh, Michel; van Brakel, Thomas; Schreurs, Wilhemina Hendrika; Wouters, Michel Wilhelmus

    2018-04-21

    The nationwide Dutch Lung Surgery Audit (DLSA) started in 2012 to monitor and evaluate the quality of lung surgery in the Netherlands as an improvement tool. This outline describes the establishment, structure and organization of the audit by the Dutch Society of Lung Surgeons (NVvL) and the Dutch Society of Cardiothoracic Surgeons (NVT), in collaboration with the Dutch Institute for Clinical Auditing (DICA). In addition, first four-year results are presented. The NVvL and NVT initiated a web-based registration including weekly updated online feedback for participating hospitals. Data verification by external data managers is performed on regular basis. The audit is incorporated in national quality improvement programs and participation in the DLSA is mandatory by health insurance organizations and the National Healthcare Inspectorate. Between 1 January 2012 and 31 December 2015, all hospitals performing lung surgery participated and a total of 19,557 patients were registered from which almost half comprised lung cancer patients. Nationwide the guideline adherence increased over the years and 96.5% of lung cancer patients were discussed in preoperative multidisciplinary teams. Overall postoperative complications and mortality after non-small cell lung cancer surgery were 15.5% and 2.0%, respectively. The audit provides reliable benchmarked information for caregivers and hospital management with potential to start local, regional or national improvement initiatives. Currently, the audit is further completed with data from non-surgical lung cancer patients including treatment data from pulmonary oncologists and radiation oncologists. This will ultimately provide a comprehensive overview of lung cancer treatment in The Netherlands. Copyright © 2018. Published by Elsevier Inc.

  3. Data Exchange Network

    DEFF Research Database (Denmark)

    Grau Larsen, Anton; Ellersgaard, Christoph

    2015-01-01

    This article presents the extensive Danish elite network. Collected during 2012 and 2013, the data comprises 56,536 positions within 5,079 affiliations, and connects 37,750 individuals. The network consists of the largest Danish corporations, state institutions, NGO’s, and other integrative...... networks such as social clubs or royal events. Data were gathered through an inclusion principle, adding all potentially interesting affiliations. Procedures of name-matching and quality control are presented. Finally, the data are introduced: made available through a package for R, which enables...

  4. Prediction of Ryznar Stability Index for Treated Water of WTPs Located on Al-Karakh Side of Baghdad City using Artificial Neural Network (ANN Technique

    Directory of Open Access Journals (Sweden)

    Awatif Soaded Alsaqqar

    2016-06-01

    Full Text Available In this research an Artificial Neural Network (ANN technique was applied for the prediction of Ryznar Index (RI of the flowing water from WTPs in Al-Karakh side (left side in Baghdad city for year 2013. Three models (ANN1, ANN2 and ANN3 have been developed and tested using data from Baghdad Mayoralty (Amanat Baghdad including drinking water quality for the period 2004 to 2013. The results indicate that it is quite possible to use an artificial neural networks in predicting the stability index (RI with a good degree of accuracy. Where ANN 2 model could be used to predict RI for the effluents from Al-Karakh, Al-Qadisiya and Al-Karama WTPs as the highest correlation coefficient were obtained 92.4, 82.9 and 79.1% respectively. For Al-Dora WTP, ANN 3 model could be used as R was 92.8%.

  5. On Delay and Security in Network Coding

    Science.gov (United States)

    Dikaliotis, Theodoros K.

    2013-01-01

    In this thesis, delay and security issues in network coding are considered. First, we study the delay incurred in the transmission of a fixed number of packets through acyclic networks comprised of erasure links. The two transmission schemes studied are routing with hop-by-hop retransmissions, where every node in the network simply stores and…

  6. Novel metabolic attributes of the genus cyanothece, comprising a group of unicellular nitrogen-fixing Cyanothece.

    Science.gov (United States)

    Bandyopadhyay, Anindita; Elvitigala, Thanura; Welsh, Eric; Stöckel, Jana; Liberton, Michelle; Min, Hongtao; Sherman, Louis A; Pakrasi, Himadri B

    2011-01-01

    The genus Cyanothece comprises unicellular cyanobacteria that are morphologically diverse and ecologically versatile. Studies over the last decade have established members of this genus to be important components of the marine ecosystem, contributing significantly to the nitrogen and carbon cycle. System-level studies of Cyanothece sp. ATCC 51142, a prototypic member of this group, revealed many interesting metabolic attributes. To identify the metabolic traits that define this class of cyanobacteria, five additional Cyanothece strains were sequenced to completion. The presence of a large, contiguous nitrogenase gene cluster and the ability to carry out aerobic nitrogen fixation distinguish Cyanothece as a genus of unicellular, aerobic nitrogen-fixing cyanobacteria. Cyanothece cells can create an anoxic intracellular environment at night, allowing oxygen-sensitive processes to take place in these oxygenic organisms. Large carbohydrate reserves accumulate in the cells during the day, ensuring sufficient energy for the processes that require the anoxic phase of the cells. Our study indicates that this genus maintains a plastic genome, incorporating new metabolic capabilities while simultaneously retaining archaic metabolic traits, a unique combination which provides the flexibility to adapt to various ecological and environmental conditions. Rearrangement of the nitrogenase cluster in Cyanothece sp. strain 7425 and the concomitant loss of its aerobic nitrogen-fixing ability suggest that a similar mechanism might have been at play in cyanobacterial strains that eventually lost their nitrogen-fixing ability. The unicellular cyanobacterial genus Cyanothece has significant roles in the nitrogen cycle in aquatic and terrestrial environments. Cyanothece sp. ATCC 51142 was extensively studied over the last decade and has emerged as an important model photosynthetic microbe for bioenergy production. To expand our understanding of the distinctive metabolic capabilities of

  7. Axon initial segment cytoskeleton comprises a multiprotein submembranous coat containing sparse actin filaments

    Science.gov (United States)

    Jones, Steven L.; Korobova, Farida

    2014-01-01

    The axon initial segment (AIS) of differentiated neurons regulates action potential initiation and axon–dendritic polarity. The latter function depends on actin dynamics, but actin structure and functions at the AIS remain unclear. Using platinum replica electron microscopy (PREM), we have characterized the architecture of the AIS cytoskeleton in mature and developing hippocampal neurons. The AIS cytoskeleton assembly begins with bundling of microtubules and culminates in formation of a dense, fibrillar–globular coat over microtubule bundles. Immunogold PREM revealed that the coat contains a network of known AIS proteins, including ankyrin G, spectrin βIV, neurofascin, neuronal cell adhesion molecule, voltage-gated sodium channels, and actin filaments. Contrary to existing models, we find neither polarized actin arrays, nor dense actin meshworks in the AIS. Instead, the AIS contains two populations of sparse actin filaments: short, stable filaments and slightly longer dynamic filaments. We propose that stable actin filaments play a structural role for formation of the AIS diffusion barrier, whereas dynamic actin may promote AIS coat remodeling. PMID:24711503

  8. An adhesome comprising laminin, dystroglycan and myosin IIA is required during notochord development in Xenopus laevis.

    Science.gov (United States)

    Buisson, Nicolas; Sirour, Cathy; Moreau, Nicole; Denker, Elsa; Le Bouffant, Ronan; Goullancourt, Aline; Darribère, Thierry; Bello, Valérie

    2014-12-01

    Dystroglycan (Dg) is a transmembrane receptor for laminin that must be expressed at the right time and place in order to be involved in notochord morphogenesis. The function of Dg was examined in Xenopus laevis embryos by knockdown of Dg and overexpression and replacement of the endogenous Dg with a mutated form of the protein. This analysis revealed that Dg is required for correct laminin assembly, for cell polarization during mediolateral intercalation and for proper differentiation of vacuoles. Using mutations in the cytoplasmic domain, we identified two sites that are involved in cell polarization and are required for mediolateral cell intercalation, and a site that is required for vacuolation. Furthermore, using a proteomic analysis, the cytoskeletal non-muscle myosin IIA has been identified for the first time as a molecular link between the Dg-cytoplasmic domain and cortical actin. The data allowed us to identify the adhesome laminin-Dg-myosin IIA as being required to maintain the cortical actin cytoskeleton network during vacuolation, which is crucial to maintain the shape of notochordal cells. © 2014. Published by The Company of Biologists Ltd.

  9. Serial Network Flow Monitor

    Science.gov (United States)

    Robinson, Julie A.; Tate-Brown, Judy M.

    2009-01-01

    Using a commercial software CD and minimal up-mass, SNFM monitors the Payload local area network (LAN) to analyze and troubleshoot LAN data traffic. Validating LAN traffic models may allow for faster and more reliable computer networks to sustain systems and science on future space missions. Research Summary: This experiment studies the function of the computer network onboard the ISS. On-orbit packet statistics are captured and used to validate ground based medium rate data link models and enhance the way that the local area network (LAN) is monitored. This information will allow monitoring and improvement in the data transfer capabilities of on-orbit computer networks. The Serial Network Flow Monitor (SNFM) experiment attempts to characterize the network equivalent of traffic jams on board ISS. The SNFM team is able to specifically target historical problem areas including the SAMS (Space Acceleration Measurement System) communication issues, data transmissions from the ISS to the ground teams, and multiple users on the network at the same time. By looking at how various users interact with each other on the network, conflicts can be identified and work can begin on solutions. SNFM is comprised of a commercial off the shelf software package that monitors packet traffic through the payload Ethernet LANs (local area networks) on board ISS.

  10. Network-Centric Maritime Radiation Awareness and Interdiction Experiments

    National Research Council Canada - National Science Library

    Bordetsky, Alex; Dougan, Arden D; Nekoogar, Faranak

    2006-01-01

    .... This joint NPS-LLNL project is based on the NPS Tactical Network Topology (TNT) comprised of long-haul OFDM networks combined with self-forming wireless mesh links to air, surface, ground, and underwater unmanned vehicles...

  11. Distributed cloud association in downlink multicloud radio access networks

    KAUST Repository

    Dahrouj, Hayssam; Al-Naffouri, Tareq Y.; Alouini, Mohamed-Slim

    2015-01-01

    This paper considers a multicloud radio access network (M-CRAN), wherein each cloud serves a cluster of base-stations (BS's) which are connected to the clouds through high capacity digital links. The network comprises several remote users, where

  12. Design and implementation of a topology control scheme for wireless mesh networks

    CSIR Research Space (South Africa)

    Mudali, P

    2009-09-01

    Full Text Available The Wireless Mesh Network (WMN) backbone is usually comprised of stationary nodes but the transient nature of wireless links results in changing network topologies. Topology Control (TC) aims to preserve network connectivity in ad hoc and mesh...

  13. Network Analysis Tools: from biological networks to clusters and pathways.

    Science.gov (United States)

    Brohée, Sylvain; Faust, Karoline; Lima-Mendez, Gipsi; Vanderstocken, Gilles; van Helden, Jacques

    2008-01-01

    Network Analysis Tools (NeAT) is a suite of computer tools that integrate various algorithms for the analysis of biological networks: comparison between graphs, between clusters, or between graphs and clusters; network randomization; analysis of degree distribution; network-based clustering and path finding. The tools are interconnected to enable a stepwise analysis of the network through a complete analytical workflow. In this protocol, we present a typical case of utilization, where the tasks above are combined to decipher a protein-protein interaction network retrieved from the STRING database. The results returned by NeAT are typically subnetworks, networks enriched with additional information (i.e., clusters or paths) or tables displaying statistics. Typical networks comprising several thousands of nodes and arcs can be analyzed within a few minutes. The complete protocol can be read and executed in approximately 1 h.

  14. Learning Networks, Networked Learning

    NARCIS (Netherlands)

    Sloep, Peter; Berlanga, Adriana

    2010-01-01

    Sloep, P. B., & Berlanga, A. J. (2011). Learning Networks, Networked Learning [Redes de Aprendizaje, Aprendizaje en Red]. Comunicar, XIX(37), 55-63. Retrieved from http://dx.doi.org/10.3916/C37-2011-02-05

  15. Canada-Africa Prevention Trials Network : Building African Capacity ...

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

    Canada-Africa Prevention Trials Network : Building African Capacity for HIV/AIDS Prevention Trials. The Canada-Africa Prevention Trials Network (CAPT Network) was formed through a capacity building grant from the Global Health Research Initiative (GHRI). The Network comprises eight African centres (four in Uganda, ...

  16. Sunrise deploys mobile network for CERN

    CERN Multimedia

    2004-01-01

    Sunrise, the alternative telecoms provider in Switzerland, is finalizing the installation of a mobile network comprising about forty sites located around the new particle accelerator at CERN (1 paragraph)

  17. Tuning chaos in network sharing common nonlinearity

    Science.gov (United States)

    Paul Asir, M.; Jeevarekha, A.; Philominathan, P.

    2016-06-01

    In this paper, a novel type of network called network sharing common nonlinearity comprising both autonomous and non-autonomous oscillators have been investigated. We propose that these networks are robust for operating at desired modes i.e., chaotic or periodic by altering the v-i characteristics of common nonlinear element alone. The dynamics of these networks were examined through numerical, analytical, experimental and Multisim simulations.

  18. Functional asynchronous networks: Factorization of dynamics and function

    Directory of Open Access Journals (Sweden)

    Bick Christian

    2016-01-01

    Full Text Available In this note we describe the theory of functional asynchronous networks and one of the main results, the Modularization of Dynamics Theorem, which for a large class of functional asynchronous networks gives a factorization of dynamics in terms of constituent subnetworks. For these networks we can give a complete description of the network function in terms of the function of the events comprising the network and thereby answer a question originally raised by Alon in the context of biological networks.

  19. Methods of forming aluminum oxynitride-comprising bodies, including methods of forming a sheet of transparent armor

    Science.gov (United States)

    Chu, Henry Shiu-Hung [Idaho Falls, ID; Lillo, Thomas Martin [Idaho Falls, ID

    2008-12-02

    The invention includes methods of forming an aluminum oxynitride-comprising body. For example, a mixture is formed which comprises A:B:C in a respective molar ratio in the range of 9:3.6-6.2:0.1-1.1, where "A" is Al.sub.2O.sub.3, "B" is AlN, and "C" is a total of one or more of B.sub.2O.sub.3, SiO.sub.2, Si--Al--O--N, and TiO.sub.2. The mixture is sintered at a temperature of at least 1,600.degree. C. at a pressure of no greater than 500 psia effective to form an aluminum oxynitride-comprising body which is at least internally transparent and has at least 99% maximum theoretical density.

  20. Does mean heart dose sufficiently reflect coronary artery exposure in left-sided breast cancer radiotherapy. Influence of respiratory gating

    Energy Technology Data Exchange (ETDEWEB)

    Becker-Schiebe, Martina [Klinikum Braunschweig, Department of Radiotherapy and Radio-Oncology, Braunschweig (Germany); Hannover Medical School, Radiation Oncology, Hannover (Germany); Stockhammer, Maxi; Franz, Heiko [Klinikum Braunschweig, Department of Gynecology and Obstetrics, Braunschweig (Germany); Hoffmann, Wolfgang; Wetzel, Fabian [Klinikum Braunschweig, Department of Radiotherapy and Radio-Oncology, Braunschweig (Germany)

    2016-09-15

    With extensive use of systemic treatment, the issue of cardiac mortality after breast cancer radiation (RT) is still important. The aim of our analysis was to clarify whether the dose to one surrogate parameter (e. g., mean heart dose, as used in most studies) reflects the dose to the other cardiovascular structures especially the left anterior descending artery depending on breathing-adapted RT. A total of 130 patients who underwent adjuvant RT (50.4 Gy plus boost 9-16 Gy) were evaluated. In all, 71 patients were treated with free-breathing and 59 patients using respiratory monitoring (gated RT). Dosimetric associations were calculated. The mean dose to the heart (Dmean heart) was reduced from 2.7 (0.8-5.2) Gy to 2.4 (1.1-4.6) Gy, the Dmean LAD (left anterior descending artery) decreased from 11.1 (1.3-28.6) Gy to 9.3 (2.2-19.9) Gy with gated RT (p = 0.04). A significant relationship was shown for Dmean{sub heart}-Dmean LAD, V25heart-Dmean LAD and Dmax heart-Dmax LAD for gated patients only (p < 0.01). For every 1 Gy increase in Dmean heart, mean LAD doses rose by 3.6 Gy, without gating V25 ≤5 % did not assure a benefit and resulted in Dmean LAD between 1.3 and 28.6 Gy. A significant reduction and association of heart and coronary artery (LAD) doses using inspiratory gating was shown. However, in free-breathing plans commonly measured dose constraints do not allow precise estimation of the dose to the coronary arteries. (orig.) [German] Das Risiko kardialer Spaetfolgen nach Bestrahlung (RT) eines Mammakarzinoms spielt insbesondere auch aufgrund der zunehmenden systemischen Begleittherapien eine wichtige Rolle. Unklar ist, welche koronaren und/oder myokardialen Mechanismen hier entscheidend sind. Der Einfluss der Atemtriggerung und der daraus resultierenden geometrischen Lagevariabilitaet der Risikoorgane auf die Dosisverteilung am Herzen/Koronarien sollte geprueft werden, um zu klaeren, inwieweit die mittlere Herzdosis ein ausreichender Surrogatparameter fuer die Dosisbelastung der Koronarien ist. Ausgewertet wurden 130 Patientinnen mit Mammakarzinom, die mit einer adjuvanten RT (50,4 Gy + Boost 9-16 Gy) bestrahlt wurden. Hiervon wurden 71 Patientinnen in freier Atmung und 59 Patientinnen inspiratorisch atemgetriggert bestrahlt. Des Weiteren wurde die kardiale/koronare Dosisbelastung mit und ohne Atemtriggerung verglichen. Die mittlere Herdosis (Dmean Herz) wurde durch Atemtriggerung von 2,7 Gy (Spanne 0,8-5,2 Gy) auf 2,4 Gy (Spanne 1,1-4,6 Gy) reduziert. Die mittlere LAD-Dosis (''left anterior descending artery'', Ramus interventricularis anterior, RIVA) nahm mit Atemtriggerung von 11,1 Gy (Spanne 1,3-28,6 Gy) auf 9,3 Gy (Spanne 2,2-19,9 Gy) ab (p = 0,04). Die Dosisparameter Dmean Herz - Dmean LAD, V25 Herz - Dmean LAD und Dmax Herz - Dmax LAD waren nur fuer atemgetriggerte Faelle signifikant korrelierbar (p < 0,01), mit einem durchschnittlichen Anstieg der mittleren LAD-Dosis von 3,6 Gy pro 1 Gy mittlere Herzdosis. Bei einer nicht-atemgetriggerten RT lagen die mittleren LAD-Dosen zwischen 1,3 und 28,6 Gy trotz V25 ≤5 %. Unter Einsatz einer atemgetriggerten Bestrahlungstechnik lassen sich sowohl die mittlere Herz- als auch die LAD-Dosis senken und die kardialen Dosisparameter miteinander korrelieren. Fuer die RT ohne Atemtriggerung laesst sich die LAD-Belastung jedoch nicht sicher abschaetzen. (orig.)

  1. Long Term Neuropsychological Follow-Up in Patients With Herpes Simplex Encephalitis and Predominantly Left-Sided Lesions

    Directory of Open Access Journals (Sweden)

    B. Laurent

    1991-01-01

    Full Text Available Five patients with predominantly dominant cerebral hemisphere lesions due to herpes simplex encephalitis are described. Verbal amnesia was the main deficit but amnesic aphasia sometimes associated with impairment of remote memory also occurred. Semantic and episodic memory deficits were also explored in one case and the role of the right cerebral hemisphere in facilitating recovery of learning is discussed.

  2. Left sided circumaortic and retroaortic left renal veins, renal artery arising from iliac common artery in L-shaped kidney

    International Nuclear Information System (INIS)

    Al-Amin, M.

    2012-01-01

    Full text: Introduction: Renal ectopia is a congenital anomaly with variable clinical presentation. Kidneys are normally located in the retroperitoneal position, on either side of vertebral column, against the psoas muscles but when not at such position, it is called renal ectopia or ectopic kidney. Ectopic kidneys are thought to occur in approximately 1 in 1,000 births but only about 1 in 10 of these is ever diagnosed. In 90% of crossed ectopy, there is at least partial fusion of the kidneys. Left-to right ectopy is thought to be three times more common. Some of these are discovered incidentally, when a child or adult is having ultrasonography for a medical condition unrelated to renal ectopia. In a crossed fused renal ectopic kidney, complications such as nephrolithiasis, infection, and hydronephrosis approaches over 50%. Simple renal ectopia refers to kidney that is located on the proper side but abnormal in position. Crossed renal ectopia was first described by Pannorlus in 1964 and refer to kidney that has crossed from left to right or vice-versa, with moving of one kidney to the opposite side following ascent of the other kidney, so that both kidneys are located on the same side of the body, mostly fused called crossed fused ectopia. The fusion of the two kidneys is believed to result from (1) failure of the primitive nephrogenic cell masses to separate or (2) fusion of the two blastemas during their abdominal ascent. Discussion: A 57-year-old woman with a new found hematological disease. CT exam was performed with intravenous application of contrast media. Like an additional findings we visualized the presence of right to-left ectopy (L - shaped kidney) and the presence of left circumaortic renal vein emanating from a normally situated left kidney and retroaortic renal vein as having been located by the ectopic right kidney. Conclusion: By crossed renal ectopia is meant congenital displacement of one kidney to the opposite side. The conditional may present in any of three forms: 1) the two kidneys may be fused, as most of the cases are, 2) the two kidneys may lie of one side without fusion and 3) it may present as a solitary crossed renal ectopia - the rarest form. The abnormal kidney position and the anomalous kidney supply may impede drainage from the collecting system, creating a predisposition to urinary tract infection and calculus formation. The colic in this patient sometimes is misdiagnosed how abdominal disease. The usual method of detection was excretory urography but now ultrasonography and CT have showed more cases

  3. US-guided percutaneous transhepatic biliary drainage: comparative study of right-sided and left-sided approach

    International Nuclear Information System (INIS)

    Kim, Young Hwan; Cha, Soon Joo

    2002-01-01

    To compare the feasibility and safety of US-guided right and left percutaneous transhepatic biliary drainage (PTBD). Between March 1998 and May 1999, 32 patients underwent 36 US-guided right or left PTBD in referred order, alternatively. The causes of biliary obstruction were bile duct stone (n=2), bile duct carcinoma (n=10), carcinoma of the pancreas (n=9), GB carcinoma (n=7), metastasis to the porta hepatis (n=3), and carcinoma of the ampulla of vater (n=1). Technical success, procedure time, fluoroscopic time, and complications were evaluated. PTBD was successful in 94% of both right and left approach. The average procedure time was 9.7 ±3.8 min. in the right approach and 9.6 ±3.1 min. in the left approach, respectively (p=0.794). The average fluoroscopic time were 3.9±2.4 min. in the right approach and 3.8±2.2 min. in the left approach (p=0.892). A major complication, bile peritonitis, occurred in one of 16 patient with right-sided approach. Minor complications occurred in six right (2 hemobilia, 3 tube malfunction, 1 cholangitis) and three left (1 hemobilia, 1 fever, 1cholangitis) PTBD. There were no significant difference in the complication rates between right and left PTBD (p=0.729). There were no significant differences in feasibility and safety in US-guided right and left PTBD

  4. Echocardiographic Evaluation of Hemodynamic Changes in Left-Sided Heart Valves in Pregnant Women With Valvular Heart Disease.

    Science.gov (United States)

    Samiei, Niloufar; Amirsardari, Mandana; Rezaei, Yousef; Parsaee, Mozhgan; Kashfi, Fahimeh; Hantoosh Zadeh, Sedigheh; Beikmohamadi, Somayeh; Fouladi, Masoumeh; Hosseini, Saeid; Peighambari, Mohammad Mehdi; Mohebbi, Ahmad

    2016-10-01

    Physiologic changes during pregnancy can deteriorate or improve patients' hemodynamic status in the setting of valvular heart disease. There are sparse data regarding the effect of pregnancy on valve hemodynamics in normal pregnant women with known valvular heart disease. In a prospective study from July 2014 to January 2016, a total of 52 normal pregnant women who had mitral stenosis, aortic stenosis, or a history of mitral valve or aortic valve replacements were assessed. All patients underwent echocardiographic examinations and hemodynamic parameters were measured for both the mitral valve and aortic valve at first, second, and third trimesters. The parameters included mean gradient, peak gradient, mean gradient/heart rate, peak gradient/heart rate, pressure halftime, dimensionless velocity index, and valve area. Although most hemodynamic parameters (i.e., mean gradient, peak gradient, mean gradient/heart rate, and peak gradient/heart rate) increased approximately 50% from first to second trimester and first to third trimester (p 0.05). The ratio of changes between trimesters for valve area and dimensionless velocity index were comparable. No clinical decompensations were observed except for 3 and 7 cases of deterioration to functional class II at second and third trimesters, respectively. In conclusion, during a full-term and uncomplicated pregnancy, mitral and aortic valve gradients increase without significant changes in valve area that are more marked between the second and first trimester than between the third and second trimester. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Relationship of right- to left-sided ventricular filling pressures in advanced heart failure: insights from the ESCAPE trial.

    Science.gov (United States)

    Drazner, Mark H; Velez-Martinez, Mariella; Ayers, Colby R; Reimold, Sharon C; Thibodeau, Jennifer T; Mishkin, Joseph D; Mammen, Pradeep P A; Markham, David W; Patel, Chetan B

    2013-03-01

    Although right atrial pressure (RAP) and pulmonary capillary wedge pressure (PCWP) are correlated in heart failure, in a sizeable minority of patients, the RAP and PCWP are not tightly coupled. The basis of this variability in the RAP/PCWP ratio, and whether it conveys prognostic value, is not known. We analyzed the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) trial database. Baseline characteristics, including echocardiographic assessment of right ventricular (RV) structure and function, and invasively measured hemodynamic parameters, were compared among tertiles of the RAP/PCWP ratio. Multivariable Cox proportional hazard models assessed the association of RAP/PCWP ratio with the primary ESCAPE outcome (6-month death or hospitalization [days]) adjusting for systolic blood pressure, blood urea nitrogen, 6-minute walk distance, and PCWP. The RAP/PCWP tertiles were 0.27 to 0.4 (tertile 1); 0.41 to 0.615 (tertile 2), and 0.62 to 1.21 (tertile 3). Increasing RAP/PCWP was associated with increasing median right atrial area (23, 26, 29 cm2, respectively; P<0.005), RV area in diastole (21, 27, 27 cm2, respectively; P<0.005), and pulmonary vascular resistance (2.4, 2.9, 3.6 woods units, respectively; P=0.003), and lower RV stroke work index (8.6, 8.4, 5.5 g·m/m2 per beat, respectively; P<0.001). RAP/PCWP ratio was associated with death or hospitalization within 6 months (hazard ratio, 1.16 [1, 1.4]; P<0.05). Increased RAP/PCWP ratio was associated with higher pulmonary vascular resistance, reduced RV function (manifest as a larger right atrium and ventricle and lower RV stroke work index), and an increased risk of adverse outcomes in patients with advanced heart failure.

  6. Neurohormones as markers of right- and left-sided cardiac dimensions and function in patients with untreated chronic heart failure

    DEFF Research Database (Denmark)

    Kjaer, Andreas; Hildebrandt, Per; Appel, Jon

    2005-01-01

    and that neuroendocrine profiling could be of value. In order to study this, we investigated the relationship between hormones and cardiac dimensions and function of both the right and left ventricle. METHODS: Twenty-three patients with newly diagnosed, untreated CHF were included. Right (RVEF) and left ventricular...... was normal in all subjects as well as right ventricular volumes. Likewise, on average, the lung transit time (LTT) was normal. Brain natriuretic peptide (BNP) significantly correlated with LVEF, left ventricular end-diastolic volume index (LVEDVI) and left ventricular end-systolic volume index (LVESVI...... ejection fractions (LVEF) and volumes were measured by means of first-pass and equilibrium radionuclide ventriculography. RESULTS: LVEF was 0.29 (range: 0.11-0.55). Two-thirds of the patients had dilated left ventricles with volumes above upper reference limit. Right ventricular ejection fraction...

  7. US-guided percutaneous transhepatic biliary drainage: comparative study of right-sided and left-sided approach

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Hwan; Cha, Soon Joo [College of Medicine, Inje Univ., Kimhae (Korea, Republic of)

    2002-02-01

    To compare the feasibility and safety of US-guided right and left percutaneous transhepatic biliary drainage (PTBD). Between March 1998 and May 1999, 32 patients underwent 36 US-guided right or left PTBD in referred order, alternatively. The causes of biliary obstruction were bile duct stone (n=2), bile duct carcinoma (n=10), carcinoma of the pancreas (n=9), GB carcinoma (n=7), metastasis to the porta hepatis (n=3), and carcinoma of the ampulla of vater (n=1). Technical success, procedure time, fluoroscopic time, and complications were evaluated. PTBD was successful in 94% of both right and left approach. The average procedure time was 9.7 {+-}3.8 min. in the right approach and 9.6 {+-}3.1 min. in the left approach, respectively (p=0.794). The average fluoroscopic time were 3.9{+-}2.4 min. in the right approach and 3.8{+-}2.2 min. in the left approach (p=0.892). A major complication, bile peritonitis, occurred in one of 16 patient with right-sided approach. Minor complications occurred in six right (2 hemobilia, 3 tube malfunction, 1 cholangitis) and three left (1 hemobilia, 1 fever, 1cholangitis) PTBD. There were no significant difference in the complication rates between right and left PTBD (p=0.729). There were no significant differences in feasibility and safety in US-guided right and left PTBD.

  8. Endoscopic stenting as bridge-to-surgery (BTS) in left-sided obstructing colorectal cancer: Experience with conformable stents.

    Science.gov (United States)

    Parodi, Andrea; De Ceglie, Antonella; De Luca, Luca; Conigliaro, Rita; Naspetti, Riccardo; Arpe, Paola; Coccia, Gianni; Conio, Massimo

    2016-11-01

    Compared to emergency surgery, self-expandable metallic stents are effective and safe when used as bridge-to-surgery (BTS) in operable patients with acute colorectal cancer obstruction. In this study, we report data on the new conformable colonic stents. To evaluate clinical effectiveness of conformable stents as BTS in patients with acute colorectal cancer obstruction. This was a retrospective study. The study was conducted at six Italian Endoscopic Units. Data about patients with acute malignant colorectal obstruction were collected between 2007 and 2012. All patients were treated with conformable stents as BTS. Technical success, clinical success, rate of primary anastomosis and colostomy, early and late complications were evaluated. Data about 88 patients (62 males) were reviewed in this study. Conformable SEMS were correctly deployed in 86 out of 88 patients, with resolution of obstruction in all treated patients. Tumor resection with primary anastomosis was possible in all patients. A temporary colostomy was performed in 40. Early complications did not occur. Late complications occurred in 11 patients. Stent migration was significantly higher in patients treated with partially-covered stents compared to the uncovered group (35% vs. 0%, P<0.001). Endoscopical re-intervention was required in 12% of patients. One patient with rectal cancer had an anastomotic dehiscence after surgery and he was successfully treated with endoscopic clipping. One year after surgery, all patients were alive and local recurrence have not been documented. This was a retrospective and uncontrolled study. Preliminary data from this large case series are encouraging, with a high rate of technical and clinical success and low rate of clinically relevant complications. Partially-covered SEMS should be avoided in order to reduce the risk of endoscopic re-intervention. Copyright © 2016. Published by Elsevier Masson SAS.

  9. The relationship between cerebrovascular complications and previously established use of antiplatelet therapy in left-sided infective endocarditis

    DEFF Research Database (Denmark)

    Snygg-Martin, Ulrika; Rasmussen, Rasmus Vedby; Hassager, Christian

    2011-01-01

    Cerebrovascular complications (CVC) in infective endocarditis (IE) are common. The only established treatments to reduce the incidence of CVC in IE are antibiotics and in selected cases early cardiac surgery. Potential effects of previously established antiplatelet therapy are under debate....

  10. Gait COP trajectory of left side hip-dislocation and scoliotic patient using ankle-foot orthoses

    Science.gov (United States)

    Chong, Albert K.; Alrikabi, Redha; Milburn, Peter

    2017-07-01

    Plantar pressure-sensing mats and insole plantar sensor pads are ideal low-cost alternatives to force plates for capturing plantar COP excursion during gait. The acquired COP traces, in the form of pedobarographic images are favored by many clinicians and allied health professionals for evaluation of foot loading and balance in relation to foot biomechanics, foot injury, foot deformation, and foot ulceration. Researchers have recommended the use of COP trace for the biomechanical study of the deformed foot and lower-limb to improve orthosis design and testing. A correctly designed orthoses improves mobility and reduces pain in the foot, lower limb and lower spine region during gait. The research was carried out to evaluate the performance of two types of orthosis, namely: a custom-molded orthosis and an over-the-counter molded orthosis to determine the quality of gait of an adult scoliotic patient. COP trace patterns were compared with those of a healthy adult and showed the design of the custom-molded orthosis resulted in an improved quality of movements and provided enhanced stability for the deformed left foot during gait.

  11. LHCb Online Networking Requirements

    CERN Document Server

    Jost, B

    2003-01-01

    This document describes the networking requirements of the LHCb online installation. It lists both quantitative aspects such as the number of required switch ports, as well as some qualitative features of the equipment, such as minimum buffer sizes in switches. The document comprises both the data acquisition network and the controls/general-purpose network. While the numbers represent our best current knowledge and are intended to give (in particular) network equipment manufacturers an overview of our needs, this document should not be confused with a market survey questionnaire or a formal tendering document. However the information contained in this document will be the input of any such document. A preliminary schedule for procurement and installation is also given.

  12. Self-composite comprised of nanocrystalline diamond and a non-diamond component useful for thermoelectric applications

    Science.gov (United States)

    Gruen, Dieter M [Downers Grove, IL

    2009-08-11

    One provides nanocrystalline diamond material that comprises a plurality of substantially ordered diamond crystallites that are sized no larger than about 10 nanometers. One then disposes a non-diamond component within the nanocrystalline diamond material. By one approach this non-diamond component comprises an electrical conductor that is formed at the grain boundaries that separate the diamond crystallites from one another. The resultant nanowire is then able to exhibit a desired increase with respect to its ability to conduct electricity while also preserving the thermal conductivity behavior of the nanocrystalline diamond material.

  13. Location of terminals in a communications network

    DEFF Research Database (Denmark)

    2015-01-01

    A method (400, 500) of identifying nodes in a communications network is disclosed, the nodes being for use in locating wireless terminals within the network based upon reports from the wireless terminals of transmissions received from the nodes. The method (400, 500) comprises prioritising...... combinations of nodes in which at least three nodes are located around a reference node in a configuration satisfying similarity criteria to an idealised star configuration, wherein an idealised star configuration comprises three nodes evenly angularly distributed around, and at the same distance from......, a reference node. Also disclosed is a method (100, 200) for locating a plurality of wireless terminals in a communications network, the network comprising a plurality of network nodes at known locations, wherein the nodes emit wireless transmissions in an unsynchronised manner, such that a time difference...

  14. Canadian safeguards research and development in support of the IAEA program document outlining the various tasks which comprise the program

    International Nuclear Information System (INIS)

    1985-12-01

    Canada has established a safeguards research and development program, the purpose of which is to supplement the resources of the International Atomic Energy Agency. The program of support is a coordinated effort for the development and application of safeguards techniques and instruments to facilities safeguarded by the IAEA. This document sets forth those tasks which comprise the program

  15. Formulation comprising silicon microparticles, as a pigment that can absorb visible UV radiation and reflect ir radiation

    OpenAIRE

    Rodríguez, Marie-Isabelle; Fenollosa Esteve, Roberto; Meseguer, Francisco

    2011-01-01

    [EN] The invention relates to a formulation characterised in that it comprises silicon microparticles having a size between 0.010 um and 50 um in diameter, and to the use thereof as a pigment that can absorb visible UV radiation and reflect IR radiation.

  16. Integrated circuit and method of arbitration in a network on an integrated circuit.

    NARCIS (Netherlands)

    2011-01-01

    The invention relates to an integrated circuit and to a method of arbitration in a network on an integrated circuit. According to the invention, a method of arbitration in a network on an integrated circuit is provided, the network comprising a router unit, the router unit comprising a first input

  17. Porous polymer networks and ion-exchange media and metal-polymer composites made therefrom

    Energy Technology Data Exchange (ETDEWEB)

    Kanatzidis, Mercouri G.; Katsoulidis, Alexandros

    2016-10-18

    Porous polymeric networks and composite materials comprising metal nanoparticles distributed in the polymeric networks are provided. Also provided are methods for using the polymeric networks and the composite materials in liquid- and vapor-phase waste remediation applications. The porous polymeric networks, are highly porous, three-dimensional structures characterized by high surface areas. The polymeric networks comprise polymers polymerized from aldehydes and phenolic molecules.

  18. Security in wireless sensor networks

    CERN Document Server

    Oreku, George S

    2016-01-01

    This monograph covers different aspects of sensor network security including new emerging technologies. The authors present a mathematical approach to the topic and give numerous practical examples as well as case studies to illustrate the theory. The target audience primarily comprises experts and practitioners in the field of sensor network security, but the book may also be beneficial for researchers in academia as well as for graduate students.

  19. Networked Microgrids Scoping Study

    Energy Technology Data Exchange (ETDEWEB)

    Backhaus, Scott N. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Dobriansky, Larisa [General MicroGrids, San Diego, CA (United States); Glover, Steve [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Liu, Chen-Ching [Washington State Univ., Pullman, WA (United States); Looney, Patrick [Brookhaven National Lab. (BNL), Upton, NY (United States); Mashayekh, Salman [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Pratt, Annabelle [National Renewable Energy Lab. (NREL), Golden, CO (United States); Schneider, Kevin [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Stadler, Michael [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Starke, Michael [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Wang, Jianhui [Argonne National Lab. (ANL), Argonne, IL (United States); Yue, Meng [Brookhaven National Lab. (BNL), Upton, NY (United States)

    2016-12-05

    Much like individual microgrids, the range of opportunities and potential architectures of networked microgrids is very diverse. The goals of this scoping study are to provide an early assessment of research and development needs by examining the benefits of, risks created by, and risks to networked microgrids. At this time there are very few, if any, examples of deployed microgrid networks. In addition, there are very few tools to simulate or otherwise analyze the behavior of networked microgrids. In this setting, it is very difficult to evaluate networked microgrids systematically or quantitatively. At this early stage, this study is relying on inputs, estimations, and literature reviews by subject matter experts who are engaged in individual microgrid research and development projects, i.e., the authors of this study The initial step of the study gathered input about the potential opportunities provided by networked microgrids from these subject matter experts. These opportunities were divided between the subject matter experts for further review. Part 2 of this study is comprised of these reviews. Part 1 of this study is a summary of the benefits and risks identified in the reviews in Part 2 and synthesis of the research needs required to enable networked microgrids.

  20. Concept for the generation of the model designated for the simulation of interaction between enterprises comprising one major construction company

    Directory of Open Access Journals (Sweden)

    Dubovkina Alla Viktorovna

    2014-12-01

    Full Text Available The author offers an original concept designated for the generation of the model designated to simulate interaction between the enterprises comprising one major construction company within the framework of the production and logistics chain, comprising production facilities, transport enterprises, construction and assembly companies. The author has identified the factors that may produce an adverse effect on construction operations or cause untimely commissioning of a construction facility. The author employed methods of mathematics to describe the operations performed by each constituent enterprise. A graphic model describing each operation was compiled through the integration of mathematical functions. The model binds specific operations, performed by constituent companies, to deadlines, drives attention to interaction bottlenecks, and makes adjustments to assure reliable attainment of the main goal, that is, the timely commissioning of a construction facility.

  1. Sensor devices comprising a metal-organic framework material and methods of making and using the same

    Science.gov (United States)

    Wang, Alan X.; Chang, Chih-hung; Kim, Ki-Joong; Chong, Xinyuan; Ohodnicki, Paul R.

    2018-05-29

    Disclosed herein are embodiments of sensor devices comprising a sensing component able to determine the presence of, detect, and/or quantify detectable species in a variety of environments and applications. The sensing components disclosed herein can comprise MOF materials, plasmonic nanomaterials, or combinations thereof. In an exemplary embodiment, light guides can be coupled with the sensing components described herein to provide sensor devices capable of increased NIR detection sensitivity in determining the presence of detectable species, such as gases and volatile organic compounds. In another exemplary embodiment, optical properties of the plasmonic nanomaterials combined with MOF materials can be monitored directly to detect analyte species through their impact on external conditions surrounding the particle or as a result of charge transfer to and from the plasmonic material as a result of interactions with the plasmonic material and/or the MOF material.

  2. Declarative Networking

    CERN Document Server

    Loo, Boon Thau

    2012-01-01

    Declarative Networking is a programming methodology that enables developers to concisely specify network protocols and services, which are directly compiled to a dataflow framework that executes the specifications. Declarative networking proposes the use of a declarative query language for specifying and implementing network protocols, and employs a dataflow framework at runtime for communication and maintenance of network state. The primary goal of declarative networking is to greatly simplify the process of specifying, implementing, deploying and evolving a network design. In addition, decla

  3. Creative Network Communities in the Translocal Space of Digital Networks

    Directory of Open Access Journals (Sweden)

    Rasa Smite

    2013-01-01

    Full Text Available What should sociological research be in the age of Web 2.0? Considering that the task of “network sociology” is not only empirical research but also the interpretation of tendencies of the network culture, this research explores the rise of network communities within Eastern and Western Europe in the early Internet era. I coined the term creative networks to distinguish these early creative and social activities from today’s popular social networking. Thus I aimed to interpret the meaning of social action; the motivation of creative community actors, their main fields of activities and social organization forms; and the potential that these early developments contain for the future sustainability of networks. Data comprise interviews with networking experts and founders and members of various networks. Investigating respondents’ motivations for creating online networks and communities, and interpreting those terms, allows for comparing the creative networks of the 1990s with today’s social networks and for drawing conclusions.

  4. Innovation in Downstream Fashion Retail Networks

    DEFF Research Database (Denmark)

    Tambo, Torben

    2012-01-01

    While product marketers and brand owners struggle to make new products, manufacturing processes and inbound logistics, innovation taking place in retail networks is often overlooked. Networks in retailing are comprised by varieties of single- and multi-brand stores, chains and departments stores...

  5. Altered organization of face processing networks in temporal lobe epilepsy

    Science.gov (United States)

    Riley, Jeffrey D.; Fling, Brett W.; Cramer, Steven C.; Lin, Jack J.

    2015-01-01

    SUMMARY Objective Deficits in social cognition are common and significant in people with temporal lobe epilepsy (TLE), but the functional and structural underpinnings remain unclear. The present study investigated how the side of seizure focus impacts face processing networks in temporal lobe epilepsy. Methods We used functional magnetic resonance imaging (fMRI) of a face processing paradigm to identify face responsive regions in 24 individuals with unilateral temporal lobe epilepsy (Left = 15; Right = 9) and 19 healthy controls. fMRI signals of face responsive regions ispilateral and contralateral to the side of seizure onset were delineated in TLE and compared to the healthy controls with right and left side combined. Diffusion tensor images were acquired to investigate structural connectivity between face regions that differed in fMRI signals between the two groups. Results In temporal lobe epilepsy, activation of the cortical face processing networks varied according to side of seizure onset. In temporal lobe epilepsy, the laterality of amygdala activation was shifted to the side contralateral to the seizure focus while controls showed no significant asymmetry. Furthermore, compared to controls, patients with TLE showed decreased activation of the occipital face responsive region in the ipsilateral side and an increased activity of the anterior temporal lobe in the contralateral side to the seizure focus. Probabilistic tractography revealed that the occipital face area and anterior temporal lobe are connected via the inferior longitudinal fasciculus, which in individuals with temporal lobe epilepsy showed reduced integrity. Significance Taken together, these findings suggest that brain function and white matter integrity of networks subserving face processing are impaired on the side of seizure onset, accompanied by altered responses on the side contralateral to the seizure. PMID:25823855

  6. [Network structures in biological systems].

    Science.gov (United States)

    Oleskin, A V

    2013-01-01

    Network structures (networks) that have been extensively studied in the humanities are characterized by cohesion, a lack of a central control unit, and predominantly fractal properties. They are contrasted with structures that contain a single centre (hierarchies) as well as with those whose elements predominantly compete with one another (market-type structures). As far as biological systems are concerned, their network structures can be subdivided into a number of types involving different organizational mechanisms. Network organization is characteristic of various structural levels of biological systems ranging from single cells to integrated societies. These networks can be classified into two main subgroups: (i) flat (leaderless) network structures typical of systems that are composed of uniform elements and represent modular organisms or at least possess manifest integral properties and (ii) three-dimensional, partly hierarchical structures characterized by significant individual and/or intergroup (intercaste) differences between their elements. All network structures include an element that performs structural, protective, and communication-promoting functions. By analogy to cell structures, this element is denoted as the matrix of a network structure. The matrix includes a material and an immaterial component. The material component comprises various structures that belong to the whole structure and not to any of its elements per se. The immaterial (ideal) component of the matrix includes social norms and rules regulating network elements' behavior. These behavioral rules can be described in terms of algorithms. Algorithmization enables modeling the behavior of various network structures, particularly of neuron networks and their artificial analogs.

  7. Network topology mapper

    Science.gov (United States)

    Quist, Daniel A [Los Alamos, NM; Gavrilov, Eugene M [Los Alamos, NM; Fisk, Michael E [Jemez, NM

    2008-01-15

    A method enables the topology of an acyclic fully propagated network to be discovered. A list of switches that comprise the network is formed and the MAC address cache for each one of the switches is determined. For each pair of switches, from the MAC address caches the remaining switches that see the pair of switches are located. For each pair of switches the remaining switches are determined that see one of the pair of switches on a first port and the second one of the pair of switches on a second port. A list of insiders is formed for every pair of switches. It is determined whether the insider for each pair of switches is a graph edge and adjacent ones of the graph edges are determined. A symmetric adjacency matrix is formed from the graph edges to represent the topology of the data link network.

  8. Synthesis of Industrial Water Networks

    DEFF Research Database (Denmark)

    Pennati, A.; Quaglia, Alberto; Gani, Rafiqul

    of the water networks proposed comprise few contaminants and do not consider critical parameters for wastewater treatment equipment, such as limiting inlet concentrations, flow rates, and other specific design constraints. Thus, these networks are arguably not fit to manage the complexity of a real industrial...... case (in terms of number of contaminants, number of processing options, design constraints etc.). In this work, a systematic framework for the formulation and solution of water networks problems is proposed, based on the modification of an earlier work [3]. The optimization problem is formulated...

  9. Copolymer semiconductors comprising thiazolothiazole or benzobisthiazole, or benzobisoxazole electron acceptor subunits, and electron donor subunits, and their uses in transistors and solar cells

    Science.gov (United States)

    Jenekhe, Samson A; Subramaniyan, Selvam; Ahmed, Eilaf; Xin, Hao; Kim, Felix Sunjoo

    2014-10-28

    The inventions disclosed, described, and/or claimed herein relate to copolymers comprising copolymers comprising electron accepting A subunits that comprise thiazolothiazole, benzobisthiazole, or benzobisoxazoles rings, and electron donating subunits that comprise certain heterocyclic groups. The copolymers are useful for manufacturing organic electronic devices, including transistors and solar cells. The invention also relates to certain synthetic precursors of the copolymers. Methods for making the copolymers and the derivative electronic devices are also described.

  10. Dynamic Frequency Control in Power Networks

    OpenAIRE

    Zhao, Changhong; Mallada Garcia, Enrique; Low, Steven H.

    2016-01-01

    Node controllers in power distribution networks in accordance with embodiments of the invention enable dynamic frequency control. One embodiment includes a node controller comprising a network interface a processor; and a memory containing a frequency control application; and a plurality of node operating parameters describing the operating parameters of a node, where the node is selected from a group consisting of at least one generator node in a power distribution network wherein the proces...

  11. Preparation and Study of Electromagnetic Interference Shielding Materials Comprised of Ni-Co Coated on Web-Like Biocarbon Nanofibers via Electroless Deposition

    Directory of Open Access Journals (Sweden)

    Xiaohu Huang

    2015-01-01

    Full Text Available Electromagnetic interference (EMI shielding materials made of Ni-Co coated on web-like biocarbon nanofibers were successfully prepared by electroless plating. Biocarbon nanofibers (CF with a novel web-like structure comprised of entangled and interconnected carbon nanoribbons were obtained using bacterial cellulose pyrolyzed at 1200°C. Paraffin wax matrix composites filled with different loadings (10, 20, and 30 wt%, resp. of CF and Ni-Co coated CF (NCCF were prepared. The electrical conductivities and electromagnetic parameters of the composites were investigated by the four-probe method and vector network analysis. From these results, the EMI shielding efficiencies (SE of NCCF composites were shown to be significantly higher than that of CF at the same mass fraction. The paraffin wax composites containing 30 wt% NCCF showed the highest EMI SE of 41.2 dB (99.99% attenuation, which are attributed to the higher electrical conductivity and permittivity of the NCCF composites than the CF composites. Additionally, EMI SE increased with an increase in CF and NCCF loading and the absorption was determined to be the primary factor governing EMI shielding. This study conclusively reveals that NCCF composites have potential applications as EMI shielding materials.

  12. The future of network governance research

    DEFF Research Database (Denmark)

    Lewis, Jenny

    2011-01-01

    that comprises it. The main theoretical and empirical approaches that have been used to guide it to date are then briefly described, emphasizing recent debates about interpretivism and decentring. Next, it suggests that a robust and interesting future for network governance requires diversity, rather than...... adherence to a single approach. It is argued that more sophisticated approaches for examining network governance are fashioned through a synthesis of ideas and methods to create an analysis of networks as networks. This is especially the case where some formal analysis of network structure is used...

  13. Computer networks ISE a systems approach

    CERN Document Server

    Peterson, Larry L

    2007-01-01

    Computer Networks, 4E is the only introductory computer networking book written by authors who have had first-hand experience with many of the protocols discussed in the book, who have actually designed some of them as well, and who are still actively designing the computer networks today. This newly revised edition continues to provide an enduring, practical understanding of networks and their building blocks through rich, example-based instruction. The authors' focus is on the why of network design, not just the specifications comprising today's systems but how key technologies and p

  14. Rod-shaped ion exchanger useful for purifying liquids or recovering components from liquids comprises a metal wire core surrounded by an ion-exchange resin

    NARCIS (Netherlands)

    Koopman, C.; Witkamp, G.J.

    2002-01-01

    Rod-shaped ion exchanger comprises a metal wire core surrounded by an ion-exchange resin. Independent claims are also included for: (1) a module comprising a housing with an inlet and outlet and one or more ion exchangers as above; (2) a process for producing an ion exchanger as above, comprising

  15. Survival data for postoperative adjuvant chemotherapy comprising cisplatin plus vinorelbine after complete resection of non-small cell lung cancer.

    Science.gov (United States)

    Kenmotsu, Hirotsugu; Ohde, Yasuhisa; Wakuda, Kazushige; Nakashima, Kazuhisa; Omori, Shota; Ono, Akira; Naito, Tateaki; Murakami, Haruyasu; Kojima, Hideaki; Takahashi, Shoji; Isaka, Mitsuhiro; Endo, Masahiro; Takahashi, Toshiaki

    2017-09-01

    Despite the efficacy of postoperative adjuvant cisplatin (CDDP)-based chemotherapy for patients who have undergone surgical resection of non-small cell lung cancer (NSCLC), few reports have presented survival data for Asian patients treated with adjuvant chemotherapy involving a combination of CDDP and vinorelbine (VNR). This study was performed to evaluate the survival of patients with NSCLC who received postoperative adjuvant chemotherapy comprising CDDP + VNR. We retrospectively evaluated patients with NSCLC who received adjuvant chemotherapy comprising CDDP + VNR at the Shizuoka Cancer Center between February 2006 and October 2011. One hundred patients who underwent surgical resection of NSCLC were included in this study. The patients' characteristics were as follows: median age 63 years (range 36-74 years), female 34%, never-smokers 20%, and non-squamous NSCLC 73%. Pathological stages IIA, IIB, and IIIA were observed in 31, 22, and 47% of patients, respectively. The 5- and 2-year overall survival rates were 73 and 93%, respectively. The 5- and 2-year relapse-free survival rates were 53 and 62%, respectively. Univariate analysis of prognostic factors showed that patient characteristics (sex, histology, and pathological stage) and CDDP dose intensity were not significantly associated with survival. In 48 patients who developed NSCLC recurrence, the 5-year survival rate after recurrence was 29%, and the median survival time after recurrence was 37 months. Our results suggest that the prognosis after surgical resection of NSCLC and adjuvant chemotherapy comprising CDDP + VNR might be improving compared with previous survival data of adjuvant chemotherapy for NSCLC.

  16. Network cohesion

    OpenAIRE

    Cavalcanti, Tiago Vanderlei; Giannitsarou, Chrysi; Johnson, CR

    2017-01-01

    We define a measure of network cohesion and show how it arises naturally in a broad class of dynamic models of endogenous perpetual growth with network externalities. Via a standard growth model, we show why network cohesion is crucial for conditional convergence and explain that as cohesion increases, convergence is faster. We prove properties of network cohesion and define a network aggregator that preserves network cohesion.

  17. A Dew Point Meter Comprising a Nanoporous Thin Film Alumina Humidity Sensor with a Linearizing Capacitance Measuring Electronics

    Directory of Open Access Journals (Sweden)

    Dilip Kumar Ghara

    2008-02-01

    Full Text Available A novel trace moisture analyzer is presented comprising a capacitive nanoporous film of metal oxide sensor and electronics. The change in capacity of the sensor is due to absorption of water vapor by the pores. A simple capacitance measuring electronics is developed which can detect any change in capacitance and correlates to ambient humidity. The circuit can minimize the parasitic earth capacitance. The non linear response of the sensor is linearized with a micro-controller linearizing circuit. The experimental result shows a resolution of -4°C DP and accuracy within 2%.

  18. Polycondensation of Asparagine-comprising Dipeptides in Aqueous Media-A Simulation of Polypeptide Formation in Primordial Earth Hydrosphere

    Science.gov (United States)

    Munegumi, Toratane; Tanikawa, Naoya

    2017-09-01

    Asparagine and aspartic acid might have mutually transformed in the primordial hydrosphere of the earth, if ammonia and aspartic acid had existed in equilibrium. These amino acids seem to contribute to polypeptides, while the simple amino acids glycine and alanine easily form cyclic dipeptides and do not achieve long peptide chains. Asparagine-comprising dipeptides contribute some kinds of activation forms of dipeptides because these can polymerize faster than asparagine only. The new finding of polypeptide formation suggests a pathway of sequential polypeptides to evolve a diversity of polypeptides.

  19. Microstructure and corrosion behavior of shielded metal arc-welded dissimilar joints comprising duplex stainless steel and low alloy steel

    Science.gov (United States)

    Srinivasan, P. Bala; Muthupandi, V.; Sivan, V.; Srinivasan, P. Bala; Dietzel, W.

    2006-12-01

    This work describes the results of an investigation on a dissimilar weld joint comprising a boiler-grade low alloy steel and duplex stainless steel (DSS). Welds produced by shielded metal arc-welding with two different electrodes (an austenitic and a duplex grade) were examined for their microstructural features and properties. The welds were found to have overmatching mechanical properties. Although the general corrosion resistance of the weld metals was good, their pitting resistance was found to be inferior when compared with the DSS base material.

  20. Polycondensation of Asparagine-comprising Dipeptides in Aqueous Media-A Simulation of Polypeptide Formation in Primordial Earth Hydrosphere.

    Science.gov (United States)

    Munegumi, Toratane; Tanikawa, Naoya

    2017-09-01

    Asparagine and aspartic acid might have mutually transformed in the primordial hydrosphere of the earth, if ammonia and aspartic acid had existed in equilibrium. These amino acids seem to contribute to polypeptides, while the simple amino acids glycine and alanine easily form cyclic dipeptides and do not achieve long peptide chains. Asparagine-comprising dipeptides contribute some kinds of activation forms of dipeptides because these can polymerize faster than asparagine only. The new finding of polypeptide formation suggests a pathway of sequential polypeptides to evolve a diversity of polypeptides.

  1. The network researchers' network

    DEFF Research Database (Denmark)

    Henneberg, Stephan C.; Jiang, Zhizhong; Naudé, Peter

    2009-01-01

    The Industrial Marketing and Purchasing (IMP) Group is a network of academic researchers working in the area of business-to-business marketing. The group meets every year to discuss and exchange ideas, with a conference having been held every year since 1984 (there was no meeting in 1987). In thi......The Industrial Marketing and Purchasing (IMP) Group is a network of academic researchers working in the area of business-to-business marketing. The group meets every year to discuss and exchange ideas, with a conference having been held every year since 1984 (there was no meeting in 1987......). In this paper, based upon the papers presented at the 22 conferences held to date, we undertake a Social Network Analysis in order to examine the degree of co-publishing that has taken place between this group of researchers. We identify the different components in this database, and examine the large main...

  2. A combination vaccine comprising of inactivated enterovirus 71 and coxsackievirus A16 elicits balanced protective immunity against both viruses.

    Science.gov (United States)

    Cai, Yicun; Ku, Zhiqiang; Liu, Qingwei; Leng, Qibin; Huang, Zhong

    2014-05-01

    Enterovirus 71 (EV71) and coxsackievirus A16 (CA16) are the two major causative agents of hand, foot and mouth disease (HFMD), which is an infectious disease frequently occurring in children. A bivalent vaccine against both EV71 and CA16 is highly desirable. In the present study, we compare monovalent inactivated EV71, monovalent inactivated CA16, and a combination vaccine candidate comprising of both inactivated EV71 and CA16, for their immunogenicity and in vivo protective efficacy. The two monovalent vaccines were found to elicit serum antibodies that potently neutralized the homologous virus but had no or weak neutralization activity against the heterologous one; in contrast, the bivalent vaccine immunized sera efficiently neutralized both EV71 and CA16. More importantly, passive immunization with the bivalent vaccine protected mice against either EV71 or CA16 lethal infections, whereas the monovalent vaccines only prevented the homologous but not the heterologous challenges. Together, our results demonstrate that the experimental bivalent vaccine comprising of inactivated EV71 and CA16 induces a balanced protective immunity against both EV71 and CA16, and thus provide proof-of-concept for further development of multivalent vaccines for broad protection against HFMD. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Network cosmology.

    Science.gov (United States)

    Krioukov, Dmitri; Kitsak, Maksim; Sinkovits, Robert S; Rideout, David; Meyer, David; Boguñá, Marián

    2012-01-01

    Prediction and control of the dynamics of complex networks is a central problem in network science. Structural and dynamical similarities of different real networks suggest that some universal laws might accurately describe the dynamics of these networks, albeit the nature and common origin of such laws remain elusive. Here we show that the causal network representing the large-scale structure of spacetime in our accelerating universe is a power-law graph with strong clustering, similar to many complex networks such as the Internet, social, or biological networks. We prove that this structural similarity is a consequence of the asymptotic equivalence between the large-scale growth dynamics of complex networks and causal networks. This equivalence suggests that unexpectedly similar laws govern the dynamics of complex networks and spacetime in the universe, with implications to network science and cosmology.

  4. Effects of low frequency rTMS treatment on brain networks for inner speech in patients with schizophrenia and auditory verbal hallucinations.

    Science.gov (United States)

    Bais, Leonie; Liemburg, Edith; Vercammen, Ans; Bruggeman, Richard; Knegtering, Henderikus; Aleman, André

    2017-08-01

    Efficacy of repetitive Transcranial Magnetic Stimulation (rTMS) targeting the temporo-parietal junction (TPJ) for the treatment of auditory verbal hallucinations (AVH) remains under debate. We assessed the influence of a 1Hz rTMS treatment on neural networks involved in a cognitive mechanism proposed to subserve AVH. Patients with schizophrenia (N=24) experiencing medication-resistant AVH completed a 10-day 1Hz rTMS treatment. Participants were randomized to active stimulation of the left or bilateral TPJ, or sham stimulation. The effects of rTMS on neural networks were investigated with an inner speech task during fMRI. Changes within and between neural networks were analyzed using Independent Component Analysis. rTMS of the left and bilateral TPJ areas resulted in a weaker network contribution of the left supramarginal gyrus to the bilateral fronto-temporal network. Left-sided rTMS resulted in stronger network contributions of the right superior temporal gyrus to the auditory-sensorimotor network, right inferior gyrus to the left fronto-parietal network, and left middle frontal gyrus to the default mode network. Bilateral rTMS was associated with a predominant inhibitory effect on network contribution. Sham stimulation showed different patterns of change compared to active rTMS. rTMS of the left temporo-parietal region decreased the contribution of the left supramarginal gyrus to the bilateral fronto-temporal network, which may reduce the likelihood of speech intrusions. On the other hand, left rTMS appeared to increase the contribution of functionally connected regions involved in perception, cognitive control and self-referential processing. These findings hint to potential neural mechanisms underlying rTMS for hallucinations but need corroboration in larger samples. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Telecommunications Network Plan

    International Nuclear Information System (INIS)

    1989-05-01

    The Office of Civilian Radioactive Waste Management (OCRWM) must, among other things, be equipped to readily produce, file, store, access, retrieve, and transfer a wide variety of technical and institutional data and information. The data and information regularly produced by members of the OCRWM Program supports, and will continue to support, a wide range of program activities. Some of the more important of these information communication-related activities include: supporting the preparation, submittal, and review of a license application to the Nuclear Regulatory Commission (NRC) to authorize the construction of a geologic repository; responding to requests for information from parties affected by and/or interested in the program; and providing evidence of compliance with all relevant Federal, State, local, and Indian Tribe regulations, statutes, and/or treaties. The OCRWM Telecommunications Network Plan (TNP) is intended to identify, as well as to present the current strategy for satisfying, the telecommunications requirements of the civilian radioactive waste management program. The TNP will set forth the plan for integrating OCRWM's information resources among major program sites. Specifically, this plan will introduce a telecommunications network designed to establish communication linkages across the program's Washington, DC; Chicago, Illinois; and Las Vegas, Nevada, sites. The linkages across these and associated sites will comprise Phase I of the proposed OCRWM telecommunications network. The second phase will focus on the modification and expansion of the Phase I network to fully accommodate access to the OCRWM Licensing Support System (LSS). The primary components of the proposed OCRWM telecommunications network include local area networks; extended local area networks; and remote extended (wide) area networks. 10 refs., 6 figs

  6. Basic general concepts in the network analysis

    Directory of Open Access Journals (Sweden)

    Boja Nicolae

    2004-01-01

    Full Text Available This survey is concerned oneself with the study of those types of material networks which can be met both in civil engineering and also in electrotechnics, in mechanics, or in hydrotechnics, and of which behavior lead to linear problems, solvable by means of Finite Element Method and adequate algorithms. Here, it is presented a unitary theory of networks met in the domains mentioned above and this one is illustrated with examples for the structural networks in civil engineering, electric circuits, and water supply networks, but also planar or spatial mechanisms can be comprised in this theory. The attention is focused to make evident the essential proper- ties and concepts in the network analysis, which differentiate the networks under force from other types of material networks. To such a network a planar, connected, and directed or undirected graph is associated, and with some vector fields on the vertex set this graph is endowed. .

  7. Full-power test of a string of magnets comprising a half-cell of the Superconducting Super Collider

    International Nuclear Information System (INIS)

    Burgett, W.; Christianson, M.; Coombes, R.

    1992-10-01

    In this paper we describe the full-powered operation of a string of industrially-fabricated magnets comprising a half-cell of the Superconducting Super Collider (SSC). The completion of these tests marks the first successful operation of a major SSC subsystem. The five 15-m long dipole magnets in the string had an aperture of 50 mm and the single 5-m long quadrupole aperture was 40 mm. Power and cryogenic connections were made to the string through spool pieces that are prototypes for SSC operations. The string was cooled to cryogenic temperatures in early July, 1992, and power tests were performed at progressively higher currents up to the nominal SSC operating point above 6500 amperes achieved in mid-August. In this paper we report on the electrical and cryogenic performance of the string components and the quench protection system during these initial tests

  8. Method of making Tl-Sr-Ca-Cu-oxide superconductors comprising heating at elevated pressures in a sealed container

    International Nuclear Information System (INIS)

    Lechtev, W.L.; Osofsky, M.S.; Skelton, E.F.; Toth, L.E.

    1992-01-01

    This patent describes a method of forming a Tl-Sr-Ca-Cu-oxide high T c superconductor. It comprises forming a reaction mixture of the oxides of Sr, Cu, Ca, and Tl in stoichiometric proportions to make a Tl-Sr-Ca-Cu-oxide high T c superconducting compound; compressing the reaction mixture into a hard body; placing the hard body into a container for containing thallium vapor; evacuating and sealing the hard body in the container; heating the hard body and the container at a temperature of about 800 degrees C to about 950 degrees C and under pressure of at least about 30,000 psi until the container metal around the hard body and the oxides of Tl, Sr, Ca, and Cu react to form a superconducting compound; and cooling the superconducting compound to room temperature and returning the superconducting compound to atmospheric pressure

  9. Erythrocyte folate, plasma folate and plasma homocysteine during normal pregnancy and postpartum: a longitudinal study comprising 404 danish women

    DEFF Research Database (Denmark)

    Milman, N; Byg, KE; Hvas, Anne-Mette

    2006-01-01

    OBJECTIVE: To assess folate and homocysteine status during normal pregnancy and postpartum in a longitudinal setting. METHODS: This study, performed in 1995-1996, comprised 404 healthy pregnant Danish Caucasian women residential in Copenhagen County. Women taking folic acid tablets or vitamin B12...... injections were not included. Dietary multivitamin supplements containing folic acid 100 microg or vitamin B12 1 microg, taken by 34%, were discontinued at inclusion. Participants had normal renal function. Folate status [erythrocyte (Ery-) folate, plasma (P-) folate, P-homocysteine] was measured at 18, 32...... new guidelines for folic acid supplement since 1997, only 13% of pregnant women followed the guidelines in 2003. The official recommendations for periconceptional folic acid supplement should be reconsidered and reinforced....

  10. Telecommunication networks

    CERN Document Server

    Iannone, Eugenio

    2011-01-01

    Many argue that telecommunications network infrastructure is the most impressive and important technology ever developed. Analyzing the telecom market's constantly evolving trends, research directions, infrastructure, and vital needs, Telecommunication Networks responds with revolutionized engineering strategies to optimize network construction. Omnipresent in society, telecom networks integrate a wide range of technologies. These include quantum field theory for the study of optical amplifiers, software architectures for network control, abstract algebra required to design error correction co

  11. Qualitative exploration of centralities in municipal science education networks

    DEFF Research Database (Denmark)

    von der Fehr, Ane; Sølberg, Jan

    2016-01-01

    This article examines the social nature of educational change by conducting a social network analysis of social networks involving stakeholders of science education from teachers to political stakeholders. Social networks that comprise supportive structures for development of science education ar...... of science education, especially if they are aware of their own centrality and are able to use their position intentionally for the benefit of science education.......This article examines the social nature of educational change by conducting a social network analysis of social networks involving stakeholders of science education from teachers to political stakeholders. Social networks that comprise supportive structures for development of science education...... are diverse and in order to understand how municipal stakeholders may support such development, we explored four different municipal science education networks (MSE networks) using three different measures of centrality. The centrality measures differed in terms of what kind of stakeholder functions...

  12. Micro and Macro Spatial Networks in Two Contexts: Collaboration and Interpersonal Risk Communication

    NARCIS (Netherlands)

    Lee, Ju-Sung; van Duinen, Rianne; Filatova, Tatiana

    2015-01-01

    Networks researchers have been learning the prominent role geographic/physical proximity plays in network dynamics. In this paper, we examine spatial distance in the context of two distinct social networks differing in size, geographic boundaries, and relation types. The first network comprises

  13. Temporal networks

    CERN Document Server

    Saramäki, Jari

    2013-01-01

    The concept of temporal networks is an extension of complex networks as a modeling framework to include information on when interactions between nodes happen. Many studies of the last decade examine how the static network structure affect dynamic systems on the network. In this traditional approach  the temporal aspects are pre-encoded in the dynamic system model. Temporal-network methods, on the other hand, lift the temporal information from the level of system dynamics to the mathematical representation of the contact network itself. This framework becomes particularly useful for cases where there is a lot of structure and heterogeneity both in the timings of interaction events and the network topology. The advantage compared to common static network approaches is the ability to design more accurate models in order to explain and predict large-scale dynamic phenomena (such as, e.g., epidemic outbreaks and other spreading phenomena). On the other hand, temporal network methods are mathematically and concept...

  14. Interconnected networks

    CERN Document Server

    2016-01-01

    This volume provides an introduction to and overview of the emerging field of interconnected networks which include multi layer or multiplex networks, as well as networks of networks. Such networks present structural and dynamical features quite different from those observed in isolated networks. The presence of links between different networks or layers of a network typically alters the way such interconnected networks behave – understanding the role of interconnecting links is therefore a crucial step towards a more accurate description of real-world systems. While examples of such dissimilar properties are becoming more abundant – for example regarding diffusion, robustness and competition – the root of such differences remains to be elucidated. Each chapter in this topical collection is self-contained and can be read on its own, thus making it also suitable as reference for experienced researchers wishing to focus on a particular topic.

  15. Proliferating cells in psoriatic dermis are comprised primarily of T cells, endothelial cells, and factor XIIIa+ perivascular dendritic cells

    International Nuclear Information System (INIS)

    Morganroth, G.S.; Chan, L.S.; Weinstein, G.D.; Voorhees, J.J.; Cooper, K.D.

    1991-01-01

    Determination of the cell types proliferating in the dermis of patients with psoriasis should identify those cells experiencing activation or responding to growth factors in the psoriatic dermal milieu. Toward that end, sections of formalin-fixed biopsies obtained from 3H-deoxyuridine (3H-dU)-injected skin of eight psoriatic patients were immunostained, followed by autoradiography. Proliferating dermal cells exhibit silver grains from tritium emissions. The identity of the proliferating cells could then be determined by simultaneous visualization with antibodies specific for various cell types. UCHL1+ (CD45RO+) T cells (recall antigen-reactive helper T-cell subset) constituted 36.6 +/- 3.1% (mean +/- SEM, n = 6) of the proliferating dermal cells in involved skin, whereas Leu 18+ (CD45RA+) T cells (recall antigen naive T-cell subsets) comprised only 8.7 +/- 1.5% (n = 6). The Factor XIIIa+ dermal perivascular dendritic cell subset (24.9 +/- 1.5% of proliferating dermal cells, n = 6) and Factor VIII+ endothelial cells represented the two other major proliferating populations in lesional psoriatic dermis. Differentiated tissue macrophages, identified by phase microscopy as melanophages or by immunostaining with antibodies to Leu M1 (CD15) or myeloid histiocyte antigen, comprised less than 5% of the proliferating population in either skin type. In addition to calculating the relative proportions of these cells to each other as percent, we also determined the density of cells, in cells/mm2 of tissue. The density of proliferating cells within these populations was increased in involved versus uninvolved skin: UCHL1+, 9.0 +/- 1.7 cells/mm2 versus 1.8 +/- 0.6 cells/mm2, p less than 0.01; Factor XIIIa+, 6.0 +/- 0.7 cells/mm2 versus 1.5 +/- 0.5 cells/mm2, p less than 0.01; Factor VIII+, 5.5 +/- 1.4 cells/mm2 versus 0.0 cells/mm2, p less than 0.05

  16. A novel off-grid hybrid power system comprised of solar photovoltaic, wind, and hydro energy sources

    International Nuclear Information System (INIS)

    Bhandari, Binayak; Lee, Kyung-Tae; Lee, Caroline Sunyong; Song, Chul-Ki; Maskey, Ramesh K.; Ahn, Sung-Hoon

    2014-01-01

    Highlights: • We propose two hybridization methods for small off-grid power systems consisting solar (PV), wind, and micro-hydro sources. • One of the methods was implemented in a mini-grid connecting Thingan and Kolkhop villages in Makawanpur District, Nepal. • The results can be applied to help achieve Millennium Development Goal 7: Ensuring environmental sustainability. • This is the first implementation anywhere comprising of three renewable energy power, in a single off-grid power system. • This research may be applied as a practical guide for implementing similar systems in various locations. - Abstract: Several factors must be considered before adopting a full-phase power generation system based on renewable energy sources. Long-term necessary data (for one year if possible) should be collected before making any decisions concerning implementation of such a systems. To accurately assess the potential of available resources, we measured solar irradiation, wind speed, and ambient temperature at two high-altitude locations in Nepal: the Lama Hotel in Rasuwa District and Thingan in Makawanpur District. Here, we propose two practical, economical hybridization methods for small off-grid systems consisting entirely of renewable energy sources—specifically solar photovoltaic (PV), wind, and micro-hydro sources. One of the methods was tested experimentally, and the results can be applied to help achieve Millennium Development Goal 7: Ensuring environmental sustainability. Hydro, wind, and solar photovoltaic energy are the top renewable energy sources in terms of globally installed capacity. However, no reports have been published about off-grid hybrid systems comprised of all three sources, making this implementation the first of its kind anywhere. This research may be applied as a practical guide for implementing similar systems in various locations. Of the four off-grid PV systems installed by the authors for village electrification in Nepal, one was

  17. Network maintenance

    CERN Multimedia

    GS Department

    2009-01-01

    A site-wide network maintenance operation has been scheduled for Saturday 28 February. Most of the network devices of the general purpose network will be upgraded to a newer software version, in order to improve our network monitoring capabilities. This will result in a series of short (2-5 minutes) random interruptions everywhere on the CERN sites throughout the day. This upgrade will not affect the Computer Centre itself, Building 613, the Technical Network and the LHC experiments, dedicated networks at the pits. For further details of this intervention, please contact Netops by phone 74927 or e-mail mailto:Netops@cern.ch. IT/CS Group

  18. Network maintenance

    CERN Multimedia

    IT Department

    2009-01-01

    A site wide network maintenance has been scheduled for Saturday 28 February. Most of the network devices of the General Purpose network will be upgraded to a newer software version, in order to improve our network monitoring capabilities. This will result in a series of short (2-5 minutes) random interruptions everywhere on the CERN sites along this day. This upgrade will not affect: the Computer centre itself, building 613, the Technical Network and the LHC experiments dedicated networks at the pits. Should you need more details on this intervention, please contact Netops by phone 74927 or email mailto:Netops@cern.ch. IT/CS Group

  19. Comparison of Communication Architectures and Network Topologies for Distributed Propulsion Controls (Preprint)

    Science.gov (United States)

    2013-05-01

    Interconnection ( OSI ) network model for the engine control application. Figure 1 summarizes the OSI network model, which is comprised by 7 layers [21]. In...59th International Instrumentation Symposium; http://www.isa.org Approved for public release; distribution unlimited. 7 Figure 1: OSI Network...21st International Conference on, pages 3–7. IEEE, 2011. [9] LAN Network Topologies. http://www.firewall.cx/networking-topics/general- networking/103

  20. Network Learning and Innovation in SME Formal Networks

    Directory of Open Access Journals (Sweden)

    Jivka Deiters

    2013-02-01

    Full Text Available The driver for this paper is the need to better understand the potential for learning and innovation that networks canprovide especially for small and medium sized enterprises (SMEs which comprise by far the majority of enterprises in the food sector. With the challenges the food sector is facing in the near future, learning and innovation or more focused, as it is being discussed in the paper, ‘learning for innovation’ are not just opportunities but pre‐conditions for the sustainability of the sector. Network initiatives that could provide appropriate support involve social interaction and knowledge exchange, learning, competence development, and coordination (organization and management of implementation. The analysis identifies case studies in any of these orientations which serve different stages of the innovation process: invention and implementation. The variety of network case studies cover networks linked to a focus group for training, research, orconsulting, networks dealing with focused market oriented product or process development, promotional networks, and networks for open exchange and social networking.

  1. Improved Maximum Parsimony Models for Phylogenetic Networks.

    Science.gov (United States)

    Van Iersel, Leo; Jones, Mark; Scornavacca, Celine

    2018-05-01

    Phylogenetic networks are well suited to represent evolutionary histories comprising reticulate evolution. Several methods aiming at reconstructing explicit phylogenetic networks have been developed in the last two decades. In this article, we propose a new definition of maximum parsimony for phylogenetic networks that permits to model biological scenarios that cannot be modeled by the definitions currently present in the literature (namely, the "hardwired" and "softwired" parsimony). Building on this new definition, we provide several algorithmic results that lay the foundations for new parsimony-based methods for phylogenetic network reconstruction.

  2. Triple primary urogenital cancer. A case of secondary cancers following combination therapy comprising chemotherapy plus radiation therapy for testicular cancer

    International Nuclear Information System (INIS)

    Iuchi, Hiromichi; Watabe, Yoshihiko; Hashimoto, Hiroshi; Kitahara, Katsuyuki; Takeyama, Yoshihiro; Fujita, Shinji

    2012-01-01

    A 68-year-old man was referred to our outpatient clinic with left renal cell cancer and bladder cancer. He had undergone combination therapy comprising chemotherapy plus radiation therapy following radical orchiectomy for testicular cancer at the age of 48 years. The right testis could be felt within the scrotum, however the left testis could not. Blood tests showed no abnormality in regard to testicular tumor markers. Urine cytology was class V. Computed tomography revealed a 3.0 x 3.4 cm mass in the left kidney and a 4.5 x 1.5 cm mass in the left wall of the bladder. We made it a priority to treat the bladder cancer which was strongly suspected to be invasive cancer. At first the patient underwent radical cystectomy. Then left partial nephrectomy was carried out. Our case would appear to be the 24th case of triple primary urogenital cancer in Japan that consisted of left testicular cancer, left renal cancer and bladder cancer. Our case was also thought to be a case of secondary cancer that developed following treatment for testicular cancer. (author)

  3. Preparation and characterization of biopolymers comprising chitosan-grafted-ENR via acid-induced reaction of ENR50 with chitosan

    Directory of Open Access Journals (Sweden)

    M. R. H. Mas Haris

    2014-02-01

    Full Text Available This paper describes the first detailed tailored-approach for the preparation of biopolymers comprising chitosan (CTS grafted onto the backbone of epoxidized natural rubber (CTS-g-ENR. In a typical experiment, appropriate amount of CTS and AlCl3•6H2O was added to a specified amount of ENR50 (ENR with about 50% epoxy content dissolved in a dual-solvent consisting of 1,4-dioxane and water (97.5:2.5% v/v and the resulting mixture refluxed with continuous stirring for 6 hours. Nuclear magnetic resonance (NMR spectral analysis of a biocomposite, CTS-g-ENR-P1, revealed that its epoxy content is 22.36% which is considerably lower than 44.93% as determined for ENR50-control (ENR50 derivative obtained under similar experimental condition but in the absence of CTS. This means that the grafting of CTS onto the backbone of ENR had occurred. The revelation is affirmed by the presence of the characteristic absorption bands of CTS and ENR, and the appearance of new bands at 1219, 902 and 733 cm–1 in the Fourier transform infrared (FTIR spectrum of CTS-g-ENR-P1. Further evidence that CTS had been successfully grafted onto the backbone of ENR can be deduced and described in this paper from the data obtained by means of Differential Scanning Calorimetric analysis, Thermogravimetric analysis and Variable Pressure Scanning Electron Microscopy.

  4. Clinical instructors' perceptions of behaviors that comprise entry-level clinical performance in physical therapist students: a qualitative study.

    Science.gov (United States)

    Jette, Diane U; Bertoni, Alicia; Coots, Renee; Johnson, Heidi; McLaughlin, Catherine; Weisbach, Cody

    2007-07-01

    The purpose of this study was to qualitatively explore clinical instructors' (CIs) perceptions of students' behaviors that comprise entry-level clinical performance, as well as how those perceptions were integrated into their decision making. The participants were 21 physical therapists who were CIs for physical therapist students. Using a grounded theory approach, we conducted interviews, asking the question, "What is it about students' performance that makes you see them as entry-level therapists?" We determined common themes among the interviews and developed a schema to explain the decision-making process. Participants identified 7 attributes that, when demonstrated to a sufficient degree, illustrated to them students' ability to practice at the entry level. Those attributes were knowledge, clinical skills, safety, clinical decision making, self-directed learning, interpersonal communication, and professional demeanor. Participants viewed these attributes in concert to form a subjective "gut feeling" that a student demonstrated entry-level performance. A final theme emerged suggesting a definition of entry-level performance as "mentored independence." Participants reported evaluating students' performance based on attributes similar to those suggested by the American Physical Therapy Association's Physical Therapist Clinical Performance Instrument and previous research. However, subjectivity also was involved in their decision about whether students were able to practice at the entry level. Participants also concluded that entry-level students need not be independent in all clinical situations.

  5. A gas sensor comprising two back-to-back connected Au/TiO2 Schottky diodes

    Science.gov (United States)

    Dehghani, Niloofar; Yousefiazari, Ehsan

    2018-04-01

    A miniature, but sturdy, gas sensor capable of operation at temperatures as high as 600 °C is presented. The device comprises two back-to-back connected gold/rutile Schottky diodes, which are fabricated on the opposite bases of a self-standing 100 μm-thick pellet of polycrystalline rutile. The rutile layer is formed by the direct oxidation of titanium metal in air at 900 °C, and the Au/rutile diodes are formed by the diffusion bonding of the gold wire segments to the pellet bases. The current versus voltage diagrams and gas sensing properties of the Au/rutile/Au structured device are recorded at different voltage sweeping frequencies and operating temperatures. The interesting features of these diagrams are explained based on an equivalent circuit of the device, which considers Schottky-type contacts at both bases and memristive conduction for the rutile in between. The device current is controlled by the leakage current of the reverse biased diode, which depends on the concentration of the oxygen vacancy at the Au/rutile interface and, hence, on the composition of the surrounding atmosphere. The device current increases 15 times in response to the presence of 1000 ppm of ethanol vapor in air. Consisting only of bulk gold and bulk rutile, the device is resilient to harsh environments and elevated temperatures; a suitable gas sensor for in-exhaust installation.

  6. Hepatoprotective Activity of Herbal Composition SAL, a Standardize Blend Comprised of Schisandra chinensis, Artemisia capillaris, and Aloe barbadensis

    Directory of Open Access Journals (Sweden)

    Mesfin Yimam

    2016-01-01

    Full Text Available Some botanicals have been reported to possess antioxidative activities acting as scavengers of free radicals rendering their usage in herbal medicine. Here we describe the potential use of “SAL,” a standardized blend comprised of three extracts from Schisandra chinensis, Artemisia capillaris, and Aloe barbadensis, in mitigating chemically induced acute liver toxicities. Acetaminophen and carbon tetrachloride induced acute liver toxicity models in mice were utilized. Hepatic functional tests from serum collected at T24 and hepatic glutathione and superoxide dismutases from liver homogenates were evaluated. Histopathology analysis and merit of blending 3 standardized extracts were also confirmed. Statistically significant and dose-correlated inhibitions in serum ALT ranging from 52.5% (p=0.004 to 34.6% (p=0.05 in the APAP and 46.3% (p<0.001 to 29.9% (p=0.02 in the CCl4 models were observed for SAL administered at doses of 400–250 mg/kg. Moreover, SAL resulted in up to 60.6% and 80.2% reductions in serums AST and bile acid, respectively. The composition replenished depleted hepatic glutathione in association with an increase of hepatic superoxide dismutase. Unexpected synergistic protection from liver damage was also observed. Therefore, the composition SAL could be potentially utilized as an effective hepatic-detoxification agent for the protection from liver damage.

  7. Antigenicity of peptides comprising the immunosuppressive domain of the retroviral envelope glycoprotein [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Bryony Jenkins

    2016-12-01

    Full Text Available To achieve persistent infection of the host, viruses often subvert or suppress host immunity through mechanisms that are not entirely understood. The envelope glycoprotein of several retroviruses is thought to possess potent immunosuppressive activity, mapped to a 17-amino acid residue conserved domain. Synthetic peptides corresponding to this immunosuppressive domain can inhibit lymphocyte activation, whereas mutation of key domain residues can increase the lymphocyte response to linked antigenic epitopes. Using three T cell receptors (TCRs of defined specificity, we examine the effect of the immunosuppressive domain on the T cell response to their respective antigenic peptides. We find that fusion of a T cell epitope to the immunosuppressive domain can greatly modulate its potency. However, the effects heavily depend on the particular combination of TCR and peptide-major histocompatibility complex class II (pMHC II, and are mimicked by sequence-scrambled peptides of similar length, suggesting they operate at the level of TCR-pMHC interaction. These results offer an alternative explanation for the immunogenicity of T cell epitopes comprising the putative immunosuppressive domain, which is more consistent with an effect on peptide antigenicity than true immunosuppressive activity.

  8. Antigenicity of peptides comprising the immunosuppressive domain of the retroviral envelope glycoprotein [version 2; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Bryony Jenkins

    2017-02-01

    Full Text Available To achieve persistent infection of the host, viruses often subvert or suppress host immunity through mechanisms that are not entirely understood. The envelope glycoprotein of several retroviruses is thought to possess potent immunosuppressive activity, mapped to a 17-amino acid residue conserved domain. Synthetic peptides corresponding to this immunosuppressive domain can inhibit lymphocyte activation, whereas mutation of key domain residues can increase the lymphocyte response to linked antigenic epitopes. Using three T cell receptors (TCRs of defined specificity, we examine the effect of the immunosuppressive domain on the T cell response to their respective antigenic peptides. We find that fusion of a T cell epitope to the immunosuppressive domain can greatly modulate its potency. However, the effects heavily depend on the particular combination of TCR and peptide-major histocompatibility complex class II (pMHC II, and are mimicked by sequence-scrambled peptides of similar length, suggesting they operate at the level of pMHC formation or TCR-pMHC interaction. These results offer an alternative explanation for the immunogenicity of T cell epitopes comprising the putative immunosuppressive domain, which is more consistent with an effect on peptide antigenicity than true immunosuppressive activity.

  9. Influence on Learning of a Collaborative Learning Method Comprising the Jigsaw Method and Problem-based Learning (PBL).

    Science.gov (United States)

    Takeda, Kayoko; Takahashi, Kiyoshi; Masukawa, Hiroyuki; Shimamori, Yoshimitsu

    2017-01-01

    Recently, the practice of active learning has spread, increasingly recognized as an essential component of academic studies. Classes incorporating small group discussion (SGD) are conducted at many universities. At present, assessments of the effectiveness of SGD have mostly involved evaluation by questionnaires conducted by teachers, by peer assessment, and by self-evaluation of students. However, qualitative data, such as open-ended descriptions by students, have not been widely evaluated. As a result, we have been unable to analyze the processes and methods involved in how students acquire knowledge in SGD. In recent years, due to advances in information and communication technology (ICT), text mining has enabled the analysis of qualitative data. We therefore investigated whether the introduction of a learning system comprising the jigsaw method and problem-based learning (PBL) would improve student attitudes toward learning; we did this by text mining analysis of the content of student reports. We found that by applying the jigsaw method before PBL, we were able to improve student attitudes toward learning and increase the depth of their understanding of the area of study as a result of working with others. The use of text mining to analyze qualitative data also allowed us to understand the processes and methods by which students acquired knowledge in SGD and also changes in students' understanding and performance based on improvements to the class. This finding suggests that the use of text mining to analyze qualitative data could enable teachers to evaluate the effectiveness of various methods employed to improve learning.

  10. Aggressive electrolyte poisons and multifunctional fluids comprised of diols and diamines for emergency shutdown of lithium-ion batteries

    Science.gov (United States)

    Noelle, Daniel J.; Shi, Yang; Wang, Meng; Le, Anh V.; Qiao, Yu

    2018-04-01

    Electrolyte poisons comprised of diols and diamines are investigated for the intended function of exacerbating internal resistance in lithium-ion batteries upon short circuit failure, to quickly arrest uncontrolled joule heat generation in the earliest stages. The competing dynamics of powerful short circuit currents and electrolyte poisoning interactions are evaluated via simultaneous nail penetration and poison injection of LIR2450 format LiCoO2/graphite 120 mAh coin cells. To forcibly increase electrolyte impedance, diols serve to hinder charge-carrying ion mobility by raising solution viscosity, while diamines disrupt solvent permittivity by rapidly polymerizing the ethylene carbonate solvent. Diamines demonstrate great potency, and are suitable for integration into battery cells within chemically-inert, breakable containers, rigged for release upon mechanical activation. Mixtures of 1,2-ethanediol and 1,2-ethanediamine show synergistic poisoning effects, decreasing peak temperature accrued by 70% when introduced simultaneously upon nail penetration. With the innate presence and abundance of diols and diamines in electric vehicle heat exchangers, they may be employed for multifunctional applications.

  11. Thermal Resistance across Interfaces Comprising Dimensionally Mismatched Carbon Nanotube-Graphene Junctions in 3D Carbon Nanomaterials

    Directory of Open Access Journals (Sweden)

    Jungkyu Park

    2014-01-01

    Full Text Available In the present study, reverse nonequilibrium molecular dynamics is employed to study thermal resistance across interfaces comprising dimensionally mismatched junctions of single layer graphene floors with (6,6 single-walled carbon nanotube (SWCNT pillars in 3D carbon nanomaterials. Results obtained from unit cell analysis indicate the presence of notable interfacial thermal resistance in the out-of-plane direction (along the longitudinal axis of the SWCNTs but negligible resistance in the in-plane direction along the graphene floor. The interfacial thermal resistance in the out-of-plane direction is understood to be due to the change in dimensionality as well as phonon spectra mismatch as the phonons propagate from SWCNTs to the graphene sheet and then back again to the SWCNTs. The thermal conductivity of the unit cells was observed to increase nearly linearly with an increase in cell size, that is, pillar height as well as interpillar distance, and approaches a plateau as the pillar height and the interpillar distance approach the critical lengths for ballistic thermal transport in SWCNT and single layer graphene. The results indicate that the thermal transport characteristics of these SWCNT-graphene hybrid structures can be tuned by controlling the SWCNT-graphene junction characteristics as well as the unit cell dimensions.

  12. Removal of trace organic contaminants by an MBR comprising a mixed culture of bacteria and white-rot fungi.

    Science.gov (United States)

    Nguyen, Luong N; Hai, Faisal I; Yang, Shufan; Kang, Jinguo; Leusch, Frederic D L; Roddick, Felicity; Price, William E; Nghiem, Long D

    2013-11-01

    The degradation of 30 trace organic contaminants (TrOC) by a white-rot fungus-augmented membrane bioreactor (MBR) was investigated. The results show that white-rot fungal enzyme (laccase), coupled with a redox mediator (1-hydroxy benzotriazole, HBT), could degrade TrOC that are resistant to bacterial degradation (e.g. diclofenac, triclosan, naproxen and atrazine) but achieved low removal of compounds (e.g. ibuprofen, gemfibrozil and amitriptyline) that are well removed by conventional activated sludge treatment. Overall, the fungus-augmented MBR showed better TrOC removal compared to a system containing conventional activated sludge. The major role of biodegradation in removal by the MBR was noted. Continuous mediator dosing to MBR may potentially enhance its performance, although not as effectively as for mediator-enhanced batch laccase systems. A ToxScreen3 assay revealed no significant increase in the toxicity of the effluent during MBR treatment of the synthetic wastewater comprising TrOC, confirming that no toxic by-products were produced. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. The human Vδ2+ T-cell compartment comprises distinct innate-like Vγ9+ and adaptive Vγ9- subsets.

    Science.gov (United States)

    Davey, Martin S; Willcox, Carrie R; Hunter, Stuart; Kasatskaya, Sofya A; Remmerswaal, Ester B M; Salim, Mahboob; Mohammed, Fiyaz; Bemelman, Frederike J; Chudakov, Dmitriy M; Oo, Ye H; Willcox, Benjamin E

    2018-05-02

    Vδ2 + T cells form the predominant human γδ T-cell population in peripheral blood and mediate T-cell receptor (TCR)-dependent anti-microbial and anti-tumour immunity. Here we show that the Vδ2 + compartment comprises both innate-like and adaptive subsets. Vγ9 + Vδ2 + T cells display semi-invariant TCR repertoires, featuring public Vγ9 TCR sequences equivalent in cord and adult blood. By contrast, we also identify a separate, Vγ9 - Vδ2 + T-cell subset that typically has a CD27 hi CCR7 + CD28 + IL-7Rα + naive-like phenotype and a diverse TCR repertoire, however in response to viral infection, undergoes clonal expansion and differentiation to a CD27 lo CD45RA + CX 3 CR1 + granzymeA/B + effector phenotype. Consistent with a function in solid tissue immunosurveillance, we detect human intrahepatic Vγ9 - Vδ2 + T cells featuring dominant clonal expansions and an effector phenotype. These findings redefine human γδ T-cell subsets by delineating the Vδ2 + T-cell compartment into innate-like (Vγ9 + ) and adaptive (Vγ9 - ) subsets, which have distinct functions in microbial immunosurveillance.

  14. Network Ambivalence

    Directory of Open Access Journals (Sweden)

    Patrick Jagoda

    2015-08-01

    Full Text Available The language of networks now describes everything from the Internet to the economy to terrorist organizations. In distinction to a common view of networks as a universal, originary, or necessary form that promises to explain everything from neural structures to online traffic, this essay emphasizes the contingency of the network imaginary. Network form, in its role as our current cultural dominant, makes scarcely imaginable the possibility of an alternative or an outside uninflected by networks. If so many things and relationships are figured as networks, however, then what is not a network? If a network points towards particular logics and qualities of relation in our historical present, what others might we envision in the future? In  many ways, these questions are unanswerable from within the contemporary moment. Instead of seeking an avant-garde approach (to move beyond networks or opting out of networks (in some cases, to recover elements of pre-networked existence, this essay proposes a third orientation: one of ambivalence that operates as a mode of extreme presence. I propose the concept of "network aesthetics," which can be tracked across artistic media and cultural forms, as a model, style, and pedagogy for approaching interconnection in the twenty-first century. The following essay is excerpted from Network Ambivalence (Forthcoming from University of Chicago Press. 

  15. Epidemics in interconnected small-world networks.

    Science.gov (United States)

    Liu, Meng; Li, Daqing; Qin, Pengju; Liu, Chaoran; Wang, Huijuan; Wang, Feilong

    2015-01-01

    Networks can be used to describe the interconnections among individuals, which play an important role in the spread of disease. Although the small-world effect has been found to have a significant impact on epidemics in single networks, the small-world effect on epidemics in interconnected networks has rarely been considered. Here, we study the susceptible-infected-susceptible (SIS) model of epidemic spreading in a system comprising two interconnected small-world networks. We find that the epidemic threshold in such networks decreases when the rewiring probability of the component small-world networks increases. When the infection rate is low, the rewiring probability affects the global steady-state infection density, whereas when the infection rate is high, the infection density is insensitive to the rewiring probability. Moreover, epidemics in interconnected small-world networks are found to spread at different velocities that depend on the rewiring probability.

  16. Epidemics in interconnected small-world networks.

    Directory of Open Access Journals (Sweden)

    Meng Liu

    Full Text Available Networks can be used to describe the interconnections among individuals, which play an important role in the spread of disease. Although the small-world effect has been found to have a significant impact on epidemics in single networks, the small-world effect on epidemics in interconnected networks has rarely been considered. Here, we study the susceptible-infected-susceptible (SIS model of epidemic spreading in a system comprising two interconnected small-world networks. We find that the epidemic threshold in such networks decreases when the rewiring probability of the component small-world networks increases. When the infection rate is low, the rewiring probability affects the global steady-state infection density, whereas when the infection rate is high, the infection density is insensitive to the rewiring probability. Moreover, epidemics in interconnected small-world networks are found to spread at different velocities that depend on the rewiring probability.

  17. Delays and networked control systems

    CERN Document Server

    Hetel, Laurentiu; Daafouz, Jamal; Johansson, Karl

    2016-01-01

    This edited monograph includes state-of-the-art contributions on continuous time dynamical networks with delays. The book is divided into four parts. The first part presents tools and methods for the analysis of time-delay systems with a particular attention on control problems of large scale or infinite-dimensional systems with delays. The second part of the book is dedicated to the use of time-delay models for the analysis and design of Networked Control Systems. The third part of the book focuses on the analysis and design of systems with asynchronous sampling intervals which occur in Networked Control Systems. The last part of the book exposes several contributions dealing with the design of cooperative control and observation laws for networked control systems. The target audience primarily comprises researchers and experts in the field of control theory, but the book may also be beneficial for graduate students. .

  18. Network workshop

    DEFF Research Database (Denmark)

    Bruun, Jesper; Evans, Robert Harry

    2014-01-01

    This paper describes the background for, realisation of and author reflections on a network workshop held at ESERA2013. As a new research area in science education, networks offer a unique opportunity to visualise and find patterns and relationships in complicated social or academic network data....... These include student relations and interactions and epistemic and linguistic networks of words, concepts and actions. Network methodology has already found use in science education research. However, while networks hold the potential for new insights, they have not yet found wide use in the science education...... research community. With this workshop, participants were offered a way into network science based on authentic educational research data. The workshop was constructed as an inquiry lesson with emphasis on user autonomy. Learning activities had participants choose to work with one of two cases of networks...

  19. Network Convergence

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Network Convergence. User is interested in application and content - not technical means of distribution. Boundaries between distribution channels fade out. Network convergence leads to seamless application and content solutions.

  20. Industrial Networks

    DEFF Research Database (Denmark)

    Karlsson, Christer

    2015-01-01

    Companies organize in a way that involves many activities that are external to the traditional organizational boundaries. This presents challenges to operations management and managing operations involves many issues and actions dealing with external networks. Taking a network perspective changes...

  1. Network Science

    National Research Council Canada - National Science Library

    Leland, Will

    2006-01-01

    OVERVIEW: (1) A committee of technical experts, military officers and R&D managers was assembled by the National Research Council to reach consensus on the nature of networks and network research. (2...

  2. Network Coded Software Defined Networking

    DEFF Research Database (Denmark)

    Krigslund, Jeppe; Hansen, Jonas; Roetter, Daniel Enrique Lucani

    2015-01-01

    Software Defined Networking (SDN) and Network Coding (NC) are two key concepts in networking that have garnered a large attention in recent years. On the one hand, SDN's potential to virtualize services in the Internet allows a large flexibility not only for routing data, but also to manage....... This paper advocates for the use of SDN to bring about future Internet and 5G network services by incorporating network coding (NC) functionalities. The inherent flexibility of both SDN and NC provides a fertile ground to envision more efficient, robust, and secure networking designs, that may also...

  3. Network Simulation

    CERN Document Server

    Fujimoto, Richard

    2006-01-01

    "Network Simulation" presents a detailed introduction to the design, implementation, and use of network simulation tools. Discussion topics include the requirements and issues faced for simulator design and use in wired networks, wireless networks, distributed simulation environments, and fluid model abstractions. Several existing simulations are given as examples, with details regarding design decisions and why those decisions were made. Issues regarding performance and scalability are discussed in detail, describing how one can utilize distributed simulation methods to increase the

  4. Neuromorphic atomic switch networks.

    Directory of Open Access Journals (Sweden)

    Audrius V Avizienis

    Full Text Available Efforts to emulate the formidable information processing capabilities of the brain through neuromorphic engineering have been bolstered by recent progress in the fabrication of nonlinear, nanoscale circuit elements that exhibit synapse-like operational characteristics. However, conventional fabrication techniques are unable to efficiently generate structures with the highly complex interconnectivity found in biological neuronal networks. Here we demonstrate the physical realization of a self-assembled neuromorphic device which implements basic concepts of systems neuroscience through a hardware-based platform comprised of over a billion interconnected atomic-switch inorganic synapses embedded in a complex network of silver nanowires. Observations of network activation and passive harmonic generation demonstrate a collective response to input stimulus in agreement with recent theoretical predictions. Further, emergent behaviors unique to the complex network of atomic switches and akin to brain function are observed, namely spatially distributed memory, recurrent dynamics and the activation of feedforward subnetworks. These devices display the functional characteristics required for implementing unconventional, biologically and neurally inspired computational methodologies in a synthetic experimental system.

  5. Method of preparing an Al-Ti-B grain refiner for aluminium-comprising products, and a method of casting aluminium products

    NARCIS (Netherlands)

    Brinkman, H.J.; Duszczyk, J.; Katgerman, L.

    1999-01-01

    The invention relates to a method of preparing an Al-Ti-B grain refiner for cast aluminium-comprising products. According to the invention the preparation is realized by mixing powders selected from the group comprising aluminium, titanium, boron, and alloys and intermetallic compounds thereof,

  6. Dynamic and interacting complex networks

    Science.gov (United States)

    Dickison, Mark E.

    individuals protect themselves by disconnecting their links to infected neighbors with probability w and reconnecting them to other susceptible individuals chosen at random. Starting from a single infected individual, we show by an analytical approach and simulations that there is a phase transition at a critical rewiring (quarantine) threshold wc separating a phase (w wc) where the disease does not spread out. We find that in our model the topology of the network strongly affects the size of the propagation and that wc increases with the mean degree and heterogeneity of the network. We also find that wc is reduced if we perform a preferential rewiring, in which the rewiring probability is proportional to the degree of infected nodes. In the fourth chapter, we study epidemic processes on interconnected network systems, and find two distinct regimes. In strongly-coupled network systems, epidemics occur simultaneously across the entire system at a critical value betac. In contrast, in weakly-coupled network systems, a mixed phase exists below betac where an epidemic occurs in one network but does not spread to the coupled network. We derive an expression for the network and disease parameters that allow this mixed phase and verify it numerically. Public health implications of communities comprising these two classes of network systems are also mentioned.

  7. Technical Network

    CERN Multimedia

    2007-01-01

    In order to optimise the management of the Technical Network (TN), to facilitate understanding of the purpose of devices connected to the TN and to improve security incident handling, the Technical Network Administrators and the CNIC WG have asked IT/CS to verify the "description" and "tag" fields of devices connected to the TN. Therefore, persons responsible for systems connected to the TN will receive e-mails from IT/CS asking them to add the corresponding information in the network database at "network-cern-ch". Thank you very much for your cooperation. The Technical Network Administrators & the CNIC WG

  8. Spatial networks

    Science.gov (United States)

    Barthélemy, Marc

    2011-02-01

    Complex systems are very often organized under the form of networks where nodes and edges are embedded in space. Transportation and mobility networks, Internet, mobile phone networks, power grids, social and contact networks, and neural networks, are all examples where space is relevant and where topology alone does not contain all the information. Characterizing and understanding the structure and the evolution of spatial networks is thus crucial for many different fields, ranging from urbanism to epidemiology. An important consequence of space on networks is that there is a cost associated with the length of edges which in turn has dramatic effects on the topological structure of these networks. We will thoroughly explain the current state of our understanding of how the spatial constraints affect the structure and properties of these networks. We will review the most recent empirical observations and the most important models of spatial networks. We will also discuss various processes which take place on these spatial networks, such as phase transitions, random walks, synchronization, navigation, resilience, and disease spread.

  9. Network science

    CERN Document Server

    Barabasi, Albert-Laszlo

    2016-01-01

    Networks are everywhere, from the Internet, to social networks, and the genetic networks that determine our biological existence. Illustrated throughout in full colour, this pioneering textbook, spanning a wide range of topics from physics to computer science, engineering, economics and the social sciences, introduces network science to an interdisciplinary audience. From the origins of the six degrees of separation to explaining why networks are robust to random failures, the author explores how viruses like Ebola and H1N1 spread, and why it is that our friends have more friends than we do. Using numerous real-world examples, this innovatively designed text includes clear delineation between undergraduate and graduate level material. The mathematical formulas and derivations are included within Advanced Topics sections, enabling use at a range of levels. Extensive online resources, including films and software for network analysis, make this a multifaceted companion for anyone with an interest in network sci...

  10. Vulnerability of network of networks

    Science.gov (United States)

    Havlin, S.; Kenett, D. Y.; Bashan, A.; Gao, J.; Stanley, H. E.

    2014-10-01

    Our dependence on networks - be they infrastructure, economic, social or others - leaves us prone to crises caused by the vulnerabilities of these networks. There is a great need to develop new methods to protect infrastructure networks and prevent cascade of failures (especially in cases of coupled networks). Terrorist attacks on transportation networks have traumatized modern societies. With a single blast, it has become possible to paralyze airline traffic, electric power supply, ground transportation or Internet communication. How, and at which cost can one restructure the network such that it will become more robust against malicious attacks? The gradual increase in attacks on the networks society depends on - Internet, mobile phone, transportation, air travel, banking, etc. - emphasize the need to develop new strategies to protect and defend these crucial networks of communication and infrastructure networks. One example is the threat of liquid explosives a few years ago, which completely shut down air travel for days, and has created extreme changes in regulations. Such threats and dangers warrant the need for new tools and strategies to defend critical infrastructure. In this paper we review recent advances in the theoretical understanding of the vulnerabilities of interdependent networks with and without spatial embedding, attack strategies and their affect on such networks of networks as well as recently developed strategies to optimize and repair failures caused by such attacks.

  11. Operationalizing Heedful Interrelating: How Attending, Responding, and Feeling Comprise Coordinating and Predict Performance in Self-Managing Teams

    Science.gov (United States)

    Stephens, John Paul; Lyddy, Christopher J.

    2016-01-01

    Team coordination implies a system of individual behavioral contributions occurring within a network of interpersonal relationships to achieve a collective goal. Current research on coordination has emphasized its relational aspects, but has not adequately accounted for how team members also simultaneously manage individual behavioral contributions and represent the whole system of the team's work. In the current study, we develop theory and test how individuals manage all three aspects of coordinating through the three facets described in the theory of heedful interrelating. We operationalize the facet of contributing as distributing attention between self and others, subordinating as responsively communicating, and representing as feeling the system of the team's work as a cohesive whole. We then test the relationships among these facets and their influence on team performance in an experiment with 50 ad hoc triads of undergraduate student self-managing teams tasked with collectively composing a song in the lab. In analyzing thin-slices of video data of these teams' coordination, we found that teams with members displaying greater dispersion of attentional distribution and more responsive communicating experienced a stronger feeling of the team as a whole. Responsive communication also predicted team performance. Accounting for how the three aspects of coordinating are managed by individual team members provides a more critical understanding of heedful interrelating, and insight into emergent coordination processes. PMID:27047407

  12. Operationalizing heedful interrelating: How attending, responding, and feeling comprise coordinating and predict performance in self-managing teams

    Directory of Open Access Journals (Sweden)

    John Paul Stephens

    2016-03-01

    Full Text Available Team coordination implies a system of individual behavioral contributions occurring within a network of interpersonal relationships to achieve a collective goal. Current research on coordination has emphasized its relational aspects, but has not adequately accounted for how team members also simultaneously manage individual behavioral contributions and represent the whole system of the team’s work. In the current study, we develop theory and test how individuals manage all three aspects of coordinating through the three facets described in the theory of heedful interrelating. We operationalize the facet of contributing as distributing attention between self and others, subordinating as responsively communicating, and representing as feeling the system of the team’s work as a cohesive whole. We then test the relationships among these facets and their influence on team performance in an experiment with 50 ad hoc triads of undergraduate student self-managing teams tasked with collectively composing a song in the lab. In analyzing thin-slices of video data of these teams’ coordination, we found that teams with members displaying greater dispersion of attentional distribution and more responsive communicating experienced a stronger feeling of the team as a whole. Responsive communication also predicted team performance. Accounting for how the three aspects of coordinating are managed by individual team members provides a more critical understanding of heedful interrelating, and insight into emergent coordination processes.

  13. Operationalizing Heedful Interrelating: How Attending, Responding, and Feeling Comprise Coordinating and Predict Performance in Self-Managing Teams.

    Science.gov (United States)

    Stephens, John Paul; Lyddy, Christopher J

    2016-01-01

    Team coordination implies a system of individual behavioral contributions occurring within a network of interpersonal relationships to achieve a collective goal. Current research on coordination has emphasized its relational aspects, but has not adequately accounted for how team members also simultaneously manage individual behavioral contributions and represent the whole system of the team's work. In the current study, we develop theory and test how individuals manage all three aspects of coordinating through the three facets described in the theory of heedful interrelating. We operationalize the facet of contributing as distributing attention between self and others, subordinating as responsively communicating, and representing as feeling the system of the team's work as a cohesive whole. We then test the relationships among these facets and their influence on team performance in an experiment with 50 ad hoc triads of undergraduate student self-managing teams tasked with collectively composing a song in the lab. In analyzing thin-slices of video data of these teams' coordination, we found that teams with members displaying greater dispersion of attentional distribution and more responsive communicating experienced a stronger feeling of the team as a whole. Responsive communication also predicted team performance. Accounting for how the three aspects of coordinating are managed by individual team members provides a more critical understanding of heedful interrelating, and insight into emergent coordination processes.

  14. Crawling Facebook for Social Network Analysis Purposes

    OpenAIRE

    Catanese, Salvatore A.; De Meo, Pasquale; Ferrara, Emilio; Fiumara, Giacomo; Provetti, Alessandro

    2011-01-01

    We describe our work in the collection and analysis of massive data describing the connections between participants to online social networks. Alternative approaches to social network data collection are defined and evaluated in practice, against the popular Facebook Web site. Thanks to our ad-hoc, privacy-compliant crawlers, two large samples, comprising millions of connections, have been collected; the data is anonymous and organized as an undirected graph. We describe a set of tools that w...

  15. A microcomputer for a packet switched network

    International Nuclear Information System (INIS)

    Seller, P.; Bairstow, R.; Barlow, J.; Waters, M.

    1982-12-01

    The Bubble Chamber Research Group of the Rutherford and Appleton Laboratory has a large film analysis facility. This comprises 16 digitising tables used for the measurement of bubble chamber film. Each of these tables has an associated microcomputer. These microcomputers are linked by a star structured packet switched local area network (LAN) to a VAX 11/780. The LAN, and in particular a microcomputer of novel architecture designed to act as the central switch of the network, is described. (author)

  16. Network Coded Software Defined Networking

    DEFF Research Database (Denmark)

    Hansen, Jonas; Roetter, Daniel Enrique Lucani; Krigslund, Jeppe

    2015-01-01

    Software defined networking has garnered large attention due to its potential to virtualize services in the Internet, introducing flexibility in the buffering, scheduling, processing, and routing of data in network routers. SDN breaks the deadlock that has kept Internet network protocols stagnant...... for decades, while applications and physical links have evolved. This article advocates for the use of SDN to bring about 5G network services by incorporating network coding (NC) functionalities. The latter constitutes a major leap forward compared to the state-of-the- art store and forward Internet paradigm...

  17. The APS control system network

    International Nuclear Information System (INIS)

    Sidorowicz, K.V.; McDowell, W.P.

    1995-01-01

    The APS accelerator control system is a distributed system consisting of operator interfaces, a network, and computer-controlled interfaces to hardware. This implementation of a control system has come to be called the open-quotes Standard Model.close quotes The operator interface is a UNDC-based workstation with an X-windows graphical user interface. The workstation may be located at any point on the facility network and maintain full functionality. The function of the network is to provide a generalized communication path between the host computers, operator workstations, input/output crates, and other hardware that comprise the control system. The crate or input/output controller (IOC) provides direct control and input/output interfaces for each accelerator subsystem. The network is an integral part of all modem control systems and network performance will determine many characteristics of a control system. This paper will describe the overall APS network and examine the APS control system network in detail. Metrics are provided on the performance of the system under various conditions

  18. Zone routing in a torus network

    Science.gov (United States)

    Chen, Dong; Heidelberger, Philip; Kumar, Sameer

    2013-01-29

    A system for routing data in a network comprising a network logic device at a sending node for determining a path between the sending node and a receiving node, wherein the network logic device sets one or more selection bits and one or more hint bits within the data packet, a control register for storing one or more masks, wherein the network logic device uses the one or more selection bits to select a mask from the control register and the network logic device applies the selected mask to the hint bits to restrict routing of the data packet to one or more routing directions for the data packet within the network and selects one of the restricted routing directions from the one or more routing directions and sends the data packet along a link in the selected routing direction toward the receiving node.

  19. Networked Identities

    DEFF Research Database (Denmark)

    Ryberg, Thomas; Larsen, Malene Charlotte

    2008-01-01

    of CoPs we shall argue that the metaphor or theory of networked learning is itself confronted with some central tensions and challenges that need to be addressed. We then explore these theoretical and analytic challenges to the network metaphor, through an analysis of a Danish social networking site. We......In this article we take up a critique of the concept of Communities of Practice (CoP) voiced by several authors, who suggest that networks may provide a better metaphor to understand social forms of organisation and learning. Through a discussion of the notion of networked learning and the critique...... argue that understanding meaning-making and ‘networked identities’ may be relevant analytic entry points in navigating the challenges....

  20. Fluid temperatures: Modeling the thermal regime of a river network

    Science.gov (United States)

    Rhonda Mazza; Ashley Steel

    2017-01-01

    Water temperature drives the complex food web of a river network. Aquatic organisms hatch, feed, and reproduce in thermal niches within the tributaries and mainstem that comprise the river network. Changes in water temperature can synchronize or asynchronize the timing of their life stages throughout the year. The water temperature fluctuates over time and place,...

  1. Network security

    CERN Document Server

    Perez, André

    2014-01-01

    This book introduces the security mechanisms deployed in Ethernet, Wireless-Fidelity (Wi-Fi), Internet Protocol (IP) and MultiProtocol Label Switching (MPLS) networks. These mechanisms are grouped throughout the book according to the following four functions: data protection, access control, network isolation, and data monitoring. Data protection is supplied by data confidentiality and integrity control services. Access control is provided by a third-party authentication service. Network isolation is supplied by the Virtual Private Network (VPN) service. Data monitoring consists of applying

  2. Network cohesion

    OpenAIRE

    Cavalcanti, Tiago V. V.; Giannitsarou, Chryssi; Johnson, Charles R.

    2016-01-01

    This is the final version of the article. It first appeared from Springer via http://dx.doi.org/10.1007/s00199-016-0992-1 We define a measure of network cohesion and show how it arises naturally in a broad class of dynamic models of endogenous perpetual growth with network externalities. Via a standard growth model, we show why network cohesion is crucial for conditional convergence and explain that as cohesion increases, convergence is faster. We prove properties of network cohesion and d...

  3. Technical Network

    CERN Multimedia

    2007-01-01

    In order to optimize the management of the Technical Network (TN), to ease the understanding and purpose of devices connected to the TN, and to improve security incident handling, the Technical Network Administrators and the CNIC WG have asked IT/CS to verify the "description" and "tag" fields of devices connected to the TN. Therefore, persons responsible for systems connected to the TN will receive email notifications from IT/CS asking them to add the corresponding information in the network database. Thank you very much for your cooperation. The Technical Network Administrators & the CNIC WG

  4. Flexible network wireless transceiver and flexible network telemetry transceiver

    Science.gov (United States)

    Brown, Kenneth D.

    2008-08-05

    A transceiver for facilitating two-way wireless communication between a baseband application and other nodes in a wireless network, wherein the transceiver provides baseband communication networking and necessary configuration and control functions along with transmitter, receiver, and antenna functions to enable the wireless communication. More specifically, the transceiver provides a long-range wireless duplex communication node or channel between the baseband application, which is associated with a mobile or fixed space, air, water, or ground vehicle or other platform, and other nodes in the wireless network or grid. The transceiver broadly comprises a communication processor; a flexible telemetry transceiver including a receiver and a transmitter; a power conversion and regulation mechanism; a diplexer; and a phased array antenna system, wherein these various components and certain subcomponents thereof may be separately enclosed and distributable relative to the other components and subcomponents.

  5. Identifying a compound modifying a cellular response, comprises attaching cells having a reporter system onto solid supports, releasing a library member, screening and identifying target cells

    DEFF Research Database (Denmark)

    2011-01-01

    The present invention relates to methods for identifying compounds capable of modulating a cellular response. The methods involve attaching living cells to solid supports comprising a library of test compounds. Test compounds modulating a cellular response, for example via a cell surface molecule...... may be identified by selecting solid supports comprising cells, wherein the cellular response of interest has been modulated. The cellular response may for example be changes in signal transduction pathways modulated by a cell surface molecule....

  6. Method of preparing an Al-Ti-B grain refiner for aluminium-comprising products, and a method of casting aluminium products

    OpenAIRE

    Brinkman, H.J.; Duszczyk, J.; Katgerman, L.

    1999-01-01

    The invention relates to a method of preparing an Al-Ti-B grain refiner for cast aluminium-comprising products. According to the invention the preparation is realized by mixing powders selected from the group comprising aluminium, titanium, boron, and alloys and intermetallic compounds thereof, compressing, heating in an inert environment until an exothermic reaction is initiated and cooling. It has been shown that when the grain refiner thus prepared is applied, the quality of cast products ...

  7. Response variability in balanced cortical networks

    DEFF Research Database (Denmark)

    Lerchner, Alexander; Ursta, C.; Hertz, J.

    2006-01-01

    We study the spike statistics of neurons in a network with dynamically balanced excitation and inhibition. Our model, intended to represent a generic cortical column, comprises randomly connected excitatory and inhibitory leaky integrate-and-fire neurons, driven by excitatory input from an external...

  8. An eccentric perspective on brain networks

    NARCIS (Netherlands)

    Reus, M.A. de

    2015-01-01

    The adult human brain comprises an estimated number of 80-100 billion neurons. These neurons do not operate independently, but are interconnected to each other through circa 100-500 trillion neuronal connections, together forming a network of incredible complexity. Although this vast system of

  9. Physics of flow in weighted complex networks

    Science.gov (United States)

    Wu, Zhenhua

    This thesis uses concepts from statistical physics to understand the physics of flow in weighted complex networks. The traditional model for random networks is the Erdoḧs-Renyi (ER.) network, where a network of N nodes is created by connecting each of the N(N - 1)/2 pairs of nodes with a probability p. The degree distribution, which is the probability distribution of the number of links per node, is a Poisson distribution. Recent studies of the topology in many networks such as the Internet and the world-wide airport network (WAN) reveal a power law degree distribution, known as a scale-free (SF) distribution. To yield a better description of network dynamics, we study weighted networks, where each link or node is given a number. One asks how the weights affect the static and the dynamic properties of the network. In this thesis, two important dynamic problems are studied: the current flow problem, described by Kirchhoff's laws, and the maximum flow problem, which maximizes the flow between two nodes. Percolation theory is applied to these studies of the dynamics in complex networks. We find that the current flow in disordered media belongs to the same universality class as the optimal path. In a randomly weighted network, we identify the infinite incipient percolation cluster as the "superhighway", which contains most of the traffic in a network. We propose an efficient strategy to improve significantly the global transport by improving the superhighways, which comprise a small fraction of the network. We also propose a network model with correlated weights to describe weighted networks such as the WAN. Our model agrees with WAN data, and provides insight into the advantages of correlated weights in networks. Lastly, the upper critical dimension is evaluated using two different numerical methods, and the result is consistent with the theoretical prediction.

  10. Network Regulation and Support Schemes

    DEFF Research Database (Denmark)

    Ropenus, Stephanie; Schröder, Sascha Thorsten; Jacobsen, Henrik

    2009-01-01

    -in tariffs to market-based quota systems, and network regulation approaches, comprising rate-of-return and incentive regulation. National regulation and the vertical structure of the electricity sector shape the incentives of market agents, notably of distributed generators and network operators......At present, there exists no explicit European policy framework on distributed generation. Various Directives encompass distributed generation; inherently, their implementation is to the discretion of the Member States. The latter have adopted different kinds of support schemes, ranging from feed....... This article seeks to investigate the interactions between the policy dimensions of support schemes and network regulation and how they affect the deployment of distributed generation. Firstly, a conceptual analysis examines how the incentives of the different market agents are affected. In particular...

  11. Flux networks in metabolic graphs

    International Nuclear Information System (INIS)

    Warren, P B; Queiros, S M Duarte; Jones, J L

    2009-01-01

    A metabolic model can be represented as a bipartite graph comprising linked reaction and metabolite nodes. Here it is shown how a network of conserved fluxes can be assigned to the edges of such a graph by combining the reaction fluxes with a conserved metabolite property such as molecular weight. A similar flux network can be constructed by combining the primal and dual solutions to the linear programming problem that typically arises in constraint-based modelling. Such constructions may help with the visualization of flux distributions in complex metabolic networks. The analysis also explains the strong correlation observed between metabolite shadow prices (the dual linear programming variables) and conserved metabolite properties. The methods were applied to recent metabolic models for Escherichia coli, Saccharomyces cerevisiae and Methanosarcina barkeri. Detailed results are reported for E. coli; similar results were found for other organisms

  12. Overlay networks toward information networking

    CERN Document Server

    Tarkoma, Sasu

    2010-01-01

    With their ability to solve problems in massive information distribution and processing, while keeping scaling costs low, overlay systems represent a rapidly growing area of R&D with important implications for the evolution of Internet architecture. Inspired by the author's articles on content based routing, Overlay Networks: Toward Information Networking provides a complete introduction to overlay networks. Examining what they are and what kind of structures they require, the text covers the key structures, protocols, and algorithms used in overlay networks. It reviews the current state of th

  13. Probabilistic Networks

    DEFF Research Database (Denmark)

    Jensen, Finn Verner; Lauritzen, Steffen Lilholt

    2001-01-01

    This article describes the basic ideas and algorithms behind specification and inference in probabilistic networks based on directed acyclic graphs, undirected graphs, and chain graphs.......This article describes the basic ideas and algorithms behind specification and inference in probabilistic networks based on directed acyclic graphs, undirected graphs, and chain graphs....

  14. Bipartite Networks

    NARCIS (Netherlands)

    Agneessens, F.; Moser, C.; Barnett, G.A.

    2011-01-01

    Bipartite networks refer to a specific kind of network in which the nodes (or actors) can be partitioned into two subsets based on the fact that no links exist between actors within each subset, but only between the two subsets. Due to the partition of actors in two sets and the absence of relations

  15. Temporal networks

    Science.gov (United States)

    Holme, Petter; Saramäki, Jari

    2012-10-01

    A great variety of systems in nature, society and technology-from the web of sexual contacts to the Internet, from the nervous system to power grids-can be modeled as graphs of vertices coupled by edges. The network structure, describing how the graph is wired, helps us understand, predict and optimize the behavior of dynamical systems. In many cases, however, the edges are not continuously active. As an example, in networks of communication via e-mail, text messages, or phone calls, edges represent sequences of instantaneous or practically instantaneous contacts. In some cases, edges are active for non-negligible periods of time: e.g., the proximity patterns of inpatients at hospitals can be represented by a graph where an edge between two individuals is on throughout the time they are at the same ward. Like network topology, the temporal structure of edge activations can affect dynamics of systems interacting through the network, from disease contagion on the network of patients to information diffusion over an e-mail network. In this review, we present the emergent field of temporal networks, and discuss methods for analyzing topological and temporal structure and models for elucidating their relation to the behavior of dynamical systems. In the light of traditional network theory, one can see this framework as moving the information of when things happen from the dynamical system on the network, to the network itself. Since fundamental properties, such as the transitivity of edges, do not necessarily hold in temporal networks, many of these methods need to be quite different from those for static networks. The study of temporal networks is very interdisciplinary in nature. Reflecting this, even the object of study has many names-temporal graphs, evolving graphs, time-varying graphs, time-aggregated graphs, time-stamped graphs, dynamic networks, dynamic graphs, dynamical graphs, and so on. This review covers different fields where temporal graphs are considered

  16. Network Affordances

    DEFF Research Database (Denmark)

    Samson, Audrey; Soon, Winnie

    2015-01-01

    This paper examines the notion of network affordance within the context of network art. Building on Gibson's theory (Gibson, 1979) we understand affordance as the perceived and actual parameters of a thing. We expand on Gaver's affordance of predictability (Gaver, 1996) to include ecological...... and computational parameters of unpredictability. We illustrate the notion of unpredictability by considering four specific works that were included in a network art exhibiton, SPEED SHOW [2.0] Hong Kong. The paper discusses how the artworks are contingent upon the parameteric relations (Parisi, 2013......), of the network. We introduce network affordance as a dynamic framework that could articulate the experienced tension arising from the (visible) symbolic representation of computational processes and its hidden occurrences. We base our proposal on the experience of both organising the SPEED SHOW and participating...

  17. Network chemistry, network toxicology, network informatics, and network behavioristics: A scientific outline

    OpenAIRE

    WenJun Zhang

    2016-01-01

    In present study, I proposed some new sciences: network chemistry, network toxicology, network informatics, and network behavioristics. The aims, scope and scientific foundation of these sciences are outlined.

  18. Transportation Network Topologies

    Science.gov (United States)

    Holmes, Bruce J.; Scott, John

    2004-01-01

    A discomforting reality has materialized on the transportation scene: our existing air and ground infrastructures will not scale to meet our nation's 21st century demands and expectations for mobility, commerce, safety, and security. The consequence of inaction is diminished quality of life and economic opportunity in the 21st century. Clearly, new thinking is required for transportation that can scale to meet to the realities of a networked, knowledge-based economy in which the value of time is a new coin of the realm. This paper proposes a framework, or topology, for thinking about the problem of scalability of the system of networks that comprise the aviation system. This framework highlights the role of integrated communication-navigation-surveillance systems in enabling scalability of future air transportation networks. Scalability, in this vein, is a goal of the recently formed Joint Planning and Development Office for the Next Generation Air Transportation System. New foundations for 21st thinking about air transportation are underpinned by several technological developments in the traditional aircraft disciplines as well as in communication, navigation, surveillance and information systems. Complexity science and modern network theory give rise to one of the technological developments of importance. Scale-free (i.e., scalable) networks represent a promising concept space for modeling airspace system architectures, and for assessing network performance in terms of scalability, efficiency, robustness, resilience, and other metrics. The paper offers an air transportation system topology as framework for transportation system innovation. Successful outcomes of innovation in air transportation could lay the foundations for new paradigms for aircraft and their operating capabilities, air transportation system architectures, and airspace architectures and procedural concepts. The topology proposed considers air transportation as a system of networks, within which

  19. Statistical and machine learning approaches for network analysis

    CERN Document Server

    Dehmer, Matthias

    2012-01-01

    Explore the multidisciplinary nature of complex networks through machine learning techniques Statistical and Machine Learning Approaches for Network Analysis provides an accessible framework for structurally analyzing graphs by bringing together known and novel approaches on graph classes and graph measures for classification. By providing different approaches based on experimental data, the book uniquely sets itself apart from the current literature by exploring the application of machine learning techniques to various types of complex networks. Comprised of chapters written by internation

  20. Accelerating networks

    International Nuclear Information System (INIS)

    Smith, David M D; Onnela, Jukka-Pekka; Johnson, Neil F

    2007-01-01

    Evolving out-of-equilibrium networks have been under intense scrutiny recently. In many real-world settings the number of links added per new node is not constant but depends on the time at which the node is introduced in the system. This simple idea gives rise to the concept of accelerating networks, for which we review an existing definition and-after finding it somewhat constrictive-offer a new definition. The new definition provided here views network acceleration as a time dependent property of a given system as opposed to being a property of the specific algorithm applied to grow the network. The definition also covers both unweighted and weighted networks. As time-stamped network data becomes increasingly available, the proposed measures may be easily applied to such empirical datasets. As a simple case study we apply the concepts to study the evolution of three different instances of Wikipedia, namely, those in English, German, and Japanese, and find that the networks undergo different acceleration regimes in their evolution

  1. Social networks

    CERN Document Server

    Etaner-Uyar, A Sima

    2014-01-01

    The present volume provides a comprehensive resource for practitioners and researchers alike-both those new to the field as well as those who already have some experience. The work covers Social Network Analysis theory and methods with a focus on current applications and case studies applied in various domains such as mobile networks, security, machine learning and health. With the increasing popularity of Web 2.0, social media has become a widely used communication platform. Parallel to this development, Social Network Analysis gained in importance as a research field, while opening up many

  2. Network Warrior

    CERN Document Server

    Donahue, Gary

    2011-01-01

    Pick up where certification exams leave off. With this practical, in-depth guide to the entire network infrastructure, you'll learn how to deal with real Cisco networks, rather than the hypothetical situations presented on exams like the CCNA. Network Warrior takes you step by step through the world of routers, switches, firewalls, and other technologies based on the author's extensive field experience. You'll find new content for MPLS, IPv6, VoIP, and wireless in this completely revised second edition, along with examples of Cisco Nexus 5000 and 7000 switches throughout. Topics include: An

  3. Method and article of manufacture corresponding to a composite comprised of ultra nonacrystalline diamond, metal, and other nanocarbons useful for thermoelectric and other applications

    Science.gov (United States)

    Gruen, Dieter M.

    2010-05-18

    One provides (101) disperse ultra-nanocrystalline diamond powder material that comprises a plurality of substantially ordered crystallites that are each sized no larger than about 10 nanometers. One then reacts (102) these crystallites with a metallic component. The resultant nanowire is then able to exhibit a desired increase with respect to its ability to conduct electricity while also substantially preserving the thermal conductivity behavior of the disperse ultra-nanocrystalline diamond powder material. The reaction process can comprise combining (201) the crystallites with one or more metal salts in an aqueous solution and then heating (203) that aqueous solution to remove the water. This heating can occur in a reducing atmosphere (comprising, for example, hydrogen and/or methane) to also reduce the salt to metal.

  4. Convergent dynamics for multistable delayed neural networks

    International Nuclear Information System (INIS)

    Shih, Chih-Wen; Tseng, Jui-Pin

    2008-01-01

    This investigation aims at developing a methodology to establish convergence of dynamics for delayed neural network systems with multiple stable equilibria. The present approach is general and can be applied to several network models. We take the Hopfield-type neural networks with both instantaneous and delayed feedbacks to illustrate the idea. We shall construct the complete dynamical scenario which comprises exactly 2 n stable equilibria and exactly (3 n − 2 n ) unstable equilibria for the n-neuron network. In addition, it is shown that every solution of the system converges to one of the equilibria as time tends to infinity. The approach is based on employing the geometrical structure of the network system. Positively invariant sets and componentwise dynamical properties are derived under the geometrical configuration. An iteration scheme is subsequently designed to confirm the convergence of dynamics for the system. Two examples with numerical simulations are arranged to illustrate the present theory

  5. Heterodox networks

    DEFF Research Database (Denmark)

    Lala, Purnima; Kumar, Ambuj

    2016-01-01

    It is imperative for the service providers to bring innovation in the network design to meet the exponential growth of mobile subscribers for multi-technology future wireless networks. As a matter of research, studies on providing services to moving subscriber groups aka ‘Place Time Capacity (PTC......)’ have not been considered much in the literature. In this article we present Heterodox networks as an innovative and alternate approach to handle the PTC congestion. We describe two different approaches to combat the PTC congestion where the traditional terrestrial infrastructure fails to provide......-Configurable Intelligent Distributed Antenna System (SCIDAS)’ that overlays intelligence over the conventional DAS architecture and latter is in the form of a swarm of intelligent hovering base stations working in a team to cooperatively resolve the PTC congestion at the Area of Event (AoE). A suitable network...

  6. Networking Japan

    DEFF Research Database (Denmark)

    Hansen, Annette Skovsted

    Human Resource Development was the first and remains an important pillar in Japanese foreign aid. I will argue that Japan has access to a global network of alumni who will co-define Japanese foreign aid in the future, because Japan has encouraged alumni societies and networking since 1965. A total...... of more than a million people in more than 100 countries have attended courses in Japan funded fully or partly by Japanese ODA since the inception of the technical assistance programs in 1954 through the Colombo Plan and since 1959 through the Association of Overseas Technical Scholarships (AOTS from 2009...... HIDA). Many of these alumni have and will in the future exchange ideas and keep contact not only to Japan, but also to fellow alumni around the globe and, thereby, practice south-south exchanges, which are made possible and traceable by their established alumni network and the World Network of Friends...

  7. Sentinel Network

    Science.gov (United States)

    The Sentinel Network is an integrated, electronic, national medical product safety initiative that compiles information about the safe and effective use of medical products accessible to patients and healthcare practitioners.

  8. Exchange Network

    Science.gov (United States)

    The Environmental Information Exchange Network (EN) is an Internet-based system used by state, tribal and territorial partners to securely share environmental and health information with one another and EPA.

  9. Diversity Networks

    Science.gov (United States)

    and professional growth of women through networking, mentoring and training. We strive to ensure that will be used. National Processing Center Seniors Leader: Jo Anne Hankins Champion: Eric Milliner NO

  10. Nepal Networking

    DEFF Research Database (Denmark)

    Hansen, Annette Skovsted

    , as a Danida fellow. Today, the older sister works in Nepal and the younger in Seattle, where they still make use of their personal networks including connections to their fellow alumni of technical assistance courses. Inspired by work on social remittances in combination with network theory , I argue......Technical Assistance courses have many functions apart from disseminating knowledge and information, one such function is to engender networks. During the course period, participants meet and establish contact and some of these contacts remain connections between alumni for many years after...... the courses are finished. The alumni networks depend on the uses they are put to by the individual alumni and the support they get from alumni and host countries. The United Nations initiated technical assistance courses in the late 1940s in order to train nationals from developing countries as a means...

  11. computer networks

    Directory of Open Access Journals (Sweden)

    N. U. Ahmed

    2002-01-01

    Full Text Available In this paper, we construct a new dynamic model for the Token Bucket (TB algorithm used in computer networks and use systems approach for its analysis. This model is then augmented by adding a dynamic model for a multiplexor at an access node where the TB exercises a policing function. In the model, traffic policing, multiplexing and network utilization are formally defined. Based on the model, we study such issues as (quality of service QoS, traffic sizing and network dimensioning. Also we propose an algorithm using feedback control to improve QoS and network utilization. Applying MPEG video traces as the input traffic to the model, we verify the usefulness and effectiveness of our model.

  12. Neural networks

    International Nuclear Information System (INIS)

    Denby, Bruce; Lindsey, Clark; Lyons, Louis

    1992-01-01

    The 1980s saw a tremendous renewal of interest in 'neural' information processing systems, or 'artificial neural networks', among computer scientists and computational biologists studying cognition. Since then, the growth of interest in neural networks in high energy physics, fueled by the need for new information processing technologies for the next generation of high energy proton colliders, can only be described as explosive

  13. Pintadas network

    OpenAIRE

    Cruz, Maria do Carmo Meirelles T.

    2006-01-01

    The Pintadas Network has been organized in Pintadas, a small municipality (11.254 inhabitants) in Bahia, located in the semi-arid region. It has been composed by civil society organizacions (social, productive, cultural and religious organizations and a credit cooperative), with support from the local town hall and from national and international institutions. The Network is a space for articulation, which intends to formulate, execute, follow-up, inspect and evaluate the municipal public pol...

  14. Organizational Networks

    DEFF Research Database (Denmark)

    Grande, Bård; Sørensen, Ole Henning

    1998-01-01

    The paper focuses on the concept of organizational networks. Four different uses of the concept of organizational network are identified and critically discussed. Special focus is placed on how information and communication technologies as communication mediators and cognitive pictures influence...... the organizational forms discussed in the paper. It is asserted that the underlying organizational phenomena are not changing but that the manifestations and representations are shifting due to technological developments....

  15. Porous Cross-Linked Polyimide-Urea Networks

    Science.gov (United States)

    Meador, Mary Ann B. (Inventor); Nguyen, Baochau N. (Inventor)

    2015-01-01

    Porous cross-linked polyimide-urea networks are provided. The networks comprise a subunit comprising two anhydride end-capped polyamic acid oligomers in direct connection via a urea linkage. The oligomers (a) each comprise a repeating unit of a dianhydride and a diamine and a terminal anhydride group and (b) are formulated with 2 to 15 of the repeating units. The subunit was formed by reaction of the diamine and a diisocyanate to form a diamine-urea linkage-diamine group, followed by reaction of the diamine-urea linkage-diamine group with the dianhydride and the diamine to form the subunit. The subunit has been cross-linked via a cross-linking agent, comprising three or more amine groups, at a balanced stoichiometry of the amine groups to the terminal anhydride groups. The subunit has been chemically imidized to yield the porous cross-linked polyimide-urea network. Also provided are wet gels, aerogels, and thin films comprising the networks, and methods of making the networks.

  16. Concentric network symmetry grasps authors' styles in word adjacency networks

    Science.gov (United States)

    Amancio, Diego R.; Silva, Filipi N.; Costa, Luciano da F.

    2015-06-01

    Several characteristics of written texts have been inferred from statistical analysis derived from networked models. Even though many network measurements have been adapted to study textual properties at several levels of complexity, some textual aspects have been disregarded. In this paper, we study the symmetry of word adjacency networks, a well-known representation of text as a graph. A statistical analysis of the symmetry distribution performed in several novels showed that most of the words do not display symmetric patterns of connectivity. More specifically, the merged symmetry displayed a distribution similar to the ubiquitous power-law distribution. Our experiments also revealed that the studied metrics do not correlate with other traditional network measurements, such as the degree or the betweenness centrality. The discriminability power of the symmetry measurements was verified in the authorship attribution task. Interestingly, we found that specific authors prefer particular types of symmetric motifs. As a consequence, the authorship of books could be accurately identified in 82.5% of the cases, in a dataset comprising books written by 8 authors. Because the proposed measurements for text analysis are complementary to the traditional approach, they can be used to improve the characterization of text networks, which might be useful for applications based on stylistic classification.

  17. Complex Networks

    CERN Document Server

    Evsukoff, Alexandre; González, Marta

    2013-01-01

    In the last decade we have seen the emergence of a new inter-disciplinary field focusing on the understanding of networks which are dynamic, large, open, and have a structure sometimes called random-biased. The field of Complex Networks is helping us better understand many complex phenomena such as the spread of  deseases, protein interactions, social relationships, to name but a few. Studies in Complex Networks are gaining attention due to some major scientific breakthroughs proposed by network scientists helping us understand and model interactions contained in large datasets. In fact, if we could point to one event leading to the widespread use of complex network analysis is the availability of online databases. Theories of Random Graphs from Erdös and Rényi from the late 1950s led us to believe that most networks had random characteristics. The work on large online datasets told us otherwise. Starting with the work of Barabási and Albert as well as Watts and Strogatz in the late 1990s, we now know th...

  18. Composition and structure of a large online social network in The Netherlands.

    Directory of Open Access Journals (Sweden)

    Rense Corten

    Full Text Available Limitations in data collection have long been an obstacle in research on friendship networks. Most earlier studies use either a sample of ego-networks, or complete network data on a relatively small group (e.g., a single organization. The rise of online social networking services such as Friendster and Facebook, however, provides researchers with opportunities to study friendship networks on a much larger scale. This study uses complete network data from Hyves, a popular online social networking service in The Netherlands, comprising over eight million members and over 400 million online friendship relations. In the first study of its kind for The Netherlands, I examine the structure of this network in terms of the degree distribution, characteristic path length, clustering, and degree assortativity. Results indicate that this network shares features of other large complex networks, but also deviates in other respects. In addition, a comparison with other online social networks shows that these networks show remarkable similarities.

  19. Composition and structure of a large online social network in The Netherlands.

    Science.gov (United States)

    Corten, Rense

    2012-01-01

    Limitations in data collection have long been an obstacle in research on friendship networks. Most earlier studies use either a sample of ego-networks, or complete network data on a relatively small group (e.g., a single organization). The rise of online social networking services such as Friendster and Facebook, however, provides researchers with opportunities to study friendship networks on a much larger scale. This study uses complete network data from Hyves, a popular online social networking service in The Netherlands, comprising over eight million members and over 400 million online friendship relations. In the first study of its kind for The Netherlands, I examine the structure of this network in terms of the degree distribution, characteristic path length, clustering, and degree assortativity. Results indicate that this network shares features of other large complex networks, but also deviates in other respects. In addition, a comparison with other online social networks shows that these networks show remarkable similarities.

  20. A Phylogenetic Analysis of Chloroplast Genomes Elucidates the Relationships of the Six Economically Important Brassica Species Comprising the Triangle of U

    NARCIS (Netherlands)

    Li, Peirong; Zhang, Shujiang; Li, Fei; Zhang, Shifan; Zhang, Hui; Wang, Xiaowu; Sun, Rifei; Bonnema, Guusje; Borm, Theo J.A.

    2017-01-01

    The Brassica genus comprises many economically important worldwide cultivated crops. The well-established model of the Brassica genus, U’s triangle, consists of three basic diploid plant species (Brassica rapa, Brassica oleracea, and Brassica nigra) and three amphidiploid species (Brassica napus,

  1. Methods for applying microchannels to separate methane using liquid absorbents, especially ionic liquid absorbents from a mixture comprising methane and nitrogen

    Science.gov (United States)

    Tonkovich, Anna Lee Y [Dublin, OH; Litt, Robert D [Westerville, OH; Dongming, Qiu [Dublin, OH; Silva, Laura J [Plain City, OH; Lamont, Micheal Jay [Plain City, OH; Fanelli, Maddalena [Plain City, OH; Simmons, Wayne W [Plain city, OH; Perry, Steven [Galloway, OH

    2011-10-04

    Methods of using microchannel separation systems including absorbents to improve thermal efficiency and reduce parasitic power loss. Energy is typically added to desorb methane and then energy or heat is removed to absorb methane using a working solution. The working solution or absorbent may comprise an ionic liquid, or other fluids that demonstrate a difference in affinity between methane and nitrogen in a solution.

  2. Electrode assembly for a lithium ion battery, process for the production of such electrode assembly, and lithium ion battery comprising such electrode assemblies

    NARCIS (Netherlands)

    Mulder, F.M.; Wagemaker, M.

    2013-01-01

    The invention provides an electrode assembly for a lithium ion battery, the electrode assembly comprising a lithium storage electrode layer on a current collector, wherein the lithium storage electrode layer is a porous layer having a porosity in the range of -35 %, with pores having pore widths in

  3. STEREO PHOTO HYDROFEL, A PROCESS OF MAKING SAID STEREO PHOTO HYDROGEL, POLYMERS FOR USE IN MAKING SUCH HYDROGEL AND A PHARMACEUTICAL COMPRISING SAID POLYMERS

    NARCIS (Netherlands)

    Hiemstra, C.; Zhong, Zhiyuan; Feijen, Jan

    2008-01-01

    The Invention relates to a stereo photo hydrogel formed by stereo complexed and photo cross-linked polymers, which polymers comprise at least two types of polymers having at least one hydrophilic component, at least one hydrophobic mutually stereo complexing component, and at least one of the types

  4. Determination of hydrophobic coenzyme a esters and other lipids using a biosensor comprising a modified coenzyme a- and acyl-coa binding protein (acbp)

    DEFF Research Database (Denmark)

    2002-01-01

    , food and feed preparations, tissue extracts, acyl-CoA synthetase reaction media and various laboratory conditions using a modified Coenzyme A- and acyl-CoA binding protein (ACBP) is provided. Furthermore the invention relates to a construct comprising a peptide and a signal moiety for performing...

  5. Neural Networks

    International Nuclear Information System (INIS)

    Smith, Patrick I.

    2003-01-01

    Physicists use large detectors to measure particles created in high-energy collisions at particle accelerators. These detectors typically produce signals indicating either where ionization occurs along the path of the particle, or where energy is deposited by the particle. The data produced by these signals is fed into pattern recognition programs to try to identify what particles were produced, and to measure the energy and direction of these particles. Ideally, there are many techniques used in this pattern recognition software. One technique, neural networks, is particularly suitable for identifying what type of particle caused by a set of energy deposits. Neural networks can derive meaning from complicated or imprecise data, extract patterns, and detect trends that are too complex to be noticed by either humans or other computer related processes. To assist in the advancement of this technology, Physicists use a tool kit to experiment with several neural network techniques. The goal of this research is interface a neural network tool kit into Java Analysis Studio (JAS3), an application that allows data to be analyzed from any experiment. As the final result, a physicist will have the ability to train, test, and implement a neural network with the desired output while using JAS3 to analyze the results or output. Before an implementation of a neural network can take place, a firm understanding of what a neural network is and how it works is beneficial. A neural network is an artificial representation of the human brain that tries to simulate the learning process [5]. It is also important to think of the word artificial in that definition as computer programs that use calculations during the learning process. In short, a neural network learns by representative examples. Perhaps the easiest way to describe the way neural networks learn is to explain how the human brain functions. The human brain contains billions of neural cells that are responsible for processing

  6. Low-Power Wireless Sensor Networks Protocols, Services and Applications

    CERN Document Server

    Suhonen, Jukka; Kaseva, Ville; Hämäläinen, Timo D; Hännikäinen, Marko

    2012-01-01

    Wireless sensor network (WSN) is an ad-hoc network technology comprising even thousands of autonomic and self-organizing nodes that combine environmental sensing, data processing, and wireless networking. The applications for sensor networks range from home and industrial environments to military uses. Unlike the traditional computer networks, a WSN is application-oriented and deployed for a specific task. WSNs are data centric, which means that messages are not send to individual nodes but to geographical locations or regions based on the data content. A WSN node is typically battery powered and characterized by extremely small size and low cost. As a result, the processing power, memory, and energy resources of an individual sensor node are limited. However, the feasibility of a WSN lies on the collaboration between the nodes. A reference WSN node comprises a Micro-Controller Unit (MCU) having few Million Instructions Per Second (MIPS) processing speed, tens of kilobytes program memory, few kilobytes data m...

  7. Precursor polymer compositions comprising polybenzimidazole

    Science.gov (United States)

    Klaehn, John R.; Peterson, Eric S.; Orme, Christopher J.

    2015-07-14

    Stable, high performance polymer compositions including polybenzimidazole (PBI) and a melamine-formaldehyde polymer, such as methylated, poly(melamine-co-formaldehyde), for forming structures such as films, fibers and bulky structures. The polymer compositions may be formed by combining polybenzimidazole with the melamine-formaldehyde polymer to form a precursor. The polybenzimidazole may be reacted and/or intertwined with the melamine-formaldehyde polymer to form the polymer composition. For example, a stable, free-standing film having a thickness of, for example, between about 5 .mu.m and about 30 .mu.m may be formed from the polymer composition. Such films may be used as gas separation membranes and may be submerged into water for extended periods without crazing and cracking. The polymer composition may also be used as a coating on substrates, such as metal and ceramics, or may be used for spinning fibers. Precursors for forming such polymer compositions are also disclosed.

  8. Renewable energy export network

    International Nuclear Information System (INIS)

    Anon

    2000-01-01

    A Renewable Energy Exporters Network (REEN) has recently been established, following a meeting of renewable energy exporters and government agencies on 30 October 2000. REEN will assist the Australian renewable energy industry to take advantage of the opportunities offered by the burgeoning global market for renewable energy goods and services. Recent estimates of the significant potential global growth is renewable energy demand have reinforced the industry and Government's view that, in the medium to long-term, growth in the Australian renewable energy industry will largely depend on capturing export market share. Expanding the export market was identified as a crucial component in the Renewable Energy Action Agenda, developed jointly by industry and Government and released in June 2000. It was estimated that, for the industry to achieve its vision of sales of $4 billion per year by 2010, exports would need to comprise approximately 50% of the forecast growth in sales. As such, the need for a specific export strategy for the Australian renewable energy industry was recognised in the Action Agenda, and the establishment of the REEN is one of the first initiatives undertaken as part of the Renewable Energy Export Strategy. The REEN comprises approximately 50 export-ready renewable energy companies, the Department of Industry, Science and Resources, Austrade, and Stage Government agencies such as NSW's Sustainable Energy Development Authority. The Export Network will operate electronically, with face-to-face meetings held as appropriate. The Department of Industry, Science and Resources will facilitate the Export Network and has published a website at www.isr.gov.au/industry/reen. The site includes: a members directory; a discussion forum; information on opportunities to showcase Australian renewable; energy products and services; and Iinks to sites containing information that may be useful to renewable energy exporters. Other actions that are being undertaken as

  9. Vulnerability of complex networks

    Science.gov (United States)

    Mishkovski, Igor; Biey, Mario; Kocarev, Ljupco

    2011-01-01

    We consider normalized average edge betweenness of a network as a metric of network vulnerability. We suggest that normalized average edge betweenness together with is relative difference when certain number of nodes and/or edges are removed from the network is a measure of network vulnerability, called vulnerability index. Vulnerability index is calculated for four synthetic networks: Erdős-Rényi (ER) random networks, Barabási-Albert (BA) model of scale-free networks, Watts-Strogatz (WS) model of small-world networks, and geometric random networks. Real-world networks for which vulnerability index is calculated include: two human brain networks, three urban networks, one collaboration network, and two power grid networks. We find that WS model of small-world networks and biological networks (human brain networks) are the most robust networks among all networks studied in the paper.

  10. Radiation monitoring network in Poland

    International Nuclear Information System (INIS)

    Grabowski, D.; Kurowski, W.; Muszynski, W.; Rubel, B.; Smagala, G.; Swietochowska, J.

    2001-01-01

    In Poland the radioactive contamination of the environment and food has been controlled since the early sixties by the Service for Measurements of Radioactive Contamination (SPSP). The service comprises a network of measuring stations and the Centre of Radioactive Contamination Measurements (COPSP). Actually, there are 100 measurement stations. The main task of such station is systematic measurement of radioactivity level in samples of environment components and food. Nine stations of SPSP acting within meteorological stations, ten stations of low level air radioactivity measurements (Aerosols Sampling Stations-500) and eleven permanent monitoring stations (PMS) form the radiation monitoring warning system in Poland. (author)

  11. Network Survivability

    DEFF Research Database (Denmark)

    Marzo, José L.; Stidsen, Thomas Riis; Ruepp, Sarah Renée

    2010-01-01

    – are vital to modern services such as mobile telephony, online banking and VoIP. This book examines communication networking from a mathematical viewpoint. The contributing authors took part in the European COST action 293 – a four-year program of multidisciplinary research on this subject. In this book...... they offer introductory overviews and state-of-the-art assessments of current and future research in the fields of broadband, optical, wireless and ad hoc networks. Particular topics of interest are design, optimization, robustness and energy consumption. The book will be of interest to graduate students......, researchers and practitioners in the areas of networking, theoretical computer science, operations research, distributed computing and mathematics....

  12. Nuclear networking.

    Science.gov (United States)

    Xie, Wei; Burke, Brian

    2017-07-04

    Nuclear lamins are intermediate filament proteins that represent important structural components of metazoan nuclear envelopes (NEs). By combining proteomics and superresolution microscopy, we recently reported that both A- and B-type nuclear lamins form spatially distinct filament networks at the nuclear periphery of mouse fibroblasts. In particular, A-type lamins exhibit differential association with nuclear pore complexes (NPCs). Our studies reveal that the nuclear lamina network in mammalian somatic cells is less ordered and more complex than that of amphibian oocytes, the only other system in which the lamina has been visualized at high resolution. In addition, the NPC component Tpr likely links NPCs to the A-type lamin network, an association that appears to be regulated by C-terminal modification of various A-type lamin isoforms. Many questions remain, however, concerning the structure and assembly of lamin filaments, as well as with their mode of association with other nuclear components such as peripheral chromatin.

  13. Telecommunication Networks

    DEFF Research Database (Denmark)

    Olsen, Rasmus Løvenstein; Balachandran, Kartheepan; Hald, Sara Ligaard

    2014-01-01

    In this chapter, we look into the role of telecommunication networks and their capability of supporting critical infrastructure systems and applications. The focus is on smart grids as the key driving example, bearing in mind that other such systems do exist, e.g., water management, traffic control......, etc. First, the role of basic communication is examined with a focus on critical infrastructures. We look at heterogenic networks and standards for smart grids, to give some insight into what has been done to ensure inter-operability in this direction. We then go to the physical network, and look...... threats to the critical infrastructure. Finally, before our conclusions and outlook, we give a brief overview of some key activities in the field and what research directions are currently investigated....

  14. Network interruptions

    CERN Multimedia

    2005-01-01

    On Sunday 12 June 2005, a site-wide security software upgrade will be performed on all CERN network equipment. This maintenance operation will cause at least 2 short network interruptions of 2 minutes on each equipment item. There are hundreds of such items across the CERN site (Meyrin, Prévessin and all SPS and LHC pits), and it will thus take the whole day to treat them all. All network users and services will be affected. Central batch computing services will be interrupted during this period, expected to last from 8 a.m. until late evening. Job submission will still be possible but no jobs will actually be run. It is hoped to complete the computer centre upgrades in the morning so that stable access can be restored to lxplus, afs and nice services as soon as possible; this cannot be guaranteed, however. The opportunity will be used to interrupt and perform upgrades on the CERN Document Servers.

  15. Estimation of heart-position variability in 3D-surface-image-guided deep-inspiration breath-hold radiation therapy for left-sided breast cancer

    International Nuclear Information System (INIS)

    Alderliesten, Tanja; Betgen, Anja; Elkhuizen, Paula H.M.; Vliet-Vroegindeweij, Corine van; Remeijer, Peter

    2013-01-01

    Purpose: To investigate the heart position variability in deep-inspiration breath-hold (DIBH) radiation therapy (RT) for breast cancer when 3D surface imaging would be used for monitoring the BH depth during treatment delivery. For this purpose, surface setup data were compared with heart setup data. Materials and methods: Twenty patients treated with DIBH-RT after breast-conserving surgery were included. Retrospectively, heart registrations were performed for cone-beam computed tomography (CBCT) to planning CT. Further, breast-surface registrations were performed for a surface, captured concurrently with CBCT, to planning CT. The resulting setup errors were compared with linear regression analysis. Furthermore, geometric uncertainties of the heart (systematic [Σ] and random [σ]) were estimated relative to the surface registration. Based on these uncertainties planning organ at risk volume (PRV) margins for the heart were calculated: 1.3Σ − 0.5σ. Results: Moderate correlation between surface and heart setup errors was found: R 2 = 0.64, 0.37, 0.53 in left–right (LR), cranio-caudal (CC), and in anterior–posterior (AP) direction, respectively. When surface imaging would be used for monitoring, the geometric uncertainties of the heart (cm) are [Σ = 0.14, σ = 0.14]; [Σ = 0.66, σ = 0.38]; [Σ = 0.27, σ = 0.19] in LR; CC; AP. This results in PRV margins of 0.11; 0.67; 0.25 cm in LR; CC; AP. Conclusion: When DIBH-RT after breast-conserving surgery is guided by the breast-surface position then PRV margins should be used to take into account the heart-position variability relative to the breast-surface

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

    DEFF Research Database (Denmark)

    Stærk, Mathilde; Bødtker, Henrik; Rahbek, Søren

    2015-01-01

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

  17. Poster – 41: External marker block placement on the breast or chest wall for left-sided deep inspiration breath-hold radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Conroy, Leigh; Guebert, Alexandra; Smith, Wendy [Tom Baker Cancer Centre (Canada)

    2016-08-15

    Purpose: We investigate DIBH breast radiotherapy using the Real-time Position Management (RPM) system with the marker-block placed on the target breast or chest wall. Methods: We measured surface dose for three different RPM marker-blocks using EBT3 Gafchromic film at 0° and 30° incidence. A registration study was performed to determine the breast surface position that best correlates with overall internal chest wall position. Surface and chest wall contours from MV images of the medial tangent field were extracted for 15 patients. Surface contours were divided into three potential marker-block positions on the breast: Superior, Middle, and Inferior. Translational registration was used to align the partial contours to the first-fraction contour. Each resultant transformation matrix was applied to the chest wall contour, and the minimum distance between the reference chest wall contour and the transformed chest wall contour was evaluated for each pixel. Results: The measured surface dose for the 2-dot, 6-dot, and 4-dot marker-blocks at 0° incidence were 74%, 71%, and 77% of dose to dmax respectively. At 30° beam incidence this increased to 76%, 72%, and 81%. The best external surface position was patient and fraction dependent, with no consistent best choice. Conclusions: The increase in surface dose directly under the RPM block is approximately equivalent to 3 mm of bolus. No marker-block position on the breast surface was found to be more representative of overall chest wall motion; therefore block positional stability and reproducibility can be used to determine optimal placement on the breast or chest wall.

  18. Compression anastomotic ring-locking procedure (CARP) is a safe and effective method for intestinal anastomoses following left-sided colonic resection

    DEFF Research Database (Denmark)

    Vilhjalmsson, Dadi; Appelros, Stefan; Toth, Ervin

    2015-01-01

    -sided colonic resection. Time for evacuation of the anastomotic rings, perioperative compression pressure, and adverse effects were recorded. Postoperative blood samples were collected daily, and flexible sigmoidoscopy was performed 8-12 weeks after surgery to examine the anastomoses. RESULTS: Fourteen out......BACKGROUND: Compression anastomotic ring-locking procedure (CARP) is a novel procedure for creating colonic anastomoses. The surgical procedure allows perioperative quantification of the compression pressure between the intestinal ends within the anastomosis and postoperative monitoring...... device evacuated spontaneously in all patients by the natural route after a median of 10 days. Perioperative compression pressure ranged between 85 and 280 mBar (median 130 mBar). Flexible sigmoidoscopy revealed smooth anastomoses without signs of pathological inflammation or stenosis in all cases...

  19. MRI-based volumetric assessment of cardiac anatomy and dose reduction via active breathing control during irradiation for left-sided breast cancer

    International Nuclear Information System (INIS)

    Krauss, Daniel J.; Kestin, Larry L.; Raff, Gilbert; Yan Di; Wong, John; Gentry, Ralph; Letts, Nicola; Vargas, Carlos E.; Martinez, Alvaro A.; Vicini, Frank A.

    2005-01-01

    Purpose: Heart dose-volume analysis using computed tomography (CT) is limited because of motion artifact and poor delineation between myocardium and ventricular space. We used dedicated cardiac magnetic resonance imaging (MRI) to quantify exclusion of left ventricular (LV) myocardium via active breathing control (ABC) during left breast irradiation and to determine the correlation between irradiated whole heart and LV volumes. Methods and materials: Fifteen patients who completed adjuvant irradiation for early-stage left breast cancer participated. Treatment consisted of 45 Gy to the entire breast using ABC followed by a 16-Gy electron boost to the lumpectomy cavity. Patients underwent planning CT scans in free breathing (FB) and moderate deep inspiration breath hold (mDIBH). Electrocardiogram-gated cardiac MRI was performed in the treatment position using α-cradle immobilization. MRI scans were acquired in late diastole (LD), mid-diastole (MD), and systole (S) for both FB and mDIBH. After image fusion with the patients' radiation therapy planning CT scan, MRI LV volumes were defined for the three examined phases of the cardiac cycle, and comparative dose-volume analysis was performed. Results: Cardiac volume definition was found to differ significantly because of combinations of respiratory and intrinsic heart motion. The fraction of LV myocardium receiving 50% (22.5 Gy) of the prescribed whole breast dose (V 22.5 ) was reduced by 85.3%, 91.8%, and 94.6% via ABC for LD, MD, and S, respectively. Linear regression revealed strong correlation between MRI-defined whole heart and LV V 22.5 reduction via ABC, suggesting that LV myocardium accounts for up to approximately 50% of the excluded heart volume through this technique. Significant but weaker correlations were noted between CT-defined whole heart and LV V 22.5 reductions with marked variability in the measurements of patients with larger amounts of heart in the treatment field. Conclusions: Cardiac MRI demonstrated a significant reduction in LV myocardium irradiated with the use of ABC. The correlation between reduction in V 22.5 values for LV wall and CT-defined whole heart suggests that CT is adequate for determining which patients are likely to benefit from ABC treatment, but inaccuracies inherent to standard CT dictate that more detailed imaging studies such as MRI are required for accurate cardiotoxicity assessment

  20. Clinical Case of the Month: A 49 Year-Old Man Who Presents with Left Sided Weakness: An Update on Ischemic Stroke.

    Science.gov (United States)

    Masri, Najy; Weems, Rikki; Brown, Falon; Andres, Ben; Lopez, Fred

    2016-01-01

    A 49 year-old man with a past medical history significant for essential hypertension, hyperlipidemia, and coronary artery disease status post percutaneous coronary intervention and stent placement in the right coronary artery in 2010 presented for evaluation of left hemiplegia. He was feeling well until three hours prior to presentation, at which time he fell while walking from his bedroom into the kitchen. After falling, he noticed that his left upper and lower extremities felt weak. He denied any symptoms preceding the fall or any loss of consciousness. On initial exam, the temperature was 99°F, the pulse was 93 beats per minute, the blood pressure was 191/100 mmHg, the respiratory rate was 22 breaths per minute, and the oxygen saturation was 100% while breathing room air. His neurological exam revealed diminished strength in the left upper extremity: 4/5 arm abduction and adduction of the left shoulder; 4/5 elbow and wrist extension and flexion; and 4/5 extension, abduction, and adduction of the digits. The patient also exhibited slight left upper extremity pronator drift. The strength was also diminished in the left lower extremity: 2/5 hip flexion, extension, and rotation; 3/5 knee flexion and extension; and 3/5 ankle dorsiflexion and plantar flexion. Initial NIH stroke scale score was 5, otherwise, there were no focal neurological deficits and the remainder of his exam was unremarkable. Initial computed tomography (CT) of the head was negative for any acute intracranial hemorrhage or infarct. A subsequent CT cerebral perfusion scan (Figure 1) was notable for areas of ischemia in the right cingulate gyrus as well as the medial frontal and parietal lobes. CT angiogram of the neck revealed bilateral atherosclerotic plaque in the carotid arteries; however, there was no evidence of any flow-limiting stenosis.