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Sample records for minimal pulmonary oedema

  1. Unilateral pulmonary oedema after minimally invasive mitral valve surgery: a single-centre experience.

    Science.gov (United States)

    Renner, Jochen; Lorenzen, Ulf; Borzikowsky, Christoph; Schoeneich, Felix; Cremer, Jochen; Haneya, Assad; Hensler, Johannes; Panholzer, Bernd; Huenges, Katharina; Broch, Ole

    2018-04-01

    Unilateral pulmonary oedema (UPE) is a rare but potentially life-threatening complication that has been described after minimally invasive mitral valve surgery (MICS). Over the last 8 years, we have witnessed, in our institution, several cases of severe UPE requiring immediate postoperative extracorporeal life support after MICS. Reviewing the available literature, data regarding this complication after MICS are rare. Consequently, we decided to retrospectively analyse patients scheduled for MICS in our institution. After approval by our institutional review board, 256 MICS patients were analysed. As a primary end-point, we defined a newly developed UPE, radiographically evident within the first 24 h postoperatively. Secondary end-points were length of stay in the intensive care unit, length of stay in the hospital and in-hospital mortality. Chest radiographs were analysed by an independent consultant of radiology. Fifty-one (19.9%) patients showed increased right-sided pulmonary vascular congestion in the 1st postoperative chest radiography performed in the intensive care unit. Five (1.95%) patients immediately required extracorporeal life support after admission to the intensive care unit. Cardiopulmonary bypass time was significantly longer in the UPE group [UPE vs non-UPE 213 (49) vs 196 (43) min; P = 0.013]. More patients with UPE showed a preoperative increase of C-reactive protein >0.4265 mg/dl (P = 0.05). Logistic regression analysis identified a preoperative increase in C-reactive protein >0.4265 mg/dl as well as a prolonged cardiopulmonary bypass time (odds ratio 1.009, 95% confidence level 1.002-1.016; P = 0.014) independent risk factors, significantly associated with the development of UPE (odds ratio 2.583, 95% confidence interval 1.275-5.233; P = 0.008), a prolonged cardiopulmonary bypass time (odds ratio 1.009, 95% confidence interval 1.002-1.016; P = 0.014). The presence of pulmonary hypertension (odds ratio 0.273, 95

  2. Haemorrhagic pulmonary oedema following postoperative ...

    African Journals Online (AJOL)

    Introduction: After the initial report by Oswalt in 1977 some cases of postanaesthetic laryngospasm causing pulmonary oedema, have been reported in the anaesthesia and surgery literature. However none of these is from West Africa. We therefore report this uncommon entity in a Nigerian adult male following ear ...

  3. Pulmonary oedema after hexoprenaline administration in preterm ...

    African Journals Online (AJOL)

    Despite the widespread use of ,a-sympathomimetic agents for preterm labour there appears to be a limited appreciation of the need for cardiovascular monitoring in the mother. Four patients in whom pulmonary oedema developed during tocolysis with hexoprenaline are described and the aetiological factors and ...

  4. Negative pressure pulmonary oedema after septoplasty.

    Science.gov (United States)

    García de Hombre, Alina M; Cuffini, Alejandro; Bonadeo, Alejandro

    2013-01-01

    Negative pressure pulmonary oedema (NPPO) is an anaesthetic complication due to acute obstruction of the upper airway, whose main cause is laryngospasm. The pathophysiology involves a strong negative intrapleural pressure during inspiration against a closed glottis, which triggers excessive pressure in the pulmonary microvasculature. Although its diagnosis can be difficult, its recognition helps to minimise morbidity and mortality. This article presents a case of NPPO due to postextubation laryngospasm. Copyright © 2011 Elsevier España, S.L. All rights reserved.

  5. The acute pulmonary oedema in the intensive-care ward

    International Nuclear Information System (INIS)

    Marciniak, R.; Aronski, A.

    1989-01-01

    760 patients suffering from acute pulmonary oedema were treated between 1980 and 1986 at the Institute of Anaesthesiology of the Medical Academy in Wroclaw. The radiological image of the pulmonary oedema was subdivided into three forms (hilar, hilar and perihilar, and hilar with massive plane-shaped infiltrates). In the treatment of acute pulmonary oedema in the intensive-care ward a thorough diagnostic programme is mandatory after the immediately necessary measures have been taken. (orig.) [de

  6. Pathology of high altitude pulmonary oedema

    International Nuclear Information System (INIS)

    Saleem, N.

    2014-01-01

    Objective: To describe autopsy findings in fatal cases of high altitude pulmonary oedema. Study Design: Descriptive study. Place and Duration of Study: The study was carried out between 1999 and 2002 at an army field medical unit in Baltistan, Armed Forces Institute of Pathology, Rawalpindi and Army Medical College, Rawalpindi, Pakistan. Patients and Methods:Autopsies were performed in 17 fatal cases of High Altitude Pulmonary Edema (HAPE) occurring among soldiers serving in Siachen. Results:All cases were males with a mean age of 26.8 years (19-35). The mean altitude at which HAPE occurred was 5192 meters (2895-6492), and the mean duration of stay at these altitudes was 15.3 days (1-30). Eleven individuals had undergone proper acclimatization. The commonest clinical findings were cough (70%), dyspnoea (53%), nausea (47%), headache (41%), vomiting (35%), chest pain (35%) and tightness in chest (24%). Cyanosis and frothy secretions in the nostrils and mouth were present in all but one case. Mean combined weight of lungs was 1470 grams (1070-1810). There was marked congestion of outer and cut surfaces. Interstitial oedema was present in all cases. RBCs and leukocyte infiltrates were seen in 13 and alveolar hyaline membranes in 9 cases. Thrombi were seen in 2 cases. Cerebral oedema was present in 9 cases. Conclusion:HAPE can occur after more than two weeks of stay at high altitudes despite proper acclimatization. Concomitant cerebral oedema is frequently present. Our autopsy findings are consistent with what has been reported previously. (author)

  7. Ketamine and Pulmonary Oedema-Report of Two Cases

    Directory of Open Access Journals (Sweden)

    S Parthasarathy

    2009-01-01

    Full Text Available Perioperative pulmonary oedema is one of the most challenging complications faced by anaesthesiologists. In most of the instances, coronary artery disease, valvular heart diseases, hypertension may precipitate pulmonary oedema due to increased hydrostatic pressure while acid aspiration, airway obstruction may cause it due to increased vascular permeability. In a few instances, acute pulmonary oedema can present in an otherwise healthy patient to cause diagnostic difficulties. We report two such cases of intra operative pulmonary oedema with the use of ketamine which were identified and managed successfully. The most probable cause is also described.

  8. Acute Toxic Myocarditis and Pulmonary Oedema Developing from Scorpion Sting

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    Cem Sahin

    2015-03-01

    Full Text Available The majority of scorpion stings are generally seen with a set of simple clinical findings, such as pain, oedema, numbness, and tenderness in the area of the sting. However, occasionally events, such as toxic myocarditis, acute heart failure, acute pulmonary oedema, and Acute Respiratory Distress Syndrome (ARDS, which occur in scorpion sting cases are a significant problem which determine mortality and morbidity. The case presented here was a 38-year-old man who developed acute toxic myocarditis, acute heart failure, and acute pulmonary oedema following a scorpion sting on the 3rd finger of his right hand.

  9. Prehospital lung ultrasound for the diagnosis of cardiogenic pulmonary oedema

    DEFF Research Database (Denmark)

    Laursen, Christian B; Hänselmann, Anja; Posth, Stefan

    2016-01-01

    diagnostic criteria for cardiogenic pulmonary oedema was used as gold standard. RESULTS: A total of 40 patients were included in the study. Feasibility of PLUS was 100 % and median time used was 3 min. The gold standard diagnosed 18 (45.0 %) patients with cardiogenic pulmonary oedema. The diagnostic accuracy......: The sensitivity of PLUS is high, making it a potential tool for ruling-out cardiogenic pulmonary. The observed specificity was lower than what has been described in previous studies. CONCLUSIONS: Performed, as part of a physician based prehospital emergency service, PLUS seems fast and highly feasible in patients...... with respiratory failure. Due to its diagnostic accuracy, PLUS may have potential as a prehospital tool, especially to rule out cardiogenic pulmonary oedema....

  10. Pathophysiology of acute mountain sickness and high altitude pulmonary oedema

    DEFF Research Database (Denmark)

    Sutton, J R; Lassen, N

    1979-01-01

    We review the evidence that acute mountain sickness (AMS) and high altitude pulmonary oedema (HAPO) occur together more often than is realized. We hypothesize that AMS and HAPO have a common pathophysiological basis: both are due to increased pressure and flow in the microcirculation, causing...

  11. Pulmonary oedema after hexoprenaline administration in preterm ...

    African Journals Online (AJOL)

    1991-05-18

    May 18, 1991 ... ing antidiuretic hormone, producing an increase in plasma volume and a fall in both haematocrit and colloid osmotic pressure. 1l These effects are most pronounced when isotonic saline solutions are used, resulting in expansion of the plasma volume, producing pulmonary congestion and, in some cases,.

  12. The acute pulmonary oedema in the intensive-care ward. Das akute Lungenoedem auf der Intensivstation

    Energy Technology Data Exchange (ETDEWEB)

    Marciniak, R.; Aronski, A. (Akademia Medyczna, Wroclaw (Poland))

    1989-07-01

    760 patients suffering from acute pulmonary oedema were treated between 1980 and 1986 at the Institute of Anaesthesiology of the Medical Academy in Wroclaw. The radiological image of the pulmonary oedema was subdivided into three forms (hilar, hilar and perihilar, and hilar with massive plane-shaped infiltrates). In the treatment of acute pulmonary oedema in the intensive-care ward a thorough diagnostic programme is mandatory after the immediately necessary measures have been taken. (orig.).

  13. Use of toxicogenomics for identifying genetic markers of pulmonary oedema

    International Nuclear Information System (INIS)

    Balharry, Dominique; Oreffo, Victor; Richards, Roy

    2005-01-01

    This study was undertaken primarily to identify genetic markers of oedema and inflammation. Mild pulmonary injury was induced following the instillation of the oedema-producing agent, bleomycin (0.5 units). Oedema was then confirmed by conventional toxicology (lavage protein levels, free cell counts and lung/body weight ratios) and histology 3 days post-bleomycin instillation.The expression profile of 1176 mRNA species was determined for bleomycin-exposed lung (Clontech Atlas macroarray, n = 9). To obtain pertinent results from these data, it was necessary to develop a simple, effective method for bioinformatic analysis of altered gene expression. Data were log 10 transformed followed by global normalisation. Differential gene expression was accepted if: (a) genes were statistically significant (P ≤ 0.05) from a two-tailed t test; (b) genes were consistently outside a two standard deviation (SD) range from control levels. A combination of these techniques identified 31 mRNA transcripts (approximately 3%) which were significantly altered in bleomycin treated tissue. Of these genes, 26 were down-regulated whilst only five were up-regulated. Two distinct clusters were identified, with 17 genes classified as encoding hormone receptors, and nine as encoding ion channels. Both these clusters were consistently down-regulated.The magnitude of the changes in gene expression were quantified and confirmed by Q-PCR (n = 6), validating the macroarray data and the bioinformatic analysis employed.In conclusion, this study has developed a suitable macroarray analysis procedure and provides the basis for a better understanding of the gene expression changes occurring during the early phase of drug-induced pulmonary oedema

  14. Recurrent acute pulmonary oedema after aortic and mitral valve surgery due to trachea malacia and obstructive sleep apnoea syndrome

    NARCIS (Netherlands)

    Sankatsing, S. U. C.; Hanselaar, W. E. J. J.; van Steenwijk, R. P.; Van der Sloot, J. A. P.; Broekhuis, E.; Kok, W. E. M.

    2008-01-01

    In this report we describe a patient with recurrent episodes of acute pulmonary oedema after aortic and mitral valve surgery. The first episode of pulmonary oedema was caused by mitral valve dysfunction. The second episode of pulmonary oedema was not clearly associated with a mitral valve problem,

  15. Flash pulmonary oedema after relief of haemodialysis graft stenosis.

    Science.gov (United States)

    Vélez-Martínez, Mariella; Weinberg, Brent D; Mishkin, Joseph D

    2013-08-01

    Heart failure (HF) and chronic kidney disease (CKD) are undoubtedly very much interrelated, especially in patients with end-stage renal disease (ESRD) who are dependent on renal replacement therapy. Haemodialysis (HD) is of particular interest in cardiovascular patients due to the creation of a haemodialysis vascular access and the haemodynamic changes associated with it. Adequate HD though is very dependent on a properly functioning vascular access. Unfortunately, these surgical vascular accesses are vulnerable to stenoses and occlusions. Percutaneous endovascular treatment of these stenoses is often performed and has been found to be safe and effective. Despite its frequent use, acute medical complications of this percutaneous procedure have not been well-documented. In this report, we describe a patient who developed flash pulmonary oedema after balloon angioplasty treatment of an arteriovenous graft (AVG) stenosis. Copyright © 2012 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  16. Low pulmonary artery flush perfusion pressure combined with high positive end-expiratory pressure reduces oedema formation in isolated porcine lungs

    International Nuclear Information System (INIS)

    Schumann, Stefan; Schließmann, Stephan J; Wagner, Giskard; Goebel, Ulrich; Priebe, Hans-Joachim; Guttmann, Josef; Kirschbaum, Andreas

    2010-01-01

    Flush perfusion of the pulmonary artery with organ protection solution is a standard procedure before lung explantation. However, rapid flush perfusion may cause pulmonary oedema which is deleterious in the lung transplantation setting. In this study we tested the hypotheses that high pulmonary perfusion pressure contributes to the development of pulmonary oedema and positive end-expiratory pressure (PEEP) counteracts oedema formation. We expected oedema formation to increase weight and decrease compliance of the lungs on the basis of a decrease in alveolar volume as fluid replaces alveolar air spaces. The pulmonary artery of 28 isolated porcine lungs was perfused with a low-potassium dextrane solution at low (mean 27 mmHg) or high (mean 40 mmHg) pulmonary artery pressure (PAP) during mechanical ventilation at low (4 cmH 2 O) or high (8 cmH 2 O) PEEP, respectively. Following perfusion and storage, relative increases in lung weight were smaller (p < 0.05) during perfusion at low PAP (62 ± 32% and 42 ± 26%, respectively) compared to perfusion at high PAP (133 ± 54% and 87 ± 30%, respectively). Compared to all other PAP–PEEP combinations, increases in lung weight were smallest (44 ± 9% and 27 ± 12%, respectively), nonlinear intratidal lung compliance was largest (46% and 17% respectively, both p < 0.05) and lung histology showed least infiltration of mononuclear cells in the alveolar septa, and least alveolar destruction during the combination of low perfusion pressure and high PEEP. The findings suggest that oedema formation during pulmonary artery flush perfusion in isolated and ventilated lungs can be reduced by choosing low perfusion pressure and high PEEP. PAP–PEEP titration to minimize pulmonary oedema should be based on lung mechanics and PAP monitoring

  17. Acute Pulmonary Oedema after Removal of Sand Bag at the End of Open Cholecystectomy due to Unknown Cause

    Directory of Open Access Journals (Sweden)

    Pramod Gupta

    2008-01-01

    Full Text Available Pulmonary oedema developes acutely during perioperative period and is usually due to unknown cause,but this life threatening complication if managed on time ,leads to rapid and full recovery. Here a case of 70 year old man is reported who developed acute pulmonary oedema after conclusion of surgery due to unknown cause.

  18. Leucocyte depletion in a drowning victim during rewarming with extracorporeal circulation may limit pulmonary oedema

    NARCIS (Netherlands)

    Vermeijden, Wytze J.; de Vries, Hans; Kieboom, Joke; Waterbolk, Tjalling

    2006-01-01

    We report two drowning victims with hypothermic circulatory arrest who were resuscitated with the use of extracorporeal circulation (ECC). The first patient developed severe post-bypass pulmonary oedema and inspired us to use a leucocyte-depletion filter in the second patient to attenuate

  19. Effect of the histaminergic antagonist over the pulmonary oedema growth in P. berghei - infected mice

    International Nuclear Information System (INIS)

    Martins, M.A.

    1985-01-01

    The involvement of histaminergic mechanisms in the pathogenesis of pulmonary oedema observed in p. berghei - infected mice was investigated. Histamine concentrations in plasma and whole blood of infected and normal mice were determined by radioenzymatic assay during the seven days of the infection. Elevated plasma and whole blood histamine levels were found at the last stages of infection (sixth day and seventh day) after intraperitoneal injection of parasitized erythrocytes, showing a close temporal correlation between the development of the oedema and the elevation of the circulating histamine concentrations. The participation of H 1 and H 2 receptors in the increase in vascular permeability (IVP) induced by histamine was also verified. (author)

  20. Unilateral re-expansion pulmonary oedema treated with C-PAP

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    Giovanni Volpicelli

    2009-06-01

    Full Text Available Unilateral re-expansion pulmonary oedema is a rare but dangerous complication of treatment for pulmonary atelectasis, pleural effusion and pneumothorax, whose pathogenesis is not completely known. The clinical picture varies considerably from asymptomatic forms with positive radiographic findings to forms with severe respiratory insufficiency and haemodynamic instability. Little data is available in literature on the treatment of re-expansion pulmonary oedema with non-invasive continuous positive airway pressure ventilation. In this article, we describe the case of a 75 year-old man who reported to our Emergency Department with extensive spontaneous left pneumothorax. Following placement of the transthoracic drain, the patient presented a clinical picture of severe respiratory insufficiency with circulatory collapse caused by unilateral re-expansion pulmonary oedema. The case was successfully treated with the application of non-invasive continuous positive airway pressure ventilation. The article briefly discusses current knowledge with regard to the aetiological and pathogenetic factors of this complication of emergency pneumothorax treatment.

  1. Prevalence of renal artery stenosis in flash pulmonary oedema: determination using gadolinium-enhanced MRA.

    LENUS (Irish Health Repository)

    McMahon, Colm J

    2012-02-01

    PURPOSE: The primary purpose was to determine the prevalence of renal artery stenosis (RAS) in patients presenting with acute ("flash") pulmonary oedema (FPE), without identifiable cause using contrast-enhanced magnetic resonance angiography (CE-MRA) of renal arteries. A secondary goal was to correlate clinical parameters at presentation with the presence or absence of RAS. MATERIALS AND METHODS: Patients presenting with acute pulmonary oedema without identifiable cause prospectively underwent CE-MRA. >50% renal artery stenosis was considered significant. Clinical parameters (blood pressure, serum creatinine, history of hypertension\\/hyperlipidaemia) were compared in patients with and without RAS using an unpaired t-test. Results expressed; mean (+\\/-SD). RESULTS: 20 patients (4 male, 16 female, age 78.5+\\/-11 years) underwent CE-MRA. 9 patients (45%) had significant RAS (6 (30%) bilateral, 3 (15%) unilateral). Systolic BP was higher in patients with RAS (192+\\/-38 mm Hg) than those without (134+\\/-30 mm Hg) (p<.005). Diastolic BP was higher in patients with RAS (102+\\/-23 mm Hg) than those without (76+\\/-17 mm Hg) (p<.01). All patients with RAS and 6\\/11(55%) patients without RAS had a history of hypertension. No significant difference in creatinine or hyperlipidaemia history was observed. CONCLUSION: The prevalence of RAS in patients presenting with FPE is 45%. The diagnosis should be considered in patients presenting with unexplained acute pulmonary oedema, particularly if hypertensive at presentation.

  2. Swimming-induced pulmonary oedema an uncommon condition diagnosed with POCUS ultrasound.

    Science.gov (United States)

    Alonso, Joaquín Valle; Chowdhury, Motiur; Borakati, Raju; Gankande, Upali

    2017-12-01

    Swimming Induced Pulmonary Edema, or SIPE, is an emerging condition occurring in otherwise healthy individuals during surface swimming or diving that is characterized by cough, dyspnea, hemoptysis, and hypoxemia. It is typically found in those who spend time in cold water exercise with heavy swimming and surface swimming, such as civilian training for iron Man, triathalon, and military training. We report the case of a highly trained young female swimmer in excellent cardiopulmonary health, who developed acute alveolar pulmonary oedema in an open water swimming training diagnosed in the emergency department using POCUS ultrasound. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Peculiarities of hemodynamic pulmonary oedema formation in the irradiated body. [Lung oedema, whole-body irradiation, time dependence, survival curves

    Energy Technology Data Exchange (ETDEWEB)

    Kurygin, G V; Kopylov, V N; Girs, E F; Chizhov, P A [Yaroslavskij Meditsinskij Inst. (USSR)

    1978-09-01

    233 white rats have been tested to establish that large doses of ionizing radiation, which cause pronounced leukopenia, increase resistance of animals to lung oedema under the effect of adrenaline. It is most pronounced on the fourth day after irradiation. Relatively small doses (lower than 100r), as well as separate irradiation of the head, chest and abdomen, in reverse, contribute to lung oedema.

  4. Prediction of quantitative intrathoracic fluid volume to diagnose pulmonary oedema using LabVIEW.

    Science.gov (United States)

    Urooj, Shabana; Khan, M; Ansari, A Q; Lay-Ekuakille, Aimé; Salhan, Ashok K

    2012-01-01

    Pulmonary oedema is a life-threatening disease that requires special attention in the area of research and clinical diagnosis. Computer-based techniques are rarely used to quantify the intrathoracic fluid volume (IFV) for diagnostic purposes. This paper discusses a software program developed to detect and diagnose pulmonary oedema using LabVIEW. The software runs on anthropometric dimensions and physiological parameters, mainly transthoracic electrical impedance (TEI). This technique is accurate and faster than existing manual techniques. The LabVIEW software was used to compute the parameters required to quantify IFV. An equation relating per cent control and IFV was obtained. The results of predicted TEI and measured TEI were compared with previously reported data to validate the developed program. It was found that the predicted values of TEI obtained from the computer-based technique were much closer to the measured values of TEI. Six new subjects were enrolled to measure and predict transthoracic impedance and hence to quantify IFV. A similar difference was also observed in the measured and predicted values of TEI for the new subjects.

  5. Pulmonary oedema in a patient undergoing vitreo-retinal surgery under peribulbar block

    Directory of Open Access Journals (Sweden)

    Anjolie Chhabra

    2012-01-01

    Full Text Available A 42 - year-old diabetic and hypertensive male with good effort tolerance was administered peribulbar block for vitreo-retinal surgery. Ten millilitres of an equal mixture of 2% lignocaine and 0.5% bupivacaine was administered for the block after ascertaining negative aspiration for blood. Inadequate akinesia of the eye necessitated further supplementation with 4 mL of local anaesthetic (LA mixture. Thirty minutes later, the patient complained of uneasiness, respiratory distress and desaturated despite oxygen supplementation. He was found to be in pulmonary oedema. He subsequently developed a weak thready pulse, became unresponsive, apnoeic and had generalized tonic clonic convulsions. Immediately, atropine 0.6 mg, followed by midazolam, intubation, mechanical ventilation, morphine and furosemide, were administered intravenously. Spontaneous respiration returned in 20 minutes and he started responding to verbal commands 90 minutes later. He was weaned off the ventilator the next morning. There was no evidence of an ischemic myocardial event and non-contrast computerized tomography scan of the head was normal. The reversible cardiorespiratory arrest, associated convulsions and loss of consciousness were suggestive of LA toxicity. Pulmonary oedema manifesting as respiratory distress and desaturation can be the initial manifestation of LA toxicity in patients with pre-existing cardiovascular disease undergoing eye surgery under peribulbar block.

  6. Immersion pulmonary oedema in a healthy diver not exposed to cold or strenuous exercise.

    Science.gov (United States)

    Castagna, Olivier; de Maistre, Sébastien; Schmid, Bruno; Caudal, Delphine; Regnard, Jacques

    2018-03-31

    In healthy divers, the occurrence of immersion pulmonary oedema (IPE) is commonly caused by contributory factors including strenuous exercise, cold water and negative-pressure breathing. Contrary to this established paradigm, this case reports on a 26-year-old, well-trained combat swimmer who succumbed to acute IPE during static immersion in temperate (21°C) water, while using a front-mounted counterlung rebreather. The incident occurred during repeated depth-controlled ascent practice at the French military diving school. It was discovered that the diver had attempted to stop any gas leakage into the system by over-tightening the automatic diluent valve (ADV) (25th notch of 27) during the dive, thus causing a high resistance to inspiratory flow. The ventilatory constraints imposed by this ADV setting were assessed as a 3.2 Joules·L⁻¹ inspiratory work of breathing and -5 kPa (-50 mbar) transpulmonary pressure. This report confirms the key role of negative pressure breathing in the development of interstitial pulmonary oedema. Such a breathing pattern can cause a lowering of thoracic, airway and interstitial lung pressure, leading to high capillary pressure during each inspiration. Repetition of the diving drills resulted in an accumulation of interstitial lung water extravasation, causing pathological decompensation and proven symptoms. Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.

  7. Treatment of presumed acute cardiogenic pulmonary oedema in an ambulance system by nurses using Boussignac continuous positive airway pressure

    NARCIS (Netherlands)

    Dieperink, Willem; Weelink, E. E. M.; van der Horst, I. C. C.; de Vos, R.; Jaarsma, T.; Aarts, L. P. H. J.; Zijlstra, F.; Nijsten, M. W. N.

    Background: Early initiation of continuous positive airway pressure (CPAP) applied by face mask benefits patients with acute cardiogenic pulmonary oedema (ACPE). The simple disposable Boussignac CPAP (BCPAP) has been used in ambulances by physicians. In the Netherlands, ambulances are manned by

  8. Acute pulmonary oedema: clinical characteristics, prognostic factors, and in-hospital management.

    Science.gov (United States)

    Parissis, John T; Nikolaou, Maria; Mebazaa, Alexandre; Ikonomidis, Ignatios; Delgado, Juan; Vilas-Boas, Fabio; Paraskevaidis, Ioannis; Mc Lean, Antony; Kremastinos, Dimitrios; Follath, Ferenc

    2010-11-01

    Acute pulmonary oedema (APE) is the second, after acutely decompensated chronic heart failure (ADHF), most frequent form of acute heart failure (AHF). This subanalysis examines the clinical profile, prognostic factors, and management of APE patients (n = 1820, 36.7%) included in the Acute Heart Failure Global Survey of Standard Treatment (ALARM-HF). ALARM-HF included a total of 4953 patients hospitalized for AHF in Europe, Latin America, and Australia. The final diagnosis was made at discharge, and patients were classified according to European Society of Cardiology guidelines. Patients with APE had higher in-hospital mortality (7.4 vs. 6.0%, P = 0.057) compared with ADHF patients (n = 1911, 38.5%), and APE patients exhibited higher systolic blood pressures (P chronic renal disease (P renal function, and history may identify high-risk APE patients.

  9. Negative pressure pulmonary oedema following use of ProSeal LMA

    Directory of Open Access Journals (Sweden)

    Richa Jain

    2013-01-01

    Full Text Available Negative pressure pulmonary oedema (NPPO is a life threatening condition, manifested due to upper airway obstruction in a spontaneously breathing patient. Upper airway obstruction caused by classic laryngeal mask airway (cLMA and ProSeal laryngeal mask airway (PLMA has been reported, and NPPO has also been reported following the use of cLMA. Search of literature did not confirm NPPO following the use of PLMA. We encountered a female patient of NPPO scheduled for incision and drainage of an abscess who had signs of airway obstruction following PLMA insertion. Multiple attempts were made to get patent airway without success. PLMA was replaced with endotracheal tube following which pink frothy secretion appeared in breathing circuit. Patient was managed successfully with ICU care.

  10. Severe pulmonary oedema following therapeutic embolization with Onyx for cerebral arteriovenous malformation

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    Murugesan, C.; Saravanan, Sundararaj; Rajkumar, John; Prasad, Jagadish; Banakal, Sanjay; Muralidhar, Kanchi [Narayana Hrudayalaya Institute of Medical Sciences, Bangalore (India)

    2008-05-15

    Acute respiratory distress syndrome (ARDS) is characterized by sudden onset of respiratory distress, infiltrates on radiographs consistent with pulmonary oedema, hypoxaemia and increased work in breathing. Infiltrates on radiographs are bilateral, but may be patchy or diffuse and fluffy or dense. It is associated with absence of left heart failure and a PaO{sub 2}/FiO{sub 2} ratio of {<=}200. Ethylene vinyl alcohol copolymer dissolved in dimethyl sulfoxide (DMSO), which was approved by the US FDA in July 2005, is used as an embolic agent for cerebral arteriovenous malformation (AVM). It is a biocompatible liquid polymer that precipitates and solidifies on contact with blood, thus forming a soft and spongy embolus. We report a case of ARDS following therapeutic embolization with ethylene vinyl alcohol copolymer for cerebral AVM under general anaesthesia. Experienced perioperative physicians adopted standard anaesthetic technique and monitoring for this procedure. Acute respiratory distress and hypoxaemia developed in the patient following extubation of the trachea. Infiltrates seen on postprocedural chest radiographs were consistent with pulmonary oedema. DMSO, the solvent for the ethylene vinyl alcohol copolymer, is excreted via the lungs after administration and we postulate that DMSO was the possible cause of ARDS in this patient. Monitoring of haemodynamic parameters (invasive blood pressure, electrocardiography) and ventilatory parameters (ETCO{sub 2}, SpO{sub 2}, airway pressure monitoring) are important in the recognition of this possible event. One should be vigilant and anticipate this complication following therapeutic embolization with ethylene vinyl alcohol polymer for the treatment of cerebral AVM. (orig.)

  11. Takotsubo cardiomyopathy precipitated by negative pressure pulmonary oedema following total thyroidectomy

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    K S Bharathi

    2016-01-01

    Full Text Available 'Takotsubo cardiomyopathy (TCM' or 'stress cardiomyopathy' is a reversible cardiomyopathy that is precipitated by intense emotional or physical stress. This syndrome is characterised by symptoms mimicking acute coronary syndrome with transient systolic dysfunction associated with regional wall motion abnormalities, which extend beyond a single coronary vascular bed in the absence of obstructive coronary vascular disease. The presentation of TCM and myocardial infarction is similar with sudden onset of chest pain, breathlessness as well as abnormalities in both the electrocardiogram and cardiac enzymes. It is difficult to differentiate between the two until cardiac catheterisation establishes the diagnosis. We report a case of TCM in a post-menopausal female, precipitated by negative pressure pulmonary oedema following total thyroidectomy in whom timely cardiac catheterisation established the diagnosis and influenced the management. Heightened awareness of this unique cardiomyopathy is essential to have a high index of suspicion in at-risk population for the prompt diagnosis of stress-related cardiomyopathy syndromes occurring in the perioperative period.

  12. Re-expansion pulmonary oedema - differential lung ventilation comes to the rescue

    Directory of Open Access Journals (Sweden)

    Shreepathi K Achar

    2014-01-01

    Full Text Available Re-expansion pulmonary oedema (REPE is a rare complication following re-inflation of a chronically collapsed lung, which is often fatal. We present a case of a 22-year-old male who presented to the hospital with severe respiratory distress and a history of blunt abdominal trauma 3 months back. He was diagnosed to have left sided diaphragmatic hernia with a mediastinal shift to the right, and was posted for emergency repair of the same. After surgical decompression of the left hemi-thorax and reduction of the abdominal contents, re-expansion of the left lung was achieved, following which patient developed REPE. A left sided double lumen tube was then inserted to prevent flooding and cross contamination of the right lung and ventilation of both lungs was maintained intraoperatively. Post-operatively, REPE was successfully managed by differential lung ventilation with a lung salvage strategy to the left lung and a lung protective strategy to the right lung.

  13. Estimation of non-cardiogenic pulmonary oedema using dual-frequency electrical impedance

    NARCIS (Netherlands)

    Raaijmakers, E.; Faes, T. J.; Meijer, J. M.; Kunst, P. W.; Bakker, J.; Goovaerts, H. G.; Heethaar, R. M.

    1998-01-01

    The study investigates the effects of non-cardiogenic oedema, especially the accumulation of protein in extracellular fluid, on thoracic impedance and proposes a new method of oedema measurement based on an impedance ratio from a dual-frequency measurement. In vitro measurements in a cell containing

  14. 'A one-sided affair': unilateral pulmonary oedema and the role of cardiac MRI in diagnosing premature coronary artery disease in a patient with Prader-Willi syndrome.

    Science.gov (United States)

    Jabbar, Avais; Khan, Jamal N; Singh, Anvesha; McCann, Gerry P

    2013-05-22

    There is no formal association between premature coronary artery disease (CAD) and Prader-Willi syndrome despite its association with hyperlipidaemia, diabetes mellitus and hypertension. A 36-year-old man with Prader-Willi syndrome presented with acute breathlessness. Inflammatory markers were borderline elevated and chest radiography demonstrated unilateral diffuse alveolar shadowing. Bronchopneumonia was diagnosed and despite treatment with multiple courses of antimicrobial therapy, there was minimal symptomatic and radiographical improvement. A diagnosis of unilateral pulmonary oedema was suspected. Echocardiography was non-diagnostic due to body habitus and coronary angiography was deemed inappropriate due to uncertainty in diagnosis, invasiveness and pre-existing chronic kidney disease. Therefore, cardiac magnetic resonance was performed, confirming severe triple-vessel CAD. This case demonstrates a presentation of heart failure with unilateral chest radiograph changes in a young patient with Prader-Willi syndrome and severe premature CAD detected by multiparametric cardiac magnetic resonance imaging.

  15. PREVALENCE, CLINICAL PRESENTATION, DIAGNOSIS AND TREATMENT OF ACUTE PULMONARY OEDEMA IN SEVERE PREGNANCY-INDUCED HYPERTENSION AND ECLAMPSIA CASES IN TRIBAL POPULATION OF SOUTH RAJASTHAN

    Directory of Open Access Journals (Sweden)

    (Brig. Pradeep Kuma

    2016-05-01

    Full Text Available BACKGROUND Pulmonary oedema in severe pregnancy-induced hypertension is a life threatening complication with high maternal mortality, particularly in tribal population of South Rajasthan. METHODS Thirteen cases which occurred in the duration of two and half years were analysed through medical records and findings were recorded. RESULTS Maximum cases 10(76.92% were in less than 20 years of age. 12 (92.30% cases were nulliparous. Out of 13 cases of PIH, pulmonary oedema developed in 5 (38.46% cases of eclampsia and 8 (61.54% cases of severe pregnancy-induced hypertension. 10 (76.92%cases were 28 to 30 weeks of gestation and 3 (23.08% were 31 to 34 weeks of gestation. 8 (61.54% cases were severely anaemic. 12 (92.30% were unbooked cases. CONCLUSION Regular antenatal checkups, early diagnosis, prompt treatment of hypertension and pulmonary oedema and termination of pregnancy is required to prevent maternal death.

  16. Increased permeability-oedema and atelectasis in pulmonary dysfunction after trauma and surgery: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Groeneveld AB Johan

    2007-07-01

    Full Text Available Abstract Background Trauma and surgery may be complicated by pulmonary dysfunction, acute lung injury (ALI and acute respiratory distress syndrome (ARDS, but the mechanisms are incompletely understood. Methods We evaluated lung capillary protein permeability non-invasively with help of the 67Ga-transferrin pulmonary leak index (PLI technique and extravascular lung water (EVLW by the transpulmonary thermal-dye dilution technique in consecutive, mechanically ventilated patients in the intensive care unit within 24 h of direct, blunt thoracic trauma (n = 5, 2 with ARDS, and within 12 h of indirect trauma by transhiatal oesophagectomy (n = 8, abdominal surgery for cancer (n = 6 and bone surgery (n = 4. We studied transfusion history, haemodynamics, oxygenation and mechanics of the lungs. The lung injury score (LIS, 0–4 was calculated. Plain radiography was also done to judge densities and atelectasis. Results The PLI and EVLW were elevated above normal in 61 and 30% of patients, respectively, and the PLI directly related to the number of red cell concentrates given (rs = 0.69, P s = 0.55, P = 0.007. Thoracic trauma patients had a worse oxygenation requiring higher airway pressures and thus higher LIS than the other patient groups, unrelated to PLI and EVLW but attributable to a higher cardiac output and thereby venous admixture. Finally, patients with radiographic signs of atelectasis had more impaired oxygenation and more densities than those without. Conclusion The oxygenation defect and radiographic densities in mechanically ventilated patients with pulmonary dysfunction and ALI/ARDS after trauma and surgery are likely caused by atelectasis rather than by increased permeability-oedema related to red cell transfusion.

  17. Minimal impairment in pulmonary function following laparoscopic surgery

    DEFF Research Database (Denmark)

    Staehr-Rye, Anne K; Rasmussen, L S; Rosenberg, J

    2014-01-01

    BACKGROUND: Pulmonary function may be impaired in connection with laparoscopic surgery, especially in the head-down body position, but the clinical importance has not been assessed in detail. The aim of this study was to assess pulmonary function after laparoscopic hysterectomy and laparoscopic...... cholecystectomy in the 20° head-up position or hysterectomy in the 30° head-down position. The primary outcome was the difference between arterial oxygenation (PaO2 ) 2 h postoperatively and the preoperative value. Two hours and 24 h after surgery, pulmonary shunt and ventilation-perfusion mismatch were assessed.......88). Shunt was significantly greater in the cholecystectomy group 24 h after surgery compared to the hysterectomy group [4%, 95% CI 0 to 9 vs. 0%, 95% CI 0 to 7, P = 0.02]. CONCLUSIONS: Minimal impairment in pulmonary gas exchange was found after laparoscopic surgery. Pulmonary shunt was larger after...

  18. Idiopathic oedema

    DEFF Research Database (Denmark)

    Courtnadge, Christina; Madsen, Flemming; Bygum, Anette

    2018-01-01

    during the day. Patients may be disabled due to accompanying symptoms like headache, dizziness, fatigue, anxiety, and depression. The diagnosis is based on clinical features and exclusion of other causes of oedema. Non-pharmacological interventions and pharmacological therapies are reviewed....

  19. In reply to: "Intra-aortic balloon pump protects against hydrostatic pulmonary oedema during peripheral venoarterial-extracorporeal membrane oxygenation".

    Science.gov (United States)

    Privratsky, Jamie R; Diaz, Sebastian; Nicoara, Alina; Daneshmand, Mani A

    2018-05-01

    Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is an increasingly utilized life-saving measure. However, left-ventricular distention from inadequate left-ventricular off-loading can lead to unwanted pulmonary and cardiac complications. We are writing to indicate our agreement with a recent article by Brechot et al. published in the June 2017 issue where the authors demonstrated that intra-aortic balloon pump provides mechanical support to off-load the left ventricle during VA-ECMO, which prevents pulmonary edema.

  20. Edema agudo do pulmão pós-extubação traqueal - Caso clínico Post-tracheal extubation pulmonary oedema - Case report

    Directory of Open Access Journals (Sweden)

    Maria de Lurdes Castro

    2009-05-01

    Full Text Available O edema agudo do pulmão pós-extubação traqueal é um acontecimento raro (≈ 0,1%¹. A etiologia e multifactorial, sendo a obstrução da via aérea superior o factor desencadeante principal. O esforço inspiratório contra a glote encerrada causa pressões intratorácicas muito negativas, que se transmitem ao interstício pulmonar, condicionando uma transudação de fluidos a partir dos vasos capilares pulmonares1-5. Relatamos um caso de edema agudo do pulmão pós-extubação num doente de quinze anos, operado no serviço de urgência por amputação traumática da perna esquerda. Revemos a fisiopatologia, o padrão radiológico, potenciais factores de risco e medidas preventivas desta complicação respiratória pós-anestésica.Negative pressure pulmonary oedema is an uncommon complication of traqueal extubation (≈ 0,1%¹ mostly caused by acute upper airway obs truction. Upper airway obstruction from glottis closure leads to marked inspiratory effort, which generates negative intrathoracic pressure transmitting to pulmonary interstitium, and inducing fluid transudation from pulmonary capillary bed1-5. We report a case of post-extubation pulmonary oedema in a fifteen years old patient, submitted to surgery following traumatic amputation of his left leg. We review the pathophysiology, radiological findings, potential risk factors and preventive measures of this post-anaesthetic respiratory complication.

  1. Optic disc oedema

    DEFF Research Database (Denmark)

    Nielsen, Marianne Kromann; Hamann, Steffen

    2014-01-01

    Optic disc oedema describes the nonspecific, localized swelling of the optic nerve head regardless of aetiology. Therefore, differentiating among the various aetiologies depends on a thorough history and knowledge of the clinical characteristics of the underlying conditions. Papilloedema strictly...... refers to optic disc oedema as a consequence of elevated intracranial pressure. It is usually a bilateral condition and visual function is preserved until late. Optic disc oedema caused by an anterior optic neuropathy is usually unilateral and accompanied by the loss of visual function....

  2. Update on Pharmaceutical and Minimally Invasive Management Strategies for Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Rokhsara Rafii

    2011-01-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is a debilitating pulmonary disorder with systemic effects, and it is the fourth leading cause of death in the United States. COPD patients not only develop respiratory limitations, but can also demonstrate systemic wasting, features of depression, and can succumb to social isolation. Smoking cessation is crucial, and pharmacotherapy with bronchodilators is helpful in symptom management. Inhaled corticosteroids may be beneficial in some patients. In addition, pulmonary rehabilitation and palliative care are important components under the right clinical circumstance. This review highlights current guidelines and management strategies for COPD and emphasizes novel pharmacotherapy and minimally invasive (nonsurgical lung-volume reduction interventions that may prove to be of significant benefit in the future.

  3. Extending the use of the pacing pulmonary artery catheter for safe minimally invasive cardiac surgery.

    Science.gov (United States)

    Levin, Ricardo; Leacche, Marzia; Petracek, Michael R; Deegan, Robert J; Eagle, Susan S; Thompson, Annemarie; Pretorius, Mias; Solenkova, Nataliya V; Umakanthan, Ramanan; Brewer, Zachary E; Byrne, John G

    2010-08-01

    In this study, the therapeutic use of pacing pulmonary artery catheters in association with minimally invasive cardiac surgery was evaluated. A retrospective study. A single institutional university hospital. Two hundred twenty-four consecutive patients undergoing minimally invasive cardiac surgery through a small (5-cm) right anterolateral thoracotomy using fibrillatory arrest without aortic cross-clamping. Two hundred eighteen patients underwent mitral valve surgery (97%) alone or in combination with other procedures. Six patients underwent other cardiac operations. In all patients, the pacing pulmonary artery catheter was used intraoperatively to induce ventricular fibrillation during the cooling period, and in the postoperative period it also was used in 37 (17%) patients who needed to be paced, mainly for bradyarrhythmias (51%). There were no complications related to the insertion of the catheters. Six (3%) patients experienced a loss of pacing capture, and 2 (1%) experienced another complication requiring the surgical removal of the catheter. Seven (3%) patients needed postoperative implantation of a permanent pacemaker. In combination with minimally invasive cardiac surgery, pacing pulmonary artery catheters were therapeutically useful to induce ventricular fibrillatory arrest intraoperatively and for obtaining pacing capability in the postoperative period. Their use was associated with a low number of complications. Copyright 2010 Elsevier Inc. All rights reserved.

  4. Mechanisms of oedema formation: The minor role of ...

    African Journals Online (AJOL)

    nutritional state and serum albumin levels. Total body fluid balance was assessed by two independent observers who recorded the extent of oedema formation on a scale of 0 to 4, tissue turgor on a scale of 0 to –3, and by paying attention to the jugular venous pressure and pulse rate, blood pressure and signs of pulmonary ...

  5. Early post-operative pulmonary function tests after mitral valve replacement: Minimally invasive versus conventional approach. Which is better?

    Directory of Open Access Journals (Sweden)

    Magdy Gomaa

    2016-12-01

    Conclusion: Minimally invasive right anterolateral mini-thoracotomy is as safe as median sternotomy for mitral valve surgery, with fewer complications and postoperative pain, less ICU and hospital stay, fast recovery to work with no movement restriction after surgery. There was a highly significant difference denoting better post operative pulmonary function of the minimally invasive approach.

  6. Minimally invasive surgical treatment of patients with bilateral pulmonary tuberculosis complicated with pleural empyema

    Directory of Open Access Journals (Sweden)

    Korpusenko I.V

    2015-03-01

    Full Text Available Objective of our study was to increase the effectiveness of surgical treatment of bilateral destructive pulmonary tuberculosis complicated by pleural empyema by using VTS-technologies. The study was done in Dnepropetrovsk regional clinical therapeutic and prophylactic association "Phthisiology" in the period from 2008 to 2013. A retrospective analysis of 43 cases of bilateral destructive pulmonary tuberculosis complicated by pleural empyema on one side and dissemination focus or limited destructive process on contralateral side has been performed. Selected cases were divided into 2 groups: main (eighteen cases where the following procedures were done: performed transsternal occlusion of the main bronchus, sanation of empyema cavity using videothoracosopy, in 30-45 days followed by pleuropneumectomy with usage of minithoracothomy and control (nineteen cases who had undergone drainage of the empyema cavity, sanation, in 45-60 days followed by pleuropmeumectomy with usage of anterolateral access. The distribution of main and control groups for analyzed parameters was representative. Sanation of pleural cavity with videothoracosopy usage compared with Bulau’s drainage provides better antibacterial effect, effective sanitation of the pleural cavity as evidenced by following changes: significant decrease in the number of microbial cells; normalization of total white blood cells count and rod-shaped granulocytes in the peripheral blood 10 days after treatment; normalization of leukocyte intoxication index. The use of minimally invasive surgical treatment allowed to reduce intraoperative complications by 2 times, amount of intraoperative blood loss and hemotrasfusions by 1.5 times, postoperative mortality by 2.5 times. Pleural cavity sanation with videothoracoscopy usage with following pneumoectomy leads to reduce in the incidence and severity of postoperative complications. The most promising is stage-by-stage surgical approach with consecutive use

  7. Minimalism

    CERN Document Server

    Obendorf, Hartmut

    2009-01-01

    The notion of Minimalism is proposed as a theoretical tool supporting a more differentiated understanding of reduction and thus forms a standpoint that allows definition of aspects of simplicity. This book traces the development of minimalism, defines the four types of minimalism in interaction design, and looks at how to apply it.

  8. Negative Pressure Pulmonary Oedema Following Adenoidectomy ...

    African Journals Online (AJOL)

    threatening complication of laryngospasm that occurs during or after general anaesthesia. It is a complication of poorly treated or unrecognized laryngospasm occurring at extubation or later in the postoperative period. Objective: To emphasize ...

  9. The variability of practice in minimally invasive thoracic surgery for pulmonary resections.

    Science.gov (United States)

    Rocco, Gaetano; Internullo, Eveline; Cassivi, Stephen D; Van Raemdonck, Dirk; Ferguson, Mark K

    2008-08-01

    Thoracic surgeons participating in this survey seemed to have clearly indicated their perception of VATS major lung resections, in particular VATS lobectomy. 1. The acronym VATS as a short form of "video-assisted thoracic surgery" was the preferred terminology. 2. According to the respondents, the need or use of rib spreading served as the defining characteristic of "open" thoracic surgery. 3. It was most commonly suggested that VATS lobectomy is performed by means of two or three port incisions with the addition of a minithoracotomy or access incision. 4. Rib spreading (shearing) was not deemed acceptable as part of a strictly defined VATS procedure. 5. Although there was no general consensus, respondents suggested that the preferred approach for visualization in a VATS procedure was only through the video monitor. 6. Although minimally invasive procedures for lung resection are still mainly being used for diagnostic and minor therapeutic purposes, young surgeons seemed to be more likely to recommend VATS lung surgery for major pulmonary resections than their more senior colleagues. 7. The survey confirmed that the use of the standard posterolateral thoracotomy is still widespread. Almost 40% of the surgeons claimed to use the standard posterolateral thoracotomy for more than 50% of their cases and less than 30% use it for less than 5% of cases. 8. The major reasons to perform VATS lobectomy were perceived to be reduced pain and decreased hospitalization. 9. Approximately 60% of the surgeons claimed to perform VATS lobectomy in less than 5% of their lobectomy cases. Younger consultants reported using VATS lobectomy in up to 50% of their lobectomy cases. There was the suggestion that lack of resources could justify the minor impact of VATS lobectomy in the thoracic surgical practice in middle- to low-income countries. 10. The currently available scientific evidence on safety and effectiveness, and technologic advancements were emphasized as the two factors having a

  10. Efficacy of a minimal home-based psychoeducative intervention versus usual care for managing anxiety and dyspnoea in patients with severe chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Bove, Dorthe Gaby; Overgaard, Dorthe; Lomborg, Kirsten

    2015-01-01

    investigates the efficacy of a minimal home-based psychoeducative intervention versus usual care for patients with severe chronic obstructive pulmonary disease. METHODS AND ANALYSIS: The trial is a randomised controlled trial with a 4-week and 3-month follow-up. 66 patients with severe chronic obstructive...... pulmonary disease and associated anxiety will be randomised 1:1 to either an intervention or control group. The intervention consists of a single psychoeducative session in the patient's home in combination with a telephone booster session. The intervention is based on a manual, with a theoretical...

  11. [Brain oedema and acute liver failure].

    Science.gov (United States)

    Spahr, L

    2003-04-01

    Brain oedema leading to intracranial hypertension occurs in a significant proportion of patients with acute liver failure in whom it is a leading cause of death. Although precise pathogenic mechanisms associated to this severe complication remain incompletely understood, increasing evidence points to gut-derived neurotoxins including ammonia as key mediators in cerebral osmotic and perfusion disturbances. The management of brain oedema and intracranial hypertension requires a multidisciplinar approach in a center where liver transplantation is available, as this option is the only treatment modality that provides improvement in outcome. This article reviews the most common causes of acute liver failure and the standard of supportive care management, and describes future potential therapeutic aspects of brain oedema and intracranial hypertension.

  12. Massive vulval oedema in multiple pregnancies at Bugando Medical ...

    African Journals Online (AJOL)

    In this report we describe two cases of massive vulval oedema seen in two ... passage of yellow-whitish discharge per vagina (Figure 1). Examination revealed massive oedema, and digital vaginal examination was difficult due to tenderness.

  13. Rehabilitation Interventions for Poststroke Hand Oedema: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Thuy Anh Giang

    2016-06-01

    Conclusion: Further study needs to focus solely on interventions for poststroke hand oedema and their long-term effects. No conclusion can be made on the most effective management of poststroke hand oedema until much more evidence is available.

  14. Epidemiological, Clinical and Pathological findings of Oedema ...

    African Journals Online (AJOL)

    The main microscopic findings were subcutaneous oedema of the head, submucosa of the stomach wall, mesentery of the spiral colon and the brain and the meninges characterized by cloudy appearance, lung congestion, edema, consolidation and collapse and excessive fluid in the serous cavities. In animals that had ...

  15. Urticaria, angioneurotic oedema and Sjogren's syndrome: unusual ...

    African Journals Online (AJOL)

    Urticaria, Sjogren's syndrome and angioneurotic oedema are rare features of systemic lupus erythematosus (SLE). These are not frequently encountered in SLE as prominent presenting features although these could be seen. It is known that patients with associated renal or central nervous system involvements are not ...

  16. Facial Oedema Is Not Always Angioedema: A Case of Spontaneous Pneumomediastinum with Subcutaneous Emphysema during COPD Exacerbation

    Directory of Open Access Journals (Sweden)

    Sarah Damanti

    2015-10-01

    Full Text Available We report a case of acute facial oedema in an elderly hospitalized patient which was initially misdiagnosed as angioedema secondary to antibiotics in a patient with an allergic diathesis. We describe the differential aetiologies and then the true cause of the oedema, which was an uncommon complication of a very common condition in the elderly: a pneumomediastinum with subcutaneous emphysema probably due to rupture of an emphysematous lung bulla during chronic obstructive pulmonary disease (COPD exacerbation. Lastly, we focus on the therapeutic procedures instituted for the treatment of the pneumomediastinum.

  17. Dynamics of formation and resolution of vasogenic brain oedema. 1. Measurement of oedema clearance into ventricular CSF

    Energy Technology Data Exchange (ETDEWEB)

    Tsuyumu, M; Reulen, H J; Prioleau, G [Mainz Univ. (Germany, F.R.). Neurochirurgische Klinik

    1981-01-01

    Previous studies showed that resolution of brain oedema may occur by clearance into the CSF. The present study was performed to measure quantitatively the amount of oedema clearance in cold-induced oedema in cats. In order to determine the minute amounts of oedema fluid entering the CSF the oedema fluid was labelled with a high concentration of an extracellular marker (S/sup 35/-sodiumthiosulphate). Ventriculo-cisternal perfusion was used to collect the marker in the cisternal outflow. By using the assumption that oedema fluid has the same marker concentration as the plasma, the distribution profile of extracellular space as well as the clearance rate of oedema into CSF could be computed. Oedema and thiosulphate space were most pronounced in the white matter underlying the cortical cold injury. The values then declined progressively with the distance from the lesion towards the ventricle. Oedema fluid clearance into the ventricular CSF at 24 hours following the cold injury amounted to 0.8-1.2 ..mu..l/min or 1.15 ml/day. These data support the assumption that this may be one of the main mechanisms of the resolution of vasogenic brain oedema.

  18. Bone marrow oedema associated with benign and malignant bone tumours

    Energy Technology Data Exchange (ETDEWEB)

    James, S.L.J. [Department of Radiology, Royal Orthopaedic Hospital, Birmingham, B31 2AP (United Kingdom)], E-mail: steven.james@roh.nhs.uk; Panicek, D.M. [Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021 (United States); Davies, A.M. [Department of Radiology, Royal Orthopaedic Hospital, Birmingham, B31 2AP (United Kingdom)

    2008-07-15

    Bone marrow oedema is associated with a wide variety of pathological processes including both benign and malignant bone tumours. This imaging finding in relation to intraosseous tumours can aid in providing a more focused differential diagnosis. In this review, we will discuss the MR imaging of bone marrow oedema surrounding intraosseous neoplasms. The different pulse sequences used in differentiating underlying tumour from surrounding oedema are discussed along with the role of dynamic contrast enhanced MRI. Benign lesions commonly associated with bone marrow oedema include osteoid osteoma, osteoblastoma, chondroblastoma and Langerhan's cell histiocytosis. Metastases and malignant primary bone tumours such as osteosarcoma, Ewing's sarcoma and chondrosarcoma may also be surrounded by bone marrow oedema. The imaging findings of these conditions are reviewed and illustrated. Finally, the importance of bone marrow oedema in assessment of post chemotherapeutic response is addressed.

  19. Dengue fever associated with acute scrotal oedema: two case reports

    International Nuclear Information System (INIS)

    Shamim, M.; Naqvi, S.Z.G.

    2011-01-01

    Scrotal oedema associated with dengue fever is a rare and self limiting condition resolving in a few days without any complication or sequelae. This is a report of two cases of dengue fever associated with acute scrotal and penile oedema. (author)

  20. Atraumatic medial collateral ligament oedema in medial compartment knee osteoarthritis

    International Nuclear Information System (INIS)

    Bergin, D.; Keogh, C.; O'Connell, M.; Zoga, A.; Rowe, D.; Shah, B.; Eustace, S.

    2002-01-01

    Objective: To describe and determine the prevalence of atraumatic medial collateral oedema identified in patients with medial compartment osteoarthritis. Design and patients: Sixty patients, 30 patients with medial compartment knee osteoarthritis (Kellgren and Lawrence grade 2 to 4) and 30 age-matched patients with atraumatic knee pain without osteoarthritis, referred for MR imaging over a 2 year period were included in the study. In each case, severity of osteoarthritis was recorded on radiographs and correlated with the presence or absence of medial collateral ligament oedema at MR imaging. Results: Medial collateral oedema was identified in 27 of the 30 patients with osteoarthritis, of whom 14 had grade 1 oedema and 13 had grade 2 oedema compared with the presence of medial collateral ligament oedema (grade 1) in only two of the 30 control patients without osteoarthritis (P<<0.0001). Conclusion: Medial collateral oedema is common in patients with osteoarthritis in the absence of trauma. When identified, medial collateral ligament oedema should be considered to be a feature of osteoarthritis and should not be incorrectly attributed to an acute traumatic injury. (orig.)

  1. Minimizing Contrast Medium Doses to Diagnose Pulmonary Embolism with 80-kVp Multidetector Computed Tomography in Azotemic Patients

    Energy Technology Data Exchange (ETDEWEB)

    Holmquist, F. (Dept. of Diagnostic Radiology, Malmoe Univ. Hospital, Univ. of Lund, Malmoe (Sweden)); Hansson, K.; Pasquariello, F. (Dept. of Internal Medicine, Lasarettet Trelleborg, Univ. of Lund, Trelleborg (Sweden)); Bjoerk, J. (Competence Center for Clinical Research, Univ. Hospital, Univ. of Lund, Lund (Sweden)); Nyman, U. (Dept. of Radiology, Lasarettet Trelleborg, Univ. of Lund, Trelleborg (Sweden))

    2009-02-15

    Background: In diagnosing acute pulmonary embolism (PE) in azotemic patients, scintigraphy and magnetic resonance imaging are frequently inconclusive or not available in many hospitals. Computed tomography is readily available, but relatively high doses (30-50 g I) of potentially nephrotoxic iodine contrast media (CM) are used. Purpose: To report on the diagnostic quality and possible contrast-induced nephropathy (CIN) after substantially reduced CM doses to diagnose PE in azotemic patients using 80-peak kilovoltage (kVp) 16-row multidetector computed tomography (MDCT) combined with CM doses tailored to body weight, fixed injection duration adapted to scan time, automatic bolus tracking, and saline chaser. Material and Methods: Patients with estimated glomerular filtration rate (eGFR) <50 ml/min were scheduled to undergo 80-kVp MDCT using 200 mg I/kg, and those with eGFR =50 ml/min, 120-kVp MDCT with 320 mg I/kg. Both protocols used an 80-kg maximum dose weight and a fixed 15-s injection time. Pulmonary artery density and contrast-to-noise ratio were measured assuming 70 Hounsfield units (HU) for a fresh clot. CIN was defined as a plasma creatinine rise >44.2 mumol/l from baseline. Results: 89/148 patients (63/68 females) underwent 80-/120-kVp protocols, respectively, with 95% of the examinations being subjectively excellent or adequate. Mean values in the 80-/120-kVp cohorts regarding age were 82/65 years, body weight 66/78 kg, effective mAs 277/117, CM dose 13/23 g I, pulmonary artery density 359/345 HU, image noise (1 standard deviation) 24/21 HU, contrast-to-noise ratio 13/13, and dose-length product 173/258 mGycm. Only 1/65 and 2/119 patients in the 80- and 120-kVp cohorts, respectively, with negative CT and no anticoagulation suffered non-fatal thromboembolism during 3-month follow-up. No patient developed CIN. Conclusion: 80-kVp 16-row MDCT with optimization of injection parameters may be performed with preserved diagnostic quality, using markedly reduced CM

  2. Radionuclide assessment of pulmonary microvascular permeability

    Energy Technology Data Exchange (ETDEWEB)

    Groeneveld, A.B.J. [Medical Intensive Care Unit, Department of Internal Medicine, Free University Hospital, De Boelelaan 1117, 1081 HV Amsterdam (Netherlands)

    1997-04-01

    The literature has been reviewed to evaluate the technique and clinical value of radionuclide measurements of microvascular permeability and oedema formation in the lungs. Methodology, modelling and interpretation vary widely among studies. Nevertheless, most studies agree on the fact that the measurement of permeability via pulmonary radioactivity measurements of intravenously injected radiolabelled proteins versus that in the blood pool, the so-called pulmonary protein transport rate (PTR), can assist the clinician in discriminating between permeability oedema of the lungs associated with the adult respiratory distress syndrome (ARDS) and oedema caused by an increased filtration pressure, for instance in the course of cardiac disease, i.e. pressure-induced pulmonary oedema. Some of the techniques used to measure PTR are also able to detect subclinical forms of lung microvascular injury not yet complicated by permeability oedema. This may occur after cardiopulmonary bypass and major vascular surgery, for instance. By paralleling the clinical severity and course of the ARDS, the PTR method may also serve as a tool to evaluate new therapies for the syndrome. Taken together, the currently available radionuclide methods, which are applicable at the bedside in the intensive care unit, may provide a gold standard for detecting minor and major forms of acute microvascular lung injury, and for evaluating the severity, course and response to treatment. (orig.). With 2 tabs.

  3. Differentiating pre- and minimally invasive from invasive adenocarcinoma using CT-features in persistent pulmonary part-solid nodules in Caucasian patients

    International Nuclear Information System (INIS)

    Cohen, Julien G.; Reymond, Emilie; Lederlin, Mathieu; Medici, Maud; Lantuejoul, Sylvie; Laurent, François; Arbib, François; Jankowski, Adrien

    2015-01-01

    Highlights: •We analyzed CT-features of part-solid ground glass nodules in Caucasians. •These CT-features were compared to pathology on full resection specimen. •Several CT-features can help differentiating invasive adenocarcinoma. •A solid component larger than 5 mm had 100% sensitivity for invasive adenocarcinoma. -- Abstract: Objective: To retrospectively investigate the diagnostic value of pre-operative CT-features between pre/minimally invasive and invasive lesions in part-solid persistent pulmonary ground glass nodules in a Caucasian population. Materials and methods: Retrospective review of two pre-operative CTs for 31 nodules in 30 patients. There were 10 adenocarcinomas in situ, 1 minimally invasive adenocarcinoma, 20 invasive adenocarcinomas. We analyzed the correlation between histopathology and the following CT-features: maximal axial diameter, maximal orthogonal axial diameter, height, density, size of solid component, air bronchogram, pleural retraction, nodule mass, disappearance rate and their evolution during follow-up. Results: In univariate analysis, invasive adenocarcinomas had a higher maximal height, density, solid component size, mass, a lower disappearance rate and presented more often with pleural retraction (p < 0.05). After logistic regression performed with the uncorrelated parameters using a method of selection of variables, only the size of solid component remained significant, with 100% sensitivity for invasive adenocarcinoma when larger than 5 mm. Conclusion: Preoperative CT-features can help differentiating in situ and minimally invasive adenocarcinomas from invasive adenocarcinomas in Caucasian patients. A solid component larger than 5 mm in diameter had 100% sensitivity for the diagnosis of invasive adenocarcinoma

  4. Differentiating pre- and minimally invasive from invasive adenocarcinoma using CT-features in persistent pulmonary part-solid nodules in Caucasian patients

    Energy Technology Data Exchange (ETDEWEB)

    Cohen, Julien G., E-mail: JCohen@chu-grenoble.fr [Clinique Universitaire de Radiologie et Imagerie Médicale (CURIM), Université Joseph Fourier, Centre Hospitalier Universitaire de Grenoble, CS 10217, 38043 Grenoble Cedex 9 (France); Reymond, Emilie [Clinique Universitaire de Radiologie et Imagerie Médicale (CURIM), Université Joseph Fourier, Centre Hospitalier Universitaire de Grenoble, CS 10217, 38043 Grenoble Cedex 9 (France); Lederlin, Mathieu [Service de Radiologie, Université Segalen Bordeaux, Centre Hospitalier Universitaire de Bordeaux, 12 rue Dubernat, 33404 Bordeaux Cedex (France); Medici, Maud [Centre d’Investigation Clinique – Innovation Technologique (CIC-IT), Pavillon Taillefer, 38706 La Tronche Cedex (France); Lantuejoul, Sylvie [Departement d’Anatomie et Cytologie Pathologique (DACP), Université Joseph Fourier, Centre Hospitalier Universitaire de Grenoble, CS 10217, 38043 Grenoble Cedex 9 (France); Laurent, François [Service de Radiologie, Université Segalen Bordeaux, Centre Hospitalier Universitaire de Bordeaux, 12 rue Dubernat, 33404 Bordeaux Cedex (France); Arbib, François [Departement de Pneumologie, Université Joseph Fourier, Centre Hospitalier Universitaire de Grenoble, CS 10217, 38043 Grenoble Cedex 9 (France); Jankowski, Adrien [Clinique Universitaire de Radiologie et Imagerie Médicale (CURIM), Université Joseph Fourier, Centre Hospitalier Universitaire de Grenoble, CS 10217, 38043 Grenoble Cedex 9 (France); and others

    2015-04-15

    Highlights: •We analyzed CT-features of part-solid ground glass nodules in Caucasians. •These CT-features were compared to pathology on full resection specimen. •Several CT-features can help differentiating invasive adenocarcinoma. •A solid component larger than 5 mm had 100% sensitivity for invasive adenocarcinoma. -- Abstract: Objective: To retrospectively investigate the diagnostic value of pre-operative CT-features between pre/minimally invasive and invasive lesions in part-solid persistent pulmonary ground glass nodules in a Caucasian population. Materials and methods: Retrospective review of two pre-operative CTs for 31 nodules in 30 patients. There were 10 adenocarcinomas in situ, 1 minimally invasive adenocarcinoma, 20 invasive adenocarcinomas. We analyzed the correlation between histopathology and the following CT-features: maximal axial diameter, maximal orthogonal axial diameter, height, density, size of solid component, air bronchogram, pleural retraction, nodule mass, disappearance rate and their evolution during follow-up. Results: In univariate analysis, invasive adenocarcinomas had a higher maximal height, density, solid component size, mass, a lower disappearance rate and presented more often with pleural retraction (p < 0.05). After logistic regression performed with the uncorrelated parameters using a method of selection of variables, only the size of solid component remained significant, with 100% sensitivity for invasive adenocarcinoma when larger than 5 mm. Conclusion: Preoperative CT-features can help differentiating in situ and minimally invasive adenocarcinomas from invasive adenocarcinomas in Caucasian patients. A solid component larger than 5 mm in diameter had 100% sensitivity for the diagnosis of invasive adenocarcinoma.

  5. EVALUATION OF DIABETIC MACULAR OEDEMA WITH SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY AND FUNDUS FLUORESCEIN ANGIOGRAPHY

    Directory of Open Access Journals (Sweden)

    Mallika Venkitasubramanian

    2017-02-01

    Full Text Available BACKGROUND Macular oedema is an important cause of visual morbidity in Diabetic Retinopathy. It can be assessed by both Fundus Fluorescein Angiography (FFA and Optical Coherence Tomography (OCT. The aims of this study were to evaluate the agreement between morphological features on spectral domain Optical Coherence Tomography and Fluorescein Angiographic leakage patterns in Diabetic Macular Oedema, and to study the correlation between the best corrected visual acuity and central foveal thickness measured by Optical Coherence Tomography. MATERIALS AND METHODS This was an observational study. All patients with Diabetic Macular Oedema underwent complete ophthalmic examination and subjected to FFA and OCT. Presence or absence of macular oedema by FFA and OCT was noted and agreement between two modalities of imaging was assessed. Sensitivity of these modalities were also found out using appropriate statistical methods. Best Corrected Visual Acuity (BCVA measured were converted to LogMAR scale and Central foveal thickness measured by OCT. Linear regression analysis was done with central foveal thickness and LogMAR visual acuity. RESULTS A total of 69 eyes of 39 patients were studied. OCT revealed Diabetic Macular Oedema in 97.5% of eyes. Fundus Fluorescein Angiography performed in these patients identified leakage in 95.6% of eyes. Sensitivity and specificity of FFA and OCT were calculated keeping one as the gold standard for sensitivity and specificity of the other. FFA and OCT had almost equal sensitivity (95.46 for OCT and 96.92 for FFA for detection of DME. Specificity of OCT was found to be slightly higher (33.33% compared to FFA (25%. Our results suggest that there is minimal agreement between these two imaging modalities in evaluating DME. Statistically, Kappa value was 0.248. Linear regression analysis showed that central foveal thickness had a significant correlation with visual acuity, with Pearson correlation coefficient r=0.442, p=0

  6. Bilateral Re-Expansion Pulmonary Oedema– When the Cure Is ...

    African Journals Online (AJOL)

    Background: Re-expansion pulmonary oedema is a potentially fatal consequence of rapid reexpansion of a lung, which has been collapsed due to a pleural effusion or a pneumothorax. Case Report: We report a very unusual case in which the patient initially developed ipsilateral followed by contralateral pulmonary ...

  7. Acute haemorrhagic oedema of infancy with bullae and koebnerisation

    OpenAIRE

    Mohd Sazlly Lim, S; Shamsudin, N

    2014-01-01

    A 5-month-old Malay boy presented with purpuric papules and plaques on the face and extremities accompanied by fever, coryzal symptoms and bilateral lower limb oedema. There were also bullous linear purpuric lesions on the right upper limb. Blood and culture tests were normal. Histopathological tests showed leucocytoclastic vasculitis, confirming the diagnosis of acute haemorrhagic oedema of infancy. The patient achieved complete recovery after 2 weeks with no recurrence.

  8. Acute haemorrhagic oedema of infancy with bullae and koebnerisation

    Directory of Open Access Journals (Sweden)

    Norashikin Shamsudin

    2014-08-01

    Full Text Available A 5-month-old Malay boy presented with purpuric papules and plaques on the face and extremities accompanied by fever, coryzal symptoms and bilateral lower limb oedema. There were also bullous linear purpuric lesions on the right upper limb. Blood and culture tests were normal. Histopathological tests showed leucocytoclastic vasculitis, confirming the diagnosis of acute haemorrhagic oedema of infancy. The patient achieved complete recovery after 2 weeks with no recurrence.

  9. Intravitreal triamcinolone for diffuse diabetic macular oedema.

    LENUS (Irish Health Repository)

    Gibran, S K

    2012-02-03

    AIM: To evaluate the efficacy of intravitreal triamcinolone (IVTA) for the treatment of diffuse diabetic macular oedema (DME) refractory to conventional argon macular laser therapy. METHODS: A prospective, consecutive, and noncomparative case series was undertaken involving 38 eyes of 38 patients with refractory DME. Triamcinolone acetonide (4 mg) in 0.1 ml was injected intravitreally. LogMar visual acuity (VA) and macular thickness measured by ocular coherence tomography (OCT) were assessed preoperatively and postoperatively at 1, 3, and 6 months. RESULTS: All patients completed 6 months of follow up. VA (mean+\\/-SD) improved from 0.905+\\/-0.23 to 0.605+\\/-0.28, 0.555+\\/-0.29, and 0.730+\\/-0.30 at 1, 3, and 6 months, respectively. Macular thickness baseline (mean+\\/-SD) on OCT was 418.7+\\/-104.2 microm and this decreased to 276.9+\\/-72.6 microm, 250.6+\\/-53.1 microm, and 308.8+\\/-87.3 microm at 1, 3, and 6 months, respectively. CONCLUSIONS: IVTA may be a potential temporary treatment for refractory DME. It is effective in decreasing macular thickness and improving VA but the effect lasts approximately for 6 months in the majority of patients. Further investigations are required to establish the safety of IVTA for the treatment of DME.

  10. Effect of acute postural variation on diabetic macular oedema

    DEFF Research Database (Denmark)

    Vinten, Martin; la Cour, Morten; Lund-Andersen, Henrik

    2010-01-01

    This study aimed to study the pathophysiology of diabetic macular oedema (DMO) by analysis of concomitant changes in macular volume (MV), mean arterial blood pressure (MABP), intraocular pressure (IOP), and retinal artery and vein diameters in response to acute postural changes in patients with DMO...

  11. Development and comparison of a minimally-invasive model of autologous clot pulmonary embolism in Sprague-Dawley and Copenhagen rats

    Directory of Open Access Journals (Sweden)

    Sanapareddy Nina

    2010-02-01

    Full Text Available Abstract Background Experimental models of pulmonary embolism (PE that produce pulmonary hypertension (PH employ many different methods of inducing acute pulmonary occlusion. Many of these models induce PE with intravenous injection of exogenous impervious objects that may not completely reproduce the physiological properties of autologous thromboembolism. Current literature lacks a simple, well-described rat model of autlogous PE. Objective: Test if moderate-severity autologous PE in Sprague-Dawley (SD and Copenhagen (Cop rats can produce persistent PH. Methods blood was withdrawn from the jugular vein, treated with thrombin-Ca++ and re-injected following pretreatment with tranexamic acid. Hemodynamic values, clot weights and biochemical measurements were performed at 1 and 5 days. Results Infusion of clot significantly increased the right ventricular peak systolic pressure to 45-55 mm Hg, followed by normalization within 24 hours in SD rats, and within 5 days in COP rats. Clot lysis was 95% (24 hours and 97% (5 days in SD rats and was significantly lower in COP rats (70%, 24 hours; 87% 5 days. Plasma D-dimer was elevated in surgical sham animals and was further increased 8 hours after pulmonary embolism. Neither strain showed a significant increase in bronchoalveolar chemotactic activity, myeloperoxidase activity, leukocyte infiltration, or chemokine accumulation, indicating that there was no significant pulmonary inflammation. Conclusions Both SD and COP rats exhibited near complete fibrinolysis of autologous clot PE within 5 days. Neither strain developed persistent PH. Experimental models of PE designed to induce sustained PH and a robust inflammatory response appear to require significant, persistent pulmonary vascular occlusion.

  12. Bone marrow oedema - an early form of necrosis of the head of femur. Knochenmarkoedem - Fruehform der Hueftkopfnekrose

    Energy Technology Data Exchange (ETDEWEB)

    Neuhold, A [Inst. fuer Bildgebende Diagnostik, Krankenhaus Rudolfinerhaus, Vienna (Austria); Hofmann, S [Universitaetsklinik fuer Orthopaedie, Vienna (Germany); Engel, A [Universitaetsklinik fuer Orthopaedie, Vienna (Germany); Leder, K [2. Abt. des Orthopaedischen Krankenhauses Speising, Vienna (Austria); Kramer, J [Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria); Stiskal, M [Inst. fuer Bildgebende Diagnostik, Krankenhaus Rudolfinerhaus, Vienna (Austria); Plenk, H [Inst. fuer Osteologie der AUVA, Vienna (Austria); Wicke, L [Inst. fuer Bildgebende Diagnostik, Krankenhaus Rudolfinerhaus, Vienna (Austria)

    1993-08-01

    We examined 15 patients (16 hips) with painful hips whose radiographs were either normal (n=9) or showed a minimal decrease in radiodensity (n=7). The available bone scintigrams of 9 cases were positive. T[sub 1]-weighted images visualised a diffuse signal loss of the bone marrow in all hips, with various extensions in the head, neck, and intertrochanteric area. These regions were hyperintensive on T[sub 2]-weighted images. Focal anomalies were not seen in any of the cases. All patients underwent core decompression treatment. Histology of 13 hips confirmed not only the presence of bone marrow oedema but of bone changes corresponding to those of avascular necrosis. Follow-up examinations with MR after core decompression showed normal signal intensity in all cases. Magnetic resonance represents a viable diagnostic tool for identifying bone marrow oedema. Due to our histological results bone marrow oedema should be included in the differential diagnosis as an early stage of necrosis of the hip. (orig.)

  13. Pulmonary and central nervous system pathology in fatal cases of hand foot and mouth disease caused by enterovirus A71 infection.

    Science.gov (United States)

    Wang, Zijun; Nicholls, John M; Liu, Fengfeng; Wang, Joshua; Feng, Zijian; Liu, Dongge; Sun, Yanni; Zhou, Cheng; Li, Yunqian; Li, Hai; Qi, Shunxiang; Huang, Xueyong; Sui, Jilin; Liao, Qiaohong; Peiris, Malik; Yu, Hongjie; Wang, Yu

    2016-04-01

    In the past 17 years, neurological disease associated with enterovirus A71 (EV-A71) has increased dramatically in the Asia-Pacific region with a high fatality rate in young infants, often due to pulmonary oedema, however the mechanism of this oedema remains obscure. We analysed the brainstem, heart and lungs of 15 fatal cases of confirmed EV-A71 infection in order to understand the pathophysiological mechanism of death and pulmonary oedema. In keeping with other case studies, the main cause of death was neurogenic pulmonary oedema. In the brainstem, 11 cases showed inflammation and all cases showed parenchymal inflammation with seven cases showing moderate or severe clasmatodendrosis. No viral antigen was detected in sections of the brainstem in any of the cases. All fatal cases showed evidence of pulmonary oedema; however, there was absence of direct pulmonary viral damage or myocarditis-induced damage and EV-A71 viral antigen staining was negative. Though there was no increase in staining for Na/K-ATPase, 11 of the 15 cases showed a marked reduction in aquaporin-4 staining in the lung, and this reduction may contribute to the development of fatal pulmonary oedema. Copyright © 2016. Published by Elsevier B.V.

  14. [Cystoid macular oedema after fingolimod treatment in multiple sclerosis].

    Science.gov (United States)

    Asensio-Sánchez, V M; Trujillo-Guzmán, L; Ramoa-Osorio, R

    2014-03-01

    A woman, treated with immunomodulatory and immunosuppressive drugs for multiple sclerosis, developed macular oedema 4 months after oral fingolimod administration. The patient was previously seen by an ophthalmologist, with a normal anterior segment and funduscopic examination. Four months after the treatment she referred to decreased visual acuity in both eyes. The funduscopic and OCT examination now revealed cystoid macular oedema (CME). Attention to visual changes and periodic funduscopic examinations are an important part of monitoring while using fingolimod. In our patient early recognition and discontinuation of fingolimod did not result in resolution of the CME. Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  15. Computed tomography in deep venous thrombosis with limb oedema

    International Nuclear Information System (INIS)

    Seem, E.; Stranden, E.; Stiris, M.G.; Aker Sykehus, Oslo

    1985-01-01

    Computed tomography was used in 12 patients to investigate the distribution of oedema in the soft tissue compartments of lower limbs with deep venous thrombosis. Oedema was evenly distributed throughout the subcutis and the muscular compartments in tomograms obtained 25 cm proximal to the ankle. Significantly less swelling in the muscular compartments was found 10 cm proximal to the ankle. Interstitial fluid hydrostatic pressure was measured in the subcutis, and in anterior and posterior muscular compartments, and was significantly increased in all cases. Except for one case, the recorded pressures were well below 30 mmHg, which is considered the limit above which compartment syndromes occur. Tissue compliance was significantly lower in muscular compartments than in the subcutis. (orig.)

  16. Photocoagulation treatment for clinically significant radiation macular oedema

    Energy Technology Data Exchange (ETDEWEB)

    Kinyoun, J.L.; Zamber, R.W.; Lawrence, B.S.; Barlow, W.E.; Arnold, A.M. [Washington Univ., Seattle, WA (United States)

    1995-02-01

    Macular oedema is a leading cause of vision loss in patients with radiation retinopathy. In an effort to find an effective treatment for this vision threatening complication, 12 eyes (eight patients) were treated with photocoagulation for clinically significant radiation macular oedema (CSRMO) defined as central macular thickening, exudates threatening the macular centre, or one disc area of thickening in the macula. Median visual acuity improved from 20/100 pre-operatively to 20/90 at the initial post-operative examination (mean follow up 5 months) and to 20/75 at the final post-operative examination (mean follow up 39 months). At the final post-operative examination, visual acuity had improved in eight (67%) eyes and six (50%) eyes had complete resolution of the CSRMO; two (17%) other eyes had improved anatomically in that fewer CSRMO criteria were present. These results suggest that macular photocoagulation is effective in decreasing macular oedema and improving vision in eyes with CSRMO. (author).

  17. Photocoagulation treatment for clinically significant radiation macular oedema

    International Nuclear Information System (INIS)

    Kinyoun, J.L.; Zamber, R.W.; Lawrence, B.S.; Barlow, W.E.; Arnold, A.M.

    1995-01-01

    Macular oedema is a leading cause of vision loss in patients with radiation retinopathy. In an effort to find an effective treatment for this vision threatening complication, 12 eyes (eight patients) were treated with photocoagulation for clinically significant radiation macular oedema (CSRMO) defined as central macular thickening, exudates threatening the macular centre, or one disc area of thickening in the macula. Median visual acuity improved from 20/100 pre-operatively to 20/90 at the initial post-operative examination (mean follow up 5 months) and to 20/75 at the final post-operative examination (mean follow up 39 months). At the final post-operative examination, visual acuity had improved in eight (67%) eyes and six (50%) eyes had complete resolution of the CSRMO; two (17%) other eyes had improved anatomically in that fewer CSRMO criteria were present. These results suggest that macular photocoagulation is effective in decreasing macular oedema and improving vision in eyes with CSRMO. (author)

  18. Cervical facet oedema: prevalence, correlation to symptoms, and follow-up imaging

    International Nuclear Information System (INIS)

    Nevalainen, M.T.; Foran, P.J.; Roedl, J.B.; Zoga, A.C.; Morrison, W.B.

    2016-01-01

    Aim: To evaluate the prevalence of cervical facet oedema in patients referred for magnetic resonance imaging (MRI) to investigate neck pain and/or radiculopathy, and to investigate whether there is a correlation between the presence of oedema and patients' symptoms. Materials and methods: A retrospective report review of 1885 patients undergoing cervical spine MRI between July 2008 and June 2015 was performed. Exclusion criteria included acute trauma, surgery, neoplastic disease, or infection in the cervical spine. One hundred and seventy-three MRI studies with cervical facet oedema were evaluated by each of the two radiologists. In these patients, the grade of bone marrow oedema (BMO) and corresponding neuroforaminal narrowing at the cervical facets was assessed. Correlation with symptoms was performed based on pre-MRI questionnaire. Results: The prevalence of cervical facet oedema was 9%; the most commonly affected levels were C3–4, C4–5, and C2–3. A total of 202 cervical facets were evaluated: mild BMO was seen in 35%, moderate in 41%, and severe in 24% of cases. Surrounding soft-tissue oedema was observed in 36%, 69%, and 92% of the BMO grades, respectively. The correlations between unilateral radiculopathy and ipsilateral facet BMO grades were 79%, 83%, and 73% (chi-square, p<0.001), respectively. Furthermore, neuroforaminal narrowing on the corresponding level was found in 35%, 38%, and 11% of cases, respectively. At follow-up imaging, facet oedema was most likely to remain unchanged or to decrease. Conclusion: The prevalence of cervical facet oedema is 9%. Cervical facet oedema is associated with ipsilateral radiculopathy. Neuroforaminal narrowing, however, is not associated with facet oedema. - Highlights: • Association between the cervical facet oedema and cervical radiculopathy was studied. • Prevalence of the cervical facet oedema was 9%. • Facet oedema was associated with radiculopathy regardless of the degree of oedema. • Neuroforaminal

  19. Risk factors influencing the treatment outcome in diabetic macular oedema

    Directory of Open Access Journals (Sweden)

    Gupta Amod

    1996-01-01

    Full Text Available A multivariate analysis was done on 96 eyes to evaluate the effect of various risk factors on the final visual outcome after laser photocoagulation for clinically significant macular oedema (CSME in diabetic retinopathy. Advanced age of the patient, large size of CSME and poor baseline visual acuity were found to be significantly associated with poorer outcome (p<0.05. The association of nephropathy and hypertension with poorer visual outcome was of boderline significance (p = 0.054 and 0.07, respectively. Wavelength of the laser (argon or krypton used for treatment did not significantly influence the outcome.

  20. Retinitis pigmentosa sine pigmenti. Debut with macular oedema.

    Science.gov (United States)

    de la Mata Pérez, G; Ruiz-Moreno, O; Fernández-Pérez, S; Torrón Fernández-Blanco, C; Pablo-Júlvez, L

    2014-09-01

    A 25-year-old woman, with metamorphopsia in her left eye of one year onset. The examination revealed a bilateral cystoid macular oedema (CME) and vascular attenuation. We describe the diagnostic tests, as well as differential diagnosis and treatment response with carbonic anhydrase inhibitors. The retinitis pigmentosa sine pigment is a subtype of atypical retinitis pigmentosa characterised by the absence of pigment deposits. The night blindness is milder, and perimetric and electroretinographic impairment is lower. CME is an important cause of central vision loss, and responds to anhydrase carbonic inhibitors. Copyright © 2012 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  1. Pulmonary edema

    Science.gov (United States)

    ... congestion; Lung water; Pulmonary congestion; Heart failure - pulmonary edema ... Pulmonary edema is often caused by congestive heart failure . When the heart is not able to pump efficiently, blood ...

  2. Incidence of upper limb oedema in patients with acute hemiparetic stroke.

    Science.gov (United States)

    Gebruers, Nick; Truijen, Steven; Engelborghs, Sebastiaan; De Deyn, Peter Paul

    2011-01-01

     Assessment of the incidence of upper limb oedema in an acute care setting by means of clinical and volumetric evaluation.  Patients with acute hemiparetic stroke were recruited from 2006 until 2009 (n = 125). Baseline measurements consisted of the National Institute of Health Stroke Scale, Fugl-Meyer Assessment Arm Section and demographic characteristics. Oedema assessment was performed at 7 days after inclusion and at 1 month and 3 months follow-up. A standardised water displacement method (objective measurement) was used to define oedema and was compared to data from visual inspection and palpation (subjective measurement).  In literature, the incidence of upper limb oedema ranges from 16-83%, defined by a variety of definitions. Oedema incidence in this study was defined by strict criteria using water displacement and ranged from 9-13.9%, while the incidence of oedema defined by visual inspection and palpation ranged from 6-18.5% during the different stages of follow-up. The agreement (Kappa) between both measurements ranged from 0.23-0.38, which is not more than 'moderate' but comparable to the agreement of 0.34 found in literature.  An objective and subjective assessment of oedema was used; the agreement between both methods was only moderate. The incidence of oedema found in this study is lower than the incidences found in literature.

  3. Quincke's oedema of the uvula associated with mucous retention cyst-a case report.

    Science.gov (United States)

    Arunachalam, P S; Ramachandra, C R

    2000-04-01

    We report a rare case of recurrent angioedema of uvula (Quincke's Oedema), causing air way obstruction. A brief review of literature and treatment options are alto included. The histoloigical specimen showed an associated mucous retention eyst, which in conjunction with Quinckc's oedema has not been previously reported.

  4. Quincke’s oedema of the uvula associated with mucous retention cyst-a case report

    OpenAIRE

    Arunachalam, P. S.; Ramachandra, C. R. S.

    2000-01-01

    We report a rare case of recurrent angioedema of uvula (Quincke’s Oedema), causing air way obstruction. A brief review of literature and treatment options are alto included. The histoloigical specimen showed an associated mucous retention eyst, which in conjunction with Quinckc’s oedema has not been previously reported.

  5. Computed tomography in the evaluation of the lower leg oedema treated by intermittent pneumatic compression

    International Nuclear Information System (INIS)

    Airaksinen, O.; Partanen, K.; Kolari, P.J.; Soimakallio, S.

    1990-01-01

    The intermittent pneumatic compression (IPC) therapy has been used in post-traumatic rehabilitation of fractures of crusis, and it has reduced the oedema as measured immediately after the treatment. The purpose of the present study was to assess the amount of oedema, and its distribution with CT in lower leg fracture patients before and after IPC treatment (author). 6 refs. 2 tabs

  6. Predictors of oedema among children hospitalized with severe acute malnutrition in Jimma University Hospital, Ethiopia

    DEFF Research Database (Denmark)

    Girma, Tsinuel; Kæstel, Pernille; Mølgaard, Christian

    2013-01-01

    Severe acute malnutrition has two main clinical manifestations, i.e., oedematous and non-oedematous. However, factors of oedema are not well established.......Severe acute malnutrition has two main clinical manifestations, i.e., oedematous and non-oedematous. However, factors of oedema are not well established....

  7. Oedema disease is associated with metabolic acidosis and small intestinal acidosis

    NARCIS (Netherlands)

    Nabuurs, M.J.A.; Weijgert, van de E.; Grootendorst, A.F.; Niewold, T.A.

    2001-01-01

    Limited information is available about the pathogenesis and pathophysiology of oedema disease (OD). Oedema disease is caused by specific enterotoxemic Escherichia coli (SLTIIv-toxin producing) strains; however, the same strains are also found in non-afflicted pigs. Furthermore, it is unclear how the

  8. Pulmonary hypoplasia-diaphragmatic hernia-anophthalmia-cardiac defect (PDAC) syndrome due to STRA6 mutations--what are the minimal criteria?

    Science.gov (United States)

    Segel, Reeval; Levy-Lahad, Ephrat; Pasutto, Francesca; Picard, Elie; Rauch, Anita; Alterescu, Gheona; Schimmel, Michael S

    2009-11-01

    Microphthalmic syndrome 9 (OMIM601186) is a genetically and phenotypically variable condition, comprising anophthalmia, pulmonary hypoplasia, diaphragmatic hernia, and cardiac malformations (PDAC syndrome). Reported cases have all been associated with fetal/neonatal death or developmental delay. Recessive stimulated by retinoic acid gene 6 homolog (STRA6) mutations have recently been identified as the cause of cases of PDAC in which distinct, "bushy" eyebrows have been observed. We describe a patient with clinical anophthalmia, bushy eyebrows, patent ductus arteriosus, and normal development at age 30 months, who is a compound heterozygote for two novel STRA6 missense mutations. This patient's phenotype is consistent with the multisystemic malformations of PDAC syndrome, but is somewhat milder. This is the first living patient with compound heterozygous STRA6 mutations, which may explain her milder phenotype. We conclude that STRA6 analysis should be considered in all patients with clinical anophthalmia. Genetic counseling should be cautious with respect to long-term developmental outcomes. Copyright 2009 Wiley-Liss, Inc.

  9. Minimally invasive surgery using the open magnetic resonance imaging system combined with video-assisted thoracoscopic surgery for synchronous hepatic and pulmonary metastases from colorectal cancer: report of four cases.

    Science.gov (United States)

    Sonoda, Hiromichi; Shimizu, Tomoharu; Takebayashi, Katsushi; Ohta, Hiroyuki; Murakami, Koichiro; Shiomi, Hisanori; Naka, Shigeyuki; Hanaoka, Jun; Tani, Tohru

    2015-05-01

    Simultaneous resection of hepatic and pulmonary metastases (HPM) from colorectal cancer (CRC) has been reported to be effective, but it is also considered invasive. We report the preliminary results of performing minimally invasive surgery using the open magnetic resonance (MR) imaging system to resect synchronous HPM from CRC in four patients. All four patients were referred for thoracoscopy-assisted interventional MR-guided microwave coagulation therapy (T-IVMR-MCT) combined with video-assisted thoracoscopic surgery (VATS). The median diameters of the HPM were 18.2 and 23.2 mm, respectively. The median duration of VATS and T-IVMR-MCT was 82.5 and 139 min, respectively. All patients were discharged without any major postoperative complications. One patient was still free of disease at 24 months and the others died of disease progression 13, 36, and 47 months without evidence of recurrence in the treated area. Thus, simultaneous VATS + T-IVMR-MCT appears to be an effective option as a minimally invasive treatment for synchronous HPM from CRC.

  10. Does comprilan bandage have any influence on peripheral perfusion in patients with oedema?

    DEFF Research Database (Denmark)

    Midttun, M; Ahmadzay, N F; Henriksen, J H

    2010-01-01

    Comprilan bandage may be an attractive treatment of leg oedema, but theoretically bandage could compromise peripheral circulation. The present study was undertaken to investigate circulation in the first toe before, during, and after treatment with comprilan bandage. METHODS AND STUDY POPULATION......: Blood flow rate was measured by the heat-washout method in the pulp of the first toe of 10 patients (eight women, two men, aged 75-94) with leg oedemas, and systolic toe blood pressure was determined by the strain gauge method. Oedema was scored according to a visual scale, and the patients were treated...

  11. Left Circumflexus Coronary Artery Total Occlusion with Clinical Presentation as NSTEMI and Acute Pulmonary Oedema

    Directory of Open Access Journals (Sweden)

    Budi Yuli Setianto

    2017-04-01

    Full Text Available Current guidelines for the management of patients with acute coronary syndromes (ACSs focus on the electrocardiogram to divide patients into ST-elevation acute myocardial infarction (STEMI or non-ST-elevation acute myocardial infarction (NSTEMI/unstable angina (UA. Patients with STEMI in the earliest time will receive reperfusion therapy to destruct occlusive thrombus. An ST segment elevation is the ‘sine qua non’ for diagnosing acute total coronary occlusion causing transmural myocardial infarction. Left circumflex coronary artery (LCx occlusion is often categorized as NSTEMI because of the absence of significant ST-elevation on the 12 lead standard electrocardiogram. An ST segment elevation is presented in fewer than 50% of patients with LCx total occlusion, such that the reperfusion therapy is delayed. We reported a 77 years old woman whom being diagnosed with NSTEMI because a 12 lead electrocardiogram showed ST segment depression in lead V2-V5. On coronary angiography, we found a total occlusion in the LCx artery as the culprit lession.

  12. Donor dopamine treatment limits pulmonary oedema and inflammation in lung allografts subjected to prolonged hypothermia

    NARCIS (Netherlands)

    Hanusch, Christine; Nowak, Kai; Toerlitz, Patrizia; Gill, Ishar S.; Song, Hui; Rafat, Neysan; Brinkkoetter, Paul T.; Leuvenink, Henri G.; Van Ackern, Klaus C.; Yard, Benito A.; Beck, Grietje C.

    2008-01-01

    Background. Endothelial barrier dysfunction severely compromises organ function after reperfusion. Because dopamine pretreatment improves hypothermia mediated barrier dysfunction, we tested the hypothesis that dopamine treatment of lung allografts positively affects tissue damage associated with

  13. Pulmonary tuberculosis

    Science.gov (United States)

    TB; Tuberculosis - pulmonary; Mycobacterium - pulmonary ... Pulmonary TB is caused by the bacterium Mycobacterium tuberculosis (M tuberculosis) . TB is contagious. This means the bacteria is easily spread from an infected person ...

  14. Pituitary apoplexy with optic tract oedema and haemorrhage in a patient with idiopathic thrombocytopenic purpura

    International Nuclear Information System (INIS)

    Lenthall, R.; Jaspan, T.

    2001-01-01

    Bilateral optic tract oedema, left optic tract haemorrhage and subarachnoid haemorrhage occurred in a 70-year-old man with pituitary apoplexy associated with idiopathic thrombocytopenic purpura. Left optic tract haemorrhage was confirmed on MRI. (orig.)

  15. Subacute mandibular and hypoglossal nerve denervation causing oedema of the masticator space and tongue

    International Nuclear Information System (INIS)

    Ho, T.; Lee, K.; Lee, H.

    2003-01-01

    We report the MRI of five patients with denervation oedema in the head and neck. Four had denervation oedema in one masticator space caused by a skull-base tumour invading the ipsilateral foramen ovale. Another case had denervation oedema confined to the half of the tongue ipsilateral to oral reconstruction surgery which involved mandibulectomy, free flap repair and wide excision of a buccal mucosal carcinoma. Inversion-recovery and/or T2-weighted spin-echo images showed increased signal in the affected areas. Contrast-enhanced T1-weighted images revealed enhancement of the muscles. There was no evidence of tumour or infection in the masticator space or tongue. It is important to differentiate denervation oedema from other disease processes causing high signal on T2-weighted images, such as tumour infiltration and soft-tissue infection. (orig.)

  16. Sustained postinfarction myocardial oedema in humans visualised by magnetic resonance imaging

    DEFF Research Database (Denmark)

    Nilsson, J C; Nielsen, G; Grønning, Bjørn Aaris

    2001-01-01

    OBJECTIVE: To demonstrate postinfarction myocardial oedema in humans with particular reference to the longitudinal course, using magnetic resonance imaging (MRI). DESIGN: Prospective observational study. Subjects were studied one week, one month, three months, six months, and one year after...... presenting with a myocardial infarct. SETTING: Cardiology and magnetic resonance departments in a Danish university hospital. PATIENTS: 10 patients (three women, seven men), mean (SEM) age 58.2 (3.20) years, with a first transmural myocardial infarct. MAIN OUTCOME MEASURES: Location and duration...... of postinfarction myocardial oedema. RESULTS: All patients had signs of postinfarction myocardial oedema. The magnetic resonance images were evaluated by two blinded procedures, employing two MRI and two ECG observers: (1) MRI determined oedema location was compared with the ECG determined site of infarction...

  17. Is the 1-minute sit-to-stand test a good tool for the evaluation of the impact of pulmonary rehabilitation? Determination of the minimal important difference in COPD

    Directory of Open Access Journals (Sweden)

    Vaidya T

    2016-10-01

    Full Text Available Trija Vaidya,1,2 Claire de Bisschop,2 Marc Beaumont,3,4 Hakima Ouksel,5 Véronique Jean,6 François Dessables,7 Arnaud Chambellan,1,8 On behalf of IRSR RéhaEffort cohort group 1Explorations Fonctionnelles Respiratoires, l’institut du thorax, CHU de Nantes, 2Université de Poitiers, Laboratoire MOVE EA 6314, F-86000 Poitiers, 3Pulmonary Rehabilitation Unit, Morlaix Hospital Centre, 4European University of Occidental Brittany, EA3878, Brest, 5Service de Pneumologie, CHU d’Angers, Angers, 6Service de Réhabilitation Respiratoire, Soins de Suite et Rééducation, CHU de Nantes, 7Service de Réhabilitation Respiratoire, la Tourmaline, UGECAM, 8Université de Nantes, Laboratory EA 4334 “Mouvement, Interactions, Performance,” Nantes, France Background: The 1-minute sit-to-stand (STS test could be valuable to assess the level of exercise tolerance in chronic obstructive pulmonary disease (COPD. There is a need to provide the minimal important difference (MID of this test in pulmonary rehabilitation (PR.Methods: COPD patients undergoing the 1-minute STS test before PR were included. The test was performed at baseline and the end of PR, as well as the 6-minute walk test, and the quadriceps maximum voluntary contraction (QMVC. Home and community-based programs were conducted as recommended. Responsiveness to PR was determined by the difference in the 1-minute STS test between baseline and the end of PR. The MID was evaluated using distribution and anchor-based methods.Results: Forty-eight COPD patients were included. At baseline, the significant predictors of the number of 1-minute STS repetitions were the 6-minute walk distance (6MWD (r=0.574; P<10-3, age (r=-0.453; P=0.001, being on long-term oxygen treatment (r=-0.454; P=0.017, and the QMVC (r=0.424; P=0.031. The multivariate analysis explained 75.8% of the variance of 1-minute STS repetitions. The improvement of the 1-minute STS repetitions at the end of PR was 3.8±4.2 (P<10-3. It was mainly

  18. Clinical relevance of quantified fundus autofluorescence in diabetic macular oedema.

    Science.gov (United States)

    Yoshitake, S; Murakami, T; Uji, A; Unoki, N; Dodo, Y; Horii, T; Yoshimura, N

    2015-05-01

    To quantify the signal intensity of fundus autofluorescence (FAF) and evaluate its association with visual function and optical coherence tomography (OCT) findings in diabetic macular oedema (DMO). We reviewed 103 eyes of 78 patients with DMO and 30 eyes of 22 patients without DMO. FAF images were acquired using Heidelberg Retina Angiograph 2, and the signal levels of FAF in the individual subfields of the Early Treatment Diabetic Retinopathy Study grid were measured. We evaluated the association between quantified FAF and the logMAR VA and OCT findings. One hundred and three eyes with DMO had lower FAF signal intensity levels in the parafoveal subfields compared with 30 eyes without DMO. The autofluorescence intensity in the parafoveal subfields was associated negatively with logMAR VA and the retinal thickness in the corresponding subfields. The autofluorescence levels in the parafoveal subfield, except the nasal subfield, were lower in eyes with autofluorescent cystoid spaces in the corresponding subfield than in those without autofluorescent cystoid spaces. The autofluorescence level in the central subfield was related to foveal cystoid spaces but not logMAR VA or retinal thickness in the corresponding area. Quantified FAF in the parafovea has diagnostic significance and is clinically relevant in DMO.

  19. Minimal surfaces

    CERN Document Server

    Dierkes, Ulrich; Sauvigny, Friedrich; Jakob, Ruben; Kuster, Albrecht

    2010-01-01

    Minimal Surfaces is the first volume of a three volume treatise on minimal surfaces (Grundlehren Nr. 339-341). Each volume can be read and studied independently of the others. The central theme is boundary value problems for minimal surfaces. The treatise is a substantially revised and extended version of the monograph Minimal Surfaces I, II (Grundlehren Nr. 295 & 296). The first volume begins with an exposition of basic ideas of the theory of surfaces in three-dimensional Euclidean space, followed by an introduction of minimal surfaces as stationary points of area, or equivalently

  20. Femoroacetabular impingement: bone marrow oedema associated with fibrocystic change of the femoral head and neck junction

    Energy Technology Data Exchange (ETDEWEB)

    James, S.L.J. [Department of Radiology, RNOH Stanmore, Stanmore, Middlesex (United Kingdom) and Department of Radiology, Royal Orthopaedic Hospital, Birmingham (United Kingdom)]. E-mail: jamesslj@email.com; Connell, D.A. [Department of Radiology, RNOH Stanmore, Stanmore, Middlesex (United Kingdom); O' Donnell, P. [Department of Radiology, RNOH Stanmore, Stanmore, Middlesex (United Kingdom); Saifuddin, A. [Department of Radiology, RNOH Stanmore, Stanmore, Middlesex (United Kingdom)

    2007-05-15

    Aim: To describe the association of bone marrow oedema adjacent to areas of fibrocystic change at the femoral head and neck junction in patients with femoroacetabular impingement. Materials and methods: The clinical and imaging findings in six patients with bone marrow oedema adjacent to an area of fibrocystic change at the femoral head and neck junction are presented. There were five males and one female (age range 19-42 years, mean age 34.5 years). Three patients were referred with a clinical suspicion of femoroacetabular impingement, two with suspected osteoid osteoma and one with a clinical diagnosis of sciatica. The volume of bone marrow oedema (grade 1: 0-25%, grade 2: 26-50%, grade 3: 51-75% and grade 4: 76-100% of the femoral neck width), presence of labral and articular cartilage abnormality, joint effusion, and femoral head and neck morphology were recorded. Results: Magnetic resonance imaging (MRI) identified fibrocystic change in the anterolateral aspect of the femoral head and neck junction in all cases (mean size 9 mm, range 5-14 mm, three multilocular and three unilocular cysts). The volume of oedema was variable (one grade 1, two grade 2, one grade 3 and two grade 4). All patients had abnormality of the anterosuperior labrum with five patients demonstrating chondral loss. An abnormal femoral head and neck junction was identified in five patients. Conclusion: The radiological finding of fibrocystic change at the anterosuperior femoral neck with or without bone marrow oedema should prompt the search for femoroacetabular impingement. Bone marrow oedema may rarely be identified adjacent to these areas of cystic change and should be considered in the differential diagnosis of bone marrow oedema in the femoral neck.

  1. Femoroacetabular impingement: bone marrow oedema associated with fibrocystic change of the femoral head and neck junction

    International Nuclear Information System (INIS)

    James, S.L.J.; Connell, D.A.; O'Donnell, P.; Saifuddin, A.

    2007-01-01

    Aim: To describe the association of bone marrow oedema adjacent to areas of fibrocystic change at the femoral head and neck junction in patients with femoroacetabular impingement. Materials and methods: The clinical and imaging findings in six patients with bone marrow oedema adjacent to an area of fibrocystic change at the femoral head and neck junction are presented. There were five males and one female (age range 19-42 years, mean age 34.5 years). Three patients were referred with a clinical suspicion of femoroacetabular impingement, two with suspected osteoid osteoma and one with a clinical diagnosis of sciatica. The volume of bone marrow oedema (grade 1: 0-25%, grade 2: 26-50%, grade 3: 51-75% and grade 4: 76-100% of the femoral neck width), presence of labral and articular cartilage abnormality, joint effusion, and femoral head and neck morphology were recorded. Results: Magnetic resonance imaging (MRI) identified fibrocystic change in the anterolateral aspect of the femoral head and neck junction in all cases (mean size 9 mm, range 5-14 mm, three multilocular and three unilocular cysts). The volume of oedema was variable (one grade 1, two grade 2, one grade 3 and two grade 4). All patients had abnormality of the anterosuperior labrum with five patients demonstrating chondral loss. An abnormal femoral head and neck junction was identified in five patients. Conclusion: The radiological finding of fibrocystic change at the anterosuperior femoral neck with or without bone marrow oedema should prompt the search for femoroacetabular impingement. Bone marrow oedema may rarely be identified adjacent to these areas of cystic change and should be considered in the differential diagnosis of bone marrow oedema in the femoral neck

  2. Computed chest tomography in rats with pulmonary damage due to microembolism

    Energy Technology Data Exchange (ETDEWEB)

    Wegener, T.; Wegenius, G.; Hemmingsson, A.; Jung, B.; Saldeen, T.

    Computed chest tomography was performed in 13 rats with pulmonary damage due to microembolism, caused by injection of thrombin (500 NIH/kg body weight) and tranexamic acid, a fibrinolytic inhibitor (200 mg/kg body weight), and in 9 control rats. The purpose of the investigation was to perform attenuation measurements at two levels of the right lung, each with three regions of interest (anterior, mid and posterior). Alterations in attenuation, compared with controls, were correlated with lung weight. Compared with controls, the attenuation was significantly increased in the anterior and posterior regions at both levels in animals with pulmonary damage, but not in the mid regions. There was a statistically significant correlation between increasing attenuation and increasing lung weight. A significant difference was found between damaged and control lungs regarding the microscopic grade of interstitial oedema, alveolar oedema and fibrin. Histograms of attenuation values in computed tomograms might be of value in detecting alveolar oedema. It is concluded that computed chest tomography is a good method for detection pulmonary oedema at an early stage of experimental microembolism in the rat.

  3. Computed chest tomography in rats with pulmonary damage due to microembolism

    International Nuclear Information System (INIS)

    Wegener, T.; Wegenius, G.; Hemmingsson, A.; Jung, B.; Saldeen, T.; Uppsala Univ.; Uppsala Univ.; Uppsala Univ.

    1986-01-01

    Computed chest tomography was performed in 13 rats with pulmonary damage due to microembolism, caused by injection of thrombin (500 NIH/kg body weight) and tranexamic acid, a fibrinolytic inhibitor (200 mg/kg body weight), and in 9 control rats. The purpose of the investigation was to perform attenuation measurements at two levels of the right lung, each with three regions of interest (anterior, mid and posterior). Alterations in attenuation, compared with controls, were correlated with lung weight. Compared with controls, the attenuation was significantly increased in the anterior and posterior regions at both levels in animals with pulmonary damage, but not in the mid regions. There was a statistically significant correlation between increasing attenuation and increasing lung weight. A significant difference was found between damaged and control lungs regarding the microscopic grade of interstitial oedema, alveolar oedema and fibrin. Histograms of attenuation values in computed tomograms might be of value in detecting alveolar oedema. It is concluded that computed chest tomography is a good method for detection pulmonary oedema at an early stage of experimental microembolism in the rat. (orig.)

  4. Intravitreal Bevacizumab and Triamcinolone for Treatment of Cystoid Macular Oedema Associated with Chronic Myeloid Leukaemia and Imatinib Therapy

    Directory of Open Access Journals (Sweden)

    Eric K. Newcott

    2015-01-01

    Full Text Available Purpose. To evaluate the efficacy of intravitreal bevacizumab and triamcinolone in the treatment of cystoid macular oedema in a case with chronic myeloid leukaemia on imatinib treatment. Methods. We treated a 78-year-old man with bilateral cystoid macular oedema with intravitreal triamcinolone and subsequent bevacizumab in one eye and intravitreal bevacizumab, alone, in the fellow eye. Results. Serial intravitreal bevacizumab with and without triamcinolone treated cystoid macular oedema in both eyes and improved the vision. Conclusion. Intravitreal bevacizumab and triamcinolone could be viable options to treat cystoid macular oedema due to chronic myeloid leukaemia and imatinib therapy.

  5. Histopathological perspective on bone marrow oedema, reactive bone change and haemorrhage

    International Nuclear Information System (INIS)

    Thiryayi, W.A.; Thiryayi, S.A.; Freemont, A.J.

    2008-01-01

    This article presents a systematic review of the current biomedical literature surrounding the aetiopathogenesis and histopathological features of bone marrow oedema, reactive bone change and haemorrhage. Bone marrow oedema is generally demonstrated as a non-specific finding on magnetic resonance imaging in association with infections, tumours and avascular necrosis. When it occurs in isolation as a primary event not triggered by any obvious bony pathology in the clinical setting of debilitating joint pain, it constitutes the 'bone marrow oedema syndrome'. Although the latter diagnosis is based on magnetic resonance (MR) imaging, showing the lesion as areas of signal hyperintensity within the marrow, recent radiology-histology correlational studies have shown variably interstitial marrow oedema, necrosis, fibrosis and trabecular bone abnormalities. In light of these facts, the use of the term bone marrow oedema syndrome in a radiological context might be considered questionable, but histopathological techniques are not sensitive in detecting increased extracellular fluid. Reactive bone changes may be focal or diffuse and usually amount to increased bone formation. Bone marrow haemorrhage, due to trauma, results in bone bruising, a condition in which the size of the bruise and associated osteochondral injury determines the outcome, although the natural history of these lesions is still being researched

  6. Histopathological perspective on bone marrow oedema, reactive bone change and haemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Thiryayi, W.A.; Thiryayi, S.A. [Department of Histopathology, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL (United Kingdom); Freemont, A.J. [Division of Regenerative Medicine, University of Manchester, Oxford Road, Manchester M13 9PT (United Kingdom)], E-mail: tony.freemont@manchester.ac.uk

    2008-07-15

    This article presents a systematic review of the current biomedical literature surrounding the aetiopathogenesis and histopathological features of bone marrow oedema, reactive bone change and haemorrhage. Bone marrow oedema is generally demonstrated as a non-specific finding on magnetic resonance imaging in association with infections, tumours and avascular necrosis. When it occurs in isolation as a primary event not triggered by any obvious bony pathology in the clinical setting of debilitating joint pain, it constitutes the 'bone marrow oedema syndrome'. Although the latter diagnosis is based on magnetic resonance (MR) imaging, showing the lesion as areas of signal hyperintensity within the marrow, recent radiology-histology correlational studies have shown variably interstitial marrow oedema, necrosis, fibrosis and trabecular bone abnormalities. In light of these facts, the use of the term bone marrow oedema syndrome in a radiological context might be considered questionable, but histopathological techniques are not sensitive in detecting increased extracellular fluid. Reactive bone changes may be focal or diffuse and usually amount to increased bone formation. Bone marrow haemorrhage, due to trauma, results in bone bruising, a condition in which the size of the bruise and associated osteochondral injury determines the outcome, although the natural history of these lesions is still being researched.

  7. Intravitreal triamcinolone for the treatment of cystoid macular oedema

    Directory of Open Access Journals (Sweden)

    Aleksandra Kraut

    2005-10-01

    Full Text Available Background: Longstanding cystoid macular oedema (CME can result in loss of central vision, and there are only limited therapeutic possibilities. The aim of this article is to report clinical outcome of our patients with CME treated with intravitreal application of triamcinolone acetonide.Methods: Prospective clinical interventional non-comparative case study of patients, treated for CME in 2004 in Eye Clinic of Ljubljana. There were 15 patients (16 eyes in the 1–16 months follow-up study. Patients received an intravitreal injection of 4 mg (0,1 ml triamcinolone acetonide transconjunctivally with topical anesthesia. The visual and anatomic responses were observed as well as related potentional complications.Results: Causes of CME were: cataract surgery in 6 patients, branch retinal vein occlusion in 5 patients, uveitis in 2 patients, and diabetes and age related macular degeneration respectively in one patient. Age of patients was between 27 to 85 years, mean 69 years. Visual acuity before the treatment was from 0.017 to 0.6, mean 0.2. After the treatment visual acuity was from 0.017 to 1.0, mean 0.32. In patient series after cataract operation mean visual acuity before therapy was 0.12 and final 0.36, and in uveitis group 0.32 and final 0.42. In other CME forms there was insignificant visual improvement. In 2 patients (13% increased intraocular preasure was found and treatment with topical ocular hypertensive agents was sufficient. In one patient progressive cataract was established, and in one patient retinal fibrosis in the macula and around thrombotic vein was found.Conclusions: Intravitreal triamcinolone application is probably a good and safe therapeutic possibility for CME, the risk of serious adverse events considering good technique of injections is low. In our series of patients best results were found in patients after cataract surgery and uveitis. However, the observed series is too small to bring final conclusions.

  8. Clinical Immunology Review Series: An approach to the patient with angio-oedema

    Science.gov (United States)

    Grigoriadou, S; Longhurst, H J

    2009-01-01

    Angio-oedema is a common reason for attendance at the accident and emergency department and for referral to immunology/allergy clinics. Causative factors should always be sought, but a large proportion of patients have the idiopathic form of the disease. A minority of patients represent a diagnostic and treatment challenge. Failure to identify the more unusual causes of angio-oedema may result in life-threatening situations. Common and rare causes of angio-oedema will be discussed in this article, as well as the diagnostic and treatment pathways for the management of these patients. A comprehensive history and close monitoring of response to treatment are the most cost-effective diagnostic and treatment tools. PMID:19220828

  9. Comparative efficacy and safety of approved treatments for macular oedema secondary to branch retinal vein occlusion

    DEFF Research Database (Denmark)

    Regnier, Stephane A; Larsen, Michael; Bezlyak, Vladimir

    2015-01-01

    OBJECTIVE: To compare the efficacy and safety of approved treatments for macular oedema secondary to branch retinal vein occlusion (BRVO). DESIGN: Randomised controlled trials (RCTs) evaluating the efficacy and safety of approved treatments for macular oedema secondary to BRVO were identified from...... an updated systematic review. SETTING: A Bayesian network meta-analysis of RCTs of treatments for macular oedema secondary to BRVO. INTERVENTIONS: Ranibizumab 0.5 mg pro re nata, aflibercept 2 mg monthly (2q4), dexamethasone 0.7 mg implant, laser photocoagulation, ranibizumab+laser, or sham intervention...... pressure (IOP)/ocular hypertension (OH). RESULTS: 8 RCTs were identified for inclusion with 1743 adult patients. The probability of being the most efficacious treatment at month 6 or 12 based on letters gained was 54% for ranibizumab monotherapy, 30% for aflibercept, 16% for ranibizumab plus laser...

  10. Social, dietary and clinical correlates of oedema in children with severe acute malnutrition

    DEFF Research Database (Denmark)

    Rytter, Maren Johanne Heilskov; Namusoke, Hanifa; Babirekere-Iriso, Esther

    2015-01-01

    BACKGROUND: Severe acute malnutrition is a serious public health problem, and a challenge to clinicians. Why some children with malnutrition develop oedema (kwashiorkor) is not well understood. The objective of this study was to investigate socio-demographic, dietary and clinical correlates...... of oedema, in children hospitalised with severe acute malnutrition. METHODS: We recruited children with severe acute malnutrition admitted to Mulago Hospital, Uganda. Data was collected using questionnaires, clinical examination and measurement of blood haemoglobin, plasma c-reactive protein and α1-acid...... glycoprotein. Correlates of oedema were identified using multiple logistic regression analysis. RESULTS: Of 120 children included, 77 (64%) presented with oedematous malnutrition. Oedematous children were slightly older (17.7 vs. 15.0 months, p = 0.006). After adjustment for age and sex, oedematous children...

  11. Pulmonary Hypertension and Pulmonary Vasodilators.

    Science.gov (United States)

    Keller, Roberta L

    2016-03-01

    Pulmonary hypertension in the perinatal period can present acutely (persistent pulmonary hypertension of the newborn) or chronically. Clinical and echocardiographic diagnosis of acute pulmonary hypertension is well accepted but there are no broadly validated criteria for echocardiographic diagnosis of pulmonary hypertension later in the clinical course, although there are significant populations of infants with lung disease at risk for this diagnosis. Contributing cardiovascular comorbidities are common in infants with pulmonary hypertension and lung disease. It is not clear who should be treated without confirmation of pulmonary vascular disease by cardiac catheterization, with concurrent evaluation of any contributing cardiovascular comorbidities. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Radioisotopic and thermographic imaging of the lower limbs oedema - comparison diagnostic techniques

    International Nuclear Information System (INIS)

    Stepien, A.; Pawlus, J.; Nowak, E.; Kulka, J.; Gielzycki, J.; Kraft, O.

    2005-01-01

    In this paper, authors achieved comparison between lymphoscintigraphy and thermography in patients with limbs oedema. It allow to determinate current role of lymphoscintigraphy and verify useful of thermography in limbs oedema diagnosis. Analysis included 60 patients with the lower limbs oedema. Each patients Doppler duplex scan and thermographic study was performed. Additionally, 10 patients were classified to the lymphoscintigraphy. Thermography: In studies camera ThermaCAM S60 (FLIR SYSTEM) were used. Infrared radiation detector was 320 x 240 uncooled microbolometers with thermal resolution - 0.08 o C (for 30 o C). Lymphoscintigraphy: Each patient received subcutaneous, in the second web space, Nanosis (schering) labeled 99m Tc. Dynamic data acquisition has been started immediately after injection the radiotracer to the both extremities using digital gamma camera X Ring (Mediso). Static study of whole body was performed after 1.5 hour. Thermal disorders were observed in 58 patients. On the base ultrasound and clinical examinations 10 patients were classified to lymphoscintigraphy. In this group in 5 cases traits lymphatic insufficient were observed. Thermographic study in group of patients with scintigraphic disorders was showed regional hypothermia, with small regions of hypothermia in tissues included oedema. Lymphoscintigraphy is a useful and indispensable tool in oedema diagnosis. In patients with insufficient of lymphatic system, thermography comparison to lymphoscintigraphy, in clinical diagnosis did not influence on the future diagnosis and therapeutics proceedings. Regional hyperthermic disorders in patients with limbs oedema, who had negative results of examinations (Doppler duplex scan and lymphoscintigraphy), could indicate on inflammatory complications. In cases of venous insufficient thermography allow to visualize specific venous disorders. (author)

  13. Maternal endometrial oedema may increase perinatal mortality of cloned and transgenic piglets

    DEFF Research Database (Denmark)

    Schmidt, Mette; Winter, K.D.; Dantzer, Vibeke

    2011-01-01

    The perinatal mortality of cloned animals is a well-known problem. In the present retrospective study, we report on mortality of cloned transgenic or non-transgenic piglets produced as part of several investigations. Large White (LW) sows (n = 105) received hand-made cloned LW or minipig...... endometrial oedema in sows pregnant with cloned and transgenic piglets, as well as in empty recipients, at term. The growth of certain organs in some of the cloned piglets was reduced and the rate of stillborn piglets was greater in cloned and transgenic piglets delivered vaginally, possibly because of oedema...

  14. Local retinal sensitivity in relation to specific retinopathy lesions in diabetic macular oedema

    DEFF Research Database (Denmark)

    Soliman, Wael; Hasler, Pascal; Sander, Birgit

    2012-01-01

    with nonproliferative diabetic retinopathy and recently diagnosed untreated DMO. Investigations included microperimetry, fluorescein angiography, colour fundus photography, and OCT. All measures and gradings were made for each of the nine fields of an early treatment diabetic retinopathy study macula template......Purpose: To study microperimetric macular sensitivity in diabetic macular oedema (DMO) in relation to lesion characteristics obtained by optical coherence tomography (OCT), colour fundus photography, and fluorescein angiography (FA). Methods: The study comprised 20 eyes in 15 patients...... in foveal petaloid (r = -0.50, p = 0.02) and extrafoveal honeycomb patterns (r = -0.8, p detectable effect of focal noncystoid oedema...

  15. Serial diffusion-weighted imaging in a patient with MELAS and presumed cytotoxic oedema

    International Nuclear Information System (INIS)

    Wang, X.Y.; Noguchi, K.; Ogawa, S.; Seto, H.; Takashima, S.; Hayashi, N.

    2003-01-01

    A patient with mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) was studied with serial diffusion-weighted MRI (DWI) after stroke-like episodes and the apparent diffusion coefficient (ADC) was measured in an infarct-like lesion. In the acute and subacute stages, the affected area gave high signal on DWI and its ADC was much lower than that in a normal control region. In the chronic stage, the ADC became higher than that in normal brain. We therefore suggest that the stroke-like episodes did not cause vasogenic oedema but were related to energy failure and cytotoxic oedema. (orig.)

  16. Pulmonary complications of endocrine and metabolic disorders.

    Science.gov (United States)

    Milla, Carlos E; Zirbes, Jacquelyn

    2012-03-01

    There are many important respiratory manifestations of endocrine and metabolic diseases in children. Acute and chronic pulmonary infections are the most common respiratory abnormalities in patients with diabetes mellitus, although cardiogenic and non-cardiogenic pulmonary oedema are also possible. Pseudohypoaldosteronism type 1 may be indistinguishable from cystic fibrosis (CF) unless serum aldosterone, plasma renin activity, and urinary electrolytes are measured and mutation analysis rules out CF. Hypo- and hyperthyroidism may alter lung function and affect the central respiratory drive. The thyroid hormone plays an essential role in lung development, surfactant synthesis, and lung defence. Complications of hypoparathyroidism are largely due to hypocalcaemia. Laryngospasm can lead to stridor and airway obstruction. Ovarian tumours, benign or malignant, may present with unilateral or bilateral pleural effusions. Metabolic storage disorders, primarily as a consequence of lysosomal dysfunction from enzymatic deficiencies, constitute a diverse group of rare conditions that can have profound effects on the respiratory system. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. Introduction to Pulmonary Fibrosis

    Science.gov (United States)

    ... page: Introduction to Pulmonary Fibrosis What Is Pulmonary Fibrosis? Pulmonary fibrosis is a disease where there is scarring ... of pulmonary fibrosis. Learn more How Is Pulmonary Fibrosis Diagnosed? Pulmonary fibrosis can be difficult to diagnose, so it ...

  18. Fluid management of hypernatraemic dehydration to prevent cerebral oedema: a retrospective case control study of 97 children in China.

    Science.gov (United States)

    Fang, Chengqing; Mao, Jianhua; Dai, Yuwen; Xia, Yonghui; Fu, Haidong; Chen, Yifang; Wang, Yaping; Liu, Aimin

    2010-06-01

    To compare the fluid management of hypernatraemic dehydration in acute gastroenteritis in those who developed cerebral oedema (cases) versus those who did not (controls). A retrospective study of 97 cases of hypernatraemic dehydration at a tertiary children's hospital in China over five years, in which rehydration regimes of 49 children who developed cerebral oedema were compared with 48 children who made an uneventful recovery. Risk factors for cerebral oedema (vs. no cerebral oedema) were an initial fluid bolus (29/49 vs. 15/48, P=0.006), the mean rate of bolus infusion (14.7+/-2.2 vs. 10.8+/-1.4 mL/kg/hr, Pdehydration were too rapid a rate of rehydration, an initial fluid bolus to rapidly expand plasma volume and the severity of the hypernatraemia. Thus, we conclude that a uniformly slow rate of rehydration is the best way of preventing cerebral oedema.

  19. Diabetic macular oedema: under-represented in the genetic analysis of diabetic retinopathy.

    Science.gov (United States)

    Broadgate, Suzanne; Kiire, Christine; Halford, Stephanie; Chong, Victor

    2018-04-01

    Diabetic retinopathy, a complication of both type 1 and type 2 diabetes, is a complex disease and is one of the leading causes of blindness in adults worldwide. It can be divided into distinct subclasses, one of which is diabetic macular oedema. Diabetic macular oedema can occur at any time in diabetic retinopathy and is the most common cause of vision loss in patients with type 2 diabetes. The purpose of this review is to summarize the large number of genetic association studies that have been performed in cohorts of patients with type 2 diabetes and published in English-language journals up to February 2017. Many of these studies have produced positive associations with gene polymorphisms and diabetic retinopathy. However, this review highlights that within this large body of work, studies specifically addressing a genetic association with diabetic macular oedema, although present, are vastly under-represented. We also highlight that many of the studies have small patient numbers and that meta-analyses often inappropriately combine patient data sets. We conclude that there will continue to be conflicting results and no meaningful findings will be achieved if the historical approach of combining all diabetic retinopathy disease states within patient cohorts continues in future studies. This review also identifies several genes that would be interesting to analyse in large, well-defined cohorts of patients with diabetic macular oedema in future candidate gene association studies. © 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  20. Insulin oedema in a 9 year old child with type 1 diabetes mellitus: a ...

    African Journals Online (AJOL)

    Insulin oedema in a 9 year old child with type 1 diabetes mellitus: a case report. ... with Type 1 Diabetes Mellitus (T1DM) however, its clinical use is associated with ... in 1928.1 In the 1960's it was reported in two series from East Africa.2-3 and ...

  1. Early phacoemulsification in diabetic cataract for early recognition and management of diabetic macular oedema

    International Nuclear Information System (INIS)

    Wahab, S.; Rab, K. F. U.; Hargun, L. D.

    2013-01-01

    Objective: To get optimal visualization of fundus by early phacoemulsification in diabetic cataract for early recognition and management of diabetic macular oedema. Study Design: Interventional study. Place and Duration of Study: Ophthalmology Unit III, Sindh Government Lyari General Hospital and Dow University of Health Sciences and Al-Noor Eye Hospital, Karachi, from July 2008 to June 2009. Methodology: Patients with uncontrolled type-II diabetes mellitus of more than 10 years of duration were selected. Patients with clinical significant macular oedema (CSME), non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR) were excluded. Follow-up was done on day 1, 1 week, 1 month, 3 months and 6 months. Results: The male to female ratio was 1:1.44. Out of 218 patients; 129 (59.2%) were males and 89 (40.8%) were females. CSME was found in 82 patients (37.6%) at first postoperative week which declined to 29 cases (13.3%) at first month follow-up. Three subjects developed mild to moderate NPDR. In majority of the subjects, best corrected visual acuity (BCVA) gradually improved in each subsequent follow-up visit. Conclusion: Early phacoemulsification in diabetic cataract offers optimal posterior pole visualization and clears the ambiguity of decreased vision either caused by cataract or macular oedema. Uncomplicated phacoemulsification does not accelerate diabetic macular oedema or retinopathy provided glycemic control and co-morbids are well addressed. (author)

  2. Isolated Left Pulmonary Artery Agenesis: A Case Report

    Directory of Open Access Journals (Sweden)

    Tansel Ansal Balcı

    2012-08-01

    Full Text Available Unilateral pulmonary artery agenesis without any cardiovascular malformation is a rare anomaly. We present the imaging findings of a patient who was diagnosed as isolated left pulmonary artery agenesis. A 27-year-old female patient was admitted to our hospital due to dyspnea during exercise for five years. Chest X-ray revealed minimally small left pulmonary hilum and left lung. She was admitted to our clinic with the suspicion of pulmonary artery pathology. Absent perfusion of the left lung with normal ventilation was visualized on scintigraphy. MDCT angiography of pulmonary arteries showed absent left main pulmonary artery with systemic collaterals around left hemithorax. Pulmonary artery agenesis can be asymptomatic and isolated until adulthood. Both scintigraphy and CT angiography images of pulmonary artery agenesis of a patient are rare in the literature. Pulmonary ventilation- perfusion scintigraphy can be used not only for pulmonary embolism but also pathologies involving pulmonary artery and its branches. (MIRT 2012;21:80-83

  3. Taxonomic minimalism.

    Science.gov (United States)

    Beattle, A J; Oliver, I

    1994-12-01

    Biological surveys are in increasing demand while taxonomic resources continue to decline. How much formal taxonomy is required to get the job done? The answer depends on the kind of job but it is possible that taxonomic minimalism, especially (1) the use of higher taxonomic ranks, (2) the use of morphospecies rather than species (as identified by Latin binomials), and (3) the involvement of taxonomic specialists only for training and verification, may offer advantages for biodiversity assessment, environmental monitoring and ecological research. As such, formal taxonomy remains central to the process of biological inventory and survey but resources may be allocated more efficiently. For example, if formal Identification is not required, resources may be concentrated on replication and increasing sample sizes. Taxonomic minimalism may also facilitate the inclusion in these activities of important but neglected groups, especially among the invertebrates, and perhaps even microorganisms. Copyright © 1994. Published by Elsevier Ltd.

  4. Hereditary angio-oedema in Denmark: a nationwide survey

    DEFF Research Database (Denmark)

    Bygum, A

    2009-01-01

    diagnostic delay was 16.3 years. Five patients had HAE type II. Forty-five patients reported a characteristic serpiginous rash (erythema marginatum). More than 90% of patients had noticed precipitating factors before skin and mucosal swellings. Four patients underwent a total of eight tracheotomies and five...... families recalled 11 relatives who died of HAE. Conclusions The minimal prevalence of HAE in Denmark is approximately 1.41 per 100 000 inhabitants. The risk of upper airway obstruction underlines the importance of diagnosing these patients. Precipitating factors, a preceding or concomitant serpiginous...

  5. Pulmonary agenesis

    OpenAIRE

    Oyola, Mercedes; Pontificia Universidad Javeriana; Gordillo, Gisel; Pontificia Universidad Javeriana; García, Carlos A.; Pontificia Universidad Javeriana; Torres, David; Pontificia Universidad Javeriana

    2009-01-01

    Pulmonary agenesis is an infrequent pathology which occurs predominantly among females with no lateral preference. We report on the case of a newborn male diagnosed with prenatal diaphragm hernia though at birth seemed more likely either to be a congenital cystic adenomatoid malformation (congenital pulmonary airway malformation) or pulmonary agenesis. The patient died six days after birth and necropsy confirmed pulmonary agenesis. La agenesia pulmonar es una alteración poco frecuente, con...

  6. Pulmonary embolism: spiral CT evaluation; Embolie pulmonaire: apport de la tomodensitometrie helicoidale

    Energy Technology Data Exchange (ETDEWEB)

    Senac, J.P.; Vernhet, H.; Bousquet, C.; Giron, J.; Pieuchot, P.; Durand, G.; Benezet, O.; Aubas, P. [Centre Hospitalier Universitaire, 34 - Montpellier (France)

    1995-06-01

    Purpose: Spiral computed tomography was compared retrospectively with digital substraction pulmonary angiography (PA) in 45 patients suspected of having acute or chronic pulmonary embolism. Materials and method : 45 patients in whom the presence of acute or chronic pulmonary embolism was suspected underwent examination by spiral CT and PA. Diagnosis of pulmonary embolism was based on the direct visualization of intraluminal clots. The study of the agreement between the two methods was based on the Kappa test. In 35 cases, pulmonary emboli were proved. Acute pulmonary emboli were present in 28 cases and chronic in 7 cases. Results: Spiral computed tomography represents an excellent way to detect acute pulmonary embolism. In the chronic form, spiral CT is better than PA to detect intraluminal clots. However, Spiral CT can fail to detect small emboli in the peripheral arterial bed. In the 10 patients without pulmonary embolism, the spiral CT proved diagnosis pulmonary oedema (n=3), lymphangi-carcinoma (n=4), pleural effusion (n=3). Conclusion: This study suggest that the spiral CT examination is accurate for diagnosis of pulmonary embolism specifically in case of suspected important embolism. The advantages of spiral CT are multiple (non invasive, wide diagnosis spectrum). However, may be a limitation to is use is insufficient distal thrombi detection. This eventuality (5 to 10% in the Pioped study) justify the practice of pulmonary angiography. Spiral CT improvements should reduce this insufficiency in the next future. (Authors). 16 refs., 4 figs., 3 tabs.

  7. Oedema of the neck after ablation of the thyroid with radioactive iodine

    International Nuclear Information System (INIS)

    Goolden, A.W.G.; Kam, K.C.; Fitzpatrick, M.L.; Munro, A.J.

    1986-01-01

    Six out of 30 patients who underwent thyroid ablation with 131 I during the period 1975-85 developed acute oedema of the neck within 48 h of the therapeutic dose. The condition was painless and responded well to treatment with corticosteroids. The early onset and absence of pain distinguish this complication from radiation thyroiditis. Dosage calculations and thermoluminescent-dosemeter measurements of the dose at various points on the anterior surface of the neck of a patient with a toxic adenoma of the thyroid treated with 131 I were in fairly good agreement with one another and confirmed that the oedema of the neck could not be a direct effect of irradiation on the extrathyroidal tissues. It is suggested that this phenomenon may be a hypersensitivity reaction associated with massive destruction of thyroid tissue. (author)

  8. Correlation of MRI and histomorphological findings in bone marrow oedema syndrome of the hip

    International Nuclear Information System (INIS)

    Hofmann, S.; Kramer, J.; Leder, K.; Neuhold, A.; Plenk, H. Jr.; Engel, A.

    1993-01-01

    In 15 patients (16 hip joints) we found the clinical and radiological signs of BMOS. On T1-weighted MRI images areas of low signal intensity could be observed in the head, neck and the intertrochanteric region of the femur in various extensions. These areas showed a significant increase in signal intensity on the T2-weighted images. Because pain was resistant to conservative therapy all these patients were treated by core decompression of the femoral head in a prospective study. Bone cores were evaluated histologically using undecalcified sections and quantitative microradiography. The existence of intramedullary oedema in exactly the regions exhibiting the MRI pattern of bone marrow oedema was verified histologically; however, bone and marrow changes similar to those of early avascular necrosis (AVN) were also visible. (orig.)

  9. Correlation of MRI and histomorphological findings in bone marrow oedema syndrome of the hip

    Energy Technology Data Exchange (ETDEWEB)

    Hofmann, S [Orthopaedic University Clinic, Vienna (Austria); [Bone and Biomaterial Research Lab. of the Histology-Embryology Inst., Vienna (Austria); Kramer, J [MR Inst. of the University, Vienna (Austria); Leder, K [2. General Dept., Orthopaedic Hospital Speising, Vienna (Austria); Neuhold, A [Inst. for Imaging Diagnostics, Rudolfinerhaus Hospital, Vienna (Austria); Plenk, H Jr [Bone and Biomaterial Research Lab. of the Histology-Embryology Inst., Vienna (Austria); Engel, A [Orthopaedic University Clinic, Vienna (Austria)

    1993-10-01

    In 15 patients (16 hip joints) we found the clinical and radiological signs of BMOS. On T1-weighted MRI images areas of low signal intensity could be observed in the head, neck and the intertrochanteric region of the femur in various extensions. These areas showed a significant increase in signal intensity on the T2-weighted images. Because pain was resistant to conservative therapy all these patients were treated by core decompression of the femoral head in a prospective study. Bone cores were evaluated histologically using undecalcified sections and quantitative microradiography. The existence of intramedullary oedema in exactly the regions exhibiting the MRI pattern of bone marrow oedema was verified histologically; however, bone and marrow changes similar to those of early avascular necrosis (AVN) were also visible. (orig.)

  10. Necrosis of the head of femur and bone marrow oedema syndrome in pregnancy. Hueftkopfnekrose und Knochenmarksoedemsyndrom in der Schwangerschaft

    Energy Technology Data Exchange (ETDEWEB)

    Kramer, J [Vienna Univ. (Austria). MR-Inst. Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria); Hofmann, S [Orthopaedische Universitaetsklinik, Vienna (Austria) Forschungslabor fuer Knochen und Biomaterial, Vienna Univ. (Austria); Engel, A [Orthopaedische Universitaetsklinik, Vienna (Austria); Leder, K [Orthopaedisches Spital Speising, 2. Orthopaedische Abt., Vienna (Austria); Neuhold, A [Inst. fuere Bildgebende Diagnostik, Rudolfinerhaus, Vienna (Austria) Ludwig-Boltzmann-Inst. fuer Radiologische-Physikalische Tumordiagnostik, Vienna (Austria); Imhof, H [Vienna Univ. (Austria). MR-Inst. Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria)

    1993-08-01

    MR examinations were performed in 9 patients suffering from severe pain of the hip during the third trimenon without any relief after birth. Pathologic signal changes could be observed in 11 hips (oedema in the region of the femoral head and neck (n=8); avascular necrosis of the femoral head surrounded by bone marrow oedema (n=3)). In 7 hips a relatively rapid decrease of the oedema following core decompression was demonstrated. Focal necrosis, however, did not show any changes. In two patients, treated conservatively, markedly delayed healing was evident. MR imaging is the modality of choice for early diagnosis as well as follow-up of therapy of the bone marrow oedema syndrome or avascular necrosis and can be performed already during pregnancy. (orig.)

  11. Delayed oedema in the pyramidal tracts remote from intracerebral missile path following gunshot injury

    Energy Technology Data Exchange (ETDEWEB)

    Thiex, R.; Uhl, E. [Department of Neurosurgery, Aachen University, Pauwelsstrasse 30, 52057, Aachen (Germany); Thron, A. [Department of Neuroradiology, Aachen University, Pauwelsstrasse 30, 52057, Aachen (Germany)

    2004-02-01

    A 60-year-old man developed a severe left hemiparesis and central facial palsy, accompanied by somnolence and dysarthria 9 days after a gunshot wound to the right temporal region, from which he slowly recovered over 3 months. MRI disclosed bilateral oedema of the pyramidal tracts. This was interpreted as a consequence of the impact of the pressure wave caused by the bullet, after excluding an infectious or vascular cause. (orig.)

  12. Life-threatening hereditary angio-oedema: Challenges of care in South Africa.

    Science.gov (United States)

    Potter, P; Peter, J

    2018-03-28

    The report and description by Coovadia et al.[1] in this issue of SAMJ of a large cohort of patients in the Western Cape Province of South Africa (SA) suffering from type 1 hereditary angio-oedema (HAE) not only documents for the first time a significant presence of this life-threatening condition on the African continent but highlights the challenges of diagnosis and management in the SA socioeconomic and healthcare context.

  13. Diagnostic usefulness of the oedema-infarct ratio to differentiate acute from chronic myocardial damage using magnetic resonance imaging

    International Nuclear Information System (INIS)

    Yamada, Kiyoyasu; Suzuki, Susumu; Kinoshita, Kousuke; Yokouchi, Kazuhiko; Iwata, Hirokazu; Sawada, Ken; Isobe, Satoshi; Ohshima, Satoru; Murohara, Toyoaki; Hirai, Makoto

    2012-01-01

    To differentiate acute from chronic damage to the myocardium in patients with myocardial infarction (MI) using DE and T2w MR. Short-axis T2w and DE MR images were acquired twice after the onset of MI in 36 patients who successfully underwent emergency coronary revascularisation. The areas of infarct and oedema were measured. The oedema-infarct ratio (O/I) of the left ventricular area was calculated by dividing the oedema by the infarct area. The oedema size on T2w MR was significantly larger than the infarct size on DE MR in the acute phase. Both the oedema size on T2w MR and the infarct size on DE MR in the acute phase were significantly larger than those in the chronic phase. The O/I was significantly greater in the acute phase compared with that in the chronic phase (P < 0.05). An analysis of relative cumulative frequency distributions revealed an O/I of 1.4 as a cut-off value for differentiating acute from chronic myocardial damage with the sensitivity, specificity, and accuracy of 85.1%, 82.7% and 83.9%, respectively. The oedema-infarct ratio may be a useful index in differentiating acute from chronic myocardial damage in patients with MI. (orig.)

  14. Managing chronic oedema and wet legs in the community: a service evaluation.

    Science.gov (United States)

    Thomas, Melanie; Morgan, Karen; Humphreys, Ioan; Jehu, Diane; Jenkins, Linda

    2017-11-08

    Patients with chronic oedema and 'wet legs' are frequently seen in the community setting, with research indicating that more than half of community nurses' caseloads are patients with chronic oedema. However, a lack of nurse education and standardised care pathways for this condition has been identified. In June 2016, the Welsh Government supported the development of the On the Ground Education Project (OGEP), which aimed to raise community nurses' awareness and recognition of chronic oedema and wet legs, to improve the management of these conditions, and to support the efficient use of community nurses' time and resources. To investigate the potential economic benefits of the OGEP and its effects on patients' quality of life. The OGEP was implemented between June 2016 and March 2017. During this time, 725 patients were assessed and chronic oedema was diagnosed in 426 (59%) of them. Of these, 100 patients were purposively recruited and 97 completed the pilot service evaluation. Data were collected observationally before and after the OGEP was implemented. Baseline measurements of resources, costs and outcomes were captured at the time the patients were initially identified and at a follow-up review three months later. The EQ-5D-5L tool was used to measure patients' health-related quality of life before and after the OGEP was implemented. Data were analysed using Microsoft Excel and SPSS Version 22. Following implementation of the OGEP, there was a significant decrease in the number of district nurse home visits, (P=<0.001), GP surgery appointments (P=0.003) and episodes of cellulitis (P=<0.001). The EQ-5D-5L utility scores showed that patients' quality of life improved after the OGEP was implemented, from a baseline of 0.401 (SD 0.254) to 0.537 (SD 0.231) at the three-month follow-up review. The OGEP may support the efficient use of community nurses' time and resources, reduce costs to the NHS, and improve the quality of life of patients with chronic oedema and wet

  15. Pulmonary atresia

    Science.gov (United States)

    ... another type of congenital heart defect called a patent ductus arteriosus (PDA). Pulmonary atresia may occur with ... known way to prevent this condition. All pregnant women should get routine prenatal care. Many congenital defects ...

  16. Pulmonary Embolism

    Science.gov (United States)

    ... increase the risk for PE, such as: Being bedridden or unable to move around much Having surgery ... of pulmonary embolism (PE) include unexplained shortness of breath, problems breathing, chest pain, coughing , or coughing up ...

  17. Oxygenator in short-term LVAD circuit: a rescue in post-LVAD pulmonary complications.

    Science.gov (United States)

    Mohite, Prashant N; Patil, Nikhil P; Popov, Aron-Frederik; Bahrami, Toufan; Simon, Andre R

    2016-10-01

    Pulmonary complications after left ventricular assist device (LVAD) implantation, though infrequent, can be potentially catastrophic. A 62-year-old female with cardiogenic shock, supported on short-term LVAD, developed pulmonary oedema. An oxygenator was introduced into the LVAD circuit, which improved the gas exchange and, eventually, after weaning off the oxygenator, the patient received long-term LVAD. The introduction of an oxygenator into the short-term LAVD circuit is a lifesaving manoeuvre in such a situation. It offers freedom of introducing and removing the oxygenator into the LVAD circuit without opening the chest and competing for LVAD flow. © The Author(s) 2016.

  18. Reexpansion pulmonary edema: review of pediatric cases.

    Science.gov (United States)

    Kira, Shinichiro

    2014-03-01

    Reexpansion pulmonary edema (RPE) is an increased permeability pulmonary edema that usually occurs in the reexpanded lung after several days of lung collapse. This condition is recognized to occur more frequently in patients under the age of 40 years, but there has been no detailed analysis of reported pediatric cases of RPE to date. For this review, PubMed literature searches were performed using the following terms: 're(-)expansion pulmonary (o)edema' AND ('child' OR 'children' OR 'infant' OR 'boy' OR 'girl' OR 'adolescent'). The 22 pediatric cases of RPE identified were included in this review. RPE was reported in almost the entire pediatric age range, and as in adult cases, the severity ranged from subclinical to lethal. No specific treatment for RPE was identified, and treatment was administered according to the clinical features of each patient. Of the 22 reported cases, 10 occurred during the perioperative period, but were not related to any specific surgical procedures or anesthetic techniques, or to the duration of lung collapse. Pediatric anesthesiologists should be aware that pediatric RPE can occur after reexpansion of any collapsed lung and that some invasive therapies can be useful in severe cases. © 2013 John Wiley & Sons Ltd.

  19. Pulmonary Fibrosis Foundation

    Science.gov (United States)

    ... submissions. MORE We Imagine a World Without Pulmonary Fibrosis The Pulmonary Fibrosis Foundation mobilizes people and resources to provide ... its battle against the deadly lung disease, pulmonary fibrosis (PF). PULMONARY FIBROSIS WALK SURPASSES PARTICIPATION AND FUNDRAISING GOALS Nearly ...

  20. Effect of re-expansion after short-period lung collapse on pulmonary capillary permeability and pro-inflammatory cytokine gene expression in isolated rabbit lungs.

    Science.gov (United States)

    Funakoshi, T; Ishibe, Y; Okazaki, N; Miura, K; Liu, R; Nagai, S; Minami, Y

    2004-04-01

    Re-expansion pulmonary oedema is a rare complication caused by rapid re-expansion of a chronically collapsed lung. Several cases of pulmonary oedema associated with one-lung ventilation (OLV) have been reported recently. Elevated levels of pro-inflammatory cytokines in pulmonary oedema fluid are suggested to play important roles in its development. Activation of cytokines after re-expansion of collapsed lung during OLV has not been thoroughly investigated. Here we investigated the effects of re-expansion of the collapsed lung on pulmonary oedema formation and pro-inflammatory cytokine expression. Lungs isolated from female white Japanese rabbits were perfused and divided into a basal (BAS) group (n=7, baseline measurement alone), a control (CONT) group (n=9, ventilated without lung collapse for 120 min) and an atelectasis (ATEL) group (n=9, lung collapsed for 55 min followed by re-expansion and ventilation for 65 min). Pulmonary vascular resistance (PVR) and the coefficient of filtration (Kfc) were measured at baseline and 60 and 120 min. At the end of perfusion, bronchoalveolar lavage fluid/plasma protein ratio (B/P), wet/dry lung weight ratio (W/D) and mRNA expressions of tumour necrosis factor (TNF)-alpha, interleukin (IL)-1beta and myeloperoxidase (MPO) were determined. TNF-alpha and IL-1beta mRNA were significantly up-regulated in lungs of the ATEL group compared with BAS and CONT, though no significant differences were noted in PVR, Kfc, B/P and W/D within and between groups. MPO increased at 120 min in CONT and ATEL groups. Pro-inflammatory cytokines were up-regulated upon re-expansion and ventilation after short-period lung collapse, though no changes were noted in pulmonary capillary permeability.

  1. Anterior cruciate ligament injury: post-traumatic bone marrow oedema correlates with long-term prognosis.

    Science.gov (United States)

    Filardo, Giuseppe; Kon, Elizaveta; Tentoni, Francesco; Andriolo, Luca; Di Martino, Alessandro; Busacca, Maurizio; Di Matteo, Berardo; Marcacci, Maurilio

    2016-01-01

    Bone marrow oedema (BME) in the knee is a feature of several pathological conditions, and it has been described with high frequency in patients with acute anterior cruciate ligament (ACL) injury. The aim of this study is to evaluate the significance of BME, assessed in MRIs performed for ACL injury, with regards to clinical outcome and return to sport. A total of 134 patients (98 men, 36 women) with ACL tear and MRI knee scan within six months from trauma were analysed. The presence of BME was evaluated on MRI images considering: extension and hyperintensity, the WORMS score oedema classification, and measuring the BME area. The clinical results were documented by IKDC-subjective score and the sport activity level by Tegner score at a minimum of five years follow up. BME was present in 74 knees (55.2 %), with a mean area of 523 ± 370 mm². The presence of BME showed a gradual decrease over time (p = 0.008), being detectable in MRIs performed more than three months after trauma in just 25.0 % of cases. Although 54 % of the patients without BME after three months returned to their previous sport level, no patients with oedema reached a full sport recovery (p = 0.01). In the group that underwent ACL reconstruction, the BME area was significantly correlated with a return to the previous sport level at the mid/long-term follow-up (p = 0.038). BME is a common finding, which decreases over time after injury. However, when BME is still detectable it correlates with clinical prognosis, and even in sport-active patients undergoing ACL reconstruction, a higher BME area is a negative predictive factor for a successful outcome at the mid/long-term follow-up.

  2. Cuboid oedema due to peroneus longus tendinopathy: a report of four cases

    International Nuclear Information System (INIS)

    O'Donnell, Paul; Saifuddin, Asif

    2005-01-01

    To highlight focal bone abnormality in the cuboid due to tendinopathy of the adjacent peroneus longus. A retrospective review was carried out of the relevant clinical and imaging features. Two male and two female patients were studied, mean age 51.5 years (range 32 - 67 years), referred with foot pain and imaging showing an abnormal cuboid thought to represent either tumour or infection. A long history of foot pain was usual with a maximum of 8 years. Radiographs were normal in two cases and showed erosion in two, one of which exhibited periosteal new bone formation affecting the cuboid. Bone scintigraphy was undertaken in two patients, both of whom showed increased uptake of isotope. MRI, performed in all patients, showed oedema in the cuboid adjacent to the peroneus longus tendon. The tendon and/or paratendinous tissues were abnormal in all cases, but no tendon discontinuity was identified. One patient possessed an os peroneum. Unequivocal evidence of bone erosion was seen using MRI in three patients, but with greater clarity in two cases using CT. Additional findings of tenosynovitis of tibialis posterior, oedema in the adjacent medial malleolus and synovitis of multiple joints in the foot were seen in one patient. Imaging diagnosis was made in all cases avoiding bone biopsy, but surgical exploration of the peroneal tendons was performed in two cases and biopsy of ankle synovium in one. Oedema with erosion of the cuboid bone, simulating a bone lesion (cuboid ''pseudotumour''), may be caused by adjacent tendinopathy of peroneus longus. It is vital to be aware of this entity to avoid unnecessary biopsy of the cuboid. (orig.)

  3. Cuboid oedema due to peroneus longus tendinopathy: a report of four cases

    Energy Technology Data Exchange (ETDEWEB)

    O' Donnell, Paul; Saifuddin, Asif [Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom)

    2005-07-01

    To highlight focal bone abnormality in the cuboid due to tendinopathy of the adjacent peroneus longus. A retrospective review was carried out of the relevant clinical and imaging features. Two male and two female patients were studied, mean age 51.5 years (range 32 - 67 years), referred with foot pain and imaging showing an abnormal cuboid thought to represent either tumour or infection. A long history of foot pain was usual with a maximum of 8 years. Radiographs were normal in two cases and showed erosion in two, one of which exhibited periosteal new bone formation affecting the cuboid. Bone scintigraphy was undertaken in two patients, both of whom showed increased uptake of isotope. MRI, performed in all patients, showed oedema in the cuboid adjacent to the peroneus longus tendon. The tendon and/or paratendinous tissues were abnormal in all cases, but no tendon discontinuity was identified. One patient possessed an os peroneum. Unequivocal evidence of bone erosion was seen using MRI in three patients, but with greater clarity in two cases using CT. Additional findings of tenosynovitis of tibialis posterior, oedema in the adjacent medial malleolus and synovitis of multiple joints in the foot were seen in one patient. Imaging diagnosis was made in all cases avoiding bone biopsy, but surgical exploration of the peroneal tendons was performed in two cases and biopsy of ankle synovium in one. Oedema with erosion of the cuboid bone, simulating a bone lesion (cuboid ''pseudotumour''), may be caused by adjacent tendinopathy of peroneus longus. It is vital to be aware of this entity to avoid unnecessary biopsy of the cuboid. (orig.)

  4. Diabetic macular oedema and visual loss: relationship to location, severity and duration

    DEFF Research Database (Denmark)

    Gardner, Thomas W; Larsen, Michael; Girach, Aniz

    2009-01-01

    Abstract. Purpose: To assess the relationship between visual acuity (VA) and diabetic macular oedema (DMO) in relation to the location of retinal thickening and the severity and duration of central macular thickening. Methods: Data from 584 eyes in 340 placebo-treated patients in the 3-years...... (Snellen equivalent = 20/125). Diabetic retinopathy and DMO status were assessed using stereo photographs. Results: Nearly one third of study eyes had foveal centre-involving DMO at the start of the trial. Sustained moderate visual loss was found in 36 eyes, most commonly associated with DMO at the centre...

  5. Pulmonary abscess

    International Nuclear Information System (INIS)

    Valencia Chavez, Maria de la Cruz

    2000-01-01

    Pulmonary abscess is defined as a suppurative process and bounded, caused by piogens organisms that it progresses to central necrosis and it commits an or more areas of the pulmonary parenchyma. Initially it is impossible to differ of a located pneumonia, but when the lesion communicates with a bronchus, part of the neurotic tissue is replaced by air, producing the classic image radiological fluid-air. The presence of multiple lesions smaller than 2 cms of diameter cm is defined arbitrarily as necrotizing pneumonia it is indistinguishable of an abscess. The paper includes the pathogenesis and etiology, clinical course, diagnostic and treatment

  6. Spontaneous regression of pulmonary bullae

    International Nuclear Information System (INIS)

    Satoh, H.; Ishikawa, H.; Ohtsuka, M.; Sekizawa, K.

    2002-01-01

    The natural history of pulmonary bullae is often characterized by gradual, progressive enlargement. Spontaneous regression of bullae is, however, very rare. We report a case in which complete resolution of pulmonary bullae in the left upper lung occurred spontaneously. The management of pulmonary bullae is occasionally made difficult because of gradual progressive enlargement associated with abnormal pulmonary function. Some patients have multiple bulla in both lungs and/or have a history of pulmonary emphysema. Others have a giant bulla without emphysematous change in the lungs. Our present case had treated lung cancer with no evidence of local recurrence. He had no emphysematous change in lung function test and had no complaints, although the high resolution CT scan shows evidence of underlying minimal changes of emphysema. Ortin and Gurney presented three cases of spontaneous reduction in size of bulla. Interestingly, one of them had a marked decrease in the size of a bulla in association with thickening of the wall of the bulla, which was observed in our patient. This case we describe is of interest, not only because of the rarity with which regression of pulmonary bulla has been reported in the literature, but also because of the spontaneous improvements in the radiological picture in the absence of overt infection or tumor. Copyright (2002) Blackwell Science Pty Ltd

  7. Pulmonary circulation

    International Nuclear Information System (INIS)

    Bongartz, G.; Boos, M.; Scheffler, K.; Steinbrich, W.

    1998-01-01

    Evaluation of the pulmonary vasculature is mainly indicated in patients with suspected pulmonary thromboembolism. The routine procedure so far is ventilation-perfusion scintigraphy alone or in combination with diagnostic assessment of the legs to rule out deep venous thrombosis. The results are still not reliable for the majority of patients. In the case of equivocal diagnosis, invasive conventional angiography is considered the gold standard. With steady improvements in tomographic imaging techniques, such as computed tomography (CT) or magnetic resonance imaging (MRI), non-invasive alternatives to the routine diagnostic work-up are given. Helical CT and CTA techniques are already in clinical use and estimated to sufficiently serve the demands for detection/exclusion of pulmonary thromboembolism. The disadvantages mainly concern peripheral disease and reconstruction artifacts. MRI and MR angiography have been implemented in the diagnosis of pulmonary vascular disease since the introduction of contrast-enhanced MRA. In breath-hold techniques, the entire lung vascularization can be delineated and thromboemboli can be detected. The clinical experience in this field is limited, but MRI has the potential to demonstrate its superiority over CT due to its improved delineation of the vascular periphery and the more comprehensive three-dimensional reconstruction. (orig.)

  8. Pulmonary fibrosis

    International Nuclear Information System (INIS)

    Yamakido, Michio; Okuzaki, Takeshi

    1992-01-01

    When the chest is exposed to x radiation and Co-60 gamma radiation, radiation damage may occur in the lungs 2 to 10 weeks after irradiation. This condition is generally referred to as radiation pneumonitis, with the incidence ranging from 5.4% to 91.8% in the literature. Then radiation pneumonitis may develop into pulmonary fibrosis associated with roentgenologically diffuse linear and ring-like shadows and strong contraction 6 months to one year after irradiation. Until recently, little attention has been paid to pulmonary pneumonitis as a delayed effect of A-bomb radiation. The recent study using the population of 9,253 A-bomb survivors have suggested that the prevalence of pulmonary fibrosis tended to be high in heavily exposed A-bomb survivors. Two other studies using the cohort of 16,956 and 42,728 A-bomb survivors, respectively, have shown that the prevalence of roentgenologically proven pulmonary fibrosis was higher in men than women (1.82% vs 0.41%), was increased with aging and had a higher tendency in heavily exposed A-bomb survivors. (N.K.)

  9. Vascular endothelial growth factor and basic fibroblast growth factor expression positively correlates with angiogenesis and peritumoural brain oedema in astrocytoma

    International Nuclear Information System (INIS)

    Jang, F.F.; Wei, W.

    2008-01-01

    Astrocytoma is the most malignant intracranial neoplasm and is characterized by high neovascularization and peritumoural brain oedema. Angiogenesis is a complicated process in oncogenesis regulated by the balance between angiogenic and antiangiogenic factors. The expression of two angiogenic growth factors, vascular endothelial growth factor and basic fibroblast growth factor were investigated using immunohistochemistry for astrocytoma from 82 patients and 11 normal human tissues. The expression of vascular endothelial growth factor and basic fibroblast growth factor positively correlate with the pathological grade of astrocytoma, microvessel density numbers and brain oedema, which may be responsible for the increased tumour neovascularization and peritumoural brain oedema. The results support the idea that inhibiting vascular endothelial growth factor and basic fibroblast growth factor are useful for the treatment of human astrocytoma and to improve patient's clinical outcomes and prognosis. (author)

  10. Retinitis pigmentosa-associated cystoid macular oedema: pathogenesis and avenues of intervention

    Science.gov (United States)

    Strong, S; Liew, G; Michaelides, M

    2017-01-01

    Hereditary retinal diseases are now the leading cause of blindness certification in the working age population (age 16–64 years) in England and Wales, of which retinitis pigmentosa (RP) is the most common disorder. RP may be complicated by cystoid macular oedema (CMO), causing a reduction of central vision. The underlying pathogenesis of RP-associated CMO (RP-CMO) remains uncertain, however, several mechanisms have been proposed, including: (1) breakdown of the blood-retinal barrier, (2) failure (or dysfunction) of the pumping mechanism in the retinal pigment epithelial, (3) Müller cell oedema and dysfunction, (4) antiretinal antibodies and (5) vitreous traction. There are limited data on efficacy of treatments for RP-CMO. Treatments attempted to date include oral and topical carbonic anhydrase inhibitors, oral, topical, intravitreal and periocular steroids, topical non-steroidal anti-inflammatory medications, photocoagulation, vitrectomy with internal limiting membrane peel, oral lutein and intravitreal antivascular endothelial growth factor injections. This review summarises the evidence supporting these treatment modalities. Successful management of RP-CMO should aim to improve both quality and quantity of vision in the short term and may also slow central vision loss over time. PMID:27913439

  11. Bone marrow oedema assessment by magnetic resonance imaging in rheumatoid arthritis wrist and metacarpophalangeal joints

    DEFF Research Database (Denmark)

    Krabbe, Simon; Eshed, Iris; Pedersen, Susanne Juhl

    2014-01-01

    OBJECTIVE: The aim of this study was to examine the influence of different MRI unit field strengths, coil types and image resolutions on the OMERACT RA MRI scoring system (RAMRIS) of bone marrow oedema (BME) and image quality. METHODS: Forty-one patients and 12 healthy controls participated in th...... resolutions, suggesting that these are equally suited for assessment of BME in RA. However, parameters of image quality and intrareader reliability (favouring 0.6, 1.5 and 3T) should be considered when selecting the MRI acquisition strategy.......OBJECTIVE: The aim of this study was to examine the influence of different MRI unit field strengths, coil types and image resolutions on the OMERACT RA MRI scoring system (RAMRIS) of bone marrow oedema (BME) and image quality. METHODS: Forty-one patients and 12 healthy controls participated...... STIR image sets were anonymized and scored according to RAMRIS and parameters of image quality were measured. RESULTS: The BME sum scores were similar overall when comparing the different MRI units, coil types and voxel sizes, yet significantly higher at the higher resolution of 1.5T Extr compared...

  12. Rigid telescopy and contact endoscopy in the diagnosis and surgery of Reinke’s oedema: Clinical and histological assessment

    Directory of Open Access Journals (Sweden)

    Jovanović Milan B.

    2005-01-01

    Full Text Available We focussed our attention on the use of both rigid telescopy and contact endoscopy in order to assess their effectiveness in the diagnosis and surgery of Reinke’s oedema. Changes were observed in a sample of 40 patients, suffering from different stages of Reinke’s oedema, who had undergone microlaryngoscopies. For the first time during our laryngological praxis, we discussed a number of parameters that appeared to be significant in the monitoring and detailed evaluation of this vocal fold disease. With contact endoscopy, during the early stages of the disease, the cells and nuclei of normal squamous layered epithelium continued to display uniform morphological features. The appearance of epithelial changes helps to distinguish between different stages of Reinke’s oedema, which can be associated with severe inflammation or keratinisation. With latter-stage oedemas, the following was observed: various changes in the blood vessels of the glottis, which when viewed through the endoscope have an unusual “loop-like” or “branching” appearance, as well as elongated and varicose blood vessels, and the build-up of erythrocytes inside atypical capillaries. Both endoscope techniques are non-invasive and very appropriate for precisely diagnosing Reinke’s oedema within a relatively short period of time. Rigid telescopy has the advantage of enabling the systematic observation of many details in the large area of both vocal fold mucosae, particularly when access to the larynx is difficult. This enables dynamic monitoring and immediate pathology consultations inside the operating theatre. The special contribution of contact endoscopy is that, both in vivo and in situ, it allows a detailed scanning and mapping to be performed of all cell changes and of vascularisation throughout the entire mucosa surface. Video-assisted telescopy does not permit a completely first-rate surgical resection of Reinke’s oedema, because of unsatisfactory control or

  13. Clinical application of radioaerosol studies - pulmonary embolism, inhalation burns and glue-sniffers and COPD

    International Nuclear Information System (INIS)

    Sundram, Felix

    1994-01-01

    The alveolar epithelium and the capillary endothelium together form the alveolar capillary membrane. Fluid exchange occurs across this membrane, and is dependent on intravascular and interstitial hydrostatic and oncotic pressures, and on permeability of this membrane. Damage to either the alveolar or capillary component can result in a high permeability pulmonary oedema, even though the alveolar epithelium forms an extremely tight membrane which is ten times less permeable than the capillary endothelium. Nuclear medicine methods can be used to observe changes in integrity of pulmonary capillary endothelium (with first pass dual-indicator dilution technique using successive injections of radiotracer), and of alveolar epithelium, and it is important that the damage should be detected before patients develop clinical pulmonary oedema so that intensive therapy can be instituted early. We have used 99m Tc DTPA radioaerosol to measure alteration in pulmonary epithelial permeability and to image the distribution of ventilation in normal and some pathological states. In some clinical studies Tc-99m (tin) colloid radioaerosol has been used to obtain the ventilation images

  14. High-grade MRI bone oedema is common within the surgical field in rheumatoid arthritis patients undergoing joint replacement and is associated with osteitis in subchondral bone

    DEFF Research Database (Denmark)

    McQueen, F M; Gao, A; Ostergaard, M

    2007-01-01

    OBJECTIVES: MRI bone oedema has been observed in early and advanced RA and may represent a cellular infiltrate (osteitis) in subchondral bone. We studied MRI scans from RA patients undergoing surgery, seeking to identify regions of bone oedema and examine its histopathological equivalent in resec...

  15. Sensitivity and specificity of monochromatic photography of the ocular fundus in differentiating optic nerve head drusen and optic disc oedema: optic disc drusen and oedema.

    Science.gov (United States)

    Gili, Pablo; Flores-Rodríguez, Patricia; Yangüela, Julio; Orduña-Azcona, Javier; Martín-Ríos, María Dolores

    2013-03-01

    Evaluation of the efficacy of monochromatic photography of the ocular fundus in differentiating optic nerve head drusen (ONHD) and optic disc oedema (ODE). Sixty-six patients with ONHD, 31 patients with ODE and 70 healthy subjects were studied. Colour and monochromatic fundus photography with different filters (green, red and autofluorescence) were performed. The results were analysed blindly by two observers. The sensitivity, specificity and interobserver agreement (k) of each test were assessed. Colour photography offers 65.5 % sensitivity and 100 % specificity for the diagnosis of ONHD. Monochromatic photography improves sensitivity and specificity and provides similar results: green filter (71.20 % sensitivity, 96.70 % specificity), red filter (80.30 % sensitivity, 96.80 % specificity), and autofluorescence technique (87.8 % sensitivity, 100 % specificity). The interobserver agreement was good with all techniques used: autofluorescence (k = 0.957), green filter (k = 0.897), red filter (k = 0.818) and colour (k = 0.809). Monochromatic fundus photography permits ONHD and ODE to be differentiated, with good sensitivity and very high specificity. The best results were obtained with autofluorescence and red filter study.

  16. Pulmonary lymphangioleiomyomatosis

    International Nuclear Information System (INIS)

    Shawki, Hilal B.; Muhammad, Shakir M.; Reda, Amal N.; Abdulla, Thair S.; Ardalan, Delaram M.

    2007-01-01

    A 38-year-old Iraqi female, presented with one-year history of exertional dyspnea and exercise intolerance, without systemic or constitutional symptoms. Clinical examination revealed bilateral basal crackles with signs suggestive of left side pleural effusion, chest x-ray showed left sided pleural effusion, and diffuse bilateral basal pulmonary shadowing. Her biochemical analysis, hematological tests, electrocardiogram and echocardiography were normal, aspiration of the fluid revealed a chylothorax, the radiological shadowing was proved by computed tomography scan of the chest to be diffuse cystic lesions involving mostly lower lobes. Open lung biopsy showed dilated lymphatic vessels with surrounding inflammatory cells and smooth muscle fibers consistently with the diagnosis of pulmonary lymphangioleiomyomatosis. (author)

  17. Pulmonary Cement Embolism following Percutaneous Vertebroplasty

    Directory of Open Access Journals (Sweden)

    Ümran Toru

    2014-01-01

    Full Text Available Percutaneous vertebroplasty is a minimal invasive procedure that is applied for the treatment of osteoporotic vertebral fractures. During vertebroplasty, the leakage of bone cement outside the vertebral body leads to pulmonary cement embolism, which is a serious complication of this procedure. Here we report a 48-year-old man who was admitted to our hospital with dyspnea after percutaneous vertebroplasty and diagnosed as pulmonary cement embolism.

  18. The minimally tuned minimal supersymmetric standard model

    International Nuclear Information System (INIS)

    Essig, Rouven; Fortin, Jean-Francois

    2008-01-01

    The regions in the Minimal Supersymmetric Standard Model with the minimal amount of fine-tuning of electroweak symmetry breaking are presented for general messenger scale. No a priori relations among the soft supersymmetry breaking parameters are assumed and fine-tuning is minimized with respect to all the important parameters which affect electroweak symmetry breaking. The superpartner spectra in the minimally tuned region of parameter space are quite distinctive with large stop mixing at the low scale and negative squark soft masses at the high scale. The minimal amount of tuning increases enormously for a Higgs mass beyond roughly 120 GeV

  19. Pulmonary Hypertension

    Science.gov (United States)

    Kim, John S.; McSweeney, Julia; Lee, Joanne; Ivy, Dunbar

    2015-01-01

    Objective Review the pharmacologic treatment options for pulmonary arterial hypertension (PAH) in the cardiac intensive care setting and summarize the most-recent literature supporting these therapies. Data Sources and Study Selection Literature search for prospective studies, retrospective analyses, and case reports evaluating the safety and efficacy of PAH therapies. Data Extraction Mechanisms of action and pharmacokinetics, treatment recommendations, safety considerations, and outcomes for specific medical therapies. Data Synthesis Specific targeted therapies developed for the treatment of adult patients with PAH have been applied for the benefit of children with PAH. With the exception of inhaled nitric oxide, there are no PAH medications approved for children in the US by the FDA. Unfortunately, data on treatment strategies in children with PAH are limited by the small number of randomized controlled clinical trials evaluating the safety and efficacy of specific treatments. The treatment options for PAH in children focus on endothelial-based pathways. Calcium channel blockers are recommended for use in a very small, select group of children who are responsive to vasoreactivity testing at cardiac catheterization. Phosphodiesterase type 5 inhibitor therapy is the most-commonly recommended oral treatment option in children with PAH. Prostacyclins provide adjunctive therapy for the treatment of PAH as infusions (intravenous and subcutaneous) and inhalation agents. Inhaled nitric oxide is the first line vasodilator therapy in persistent pulmonary hypertension of the newborn, and is commonly used in the treatment of PAH in the Intensive Care Unit (ICU). Endothelin receptor antagonists have been shown to improve exercise tolerance and survival in adult patients with PAH. Soluble Guanylate Cyclase Stimulators are the first drug class to be FDA approved for the treatment of chronic thromboembolic pulmonary hypertension. Conclusions Literature and data supporting the

  20. Life-threatening angio-oedema after the first dose of an ACE inhibitor-not an anaphylactic reaction

    DEFF Research Database (Denmark)

    Krogh Nielsen, Troels; Bygum, Anette; Rye Rasmussen, Eva

    2016-01-01

    We present a case of a 60-year-old Caucasian woman, with no prior history of swellings, who was admitted to a hospital due to life-threatening angio-oedema. She had, the previous day, been prescribed an ACE inhibitor for her essential hypertension. She had taken one tablet at night-time, and awoke...

  1. Oedema and fatty degeneration of the soleus and gastrocnemius muscles on MR images in patients with achilles tendon abnormalities

    International Nuclear Information System (INIS)

    Hoffmann, Adrienne; Mamisch, Nadja; Buck, Florian M.; Pfirrmann, Christian W.A.; Zanetti, Marco; Espinosa, Norman

    2011-01-01

    The purpose of this study was to evaluate the frequency of oedema and fatty degeneration of the soleus and gastrocnemius muscles in patients with Achilles tendon abnormalities. Forty-five consecutive patients (mean 51 years; range 14-84 years) with achillodynia were examined with magnetic resonance (MR) images of the calf. The frequency of oedema and fatty degeneration in the soleus and gastrocnemius muscles was determined in patients with normal tendons, tendinopathy and in patients with a partial tear or a complete tear of the Achilles tendon. Oedema was encountered in 35% (7/20) of the patients with tendinopathy (n = 20; range 13-81 years), and in 47% (9/19) of the patients with partial tears or complete tears (n = 19; 28-78 years). Fatty degeneration was encountered in 10% (2/20) of the patients with tendinopathy, and in 32% (6/19) of the patients with tears. The prevalence of fatty degeneration was significantly more common in patients with a partial or complete tear compared with the patients with a normal Achilles tendon (p = 0.032 and p = 0.021, respectively). Oedema and fatty degeneration of the soleus and gastrocnemius muscles are common in patients with Achilles tendon abnormalities. (orig.)

  2. Oedema and fatty degeneration of the soleus and gastrocnemius muscles on MR images in patients with Achilles tendon abnormalities.

    Science.gov (United States)

    Hoffmann, Adrienne; Mamisch, Nadja; Buck, Florian M; Espinosa, Norman; Pfirrmann, Christian W A; Zanetti, Marco

    2011-09-01

    The purpose of this study was to evaluate the frequency of oedema and fatty degeneration of the soleus and gastrocnemius muscles in patients with Achilles tendon abnormalities. Forty-five consecutive patients (mean 51 years; range 14-84 years) with achillodynia were examined with magnetic resonance (MR) images of the calf. The frequency of oedema and fatty degeneration in the soleus and gastrocnemius muscles was determined in patients with normal tendons, tendinopathy and in patients with a partial tear or a complete tear of the Achilles tendon. Oedema was encountered in 35% (7/20) of the patients with tendinopathy (n = 20; range 13-81 years), and in 47% (9/19) of the patients with partial tears or complete tears (n = 19; 28-78 years). Fatty degeneration was encountered in 10% (2/20) of the patients with tendinopathy, and in 32% (6/19) of the patients with tears. The prevalence of fatty degeneration was significantly more common in patients with a partial or complete tear compared with the patients with a normal Achilles tendon (p = 0.032 and p = 0.021, respectively). Oedema and fatty degeneration of the soleus and gastrocnemius muscles are common in patients with Achilles tendon abnormalities.

  3. Familial Pulmonary Fibrosis

    Science.gov (United States)

    ... Education & Training Home Conditions Familial Pulmonary Fibrosis Familial Pulmonary Fibrosis Make an Appointment Find a Doctor Ask a ... more members within the same family have Idiopathic Pulmonary Fibrosis (IPF) or any other form of Idiopathic Interstitial ...

  4. Pulmonary Hypertension Overview

    Science.gov (United States)

    ... well as sleep apnea, are common causes of secondary pulmonary hypertension. Other causes include the following: Congestive heart failure Birth defects in the heart Chronic pulmonary thromboembolism (blood clots in the pulmonary arteries) Acquired immunodeficiency syndrome ( ...

  5. Pulmonary Hypertension in Scleroderma

    Science.gov (United States)

    PULMONARY HYPERTENSION IN SCLERODERMA PULMONARY HYPERTENSION Pulmonary hypertension (PH) is high blood pressure in the blood vessels of the lungs. If the high ... the right side of the heart. Patients with scleroderma are at increased risk for developing PH from ...

  6. HIV and Pulmonary Hypertension

    Science.gov (United States)

    ... What do I need to know about pulmonary hypertension in connection with HIV? Although pulmonary hypertension and ... Should an HIV patient be tested for pulmonary hypertension? HIV patients know that medical supervision is critical ...

  7. The grey fovea sign of macular oedema or subfoveal fluid on non-stereoscopic fundus photographs

    DEFF Research Database (Denmark)

    Hasler, Pascal W; Soliman, Wael; Sander, Birgit

    2017-01-01

    PURPOSE: To describe the grey fovea sign of fovea-involving macular oedema or subretinal fluid accumulation in red-free fundus photography. METHODS: A test set of 91 digital fundus photographs of good quality from 100 consecutive eyes in 72 patients with diabetic retinopathy or central serous...... chorioretinopathy was composed by one of the investigators and evaluated by four masked observers. The photographs were graded as to whether a normal dark fovea was present or absent. The reference method was foveal thickness measurement using optical coherence tomography (OCT). RESULTS: Eyes graded as having...... a grey fovea on fundus photographs (n = 67) had a median foveal thickness of 279 μm (interquartile range 130 μm), whereas eyes graded as having a normal dark fovea (n = 24) had a median foveal thickness of 238 μm (interquartile range 44.5 μm, p = 0.025). CONCLUSION: The absence of a dark fovea on red...

  8. Sclerosing lymphangitis of the penis associated with marked penile oedema and skin erosions.

    Science.gov (United States)

    Karray, Mehdi; Litaiem, Noureddine; Jones, Mariem; Zeglaoui, Faten

    2017-07-27

    Sclerosing lymphangitis of the penis is a benign, under-reported condition consisting of a asymptomatic firm cord-like swelling around the coronal sulcus of the penis usually affecting men in the second or third decade of life. Penile oedema and erosions are rarely reported. Clinical signs may be remarkable contrasting with the self-limited character of the disease. We report a new case of sclerosing lymphangitis of the penis occurring in a 59-year-old patient marked by penile swelling and several overlying skin erosions, and discuss the clinical features and the pathogenesis aspects of the disease. © 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.

  9. Effect of ethamsylate on carrageenan-induced rat paw oedema: a comparison with indomethacin.

    Science.gov (United States)

    Gard, P R; Trigger, D J

    1990-12-01

    1. Ethamsylate (diethylammonium 2,5-dihydroxybenzene sulfonate, Dicynene), a systemic haemostatic agent with an unknown mechanism of action, was tested for anti-inflammatory activity using the carrageenan-induced rat paw oedema test. 2. Ethamsylate was shown to be an effective anti-inflammatory agent with a time course and amplitude of effect similar to that of indomethacin, although the potency was only about 4% of that for indomethacin. 3. When ethamsylate and indomethacin were co-administered they did not show additive effects, suggesting that they do not share a common mode of action. It is proposed that ethamsylate, like indomethacin, may inhibit prostaglandin synthesis. Ulceration produced by indomethacin, it is suggested that it may prove to be a useful addition to, or replacement for, indomethacin in the treatment of inflammatory disorders.

  10. Dilutional hyponatraemia: a cause of massive fatal intraoperative cerebral oedema in a child undergoing renal transplantation.

    Science.gov (United States)

    Armour, A

    1997-05-01

    A four year old boy with polyuric renal failure resulting from recurrent urinary tract infections and vesicoureteric reflux from birth underwent renal transplantation. In the past he had had five ureteric reimplant operations and a gastrostomy, as he ate nothing by mouth. He required peritoneal dialysis 13 hours a night, six nights a week. His fluid requirements were 2100 ml per day. This included a night feed of 1.5 litres Nutrizon. Before operation he received 900 ml of Dioralyte instead of the Nutrizon feed, and peritoneal dialysis was performed as usual. The operation itself was technically difficult and there was more blood loss than anticipated, requiring intravenous fluids and blood. The operation ended about four hours later but he did not wake up. Urgent computed tomography revealed gross cerebral oedema. He died the next day. At necropsy the brain was massively oedematous and weighed 1680 g.

  11. Auricular Oedema and Dyshidrotic Eczema in a Patient with Acute Myeloid Leukaemia Treated with Cytarabine

    Directory of Open Access Journals (Sweden)

    K. Brandt

    2010-10-01

    Full Text Available Cytarabine is an effective drug in the treatment of haematological malignancies. The therapy is associated with various complications. Frequencies of dermatological side-effects range from 2–72% and occur most commonly after high-dose regimens. Although most cutaneous reactions are mild and resolve spontaneously within several days, they may result in an increased risk of infection and alterations in comfort. In some cases, severe life-threatening reactions have been reported. Here we describe the case of a patient with acute myeloid leukaemia, who developed severe exceptional skin toxicity in terms of auricular oedema and palmar dyshidrotic eczema after the application of low-dose cytarabine. Re-administration of the drug resulted in reduced skin toxicity during further cycles of chemotherapy. Negative epicutaneous patch-testing supported the existence of cytarabine-provoked toxicity.

  12. Erysipelas in a free-range layer flock with conjunctival oedema as an unusual clinical sign.

    Science.gov (United States)

    Schmitt, Ferdinand; Schade, Benjamin; Böhm, Brigitte; Shimoji, Yoshihiro; Pfahler, Corinna

    2014-01-01

    Erysipelas was diagnosed in a free-range laying flock with a high mortality of up to 7% per day and a severe decrease in egg production to 45%. The disease had a short course and unusual clinical features for erysipelas, including swollen, lacrimating and encrusted eyes. Bacteriologically, trapped poultry red mites and affected animals were culture-positive for Erysipelothrix rhusiopathiae. Isolates from layers and mites were both serotype 1b. Histopathology revealed disseminated intravasal coagulopathy in conjunctival small vessels as the cause of the oedema of the eye adnexes. After treatment with penicillin, mortality and egg production returned to normal levels. Although erysipelas in laying hens is rarely reported, it can develop as an emerging disease in alternative rearing systems and should always be considered if mortality increases in an older flock, especially with a high infestation of poultry red mites.

  13. A Dual Lung Scan for the Evaluation of Pulmonary Function in Patients with Pulmonary Tuberculosis before and after Treatment

    International Nuclear Information System (INIS)

    Rhee, Chong Heon

    1967-01-01

    In 20 normal cases and 39 pulmonary tuberculosis cases, regional pulmonary arterial blood flow measurement and lung perfusion scans by 131 I-Macroaggregated albumin, lung inhalation scans by colloidal 198 Au and spirometries by respirometer were done at the Radiological Research Institute. The measured lung function tests were compared and the results were as the following: 1) The normal distribution of pulmonary blood flow was found to be 54.5±2.82% to the right lung and 45.5±2.39% to the left lung. The difference between the right and left pulmonary arterial blood flow was significant statistically (p 131 I-MAA in patients with pulmonary tuberculosis was as follows: a) In the pretreated minimal pulmonary tuberculosis, the decreased area of pulmonary arterial blood flow was corresponding to the chest roentgenogram, but the decrease of pulmonary arterial blood flow was more extensive than had been expected from the chest roentgenogram in the apparently healed minimal pulmonary tuberculosis. b) In the pretreated moderately advanced pulmonary tuberculosis, the decrease of pulmonary arterial blood flow to the diseased area was corresponding to the chest roentgenogram, but the decrease of pulmonary arterial blood flow was more extensive in the treated moderately advanced pulmonary tuberculosis as in the treated minimal pulmonary tuberculosis. c) Pulmonary arterial blood flow in the patients with far advanced pulmonary tuberculosis both before and after chemotherapy were almost similar to the chest roentgenogram. Especially the decrease of pulmonary arterial blood flow to the cavity was usually greater than had been expected from the chest roentgenogram. 3) Lung inhalation scan by colloidal 198 Au in patients with pulmonary tuberculosis was as follows: a) In the minimal pulmonary tuberculosis, lung inhalation scan showed almost similar decrease of radioactivity corresponding to the chest roentgenogram. b) In the moderately advanced pulmonary tuberculosis the decrease

  14. Quantitative CT analysis of pulmonary ground-glass opacity nodules for distinguishing invasive adenocarcinoma from non-invasive or minimally invasive adenocarcinoma: the added value of using iodine mapping

    International Nuclear Information System (INIS)

    Son, Ji Ye; Lee, Ho Yun; Kim, Jae-Hun; Lee, Kyung Soo; Han, Joungho; Jeong, Ji Yun; Kwon, O.J.; Shim, Young Mog

    2016-01-01

    To determine whether quantitative analysis of iodine-enhanced images generated from dual-energy CT (DECT) have added value in distinguishing invasive adenocarcinoma from non-invasive or minimally invasive adenocarcinoma (MIA) showing ground-glass nodule (GGN). Thirty-four patients with 39 GGNs were enrolled in this prospective study and underwent DECT followed by complete tumour resection. Various quantitative imaging parameters were assessed, including virtual non-contrast (VNC) imaging and iodine-enhanced imaging. Of all 39 GGNs, four were adenocarcinoma in situ (AIS) (10 %), nine were MIA (23 %), and 26 were invasive adenocarcinoma (67 %). When assessing only VNC imaging, multivariate analysis revealed that mass, uniformity, and size-zone variability were independent predictors of invasive adenocarcinoma (odds ratio [OR] = 19.92, P = 0.02; OR = 0.70, P = 0.01; OR = 16.16, P = 0.04, respectively). After assessing iodine-enhanced imaging with VNC imaging, both mass on the VNC imaging and uniformity on the iodine-enhanced imaging were independent predictors of invasive adenocarcinoma (OR = 5.51, P = 0.04 and OR = 0.67, P < 0.01). The power of diagnosing invasive adenocarcinoma was improved after adding the iodine-enhanced imaging parameters versus VNC imaging alone, from 0.888 to 0.959, respectively (P = 0.029). Quantitative analysis using iodine-enhanced imaging metrics versus VNC imaging metrics alone generated from DECT have added value in distinguishing invasive adenocarcinoma from AIS or MIA. (orig.)

  15. Quantitative CT analysis of pulmonary ground-glass opacity nodules for distinguishing invasive adenocarcinoma from non-invasive or minimally invasive adenocarcinoma: the added value of using iodine mapping

    Energy Technology Data Exchange (ETDEWEB)

    Son, Ji Ye; Lee, Ho Yun; Kim, Jae-Hun; Lee, Kyung Soo [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Samsung Medical Center, 81 Irwon-Ro, Gangnam-gu, Seoul (Korea, Republic of); Han, Joungho [Sungkyunkwan University School of Medicine, Department of Pathology, Samsung Medical Center, Seoul (Korea, Republic of); Jeong, Ji Yun [Sungkyunkwan University School of Medicine, Department of Pathology, Samsung Medical Center, Seoul (Korea, Republic of); Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Department of Pathology, Daegu (Korea, Republic of); Kwon, O.J. [Sungkyunkwan University School of Medicine, Division of Respiratory and Critical Medicine of the Department of Internal Medicine, Samsung Medical Center, Seoul (Korea, Republic of); Shim, Young Mog [Sungkyunkwan University School of Medicine, Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, 81 Irwon-Ro, Gangnam-gu, Seoul (Korea, Republic of)

    2016-01-15

    To determine whether quantitative analysis of iodine-enhanced images generated from dual-energy CT (DECT) have added value in distinguishing invasive adenocarcinoma from non-invasive or minimally invasive adenocarcinoma (MIA) showing ground-glass nodule (GGN). Thirty-four patients with 39 GGNs were enrolled in this prospective study and underwent DECT followed by complete tumour resection. Various quantitative imaging parameters were assessed, including virtual non-contrast (VNC) imaging and iodine-enhanced imaging. Of all 39 GGNs, four were adenocarcinoma in situ (AIS) (10 %), nine were MIA (23 %), and 26 were invasive adenocarcinoma (67 %). When assessing only VNC imaging, multivariate analysis revealed that mass, uniformity, and size-zone variability were independent predictors of invasive adenocarcinoma (odds ratio [OR] = 19.92, P = 0.02; OR = 0.70, P = 0.01; OR = 16.16, P = 0.04, respectively). After assessing iodine-enhanced imaging with VNC imaging, both mass on the VNC imaging and uniformity on the iodine-enhanced imaging were independent predictors of invasive adenocarcinoma (OR = 5.51, P = 0.04 and OR = 0.67, P < 0.01). The power of diagnosing invasive adenocarcinoma was improved after adding the iodine-enhanced imaging parameters versus VNC imaging alone, from 0.888 to 0.959, respectively (P = 0.029). Quantitative analysis using iodine-enhanced imaging metrics versus VNC imaging metrics alone generated from DECT have added value in distinguishing invasive adenocarcinoma from AIS or MIA. (orig.)

  16. Feature-tracking myocardial strain analysis in acute myocarditis. Diagnostic value and association with myocardial oedema

    International Nuclear Information System (INIS)

    Luetkens, Julian A.; Schlesinger-Irsch, Ulrike; Kuetting, Daniel L.; Dabir, Darius; Homsi, Rami; Schmeel, Frederic C.; Sprinkart, Alois M.; Naehle, Claas P.; Schild, Hans H.; Thomas, Daniel; Doerner, Jonas; Fimmers, Rolf

    2017-01-01

    To investigate the diagnostic value of cardiac magnetic resonance (CMR) feature-tracking (FT) myocardial strain analysis in patients with suspected acute myocarditis and its association with myocardial oedema. Forty-eight patients with suspected acute myocarditis and 35 control subjects underwent CMR. FT CMR analysis of systolic longitudinal (LS), circumferential (CS) and radial strain (RS) was performed. Additionally, the protocol allowed for the assessment of T1 and T2 relaxation times. When compared with healthy controls, myocarditis patients demonstrated reduced LS, CS and RS values (LS: -19.5 ± 4.4% vs. -23.6 ± 3.1%, CS: -23.0 ± 5.8% vs. -27.4 ± 3.4%, RS: 28.9 ± 8.5% vs. 32.4 ± 7.4%; P < 0.05, respectively). LS (T1: r = 0.462, P < 0.001; T2: r = 0.436, P < 0.001) and CS (T1: r = 0.429, P < 0.001; T2: r = 0.467, P < 0.001) showed the strongest correlations with T1 and T2 relaxations times. Area under the curve of LS (0.79) was higher compared with those of CS (0.75; P = 0.478) and RS (0.62; P = 0.008). FT CMR myocardial strain analysis might serve as a new tool for assessment of myocardial dysfunction in the diagnostic work-up of patients suspected of having acute myocarditis. Especially, LS and CS show a sufficient diagnostic performance and were most closely correlated with CMR parameters of myocardial oedema. (orig.)

  17. Feature-tracking myocardial strain analysis in acute myocarditis. Diagnostic value and association with myocardial oedema

    Energy Technology Data Exchange (ETDEWEB)

    Luetkens, Julian A.; Schlesinger-Irsch, Ulrike; Kuetting, Daniel L.; Dabir, Darius; Homsi, Rami; Schmeel, Frederic C.; Sprinkart, Alois M.; Naehle, Claas P.; Schild, Hans H.; Thomas, Daniel [University of Bonn, Department of Radiology, Bonn (Germany); Doerner, Jonas [University Hospital Cologne, Department of Radiology, Cologne (Germany); Fimmers, Rolf [University of Bonn, Department of Medical Biometry, Informatics, and Epidemiology, Bonn (Germany)

    2017-11-15

    To investigate the diagnostic value of cardiac magnetic resonance (CMR) feature-tracking (FT) myocardial strain analysis in patients with suspected acute myocarditis and its association with myocardial oedema. Forty-eight patients with suspected acute myocarditis and 35 control subjects underwent CMR. FT CMR analysis of systolic longitudinal (LS), circumferential (CS) and radial strain (RS) was performed. Additionally, the protocol allowed for the assessment of T1 and T2 relaxation times. When compared with healthy controls, myocarditis patients demonstrated reduced LS, CS and RS values (LS: -19.5 ± 4.4% vs. -23.6 ± 3.1%, CS: -23.0 ± 5.8% vs. -27.4 ± 3.4%, RS: 28.9 ± 8.5% vs. 32.4 ± 7.4%; P < 0.05, respectively). LS (T1: r = 0.462, P < 0.001; T2: r = 0.436, P < 0.001) and CS (T1: r = 0.429, P < 0.001; T2: r = 0.467, P < 0.001) showed the strongest correlations with T1 and T2 relaxations times. Area under the curve of LS (0.79) was higher compared with those of CS (0.75; P = 0.478) and RS (0.62; P = 0.008). FT CMR myocardial strain analysis might serve as a new tool for assessment of myocardial dysfunction in the diagnostic work-up of patients suspected of having acute myocarditis. Especially, LS and CS show a sufficient diagnostic performance and were most closely correlated with CMR parameters of myocardial oedema. (orig.)

  18. Pulmonary arterial hypertension : an update

    NARCIS (Netherlands)

    Hoendermis, E. S.

    2011-01-01

    Pulmonary arterial hypertension (PAH), defined as group 1 of the World Heart Organisation (WHO) classification of pulmonary hypertension, is an uncommon disorder of the pulmonary vascular system. It is characterised by an increased pulmonary artery pressure, increased pulmonary vascular resistance

  19. Quantitative CT analysis of pulmonary ground-glass opacity nodules for distinguishing invasive adenocarcinoma from non-invasive or minimally invasive adenocarcinoma: the added value of using iodine mapping.

    Science.gov (United States)

    Son, Ji Ye; Lee, Ho Yun; Kim, Jae-Hun; Han, Joungho; Jeong, Ji Yun; Lee, Kyung Soo; Kwon, O Jung; Shim, Young Mog

    2016-01-01

    To determine whether quantitative analysis of iodine-enhanced images generated from dual-energy CT (DECT) have added value in distinguishing invasive adenocarcinoma from non-invasive or minimally invasive adenocarcinoma (MIA) showing ground-glass nodule (GGN). Thirty-four patients with 39 GGNs were enrolled in this prospective study and underwent DECT followed by complete tumour resection. Various quantitative imaging parameters were assessed, including virtual non-contrast (VNC) imaging and iodine-enhanced imaging. Of all 39 GGNs, four were adenocarcinoma in situ (AIS) (10 %), nine were MIA (23 %), and 26 were invasive adenocarcinoma (67 %). When assessing only VNC imaging, multivariate analysis revealed that mass, uniformity, and size-zone variability were independent predictors of invasive adenocarcinoma (odds ratio [OR] = 19.92, P = 0.02; OR = 0.70, P = 0.01; OR = 16.16, P = 0.04, respectively). After assessing iodine-enhanced imaging with VNC imaging, both mass on the VNC imaging and uniformity on the iodine-enhanced imaging were independent predictors of invasive adenocarcinoma (OR = 5.51, P = 0.04 and OR = 0.67, P VNC imaging alone, from 0.888 to 0.959, respectively (P = 0.029). Quantitative analysis using iodine-enhanced imaging metrics versus VNC imaging metrics alone generated from DECT have added value in distinguishing invasive adenocarcinoma from AIS or MIA. Quantitative analysis using DECT was used to distinguish invasive adenocarcinoma. Tumour mass and uniformity were independent predictors of invasive adenocarcinoma. Diagnostic performance was improved after adding iodine parameters to VNC parameters.

  20. Thin-section computed tomography–histopathologic comparisons of pulmonary focal interstitial fibrosis, atypical adenomatous hyperplasia, adenocarcinoma in situ, and minimally invasive adenocarcinoma with pure ground-glass opacity

    Energy Technology Data Exchange (ETDEWEB)

    Si, Ming-Jue, E-mail: smjsh@hotmail.com [Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, No. 280, Mohe Road, Shanghai 201999 (China); Tao, Xiao-Feng, E-mail: taoxiaofeng1963@hotmail.com [Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, No. 280, Mohe Road, Shanghai 201999 (China); Du, Guang-Ye, E-mail: 715376158@qq.com [Department of Pathology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, No. 280, Mohe Road, Shanghai 201999 (China); Cai, Ling-Ling, E-mail: caill_00@163.com [Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, No. 280, Mohe Road, Shanghai 201999 (China); Han, Hong-Xiu, E-mail: hanhongxiu@hotmail.com [Department of Pathology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, No. 280, Mohe Road, Shanghai 201999 (China); Liang, Xi-Zi, E-mail: liangxizish@hotmail.com [Department of Pathology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, No. 280, Mohe Road, Shanghai 201999 (China); Zhao, Jiang-Min, E-mail: zhaojiangmin1962@hotmail.com [Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, No. 280, Mohe Road, Shanghai 201999 (China)

    2016-10-15

    Objective: To retrospectively compare focal interstitial fibrosis (FIF), atypical adenomatous hyperplasia (AAH), adenocarcinoma in situ (AIS), and minimally invasive adenocarcinoma (MIA) with pure ground-glass opacity (GGO) using thin-section computed tomography (CT). Materials and methods: Sixty pathologically confirmed cases were reviewed including 7 cases of FIF, 17 of AAH, 23of AIS, and 13 of MIA. All nodules kept pure ground glass appearances before surgical resection and their last time of thin-section CT imaging data before operation were collected. Differences of patient demographics and CT features were compared among these four types of lesions. Results: FIF occurred more frequently in males and smokers while the others occurred more frequently in female nonsmokers. Nodule size was significant larger in MIA (P < 0.001, cut-off value = 7.5 mm). Nodule shape (P = 0.045), margin characteristics (P < 0.001), the presence of pleural indentation (P = 0.032), and vascular ingress (P < 0.001) were significant factors that differentiated the 4 groups. A concave margin was only demonstrated in a high proportion of FIF at 85.7% (P = 0.002). There were no significant differences (all P > 0.05) in age, malignant history, attenuation value, location, and presence of bubble-like lucency. Conclusion: A nodule size >7.5 mm increases the possibility of MIA. A concave margin could be useful for differentiation of FIF from the other malignant or pre-malignant GGO nodules. The presence of spiculation or pleural indentation may preclude the diagnosis of AAH.

  1. The minimal non-minimal standard model

    International Nuclear Information System (INIS)

    Bij, J.J. van der

    2006-01-01

    In this Letter I discuss a class of extensions of the standard model that have a minimal number of possible parameters, but can in principle explain dark matter and inflation. It is pointed out that the so-called new minimal standard model contains a large number of parameters that can be put to zero, without affecting the renormalizability of the model. With the extra restrictions one might call it the minimal (new) non-minimal standard model (MNMSM). A few hidden discrete variables are present. It is argued that the inflaton should be higher-dimensional. Experimental consequences for the LHC and the ILC are discussed

  2. Pulmonary complications of liver transplantation: radiological appearance and statistical evaluation of risk factors in 300 cases

    International Nuclear Information System (INIS)

    Golfieri, R.; Giampalma, E.; D'Arienzo, P.; Maffei, M.; Muzzi, C.; Tancioni, S.; Gavelli, G.; Morselli Labate, A.M.; Sama, C.; Jovine, E.; Grazi, G.L.; Mazziotti, A.; Cavallari, A.

    2000-01-01

    The aim of this study was to evaluate the incidence, radiographic appearance, time of onset, outcome and risk factors of non-infectious and infectious pulmonary complications following liver transplantation. Chest X-ray features of 300 consecutive patients who had undergone 333 liver transplants over an 11-year period were analysed: the type of pulmonary complication, the infecting pathogens and the mean time of their occurrence are described. The main risk factors for lung infections were quantified through univariate and multivariate statistical analysis. Non-infectious pulmonary abnormalities (atelectasis and/or pleural effusion: 86.7%) and pulmonary oedema (44.7%) appeared during the first postoperative week. Infectious pneumonia was observed in 13.7%, with a mortality of 36.6%. Bacterial and viral pneumonia made up the bulk of infections (63.4 and 29.3%, respectively) followed by fungal infiltrates (24.4%). A fairly good correlation between radiological chest X-ray pattern, time of onset and the cultured microorganisms has been observed in all cases. In multivariate analysis, persistent non-infectious abnormalities and pulmonary oedema were identified as the major independent predictors of posttransplant pneumonia, followed by prolonged assisted mechanical ventilation and traditional caval anastomosis. A ''pneumonia-risk score'' was calculated: low-risk score ( 3.30) population. The ''pneumonia-risk score'' identifies a specific group of patients in whom closer radiographic monitoring is recommended. In addition, a highly significant correlation (p<0.001) was observed between pneumonia-risk score and the expected survival, thus confirming pulmonary infections as a major cause of death in OLT recipients. (orig.)

  3. Pulmonary biomarkers in chronic obstructive pulmonary disease

    NARCIS (Netherlands)

    Barnes, Peter J.; Chowdhury, Badrul; Kharitonov, Sergei A.; Magnussen, Helgo; Page, Clive P.; Postma, Dirkje; Saetta, Marina

    2006-01-01

    There has been increasing interest in using pulmonary biomarkers to understand and monitor the inflammation in the respiratory tract of patients with chronic obstructive pulmonary disease (COPD). In this Pulmonary Perspective we discuss the merits of the various approaches by reviewing the current

  4. Six-minute-walk test in chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Polkey, Michael I; Spruit, Martijn A; Edwards, Lisa D

    2013-01-01

    Outcomes other than spirometry are required to assess nonbronchodilator therapies for chronic obstructive pulmonary disease. Estimates of the minimal clinically important difference for the 6-minute-walk distance (6MWD) have been derived from narrow cohorts using nonblinded intervention....

  5. Optical coherence tomography (OCT) for detection of macular oedema in patients with diabetic retinopathy.

    Science.gov (United States)

    Virgili, Gianni; Menchini, Francesca; Casazza, Giovanni; Hogg, Ruth; Das, Radha R; Wang, Xue; Michelessi, Manuele

    2015-01-07

    Diabetic macular oedema (DMO) is a thickening of the central retina, or the macula, and is associated with long-term visual loss in people with diabetic retinopathy (DR). Clinically significant macular oedema (CSMO) is the most severe form of DMO. Almost 30 years ago, the Early Treatment Diabetic Retinopathy Study (ETDRS) found that CSMO, diagnosed by means of stereoscopic fundus photography, leads to moderate visual loss in one of four people within three years. It also showed that grid or focal laser photocoagulation to the macula halves this risk. Recently, intravitreal injection of antiangiogenic drugs has also been used to try to improve vision in people with macular oedema due to DR.Optical coherence tomography (OCT) is based on optical reflectivity and is able to image retinal thickness and structure producing cross-sectional and three-dimensional images of the central retina. It is widely used because it provides objective and quantitative assessment of macular oedema, unlike the subjectivity of fundus biomicroscopic assessment which is routinely used by ophthalmologists instead of photography. Optical coherence tomography is also used for quantitative follow-up of the effects of treatment of CSMO. To determine the diagnostic accuracy of OCT for detecting DMO and CSMO, defined according to ETDRS in 1985, in patients referred to ophthalmologists after DR is detected. In the update of this review we also aimed to assess whether OCT might be considered the new reference standard for detecting DMO. We searched the Cochrane Database of Systematic Reviews (CDSR), the Database of Abstracts of Reviews of Effects (DARE), the Health Technology Assessment Database (HTA) and the NHS Economic Evaluation Database (NHSEED) (The Cochrane Library 2013, Issue 5), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to June 2013), EMBASE (January 1950 to June 2013), Web of Science Conference Proceedings

  6. Idiopathic pulmonary fibrosis misdiagnosed as sputum-negative pulmonary tuberculosis.

    Science.gov (United States)

    Isah, Muhammad Danasabe; Abbas, Aminu; Abba, Abdullahi A; Umar, Mohammed

    2016-01-01

    Idiopathic pulmonary fibrosis (IPF), also known as cryptogenic fibrosing alveolitis, is one of a spectrum of idiopathic interstitial pneumonia. IPF is an increasingly common condition which poses many diagnostic and therapeutic challenges leading to misdiagnosis and mismanagement. We presented a 55-year-old male textile trader who was initially managed as sputum-negative pulmonary tuberculosis before histology report. He presented to our clinic with Breathlessness and cough of 3 years and 2.5 years, respectively. He had commenced anti-tuberculosis two months before presentation without significant relief. General Physical examination and vital signs were essentially normal. SPO2 was 96% on room air. Chest Examination revealed end-inspiratory bi-basal velcro-like crackles. Other systemic examinations were normal. Radiological examination by way of chest X- ray and chest CT showed features suggestive of IPF. The patient also had open Lung biopsy for histology and spirometry which demonstrated restrictive ventilatory function pattern. A diagnosis of Interstitial lung disease probably Idiopathic Pulmonary Fibrosis was entertained. He was commenced on Tab prednisolone, Tab Rabeprazole, with minimal improvement. IPF have often been misdiagnosed and treated as pulmonary tuberculosis with unfavorable outcome.

  7. Retrograde pulmonary arteriography

    International Nuclear Information System (INIS)

    Calcaterra, G.; Lam, J.; Losekoot, T.G.

    1984-01-01

    The authors performed retrograde pulmonary arteriography by means of a pulmonary venous wedge injection in 10 patients with no demonstrable intrapericardial pulmonary arteries by 'conventional' angiographic techniques. In all cases but one, the procedure demonstrated the feasibility of a further operation. No complications were observed. Retrograde pulmonary arteriography is an important additional method for determining the existence of surgically accessible pulmonary arteries when other techniques have failed. (Auth.)

  8. Fundamentals of management of acute postoperative pulmonary hypertension.

    Science.gov (United States)

    Taylor, Mary B; Laussen, Peter C

    2010-03-01

    In the last several years, there have been numerous advancements in the field of pulmonary hypertension as a whole, but there have been few changes in the management of children with pulmonary hypertension after cardiac surgery. Patients at particular risk for postoperative pulmonary hypertension can be identified preoperatively based on their cardiac disease and can be grouped into four broad categories based on the mechanisms responsible for pulmonary hypertension: 1) increased pulmonary vascular resistance; 2) increased pulmonary blood flow with normal pulmonary vascular resistance; 3) a combination of increased pulmonary vascular resistance and increased blood flow; and 4) increased pulmonary venous pressure. In this review of the immediate postoperative management of pulmonary hypertension, various strategies are discussed including medical therapies, monitoring, ventilatory strategies, and weaning from these supports. With early recognition of patients at particular risk for severe pulmonary hypertension, management strategies can be directed at preventing or minimizing hemodynamic instability and thereby prevent the development of ventricular dysfunction and a low output state.

  9. Prevalence of diabetic macular oedema and related health and social care resource use in England.

    Science.gov (United States)

    Minassian, D C; Owens, D R; Reidy, A

    2012-03-01

    To address the absence from the public health ophthalmology literature of age- and sex-specific prevalence and related resource use for diabetic macular oedema (DMO) in England, UK. Calculation of age- and sex-specific rates from primary source clinical data, and application to the demographic structure of England to estimate the number of cases affected by DMO. A public health commissioner and provider of social care perspective was adopted in a standard cost of illness study. The number of people with diabetes in England in 2010 was estimated at 2,342,951 of which 2,334,550 were aged ≥ 12 years. An estimated 166,325 (7.12%) had DMO in one or both eyes, and of these, 64,725 individuals had clinically significant DMO reducing the visual acuity to poorer than 6/6 in at least one eye. The overall health and social care costs in 2010, on the pathway from screening to rehabilitation and care in the home, are estimated at £116,296,038. The outcomes of this study should alert public health commissioners and clinical providers to the burden of DMO. The methods employed should also encourage the use of clinical ophthalmic data at the interface between local population and hospital-based recording systems.

  10. Who Gets Diabetic Macular Oedema; When; and Why? Pathogenesis and Risk Factors

    Directory of Open Access Journals (Sweden)

    Banu Turgut Ozturk

    2014-10-01

    Full Text Available Diabetic macular oedema (DMO presents an enormous rise in the last decades with an increasing number of diabetic patients. It has a negative impact on the health-related quality of life beside the related visual loss. Additionally, it incurs more health centre visits, higher health costs, and lower working performance. Therefore, early diagnosis and preventive measures gain more and more importance in the management of DMO. Risk factors for DMO can be divided into systemic and ocular risk factors. The leading systemic risk factors include age, type and duration of diabetes, insulin use, and glucose regulation. Hypertension, nephropathy, hyperlipidaemia, anaemia, cardiovascular disease, smoking, and amputation are other risk factors reported. In addition, susceptibility in cases with endothelial nitric oxide synthase polymorphism and vascular endothelial growth factor C634-G polymorphism has been reported. The severity of diabetic retinopathy, microaneurysm turnover, cataract surgery, incomplete vitreous detachment, and peripheral retinal ischaemia are among ocular risk factors. Though avoiding changes in the metabolic memory related to hyperglycaemia in the early period seems to be the most efficient treatment, nowadays close follow-up of patients with high risk and effort to control the modifiable risk factors seems to be the ideal treatment.

  11. Action on diabetic macular oedema: achieving optimal patient management in treating visual impairment due to diabetic eye disease.

    Science.gov (United States)

    Gale, R; Scanlon, P H; Evans, M; Ghanchi, F; Yang, Y; Silvestri, G; Freeman, M; Maisey, A; Napier, J

    2017-05-01

    This paper identifies best practice recommendations for managing diabetes and sight-threatening diabetic eye disease. The authors provide an update for ophthalmologists and allied healthcare professionals on key aspects of diabetes management, supported by a review of the pertinent literature, and recommend practice principles for optimal patient management in treating visual impairment due to diabetic eye disease. In people with diabetes, early optimal glycaemic control reduces the long-term risk of both microvascular and macrovascular complications. The authors propose more can and should be done to maximise metabolic control, promote appropriate behavioural modifications and encourage timely treatment intensification when indicated to ameliorate diabetes-related complications. All people with diabetes should be screened for sight-threatening diabetic retinopathy promptly and regularly. It is shown that attitudes towards treatment adherence in diabetic macular oedema appear to mirror patients' views and health behaviours towards the management of their own diabetes. Awareness of diabetic macular oedema remains low among people with diabetes, who need access to education early in their disease about how to manage their diabetes to delay progression and possibly avoid eye-related complications. Ophthalmologists and allied healthcare professionals play a vital role in multidisciplinary diabetes management and establishment of dedicated diabetic macular oedema clinics is proposed. A broader understanding of the role of the diabetes specialist nurse may strengthen the case for comprehensive integrated care in ophthalmic practice. The recommendations are based on round table presentations and discussions held in London, UK, September 2016.

  12. Incidence of bowel wall oedema on computed tomography exams and association with diarrhoea in renal cell carcinoma patients treated with sunitinib

    Energy Technology Data Exchange (ETDEWEB)

    Cornelissen, Liesbeth; Claus, Filip; Keyzer, Frederik de [KU Leuven, Radiology, Department of Imaging and Pathology, University Hospitals Leuven, Leuven (Belgium); Wolter, Pascal; Dumez, Herlinde; Beuselinck, Benoit [KU Leuven, Department of Medical Oncology and Laboratory of Experimental Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven (Belgium); Lerut, Evelyne [KU Leuven, Pathology, Department of Imaging and Pathology, University Hospitals Leuven, Leuven (Belgium); Poppel, Hendrik van [KU Leuven, Department of Urology, University Hospitals Leuven, Leuven (Belgium)

    2014-08-28

    The purpose of this study was to retrospectively assess the incidence of bowel wall oedema on computed tomography (CT) in patients with renal cell carcinoma (RCC) treated with sunitinib, and to investigate its association with diarrhoea. We conducted a retrospective analysis of all RCC patients treated with sunitinib at our hospital between December 2005 and December 2011. The presence or absence of bowel wall oedema on these CT examinations was scored. The presence of diarrhoea preceding, during, or after sunitinib treatment was identified from the patient files and retrospectively graded. For 54 of 87 patients, bowel wall oedema was present on at least one CT examination. Of these 54 patients, the right-sided colonic segment was affected in 87 %. Diarrhoea was the most common reported adverse event during treatment, with 58 patients (67 %) having grade 1/2 diarrhoea and 9 patients (10 %) having grade 3. There was a statistically significant correlation between the incidence of CT-scored bowel oedema and diarrhoea during sunitinib treatment (P = 0.004). This study shows a very high incidence of bowel wall oedema and a strong correlation between the incidence of bowel wall oedema and diarrhoea in patients treated with sunitinib. (orig.)

  13. Measurement of regional extravascular lung density and of pulmonary blood volume with positron emitting isotopes

    Energy Technology Data Exchange (ETDEWEB)

    Larock, M.P.; Quaglia, L.; Lamotte, D.; De Landsheere, C.; Del Fiore, G.; Chevigne, M.; Peters, J.M.; Rigo, P. (Universite de Liege (Belgium))

    1982-01-01

    Studies of pulmonary blood volume changes with exercise can be performed after labelling of the blood pool by /sup 11/CO inhalation. Positron transaxial tomography permits the quantitative study of density distribution of the chest and of the pulmonary blood volume. This paper represents our preliminary experience with these techniques on models and control patients. We have first verified the linearity of transmission for density distribution below one. The tomographic examination first records a transmission image, then an emission image on the same section. We next normalize emission and transmission values on a region of unit density corresponding to blood: then we substract the emission from the transmission values to measure the extravascular pulmonary density. With crystal probes we record pulmonary blood volume variations before, during and after exercise. Peripheral hemodynamic variations explain the change recorded at the begining and at the end of exercise. Combination of these two techniques should help us to better study the importance of the acute changes in the ''formation'' of pulmonary oedema and its influence on regional pulmonary blood volume.

  14. A Dual Lung Scan for the Evaluation of Pulmonary Function in Patients with Pulmonary Tuberculosis before and after Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Rhee, Chong Heon [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1967-09-15

    In 20 normal cases and 39 pulmonary tuberculosis cases, regional pulmonary arterial blood flow measurement and lung perfusion scans by {sup 131}I-Macroaggregated albumin, lung inhalation scans by colloidal {sup 198}Au and spirometries by respirometer were done at the Radiological Research Institute. The measured lung function tests were compared and the results were as the following: 1) The normal distribution of pulmonary blood flow was found to be 54.5{+-}2.82% to the right lung and 45.5{+-}2.39% to the left lung. The difference between the right and left pulmonary arterial blood flow was significant statistically (p<0.01). In the minimal pulmonary tuberculosis, the average distribution of pulmonary arterial blood flow was found to be 52.5{+-}5.3% to the right lung and 47.5{+-}1.0% to the left lung when the tuberculous lesion was in the right lung, and 56.2{+-}4.4% to the right lung and 43.8{+-}3.1% to the left lung when the tuberculous lesion was in the left lung. The difference of pulmonary arterial blood flow between the right and left lung was statistically not significant compared with the normal distribution. In the moderately advanced pulmonary tuberculosis, the average distribution of pulmonary arterial blood flow was found to be 26.9{+-}13.9% to the right lung and 73.1{+-}13.9% to the left lung when the tuberculous lesion was more severe in the right lung, and 79.6{+-}12.8% to the right lung and 20.4{+-}13.0% to the left lung when the tuberculous lesion was more severe in the left lung. These were found to be highly significant statistically compared with the normal distribution of pulmonary arterial blood flow (p<0.01). When both lungs were evenly involved, the average distribution of pulmonary arterial blood flow was found to be 49.5{+-}8.01% to the right lung and 50.5{+-}8.01% to the left lung. In the far advanced pulmonary tuberculosis, the average distribution of pulmonary arterial blood flow was found to be 18.5{+-}11.6% to the right lung and 81

  15. Regularity of Minimal Surfaces

    CERN Document Server

    Dierkes, Ulrich; Tromba, Anthony J; Kuster, Albrecht

    2010-01-01

    "Regularity of Minimal Surfaces" begins with a survey of minimal surfaces with free boundaries. Following this, the basic results concerning the boundary behaviour of minimal surfaces and H-surfaces with fixed or free boundaries are studied. In particular, the asymptotic expansions at interior and boundary branch points are derived, leading to general Gauss-Bonnet formulas. Furthermore, gradient estimates and asymptotic expansions for minimal surfaces with only piecewise smooth boundaries are obtained. One of the main features of free boundary value problems for minimal surfaces is t

  16. Sensitivity and specificity of a new scoring system for diabetic macular oedema detection using a confocal laser imaging system

    Science.gov (United States)

    Tong, L; Ang, A; Vernon, S; Zambarakji, H; Bhan, A; Sung, V; Page, S

    2001-01-01

    AIM—To assess the use of the Heidelberg retina tomograph (HRT) in screening for sight threatening diabetic macular oedema in a hospital diabetic clinic, using a new subjective analysis system (SCORE).
METHODS—200 eyes of 100 consecutive diabetic patients attending a diabetologist's clinic were studied, all eyes had an acuity of 6/9 or better. All patients underwent clinical examination by an ophthalmologist. Using the HRT, one good scan was obtained for each eye centred on the fovea. A System for Classification and Ordering of Retinal Edema (SCORE) was developed using subjective assessment of the colour map and the reflectivity image. The interobserver agreement of using this method to detect macular oedema was assessed by two observers (ophthalmic trainees) who were familiarised with SCORE by studying standard pictures of eyes not in the study. All scans were graded from 0-6 and test positive cases were defined as having a SCORE value of 0-2. The sensitivity of SCORE was assessed by pooling the data with an additional 88 scans of 88 eyes in order to reduce the confidence interval of the index.
RESULTS—12 eyes in eight out of the 100 patients had macular oedema clinically. Three scans in three patients could not be analysed because of poor scan quality. In the additional group of scans 76 out of 88 eyes had macular oedema clinically. The scoring system had a specificity of 99% (95% CI 96-100) and sensitivity of 67% (95% CI 57-76). The predictive value of a negative test was 87% (95% CI 82-99), and that of a positive test was 95% (95% CI 86-99). The mean difference of the SCORE value between two observers was -0.2 (95% CI -0.5 to +0.07).
CONCLUSIONS—These data suggest that SCORE is potentially useful for detecting diabetic macular oedema in hospital diabetic patients.

 PMID:11133709

  17. Hereditary angio-oedema in the Western Cape Province, South Africa.

    Science.gov (United States)

    Coovadia, K M; Chothia, M-Y; Baker, S G; Peter, J G; Potter, P C

    2018-03-28

    Hereditary angio-oedema (HAE) is an autosomal dominant condition caused by a deficiency in the C1-esterase inhibitor protein, resulting in increased bradykinin release. It presents clinically with recurrent attacks of angio-oedema, commonly affecting the limbs, face, upper airway and gastrointestinal tract. Little is known about this condition in sub-Saharan Africa. To analyse and report on the clinical presentation and treatment of patients with HAE in the Western Cape Province, South Africa. A retrospective analysis was conducted on a series of 60 cases of HAE seen between 2010 and 2015 at the Allergy Diagnostic and Clinical Research Unit, University of Cape Town Lung Institute, and the Allergy Clinic at Groote Schuur Hospital, Cape Town. The findings in 43 cases of type 1 HAE are described. Parameters assessed included age, gender, age of diagnosis, duration of illness, family history, identifiable triggers, average duration of attack, number of attacks per year and type of attack. A total of 43 patients were included in this study. Of these, 65.1% (28/43) were female. The median age at diagnosis was 20 years (interquartile range (IQR) 10 - 27) and the median duration of illness 10.5 years (IQR 6 - 22). Of the patients, 62.8% (27/43), 32.6% (14/43) and 4.7% (2/43) were of mixed ancestry, white and black African, respectively; 51.2% (22/43) were index cases, with the remaining 48.8% (21/43) diagnoses via family member screening, 12 families making up the majority of the cohort. The mean (standard deviation) duration of an acute attack was 49 (25.8) hours, and 64.3% (27/42), 71.4% (30/42), 14.3% (6/42) and 88.1% (37/42) of patients experienced facial or upper airway, abdominal, external genitalia and limb attacks, respectively. Danazol for long-term prophylaxis was used in 21 patients, while C1-inhibitor concentrate (Berinert) was accessed for short-term prophylaxis in only four patients. Acute life-threating attacks were treated with fresh frozen plasma in 11

  18. Solitary pulmonary nodule

    Science.gov (United States)

    ... Adenocarcinoma - chest x-ray Pulmonary nodule - front view chest x-ray Pulmonary nodule, solitary - CT scan Respiratory system References Gotway MB, Panse PM, Gruden JF, Elicker BM. Thoracic radiology: noninvasive diagnostic imaging. In: Broaddus VC, Mason RJ, ...

  19. Hantavirus Pulmonary Syndrome (HPS)

    Science.gov (United States)

    ... to Yosemite FAQ: Non-U.S. Visitors to Yosemite History of HPS Related Links Prevent Rodent Infestations Cleaning Up After Rodents Diseases From Rodent Hantavirus Pulmonary Syndrome (HPS) Recommend on Facebook Tweet Share Compartir Hantavirus Pulmonary Syndrome (HPS) is ...

  20. Risk factors for cerebral oedema in children and adolescents with diabetic ketoacidosis

    Directory of Open Access Journals (Sweden)

    Natasha Y. Yaneva

    2016-11-01

    Full Text Available Cerebral oedema (CO is a rare life-threatening complication of diabetic ketoacidosis (DKA in children. We analysed the biochemical and therapeutic risk factors for CO in DKA by a retrospective review of 256 children hospitalized for DKA between February 2003 and March 2015. The demographic characteristics, biochemical variables and therapeutic interventions were compared between the patients with and without CO. CO was observed in 22 (8.6% of the 256 subjects included in the study. One of these patients (5% had a fatal outcome and two patients (9% survived with neurological consequences. CO was significantly associated with severe DKA: lower initial venous pH (p < 0.001 and bicarbonate (p < 0.001, higher initial blood glucose (p < 0.01, urea level (p < 0.05 and baseline serum osmolality (р < 0.05. During the treatment of DKA, low serum phosphate level was found to be significantly associated with CO (p < 0.05. We also found significant dependence between the development of CO and the initiation of treatment for DKA in another facility before hospitalization in our hospital (p < 0.05, bicarbonate application (p < 0.001, higher fluid volume infused initially (p < 0.01 and delayed potassium substitution (p < 0.01. Severe ketoacidosis, hyperglycaemia and dehydration at presentation, and low serum phosphate during treatment are significantly related to CO formation in children with DKA. The initial severe acidosis and hyperglycaemia probably cause brain injury which progresses into CO in the course of developing hypophosphatemia and cerebral hypervolemia.

  1. Minimally invasive orthognathic surgery.

    Science.gov (United States)

    Resnick, Cory M; Kaban, Leonard B; Troulis, Maria J

    2009-02-01

    Minimally invasive surgery is defined as the discipline in which operative procedures are performed in novel ways to diminish the sequelae of standard surgical dissections. The goals of minimally invasive surgery are to reduce tissue trauma and to minimize bleeding, edema, and injury, thereby improving the rate and quality of healing. In orthognathic surgery, there are two minimally invasive techniques that can be used separately or in combination: (1) endoscopic exposure and (2) distraction osteogenesis. This article describes the historical developments of the fields of orthognathic surgery and minimally invasive surgery, as well as the integration of the two disciplines. Indications, techniques, and the most current outcome data for specific minimally invasive orthognathic surgical procedures are presented.

  2. Correlates of minimal dating.

    Science.gov (United States)

    Leck, Kira

    2006-10-01

    Researchers have associated minimal dating with numerous factors. The present author tested shyness, introversion, physical attractiveness, performance evaluation, anxiety, social skill, social self-esteem, and loneliness to determine the nature of their relationships with 2 measures of self-reported minimal dating in a sample of 175 college students. For women, shyness, introversion, physical attractiveness, self-rated anxiety, social self-esteem, and loneliness correlated with 1 or both measures of minimal dating. For men, physical attractiveness, observer-rated social skill, social self-esteem, and loneliness correlated with 1 or both measures of minimal dating. The patterns of relationships were not identical for the 2 indicators of minimal dating, indicating the possibility that minimal dating is not a single construct as researchers previously believed. The present author discussed implications and suggestions for future researchers.

  3. Pulmonary Arterial Hypertension

    Science.gov (United States)

    ... heart). This type of pulmonary hypertension was called “secondary pulmonary hypertension” but is now referred to as PH, because the cause is known to be from lung disease, heart disease, or chronic thromboemboli (blood clots). Pulmonary Arterial Hypertension (PAH) used to be ...

  4. Pulmonary manifestations of malaria

    International Nuclear Information System (INIS)

    Rauber, K.; Enkerlin, H.L.; Riemann, H.; Schoeppe, W.; Frankfurt Univ.

    1987-01-01

    We report on the two different types of pulmonary manifestations in acute plasmodium falciparum malaria. The more severe variant shows long standing interstitial pulmonary infiltrates, whereas in the more benign courses only short-term pulmonary edemas are visible. (orig.) [de

  5. Hexavalent Chromium Minimization Strategy

    Science.gov (United States)

    2011-05-01

    Logistics 4 Initiative - DoD Hexavalent Chromium Minimization Non- Chrome Primer IIEXAVAJ ENT CHRO:M I~UMI CHROMIUM (VII Oil CrfVli.J CANCEfl HAnRD CD...Management Office of the Secretary of Defense Hexavalent Chromium Minimization Strategy Report Documentation Page Form ApprovedOMB No. 0704-0188...00-2011 4. TITLE AND SUBTITLE Hexavalent Chromium Minimization Strategy 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6

  6. Minimal Super Technicolor

    DEFF Research Database (Denmark)

    Antola, M.; Di Chiara, S.; Sannino, F.

    2011-01-01

    We introduce novel extensions of the Standard Model featuring a supersymmetric technicolor sector (supertechnicolor). As the first minimal conformal supertechnicolor model we consider N=4 Super Yang-Mills which breaks to N=1 via the electroweak interactions. This is a well defined, economical......, between unparticle physics and Minimal Walking Technicolor. We consider also other N =1 extensions of the Minimal Walking Technicolor model. The new models allow all the standard model matter fields to acquire a mass....

  7. Minimally invasive non-surgical lung volume reduction

    International Nuclear Information System (INIS)

    Shen Liming; Zhou Dayong; Shen Junkang

    2006-01-01

    Minimally invasive treatment with lung volume reduction is the promising future for severe pulmonary emphysema patients. With emerging and improving of new techniques and instruments, it would become an important choice for managing severe emphysema. A comprehensive review is here documented through the correlative techniques, instruments, new achievements and latest research work. (authors)

  8. [Unilateral acute pulmonary edema and ischemic myocardial process: a case report].

    Science.gov (United States)

    Bentaleb, A; Tagu, P; Vascaut, L

    2008-08-01

    Unilateral acute pulmonary oedema (APO) is a rare radioclinical finding. It occurs secondary to multiple specific and rare pathological processes. Functional ischemic mitral regurgitation (FIMR) secondary to myocardial necrosis is one of the rare aetiologies involved in its pathogenesis. This concerns a 94-year-old male patient with a history of myocardial infarction who presented with a clinical picture of unilateral APO secondary to functional mitral regurgitation as a complication of myocardial necrosis. In addition to the clinical presentation and unilateral radiological findings, the diagnosis was based essentially on the electrocardiographic tracing, as well as changes in cardiac enzyme levels and transthoracic echocardiogram coupled with Doppler tissue imaging. This resulted after ruling out many differential diagnoses. Unilateral APO secondary to functional mitral regurgitation often presents diagnostic challenges and problems of initial management for the clinician. There are multiple aetiologies of acute unilateral pulmonary oedema, namely mechanical (re-expansion), lesional, vascular, bronchial obstructions, as well as iatrogenic causes, as is the case with some lung transplantations. As with all cases of APO, the treatment is based mainly on diuretics with high-flow oxygen therapy in association with an anticoagulant, which is usually effectively combined with a platelet aggregation inhibiting drug and sometimes with vasodilators and beta-blockers. Surgical treatment with valvuloplasty or valvular replacement appears to be the most effective means for preventing relapse.

  9. Is a linear probe helpful in diagnosing diseases of pulmonary interstitial spaces?

    Directory of Open Access Journals (Sweden)

    Natalia Buda

    2017-06-01

    Full Text Available In a lung ultrasound examination, interstitial lung lesions are visible as numerous B-line artifacts, and are best recorded with the use of a convex probe. Interstitial lung lesions may result from many conditions, including cardiogenic pulmonary oedema, non-cardiogenic pulmonary oedema, or interstitial lung disease. Hence difficulties in the differential diagnostics of the above clinical conditions. This article presents cases of patients suffering from interstitial lung lesions discovered in the course of lung ultrasound examination. The patients were examined with a 3.5–5.0 MHz convex probe and a 7.0–11.0 MHz linear probe. Ultrasound images have been analysed, and differences in the imaging with both probes in patients with interstitial lung lesions have been detailed. The use of a linear probe in patients with interstitial lung lesions (discovered with a convex or a micro-convex probe provides additional information on the source of the origin of the lesions.

  10. Superolateral Hoffa's fat pad (SHFP) oedema and patellar cartilage volume loss: quantitative analysis using longitudinal data from the Foundation for the National Institute of Health (FNIH) Osteoarthritis Biomarkers Consortium.

    Science.gov (United States)

    Haj-Mirzaian, Arya; Guermazi, Ali; Hafezi-Nejad, Nima; Sereni, Christopher; Hakky, Michael; Hunter, David J; Zikria, Bashir; Roemer, Frank W; Demehri, Shadpour

    2018-04-12

    To determine the association of superolateral Hoffa's fat pad (SHFP) oedema and patellofemoral joint structural damage in participants of Foundation for the National Institute of Health Osteoarthritis Biomarkers Consortium study. Baseline and 24-month MRIs of 600 subjects were assessed. The presence of SHFP oedema (using 0-3 grading scale) and patellar morphology metrics were determined using baseline MRI. Quantitative patellar cartilage volume and semi-quantitative MRI osteoarthritis knee score (MOAKS) variables were extracted. The associations between SHFP oedema and patellar cartilage damage, bone marrow lesion (BML), osteophyte and morphology were evaluated in cross-sectional model. In longitudinal analysis, the associations between oedema and cartilage volume loss (defined using reliable change index) and MOAKS worsening were evaluated. In cross-sectional evaluations, the presence of SHFP oedema was associated with simultaneous lateral patellar cartilage/BML defects and inferior-medial patellar osteophyte size. A significant positive correlation between the degree of patella alta and SHFP oedema was detected (r = 0.259, p < 0.001). The presence of oedema was associated with 24-month cartilage volume loss (odds ratio (OR) 2.11, 95% confidence interval 1.46-3.06) and medial patellar BML size (OR 1.92 (1.15-3.21)) and number (OR 2.50 (1.29-4.88)) worsening. The optimal cut-off value for the grade of baseline SHFP oedema regarding both presence and worsening of patellar structural damage was ≥ 1 (presence of any SHFP hyperintensity). The presence of SHFP oedema could be considered as a predictor of future patellar cartilage loss and BML worsening, and an indicator of simultaneous cartilage, BML and osteophyte defects. • SHFP oedema was associated with simultaneous lateral patellar OA-related structural damage. • SHFP oedema was associated with longitudinal patellar cartilage loss over 24 months. • SHFP oedema could be considered as indicator and predictor

  11. Minimizing Mutual Couping

    DEFF Research Database (Denmark)

    2010-01-01

    Disclosed herein are techniques, systems, and methods relating to minimizing mutual coupling between a first antenna and a second antenna.......Disclosed herein are techniques, systems, and methods relating to minimizing mutual coupling between a first antenna and a second antenna....

  12. Ruled Laguerre minimal surfaces

    KAUST Repository

    Skopenkov, Mikhail; Pottmann, Helmut; Grohs, Philipp

    2011-01-01

    A Laguerre minimal surface is an immersed surface in ℝ 3 being an extremal of the functional ∫ (H 2/K-1)dA. In the present paper, we prove that the only ruled Laguerre minimal surfaces are up to isometry the surfaces ℝ (φλ) = (Aφ, Bφ, Cφ + D cos 2φ

  13. [Association between visual improvement after photocoagulation and the use of angiotensin converting enzyme inhibitors in diabetic macular oedema].

    Science.gov (United States)

    Somilleda-Ventura, Selma Alin; García-Rubio, Yatzul Zuhaila; Razo Blanco-Hernández, Dulce Milagros; Lima-Gómez, Virgilio

    2016-01-01

    Angiotensin converting enzyme inhibitors are effective in delaying the progression of diabetic retinopathy. It is unknown if their use is associated with a better visual outcome in patients with diabetic macular oedema. A non-experimental, comparative, longitudinal and retrospective study was performed on patients with diabetic macular oedema treated by focal photocoagulation, and with systemic arterial hypertension treated with angiotensin converting enzyme inhibitors (Group 1), and without hypertension (Group 2). The dependent variable was the proportion with visual improvement, operatively defined as the gain of one or more lines of vision three weeks after photocoagulation. The independent variable was the use of angiotensin converting enzyme inhibitors. The proportion of eyes with visual improvement after treatment was compared between groups using the Chi squared (χ(2)) test. A total of 33 eyes (51.6%) were assigned to group 1, and 31 (48.2%), to group 2. The mean of visual acuity improved after three weeks, compared with baseline (p=0.002). The proportion of eyes with visual improvement did not differ between patients treated with angiotensin converting enzyme inhibitors (45.5%) and those that did not use them (51.6%, p=0.4). There was no statistical difference in the proportion of eyes with visual improvement between patients treated with angiotensin converting enzyme inhibitors and in those where they were not used. There is no support for the inhibition of angiotensin II in addition to photocoagulation for improving the outcome in patients with diabetic macular oedema. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  14. Measuring the relative extent of pulmonary infiltrates by hierarchical classification of patient-specific image features

    Science.gov (United States)

    Tsevas, S.; Iakovidis, D. K.

    2011-11-01

    Pulmonary infiltrates are common radiological findings indicating the filling of airspaces with fluid, inflammatory exudates, or cells. They are most common in cases of pneumonia, acute respiratory syndrome, atelectasis, pulmonary oedema and haemorrhage, whereas their extent is usually correlated with the extent or the severity of the underlying disease. In this paper we propose a novel pattern recognition framework for the measurement of the extent of pulmonary infiltrates in routine chest radiographs. The proposed framework follows a hierarchical approach to the assessment of image content. It includes the following: (a) sampling of the lung fields; (b) extraction of patient-specific grey-level histogram signatures from each sample; (c) classification of the extracted signatures into classes representing normal lung parenchyma and pulmonary infiltrates; (d) the samples for which the probability of belonging to one of the two classes does not reach an acceptable level are rejected and classified according to their textural content; (e) merging of the classification results of the two classification stages. The proposed framework has been evaluated on real radiographic images with pulmonary infiltrates caused by bacterial infections. The results show that accurate measurements of the infiltration areas can be obtained with respect to each lung field area. The average measurement error rate on the considered dataset reached 9.7% ± 1.0%.

  15. Efficacy and safety of balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension guided by cone-beam computed tomography and electrocardiogram-gated area detector computed tomography.

    Science.gov (United States)

    Ogo, Takeshi; Fukuda, Tetsuya; Tsuji, Akihiro; Fukui, Shigefumi; Ueda, Jin; Sanda, Yoshihiro; Morita, Yoshiaki; Asano, Ryotaro; Konagai, Nao; Yasuda, Satoshi

    2017-04-01

    Chronic thromboembolic pulmonary hypertension (CTEPH) is a disease characterized by chronic obstructive thrombus and pulmonary hypertension. Balloon pulmonary angioplasty (BPA), an emerging alternative catheter-based treatment for inoperable patients with CTEPH, has not yet been standardised, especially for lesion assessment in distal pulmonary arteries. Recent advancement in computed tomography enables distal CTEPH lesions to be visualized. We retrospectively studied 80 consecutive patients with inoperable CTEPH who received BPA guided by cone-beam computed tomography (CT) (CBCT) or electrocardiogram (ECG)-gated area detector CT (ADCT) for target lesion assessment. We collected clinical and hemodynamic data, including procedural complications, before BPA and at 3 months and 1year after BPA. Three hundred eight-five BPA sessions (4.8 sessions/patient) were performed for the lesions of subsegmental arteries (1155 lesions), segmental arteries (738 lesions), and lobar arteries (4 lesions) identified by CBCT or ECG-gated ADCT. Significant improvements in the symptoms, 6-min walk distance, brain natriuretic peptide level, exercise capacity, and haemodynamics were observed 3 months and 1year after BPA. No cases of death or cardiogenic shock with a low rate of severe wire perforation (0.3%) and severe reperfusion oedema (0.3%) were observed. BPA guided by CBCT or ECG-gated ADCT is effective and remarkably safe in patients with CTEPH . These new advanced CT techniques may be useful in pre-BPA target lesion assessment. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Rosiglitazone attenuates pulmonary fibrosis and radiation-induced intestinal damage

    International Nuclear Information System (INIS)

    Mangoni, M.; Gerini, C.; Sottili, M.; Cassani, S.; Stefania, G.; Biti, G.; Castiglione, F.; Vanzi, E.; Bottoncetti, A.; Pupi, A.

    2011-01-01

    Full text of publication follows: Purpose.-The aim of the study was to evaluate radioprotective effect of rosiglitazone (RGZ) on a murine model of late pulmonary damage and of acute intestinal damage. Methods.- Lung fibrosis: C57 mice were treated with the radiomimetic agent bleomycin, with or without rosiglitazone (5 mg/kg/day). To obtain an independent qualitative and quantitative measure for lung fibrosis we used high resolution CT, performed twice a week during the entire observation period. Hounsfield Units (HU) of section slides from the upper and lower lung region were determined. On day 31 lungs were collected for histological analysis. Acute intestinal damage: mice underwent 12 Gy total body irradiation with or without rosiglitazone. Mice were sacrificed 24 or 72 h after total body irradiation and ileum and colon were collected. Results.- Lung fibrosis: after bleomycin treatment, mice showed typical CT features of lung fibrosis, including irregular septal thickening and patchy peripheral reticular abnormalities. Accordingly, HU lung density was dramatically increased. Rosiglitazone markedly attenuated the radiological signs of fibrosis and strongly inhibited HU lung density increase (60% inhibition at the end of the observation period). Histological analysis revealed that in bleomycin-treated mice, fibrosis involved 50-55% of pulmonary parenchyma and caused an alteration of the alveolar structures in 10% of parenchyma, while in rosiglitazone-treated mice, fibrosis involved only 20-25% of pulmonary parenchyma, without alterations of the alveolar structures. Acute intestinal damage: 24 h after 12 Gy of total body irradiation intestinal mucosa showed villi shortening, mucosal thickness and crypt necrotic changes. Rosiglitazone showed a histological improvement of tissue structure, with villi and crypts normalization and oedema reduction. Conclusion.- These results demonstrate that rosiglitazone displays a protective effect on pulmonary fibrosis and radiation

  17. Exchangeable pulmonary water space evaluation using giant liposomes

    International Nuclear Information System (INIS)

    Santos, A.C.; Ribeiro, M.J.; Ferreira, N.; De Lima, J.J.P.

    1998-01-01

    The present work aims to study the potential use of liposomes for the evaluation of pulmonary exchangeable water space, important parameter in some pulmonary oedema situations. This study is based upon the delivery of a diffusible water radiotracer into pulmonary capillary network, which equilibrates with interstitial water space of the lung and returns to the blood circulation. The time constant of this phenomena depends on the magnitude of the water space under study. The release of the diffusible radiotracer in lung capillaries is performed using liposomes with specific formulation. The giant liposomes (15-30μm diameter) used in this study are instable at 37 deg. C. They are biocompatible, biodegradable, with low toxicity and showed no immunogenicity. A water tracer labelled with 99m Tc, encapsulated in the aqueous phase of giant liposomes, has been used. Liposomes were prepared in sterile conditions and with apyrogenic materials. The lipid films composition is L-α-diestearoylphosphatidylcholine (DSPC), L-α-phosphatidyl-DL-glycerol (EPG) and cholesterol (CHOL) (60%/10%/30% mass ratio). After iv injection at +-20 deg. C in the femoral vein of Wistar rats (300g-600g) or albine rabbits (4.5-5Kg), the thermolabile liposomes will be entrapped in lung capillaries and release the radiotracer locally. When the radiodrug is diffusible we will evaluate the volume of the exchangeable pulmonary water analyzing the activity/time curves. These curves are slower for greater water spaces. When the radiotracer is non-diffusible, the disappearance curves are not influenced by the extravascular water space. (author)

  18. Rosiglitazone attenuates pulmonary fibrosis and radiation-induced intestinal damage

    Energy Technology Data Exchange (ETDEWEB)

    Mangoni, M.; Gerini, C.; Sottili, M.; Cassani, S.; Stefania, G.; Biti, G. [Radiotherapy Unit, Clinical Physiopathology Department, University of Florence, Firenze (Italy); Castiglione, F. [Department of Human Pathology and Oncology, University of Florence, Firenze (Italy); Vanzi, E.; Bottoncetti, A.; Pupi, A. [Nuclear Medicine Unit, Clinical Physiopathology Department, University of Florence, Firenze (Italy)

    2011-10-15

    Full text of publication follows: Purpose.-The aim of the study was to evaluate radioprotective effect of rosiglitazone (RGZ) on a murine model of late pulmonary damage and of acute intestinal damage. Methods.- Lung fibrosis: C57 mice were treated with the radiomimetic agent bleomycin, with or without rosiglitazone (5 mg/kg/day). To obtain an independent qualitative and quantitative measure for lung fibrosis we used high resolution CT, performed twice a week during the entire observation period. Hounsfield Units (HU) of section slides from the upper and lower lung region were determined. On day 31 lungs were collected for histological analysis. Acute intestinal damage: mice underwent 12 Gy total body irradiation with or without rosiglitazone. Mice were sacrificed 24 or 72 h after total body irradiation and ileum and colon were collected. Results.- Lung fibrosis: after bleomycin treatment, mice showed typical CT features of lung fibrosis, including irregular septal thickening and patchy peripheral reticular abnormalities. Accordingly, HU lung density was dramatically increased. Rosiglitazone markedly attenuated the radiological signs of fibrosis and strongly inhibited HU lung density increase (60% inhibition at the end of the observation period). Histological analysis revealed that in bleomycin-treated mice, fibrosis involved 50-55% of pulmonary parenchyma and caused an alteration of the alveolar structures in 10% of parenchyma, while in rosiglitazone-treated mice, fibrosis involved only 20-25% of pulmonary parenchyma, without alterations of the alveolar structures. Acute intestinal damage: 24 h after 12 Gy of total body irradiation intestinal mucosa showed villi shortening, mucosal thickness and crypt necrotic changes. Rosiglitazone showed a histological improvement of tissue structure, with villi and crypts normalization and oedema reduction. Conclusion.- These results demonstrate that rosiglitazone displays a protective effect on pulmonary fibrosis and radiation

  19. Single-blind trial addressing the differential effects of two reflexology techniques versus rest, on ankle and foot oedema in late pregnancy.

    Science.gov (United States)

    Mollart, L

    2003-11-01

    This single-blind randomised controlled trial explored the differential effects of two different foot reflexology techniques with a period of rest on oedema-relieving effects and symptom relief in healthy pregnant women with foot oedema. Fifty-five women in the third trimester were randomly assigned to one of the three groups: a period of rest, 'relaxing' reflexology techniques or a specific 'lymphatic' reflexology technique for 15 min with pre- and post-therapy ankle and foot circumference measurements and participant questionnaire. There was no statistically significant difference in the circumference measurements between the three groups; however, the lymphatic technique reflexology group mean circumference measurements were all decreased. A significant reduction in the women's symptom mean measurements in all groups (preflexology techniques, relaxing reflexology techniques and a period of rest had a non-significant oedema-relieving effect. From the women's viewpoint, lymphatic reflexology was the preferred therapy with significant increase in symptom relief.

  20. Minimizing Exposure at Work

    Science.gov (United States)

    ; Environment Human Health Animal Health Safe Use Practices Food Safety Environment Air Water Soil Wildlife Home Page Pesticide Health and Safety Information Safe Use Practices Minimizing Exposure at Work Pesticides - Pennsylvania State University Cooperative Extension Personal Protective Equipment for Working

  1. Minimalism. Clip and Save.

    Science.gov (United States)

    Hubbard, Guy

    2002-01-01

    Provides background information on the art movement called "Minimalism" discussing why it started and its characteristics. Includes learning activities and information on the artist, Donald Judd. Includes a reproduction of one of his art works and discusses its content. (CMK)

  2. Ruled Laguerre minimal surfaces

    KAUST Repository

    Skopenkov, Mikhail

    2011-10-30

    A Laguerre minimal surface is an immersed surface in ℝ 3 being an extremal of the functional ∫ (H 2/K-1)dA. In the present paper, we prove that the only ruled Laguerre minimal surfaces are up to isometry the surfaces ℝ (φλ) = (Aφ, Bφ, Cφ + D cos 2φ) + λ(sin φ, cos φ, 0), where A,B,C,D ε ℝ are fixed. To achieve invariance under Laguerre transformations, we also derive all Laguerre minimal surfaces that are enveloped by a family of cones. The methodology is based on the isotropic model of Laguerre geometry. In this model a Laguerre minimal surface enveloped by a family of cones corresponds to a graph of a biharmonic function carrying a family of isotropic circles. We classify such functions by showing that the top view of the family of circles is a pencil. © 2011 Springer-Verlag.

  3. Minimal and careful processing

    OpenAIRE

    Nielsen, Thorkild

    2004-01-01

    In several standards, guidelines and publications, organic food processing is strongly associated with "minimal processing" and "careful processing". The term "minimal processing" is nowadays often used in the general food processing industry and described in literature. The term "careful processing" is used more specifically within organic food processing but is not yet clearly defined. The concept of carefulness seems to fit very well with the processing of organic foods, especially if it i...

  4. Pulmonary capillary pressure in pulmonary hypertension.

    Science.gov (United States)

    Souza, Rogerio; Amato, Marcelo Britto Passos; Demarzo, Sergio Eduardo; Deheinzelin, Daniel; Barbas, Carmen Silvia Valente; Schettino, Guilherme Paula Pinto; Carvalho, Carlos Roberto Ribeiro

    2005-04-01

    Pulmonary capillary pressure (PCP), together with the time constants of the various vascular compartments, define the dynamics of the pulmonary vascular system. Our objective in the present study was to estimate PCPs and time constants of the vascular system in patients with idiopathic pulmonary arterial hypertension (IPAH), and compare them with these measures in patients with acute respiratory distress syndrome (ARDS). We conducted the study in two groups of patients with pulmonary hypertension: 12 patients with IPAH and 11 with ARDS. Four methods were used to estimate the PCP based on monoexponential and biexponential fitting of pulmonary artery pressure decay curves. PCPs in the IPAH group were considerably greater than those in the ARDS group. The PCPs measured using the four methods also differed significantly, suggesting that each method measures the pressure at a different site in the pulmonary circulation. The time constant for the slow component of the biexponential fit in the IPAH group was significantly longer than that in the ARDS group. The PCP in IPAH patients is greater than normal but methodological limitations related to the occlusion technique may limit interpretation of these data in isolation. Different disease processes may result in different times for arterial emptying, with resulting implications for the methods available for estimating PCP.

  5. Management of Pulmonary Nodules

    OpenAIRE

    Arvin Aryan

    2010-01-01

    Pulmonary nodule characterization is currently being redefined as new clinical, radiological and pathological data are reported, necessitating a reevaluation of the clinical management."nIn approach to an incidentally detected pulmonary nodule, we should consider that there are different risk situations, different lesion morphologies, and different sizes with various management options."nIn this session we will review the different risk situations for patients with pulmonary nodules...

  6. Cystic pulmonary hydatidosis

    Directory of Open Access Journals (Sweden)

    Malay Sarkar

    2016-01-01

    Full Text Available Cystic echinococcosis (CE is a zoonotic parasitic disease caused by the larval stages of the cestode Echinococcus granulosus. Worldwide, pulmonary hydatid cyst is a significant problem medically, socially, and economically. Surgery is the definitive therapy of pulmonary hydatidosis. Benzimidazoles may be considered in patients with a surgical contraindication. This review will focus on pathogenesis, lifecycle, clinical features, and management of pulmonary hydatid disease.

  7. Pulmonary CT findings in acute mercury vapour exposure

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, Manabu; Sato, Kimihiko; Heianna, Jyouiti; Hirano, Yoshinori; Omachi, Kohiti; Izumi, Jyunichi; Watarai, Jiro

    2001-01-01

    AIM: We describe the pulmonary computed tomography (CT) findings in acute mercury poisoning. MATERIALS AND METHODS: Initial (n= 8) and follow-up (n= 6) chest CT examinations in eight patients exposed to mercury vapour while cutting pipes in a sulphuric acid plant were reviewed. Of the eight patients, two were asymptomatic and had normal CT results, two were asymptomatic but had abnormalities on CT, and four had both acute symptoms and positive CT results. The patients were all men whose ages ranged from 37 to 54 years (mean, 49 years). RESULTS: Poorly defined nodules were present in five of six patients with positive CT findings, present alone in two patients or as part of a mixed pattern in three. They were random in distribution. Alveolar consolidation (n= 3) and areas of ground-glass opacity (n= 4) were observed and were more prominent in the most severely affected patients with the highest blood and urine level of mercury, predominantly in the upper and/or middle zone. These abnormal findings on CT resolved with (n= 1) or without (n= 5) steroid therapy. Pathological findings (n= 1) demonstrated acute interstitial changes predominantly with oedema. CONCLUSION: We report CT findings in eight patients acutely exposed to mercury vapour. The pulmonary injury was reversible on CT in these cases. Hashimoto, M. (2001)

  8. Pulmonary vasculitis: imaging features

    International Nuclear Information System (INIS)

    Seo, Joon Beom; Im, Jung Gi; Chung, Jin Wook; Goo, Jin Mo; Park, Jae Hyung; Yeon, Kyung Mo; Song, Jae Woo

    1999-01-01

    Vasculitis is defined as an inflammatory process involving blood vessels, and can lead to destruction of the vascular wall and ischemic damage to the organs supplied by these vessels. The lung is commonly affected. A number of attempts have been made to classify and organize pulmonary vasculitis, but because the clinical manifestations and pathologic features of the condition overlap considerably, these afforts have failed to achieve a consensus. We classified pulmonary vasculitis as belonging to either the angitiis-granulomatosis group, the diffuse pulmonary hemorrhage with capillaritis group, or 'other'. Characteristic radiographic and CT findings of the different types of pulmonary vasculitis are illustrated, with a brief discussion of the respective disease entities

  9. Waste minimization assessment procedure

    International Nuclear Information System (INIS)

    Kellythorne, L.L.

    1993-01-01

    Perry Nuclear Power Plant began developing a waste minimization plan early in 1991. In March of 1991 the plan was documented following a similar format to that described in the EPA Waste Minimization Opportunity Assessment Manual. Initial implementation involved obtaining management's commitment to support a waste minimization effort. The primary assessment goal was to identify all hazardous waste streams and to evaluate those streams for minimization opportunities. As implementation of the plan proceeded, non-hazardous waste streams routinely generated in large volumes were also evaluated for minimization opportunities. The next step included collection of process and facility data which would be useful in helping the facility accomplish its assessment goals. This paper describes the resources that were used and which were most valuable in identifying both the hazardous and non-hazardous waste streams that existed on site. For each material identified as a waste stream, additional information regarding the materials use, manufacturer, EPA hazardous waste number and DOT hazard class was also gathered. Once waste streams were evaluated for potential source reduction, recycling, re-use, re-sale, or burning for heat recovery, with disposal as the last viable alternative

  10. Regulation of pulmonary inflammation by mesenchymal cells

    NARCIS (Netherlands)

    Alkhouri, Hatem; Poppinga, Wilfred Jelco; Tania, Navessa Padma; Ammit, Alaina; Schuliga, Michael

    2014-01-01

    Pulmonary inflammation and tissue remodelling are common elements of chronic respiratory diseases such as asthma, chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), and pulmonary hypertension (PH). In disease, pulmonary mesenchymal cells not only contribute to tissue

  11. Minimal quantization and confinement

    International Nuclear Information System (INIS)

    Ilieva, N.P.; Kalinowskij, Yu.L.; Nguyen Suan Han; Pervushin, V.N.

    1987-01-01

    A ''minimal'' version of the Hamiltonian quantization based on the explicit solution of the Gauss equation and on the gauge-invariance principle is considered. By the example of the one-particle Green function we show that the requirement for gauge invariance leads to relativistic covariance of the theory and to more proper definition of the Faddeev - Popov integral that does not depend on the gauge choice. The ''minimal'' quantization is applied to consider the gauge-ambiguity problem and a new topological mechanism of confinement

  12. Minimal Composite Inflation

    DEFF Research Database (Denmark)

    Channuie, Phongpichit; Jark Joergensen, Jakob; Sannino, Francesco

    2011-01-01

    We investigate models in which the inflaton emerges as a composite field of a four dimensional, strongly interacting and nonsupersymmetric gauge theory featuring purely fermionic matter. We show that it is possible to obtain successful inflation via non-minimal coupling to gravity, and that the u......We investigate models in which the inflaton emerges as a composite field of a four dimensional, strongly interacting and nonsupersymmetric gauge theory featuring purely fermionic matter. We show that it is possible to obtain successful inflation via non-minimal coupling to gravity...

  13. Minimalism and Speakers’ Intuitions

    Directory of Open Access Journals (Sweden)

    Matías Gariazzo

    2011-08-01

    Full Text Available Minimalism proposes a semantics that does not account for speakers’ intuitions about the truth conditions of a range of sentences or utterances. Thus, a challenge for this view is to offer an explanation of how its assignment of semantic contents to these sentences is grounded in their use. Such an account was mainly offered by Soames, but also suggested by Cappelen and Lepore. The article criticizes this explanation by presenting four kinds of counterexamples to it, and arrives at the conclusion that minimalism has not successfully answered the above-mentioned challenge.

  14. Minimal open strings

    International Nuclear Information System (INIS)

    Hosomichi, Kazuo

    2008-01-01

    We study FZZT-branes and open string amplitudes in (p, q) minimal string theory. We focus on the simplest boundary changing operators in two-matrix models, and identify the corresponding operators in worldsheet theory through the comparison of amplitudes. Along the way, we find a novel linear relation among FZZT boundary states in minimal string theory. We also show that the boundary ground ring is realized on physical open string operators in a very simple manner, and discuss its use for perturbative computation of higher open string amplitudes.

  15. Radiographic findings in adult pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Kang, T. W.; Youn, Y. S.; Won, J. J

    1981-01-01

    During the period from March, 1980 to February, 1981 in the Department of Radiology, Jeonbug National University Hospital, we reviewed the radiologic findings of 879 cases newly diagnosed pulmonary tuberculosis and 56 cases diagnosed tuberculous pleural effusion without lung parenchymal lesion on initial chest P-A film in the adult (older than 16 years). The results were as follows. 1. Sex distribution of pulmonary tuberculosis was 668 cases (76%) in male, 211 cases (24%) in female, the average age 44.6, and the highest incidence in the third and sixth decade with similarity. 2. The incidence of pulmonary tuberculosis was highest in the springtime (29.5%) and its peak particularly in May. 3. Classifying the extent of pulmonary tuberculosis into minimal, moderately advanced and far advanced pulmonary tuberculosis, their ratio was 6 : 1.5 : 1 with the concrete date of 553 cases (70.8%), 136 cases (17.4%) and 92 cases (11.8%) respectively. 4. In the case of minimal pulmonary tuberculosis the location of TB-lesion incidence were right upper, left upper and both upper lobes in the ratio of 45 : 27 :28 (%) 5. The radiological findings of pulmonary tuberculosis appeared various, but the ill-defined patchy density of exudative reaction signifying an initial lesion were than the most (35%). 6. As an unusual type of tuberculosis, cavitary TB was 38 cases (4.3%), among them, in 3 cases (7.9%) there appeared air-fluid level. Miliary TB was 8 cases (0.9%), mostly abundant in the youngsters (esp. in the third decade), and female immensely outnumbered male. Tuberculoma was 10 cases (1.4%), female preceded male in the ratio of 7 : 3, and in right upper lobe in the incidence was highest (50%). 7. Without lung parenchymal lesion, the cases to have caused an tuberculous pleural effusion were 56 (6.0%), and in the years of 16 to 29 it was the most frequent with 26 cases (46.4%). 8. With complicated pulmonary tuberculosis, 78 cases (9.5%) showed to combine with other diseases. Among

  16. The Critical Role of Pulmonary Arterial Compliance in Pulmonary Hypertension

    Science.gov (United States)

    Prins, Kurt W.; Pritzker, Marc R.; Scandurra, John; Volmers, Karl; Weir, E. Kenneth

    2016-01-01

    The normal pulmonary circulation is a low-pressure, high-compliance system. Pulmonary arterial compliance decreases in the presence of pulmonary hypertension because of increased extracellular matrix/collagen deposition in the pulmonary arteries. Loss of pulmonary arterial compliance has been consistently shown to be a predictor of increased mortality in patients with pulmonary hypertension, even more so than pulmonary vascular resistance in some studies. Decreased pulmonary arterial compliance causes premature reflection of waves from the distal pulmonary vasculature, leading to increased pulsatile right ventricular afterload and eventually right ventricular failure. Evidence suggests that decreased pulmonary arterial compliance is a cause rather than a consequence of distal small vessel proliferative vasculopathy. Pulmonary arterial compliance decreases early in the disease process even when pulmonary artery pressure and pulmonary vascular resistance are normal, potentially enabling early diagnosis of pulmonary vascular disease, especially in high-risk populations. With the recognition of the prognostic importance of pulmonary arterial compliance, its impact on right ventricular function, and its contributory role in the development and progression of distal small-vessel proliferative vasculopathy, pulmonary arterial compliance is an attractive target for the treatment of pulmonary hypertension. PMID:26848601

  17. Bronchial Artery Embolization in the Management of Pulmonary Parenchymal Endometriosis with Hemoptysis

    International Nuclear Information System (INIS)

    Kervancioglu, Selim; Andic, Cagatay; Bayram, Nazan; Telli, Cumali; Sarica, Akif; Sirikci, Akif

    2008-01-01

    Pulmonary parenchymal endometriosis is extremely rare and usually manifests itself with a recurrent hemoptysis associated with the menstrual cycle. The therapies proposed for women with endometriosis consist of medical treatments and surgery. Bronchial artery embolization has become a well-established and minimally invasive treatment modality for hemoptysis, and to the best of our knowledge, it has not been reported in pulmonary endometriosis. We report a case of pulmonary parenchymal endometriosis treated with embolotheraphy for hemoptysis.

  18. Modelling the presence of myelin and oedema in the brain based on multi-parametric quantitative MRI

    Directory of Open Access Journals (Sweden)

    Marcel eWarntjes

    2016-02-01

    Full Text Available The aim of this study was to present a model that uses multi-parametric quantitative MRI to estimate the presence of myelin and oedema in the brain. The model relates simultaneous measurement of R1 and R2 relaxation rates and proton density to four partial volume compartments, consisting of myelin partial volume, cellular partial volume, free water partial volume and excess parenchymal water partial volume. The model parameters were obtained using spatially normalised brain images of a group of 20 healthy controls. The pathological brain was modelled in terms of the reduction of myelin content and presence of excess parenchymal water, which indicates the degree of oedema. The method was tested on spatially normalised brain images of a group of 20 age-matched multiple sclerosis (MS patients. Clear differences were observed with respect to the healthy controls: the MS group had a 79 mL smaller brain volume (1069 vs. 1148 mL, a 38 mL smaller myelin volume (119 vs. 157 mL and a 21 mL larger excess parenchymal water volume (78 vs. 57 mL. Template regions of interest of various brain structures indicated that the myelin partial volume in the MS group was 1.6±1.5% lower for grey matter (GM structures and 2.8±1.0% lower for white matter (WM structures. The excess parenchymal water partial volume was 9±10% larger for GM and 5±2% larger for WM. Manually placed ROIs indicated that the results using the template ROIs may have suffered from loss of anatomical detail due to the spatial normalization process. Examples of the application of the method on high-resolution images are provided for three individual subjects, a 45-year-old healthy subject, a 72-year-old healthy subject and a 45-year-old MS patient. The observed results agreed with the expected behaviour considering both age and disease. In conclusion, the proposed model may provide clinically important parameters such as the total brain volume, degree of myelination and degree of oedema, based on

  19. Bilateral meandering pulmonary veins

    Energy Technology Data Exchange (ETDEWEB)

    Thupili, Chakradhar R.; Udayasankar, Unni [Pediatric Imaging, Imaging Institute Cleveland Clinic, Cleveland, OH (United States); Renapurkar, Rahul [Imaging Institute Cleveland Clinic, Thoracic Imaging, L10, Cleveland, OH (United States)

    2015-06-15

    Meandering pulmonary veins is a rare clinical entity that can be mistaken for more complex congenital syndromes such as hypogenetic lung syndrome. We report imaging findings in a rare incidentally detected case of bilateral meandering pulmonary veins. We briefly discuss the role of imaging in diagnosing this condition, with particular emphasis on contrast-enhanced CT. (orig.)

  20. pulmonary tuberculosis, jimma hospital

    African Journals Online (AJOL)

    and National Tuberculosis and Leprosy Control Program manual. RESULTS: A total of 112 extra pulmonary ... Key words: Clinical audit; extra pulmonary Tuberculosis; National Tuberculosis and. Leprosy Control manual. "Addis Ababa ..... intern influence drug regimen selection. Compliance to the 1997 NTLCP inanual is.

  1. Pulmonary artery aneurysm

    African Journals Online (AJOL)

    Enrique

    Introduction. Pulmonary artery aneurysms are a rare finding in general radiological practice. The possible causes are myriad and diverse in pathophysiolo- gy. Patients with post-stenotic dilata- tion of the main pulmonary artery usually present fairly late with insidi- ous cardiorespiratory symptoms. Diagnosis requires ...

  2. Pulmonary hypertension CT imaging

    International Nuclear Information System (INIS)

    Nedevska, A.

    2013-01-01

    Full text: The right heart catheterization is the gold standard in the diagnosis and determines the severity of pulmonary hypertension. The significant technical progress of noninvasive diagnostic imaging methods significantly improves the pixel density and spatial resolution in the study of cardiovascular structures, thus changes their role and place in the overall diagnostic plan. Learning points: What is the etiology, clinical manifestation and general pathophysiological disorders in pulmonary hypertension. What are the established diagnostic methods in the diagnosis and follow-up of patients with pulmonary hypertension. What is the recommended protocol for CT scanning for patients with clinically suspected or documented pulmonary hypertension. What are the important diagnostic findings in CT scan of a patient with pulmonary hypertension. Discussion: The prospect of instantaneous complex - anatomical and functional cardiopulmonary and vascular diagnostics seems extremely attractive. The contrast enhanced multislice computed (CT ) and magnetic resonance imaging are very suitable methods for imaging the structures of the right heart, with the possibility of obtaining multiple projections and three-dimensional imaging reconstructions . There are specific morphological features that, if carefully analyzed, provide diagnostic information. Thus, it is possible to avoid or at least reduce the frequency of use of invasive diagnostic cardiac catheterization in patients with pulmonary hypertension. Conclusion: This review focuses on the use of contrast-enhanced CT for comprehensive evaluation of patients with pulmonary hypertension and presents the observed characteristic changes in the chest, lung parenchyma , the structures of the right half of the heart and pulmonary vessels

  3. Minimal model holography

    International Nuclear Information System (INIS)

    Gaberdiel, Matthias R; Gopakumar, Rajesh

    2013-01-01

    We review the duality relating 2D W N minimal model conformal field theories, in a large-N ’t Hooft like limit, to higher spin gravitational theories on AdS 3 . This article is part of a special issue of Journal of Physics A: Mathematical and Theoretical devoted to ‘Higher spin theories and holography’. (review)

  4. Minimal constrained supergravity

    Energy Technology Data Exchange (ETDEWEB)

    Cribiori, N. [Dipartimento di Fisica e Astronomia “Galileo Galilei”, Università di Padova, Via Marzolo 8, 35131 Padova (Italy); INFN, Sezione di Padova, Via Marzolo 8, 35131 Padova (Italy); Dall' Agata, G., E-mail: dallagat@pd.infn.it [Dipartimento di Fisica e Astronomia “Galileo Galilei”, Università di Padova, Via Marzolo 8, 35131 Padova (Italy); INFN, Sezione di Padova, Via Marzolo 8, 35131 Padova (Italy); Farakos, F. [Dipartimento di Fisica e Astronomia “Galileo Galilei”, Università di Padova, Via Marzolo 8, 35131 Padova (Italy); INFN, Sezione di Padova, Via Marzolo 8, 35131 Padova (Italy); Porrati, M. [Center for Cosmology and Particle Physics, Department of Physics, New York University, 4 Washington Place, New York, NY 10003 (United States)

    2017-01-10

    We describe minimal supergravity models where supersymmetry is non-linearly realized via constrained superfields. We show that the resulting actions differ from the so called “de Sitter” supergravities because we consider constraints eliminating directly the auxiliary fields of the gravity multiplet.

  5. Hazardous waste minimization

    International Nuclear Information System (INIS)

    Freeman, H.

    1990-01-01

    This book presents an overview of waste minimization. Covers applications of technology to waste reduction, techniques for implementing programs, incorporation of programs into R and D, strategies for private industry and the public sector, and case studies of programs already in effect

  6. Minimally invasive distal pancreatectomy

    NARCIS (Netherlands)

    Røsok, Bård I.; de Rooij, Thijs; van Hilst, Jony; Diener, Markus K.; Allen, Peter J.; Vollmer, Charles M.; Kooby, David A.; Shrikhande, Shailesh V.; Asbun, Horacio J.; Barkun, Jeffrey; Besselink, Marc G.; Boggi, Ugo; Conlon, Kevin; Han, Ho Seong; Hansen, Paul; Kendrick, Michael L.; Kooby, David; Montagnini, Andre L.; Palanivelu, Chinnasamy; Wakabayashi, Go; Zeh, Herbert J.

    2017-01-01

    The first International conference on Minimally Invasive Pancreas Resection was arranged in conjunction with the annual meeting of the International Hepato-Pancreato-Biliary Association (IHPBA), in Sao Paulo, Brazil on April 19th 2016. The presented evidence and outcomes resulting from the session

  7. Minimal DBM Substraction

    DEFF Research Database (Denmark)

    David, Alexandre; Håkansson, John; G. Larsen, Kim

    In this paper we present an algorithm to compute DBM substractions with a guaranteed minimal number of splits and disjoint DBMs to avoid any redundance. The substraction is one of the few operations that result in a non-convex zone, and thus, requires splitting. It is of prime importance to reduce...

  8. Minimal constrained supergravity

    Directory of Open Access Journals (Sweden)

    N. Cribiori

    2017-01-01

    Full Text Available We describe minimal supergravity models where supersymmetry is non-linearly realized via constrained superfields. We show that the resulting actions differ from the so called “de Sitter” supergravities because we consider constraints eliminating directly the auxiliary fields of the gravity multiplet.

  9. Minimal constrained supergravity

    International Nuclear Information System (INIS)

    Cribiori, N.; Dall'Agata, G.; Farakos, F.; Porrati, M.

    2017-01-01

    We describe minimal supergravity models where supersymmetry is non-linearly realized via constrained superfields. We show that the resulting actions differ from the so called “de Sitter” supergravities because we consider constraints eliminating directly the auxiliary fields of the gravity multiplet.

  10. Quantification of fluid resorption from diabetic macular oedema with foveal serous detachment after dexamethasone intravitreal implant (Ozurdex®) in a pregnant diabetic

    DEFF Research Database (Denmark)

    Hodzic-Hadzibegovic, Delila; Ba-Ali, Shakoor; Valerius, Marianne

    2017-01-01

    PURPOSE: To quantify the fluid resorption from the centre of the fovea in a pregnant woman with diabetic macular oedema by daily optical coherence tomography (OCT) measurements after the administration of intravitreal dexamethasone implant (Ozurdex®). METHODS: A 36-year-old pregnant woman with ty...

  11. The site of embolization related to infarct size, oedema and clinical outcome in a rat stroke model - further translational stroke research

    DEFF Research Database (Denmark)

    Overgaard, Karsten; Rasmussen, Rune S; Johansen, Flemming F

    2010-01-01

    Reliable models are essential for translational stroke research to study the pathophysiology of ischaemic stroke in an effort to find therapies that may ultimately reduce oedema, infarction and mortality in the clinic. The purpose of this study was to investigate the relation between the site...

  12. Antibiotic treatment in patients with low-back pain associated with Modic changes Type 1 (bone oedema): a pilot study

    DEFF Research Database (Denmark)

    Albert, HB; Manniche, C; Sørensen, JS

    2008-01-01

    OBJECTIVE: The aim of this study was to assess the clinical effect of antibiotic treatment in a cohort of patients with low-back pain (LBP) and Modic changes Type 1 (bone oedema) following a lumbar herniated disc. DESIGN: This was a prospective uncontrolled trial of 32 LBP patients who had Modic...... and LBP at 14 months follow-up (n = 37) were invited to participate in this subsequent antibiotic trial but five did not meet the inclusion criteria. RESULTS: 29 patients completed the treatment, as three patients dropped out due to severe diarrhoea. At the end of treatment and at long-term follow...... changes and were treated with Amoxicillin-clavulanate (500 mg/125 mg) 3 x day for 90 days. All patients had previously participated in a randomised controlled trial (RCT) that investigated active conservative treatment for a lumbar herniated disc (n = 166). All patients in that RCT who had Modic changes...

  13. Pulmonary capillary haemangiomatosis: a rare cause of pulmonary hypertension.

    Science.gov (United States)

    Babu, K Anand; Supraja, K; Singh, Raj B

    2014-01-01

    Pulmonary capillary haemangiomatosis (PCH) is a rare disorder of unknown aetiology, characterised by proliferating capillaries that invade the pulmonary interstitium, alveolar septae and the pulmonary vasculature. It is often mis-diagnosed as primary pulmonary hypertension and pulmonary veno-occlusive disease. Pulmonary capillary haemangiomatosis is a locally aggressive benign vascular neoplasm of the lung. We report the case of a 19-year-old female who was referred to us in the early post-partum period with severe pulmonary artery hypertension, which was diagnosed as PCH by open lung biopsy.

  14. The immediate effect of individual manipulation techniques on pulmonary function measures in persons with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Noll, Donald R; Johnson, Jane C; Baer, Robert W; Snider, Eric J

    2009-10-08

    The use of manipulation has long been advocated in the treatment of chronic obstructive pulmonary disease (COPD), but few randomized controlled clinical trials have measured the effect of manipulation on pulmonary function. In addition, the effects of individual manipulative techniques on the pulmonary system are poorly understood. Therefore, the purpose of this study was to determine the immediate effects of four osteopathic techniques on pulmonary function measures in persons with COPD relative to a minimal-touch control protocol. Persons with COPD aged 50 and over were recruited for the study. Subjects received five, single-technique treatment sessions: minimal-touch control, thoracic lymphatic pump (TLP) with activation, TLP without activation, rib raising, and myofascial release. There was a 4-week washout period between sessions. Protocols were given in random order until all five techniques had been administered. Pulmonary function measures were obtained at baseline and 30-minutes posttreatment. For the actual pulmonary function measures and percent predicted values, Wilcoxon signed rank tests were used to test within-technique changes from baseline. For the percent change from baseline, Friedman tests were used to test for between-technique differences. Twenty-five subjects were enrolled in the study. All four tested osteopathic techniques were associated with adverse posttreatment changes in pulmonary function measures; however, different techniques changed different measures. TLP with activation increased posttreatment residual volume compared to baseline, while TLP without activation did not. Side effects were mild, mostly posttreatment chest wall soreness. Surprisingly, the majority of subjects believed they could breathe better after receiving osteopathic manipulation. In persons with COPD, TLP with activation, TLP without activation, rib raising, and myofascial release mildly worsened pulmonary function measures immediately posttreatment relative to

  15. Minimal abdominal incisions

    Directory of Open Access Journals (Sweden)

    João Carlos Magi

    2017-04-01

    Full Text Available Minimally invasive procedures aim to resolve the disease with minimal trauma to the body, resulting in a rapid return to activities and in reductions of infection, complications, costs and pain. Minimally incised laparotomy, sometimes referred to as minilaparotomy, is an example of such minimally invasive procedures. The aim of this study is to demonstrate the feasibility and utility of laparotomy with minimal incision based on the literature and exemplifying with a case. The case in question describes reconstruction of the intestinal transit with the use of this incision. Male, young, HIV-positive patient in a late postoperative of ileotiflectomy, terminal ileostomy and closing of the ascending colon by an acute perforating abdomen, due to ileocolonic tuberculosis. The barium enema showed a proximal stump of the right colon near the ileostomy. The access to the cavity was made through the orifice resulting from the release of the stoma, with a lateral-lateral ileo-colonic anastomosis with a 25 mm circular stapler and manual closure of the ileal stump. These surgeries require their own tactics, such as rigor in the lysis of adhesions, tissue traction, and hemostasis, in addition to requiring surgeon dexterity – but without the need for investments in technology; moreover, the learning curve is reported as being lower than that for videolaparoscopy. Laparotomy with minimal incision should be considered as a valid and viable option in the treatment of surgical conditions. Resumo: Procedimentos minimamente invasivos visam resolver a doença com o mínimo de trauma ao organismo, resultando em retorno rápido às atividades, reduções nas infecções, complicações, custos e na dor. A laparotomia com incisão mínima, algumas vezes referida como minilaparotomia, é um exemplo desses procedimentos minimamente invasivos. O objetivo deste trabalho é demonstrar a viabilidade e utilidade das laparotomias com incisão mínima com base na literatura e

  16. Minimal Walking Technicolor

    DEFF Research Database (Denmark)

    Foadi, Roshan; Frandsen, Mads Toudal; A. Ryttov, T.

    2007-01-01

    Different theoretical and phenomenological aspects of the Minimal and Nonminimal Walking Technicolor theories have recently been studied. The goal here is to make the models ready for collider phenomenology. We do this by constructing the low energy effective theory containing scalars......, pseudoscalars, vector mesons and other fields predicted by the minimal walking theory. We construct their self-interactions and interactions with standard model fields. Using the Weinberg sum rules, opportunely modified to take into account the walking behavior of the underlying gauge theory, we find...... interesting relations for the spin-one spectrum. We derive the electroweak parameters using the newly constructed effective theory and compare the results with the underlying gauge theory. Our analysis is sufficiently general such that the resulting model can be used to represent a generic walking technicolor...

  17. Intravascular pulmonary metastases

    International Nuclear Information System (INIS)

    Shepard, J.A.O.; Moore, E.H.; Templeton, P.A.; McLoud, T.C.

    1988-01-01

    The diagnosis of intravascular metastatic tumor emboli to the lungs is rarely made. The authors present a characteristic radiographic finding of intravascular lung metastases that they observed in four patients with diagnoses or right atrial myoxoma, invasive renal cell carcinoma, invasive pelvic osteosarcoma, and recurrent pelvic chondrosarcoma. Substantiation of intravascular pulmonary metastases was achieved by means of autopsy, pulmonary artery biopsy, and surgical documentation of tumor invasion of the inferior vena cava or pelvic veins. In all four cases, chest computed tomography (CT) demonstrated branching, beaded opacities extending from the hila into the periphery of the lung in the distribution of pulmonary arteries. In one case, similar findings were observed in magnetic resonance (MR) images of the chest. Follow-up studies in three cases showed progressive enlargement and varicosity of the abnormal pulmonary artery consistent with proliferation of intravascular tumor. In the case of metastatic osteosarcoma, intraluminal ossification was also observed at CT. In three of four cases, pulmonary infarction was demonstrated in the distribution of the abnormal pulmonary arteries seen at CT as small, peripheral, wedge-shaped opacities. The demonstration of progressively dilated and beaded pulmonary arteries in patients with extrathoracic malignancies is suggestive of intravascular lung metastases, particularly when accompanied by peripheral infarction

  18. Pulmonary vascular imaging

    International Nuclear Information System (INIS)

    Fedullo, P.F.; Shure, D.

    1987-01-01

    A wide range of pulmonary vascular imaging techniques are available for the diagnostic evaluation of patients with suspected pulmonary vascular disease. The characteristics of any ideal technique would include high sensitivity and specificity, safety, simplicity, and sequential applicability. To date, no single technique meets these ideal characteristics. Conventional pulmonary angiography remains the gold standard for the diagnosis of acute thromboembolic disease despite the introduction of newer techniques such as digital subtraction angiography and magnetic resonance imaging. Improved noninvasive lower extremity venous testing methods, particularly impedance plethysmography, and ventilation-perfusion scanning can play significant roles in the noninvasive diagnosis of acute pulmonary emboli when properly applied. Ventilation-perfusion scanning may also be useful as a screening test to differentiate possible primary pulmonary hypertension from chronic thromboembolic pulmonary hypertension. And, finally, angioscopy may be a useful adjunctive technique to detect chronic thromboembolic disease and determine operability. Optimal clinical decision-making, however, will continue to require the proper interpretation of adjunctive information obtained from the less-invasive techniques, applied with an understanding of the natural history of the various forms of pulmonary vascular disease and with a knowledge of the capabilities and shortcomings of the individual techniques

  19. Pulmonary manifestations of leptospirosis

    Directory of Open Access Journals (Sweden)

    Sameer Gulati

    2012-01-01

    Full Text Available Leptospirosis has a spectrum of presentation which ranges from mild disease to a severe form comprising of jaundice and renal failure. Involvement of the lung can vary from subtle clinical features to deadly pulmonary hemorrhage and acute respiratory distress syndrome. Of late, it has been identified that leptospirosis can present atypically with predominant pulmonary manifestations. This can delay diagnosis making and hence optimum treatment. The purpose of this review is to bring together all the reported pulmonary manifestations of leptospirosis and the recent trends in the management.

  20. Legal incentives for minimizing waste

    International Nuclear Information System (INIS)

    Clearwater, S.W.; Scanlon, J.M.

    1991-01-01

    Waste minimization, or pollution prevention, has become an integral component of federal and state environmental regulation. Minimizing waste offers many economic and public relations benefits. In addition, waste minimization efforts can also dramatically reduce potential criminal requirements. This paper addresses the legal incentives for minimizing waste under current and proposed environmental laws and regulations

  1. Diagnosing pulmonary edema: lung ultrasound versus chest radiography.

    Science.gov (United States)

    Martindale, Jennifer L; Noble, Vicki E; Liteplo, Andrew

    2013-10-01

    Diagnosing the underlying cause of acute dyspnea can be challenging. Lung ultrasound may help to identify pulmonary edema as a possible cause. To evaluate the ability of residents to recognize pulmonary edema on lung ultrasound using chest radiographs as a comparison standard. This is a prospective, blinded, observational study of a convenience sample of resident physicians in the Departments of Emergency Medicine (EM), Internal Medicine (IM), and Radiology. Residents were given a tutorial on interpreting pulmonary edema on both chest radiograph and lung ultrasound. They were then shown both ultrasounds and chest radiographs from 20 patients who had presented to the emergency department with dyspnea, 10 with a primary diagnosis of pulmonary edema, and 10 with alternative diagnoses. Cohen's κ values were calculated to describe the strength of the correlation between resident and gold standard interpretations. Participants included 20 EM, 20 IM, and 20 Radiology residents. The overall agreement with gold standard interpretation of pulmonary edema on lung ultrasound (74%, κ = 0.51, 95% confidence interval 0.46-0.55) was superior to chest radiographs (58%, κ = 0.25, 95% confidence interval 0.20-0.30) (P Radiology residents interpreted chest radiographs more accurately than did EM and IM residents. Residents were able to more accurately identify pulmonary edema with lung ultrasound than with chest radiograph. Physicians with minimal exposure to lung ultrasound may be able to correctly recognize pulmonary edema on lung ultrasound.

  2. [Pulmonary Manifestations of Vasculitis].

    Science.gov (United States)

    von Vietinghoff, S

    2016-11-01

    The variable symptoms and signs of pulmonary vasculitis are a diagnostic and therapeutic challenge. Vasculitis should be considered in rapidly progressing, severe and unusual manifestations of pulmonary disease. Clinical examination of other organ systems typically affected by vasculitis such as skin and kidney and autoantibody measurements are complementary approaches to manage this situation. Pulmonary involvement is common in small vessel vasculitis including anti-GBM disease (Goodpasture syndrome) and the ANCA-associated vasculitides. Life threatening pulmonary hemorrhage and irreversible damage of other organs, frequently the kidney, are important complications necessitating rapid diagnosis of these conditions.Vasculitides are rare diseases of multiple organs and therapies including biologics are evolving rapidly, requiring cooperation of specialities and with specialized centres to achieve best patient care. All involved physicians should be aware of typical complications of immunosuppressive therapy. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Pulmonary arteriovenous fistulas

    International Nuclear Information System (INIS)

    Medeiros Sobrinho, J.H. de; Kambara, A.M.

    1987-01-01

    Six cases of pulmonary arteriovenous fistulas, isolated, without hemorrhagic hereditary telangiectasia (Rendu-Osler-Weber Symdrome) are reported emphasizing the radiographic, tomographic and angiographic examinations, (M.A.C.) [pt

  4. Apical pulmonary abscesses

    International Nuclear Information System (INIS)

    Mercado Ferrer, Cesar A; Serrano Vasquez, Francisco O

    2004-01-01

    We presented the case of a 54 year-old man with bilateral apical pulmonary abscess who consults due to fever and bronchorrhoea, isolating moraxella catharralis that is managed with ampicillin-sulbactam with an adequate clinical and radiological evolution

  5. Idiopathic pulmonary fibrosis

    Science.gov (United States)

    ... Echocardiogram Measurements of blood oxygen level (arterial blood gases) Pulmonary function tests 6-minute walk test Tests ... 2018, A.D.A.M., Inc. Duplication for commercial use must be authorized in writing by ADAM ...

  6. The ZOOM minimization package

    International Nuclear Information System (INIS)

    Fischler, Mark S.; Sachs, D.

    2004-01-01

    A new object-oriented Minimization package is available for distribution in the same manner as CLHEP. This package, designed for use in HEP applications, has all the capabilities of Minuit, but is a re-write from scratch, adhering to modern C++ design principles. A primary goal of this package is extensibility in several directions, so that its capabilities can be kept fresh with as little maintenance effort as possible. This package is distinguished by the priority that was assigned to C++ design issues, and the focus on producing an extensible system that will resist becoming obsolete

  7. Minimizing the Pacman effect

    International Nuclear Information System (INIS)

    Ritson, D.; Chou, W.

    1997-10-01

    The Pacman bunches will experience two deleterious effects: tune shift and orbit displacement. It is known that the tune shift can be compensated by arranging crossing planes 900 relative to each other at successive interaction points (lPs). This paper gives an analytical estimate of the Pacman orbit displacement for a single as well as for two crossings. For the latter, it can be minimized by using equal phase advances from one IP to another. In the LHC, this displacement is in any event small and can be neglected

  8. Minimally Invasive Parathyroidectomy

    Directory of Open Access Journals (Sweden)

    Lee F. Starker

    2011-01-01

    Full Text Available Minimally invasive parathyroidectomy (MIP is an operative approach for the treatment of primary hyperparathyroidism (pHPT. Currently, routine use of improved preoperative localization studies, cervical block anesthesia in the conscious patient, and intraoperative parathyroid hormone analyses aid in guiding surgical therapy. MIP requires less surgical dissection causing decreased trauma to tissues, can be performed safely in the ambulatory setting, and is at least as effective as standard cervical exploration. This paper reviews advances in preoperative localization, anesthetic techniques, and intraoperative management of patients undergoing MIP for the treatment of pHPT.

  9. Partial anomalous pulmonary venous return in patients with pulmonary hypertension

    International Nuclear Information System (INIS)

    Sung, Won-kyung; Au, Virginia; Rose, Anand

    2012-01-01

    Anomalous pulmonary venous return is an uncommon congenital malformation, and may be partial or total. Partial anomalous pulmonary venous return (PAPVR) is more common than total anomalous pulmonary venous return, and is often associated with other congenital cardiac anomalies. Whilst many patients with PAPVR remain asymptomatic, some may present in later age with symptoms related to left-to-right shunt, right heart failure and pulmonary hypertension. We report two cases of PAPVR detected on Computed Tomography Pulmonary Angiogram (CTPA) for the work up of pulmonary hypertension. The cases demonstrate that, although uncommon, partial anomalous pulmonary venous return can be a contributing factor to pulmonary hypertension and pulmonary veins should be carefully examined when reading a CTPA study.

  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. [Immersion pulmonary edema].

    Science.gov (United States)

    Desgraz, Benoît; Sartori, Claudio; Saubade, Mathieu; Héritier, Francis; Gabus, Vincent

    2017-07-12

    Immersion pulmonary edema may occur during scuba diving, snorke-ling or swimming. It is a rare and often recurrent disease, mainly affecting individuals aged over 50 with high blood pressure. However it also occurs in young individuals with a healthy heart. The main symptoms are dyspnea, cough and hemoptysis. The outcome is often favorable under oxygen treatment but deaths are reported. A cardiac and pulmonary assessment is necessary to evaluate the risk of recurrence and possible contraindications to immersion.

  12. Does exercise pulmonary hypertension exist?

    Science.gov (United States)

    Lau, Edmund M; Chemla, Denis; Whyte, Kenneth; Kovacs, Gabor; Olschewski, Horst; Herve, Philippe

    2016-09-01

    The exercise definition of pulmonary hypertension using a mean pulmonary artery pressure threshold of greater than 30 mmHg was abandoned following the 4th World Pulmonary Hypertension Symposium in 2008, as this definition was not supported by evidence and healthy individuals frequently exceed this threshold. Meanwhile, the clinical value of exercise pulmonary hemodynamic testing has also been questioned. Recent data support the notion that an abnormal pulmonary hemodynamic response during exercise (or exercise pulmonary hypertension) is associated with symptoms and exercise limitation. Pathophysiologic mechanisms accounting for the development of exercise pulmonary hypertension include increased vascular resistance, excessive elevation in left atrial pressure and/or increased volume of trapped air during exercise, resulting in a steep rise in pulmonary artery pressure relative to cardiac output. Recent evidence suggests that exercise pulmonary hypertension may be defined by a mean pulmonary artery pressure surpassing 30 mmHg together with a simultaneous total pulmonary resistance exceeding 3 WU. Exercise pulmonary hypertension is a clinically relevant entity and an improved definition has been suggested based on new evidence. Exercise pulmonary hemodynamics may help unmask early or latent disease, particularly in populations that are at high risk for the development of pulmonary hypertension.

  13. Minimal conformal model

    Energy Technology Data Exchange (ETDEWEB)

    Helmboldt, Alexander; Humbert, Pascal; Lindner, Manfred; Smirnov, Juri [Max-Planck-Institut fuer Kernphysik, Heidelberg (Germany)

    2016-07-01

    The gauge hierarchy problem is one of the crucial drawbacks of the standard model of particle physics (SM) and thus has triggered model building over the last decades. Its most famous solution is the introduction of low-scale supersymmetry. However, without any significant signs of supersymmetric particles at the LHC to date, it makes sense to devise alternative mechanisms to remedy the hierarchy problem. One such mechanism is based on classically scale-invariant extensions of the SM, in which both the electroweak symmetry and the (anomalous) scale symmetry are broken radiatively via the Coleman-Weinberg mechanism. Apart from giving an introduction to classically scale-invariant models, the talk presents our results on obtaining a theoretically consistent minimal extension of the SM, which reproduces the correct low-scale phenomenology.

  14. Minimal Reducts with Grasp

    Directory of Open Access Journals (Sweden)

    Iris Iddaly Mendez Gurrola

    2011-03-01

    Full Text Available The proper detection of patient level of dementia is important to offer the suitable treatment. The diagnosis is based on certain criteria, reflected in the clinical examinations. From these examinations emerge the limitations and the degree in which each patient is in. In order to reduce the total of limitations to be evaluated, we used the rough set theory, this theory has been applied in areas of the artificial intelligence such as decision analysis, expert systems, knowledge discovery, classification with multiple attributes. In our case this theory is applied to find the minimal limitations set or reduct that generate the same classification that considering all the limitations, to fulfill this purpose we development an algorithm GRASP (Greedy Randomized Adaptive Search Procedure.

  15. Minimally extended SILH

    International Nuclear Information System (INIS)

    Chala, Mikael; Grojean, Christophe; Humboldt-Univ. Berlin; Lima, Leonardo de; Univ. Estadual Paulista, Sao Paulo

    2017-03-01

    Higgs boson compositeness is a phenomenologically viable scenario addressing the hierarchy problem. In minimal models, the Higgs boson is the only degree of freedom of the strong sector below the strong interaction scale. We present here the simplest extension of such a framework with an additional composite spin-zero singlet. To this end, we adopt an effective field theory approach and develop a set of rules to estimate the size of the various operator coefficients, relating them to the parameters of the strong sector and its structural features. As a result, we obtain the patterns of new interactions affecting both the new singlet and the Higgs boson's physics. We identify the characteristics of the singlet field which cause its effects on Higgs physics to dominate over the ones inherited from the composite nature of the Higgs boson. Our effective field theory construction is supported by comparisons with explicit UV models.

  16. Minimally extended SILH

    Energy Technology Data Exchange (ETDEWEB)

    Chala, Mikael [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Valencia Univ. (Spain). Dept. de Fisica Teorica y IFIC; Durieux, Gauthier; Matsedonskyi, Oleksii [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Grojean, Christophe [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Humboldt-Univ. Berlin (Germany). Inst. fuer Physik; Lima, Leonardo de [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Univ. Estadual Paulista, Sao Paulo (Brazil). Inst. de Fisica Teorica

    2017-03-15

    Higgs boson compositeness is a phenomenologically viable scenario addressing the hierarchy problem. In minimal models, the Higgs boson is the only degree of freedom of the strong sector below the strong interaction scale. We present here the simplest extension of such a framework with an additional composite spin-zero singlet. To this end, we adopt an effective field theory approach and develop a set of rules to estimate the size of the various operator coefficients, relating them to the parameters of the strong sector and its structural features. As a result, we obtain the patterns of new interactions affecting both the new singlet and the Higgs boson's physics. We identify the characteristics of the singlet field which cause its effects on Higgs physics to dominate over the ones inherited from the composite nature of the Higgs boson. Our effective field theory construction is supported by comparisons with explicit UV models.

  17. CT appearance of pulmonary ligament

    Energy Technology Data Exchange (ETDEWEB)

    Im, Jung Gi; Han, Man Chung; Chin, Soo Yil [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1984-03-15

    Pulmonary ligament consists of 2 serosal of pleura that connect the lower to the mediastinum. Author analyse and present CT appearance of pulmonary ligament of the 40 normal and abnormal patients on the basis of anatomic knowledge from the cross section of cadaver. Left pulmonary ligament is more frequency visualized than the right. The most important CT landmark in localizing pulmonary ligament is the esophagus where the ligament attaches on its lateral wall. Pitfalls in CT identification of pulmonary ligament are right phrenic nerve and right pericardiacophrenic vessels which emerge from lateral wall of the IVC and wall of the emphysematous bulla in the region of the pulmonary ligament.

  18. CT appearance of pulmonary ligament

    International Nuclear Information System (INIS)

    Im, Jung Gi; Han, Man Chung; Chin, Soo Yil

    1984-01-01

    Pulmonary ligament consists of 2 serosal of pleura that connect the lower to the mediastinum. Author analyse and present CT appearance of pulmonary ligament of the 40 normal and abnormal patients on the basis of anatomic knowledge from the cross section of cadaver. Left pulmonary ligament is more frequency visualized than the right. The most important CT landmark in localizing pulmonary ligament is the esophagus where the ligament attaches on its lateral wall. Pitfalls in CT identification of pulmonary ligament are right phrenic nerve and right pericardiacophrenic vessels which emerge from lateral wall of the IVC and wall of the emphysematous bulla in the region of the pulmonary ligament

  19. CT findings of pulmonary aspergillosis

    International Nuclear Information System (INIS)

    Cheon, Jung Eun; Im, Jung Gi; Goo, Jin Mo; Kim, Hong Dae; Han, Man Chung

    1995-01-01

    The fungus aspergillus can cause a variety of pulmonary disorders. Aspergilloma is a noninvasive aspergillus colonization of virtually any type of preexisting pulmonary cavity or cystic space. Invasive pulmonary aspergillosis is serious, usually fatal infection in patients being treated with immunosuppressants or who have chronic debilitating disease. Allergic bronchopulmonary aspergillosis is characterized clinically by asthma, blood and sputum eosinophilia and positive immunologic reaction to aspergillus antigen. Awareness of the radiographic and CT findings of pulmonary aspergillosis is important in making the diagnosis of aspergillus-caused pulmonary disorders. In this pictorial essay, we illustrated various radiological findings of pulmonary aspergillosis focused on CT findings correlated with gross pathologic specimens

  20. Definition and classification of pulmonary hypertension.

    Science.gov (United States)

    Humbert, Marc; Montani, David; Evgenov, Oleg V; Simonneau, Gérald

    2013-01-01

    Pulmonary hypertension is defined as an increase of mean pulmonary arterial pressure ≥25 mmHg at rest as assessed by right heart catheterization. According to different combinations of values of pulmonary wedge pressure, pulmonary vascular resistance and cardiac output, a hemodynamic classification of pulmonary hypertension has been proposed. Of major importance is the pulmonary wedge pressure which allows to distinguish pre-capillary (pulmonary wedge pressure ≤15 mmHg) and post-capillary (pulmonary wedge pressure >15 mmHg) pulmonary hypertension. Pre-capillary pulmonary hypertension includes the clinical groups 1 (pulmonary arterial hypertension), 3 (pulmonary hypertension due to lung diseases and/or hypoxia), 4 (chronic thrombo-embolic pulmonary hypertension) and 5 (pulmonary hypertension with unclear and/or multifactorial mechanisms). Post-capillary pulmonary hypertension corresponds to the clinical group 2 (pulmonary hypertension due to left heart diseases).

  1. Use of steroids in rhinoplasty with lateral osteotomies for reducing post operative oedema

    International Nuclear Information System (INIS)

    Sanober, A.; Rashid, M.; Khan, M.I.; Rehman, S.U.; Fatima, S.; Hussain, A.

    2018-01-01

    Postoperative periorbital edema is a commonly encountered side effect of rhinoplasties in which lateral osteotomies have been incorporated. It dissatisfies the surgeon as well as the patient. Osteotomies are done at the end of all soft tissue manipulation to reduce the development of edema. The aim of this study was to determine the efficacy of intravenous dexamethasone in reducing edema in patients who undergo rhinoplasty with lateral osteotomies. Methods A Prospective randomized controlled trial was done at department of plastic and reconstructive surgery, Shifa International Hospital Islamabad. Sixty patients age between 16- 55 requiring open rhinoplasty were taken for this study and divided in two groups. One group received dexamethasone 8mg intravenously peroperatively and second dose 4 hours postoperatively. The second group did not receive anything. Both groups were assessed on first post operative day and 7th day for periorbital edema. Result The overall decrease in edema in patients who received steroid was by 50% while in control group was 33.3%. By the 7th day control group 13.3% patients had grade III edema as compared to 3.33% in steroid group. Chi test was applied and p value of 0.0289 was obtained which was found to be statistically very significant. Conclusion Dexamethasone used in minimal dosage showed significant advantage in reducing periorbital edema after rhinoplasty with no evidence of any side effects secondary to steroid administration. (author)

  2. Cystoid macular oedema after phacoemulsification with and without type 2 diabetes mellitus; a hospital-based clinical prospective trial in Karachi

    International Nuclear Information System (INIS)

    Haleem, A.; Rehman, A.U.; Saleem, A.; Memon, S.; Memon, N.; Fahim, M.F.

    2017-01-01

    To know the outcomes of cystoid macular oedema after phacoemulsification in patients with and without type 2 diabetes mellitus using optical coherence tomography. Methods: This non-concurrent, clinical, prospective study was carried out at Al-Ibrahim Eye Hospital, Karachi, from January to August 2015. After phacoemulsification with injectable posterior chamber intraocular lens implantation, eyes of patients were analysed. The patients were divided into diabetic and non-diabetic groups visual acuity, optical coherence tomography and dilated fundus examination were performed preoperatively (baseline) and post-operative 1st week and 6th week. SPSS 20 was used for data analysis. Results: Of the 100 subjects, there were 50(50%) each in diabetic and non-diabetic group. Subsequently, 14(14%) patients were lost to follow-up, and 86 eyes of 86(86%) patients were analysed. Of them, 37(43%) were male and 49(57%) were female. The mean age of participants was 52.21+-7.43 years (range: 38-62 years). The non-diabetic group had 41(47.7%) patients and the diabetic group had 45(52.3%). There was no clinically significant cystoid macular oedema in either group. Central foveal thickness > 43.94 micro m was observed in 1(2.5%) eye in the non-diabetic group and in none in the diabetic group at 1st post-operative week. At the 6th post-operative week, none of eyes in the non-diabetic group and 2(4.44%) eyes of the diabetic group showed macular oedema. There was no statistically significant difference in mean foveal volume between both groups at 1st week (p=0.896) and 6th week (p=0.230). Conclusion: Cystoid macular oedema after phacoemulsification was equally present in both diabetics and non-diabetics without any retinopathy. (author)

  3. Pediatric Pulmonary Abscess

    Directory of Open Access Journals (Sweden)

    Kyle Barbour

    2018-04-01

    Full Text Available History of present illness: A 6-year-old previously healthy male presented to the emergency department with three days of left upper quadrant abdominal pain. Family endorsed one week of fevers, cough productive of yellow sputum, and non-bilious, non-bloody emesis. He denied shortness of breath and chest pain. On exam, the patient was febrile with otherwise normal vital signs. He had diffuse tenderness to his abdomen but clear lungs. Laboratory studies revealed leukocytosis to 25,000/mm3 with a left shift. Significant findings: Upright posterior-anterior plain chest films show a left lower lobe consolidation with an air-fluid level and a single septation consistent with a pulmonary abscess (white arrows. A small left pleural effusion was also present, seen as blunting of the left costophrenic angle and obscuration of the left hemidiaphragm (black arrows. Discussion: Pediatric pulmonary abscesses are rare, most commonly caused by aspiration, and the majority consequently arise in dependent portions of the lung.1 The most common pathogens in children are Streptococcus pneumoniaeand Staphylococcus aureus.1 Immunocompromised patients and those with existing pulmonary disease more commonly contract Pseudomonas aeruginosaor Bacteroides, and fungal pathogens are possible.1 Common symptoms include tachypnea, fever, and cough. Imaging is necessary to distinguish pulmonary abscesses from pneumonia, empyema, pneumatocele, and other etiologies. Plain film radiography may miss up to 18% of pulmonary abscesses yet is often the first modality to visualize an intrathoracic abnormality.2 If seen, pulmonary abscesses most often appear as consolidations with air-fluid levels. Generally, pulmonary abscesses are round with irregular, thick walls, whereas empyemas are elliptical with smooth, thin walls.3 However, these characteristics cannot definitively distinguish these processes.2 Advantages of plain films include being low cost and easily obtained. Computed

  4. Pulmonary thromboembolism in children

    Energy Technology Data Exchange (ETDEWEB)

    Babyn, Paul S.; Gahunia, Harpal K. [Hospital for Sick Children, Department of Pediatric Diagnostic Imaging, Toronto, ON (Canada); Massicotte, Patricia [Stollery Children' s Hospital and University of Alberta, Departments of Pediatric Hematology and Cardiology, Edmonton, AB (Canada)

    2005-03-01

    Pulmonary thromboembolism (PTE) is uncommonly diagnosed in the pediatric patient, and indeed often only discovered on autopsy. The incidence of pediatric PTE depends upon the associated underlying disease, diagnostic tests used, and index of suspicion. Multiple risk factors can be found including: peripartum asphyxia, dyspnea, haemoptysis, chest pain, dehydration, septicemia, central venous lines (CVLs), trauma, surgery, ongoing hemolysis, vascular lesions, malignancy, renal disease, foreign bodies or, uncommonly, intracranial venous sinus thrombosis, burns, or nonbacterial thrombotic endocarditis. Other types of embolism can occur uncommonly in childhood and need to be recognized, as the required treatment will vary. These include pulmonary cytolytic thrombi, foreign bodies, tumor and septic emboli, and post-traumatic fat emboli. No single noninvasive test for pulmonary embolism is both sensitive and specific. A combination of diagnostic procedures must be used to identify suspect or confirmed cases of PTE. This article reviews the risk factors, clinical presentation and treatment of pulmonary embolism in children. It also highlights the current diagnostic tools and protocols used to evaluate pulmonary embolism in pediatric patients. (orig.)

  5. Pulmonary thromboembolism in children

    International Nuclear Information System (INIS)

    Babyn, Paul S.; Gahunia, Harpal K.; Massicotte, Patricia

    2005-01-01

    Pulmonary thromboembolism (PTE) is uncommonly diagnosed in the pediatric patient, and indeed often only discovered on autopsy. The incidence of pediatric PTE depends upon the associated underlying disease, diagnostic tests used, and index of suspicion. Multiple risk factors can be found including: peripartum asphyxia, dyspnea, haemoptysis, chest pain, dehydration, septicemia, central venous lines (CVLs), trauma, surgery, ongoing hemolysis, vascular lesions, malignancy, renal disease, foreign bodies or, uncommonly, intracranial venous sinus thrombosis, burns, or nonbacterial thrombotic endocarditis. Other types of embolism can occur uncommonly in childhood and need to be recognized, as the required treatment will vary. These include pulmonary cytolytic thrombi, foreign bodies, tumor and septic emboli, and post-traumatic fat emboli. No single noninvasive test for pulmonary embolism is both sensitive and specific. A combination of diagnostic procedures must be used to identify suspect or confirmed cases of PTE. This article reviews the risk factors, clinical presentation and treatment of pulmonary embolism in children. It also highlights the current diagnostic tools and protocols used to evaluate pulmonary embolism in pediatric patients. (orig.)

  6. Bone marrow oedema on MR imaging indicates ARCO stage 3 disease in patients with AVN of the femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Meier, Reinhard; Schaeffeler, Christoph; Waldt, Simone; Rummeny, Ernst J.; Woertler, Klaus [Klinikum rechts der Isar, Technische Universitaet Muenchen, Department of Diagnostic and Interventional Radiology, Munich (Germany); Kraus, Tobias M. [Klinikum rechts der Isar, Technische Universitaet Muenchen, Department of Orthopaedics, Munich (Germany); Berufsgenossenschaftliche Unfallklinik Tuebingen, Department of Trauma and Orthopaedics, Tuebingen (Germany); Torka, Sebastian [Klinikum rechts der Isar, Technische Universitaet Muenchen, Department of Orthopaedics, Munich (Germany); Berufsgenossenschaftliche Unfallklinik Murnau, Department of Trauma and Orthopaedics, Murnau (Germany); Schlitter, Anna Melissa; Specht, Katja [Klinikum rechts der Isar, Technische Universitaet Muenchen, Institute of Pathology, Munich (Germany); Haller, Bernhard [Klinikum rechts der Isar, Technische Universitaet Muenchen, Institute of Medical Statistics and Epidemiology, Munich (Germany); Rechl, Hans [Klinikum rechts der Isar, Technische Universitaet Muenchen, Department of Orthopaedics, Munich (Germany)

    2014-09-15

    To test the hypothesis that bone marrow oedema (BME) observed on MRI in patients with avascular necrosis (AVN) of the femoral head represents an indicator of subchondral fracture. Thirty-seven symptomatic hips of 27 consecutive patients (53 % women, mean age 49.2) with AVN of the femoral head and associated BME on magnetic resonance (MR) imaging were included. MR findings were correlated with computed tomography (CT) of the hip and confirmed by histopathological examination of the resected femoral head. Imaging studies were analysed by two radiologists with use of the ARCO classification. On MR imaging a fracture line could be identified in 19/37 (51 %) cases, which were classified as ARCO stage 3 (n = 15) and stage 4 (n = 4). The remaining 18/37 (49 %) cases were classified as ARCO stage 2. However, in all 37/37 (100 %) cases a subchondral fracture was identified on CT, indicating ARCO stage 3/4 disease. The extent of subchondral fractures and the femoral head collapse was graded higher on CT as compared to MRI (P < 0.05). Histopathological analysis confirmed bone necrosis and subchondral fractures. In patients with AVN, BME of the femoral head represents a secondary sign of subchondral fracture and thus indicates ARCO stage 3 disease. circle BME on MRI in AVN of femoral head indicates a subchondral fracture. (orig.)

  7. Bone marrow oedema on MR imaging indicates ARCO stage 3 disease in patients with AVN of the femoral head.

    Science.gov (United States)

    Meier, Reinhard; Kraus, Tobias M; Schaeffeler, Christoph; Torka, Sebastian; Schlitter, Anna Melissa; Specht, Katja; Haller, Bernhard; Waldt, Simone; Rechl, Hans; Rummeny, Ernst J; Woertler, Klaus

    2014-09-01

    To test the hypothesis that bone marrow oedema (BME) observed on MRI in patients with avascular necrosis (AVN) of the femoral head represents an indicator of subchondral fracture. Thirty-seven symptomatic hips of 27 consecutive patients (53% women, mean age 49.2) with AVN of the femoral head and associated BME on magnetic resonance (MR) imaging were included. MR findings were correlated with computed tomography (CT) of the hip and confirmed by histopathological examination of the resected femoral head. Imaging studies were analysed by two radiologists with use of the ARCO classification. On MR imaging a fracture line could be identified in 19/37 (51%) cases, which were classified as ARCO stage 3 (n = 15) and stage 4 (n = 4). The remaining 18/37 (49%) cases were classified as ARCO stage 2. However, in all 37/37 (100%) cases a subchondral fracture was identified on CT, indicating ARCO stage 3/4 disease. The extent of subchondral fractures and the femoral head collapse was graded higher on CT as compared to MRI (P AVN, BME of the femoral head represents a secondary sign of subchondral fracture and thus indicates ARCO stage 3 disease. BME on MRI in AVN of femoral head indicates a subchondral fracture. BME in AVN of the femoral head represents ARCO stage 3/4 disease. CT identifies subchondral fractures and femoral head collapse better than MR imaging. This knowledge helps to avoid understaging and to trigger adequate treatment.

  8. Bone marrow oedema on MR imaging indicates ARCO stage 3 disease in patients with AVN of the femoral head

    International Nuclear Information System (INIS)

    Meier, Reinhard; Schaeffeler, Christoph; Waldt, Simone; Rummeny, Ernst J.; Woertler, Klaus; Kraus, Tobias M.; Torka, Sebastian; Schlitter, Anna Melissa; Specht, Katja; Haller, Bernhard; Rechl, Hans

    2014-01-01

    To test the hypothesis that bone marrow oedema (BME) observed on MRI in patients with avascular necrosis (AVN) of the femoral head represents an indicator of subchondral fracture. Thirty-seven symptomatic hips of 27 consecutive patients (53 % women, mean age 49.2) with AVN of the femoral head and associated BME on magnetic resonance (MR) imaging were included. MR findings were correlated with computed tomography (CT) of the hip and confirmed by histopathological examination of the resected femoral head. Imaging studies were analysed by two radiologists with use of the ARCO classification. On MR imaging a fracture line could be identified in 19/37 (51 %) cases, which were classified as ARCO stage 3 (n = 15) and stage 4 (n = 4). The remaining 18/37 (49 %) cases were classified as ARCO stage 2. However, in all 37/37 (100 %) cases a subchondral fracture was identified on CT, indicating ARCO stage 3/4 disease. The extent of subchondral fractures and the femoral head collapse was graded higher on CT as compared to MRI (P < 0.05). Histopathological analysis confirmed bone necrosis and subchondral fractures. In patients with AVN, BME of the femoral head represents a secondary sign of subchondral fracture and thus indicates ARCO stage 3 disease. circle BME on MRI in AVN of femoral head indicates a subchondral fracture. (orig.)

  9. Lung irradiation induces pulmonary vascular remodelling resembling pulmonary arterial hypertension

    NARCIS (Netherlands)

    Ghobadi, G.; Bartelds, B.; van der Veen, S. J.; Dickinson, M. G.; Brandenburg, S.; Berger, R. M. F.; Langendijk, J. A.; Coppes, R. P.; van Luijk, P.

    Background Pulmonary arterial hypertension (PAH) is a commonly fatal pulmonary vascular disease that is often diagnosed late and is characterised by a progressive rise in pulmonary vascular resistance resulting from typical vascular remodelling. Recent data suggest that vascular damage plays an

  10. Minimal Marking: A Success Story

    Science.gov (United States)

    McNeilly, Anne

    2014-01-01

    The minimal-marking project conducted in Ryerson's School of Journalism throughout 2012 and early 2013 resulted in significantly higher grammar scores in two first-year classes of minimally marked university students when compared to two traditionally marked classes. The "minimal-marking" concept (Haswell, 1983), which requires…

  11. Swarm robotics and minimalism

    Science.gov (United States)

    Sharkey, Amanda J. C.

    2007-09-01

    Swarm Robotics (SR) is closely related to Swarm Intelligence, and both were initially inspired by studies of social insects. Their guiding principles are based on their biological inspiration and take the form of an emphasis on decentralized local control and communication. Earlier studies went a step further in emphasizing the use of simple reactive robots that only communicate indirectly through the environment. More recently SR studies have moved beyond these constraints to explore the use of non-reactive robots that communicate directly, and that can learn and represent their environment. There is no clear agreement in the literature about how far such extensions of the original principles could go. Should there be any limitations on the individual abilities of the robots used in SR studies? Should knowledge of the capabilities of social insects lead to constraints on the capabilities of individual robots in SR studies? There is a lack of explicit discussion of such questions, and researchers have adopted a variety of constraints for a variety of reasons. A simple taxonomy of swarm robotics is presented here with the aim of addressing and clarifying these questions. The taxonomy distinguishes subareas of SR based on the emphases and justifications for minimalism and individual simplicity.

  12. Minimal dilaton model

    Directory of Open Access Journals (Sweden)

    Oda Kin-ya

    2013-05-01

    Full Text Available Both the ATLAS and CMS experiments at the LHC have reported the observation of the particle of mass around 125 GeV which is consistent to the Standard Model (SM Higgs boson, but with an excess of events beyond the SM expectation in the diphoton decay channel at each of them. There still remains room for a logical possibility that we are not seeing the SM Higgs but something else. Here we introduce the minimal dilaton model in which the LHC signals are explained by an extra singlet scalar of the mass around 125 GeV that slightly mixes with the SM Higgs heavier than 600 GeV. When this scalar has a vacuum expectation value well beyond the electroweak scale, it can be identified as a linearly realized version of a dilaton field. Though the current experimental constraints from the Higgs search disfavors such a region, the singlet scalar model itself still provides a viable alternative to the SM Higgs in interpreting its search results.

  13. Minimal mirror twin Higgs

    Energy Technology Data Exchange (ETDEWEB)

    Barbieri, Riccardo [Institute of Theoretical Studies, ETH Zurich,CH-8092 Zurich (Switzerland); Scuola Normale Superiore,Piazza dei Cavalieri 7, 56126 Pisa (Italy); Hall, Lawrence J.; Harigaya, Keisuke [Department of Physics, University of California,Berkeley, California 94720 (United States); Theoretical Physics Group, Lawrence Berkeley National Laboratory,Berkeley, California 94720 (United States)

    2016-11-29

    In a Mirror Twin World with a maximally symmetric Higgs sector the little hierarchy of the Standard Model can be significantly mitigated, perhaps displacing the cutoff scale above the LHC reach. We show that consistency with observations requires that the Z{sub 2} parity exchanging the Standard Model with its mirror be broken in the Yukawa couplings. A minimal such effective field theory, with this sole Z{sub 2} breaking, can generate the Z{sub 2} breaking in the Higgs sector necessary for the Twin Higgs mechanism. The theory has constrained and correlated signals in Higgs decays, direct Dark Matter Detection and Dark Radiation, all within reach of foreseen experiments, over a region of parameter space where the fine-tuning for the electroweak scale is 10-50%. For dark matter, both mirror neutrons and a variety of self-interacting mirror atoms are considered. Neutrino mass signals and the effects of a possible additional Z{sub 2} breaking from the vacuum expectation values of B−L breaking fields are also discussed.

  14. Neonatal Pulmonary Hemosiderosis

    Directory of Open Access Journals (Sweden)

    Boris Limme

    2014-01-01

    Full Text Available Idiopathic pulmonary hemosiderosis (IPH is a rare complex entity characterized clinically by acute or recurrent episodes of hemoptysis secondary to diffuse alveolar hemorrhage. The radiographic features are variable, including diffuse alveolar-type infiltrates, and interstitial reticular and micronodular patterns. We describe a 3-week-old infant presenting with hemoptysis and moderate respiratory distress. Idiopathic pulmonary hemosiderosis was the first working diagnosis at the Emergency Department and was confirmed, 2 weeks later, by histological studies (bronchoalveolar lavage. The immunosuppressive therapy by 1 mg/kg/d prednisone was immediately started, the baby returned home on steroid therapy at a dose of 0,5 mg/kg/d. The diagnosis of idiopathic pulmonary hemosiderosis should be evocated at any age, even in the neonate, when the clinical presentation (hemoptysis and abnormal radiological chest images is strongly suggestive.

  15. Pulmonary embolism; Lungenarterienembolie

    Energy Technology Data Exchange (ETDEWEB)

    Sudarski, Sonja; Henzler, Thomas [Heidelberg Univ., Universitaetsmedizin Mannheim (Germany). Inst. fuer Klinische Radiologie und Nuklearmedizin

    2016-09-15

    Pulmonary embolism (PE) requires a quick diagnostic algorithm, as the untreated disease has a high mortality and morbidity. Crucial for the diagnostic assessment chosen is the initial clinical likelihood of PE and the individual risk profile of the patient. The overall goal is to diagnose or rule out PE as quickly and safely as possible or to initiate timely treatment if necessary. CT angiography of the pulmonary arteries (CTPA) with multi-slice CT scanner systems presents the actual diagnostic reference standard. With CTPA further important diagnoses can be made, like presence of right ventricular dysfunction. There are different scan and contrast application protocols that can be applied in order to gain diagnostic examinations with sufficient contrast material enhancement in the pulmonary arteries while avoiding all kinds of artifacts. This review article is meant to be a practical guide to examine patients with suspected PE according to the actual guidelines.

  16. Chronicle pulmonary histoplasmosis

    International Nuclear Information System (INIS)

    Llanos, Elkin; Ojeda, Paulina

    2004-01-01

    Histoplasmosis is an acquired mycotic disease produced by the histoplasma capsulatum very frequent in Colombia, primarily affecting lungs. The pathogenesis of the histoplasmosis is similar to the one of tuberculosis. From the clinical point of view, this disease has several manifestations including the primary acute and chronic pulmonary forms. Histoplasmoma pulmonary disseminated histoplasmosis, mediastinal compromise due to granulomatosis and fibrosis, as well as ocular histoplasmosis. A clinical case of a 33-year old man is presented who consults for dry coughing of one year of evolution, without any other symptomatology, with a normal chest x-ray and after several studies including chest cat and fiber-bronchoscopy. A pulmonary histoplasmosis was determined by histopathology

  17. Pulmonary artery-to-pulmonary artery anastomoses: angiographic demonstration in patients with chronic thromboembolic pulmonary hypertension

    International Nuclear Information System (INIS)

    Hodson, J.; Graham, A.; Hughes, J.M.B.; Gibbs, J.S.R.; Jackson, J.E.

    2006-01-01

    AIM: To describe direct pulmonary artery-to-pulmonary artery anastomoses seen at pulmonary angiography in patients with chronic thromboembolic pulmonary hypertension and discuss their possible significance. MATERIALS AND METHODS: Between 1 August 2000 and 31 July 2004 43 patients (male-to-female ratio 25:18) with a diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH) underwent selective pulmonary angiography to assess the extent of disease and suitability for surgical pulmonary endarterectomy. The mean pulmonary artery pressure ranged from 27-84 mmHg (average of 51 mmHg). Selective bilateral digital subtraction pulmonary angiograms performed in all individuals were reviewed for the presence of intrapulmonary collaterals. RESULTS: In 15 of the 43 patients (male-to-female ratio =7:8) definite (n=12) or probable (n=3) pulmonary artery-to-pulmonary artery anastomoses were demonstrated. Of the remaining 28 patients in whom intrapulmonary collaterals were not seen it was felt that in 16 the angiograms were of insufficient diagnostic quality (grades 4-5) to exclude their presence. Twelve patients, eight of whom had angiograms of sufficient diagnostic quality (grades 1-3), demonstrated one or more areas of luxury perfusion but intrapulmonary collaterals were not seen. CONCLUSION: Direct pulmonary artery-to-pulmonary artery anastomoses were demonstrated in patients with chronic thromboembolic pulmonary hypertension, which to our knowledge have not been previously described. The importance of these collateral vessels is unclear but they may play a role in the maintenance of pulmonary parenchymal viability in patients with chronic pulmonary embolic disease. The rate of development of these collaterals and their prognostic significance in patients with chronic thromboembolic pulmonary hypertension are areas worthy of further study

  18. Pulmonary artery-to-pulmonary artery anastomoses: angiographic demonstration in patients with chronic thromboembolic pulmonary hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Hodson, J. [Department of Imaging, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London (United Kingdom); Graham, A. [Department of Imaging, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London (United Kingdom); Hughes, J.M.B. [Department of Respiratory Medicine, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London (United Kingdom); Gibbs, J.S.R. [Department of Cardiology, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London (United Kingdom); Jackson, J.E. [Department of Imaging, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London (United Kingdom)]. E-mail: jejackson@hhnt.org

    2006-03-15

    AIM: To describe direct pulmonary artery-to-pulmonary artery anastomoses seen at pulmonary angiography in patients with chronic thromboembolic pulmonary hypertension and discuss their possible significance. MATERIALS AND METHODS: Between 1 August 2000 and 31 July 2004 43 patients (male-to-female ratio 25:18) with a diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH) underwent selective pulmonary angiography to assess the extent of disease and suitability for surgical pulmonary endarterectomy. The mean pulmonary artery pressure ranged from 27-84 mmHg (average of 51 mmHg). Selective bilateral digital subtraction pulmonary angiograms performed in all individuals were reviewed for the presence of intrapulmonary collaterals. RESULTS: In 15 of the 43 patients (male-to-female ratio =7:8) definite (n=12) or probable (n=3) pulmonary artery-to-pulmonary artery anastomoses were demonstrated. Of the remaining 28 patients in whom intrapulmonary collaterals were not seen it was felt that in 16 the angiograms were of insufficient diagnostic quality (grades 4-5) to exclude their presence. Twelve patients, eight of whom had angiograms of sufficient diagnostic quality (grades 1-3), demonstrated one or more areas of luxury perfusion but intrapulmonary collaterals were not seen. CONCLUSION: Direct pulmonary artery-to-pulmonary artery anastomoses were demonstrated in patients with chronic thromboembolic pulmonary hypertension, which to our knowledge have not been previously described. The importance of these collateral vessels is unclear but they may play a role in the maintenance of pulmonary parenchymal viability in patients with chronic pulmonary embolic disease. The rate of development of these collaterals and their prognostic significance in patients with chronic thromboembolic pulmonary hypertension are areas worthy of further study.

  19. Pulmonary hypertension in chronic obstructive pulmonary disease

    International Nuclear Information System (INIS)

    Aguirre F, Carlos E; Torres D, Carlos A.

    2010-01-01

    Pulmonary hypertension (PH) is a relatively common complication of chronic obstructive pulmonary disease (COPD). Its appearance during the course of COPD is associated with a worsened prognosis, due to reduced life expectancy and greater use of health care resources. Although a well-defined lineal relationship has not been shown, the prevalence of PH in patients with COPD is higher in cases characterized by greater obstruction and severity. PH is infrequent in cases of mild and moderate COPD. In cases of COPD, PH is generally mild or moderate, and seldom impairs right ventricular function. In many cases it is not apparent during rest, and manifests itself during exercise. PH can be severe or out of proportion with the severity of COPD. In this situation, the possibility of associated conditions should be explored, although COPD might be the only final explanation. There is scarce knowledge about the prevalence and behavior of PH in patients with COPD residing at intermediate and high altitudes (>2.500 meters above sea level), which is a common situation in Latin America and Asia. PH in COPD is not exclusively related with hypoxia/hypoxaemia and hypercapnia. The mechanical disturbances related with COPD (hyper inflation and high alveolar pressure) and inflammation may prevail as causes of endothelial injury and remodeling of pulmonary circulation, which contribute to increased pulmonary vascular pressure and resistance. The appearance of signs of cor p ulmonale indicates advanced PH. This condition should therefore be suspected early when dyspnoea, hypoxaemia, and impairment of diffusion are not in keeping with the degree of obstruction. PH is confirmed by Doppler echocardiography. Right heart catheterization may be justified in selected cases. Long-term oxygen therapy is the only intervention proven to be temporarily useful. Conventional vasodilators do not produce medium- or long-term improvement and can be detrimental to the ventilation-perfusion relation

  20. Radiologic diagnosis of pulmonary embolism

    International Nuclear Information System (INIS)

    Fink, C.; Ley, S.; Kauczor, H.U.

    2004-01-01

    Pulmonary embolism is a frequent and potentially life-threatening complication of venous thromboembolism. Despite numerous modern diagnostic methods, the diagnosis of pulmonary embolism remains problematic, especially in view of the nonspecific clinical presentation. In this educational review, current diagnostic methods and their role in the diagnostic workup of pulmonary embolism will be discussed. In addition, practical guidelines are given for the diagnostic cascade contingent on the clinical probability for pulmonary embolism. (orig.) [de

  1. Pulmonary lymphatics and radiation

    International Nuclear Information System (INIS)

    Leeds, S.E.

    1976-01-01

    Knowledge of the anatomy and physiology of the respiratory system has been more difficult to acquire than that of other organ systems owing to the complexity of the respiratory function of the lungs and to the technical difficulties involved. This is especially true of the lymphatics of the lung and is illustrated by the fact that the first measurement of pulmonary lymph flow was in 1942 by Warren and Drinker. A review of the literature reveals that few experiments have been designed to study the pulmonary lymphatics per se in relation to the effects of external radiation or after the inhalation of radioactive particles. However, the documented involvement of hilar lymph nodes implies that the lung lymphatics have a role in transporting particles from the alveoli or malignant cells from the parenchyma. Information from clinical and experimental sources, though scattered, is fairly abundant and of value in assessing the role of the pulmonary lymphatics. Our method for collecting pulmonary lymph is presented. Studies on the pulmonary lymph flow in normal dogs and in dogs with experimental congestive heart failure are described. We irradiated (4000 to 5000 R) the medial one-third of both lungs of a series of dogs. The lymph flow of the lungs was measured immediately after the course of irradiation and after a period of about 5 months. Although lung biopsies showed characteristic radiation pneumonitis in many areas, alterations in the lung parenchyma were not quantitatively reflected in the pulmonary lymph flow either in the acute stage or after fibrosis had time to develop

  2. Efficacy and safety of balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension guided by cone-beam computed tomography and electrocardiogram-gated area detector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Ogo, Takeshi, E-mail: ogo.takeshi.hp@mail.ncvc.go.jp [Division of Pulmonary Circulation, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka (Japan); Department of Advanced Mediccal Research for Pulmonary Hypertension, National Cerebral and Cardiovascular Centre, Osaka (Japan); Fukuda, Tetsuya [Department of Radiology, National Cerebral and Cardiovascular Centre, Osaka (Japan); Tsuji, Akihiro; Fukui, Shigefumi; Ueda, Jin [Division of Pulmonary Circulation, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka (Japan); Sanda, Yoshihiro [Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka (Japan); Morita, Yoshiaki [Department of Radiology, National Cerebral and Cardiovascular Centre, Osaka (Japan); Asano, Ryotaro; Konagai, Nao [Division of Pulmonary Circulation, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka (Japan); Yasuda, Satoshi [Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka (Japan)

    2017-04-15

    Highlights: • Recent advancement in CT enables distal CTEpH lesions to be visualized. • We investigated the efficacy and safety of BPA guided by CBCT or ECG-gated area detector CT. • BPA guided by CBCT or ECG-gated area detector CT is effective and safe in patients with CTEpH . • These new advanced CT techniques may be useful in pre-BPA target lesion assessment. - Abstract: Background: Chronic thromboembolic pulmonary hypertension (CTEPH) is a disease characterized by chronic obstructive thrombus and pulmonary hypertension. Balloon pulmonary angioplasty (BPA), an emerging alternative catheter-based treatment for inoperable patients with CTEPH, has not yet been standardised, especially for lesion assessment in distal pulmonary arteries. Recent advancement in computed tomography enables distal CTEPH lesions to be visualized. Methods: We retrospectively studied 80 consecutive patients with inoperable CTEPH who received BPA guided by cone-beam computed tomography (CT) (CBCT) or electrocardiogram (ECG)-gated area detector CT (ADCT) for target lesion assessment. We collected clinical and hemodynamic data, including procedural complications, before BPA and at 3 months and 1 year after BPA. Results: Three hundred eight-five BPA sessions (4.8 sessions/patient) were performed for the lesions of subsegmental arteries (1155 lesions), segmental arteries (738 lesions), and lobar arteries (4 lesions) identified by CBCT or ECG-gated ADCT. Significant improvements in the symptoms, 6-min walk distance, brain natriuretic peptide level, exercise capacity, and haemodynamics were observed 3 months and 1 year after BPA. No cases of death or cardiogenic shock with a low rate of severe wire perforation (0.3%) and severe reperfusion oedema (0.3%) were observed. Conclusions: BPA guided by CBCT or ECG-gated ADCT is effective and remarkably safe in patients with CTEPH . These new advanced CT techniques may be useful in pre-BPA target lesion assessment.

  3. Efficacy and safety of balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension guided by cone-beam computed tomography and electrocardiogram-gated area detector computed tomography

    International Nuclear Information System (INIS)

    Ogo, Takeshi; Fukuda, Tetsuya; Tsuji, Akihiro; Fukui, Shigefumi; Ueda, Jin; Sanda, Yoshihiro; Morita, Yoshiaki; Asano, Ryotaro; Konagai, Nao; Yasuda, Satoshi

    2017-01-01

    Highlights: • Recent advancement in CT enables distal CTEpH lesions to be visualized. • We investigated the efficacy and safety of BPA guided by CBCT or ECG-gated area detector CT. • BPA guided by CBCT or ECG-gated area detector CT is effective and safe in patients with CTEpH . • These new advanced CT techniques may be useful in pre-BPA target lesion assessment. - Abstract: Background: Chronic thromboembolic pulmonary hypertension (CTEPH) is a disease characterized by chronic obstructive thrombus and pulmonary hypertension. Balloon pulmonary angioplasty (BPA), an emerging alternative catheter-based treatment for inoperable patients with CTEPH, has not yet been standardised, especially for lesion assessment in distal pulmonary arteries. Recent advancement in computed tomography enables distal CTEPH lesions to be visualized. Methods: We retrospectively studied 80 consecutive patients with inoperable CTEPH who received BPA guided by cone-beam computed tomography (CT) (CBCT) or electrocardiogram (ECG)-gated area detector CT (ADCT) for target lesion assessment. We collected clinical and hemodynamic data, including procedural complications, before BPA and at 3 months and 1 year after BPA. Results: Three hundred eight-five BPA sessions (4.8 sessions/patient) were performed for the lesions of subsegmental arteries (1155 lesions), segmental arteries (738 lesions), and lobar arteries (4 lesions) identified by CBCT or ECG-gated ADCT. Significant improvements in the symptoms, 6-min walk distance, brain natriuretic peptide level, exercise capacity, and haemodynamics were observed 3 months and 1 year after BPA. No cases of death or cardiogenic shock with a low rate of severe wire perforation (0.3%) and severe reperfusion oedema (0.3%) were observed. Conclusions: BPA guided by CBCT or ECG-gated ADCT is effective and remarkably safe in patients with CTEPH . These new advanced CT techniques may be useful in pre-BPA target lesion assessment.

  4. Pulmonary manifestation of AIDS

    International Nuclear Information System (INIS)

    Blum, U.; Dinkel, E.; Laaff, H.; Wuertemberger, G.; Senn, H.; Vaith, P.; Kroepelin, T.; Freiburg Univ.; Freiburg Univ.; Freiburg Univ.; Freiburg Univ.

    1989-01-01

    We reviewed retrospectively the clinical records of 28 patients with AIDS staged group IV according to CDC-criteria. Among these, 19 had pulmonary disease: most of them (n=17) had pneumocystis carinii pneumonia (Pcp). 12/17 patients with proven Pcp displayed typical X-ray findings with diffuse perihilar interstitial infiltration sparing lung periphery. 3/17 had atypical features and 2 normal chest x-ray findings. These data are important to identify patients with pulmonary complications of AIDS. (orig.) [de

  5. Pulmonary Artery Dissection: A Fatal Complication of Pulmonary Hypertension

    Directory of Open Access Journals (Sweden)

    Chuanchen Zhang

    2016-01-01

    Full Text Available Pulmonary artery dissection is extremely rare but it is a really life-threatening condition when it happens. Most patients die suddenly from major bleeding or tamponade caused by direct rupture into mediastinum or retrograde into the pericardial sac. What we are reporting is a rare case of a 46-year-old female patient whose pulmonary artery dissection involves both the pulmonary valve and right pulmonary artery. The patient had acute chest pain and severe dyspnea, and the diagnosis of pulmonary artery dissection was confirmed by ultrasonography and CT angiography. Moreover, its etiology, clinical manifestations, and management are also discussed in this article.

  6. Evaluation of some pulmonary functions and pleuropulmonary complications after endoscopic sclerotherapy of gastric fundal varices at Zagazig university hospitals

    Directory of Open Access Journals (Sweden)

    Jihan A. Shawky

    2016-10-01

    Conclusions: NBCA injection of gastric fundal varices was associated with significant, reversible deterioration in some pulmonary functions, atelectasis and minimal pleural effusion with significant rapid improvement if incentive spirometry is used.

  7. Isolated Pulmonary Embolism following Shoulder Arthroscopy

    Directory of Open Access Journals (Sweden)

    Nicole H. Goldhaber

    2014-01-01

    Full Text Available Pulmonary embolism (PE following shoulder arthroscopy is a rare complication. We present a unique case report of a 43-year-old right-hand dominant female who developed a PE 41 days postoperatively with no associated upper or lower extremity DVT. The patient had minimal preoperative and intraoperative risk factors. Additionally, she had no thromboembolic symptoms postoperatively until 41 days following surgery when she developed sudden right-hand swelling, labored breathing, and abdominal pain. A stat pulmonary computed tomography (CT angiogram of the chest revealed an acute PE in the right lower lobe, and subsequent extremity ultrasounds showed no upper or lower extremity deep vein thrombosis. After a thorough review of the literature, we present the first documented isolated PE following shoulder arthroscopy. Although rare, sudden development of an isolated PE is possible, and symptoms such as sudden hand swelling, trouble breathing, and systemic symptoms should be evaluated aggressively with a pulmonary CT angiogram given the fact that an extremity ultrasound may be negative for deep vein thrombosis.

  8. Radiological diagnosis of pulmonary hypertension

    International Nuclear Information System (INIS)

    Huebsch, P.; Jenny, C.; Schwaighofer, B.; Seidl, G.; Burghuber, O.C.

    1987-01-01

    In 43 patients with obstructive and restrictive lung disease a catheterisation of the right heart with measurement of pulmonary artery pressure was performed. In a retrospective study several radiological parameters of pulmonary hypertension were evaluated on the chest radiographs of these patients. Considering those parameters on the p.a. and lateral chest radiograph, the diagnosis of pulmonary hypertension in patients with elevated pulmonary artery pressure at rest can be made with great accuracy. When pulmonary artery pressure is elevated only during exercise, the accuracy of radiological diagnosis is much lower. (orig.) [de

  9. Pathogenesis of pulmonary vasculitis

    NARCIS (Netherlands)

    Heeringa, P; Schreiber, A; Falk, RJ; Jennette, JC

    2004-01-01

    Vasculitis is inflammation of blood vessels and can affect any type of vessel in any organ. Pulmonary vasculitis usually is a component of a systemic small vessel vasculitis. Three major forms of small vessel vasculitis that often affect the lungs are Wegener's granulomatosis, microscopic

  10. Pulmonary langerhans cell histiocytosis

    Directory of Open Access Journals (Sweden)

    Suri Harpreet S

    2012-03-01

    Full Text Available Abstract Pulmonary Langerhans Cell Histiocytosis (PLCH is a relatively uncommon lung disease that generally, but not invariably, occurs in cigarette smokers. The pathologic hallmark of PLCH is the accumulation of Langerhans and other inflammatory cells in small airways, resulting in the formation of nodular inflammatory lesions. While the overwhelming majority of patients are smokers, mechanisms by which smoking induces this disease are not known, but likely involve a combination of events resulting in enhanced recruitment and activation of Langerhans cells in small airways. Bronchiolar inflammation may be accompanied by variable lung interstitial and vascular involvement. While cellular inflammation is prominent in early disease, more advanced stages are characterized by cystic lung destruction, cicatricial scarring of airways, and pulmonary vascular remodeling. Pulmonary function is frequently abnormal at presentation. Imaging of the chest with high resolution chest CT scanning may show characteristic nodular and cystic abnormalities. Lung biopsy is necessary for a definitive diagnosis, although may not be required in instances were imaging findings are highly characteristic. There is no general consensus regarding the role of immunosuppressive therapy in smokers with PLCH. All smokers must be counseled on the importance of smoking cessation, which may result in regression of disease and obviate the need for systemic immunosuppressive therapy. The prognosis for most patients is relatively good, particularly if longitudinal lung function testing shows stability. Complications like pneumothoraces and secondary pulmonary hypertension may shorten life expectancy. Patients with progressive disease may require lung transplantation.

  11. Imaging pulmonary fibrosis

    International Nuclear Information System (INIS)

    Brauner, M.W.; Rety, F.; Naccache, J.M.; Girard, F.; Valeyre, D.F.

    2001-01-01

    Localized fibrosis of the lung is usually scar tissue while diffuse pulmonary fibrosis is more often a sign of active disease. Chronic infiltrative lung disease may be classified into four categories: idiopathic pneumonitis, collagen diseases, granulomatosis (sarcoidosis), and caused by known diseases (pneumoconiosis, hypersensitivity pneumonitis, drug-induced lung disease, radiation). (authors)

  12. Radiological case. Pulmonary Lymphangioleiomyomatosis

    International Nuclear Information System (INIS)

    Rivera Bernal, Aura Lucia; Carrillo Bayona, Jorge Alberto; Ojeda Leon, Paulina

    2004-01-01

    Lymphangioleiomyomatosis is a rare disorder, which affects principally the pulmonary parenchyma of young women at a reproductive age, and is pathologically characterized by the interstitial proliferation of smooth muscle and formation of cysts in the lung. We present the case of a 35-year-old woman that has a lymphangioleiomyomatosis diagnosis

  13. An unexpected pulmonary bystander

    NARCIS (Netherlands)

    Wouthuyzen-Bakker, M.; Vorm, van der P. A.; Koning, K. J.; van der Werf, T. S.

    A 30-year-old man from Eritrea was admitted with a pulmonary bacterial abscess. Unexpectedly, histopathology of the resected lobe also revealed an infection with Schistosoma mansoni with surrounding granulomatous tissue and fibrosis. Patients from endemic areas are often asymptomatic with blood

  14. Outcome after pulmonary metastasectomy

    DEFF Research Database (Denmark)

    Hornbech, Kåre; Ravn, Jesper; Steinbrüchel, Daniel Andreas

    2011-01-01

    In this study, we analyze the results of management of pulmonary metastases in 5 years consecutive operations at our institution. We aim to define the patients who are most likely to benefit from surgery by investigating long-term survival and prognostic factors associated with prolonged survival....

  15. Idiopathic pulmonary fibrosis.

    Science.gov (United States)

    Xaubet, Antoni; Ancochea, Julio; Molina-Molina, María

    2017-02-23

    Idiopathic pulmonary fibrosis is a fibrosing interstitial pneumonia associated with the radiological and/or histological pattern of usual interstitial pneumonia. Its aetiology is unknown, but probably comprises the action of endogenous and exogenous micro-environmental factors in subjects with genetic predisposition. Its diagnosis is based on the presence of characteristic findings of high-resolution computed tomography scans and pulmonary biopsies in absence of interstitial lung diseases of other aetiologies. Its clinical evolution is variable, although the mean survival rate is 2-5 years as of its clinical presentation. Patients with idiopathic pulmonary fibrosis may present complications and comorbidities which modify the disease's clinical course and prognosis. In the mild-moderate disease, the treatment consists of the administration of anti-fibrotic drugs. In severe disease, the best therapeutic option is pulmonary transplantation. In this paper we review the diagnostic and therapeutic aspects of the disease. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  16. What Is Pulmonary Hypertension?

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Pulmonary Hypertension - High Blood Pressure in the Heart-to-Lung System Updated:Jan ... Pressure" This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP Introduction What ...

  17. Hantavirus Pulmonary Syndrome

    Centers for Disease Control (CDC) Podcasts

    2011-07-14

    Dr. Adam MacNeil, epidemiologist with Viral Special Pathogens Branch at CDC, discusses hantavirus pulmonary syndrome.  Created: 7/14/2011 by National Center for Emerging Zoonotic and Infectious Diseases (NCEZID).   Date Released: 7/18/2011.

  18. Impact of oedema on implant geometry and dosimetry for temporary high dose rate brachytherapy of the prostate

    International Nuclear Information System (INIS)

    Kiffer, J.D.; Schumer, W.A.; Mantle, C.A.; McKenzie, B.J.; Feigen, M.; Quong, G.G.; Waterman, F.M.

    2003-01-01

    The optimal timing of dosimetry for permanent seed prostatic implants remains contentious given the half life of post-implant oedema resolution. The aim of this study was to establish whether prostatic oedematous change over the duration of a temporary high dose rate (HDR) interstitial brachytherapy (BR) boost would result in significant needle displacement, and whether this change in geometry would influence dosimetry. Two CT scans, one for dosimetric purposes on the day of the implant and the second just prior to implant removal, were obtained for four patients receiving transperineal interstitial prostate brachytherapy. The relative changes in cross-sectional dimensions of the implants were calculated by establishing the change in mean radial distance (MRD) of the needle positions from the geometric centre of the implant for each patient's pair of CT studies. The treatment plan, as calculated from the first CT scan, was used in the second set of CT images to allow a comparison of dose distribution. The percentage change in MRD over the duration of the temporary implants ranged from -1.91% to 1.95%. The maximum change in estimated volume was 3.94%. Dosimetric changes were negligible. In the four cases studied, the degree of oedematous change and consequent displacement of flexiguide needle positions was negligible and did not impact on the dosimetry. The rate and direction of oedematous change can be extremely variable but on the basis of the four cases studied and the results of a larger recent study, it might not be necessary to re-image patients for dosimetric purposes over the duration of a fractionated HDR BT boost to the prostate where flexiguide needles are utilized. Nevertheless, further investigation with larger patient numbers is required. Copyright (2003) Blackwell Science Pty Ltd

  19. Three cases of pulmonary varix

    Energy Technology Data Exchange (ETDEWEB)

    Takishima, Teruo; Sakuma, Hajime; Tajima, Tsunemi; Okimoto, Takao; Yamamoto, Keiichiro; Dohi, Yutaka (Saitama Medical School (Japan))

    1982-06-01

    Three cases of pulmonary varix associated with valvular heart disease were reported. Round shadows were clearer on first oblique or lateral films of chest x-ray in all 3 cases. On chest tomograms, the shadows were substantial and round-elliptical. RI angiography with sup(99m)Tc-RBC demonstrated these shadows in agreement with the site of influx of the pulmonary vein into the left atrium in Cases 1 and 3 and with the pulmonary vein slightly apart from the left atrium in Case 2. On CT scans in Cases 1 and 3, enhancement with a contrast medium visualized dilatation of the pulmonary vein close to, and in continuation with, the shadow of the left atrium. The diagnosis of pulmonary varix in agreement with the venous phase of pulmonary angiography was made for all 3 cases. Non-surgical examinations (especially CT scan) proved highly useful for the diagnosis of pulmonary varix.

  20. Three cases of pulmonary varix

    International Nuclear Information System (INIS)

    Takishima, Teruo; Sakuma, Hajime; Tajima, Tsunemi; Okimoto, Takao; Yamamoto, Keiichiro; Dohi, Yutaka

    1982-01-01

    Three cases of pulmonary varix associated with valvular heart disease were reported. Round shadows were clearer on first oblique or lateral films of chest x-ray in all 3 cases. On chest tomograms, the shadows were substantial and round-elliptical. RI angiography with sup(99m)Tc-RBC demonstrated these shadows in agreement with the site of influx of the pulmonary vein into the left atrium in Cases 1 and 3 and with the pulmonary vein slightly apart from the left atrium in Case 2. On CT scans in Cases 1 and 3, enhancement with a contrast medium visualized dilatation of the pulmonary vein close to, and in continuation with, the shadow of the left atrium. The diagnosis of pulmonary varix in agreement with the venous phase of pulmonary angiography was made for all 3 cases. Non-surgical examinations (especially CT scan) proved highly useful for the diagnosis of pulmonary varix. (Chiba, N.)

  1. Pulmonary function in space

    Science.gov (United States)

    West, J. B.; Elliott, A. R.; Guy, H. J.; Prisk, G. K.

    1997-01-01

    The lung is exquisitely sensitive to gravity, and so it is of interest to know how its function is altered in the weightlessness of space. Studies on National Aeronautics and Space Administration (NASA) Spacelabs during the last 4 years have provided the first comprehensive data on the extensive changes in pulmonary function that occur in sustained microgravity. Measurements of pulmonary function were made on astronauts during space shuttle flights lasting 9 and 14 days and were compared with extensive ground-based measurements before and after the flights. Compared with preflight measurements, cardiac output increased by 18% during space flight, and stroke volume increased by 46%. Paradoxically, the increase in stroke volume occurred in the face of reductions in central venous pressure and circulating blood volume. Diffusing capacity increased by 28%, and the increase in the diffusing capacity of the alveolar membrane was unexpectedly large based on findings in normal gravity. The change in the alveolar membrane may reflect the effects of uniform filling of the pulmonary capillary bed. Distributions of blood flow and ventilation throughout the lung were more uniform in space, but some unevenness remained, indicating the importance of nongravitational factors. A surprising finding was that airway closing volume was approximately the same in microgravity and in normal gravity, emphasizing the importance of mechanical properties of the airways in determining whether they close. Residual volume was unexpectedly reduced by 18% in microgravity, possibly because of uniform alveolar expansion. The findings indicate that pulmonary function is greatly altered in microgravity, but none of the changes observed so far will apparently limit long-term space flight. In addition, the data help to clarify how gravity affects pulmonary function in the normal gravity environment on Earth.

  2. Radiotherapy and pulmonary fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Sone, S; Miyata, Y; Tachiiri, H [Osaka Univ. (Japan). Faculty of Medicine

    1975-04-01

    Clinical findings of radiation pneumonitis and pulmonary fibrosis were outlined, and the relationship between occurence of these disorders and radiotherapy, clinical findings and X-ray picture were studied. Standard radiation dose as cell lethal response of carcinoma of the lung were 4,500 to 5,500 rad in 4 to 5.5 weeks in undifferentiated carcinoma, 6,000 to 7,000 rad in 6 to 7 weeks in squamous cell carcinoma, 7,000 to 9,000 rad in 7 to 9 weeks in adenocarcinoma, 4,500 to 5,000 rad in 4 to 5 weeks in the large sized cancer of the esophagus, 6,500 to 7,000 rad in 5 to 7 weeks in the small sized cancer of the esophagus, and irradiation of these amount of dose caused hazards in pulmonary function. Pathological and clinical findings of pulmonary hazards within 6 month period after irradiation, factors causing them and changes in X-ray pictures before and after irradiation were observed and discussed in clinical cases: the case of breast cancer in which 3,000 R/6 times/18 days of 5.5 MeV Liniac electron was irradiated to the chest wall, and the case of pulmonary cancer in which 5,000 rad/25 times/34 days of 6 MeV Liniac X-ray was irradiated in opposite 2 ports radiation beam treatment. The former revealed alveolar lesion and interlobular pleuritis at 4 month later, and remarkable lesion of pulmonary fibrosis was followed at 9 month after radiotherapy. The later developed radiation pneumonitis 1 month after radiotherapy, of which lesion extended to the upper part by 3 months later, and cancer recurred 6.5 month later.

  3. Surgical Treatment for Pulmonary Hamartomas

    Directory of Open Access Journals (Sweden)

    Funda Ižncekara

    2015-11-01

    Full Text Available Aim: In this study, we evaluated the patients operated for hamartoma and treated endobronchially and the diagnostic value of this approach has been examined. Material and Method: 59 patients (24 females, 35 males; mean age 53 years, range 28-78 years which were operated and endobronchial treated for hamartoma in our clinic between January 2003 - January 2013 were analyzed retrospectively. Patient age, sex, symptoms, histopathological, surgical procedures and treatment outcomes were evaluated. Results: The most common complaint was shortness of breath, while 25 patients were asymptomatic. Thoracotomy and mass enucleation in 29 patients (%49,15, thoracotomy and wedge resection in 18 patients (%30.5, VATS and wedge resection in 4 patients (%6.77, thoracotomy and upper lobectomy in 4 patients (%6.77, thoracotomy and lower lobectomy in 2 patients (%3.38 and left upper lobe segmentectomy in 1 patient (%1.69 and right upper bronchial sleeve resection in 1 patient were performed. The postoperative pathology of lesions examined and diagnosis were chondroid hamartoma in 28 , pulmonary hamartoma in 20 , hamartoma chondrolypomatous in 11 and the bronchial hamartoma in 2 . No mortality was observed intraoperatively. Discussion: Although hamartomas are benign , diagnosis should be made because it can be confused with lung cancer. Definitive diagnosis and treatment can be performed successfully through VATS in primarily appropriate cases with minimal morbidity or thoracotomy or endobronchial treatment.

  4. Pulmonary tuberculosis in patients with idiopathic pulmonary fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Myung Jin; Goo, Jin Mo E-mail: jmgoo@plaza.snu.ac.kr; Im, Jung-Gi

    2004-11-01

    Objectives: Patients with idiopathic pulmonary fibrosis (IPF) have an increased risk of pulmonary tuberculosis. However, detecting pulmonary tuberculosis may be difficult due to the underlying fibrosis. The aim of this report is to describe the radiological and clinical findings of pulmonary tuberculosis in patients with idiopathic pulmonary fibrosis. Materials and methods: We reviewed 143 consecutive patients in whom IPF was diagnosed by either the histological or radio-clinical criteria. Among them, nine patients were histologically (n=2) or bacteriologically (n=7) confirmed to have active pulmonary tuberculosis. The location and patterns of pulmonary tuberculosis were examined on a thin section CT scan. Results: The most common thin section CT findings were subpleural nodules (n=6; mean diameter, 3.2 cm) and a lobar or segmental consolidation (n=3). The lesions were located most commonly in the right lower lobe (n=4). The incidence of tuberculosis in patients with idiopathic pulmonary fibrosis was more than five times higher than that of the general population. Conclusion: The atypical manifestation of pulmonary tuberculosis is common in patients with idiopathic pulmonary fibrosis, which may mimic lung cancer or bacterial pneumonia.

  5. Pulmonary tuberculosis in patients with idiopathic pulmonary fibrosis

    International Nuclear Information System (INIS)

    Chung, Myung Jin; Goo, Jin Mo; Im, Jung-Gi

    2004-01-01

    Objectives: Patients with idiopathic pulmonary fibrosis (IPF) have an increased risk of pulmonary tuberculosis. However, detecting pulmonary tuberculosis may be difficult due to the underlying fibrosis. The aim of this report is to describe the radiological and clinical findings of pulmonary tuberculosis in patients with idiopathic pulmonary fibrosis. Materials and methods: We reviewed 143 consecutive patients in whom IPF was diagnosed by either the histological or radio-clinical criteria. Among them, nine patients were histologically (n=2) or bacteriologically (n=7) confirmed to have active pulmonary tuberculosis. The location and patterns of pulmonary tuberculosis were examined on a thin section CT scan. Results: The most common thin section CT findings were subpleural nodules (n=6; mean diameter, 3.2 cm) and a lobar or segmental consolidation (n=3). The lesions were located most commonly in the right lower lobe (n=4). The incidence of tuberculosis in patients with idiopathic pulmonary fibrosis was more than five times higher than that of the general population. Conclusion: The atypical manifestation of pulmonary tuberculosis is common in patients with idiopathic pulmonary fibrosis, which may mimic lung cancer or bacterial pneumonia

  6. Global Analysis of Minimal Surfaces

    CERN Document Server

    Dierkes, Ulrich; Tromba, Anthony J

    2010-01-01

    Many properties of minimal surfaces are of a global nature, and this is already true for the results treated in the first two volumes of the treatise. Part I of the present book can be viewed as an extension of these results. For instance, the first two chapters deal with existence, regularity and uniqueness theorems for minimal surfaces with partially free boundaries. Here one of the main features is the possibility of 'edge-crawling' along free parts of the boundary. The third chapter deals with a priori estimates for minimal surfaces in higher dimensions and for minimizers of singular integ

  7. Minimal Surfaces for Hitchin Representations

    DEFF Research Database (Denmark)

    Li, Qiongling; Dai, Song

    2018-01-01

    . In this paper, we investigate the properties of immersed minimal surfaces inside symmetric space associated to a subloci of Hitchin component: $q_n$ and $q_{n-1}$ case. First, we show that the pullback metric of the minimal surface dominates a constant multiple of the hyperbolic metric in the same conformal...... class and has a strong rigidity property. Secondly, we show that the immersed minimal surface is never tangential to any flat inside the symmetric space. As a direct corollary, the pullback metric of the minimal surface is always strictly negatively curved. In the end, we find a fully decoupled system...

  8. Pulmonary arterial hypertension

    Science.gov (United States)

    2013-01-01

    Pulmonary arterial hypertension (PAH) is a chronic and progressive disease leading to right heart failure and ultimately death if untreated. The first classification of PH was proposed in 1973. In 2008, the fourth World Symposium on PH held in Dana Point (California, USA) revised previous classifications. Currently, PH is devided into five subgroups. Group 1 includes patients suffering from idiopathic or familial PAH with or without germline mutations. Patients with a diagnosis of PAH should systematically been screened regarding to underlying mutations of BMPR2 gene (bone morphogenetic protein receptor type 2) or more rarely of ACVRL1 (activine receptor-like kinase type 1), ENG (endogline) or Smad8 genes. Pulmonary veno occusive disease and pulmonary capillary hemagiomatosis are individualized and designated as clinical group 1'. Group 2 'Pulmonary hypertension due to left heart diseases' is divided into three sub-groups: systolic dysfonction, diastolic dysfonction and valvular dysfonction. Group 3 'Pulmonary hypertension due to respiratory diseases' includes a heterogenous subgroup of respiratory diseases like PH due to pulmonary fibrosis, COPD, lung emphysema or interstitial lung disease for exemple. Group 4 includes chronic thromboembolic pulmonary hypertension without any distinction of proximal or distal forms. Group 5 regroup PH patients with unclear multifactorial mechanisms. Invasive hemodynamic assessment with right heart catheterization is requested to confirm the definite diagnosis of PH showing a resting mean pulmonary artery pressure (mPAP) of ≥ 25 mmHg and a normal pulmonary capillary wedge pressure (PCWP) of ≤ 15 mmHg. The assessment of PCWP may allow the distinction between pre-capillary and post-capillary PH (PCWP > 15 mmHg). Echocardiography is an important tool in the management of patients with underlying suspicion of PH. The European Society of Cardiology and the European Respiratory Society (ESC-ERS) guidelines specify its role

  9. Optimizing computed tomography pulmonary angiography using right atrium bolus monitoring combined with spontaneous respiration

    Energy Technology Data Exchange (ETDEWEB)

    Min, Wang; Jian, Li; Rui, Zhai [Jining No. 1 People' s Hospital, Department of Computed Tomography, Jining City, ShanDong Province (China); Wen, Li [Jining No. 1 People' s Hospital, Department of Gastroenterology, Jining, ShanDong (China); Dai, Lun-Hou [Shandong Chest Hospital, Department of Radiology, Jinan, ShanDong (China)

    2015-09-15

    CT pulmonary angiography (CTPA) aims to provide pulmonary arterial opacification in the absence of significant pulmonary venous filling. This requires accurate timing of the imaging acquisition to ensure synchronization with the peak pulmonary artery contrast concentration. This study was designed to test the utility of right atrium (RA) monitoring in ensuring optimal timing of CTPA acquisition. Sixty patients referred for CTPA were divided into two groups. Group A (n = 30): CTPA was performed using bolus triggering from the pulmonary trunk, suspended respiration and 70 ml of contrast agent (CA). Group B (n = 30): CTPA image acquisition was triggered using RA monitoring with spontaneous respiration and 40 ml of CA. Image quality was compared. Subjective image quality, average CT values of pulmonary arteries and density difference between artery and vein pairs were significantly higher whereas CT values of pulmonary veins were significantly lower in group B (all P < 0.05). There was no significant difference between the groups in the proportion of subjects where sixth grade pulmonary arteries were opacified (P > 0.05). RA monitoring combined with spontaneous respiration to trigger image acquisition in CTPA produces optimal contrast enhancement in pulmonary arterial structures with minimal venous filling even with reduced doses of CA. (orig.)

  10. When a pulmonary embolism is not a pulmonary embolism: a rare case of primary pulmonary leiomyosarcoma

    Directory of Open Access Journals (Sweden)

    Nargiz Muganlinskaya

    2015-12-01

    Full Text Available Arterial leiomyosarcomas account for up to 21% of vascular leiomyosarcomas, with 56% of arterial leiomyosarcomas occurring in the pulmonary artery. While isolated cases of primary pulmonary artery leiomyosarcoma document survival up to 36 months after treatment, these uncommon, aggressive tumors are highly lethal, with 1-year survival estimated at 20% from the onset of symptoms. We discuss a rare case of a pulmonary artery leiomyosarcoma that was originally diagnosed as a pulmonary embolism (PE. A 72-year-old Caucasian female was initially diagnosed with ‘saddle pulmonary embolism’ based on computerized tomographic angiography of the chest 2 months prior to admission and placed on anticoagulation. Dyspnea escalated, and serial computed tomography scans showed cardiomegaly with pulmonary emboli involving the right and left main pulmonary arteries with extension into the right and left upper and lower lobe branches. An echocardiogram on admission showed severe pulmonary hypertension with a pulmonary artery pressure of 82.9 mm Hg, and a severely enlarged right ventricle. Respiratory distress and multiorgan failure developed and, unfortunately, the patient expired. Autopsy showed a lobulated, yellow mass throughout the main pulmonary arteries measuring 13 cm in diameter. The mass extended into the parenchyma of the right upper lobe. On microscopy, the mass was consistent with a high-grade primary pulmonary artery leiomyosarcoma. Median survival of patients with primary pulmonary artery leiomyosarcoma without surgery is one and a half months, and mortality is usually due to right-sided heart failure. Pulmonary artery leiomyosarcoma is a rare but highly lethal disease commonly mistaken for PE. Thus, we recommend clinicians to suspect this malignancy when anticoagulation fails to relieve initial symptoms. In conclusion, early detection and suspicion of pulmonary artery leiomyosarcoma should be considered in patients refractory to anticoagulation

  11. Pulmonary hypertension of the newborn.

    Science.gov (United States)

    Stayer, Stephen A; Liu, Yang

    2010-09-01

    Pulmonary hypertension presenting in the neonatal period can be due to congenital heart malformations (most commonly associated with obstruction to pulmonary venous drainage), high output cardiac failure from large arteriovenous malformations and persistent pulmonary hypertension of the newborn (PPHN). Of these, the most common cause is PPHN. PPHN develops when pulmonary vascular resistance (PVR) remains elevated after birth, resulting in right-to-left shunting of blood through foetal circulatory pathways. The PVR may remain elevated due to pulmonary hypoplasia, like that seen with congenital diaphragmatic hernia; maldevelopment of the pulmonary arteries, seen in meconium aspiration syndrome; and maladaption of the pulmonary vascular bed as occurs with perinatal asphyxia. These newborn patients typically require mechanical ventilatory support and those with underlying lung disease may benefit from high-frequency oscillatory ventilation or extra-corporeal membrane oxygenation (ECMO). Direct pulmonary vasodilators, such as inhaled nitric oxide, have been shown to improve the outcome and reduce the need for ECMO. However, there is very limited experience with other pulmonary vasodilators. The goals for anaesthetic management are (1) to provide an adequate depth of anaesthesia to ablate the rise in PVR associated with surgical stimuli; (2) to maintain adequate ventilation and oxygenation; and (3) to be prepared to treat a pulmonary hypertensive crisis--an acute rise in PVR with associated cardiovascular collapse.

  12. Pulmonary histiocytosis X - imaging aspects of pulmonary involvement

    International Nuclear Information System (INIS)

    Sabedotti, Ismail Fernando; Maeda, Lucimara; Ferreira, Daniel Miranda; Montandon, Cristiano; Marins, Jose Luiz C.

    1999-01-01

    Pulmonary histiocytosis X is an idiopathic disease which is and uncommon but important cause of pulmonary fibrosis in young adults. Chest radiographs and high resolution computed tomographic (HRCT) scans of the lungs of 7 patients diagnosed as pulmonary histiocytosis X were examined retrospectively. The authors reviewed the pathologic, clinical and radiographic features of pulmonary histiocytosis X, focusing on differential diagnosis and disease progression. Pulmonary histiocytosis X can be suspected on the basis of chest radiographic findings; predominantly upper lobe nodules and cysts present an increased sensitivity and are virtually pathognomonic of this disorder. Chest HRCT allows good assessment of the evolution of pulmonary histiocytosis X and is also valuable in distinguishing histiocytosis from other disorders that produces nodules or cysts. (author)

  13. Solitary pulmonary nodule by pulmonary hematoma under warfarin therapy

    International Nuclear Information System (INIS)

    Scheppach, W.; Kulke, H.; Liebau, G.; Braun, H.; Wuerzburg Univ.

    1983-01-01

    Pulmonary hematoma is a rare cause of a pulmonary nodule. Mostly it results from penetrating or blunt chest injuries. The case of a patient is reported, whose chest X-ray showed a pulmonary nodule suspected of malignancy. This patient was maintained permanently on anticoagulants (warfarin derivates) after cardiac valve replacement with a prosthesis. A definite diagnosis could not be established by non-invasive methods. A needle biopsy of the lung was impracticable because of the location of the pulmonary lesion; an exploratory thoracotomy could not be carried out due to a general indication of nonoperability. Control examinations showed that the pulmonary nodule had vanished completely within four months. In consideration of the patient's clinical situation it can be concluded that the pulmonary lesion was caused by a hematoma of the lung. (orig.) [de

  14. Solitary pulmonary nodule by pulmonary hematoma under warfarin therapy

    Energy Technology Data Exchange (ETDEWEB)

    Scheppach, W.; Kulke, H.; Liebau, G.; Braun, H.

    1983-06-01

    Pulmonary hematoma is a rare cause of a pulmonary nodule. Mostly it results from penetrating or blunt chest injuries. The case of a patient is reported, whose chest X-ray showed a pulmonary nodule suspected of malignancy. This patient was maintained permanently on anticoagulants (warfarin derivates) after cardiac valve replacement with a prosthesis. A definite diagnosis could not be established by non-invasive methods. A needle biopsy of the lung was impracticable because of the location of the pulmonary lesion; an exploratory thoracotomy could not be carried out due to a general indication of nonoperability. Control examinations showed that the pulmonary nodule had vanished completely within four months. In consideration of the patient's clinical situation it can be concluded that the pulmonary lesion was caused by a hematoma of the lung.

  15. Guidelines for mixed waste minimization

    International Nuclear Information System (INIS)

    Owens, C.

    1992-02-01

    Currently, there is no commercial mixed waste disposal available in the United States. Storage and treatment for commercial mixed waste is limited. Host States and compacts region officials are encouraging their mixed waste generators to minimize their mixed wastes because of management limitations. This document provides a guide to mixed waste minimization

  16. Minimal changes in health status questionnaires: distinction between minimally detectable change and minimally important change

    Directory of Open Access Journals (Sweden)

    Knol Dirk L

    2006-08-01

    Full Text Available Abstract Changes in scores on health status questionnaires are difficult to interpret. Several methods to determine minimally important changes (MICs have been proposed which can broadly be divided in distribution-based and anchor-based methods. Comparisons of these methods have led to insight into essential differences between these approaches. Some authors have tried to come to a uniform measure for the MIC, such as 0.5 standard deviation and the value of one standard error of measurement (SEM. Others have emphasized the diversity of MIC values, depending on the type of anchor, the definition of minimal importance on the anchor, and characteristics of the disease under study. A closer look makes clear that some distribution-based methods have been merely focused on minimally detectable changes. For assessing minimally important changes, anchor-based methods are preferred, as they include a definition of what is minimally important. Acknowledging the distinction between minimally detectable and minimally important changes is useful, not only to avoid confusion among MIC methods, but also to gain information on two important benchmarks on the scale of a health status measurement instrument. Appreciating the distinction, it becomes possible to judge whether the minimally detectable change of a measurement instrument is sufficiently small to detect minimally important changes.

  17. Pulmonary lymphangioleiomyomatosis as a pulmonary manifestation of tuberous sclerosis - a case report-

    International Nuclear Information System (INIS)

    Lee, Young Rahn; Kang, Eun Young; Lee, Nam Joon; Suh, Won Hyuck

    1991-01-01

    Pulmonary lymphangioleiomyomatosis is a very rare disease mainly arising in reproductive-aged women. Pulmonary lymphangioleiomyomatosis as a pulmonary involvement of tuberous sclerosis is found in only 1 out of 100 patients. Pulmonary involvement in pulmonary lymphangioleiomyomatosis itself and that as a pulmonary manifestation of tuberous sclerosis has been considered very similar with regard to clinical, radiologic, and pathologic manifestations. We report 1 case of pulmonary lymphangioleiomyomatosis as a pulmonary manifestation of tuberous sclerosis in a 39-year-old Korean woman

  18. Persistent diffuse pulmonary interstitial emphysema mimicking pulmonary emphysema

    OpenAIRE

    Demura, Y; Ishizaki, T; Nakanishi, M; Ameshima, S; Itoh, H

    2009-01-01

    A 69-year-old male non-smoker with a history of atopic asthma presented with symptoms suggestive of chronic obstructive pulmonary disease and this appeared to be corroborated by lung function testing and a chest radiograph. However, a chest CT showed no evidence of pulmonary emphysema and instead demonstrated free air along the bronchovascular sheaths indicative of pulmonary interstistial emphysema, possibly caused by repeated prior exacerbations of asthma. His lung function tests and symptom...

  19. Intimal sarcoma of the pulmonary artery presenting as pulmonary embolism

    OpenAIRE

    Plata, María Camila; Rey, Diana Lucía; Villaquirán, Claudio; Rosselli, Diego

    2017-01-01

    SUMMARY Pulmonary artery sarcomas are extremely rare; due to their insidious growth, diagnosis occurs late and prognosis is poor. We present the case of a 33-year-old woman with a history of dyspnea, chest pain and syncope. An obstructing mass on the right ventricle, main pulmonary artery and right branch were interpreted as a possible pulmonary embolism. RESUMEN Los sarcomas de la arteria pulmonar son extremadamente raros; debido a su crecimiento lento y silencioso, el diagnóstico suele s...

  20. Pulmonary endarterectomy outputs in chronic thromboembolic pulmonary hypertension.

    Science.gov (United States)

    López Gude, María Jesús; Pérez de la Sota, Enrique; Pérez Vela, Jose Luís; Centeno Rodríguez, Jorge; Muñoz Guijosa, Christian; Velázquez, María Teresa; Alonso Chaterina, Sergio; Hernández González, Ignacio; Escribano Subías, Pilar; Cortina Romero, José María

    2017-07-07

    Pulmonary thromboendarterectomy surgery is the treatment of choice for patients with chronic thromboembolic pulmonary hypertension; extremely high pulmonary vascular resistance constitutes a risk factor for hospital mortality. The objective of this study was to analyze the immediate and long-term results of the surgical treatment of chronic thromboembolic pulmonary hypertension in patients with very severe pulmonary hypertension. Since February 1996, we performed 160 pulmonary thromboendarterectomies. We divided the patient population in 2 groups: group 1, which included 40 patients with pulmonary vascular resistance≥1090dyn/sec/cm -5 , and group 2, which included the remaining 120 patients. Hospital mortality (15 vs. 2.5%), reperfusion pulmonary edema (33 vs. 14%) and heart failure (23 vs. 3.3%) were all higher in group 1; however, after one year of follow-up, there were no significant differences in the clinical, hemodynamic and echocardiographic conditions of both groups. Survival rate after 5 years was 77% in group 1 and 92% in group 2 (P=.033). After the learning curve including the 46 first patients, there was no difference in hospital mortality (3.8 vs. 2.3%) or survival rate after 5 years (96.2% in group 1 and 96.2% in group 2). Pulmonary thromboendarterectomy is linked to significantly higher morbidity and mortality rates in patients with severe chronic thromboembolic pulmonary hypertension. Nevertheless, these patients benefit the same from the procedure in the mid-/long-term. In our experience, after the learning curve, this surgery is safe in severe pulmonary hypertension and no level of pulmonary vascular resistance should be an absolute counter-indication for this surgery. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  1. Waste minimization handbook, Volume 1

    International Nuclear Information System (INIS)

    Boing, L.E.; Coffey, M.J.

    1995-12-01

    This technical guide presents various methods used by industry to minimize low-level radioactive waste (LLW) generated during decommissioning and decontamination (D and D) activities. Such activities generate significant amounts of LLW during their operations. Waste minimization refers to any measure, procedure, or technique that reduces the amount of waste generated during a specific operation or project. Preventive waste minimization techniques implemented when a project is initiated can significantly reduce waste. Techniques implemented during decontamination activities reduce the cost of decommissioning. The application of waste minimization techniques is not limited to D and D activities; it is also useful during any phase of a facility's life cycle. This compendium will be supplemented with a second volume of abstracts of hundreds of papers related to minimizing low-level nuclear waste. This second volume is expected to be released in late 1996

  2. Waste minimization handbook, Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    Boing, L.E.; Coffey, M.J.

    1995-12-01

    This technical guide presents various methods used by industry to minimize low-level radioactive waste (LLW) generated during decommissioning and decontamination (D and D) activities. Such activities generate significant amounts of LLW during their operations. Waste minimization refers to any measure, procedure, or technique that reduces the amount of waste generated during a specific operation or project. Preventive waste minimization techniques implemented when a project is initiated can significantly reduce waste. Techniques implemented during decontamination activities reduce the cost of decommissioning. The application of waste minimization techniques is not limited to D and D activities; it is also useful during any phase of a facility`s life cycle. This compendium will be supplemented with a second volume of abstracts of hundreds of papers related to minimizing low-level nuclear waste. This second volume is expected to be released in late 1996.

  3. Minimal Webs in Riemannian Manifolds

    DEFF Research Database (Denmark)

    Markvorsen, Steen

    2008-01-01

    For a given combinatorial graph $G$ a {\\it geometrization} $(G, g)$ of the graph is obtained by considering each edge of the graph as a $1-$dimensional manifold with an associated metric $g$. In this paper we are concerned with {\\it minimal isometric immersions} of geometrized graphs $(G, g......)$ into Riemannian manifolds $(N^{n}, h)$. Such immersions we call {\\em{minimal webs}}. They admit a natural 'geometric' extension of the intrinsic combinatorial discrete Laplacian. The geometric Laplacian on minimal webs enjoys standard properties such as the maximum principle and the divergence theorems, which...... are of instrumental importance for the applications. We apply these properties to show that minimal webs in ambient Riemannian spaces share several analytic and geometric properties with their smooth (minimal submanifold) counterparts in such spaces. In particular we use appropriate versions of the divergence...

  4. Detection of pulmonary emboli

    International Nuclear Information System (INIS)

    Sostman, H.D.; Gottschalk, A.

    1988-01-01

    The imaging evaluation of patients who may have pulmonary embolism (PE) is discussed. It is generally accomplished in two stages. In the first stage, clinical suspicion of PE leads to performance of an initial screening test. In current practice, this is the ventilation-perfusion (V/Q) scintigram, which is the safest and most sensitive noninvasive test. In the second stage, the results of the V/Q scan are considered in light of the clinical picture-degree of suspicion of PE, presence of alternate explanations for the clinical and scintigraphic findings, probability level and confidence of the scintigraphic diagnosis, and the likely consequences of therapy, misdiagnosis, or performance of a more invasive test. In some instances, this evaluation leads to performance of pulmonary angiography, an invasive test, for proof of the diagnosis. Although there are exceptions and special cases that do not follow this sequence, it is accurate for the majority of patients

  5. Acute pulmonary infections

    International Nuclear Information System (INIS)

    Juhl, J.H.

    1987-01-01

    Acute pulmonary infection may be caused by a variety of organisms. In some instances they produce a reasonably characteristic, gross pathologic pattern and, therefore, a recognizable roentgenographic pattern. In the subsequent discussions the most common gross anatomic findings in the pneumonias of various causes as reflected in chest roentgenograms will be described. The roentgenographic manifestations of pulmonary infections are so varied that the pattern observed often gives us little information regarding the causative organism. Therefore, in each instance it should be remembered that roentgenographic findings must be correlated with clinical, bacteriological, and laboratory data to ascertain the correct etiologic diagnosis upon which treatment is based. The role of the radiologist is to locate and define the extent of the disease and any complicating findings such as lung abscess and pleural effusion or empyema

  6. Pulmonary ablation: a primer.

    Science.gov (United States)

    Roberton, Benjamin J; Liu, David; Power, Mark; Wan, John M C; Stuart, Sam; Klass, Darren; Yee, John

    2014-05-01

    Percutaneous image-guided thermal ablation is safe and efficacious in achieving local control and improving outcome in the treatment of both early stage non-small-cell lung cancer and pulmonary metastatic disease, in which surgical treatment is precluded by comorbidity, poor cardiorespiratory reserve, or unfavorable disease distribution. Radiofrequency ablation is the most established technology, but new thermal ablation technologies such as microwave ablation and cryoablation may offer some advantages. The use of advanced techniques, such as induced pneumothorax and the popsicle stick technique, or combining thermal ablation with radiotherapy, widens the treatment options available to the multidisciplinary team. The intent of this article is to provide the reader with a practical knowledge base of pulmonary ablation by concentrating on indications, techniques, and follow-up. Copyright © 2014 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  7. [Acute neurogenic pulmonary edema].

    Science.gov (United States)

    Roquefeuil, B

    1975-01-01

    Neurogenic edema, in the strict sense of the term, has at the present time practically not benefitted from precise hemodynamic investigations in human clinical practice, and owing to this fact, authors still classify them under the heading "mixed edema or of unknown pathogenesis". In contrast with this lack of information in man, animal experimental works are surprising by their coherence and the experimental facility of producing neurogenic edema (cranial hypertension by a small inflatable balloon and cisternal infection of fibrin). If one excludes the now ancient vagal theories (CAMERON 1949; CAMPBELL, 1949) which were never confirmed, all of the most recent experimental works (SARNOFF, 1952; DUCKER, 1968; LUISADA, 1967; MORITZ, 1974) confirm the adrenergic disorder of central origin during neurogenic A.P.E. which from the hemodynamic standpoint is like an authentic hemodynamic A.P.E. with raised left atrial pressure, pulmonary venous pressure and pulmonary capillary pressure.

  8. Multi-walled carbon nanotube physicochemical properties predict pulmonary inflammation and genotoxicity

    DEFF Research Database (Denmark)

    Poulsen, Sarah S.; Jackson, Petra; Kling, Kirsten

    2016-01-01

    Lung deposition of multi-walled carbon nanotubes (MWCNT) induces pulmonary toxicity. Commercial MWCNT vary greatly in physicochemical properties and consequently in biological effects. To identify determinants of MWCNT-induced toxicity, we analyzed the effects of pulmonary exposure to 10 commerci...... diameter was associated with increased genotoxicity. This study provides information on possible toxicity-driving physicochemical properties of MWCNT. The results may contribute to safe-by-design manufacturing of MWCNT, thereby minimizing adverse effects....

  9. Thromboembolic chronicle pulmonary Hypertension

    International Nuclear Information System (INIS)

    Ovalle, Amador

    2003-01-01

    The thromboembolic chronicle pulmonary Hypertension, also well known as chronic lung thromboembolism not resolved; it is a form not very common of lung thromboembolism. Until very recently was considered a rare curiosity of autopsy, but as the methods of diagnoses have improved and our attitude has changed, the incidence of this nosological entity has experienced a notable increment, but the most excellent in this illness is maybe that it is a form of lung hypertension, potentially recoverable

  10. [Invasive nosocomial pulmonary aspergillosis].

    Science.gov (United States)

    Germaud, P; Haloun, A

    2001-04-01

    Immunodepressed patients, particularly those with neutropenia or bone marrow or organ grafts, are at risk of developing nosocomial invasive pulmonary aspergilosis. The favoring factors, early diagnostic criteria and curative treatment protocols are well known. Prognosis remains however quite severe with a death rate above 50%. Preventive measures are required for the treatment of these high-risk patients and epidemiology surveillance is needed in case of aspergillosis acquired in the hospital.

  11. Extravascular lung water: its measurement by simultaneous pulmonary and aortic sampling and iterative convolution

    International Nuclear Information System (INIS)

    Giuntini, C.; Fazio, F.

    1975-01-01

    The inadequacy of the apparent distribution volume of THO during the first passage dilution curve (a) to account for the total lung water in in-vitro measurements in dogs and (b) to measure any increase in lung water, even in patients with obvious clinical pulmonary oedema, prompted the present investigation. Tritiated water, THO, as diffusible indicator, and human serum albumin labelled with 131 I, ALB, as intravascular tracer, are injected into the superior vena cava at the junction with the right atrium. In order to clear the aortic blood samples of recirculation, the recirculating tracers must be determined. This is accomplished by pulmonary artery sampling. Iterative convolution of the pulmonary artery dilution curves with suitable test functions eventually yields products of convolution that fit well the corresponding aortic dilution curves of THO and ALB. The test functions that yield the best fit are taken to represent the frequency functions of the transit time from pulmonary artery to aorta of THO and ALB, respectively. By applying the same procedure of iterative convolution to these frequency functions, we obtain the dilution curve of THO in the extravascular lung space. As a result of this analysis: (a) forward extrapolation is less subject to systematic errors such as overestimation of the mean transit time of ALB, i.e. of the tracer that recirculates more; and (b) the distribution volume of THO can be better defined since the dilution of THO in the extravascular lung space may be followed beyond the point of recirculation. The results indicate that both in normal subjects and in patients with left ventricular insufficiency the computed dilution curves of THO in the extravascular lung space have a long tail which is more pronounced in the patients. These findings suggest the existence in the lungs of extravascular water pools that are slowly exchanging with pulmonary water flow. This may depend both on inhomogeneities of perfusion, with lack of it at

  12. Right pulmonary aplasia, aberrant left pulmonary artery, and bronchopulmonary sequestration with an esophageal bronchus

    International Nuclear Information System (INIS)

    Lee, Peter; McCauley, Roy; Westra, Sjirk; Baba, Timothy

    2006-01-01

    Pulmonary aplasia and bronchopulmonary foregut malformations in which a patent communication between the foregut and the pulmonary system is present are rare congenital abnormalities. Pulmonary aplasia associated with a pulmonary sling is an even rarer abnormality. We report a unique case of right pulmonary aplasia, aberrant left pulmonary artery, and bronchopulmonary sequestration with an esophageal bronchus diagnosed by multidetector helical CT. (orig.)

  13. Chronic obstructive pulmonary disease

    International Nuclear Information System (INIS)

    Karabulut, N.

    2012-01-01

    Full text: Chronic obstructive pulmonary diseases (COPD) denote progressive lung diseases characterized by airway obstruction. COPD exhibits specific morphologic changes in the lung parenchyma, central and peripheral airways and pulmonary vasculature. A person with COPD may have either emphysema or chronic bronchitis, but most have both. Some people with COPD may also have an asthma-like or reactive component. Imaging modalities play important role in the detection or exclusion of COPD, distribution and extent of disease processes. Combined inspiratory and expiratory high resolution CT allows phenotyping of COPD (emphysema predominant, airway predominant, or mixed) and quantification of severity. Magnetic resonance imaging enables functional evaluation and demonstrates ventilation defects correlating closely with pulmonary function tests. Imaging techniques are also helpful in guiding the treatment, such as bullectomy in patients with bullous emphysema, lung volume reduction surgery or endoscopic interventions in those with severe emphysema, and smoking cessation and medical treatment designed to stop lung destruction in patients with mild or moderate emphysema or bronchiectasis.

  14. Leptospirose pulmonar Pulmonary leptospirosis

    Directory of Open Access Journals (Sweden)

    João Cláudio Barroso Pereira

    2007-12-01

    Full Text Available No presente artigo, os autores discutem brevemente sobre a leptospirose, realçando a forma pulmonar da doença. Revê-se a patologia, achados clínicos, diagnóstico por métodos de imagem e broncoscopia e tratamento da leptospirose pulmonar. É também lembrado o diagnóstico clínico e radiológico precoces, para que se possa iniciar terapêutica adequada. Os autores concluem que a forma pulmonar da leptospirose deve ser sempre considerada como causa e diagnóstico diferencial da hemorragia alveolar difusa e síndroma de dificuldade respiratória do adulto.In this article, the authors discuss briefly the leptospirosis, emphasizing mainly the pulmonary form of disease. The authors review pathology, clinical findings, imaging and broncoscopy diagnosis, treatment of pulmonary leptospirosis. It is also remembered about early clinics and radiology diagnosis to start therapeutics. The authors conclude that pulmonary form of disease must always be remembered and considered as cause and differential diagnosis of Diffuse Alveolar Hemorrhage and Adult Respiratory Distress Syndrome.

  15. Pulmonary alveolar microlithiasis

    International Nuclear Information System (INIS)

    Vallejo, Franco Javier; Vallejo, Alejandro; Parra, Maximiliano

    2007-01-01

    Pulmonary alveolar microlithiasis (PAM) is a rare disease characterized by the diffuse and bilateral presence of calcium phosphate microlite in the alveolar spaces. The progression of this potentially lethal disease is show and most of the patients remain asymptomatic during years or decades, resulting in a show deterioration of the pulmonary function. The typical finding of the sand storm in the chest X-ray is characteristic of this entity. Mutations in the SLC34A2 gene that does the coding for the type II co-transporter of sodium phosphate were identified as responsible for this disease. Of the almost 600 cases, only 6 have been reported in Colombia. We are presenting a case of pulmonary alveolar microlite in a 27 year old man, with progressive respiratory distress whose diagnosis was made by the X-ray findings and confirmed by trans bronchial biopsy. In the 2 years follow-up, shows evolution towards deterioration of his respiratory function making him a candidate for lung transplantation.

  16. Cerebral peritumoral oedema study: Does a single dynamic MR sequence assessing perfusion and permeability can help to differentiate glioblastoma from metastasis?

    International Nuclear Information System (INIS)

    Lehmann, Pierre; Saliou, Guillaume; Marco, Giovanni de; Monet, Pauline; Souraya, Stoquart-Elsankari; Bruniau, Alexis; Vallée, Jean Noel; Ducreux, Denis

    2012-01-01

    Our purpose was to differentiate glioblastoma from metastasis using a single dynamic MR sequence to assess perfusion and permeability parameters. 24 patients with glioblastoma or cerebral metastasis with peritumoral oedema were recruited and explored with a 3 T MR unit. Post processing used DPTools software. Regions of interest were drawn around contrast enhancement to assess relative cerebral blood volume and permeability parameters. Around the contrast enhancement Glioblastoma present high rCBV with modification of the permeability, metastasis present slight modified rCBV without modification of permeability. In conclusion, peritumoral T2 hypersignal exploration associating morphological MR and functional MR parameters can help to differentiate cerebral metastasis from glioblastoma.

  17. Post Traumatic Cerebral Oedema in Severe Head Injury is Related to Intracranial Pressure and Cerebral Perfusion Pressure but not to Cerebral Compliance

    Directory of Open Access Journals (Sweden)

    U Nujaimin

    2009-07-01

    Full Text Available This was a prospective cohort study, carried out in the Neuro Intensive Care Unit, Department of Neurosciences, Hospital Universiti Sains Malaysia, Kubang Kerian Kelantan. The study was approved by the local ethics committee and was conducted between November 2005 and September 2007 with a total of 30 patients included in the study. In our study, univariate analysis showed a statistically significant relationship between mean intracranial pressure (ICP as well as cerebral perfusion pressure (CPP with both states of basal cistern and the degree of diffuse injury and oedema based on the Marshall classification system. The ICP was higher while CPP and compliance were lower whenever the basal cisterns were effaced in cases of cerebral oedema with Marshall III and IV. In comparison, the study revealed lower ICP, higher mean CPP and better mean cerebral compliance if the basal cisterns were opened or the post operative CT brain scan showed Marshall I and II. These findings suggested the surgical evacuation of clots to reduce the mass volume and restoration of brain anatomy may reduce vascular engorgement and cerebral oedema, therefore preventing intracranial hypertension, and improving cerebral perfusion pressure and cerebral compliance. Nevertheless the study did not find any significant relationship between midline shifts and mean ICP, CPP or cerebral compliance even though lower ICP, higher CPP and compliance were frequently observed when the midline shift was less than 0.5 cm. As the majority of our patients had multiple and diffuse brain injuries, the absence of midline shift did not necessarily mean lower ICP as the pathology was bilateral and even when after excluding the multiple lesions, the result remained insignificant. We assumed that the CT brain scan obtained after evacuation of the mass lesion to assess the state basal cistern and classify the diffuse oedema may prognosticate the intracranial pressure and cerebral perfusion pressure

  18. Digital angiography in pulmonary embolism

    International Nuclear Information System (INIS)

    Bjoerk, L.

    1986-01-01

    Pulmonary digital subtraction angiography was diagnostic in 98.3% of patients with possible acute pulmonary embolism. The procedure was well tolerated even in severely ill patients. A large image intensifier made simultaneous imaging of both lungs possible reducing the number of contrast injections necessary. Small volumes of low iso-osmolar concentration of modern contrast media were used. There was no need for catherization of the pulmonary artery. Theoretical considerations and our limited experience indicate that this will reduce the number of complications compared with conventional pulmonary angiography. The procedure is rapidly performed and the diagnostic accuracy high. This makes digital subtraction angiography cost effective. Digital pulmonary angiography can be recommended as the primary diagnostic method in most patients with possible pulmonary embolism. (orig.)

  19. Minimal Poems Written in 1979 Minimal Poems Written in 1979

    Directory of Open Access Journals (Sweden)

    Sandra Sirangelo Maggio

    2008-04-01

    Full Text Available The reading of M. van der Slice's Minimal Poems Written in 1979 (the work, actually, has no title reminded me of a book I have seen a long time ago. called Truth, which had not even a single word printed inside. In either case we have a sample of how often excentricities can prove efficient means of artistic creativity, in this new literary trend known as Minimalism. The reading of M. van der Slice's Minimal Poems Written in 1979 (the work, actually, has no title reminded me of a book I have seen a long time ago. called Truth, which had not even a single word printed inside. In either case we have a sample of how often excentricities can prove efficient means of artistic creativity, in this new literary trend known as Minimalism.

  20. Pulmonary edema: radiographic differential diagnosis

    International Nuclear Information System (INIS)

    Yoo, Dong Soo; Choi, Young Hi; Kim, Seung Cheol; An, Ji Hyun; Lee, Jee Young; Park, Hee Hong

    1997-01-01

    To evaluate the feasibility of using chest radiography to differentiate between three different etiologies of pulmonary edema. Plain chest radiographs of 77 patients, who were clinically confirmed as having pulmonary edema, were retrospectively reviewed. The patients were classified into three groups : group 1 (cardiogenic edema : n = 35), group 2 (renal pulmonary edema : n = 16) and group 3 (permeability edema : n = 26). We analyzed the radiologic findings of air bronchogram, heart size, peribronchial cuffing, septal line, pleural effusion, vascular pedicle width, pulmonary blood flow distribution and distribution of pulmonary edema. In a search for radiologic findings which would help in the differentiation of these three etiologies, each finding was assessed. Cardiogenic and renal pulmonary edema showed overlapping radiologic findings, except for pulmonary blood flow distribution. In cardiogenic pulmonary edema (n=35), cardiomegaly (n=29), peribronchial cuffing (n=29), inverted pulmonary blood flow distribution (n=21) and basal distribution of edema (n=20) were common. In renal pulmonary edema (n=16), cardiomegaly (n=15), balanced blood flow distribution (n=12), and central (n=9) or basal distribution of edema (n=7) were common. Permeability edema (n=26) showed different findings. Air bronchogram (n=25), normal blood flow distribution (n=14) and peripheral distribution of edema (n=21) were frequent findings, while cardiomegaly (n=7), peribronchial cuffing (n=7) and septal line (n=5) were observed in only a few cases. On plain chest radiograph, permeability edema can be differentiated from cardiogenic or renal pulmonary edema. The radiographic findings which most reliably differentiated these two etiologies were air bronchogram, distribution of pulmonary edema, peribronchial cuffing and heart size. Only blood flow distribution was useful for radiographic differentiation of cardiogenic and renal edema

  1. Changing patterns in pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Tytle, T.L.; Johnson, T.H.

    1984-01-01

    The authors reviewed the initial chest roentgenograms of 182 consecutive adult patients with proven active tuberculosis. Less than 50% of all cases were known or suspected at the time of initial presentation. There is a low degree of correlation between radiologically discernible active pulmonary tuberculosis and extrapulmonary tuberculosis. A high percentage of cases represent uncommon pulmonary locations. The frequency of occurrence of four common pulmonary patterns is presented. 21 references, 4 figures, 5 tables

  2. Pulmonary infection in AIDS

    International Nuclear Information System (INIS)

    Kim, Seog Joon; Im, Jung Gi; Seong, Chang Kyu; Yeon, Kyung Mo; Han, Man Chung; Song, Jae Woo

    1998-01-01

    To analyze the clinical and radiological manifestations of pulmonary infection in patients with AIDS. We reviewed the medical records and analyzed retrospectively analysed the chest radiographs(n=3D24) and CT scans(n=3D11) of 26 patients with AIDS who had been followed up at our institute from 1987 to June 1998. Pulmonary infections were confirmed by sputum smear and culture(n=3D18), pleural examination(n=3D3), bronchoalveolar lavage(n=3D3), autopsy(n=3D4), transbronchial lung biopsy(n=3D1) or clinical history(n=3D9). The study group included 23 men and three women aged 25-54(average 35.2) years. We correlated the radiologic findings with CD4 lymphocyte counts. Pulmonary infections included tuberculosis(n=3D22), pneumocystis carinii pneumonia(n=3D9), cytomegalovirus(n=3D3), and unidentified bacterial pneumonia(n=3D2). Radiologically pulmonary tuberculosis was classified as primary tuberculosis(n=3D11;mean CD4 counts:41.3 cells/mm 3 ) and post-primary tuberculosis(n=3D11;mean CD4 counts:251.3cells/mm 3 ). CT findings of tuberculosis included lymphadenitis(n=3D6), bronchogenic spread(n=3D5), large consolidation(n=3D4), esophago-mediastinal fistula(n=3D2), and cavity(n=3D1). Tuberculosis in AIDS responded rapidly to anti-TB medication with complete or marked resolution of lesions within three months. Radiologic findings of Pneumocystis carinii pneumonia included diffuse ground glass opacities, cysts, and reticular opacities. Tuberculosis was the most common infection in patients with AIDS in Korea, and this is attributed to the high prevalence of tuberculosis. Radiological findings varied with CD4+cell count, showing those of primary tuberculosis as a patient's CD4+ cell count decreased. Pulmonary tuberculosis in AIDS responded rapidly to anti-Tb medication. =20

  3. Role of combined perfusion/ventilation scanning in diagnosis of pulmonary embolism

    International Nuclear Information System (INIS)

    Moustafa, H.; Elhaddad, SH.; Wageeh, SH.; Samy, A.; Abdo, S.

    1995-01-01

    This study was conducted on 200 patients with suspected pulmonary embolism. Their age ranged 9-74 years with a mean age of 41.9+14.6 years.The commonest symptoms were dyspnea; chest pain and haemoptysis in 67.5%,49.5% and 14.5% respectively, whereas the main signs were tachycardia in 64.5% followed by rales and oedema of lower limbs in 28.5% and 14% respectively. Cardiac diseases were presenting the main risk factors in 47% followed by DVT, surgery, COLD in 24%,10% and 9.5% respectively. perfusion lung scan was normal in 27.5%, whereas low, intermediate and high probability scans were seen in 7%,23.5% and 42% respectively. The addition of ventilation scan, change probability of perfusion defects into 18.5%,19% and 31.5% in low, intermediate and high probability scans respectively. In addition 3.5% of patient diagnosed as non- embolic disease. There was significant correlation with increase number of symptoms and signs in relation to scan probability in both whole group and high probability group. Also, the incidence of pulmonary embolism appear to be additive with increase number of risk factors in the group of high probability scans. 3 figs., 3 tabs

  4. Role of combined perfusion/ventilation scanning in diagnosis of pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Moustafa, H; Elhaddad, SH; Wageeh, SH; Samy, A; Abdo, S [Nuclear medicine and radiology department, faculty of medicine and Cairo university, Cairo, (Egypt)

    1995-10-01

    This study was conducted on 200 patients with suspected pulmonary embolism. Their age ranged 9-74 years with a mean age of 41.9+14.6 years.The commonest symptoms were dyspnea; chest pain and haemoptysis in 67.5%,49.5% and 14.5% respectively, whereas the main signs were tachycardia in 64.5% followed by rales and oedema of lower limbs in 28.5% and 14% respectively. Cardiac diseases were presenting the main risk factors in 47% followed by DVT, surgery, COLD in 24%,10% and 9.5% respectively. perfusion lung scan was normal in 27.5%, whereas low, intermediate and high probability scans were seen in 7%,23.5% and 42% respectively. The addition of ventilation scan, change probability of perfusion defects into 18.5%,19% and 31.5% in low, intermediate and high probability scans respectively. In addition 3.5% of patient diagnosed as non- embolic disease. There was significant correlation with increase number of symptoms and signs in relation to scan probability in both whole group and high probability group. Also, the incidence of pulmonary embolism appear to be additive with increase number of risk factors in the group of high probability scans. 3 figs., 3 tabs.

  5. Eosinofilia pulmonar Pulmonary eosinophilia

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Mendes Campos

    2009-06-01

    Full Text Available As formas de eosinofilia pulmonar constituem um grupo heterogêneo definido pela presença de um ou dois critérios: infiltrado pulmonar com eosinofilia sanguínea e/ou eosinofilia tissular caracterizada por eosinófilos demonstrados na biópsia pulmonar ou no lavado broncoalveolar. Embora o infiltrado inflamatório seja composto de macrófagos, linfócitos, neutrófilos e eosinófilos, a presença de eosinofilia é um marcador importante para o diagnóstico e tratamento. A apresentação clínica e radiológica pode revelar eosinofilia pulmonar simples, pneumonia eosinofílica crônica, pneumonia eosinofílica aguda, aspergilose broncopulmonar alérgica e eosinofilia pulmonar associada à doença sistêmica, como na síndrome de Churg-Strauss e na síndrome hipereosinofílica. A asma está frequentemente associada, podendo ser um pré-requisito, como na aspergilose broncopulmonar alérgica e na síndrome de Churg-Strauss. Nas doenças com acometimento sistêmico, a pele, o coração e o sistema nervoso são os órgãos mais comprometidos. A apresentação radiológica pode ser considerada como típica, ou pelo menos sugestiva, para três formas de eosinofilia pulmonar: pneumonia eosinofílica crônica, aspergilose broncopulmonar alérgica e pneumonia eosinofílica aguda. A etiologia da eosinofilia pulmonar pode ser de causa primária (idiopática ou secundária, compreendendo causas conhecidas, como drogas, parasitas, infecções por fungos e micobactérias, irradiação e toxinas. A eosinofilia pulmonar pode também estar associada a doenças pulmonares difusas, doenças do tecido conectivo e neoplasias.Pulmonary eosinophilia comprises a heterogeneous group of diseases defined by eosinophilia in pulmonary infiltrates (bronchoalveolar lavage fluid or in tissue (lung biopsy specimens. Although the inflammatory infiltrate is composed of macrophages, lymphocytes, neutrophils and eosinophils, eosinophilia is an important marker for the diagnosis

  6. Multimodality imaging of pulmonary infarction

    International Nuclear Information System (INIS)

    Bray, T.J.P.; Mortensen, K.H.; Gopalan, D.

    2014-01-01

    Highlights: • A plethora of pulmonary and systemic disorders, often associated with grave outcomes, may cause pulmonary infarction. • A stereotypical infarct is a peripheral wedge shaped pleurally based opacity but imaging findings can be highly variable. • Multimodality imaging is key to diagnosing the presence, aetiology and complications of pulmonary infarction. • Multimodality imaging of pulmonary infarction together with any ancillary features often guide to early targeted treatment. • CT remains the principal imaging modality with MRI increasingly used alongside nuclear medicine studies and ultrasound. - Abstract: The impact of absent pulmonary arterial and venous flow on the pulmonary parenchyma depends on a host of factors. These include location of the occlusive insult, the speed at which the occlusion develops and the ability of the normal dual arterial supply to compensate through increased bronchial arterial flow. Pulmonary infarction occurs when oxygenation is cut off secondary to sudden occlusion with lack of recruitment of the dual supply arterial system. Thromboembolic disease is the commonest cause of such an insult but a whole range of disease processes intrinsic and extrinsic to the pulmonary arterial and venous lumen may also result in infarcts. Recognition of the presence of infarction can be challenging as imaging manifestations often differ from the classically described wedge shaped defect and a number of weighty causes need consideration. This review highlights aetiologies and imaging appearances of pulmonary infarction, utilising cases to illustrate the essential role of a multimodality imaging approach in order to arrive at the appropriate diagnosis

  7. Multimodality imaging of pulmonary infarction

    Energy Technology Data Exchange (ETDEWEB)

    Bray, T.J.P., E-mail: timothyjpbray@gmail.com [Department of Radiology, Papworth Hospital NHS Foundation Trust, Ermine Street, Papworth Everard, Cambridge CB23 3RE (United Kingdom); Mortensen, K.H., E-mail: mortensen@doctors.org.uk [Department of Radiology, Papworth Hospital NHS Foundation Trust, Ermine Street, Papworth Everard, Cambridge CB23 3RE (United Kingdom); University Department of Radiology, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Box 318, Cambridge CB2 0QQ (United Kingdom); Gopalan, D., E-mail: deepa.gopalan@btopenworld.com [Department of Radiology, Papworth Hospital NHS Foundation Trust, Ermine Street, Papworth Everard, Cambridge CB23 3RE (United Kingdom)

    2014-12-15

    Highlights: • A plethora of pulmonary and systemic disorders, often associated with grave outcomes, may cause pulmonary infarction. • A stereotypical infarct is a peripheral wedge shaped pleurally based opacity but imaging findings can be highly variable. • Multimodality imaging is key to diagnosing the presence, aetiology and complications of pulmonary infarction. • Multimodality imaging of pulmonary infarction together with any ancillary features often guide to early targeted treatment. • CT remains the principal imaging modality with MRI increasingly used alongside nuclear medicine studies and ultrasound. - Abstract: The impact of absent pulmonary arterial and venous flow on the pulmonary parenchyma depends on a host of factors. These include location of the occlusive insult, the speed at which the occlusion develops and the ability of the normal dual arterial supply to compensate through increased bronchial arterial flow. Pulmonary infarction occurs when oxygenation is cut off secondary to sudden occlusion with lack of recruitment of the dual supply arterial system. Thromboembolic disease is the commonest cause of such an insult but a whole range of disease processes intrinsic and extrinsic to the pulmonary arterial and venous lumen may also result in infarcts. Recognition of the presence of infarction can be challenging as imaging manifestations often differ from the classically described wedge shaped defect and a number of weighty causes need consideration. This review highlights aetiologies and imaging appearances of pulmonary infarction, utilising cases to illustrate the essential role of a multimodality imaging approach in order to arrive at the appropriate diagnosis.

  8. Pulmonary hypertension in older adults.

    Science.gov (United States)

    McArdle, John R; Trow, Terence K; Lerz, Kathryn

    2007-12-01

    Pulmonary hypertension is a frequently encountered problem in older patients. True idiopathic pulmonary arterial hypertension can also be seen and requires careful exclusion in older patients. Institution of therapies must be tempered with an appreciation of individual comorbidities and functional limitations that may affect patients' ability to comply and benefit from the complex treatments available for pulmonary arterial hypertension. This article reviews the existing data on the various forms of pulmonary hypertension presenting in older patients and on appropriate therapy in this challenging population.

  9. Minimal Flavour Violation and Beyond

    CERN Document Server

    Isidori, Gino

    2012-01-01

    We review the formulation of the Minimal Flavour Violation (MFV) hypothesis in the quark sector, as well as some "variations on a theme" based on smaller flavour symmetry groups and/or less minimal breaking terms. We also review how these hypotheses can be tested in B decays and by means of other flavour-physics observables. The phenomenological consequences of MFV are discussed both in general terms, employing a general effective theory approach, and in the specific context of the Minimal Supersymmetric extension of the SM.

  10. Minimizing waste in environmental restoration

    International Nuclear Information System (INIS)

    Thuot, J.R.; Moos, L.

    1996-01-01

    Environmental restoration, decontamination and decommissioning, and facility dismantlement projects are not typically known for their waste minimization and pollution prevention efforts. Typical projects are driven by schedules and milestones with little attention given to cost or waste minimization. Conventional wisdom in these projects is that the waste already exists and cannot be reduced or minimized; however, there are significant areas where waste and cost can be reduced by careful planning and execution. Waste reduction can occur in three ways: beneficial reuse or recycling, segregation of waste types, and reducing generation of secondary waste

  11. Minimizing waste in environmental restoration

    International Nuclear Information System (INIS)

    Moos, L.; Thuot, J.R.

    1996-01-01

    Environmental restoration, decontamination and decommissioning and facility dismantelment projects are not typically known for their waste minimization and pollution prevention efforts. Typical projects are driven by schedules and milestones with little attention given to cost or waste minimization. Conventional wisdom in these projects is that the waste already exists and cannot be reduced or minimized. In fact, however, there are three significant areas where waste and cost can be reduced. Waste reduction can occur in three ways: beneficial reuse or recycling; segregation of waste types; and reducing generation of secondary waste. This paper will discuss several examples of reuse, recycle, segregation, and secondary waste reduction at ANL restoration programs

  12. Pulmonary complications in 110 consecutive renal transplant ...

    African Journals Online (AJOL)

    pulmonary embolism in 5, and lung abscess in 1. Sixty- nine patients ... The incidence of pulmonary complications after renal ... the factors that influence the development of these .... mobilisation have reduced the risk of pulmonary embolism.

  13. Genetics Home Reference: pulmonary arterial hypertension

    Science.gov (United States)

    ... Home Health Conditions Pulmonary arterial hypertension Pulmonary arterial hypertension Printable PDF Open All Close All Enable Javascript ... view the expand/collapse boxes. Description Pulmonary arterial hypertension is a progressive disorder characterized by abnormally high ...

  14. Deleterious genetic variants in ciliopathy genes increase risk of ritodrine-induced cardiac and pulmonary side effects.

    Science.gov (United States)

    Seo, Heewon; Kwon, Eun Jin; You, Young-Ah; Park, Yoomi; Min, Byung Joo; Yoo, Kyunghun; Hwang, Han-Sung; Kim, Ju Han; Kim, Young Ju

    2018-01-24

    Ritodrine is a commonly used tocolytic to prevent preterm labour. However, it can cause unexpected serious adverse reactions, such as pulmonary oedema, pulmonary congestion, and tachycardia. It is unknown whether such adverse reactions are associated with pharmacogenomic variants in patients. Whole-exome sequencing of 13 subjects with serious ritodrine-induced cardiac and pulmonary side-effects was performed to identify causal genes and variants. The deleterious impact of nonsynonymous substitutions for all genes was computed and compared between cases (n = 13) and controls (n = 30). The significant genes were annotated with Gene Ontology (GO), and the associated disease terms were categorised into four functional classes for functional enrichment tests. To assess the impact of distributed rare variants in cases with side effects, we carried out rare variant association tests with a minor allele frequency ≤ 1% using the burden test, the sequence Kernel association test (SKAT), and optimised SKAT. We identified 28 genes that showed significantly lower gene-wise deleteriousness scores in cases than in controls. Three of the identified genes-CYP1A1, CYP8B1, and SERPINA7-are pharmacokinetic genes. The significantly identified genes were categorized into four functional classes: ion binding, ATP binding, Ca 2+ -related, and ciliopathies-related. These four classes were significantly enriched with ciliary genes according to SYSCILIA Gold Standard genes (P side effects may be associated with deleterious genetic variants in ciliary and pharmacokinetic genes.

  15. Pulmonary infiltrates in non-HIV immunocompromised patients: a diagnostic approach using non-invasive and bronchoscopic procedures

    Science.gov (United States)

    Rano, A; Agusti, C; Jimenez, P; Angrill, J; Benito, N; Danes, C; Gonzalez, J; Rovira, M; Pumarola, T; Moreno, A; Torres, A

    2001-01-01

    BACKGROUND—The development of pulmonary infiltrates is a frequent life threatening complication in immunocompromised patients, requiring early diagnosis and specific treatment. In the present study non-invasive and bronchoscopic diagnostic techniques were applied in patients with different non-HIV immunocompromised conditions to determine the aetiology of the pulmonary infiltrates and to evaluate the impact of these methods on therapeutic decisions and outcome in this population.
METHODS—The non-invasive diagnostic methods included serological tests, blood antigen detection, and blood, nasopharyngeal wash (NPW), sputum and tracheobronchial aspirate (TBAS) cultures. Bronchoscopic techniques included fibrobronchial aspirate (FBAS), protected specimen brush (PSB), and bronchoalveolar lavage (BAL). Two hundred consecutive episodes of pulmonary infiltrates were prospectively evaluated during a 30 month period in 52 solid organ transplant recipients, 53 haematopoietic stem cell transplant (HSCT) recipients, 68 patients with haematological malignancies, and 27 patients requiring chronic treatment with corticosteroids and/or immunosuppressive drugs.
RESULTS—An aetiological diagnosis was obtained in 162 (81%) of the 200 patients. The aetiology of the pulmonary infiltrates was infectious in 125 (77%) and non-infectious in 37 (23%); 38 (19%) remained undiagnosed. The main infectious aetiologies were bacterial (48/125, 24%), fungal (33/125, 17%), and viral (20/125, 10%), and the most frequent pathogens were Aspergillus fumigatus (n=29), Staphylococcus aureus (n=17), and Pseudomonas aeruginosa (n=12). Among the non-infectious aetiologies, pulmonary oedema (16/37, 43%) and diffuse alveolar haemorrhage (10/37, 27%) were the most common causes. Non-invasive techniques led to the diagnosis of pulmonary infiltrates in 41% of the cases in which they were used; specifically, the diagnostic yield of blood cultures was 30/191 (16%); sputum cultures 27/88 (31%); NPW 9/50 (18

  16. Sludge minimization technologies - an overview

    Energy Technology Data Exchange (ETDEWEB)

    Oedegaard, Hallvard

    2003-07-01

    The management of wastewater sludge from wastewater treatment plants represents one of the major challenges in wastewater treatment today. The cost of the sludge treatment amounts to more that the cost of the liquid in many cases. Therefore the focus on and interest in sludge minimization is steadily increasing. In the paper an overview is given for sludge minimization (sludge mass reduction) options. It is demonstrated that sludge minimization may be a result of reduced production of sludge and/or disintegration processes that may take place both in the wastewater treatment stage and in the sludge stage. Various sludge disintegration technologies for sludge minimization are discussed, including mechanical methods (focusing on stirred ball-mill, high-pressure homogenizer, ultrasonic disintegrator), chemical methods (focusing on the use of ozone), physical methods (focusing on thermal and thermal/chemical hydrolysis) and biological methods (focusing on enzymatic processes). (author)

  17. Wilson loops in minimal surfaces

    International Nuclear Information System (INIS)

    Drukker, Nadav; Gross, David J.; Ooguri, Hirosi

    1999-01-01

    The AdS/CFT correspondence suggests that the Wilson loop of the large N gauge theory with N = 4 supersymmetry in 4 dimensions is described by a minimal surface in AdS 5 x S 5 . The authors examine various aspects of this proposal, comparing gauge theory expectations with computations of minimal surfaces. There is a distinguished class of loops, which the authors call BPS loops, whose expectation values are free from ultra-violet divergence. They formulate the loop equation for such loops. To the extent that they have checked, the minimal surface in AdS 5 x S 5 gives a solution of the equation. The authors also discuss the zig-zag symmetry of the loop operator. In the N = 4 gauge theory, they expect the zig-zag symmetry to hold when the loop does not couple the scalar fields in the supermultiplet. They will show how this is realized for the minimal surface

  18. Classical strings and minimal surfaces

    International Nuclear Information System (INIS)

    Urbantke, H.

    1986-01-01

    Real Lorentzian forms of some complex or complexified Euclidean minimal surfaces are obtained as an application of H.A. Schwarz' solution to the initial value problem or a search for surfaces admitting a group of Poincare transformations. (Author)

  19. Minimal Gromov-Witten rings

    International Nuclear Information System (INIS)

    Przyjalkowski, V V

    2008-01-01

    We construct an abstract theory of Gromov-Witten invariants of genus 0 for quantum minimal Fano varieties (a minimal class of varieties which is natural from the quantum cohomological viewpoint). Namely, we consider the minimal Gromov-Witten ring: a commutative algebra whose generators and relations are of the form used in the Gromov-Witten theory of Fano varieties (of unspecified dimension). The Gromov-Witten theory of any quantum minimal variety is a homomorphism from this ring to C. We prove an abstract reconstruction theorem which says that this ring is isomorphic to the free commutative ring generated by 'prime two-pointed invariants'. We also find solutions of the differential equation of type DN for a Fano variety of dimension N in terms of the generating series of one-pointed Gromov-Witten invariants

  20. Wilson loops and minimal surfaces

    International Nuclear Information System (INIS)

    Drukker, Nadav; Gross, David J.; Ooguri, Hirosi

    1999-01-01

    The AdS-CFT correspondence suggests that the Wilson loop of the large N gauge theory with N=4 supersymmetry in four dimensions is described by a minimal surface in AdS 5 xS 5 . We examine various aspects of this proposal, comparing gauge theory expectations with computations of minimal surfaces. There is a distinguished class of loops, which we call BPS loops, whose expectation values are free from ultraviolet divergence. We formulate the loop equation for such loops. To the extent that we have checked, the minimal surface in AdS 5 xS 5 gives a solution of the equation. We also discuss the zigzag symmetry of the loop operator. In the N=4 gauge theory, we expect the zigzag symmetry to hold when the loop does not couple the scalar fields in the supermultiplet. We will show how this is realized for the minimal surface. (c) 1999 The American Physical Society

  1. Clinical manifestations of pulmonary and extra-pulmonary tuberculosis

    African Journals Online (AJOL)

    85% of reported tuberculosis cases were pulmonary ... Both pulmonary and nonpulmonary 32% ... 10% of patients with apparently localized tuberculosis ... mycetoma) in a cavity or erosion into an airway ... Dyspnoea is unusual unless there is extensive disease and ... via the airways into other parts of the lungs, causing a.

  2. Minimal string theory is logarithmic

    International Nuclear Information System (INIS)

    Ishimoto, Yukitaka; Yamaguchi, Shun-ichi

    2005-01-01

    We study the simplest examples of minimal string theory whose worldsheet description is the unitary (p,q) minimal model coupled to two-dimensional gravity ( Liouville field theory). In the Liouville sector, we show that four-point correlation functions of 'tachyons' exhibit logarithmic singularities, and that the theory turns out to be logarithmic. The relation with Zamolodchikov's logarithmic degenerate fields is also discussed. Our result holds for generic values of (p,q)

  3. Annual Waste Minimization Summary Report

    International Nuclear Information System (INIS)

    Haworth, D.M.

    2011-01-01

    This report summarizes the waste minimization efforts undertaken by National Security TechnoIogies, LLC, for the U. S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO), during calendar year 2010. The NNSA/NSO Pollution Prevention Program establishes a process to reduce the volume and toxicity of waste generated by NNSA/NSO activities and ensures that proposed methods of treatment, storage, and/or disposal of waste minimize potential threats to human health and the environment.

  4. Novel Semiquantitative Bone Marrow Oedema Score and Fracture Score for the Magnetic Resonance Imaging Assessment of the Active Charcot Foot in Diabetes

    Science.gov (United States)

    Meacock, L.; Donaldson, Ana; Isaac, A.; Briody, A.; Ramnarine, R.; Edmonds, M. E.; Elias, D. A.

    2017-01-01

    There are no accepted methods to grade bone marrow oedema (BMO) and fracture on magnetic resonance imaging (MRI) scans in Charcot osteoarthropathy. The aim was to devise semiquantitative BMO and fracture scores on foot and ankle MRI scans in diabetic patients with active osteoarthropathy and to assess the agreement in using these scores. Three radiologists assessed 45 scans (Siemens Avanto 1.5T, dedicated foot and ankle coil) and scored independently twenty-two bones (proximal phalanges, medial and lateral sesamoids, metatarsals, tarsals, distal tibial plafond, and medial and lateral malleoli) for BMO (0—no oedema, 1—oedema  50% of bone volume) and fracture (0—no fracture, 1—fracture, and 2—collapse/fragmentation). Interobserver agreement and intraobserver agreement were measured using multilevel modelling and intraclass correlation (ICC). The interobserver agreement for the total BMO and fracture scores was very good (ICC = 0.83, 95% confidence intervals (CI) 0.76, 0.91) and good (ICC = 0.62; 95% CI 0.48, 0.76), respectively. The intraobserver agreement for the total BMO and fracture scores was good (ICC = 0.78, 95% CI 0.6, 0.95) and fair to moderate (ICC = 0.44; 95% CI 0.14, 0.74), respectively. The proposed BMO and fracture scores are reliable and can be used to grade the extent of bone damage in the active Charcot foot. PMID:29230422

  5. Pulmonary function in microgravity

    Science.gov (United States)

    Guy, H. J.; Prisk, G. K.; West, J. B.

    1992-01-01

    We report the successful collection of a large quantity of human resting pulmonary function data on the SLS-1 mission. Preliminary analysis suggests that cardiac stroke volumes are high on orbit, and that an adaptive reduction takes at least several days, and in fact may still be in progress after 9 days on orbit. It also suggests that pulmonary capillary blood volumes are high, and remain high on orbit, but that the pulmonary interstitium is not significantly impacted. The data further suggest that the known large gravitational gradients of lung function have only a modest influence on single breath tests such as the SBN washout. They account for only approximately 25% of the phase III slope of nitrogen, on vital capacity SBN washouts. These gradients are only a moderate source of the cardiogenic oscillations seen in argon (bolus gas) and nitrogen (resident gas), on such tests. They may have a greater role in generating the normal CO2 oscillations, as here the phase relationship to argon and nitrogen reverses in microgravity, at least at mid exhalation in those subjects studied to date. Microgravity may become a useful tool in establishing the nature of the non-gravitational mechanisms that can now be seen to play such a large part in the generation of intra-breath gradients and oscillations of expired gas concentration. Analysis of microgravity multibreath nitrogen washouts, single breath washouts from more physiological pre-inspiratory volumes, both using our existing SLS-1 data, and data from the upcoming D-2 and SLS-2 missions, should be very fruitful in this regard.(ABSTRACT TRUNCATED AT 250 WORDS).

  6. Chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    V K Vijayan

    2013-01-01

    Full Text Available The global prevalence of physiologically defined chronic obstructive pulmonary disease (COPD in adults aged >40 yr is approximately 9-10 per cent. Recently, the Indian Study on Epidemiology of Asthma, Respiratory Symptoms and Chronic Bronchitis in Adults had shown that the overall prevalence of chronic bronchitis in adults >35 yr is 3.49 per cent. The development of COPD is multifactorial and the risk factors of COPD include genetic and environmental factors. Pathological changes in COPD are observed in central airways, small airways and alveolar space. The proposed pathogenesis of COPD includes proteinase-antiproteinase hypothesis, immunological mechanisms, oxidant-antioxidant balance, systemic inflammation, apoptosis and ineffective repair. Airflow limitation in COPD is defined as a postbronchodilator FEV1 (forced expiratory volume in 1 sec to FVC (forced vital capacity ratio <0.70. COPD is characterized by an accelerated decline in FEV1. Co morbidities associated with COPD are cardiovascular disorders (coronary artery disease and chronic heart failure, hypertension, metabolic diseases (diabetes mellitus, metabolic syndrome and obesity, bone disease (osteoporosis and osteopenia, stroke, lung cancer, cachexia, skeletal muscle weakness, anaemia, depression and cognitive decline. The assessment of COPD is required to determine the severity of the disease, its impact on the health status and the risk of future events (e.g., exacerbations, hospital admissions or death and this is essential to guide therapy. COPD is treated with inhaled bronchodilators, inhaled corticosteroids, oral theophylline and oral phosphodiesterase-4 inhibitor. Non pharmacological treatment of COPD includes smoking cessation, pulmonary rehabilitation and nutritional support. Lung volume reduction surgery and lung transplantation are advised in selected severe patients. Global strategy for the diagnosis, management and prevention of Chronic Obstructive Pulmonary Disease

  7. Imaging of pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Van Dyck, P.; De Schepper, A.M.; Vanhoenacker, F.M.; Van den Brande, P.

    2003-01-01

    Tuberculosis, more than any other infectious disease, has always been a challenge, since it has been responsible for a great amount of morbidity and mortality in humans. After a steady decline in the number of new cases during the twentieth century, due to improved social and environmental conditions, early diagnosis, and the development of antituberculous medication, a stagnation and even an increase in the number of new cases was noted in the mid-1980s. The epidemiological alteration is multifactorial: global increase in developing countries; minority groups (HIV and other immunocompromised patients); and elderly patients due to an altered immune status. Other factors that may be responsible are a delayed diagnosis, especially in elderly patients, incomplete or inadequate therapy, and the emergence of multidrug-resistant tuberculosis. The course of the disease and its corresponding clinicoradiological pattern depends on the interaction between the organism and the host response. Classically, pulmonary tuberculosis has been classified in primary tuberculosis, which occurred previously in children, and postprimary tuberculosis, occurring in adult patients. In industrialized countries, however, there seems to be a shift of primary tuberculosis towards adults. Furthermore, due to an altered immunological response in certain groups, such as immunocompromised and elderly patients, an atypical radioclinical pattern may occur. The changing landscape, in which tuberculosis occurs, as well as the global resurgence, and the changed spectrum of the clinical and radiological presentation, justify a renewed interest of radiologists for the imaging features of pulmonary tuberculosis. This article deals with the usual imaging features of pulmonary tuberculosis as well as the atypical patterns encountered in immunodepressed and elderly patients. (orig.)

  8. Detection of pulmonary nodules

    International Nuclear Information System (INIS)

    Vanzulli, A.; Zanello, A.; DelMaschio, M.; Paesano, P.; Panizza, P.; DelMaschio, A.

    1989-01-01

    The authors have prospectively studied 203 pulmonary nodules in 91 patients, selected by CT (gold standard), with both subtraction digital radiography (SDR) and conventional plain film. Subtracted images were obtained by using copper filter inserted between two photostimulable imaging plates. Five radiologists randomly analyzed all conventional and subtracted images. The authors calculated sensitivity, specificity, and positive and negative predictive values for both conventional radiography and SDR. Receiver operating characteristics (ROC) curves were calculated by plotting the number of nodules detected with different degrees of confidence. SDR detected 12% more nodules than conventional radiography. ROC curves demonstrated that the level of confidence was better for SDR (P <.05)

  9. Thrombolytic therapy in pulmonary embolism.

    LENUS (Irish Health Repository)

    Nagi, D

    2010-01-01

    Massive pulmonary embolism carries a high mortality. Potential treatment includes anticoagulation, thrombolytic therapy and embolectomy. We report a case of deep vein thrombosis leading to progressive massive pulmonary embolism despite appropriate anticoagulation, where thrombolysis with IVC filter placement resulted in a successful outcome.

  10. Minimal but non-minimal inflation and electroweak symmetry breaking

    Energy Technology Data Exchange (ETDEWEB)

    Marzola, Luca [National Institute of Chemical Physics and Biophysics,Rävala 10, 10143 Tallinn (Estonia); Institute of Physics, University of Tartu,Ravila 14c, 50411 Tartu (Estonia); Racioppi, Antonio [National Institute of Chemical Physics and Biophysics,Rävala 10, 10143 Tallinn (Estonia)

    2016-10-07

    We consider the most minimal scale invariant extension of the standard model that allows for successful radiative electroweak symmetry breaking and inflation. The framework involves an extra scalar singlet, that plays the rôle of the inflaton, and is compatibile with current experimental bounds owing to the non-minimal coupling of the latter to gravity. This inflationary scenario predicts a very low tensor-to-scalar ratio r≈10{sup −3}, typical of Higgs-inflation models, but in contrast yields a scalar spectral index n{sub s}≃0.97 which departs from the Starobinsky limit. We briefly discuss the collider phenomenology of the framework.

  11. Pulmonary complications in neurosurgical patients

    Directory of Open Access Journals (Sweden)

    Randeep Guleria

    2012-01-01

    Full Text Available Pulmonary complications are a major cause of morbidity and mortality in neurosurgical patients. The common pulmonary complications in neurosurgical patients include pneumonia, postoperative atelectasis, respiratory failure, pulmonary embolism, and neurogenic pulmonary edema. Postoperative lung expansion strategies have been shown to be useful in prevention of the postoperative complications in surgical patients. Low tidal volume ventilation should be used in patients who develop acute respiratory distress syndrome. An antibiotic use policy should be put in practice depending on the local patterns of antimicrobial resistance in the hospital. Thromboprophylactic strategies should be used in nonambulatory patients. Meticulous attention should be paid to infection control with a special emphasis on hand-washing practices. Prevention and timely management of these complications can help to decrease the morbidity and mortality associated with pulmonary complications.

  12. Minimally Invasive Technique for PMMA Augmentation of Fenestrated Screws

    Directory of Open Access Journals (Sweden)

    Jan-Helge Klingler

    2015-01-01

    Full Text Available Purpose. To describe the minimally invasive technique for cement augmentation of cannulated and fenestrated screws using an injection cannula as well as to report its safety and efficacy. Methods. A total of 157 cannulated and fenestrated pedicle screws had been cement-augmented during minimally invasive posterior screw-rod spondylodesis in 35 patients from January to December 2012. Retrospective evaluation of cement extravasation and screw loosening was carried out in postoperative plain radiographs and thin-sliced triplanar computed tomography scans. Results. Twenty-seven, largely prevertebral cement extravasations were detected in 157 screws (17.2%. None of the cement extravasations was causing a clinical sequela like a new neurological deficit. One screw loosening was noted (0.6% after a mean follow-up of 12.8 months. We observed no cementation-associated complication like pulmonary embolism or hemodynamic insufficiency. Conclusions. The presented minimally invasive cement augmentation technique using an injection cannula facilitates convenient and safe cement delivery through polyaxial cannulated and fenestrated screws during minimally invasive screw-rod spondylodesis. Nevertheless, the optimal injection technique and design of fenestrated screws have yet to be identified. This trial is registered with German Clinical Trials DRKS00006726.

  13. Pulmonary function in adolescents with ataxia telangiectasia.

    Science.gov (United States)

    McGrath-Morrow, Sharon; Lefton-Greif, Maureen; Rosquist, Karen; Crawford, Thomas; Kelly, Amber; Zeitlin, Pamela; Carson, Kathryn A; Lederman, Howard M

    2008-01-01

    Pulmonary complications are common in adolescents with ataxia telangiectasia (A-T), however objective measurements of lung function may be difficult to obtain because of underlying bulbar weakness, tremors, and difficulty coordinating voluntary respiratory maneuvers. To increase the reliability of pulmonary testing, minor adjustments were made to stabilize the head and to minimize leaks in the system. Fifteen A-T adolescents completed lung volume measurements by helium dilution. To assess for reproducibility of spirometry testing, 10 A-T adolescents performed spirometry on three separate occasions. Total lung capacity (TLC) was normal or just mildly decreased in 12/15 adolescents tested. TLC correlated positively with functional residual capacity (FRC), a measurement independent of patient effort (R2=0.71). The majority of individuals had residual volumes (RV) greater than 120% predicted (10/15) and slow vital capacities (VC) less than 70% predicted (9/15). By spirometry, force vital capacity (FVC) and forced expiratory volume in 1 sec (FEV1) values were reproducible in the 10 individuals who underwent testing on three separate occasions (R=0.97 and 0.96 respectively). Seven of the 10 adolescents had FEV1/FVC ratios>90%. Lung volume measurements from A-T adolescents revealed near normal TLC values with increased RV and decreased VC values. These findings indicate a decreased ability to expire to residual volume rather then a restrictive defect. Spirometry was also found to be reproducible in A-T adolescents suggesting that spirometry testing may be useful for tracking changes in pulmonary function over time in this population. Copyright (c) 2007 Wiley-Liss, Inc.

  14. Acrolein - a pulmonary hazard.

    Science.gov (United States)

    Bein, Kiflai; Leikauf, George D

    2011-09-01

    Acrolein is a respiratory irritant that can be generated during cooking and is in environmental tobacco smoke. More plentiful in cigarette smoke than polycyclic aromatic hydrocarbons (PAH), acrolein can adduct tumor suppressor p53 (TP53) DNA and may contribute to TP53-mutations in lung cancer. Acrolein is also generated endogenously at sites of injury, and excessive breath levels (sufficient to activate metalloproteinases and increase mucin transcripts) have been detected in asthma and chronic obstructive pulmonary disease (COPD). Because of its reactivity with respiratory-lining fluid or cellular macromolecules, acrolein alters gene regulation, inflammation, mucociliary transport, and alveolar-capillary barrier integrity. In laboratory animals, acute exposures have lead to acute lung injury and pulmonary edema similar to that produced by smoke inhalation whereas lower concentrations have produced bronchial hyperreactivity, excessive mucus production, and alveolar enlargement. Susceptibility to acrolein exposure is associated with differential regulation of cell surface receptor, transcription factor, and ubiquitin-proteasome genes. Consequent to its pathophysiological impact, acrolein contributes to the morbidly and mortality associated with acute lung injury and COPD, and possibly asthma and lung cancer. Copyright © 2011 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim.

  15. Pulmonary emphysema and smoking

    Energy Technology Data Exchange (ETDEWEB)

    Satoh, Katashi; Murota, Makiko [Kagawa Medical Univ., Miki (Japan); Mitani, Masahiro (and others)

    2001-12-01

    We assessed the relation between PE and smoking in 1,563 cases (1,068 men and 495 women) who underwent CT scaring for suspicion of respiratory disease on chest radiograph or some respiratory complaints. PE was diagnosed by the existence of low attenuation areas in CT scan and not by pulmonary function tests. CT was performed with 10 mm collimation in a standard algorithm. There were 2 subtypes of pulmonary emphysema: centrilobular and paraseptal emphysema. PE, regardless of the grade, was seen: in 189 out of 348 (54.3%) cases in males smokers and in only 2 out of 63 (3.2%) cases in male non-smokers; and in 5 out of 25 (20.0%) in female smokers and in 4 out of 203 (2.0%) in female non-smokers. PE was observed in more than half of male smokers. High incidence of PE was also observed in even younger generation, and severity would progress with advancing age and smoking. Both types of emphysema progress with age and amount of cigarette smoking. (author)

  16. [Pulmonary sarcomatoid carcinoma].

    Science.gov (United States)

    Antoine, Martine; Vieira, Thibault; Fallet, Vincent; Hamard, Cécile; Duruisseaux, Michael; Cadranel, Jacques; Wislez, Marie

    2016-01-01

    Pulmonary sarcomatoid carcinomas are a rare group of tumors accounting for about one percent of non-small cell lung carcinoma (NSCLC). In 2015, the World Health Organization classification united under this name all the carcinomas with sarcomatous-like component with spindle cell or giant cell appearance, or associated with a sarcomatous component sometimes heterologous. There are five subtypes: pleomorphic carcinoma, spindle cell carcinoma, giant cell carcinoma, carcinosarcoma and pulmonary blastoma. Clinical characteristics are not specific from the other subtypes of NSCLC. Epithelial to mesenchymal transition pathway may play a key role. Patients, usually tobacco smokers, are frequently symptomatic. Tumors are voluminous more often peripherical than central, with strong fixation on FDG TEP CT. Distant metastases are frequent with atypical visceral locations. These tumors have poorer prognosis than the other NSCLC subtypes because of great aggressivity, and frequent chemoresistance. Here we present pathological description and a review of literature with molecular features in order to better describe these tumors and perhaps introduce new therapeutics. Copyright © 2016. Published by Elsevier Masson SAS.

  17. Congenital pulmonary lymphangiectasia

    Directory of Open Access Journals (Sweden)

    Campisi Corradino

    2006-10-01

    Full Text Available Abstract Congenital pulmonary lymphangiectasia (PL is a rare developmental disorder involving the lung, and characterized by pulmonary subpleural, interlobar, perivascular and peribronchial lymphatic dilatation. The prevalence is unknown. PL presents at birth with severe respiratory distress, tachypnea and cyanosis, with a very high mortality rate at or within a few hours of birth. Most reported cases are sporadic and the etiology is not completely understood. It has been suggested that PL lymphatic channels of the fetal lung do not undergo the normal regression process at 20 weeks of gestation. Secondary PL may be caused by a cardiac lesion. The diagnostic approach includes complete family and obstetric history, conventional radiologic studies, ultrasound and magnetic resonance studies, lymphoscintigraphy, lung functionality tests, lung biopsy, bronchoscopy, and pleural effusion examination. During the prenatal period, all causes leading to hydrops fetalis should be considered in the diagnosis of PL. Fetal ultrasound evaluation plays a key role in the antenatal diagnosis of PL. At birth, mechanical ventilation and pleural drainage are nearly always necessary to obtain a favorable outcome of respiratory distress. Home supplemental oxygen therapy and symptomatic treatment of recurrent cough and wheeze are often necessary during childhood, sometimes associated with prolonged pleural drainage. Recent advances in intensive neonatal care have changed the previously nearly fatal outcome of PL at birth. Patients affected by PL who survive infancy, present medical problems which are characteristic of chronic lung disease.

  18. New Compton densitometer for measuring pulmonary edema

    Energy Technology Data Exchange (ETDEWEB)

    Loo, B.W.; Goulding, F.S.; Simon, D.S.

    1985-10-01

    Pulmonary edema is the pathological increase of extravascular lung water found most often in patients with congestive heart failure and other critically ill patients who suffer from intravenous fluid overload. A non-invasive lung density monitor that is accurate, easily portable, safe and inexpensive is needed for clinical evaluation of pulmonary edema. Other researchers who have employed Compton scattering techniques generally used systems of extended size and detectors with poor energy resolution. This has resulted in significant systematic biases from multiply-scattered photons and larger errors in counting statistics at a given radiation dose to the patient. We are proposing a patented approach in which only backscattered photons are measured with a high-resolution HPGe detector in a compact system geometry. By proper design and a unique data extraction scheme, effects of the variable chest wall on lung density measurements are minimized. Preliminary test results indicate that with a radioactive source of under 30 GBq, it should be possible to make an accurate lung density measurement in one minute, with a risk of radiation exposure to the patient a thousand times smaller than that from a typical chest x-ray. The ability to make safe, frequent lung density measurements could be very helpful for monitoring the course of P.E. at the hospital bedside or outpatient clinics, and for evaluating the efficacy of therapy in clinical research. 6 refs., 5 figs.

  19. New Compton densitometer for measuring pulmonary edema

    International Nuclear Information System (INIS)

    Loo, B.W.; Goulding, F.S.; Simon, D.S.

    1985-10-01

    Pulmonary edema is the pathological increase of extravascular lung water found most often in patients with congestive heart failure and other critically ill patients who suffer from intravenous fluid overload. A non-invasive lung density monitor that is accurate, easily portable, safe and inexpensive is needed for clinical evaluation of pulmonary edema. Other researchers who have employed Compton scattering techniques generally used systems of extended size and detectors with poor energy resolution. This has resulted in significant systematic biases from multiply-scattered photons and larger errors in counting statistics at a given radiation dose to the patient. We are proposing a patented approach in which only backscattered photons are measured with a high-resolution HPGe detector in a compact system geometry. By proper design and a unique data extraction scheme, effects of the variable chest wall on lung density measurements are minimized. Preliminary test results indicate that with a radioactive source of under 30 GBq, it should be possible to make an accurate lung density measurement in one minute, with a risk of radiation exposure to the patient a thousand times smaller than that from a typical chest x-ray. The ability to make safe, frequent lung density measurements could be very helpful for monitoring the course of P.E. at the hospital bedside or outpatient clinics, and for evaluating the efficacy of therapy in clinical research. 6 refs., 5 figs

  20. Minimal modification to tribimaximal mixing

    International Nuclear Information System (INIS)

    He Xiaogang; Zee, A.

    2011-01-01

    We explore some ways of minimally modifying the neutrino mixing matrix from tribimaximal, characterized by introducing at most one mixing angle and a CP violating phase thus extending our earlier work. One minimal modification, motivated to some extent by group theoretic considerations, is a simple case with the elements V α2 of the second column in the mixing matrix equal to 1/√(3). Modifications by keeping one of the columns or one of the rows unchanged from tribimaximal mixing all belong to the class of minimal modification. Some of the cases have interesting experimentally testable consequences. In particular, the T2K and MINOS collaborations have recently reported indications of a nonzero θ 13 . For the cases we consider, the new data sharply constrain the CP violating phase angle δ, with δ close to 0 (in some cases) and π disfavored.

  1. Topological gravity with minimal matter

    International Nuclear Information System (INIS)

    Li Keke

    1991-01-01

    Topological minimal matter, obtained by twisting the minimal N = 2 supeconformal field theory, is coupled to two-dimensional topological gravity. The free field formulation of the coupled system allows explicit representations of BRST charge, physical operators and their correlation functions. The contact terms of the physical operators may be evaluated by extending the argument used in a recent solution of topological gravity without matter. The consistency of the contact terms in correlation functions implies recursion relations which coincide with the Virasoro constraints derived from the multi-matrix models. Topological gravity with minimal matter thus provides the field theoretic description for the multi-matrix models of two-dimensional quantum gravity. (orig.)

  2. Minimal Marking: A Success Story

    Directory of Open Access Journals (Sweden)

    Anne McNeilly

    2014-11-01

    Full Text Available The minimal-marking project conducted in Ryerson’s School of Journalism throughout 2012 and early 2013 resulted in significantly higher grammar scores in two first-year classes of minimally marked university students when compared to two traditionally marked classes. The “minimal-marking” concept (Haswell, 1983, which requires dramatically more student engagement, resulted in more successful learning outcomes for surface-level knowledge acquisition than the more traditional approach of “teacher-corrects-all.” Results suggest it would be effective, not just for grammar, punctuation, and word usage, the objective here, but for any material that requires rote-memory learning, such as the Associated Press or Canadian Press style rules used by news publications across North America.

  3. Pulmonary venous remodeling in COPD-pulmonary hypertension and idiopathic pulmonary arterial hypertension

    DEFF Research Database (Denmark)

    Andersen, Kasper Hasseriis; Andersen, Claus Bøgelund; Gustafsson, Finn

    2017-01-01

    Pulmonary vascular arterial remodeling is an integral and well-understood component of pulmonary hypertension (PH). In contrast, morphological alterations of pulmonary veins in PH are scarcely described. Explanted lungs (n = 101) from transplant recipients with advanced chronic obstructive...... pulmonary disease (COPD) and idiopathic pulmonary arterial hypertension (IPAH) were analyzed for venous vascular involvement according to a pre-specified, semi-quantitative grading scheme, which categorizes the intensity of venous remodeling in three groups of incremental severity: venous hypertensive (VH......) grade 0 = characterized by an absence of venous vascular remodeling; VH grade 1 = defined by a dominance of either arterialization or intimal fibrosis; and VH grade 2 = a substantial composite of arterialization and intimal fibrosis. Patients were grouped according to clinical and hemodynamic...

  4. Non-minimal inflation revisited

    International Nuclear Information System (INIS)

    Nozari, Kourosh; Shafizadeh, Somayeh

    2010-01-01

    We reconsider an inflationary model that inflaton field is non-minimally coupled to gravity. We study the parameter space of the model up to the second (and in some cases third) order of the slow-roll parameters. We calculate inflation parameters in both Jordan and Einstein frames, and the results are compared in these two frames and also with observations. Using the recent observational data from combined WMAP5+SDSS+SNIa datasets, we study constraints imposed on our model parameters, especially the non-minimal coupling ξ.

  5. Minimal Flavor Constraints for Technicolor

    DEFF Research Database (Denmark)

    Sakuma, Hidenori; Sannino, Francesco

    2010-01-01

    We analyze the constraints on the the vacuum polarization of the standard model gauge bosons from a minimal set of flavor observables valid for a general class of models of dynamical electroweak symmetry breaking. We will show that the constraints have a strong impact on the self-coupling and mas......We analyze the constraints on the the vacuum polarization of the standard model gauge bosons from a minimal set of flavor observables valid for a general class of models of dynamical electroweak symmetry breaking. We will show that the constraints have a strong impact on the self...

  6. Harm minimization among teenage drinkers

    DEFF Research Database (Denmark)

    Jørgensen, Morten Hulvej; Curtis, Tine; Christensen, Pia Haudrup

    2007-01-01

    AIM: To examine strategies of harm minimization employed by teenage drinkers. DESIGN, SETTING AND PARTICIPANTS: Two periods of ethnographic fieldwork were conducted in a rural Danish community of approximately 2000 inhabitants. The fieldwork included 50 days of participant observation among 13....... In regulating the social context of drinking they relied on their personal experiences more than on formalized knowledge about alcohol and harm, which they had learned from prevention campaigns and educational programmes. CONCLUSIONS: In this study we found that teenagers may help each other to minimize alcohol...

  7. Grape seed extract ameliorates bleomycin-induced mouse pulmonary fibrosis.

    Science.gov (United States)

    Liu, Qi; Jiang, Jun-Xia; Liu, Ya-Nan; Ge, Ling-Tian; Guan, Yan; Zhao, Wei; Jia, Yong-Liang; Dong, Xin-Wei; Sun, Yun; Xie, Qiang-Min

    2017-05-05

    Pulmonary fibrosis is common in a variety of inflammatory lung diseases, such as interstitial pneumonia, chronic obstructive pulmonary disease, and silicosis. There is currently no effective clinical drug treatment. It has been reported that grape seed extracts (GSE) has extensive pharmacological effects with minimal toxicity. Although it has been found that GSE can improve the lung collagen deposition and fibrosis pathology induced by bleomycin in rat, its effects on pulmonary function, inflammation, growth factors, matrix metalloproteinases and epithelial-mesenchymal transition remain to be researched. In the present study, we studied whether GSE provided protection against bleomycin (BLM)-induced mouse pulmonary fibrosis. ICR strain mice were treated with BLM in order to establish pulmonary fibrosis models. GSE was given daily via intragastric administration for three weeks starting at one day after intratracheal instillation. GSE at 50 or 100mg/kg significantly reduced BLM-induced inflammatory cells infiltration, proinflammatory factor protein expression, and hydroxyproline in lung tissues, and improved pulmonary function in mice. Additionally, treatment with GSE also significantly impaired BLM-induced increases in lung fibrotic marker expression (collagen type I alpha 1 and fibronectin 1) and decreases in an anti-fibrotic marker (E-cadherin). Further investigation indicated that the possible molecular targets of GSE are matrix metalloproteinases-9 (MMP-9) and TGF-β1, given that treatment with GSE significantly prevented BLM-induced increases in MMP-9 and TGF-β1 expression in the lungs. Together, these results suggest that supplementation with GSE may improve the quality of life of lung fibrosis patients by inhibiting MMP-9 and TGF-β1 expression in the lungs. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. The prevalence of pulmonary tuberculosis in Jeonbug Province

    International Nuclear Information System (INIS)

    Rhee, S. J.; Moon, M. C.; Song, H. Y.; Choi, K. C.

    1981-01-01

    A photofluorographic mass survey of P-A chest had been done to the 13136 residents (male 6264, female 6872) in Jeonbug province, Korea for about 2 years from May 5, to Dec.19, 1978 and from Mar. 5, to Dec. 22, 1979. The results are as follows: 1. The prevalence rate of all active pulmonary tuberculosis is 5.3%. 2. The prevalence rate of male(8.8%) is 4.2 times higher than that of female (2.1%). 3. The prevalence rates of all old age groups above fifty years are higher than that of remainder under fifty years of age. Of these, 61-70 years old age group is highest in prevalence rate. 4. According to extent of active pulmonary tuberculosis, 77.5% is minimal, 15.4% is moderately advanced, and 7.1% is far advanced. Inactive pulmonary tuberculosis are 39 cases (0.3% to objective population). 5. In the incidence of the involved side, right side is about 2 times higher than the left, and involvement of both sides is increased in moderately and far advance pulmonary tuberculosis. In all pulmonary tuberculosis, one or both upper lung fields are most commonly involved. The incidences of cavity in moderately and far advanced pulmonary tuberculosis show no significant difference. 6. The incidences of other intrathoracic lesions are as follows: suspected hypertensive heart disease 2.4%, dextrocardia with situs inversus 0.04%, pleural calcification 0.4%, pleural thickening 0.2%, pleural effusion 0.1%, pneumonia 0.02%, bronchiectasis 0.1%, lung abscess 0.02%, C.O.P.D. 0.2%, suspected lung tumor 0.06%, pneumothorax 0.0076%, and suspected mediastinal tumor 0.02%

  9. A novel model of IgE-mediated passive pulmonary anaphylaxis in rats.

    Directory of Open Access Journals (Sweden)

    Eva Wex

    Full Text Available Mast cells are central effector cells in allergic asthma and are augmented in the airways of asthma patients. Attenuating mast cell degranulation and with it the early asthmatic response is an important intervention point to inhibit bronchoconstriction, plasma exudation and tissue oedema formation. To validate the efficacy of novel pharmacological interventions, appropriate and practicable in vivo models reflecting mast cell-dependent mechanisms in the lung, are missing. Thus, we developed a novel model of passive pulmonary anaphylaxis in rats. Rats were passively sensitized by concurrent intratracheal and intradermal (ear application of an anti-DNP IgE antibody. Intravenous application of the antigen, DNP-BSA in combination with Evans blue dye, led to mast cell degranulation in both tissues. Quantification of mast cell degranulation in the lung was determined by (1 mediator release into bronchoalveolar lavage, (2 extravasation of Evans blue dye into tracheal and bronchial lung tissue and (3 invasive measurement of antigen-induced bronchoconstriction. Quantification of mast cell degranulation in the ear was determined by extravasation of Evans blue dye into ear tissue. We pharmacologically validated our model using the SYK inhibitor Fostamatinib, the H1-receptor antagonist Desloratadine, the mast cell stabilizer disodium cromoglycate (DSCG and the β2-adrenergic receptor agonist Formoterol. Fostamatinib was equally efficacious in lung and ear. Desloratadine effectively inhibited bronchoconstriction and ear vascular leakage, but was less effective against pulmonary vascular leakage, perhaps reflecting the differing roles for histamine receptor sub-types. DSCG attenuated both vascular leakage in the lung and bronchoconstriction, but with a very short duration of action. As an inhaled approach, Formoterol was more effective in the lung than in the ear. This model of passive pulmonary anaphylaxis provides a tissue relevant readout of early mast cell

  10. Imaging diagnosis of acute pulmonary thromboembolism

    International Nuclear Information System (INIS)

    Mut, Fernando

    2005-01-01

    Pulmonary embolism (PE) is a frequent disease which requires an accurate diagnosis in order to establish an effective treatment considering that anticoagulant therapy may lead to complications. Lung ventilation / perfusion scintigraphy (LS V/Q) has been employed as the imaging meted of choice in patients with suspicion of PE. Pulmonary angiography is considered invasive, hence its utilization is usually reserved for otherwise unresolved cases. Other methods like venous Doppler ultrasound and echocardiography have a complementary role or are not widely indicated. The introduction of spiral CT (SCT), specially with multislice capabilities has made available a fast, relatively economic and efficient method for non-invasive diagnosis of PE. Availability of the technique is increasing and it has been included in some diagnostic algorithms for PE as the initial method of evaluation (and sometimes the only one). However, most research has been performed comparing this state-of-the-art technology with classical radionuclide protocols instead of using updated techniques such as SPECT and ultrafine radio aerosols. Moreover, SCT delivers much higher dose rates to the patient which must be taken into account specially in young individuals. In general, available evidence shows superior sensitivity of LS V/Q with higher specificity of SCT, within a context of similar overall accuracy provided optimized protocols are employed. Interpretation criteria for LS V/Q should be revised in an attempt to minimize indeterminate results, and together with the routine utilization of SPECT and novel ventilation systems should improve the performance of LS V/Q. The choice of the initial diagnostic modality should be guided by a correct determination of pre-test probability, clinical characteristics of the patient potentially influencing the efficacy and safety of the method, availability of the different techniques, relative costs and operator's experience. Such a selective and pragmatic

  11. Clinical worsening in Chronic Thromboembolic Pulmonary Hypertension

    NARCIS (Netherlands)

    Schölzel, B.E.

    2015-01-01

    Chronic thromboembolic pulmonary hypertension (CTEPH) is defined as a raised mean pulmonary artery pressure (of at least 25 mmHg at rest) caused by persistent obstruction of pulmonary arteries after pulmonary embolism that has not resolved despite at least 3 months of therapeutic anticoagulation.

  12. Celiac disease with pulmonary haemosiderosis and cardiomyopathy

    OpenAIRE

    Işikay, Sedat; Yilmaz, Kutluhan; Kilinç, Metin

    2012-01-01

    Celiac disease or pulmonary haemosiderosis can be associated with several distinguished conditions. Pulmonary haemosiderosis is a rare, severe and fatal disease characterised by recurrent episodes of alveolar haemorrhage, haemoptysis and anaemia. Association of pulmonary haemosiderosis and celiac disease is extremely rare. We describe a case of celiac disease presented with dilated cardiomyopathy and pulmonary haemosiderosis without gastrointestinal symptoms of celiac disease. In addition, vi...

  13. Idiopathic pulmonary fibrosis

    Directory of Open Access Journals (Sweden)

    Noble Paul W

    2008-03-01

    Full Text Available Abstract Idiopathic pulmonary fibrosis (IPF is a non-neoplastic pulmonary disease that is characterized by the formation of scar tissue within the lungs in the absence of any known provocation. IPF is a rare disease which affects approximately 5 million persons worldwide. The prevalence is estimated to be slightly greater in men (20.2/100,000 than in women (13.2/100,000. The mean age at presentation is 66 years. IPF initially manifests with symptoms of exercise-induced breathless and dry coughing. Auscultation of the lungs reveals early inspiratory crackles, predominantly located in the lower posterior lung zones upon physical exam. Clubbing is found in approximately 50% of IPF patients. Cor pulmonale develops in association with end-stage disease. In that case, classic signs of right heart failure may be present. Etiology remains incompletely understood. Some environmental factors may be associated with IPF (cigarette smoking, exposure to silica and livestock. IPF is recognized on high-resolution computed tomography by peripheral, subpleural lower lobe reticular opacities in association with subpleural honeycomb changes. IPF is associated with a pathological lesion known as usual interstitial pneumonia (UIP. The UIP pattern consists of normal lung alternating with patches of dense fibrosis, taking the form of collagen sheets. The diagnosis of IPF requires correlation of the clinical setting with radiographic images and a lung biopsy. In the absence of lung biopsy, the diagnosis of IPF can be made by defined clinical criteria that were published in guidelines endorsed by several professional societies. Differential diagnosis includes other idiopathic interstitial pneumonia, connective tissue diseases (systemic sclerosis, polymyositis, rheumatoid arthritis, forme fruste of autoimmune disorders, chronic hypersensitivity pneumonitis and other environmental (sometimes occupational exposures. IPF is typically progressive and leads to significant

  14. Pulmonary complications in renal transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jung Bin; Choi, Yo Won; Jeon, Seok Chol; Park, Choong Ki; Lee, Seung Rho; Hahm, Chang Kok; Joo, Kyung Bin [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2003-04-01

    To evaluate the radiographic and CT findings of pulmonary complications other than pulmonary edema arising from renal transplantation. Among 393 patients who had undergone renal transplantation at our hospital during a previous ten-year period, 23 with pulmonary complications other than pulmonary edema were included in this study. The complications involved were infection caused by CMV (n=6), bacteria (n=4), fungus (n=4), tuberculosis (n=2), varicella (n=1) or chlamydia (n=1), and malignancy involving lung cancer (n=4) or Kaposi's sarcoma (n=1). Two chest radiologists reviewed all images. The complications manifesting mainly as pulmonary nodules were lung cancer (4/4), tuberculosis (1/2), and Kaposi's sarcoma (1/1). Pulmonary consolidation was a main feature in bacterial infection (4/4), fungal infection (3/4), tuberculosis (1/2), chlamydial infection (1/1), and varicellar pneumonia (1/1). Ground-glass attenuation was a main CT feature in CMV pneumonia (4/6), and increased interstitial making was a predominant radiographic feature in CMV pneumonia (2/6). The main radiologic features described above can be helpful for differential diagnosis of the pulmonary complications of renal transplantation.

  15. Variable pulmonary manifestations in hemodialysis patients

    International Nuclear Information System (INIS)

    Kim, Yoo Kyung; Shim, Sung Shine; Shin, Jung Hee; Choi, Gyu Bock; Lee, Kyung Soo; Yi, Chin A; Oh, Yu Whan

    2003-01-01

    A wide variety of pulmonary disorders related to hemodialysis or pre-existing renal disease occurs in hemodialysis patients. The disorders may be classified as 1) pulmonary abnormalities associated with chronic renal failures; 2) pulmonary complications arising during hemodialysis; 3) pulmonary infection; or 4) pulmonary-renal syndrome. An awareness of the various possible pulmonary disorders arising in hemodialysis patients may be helpful for the proper and timely management of such patients. We describe and illustrate various radiographic and CT findings of variable pulmonary disorders in hemodialysis patients

  16. Isoperimetric inequalities for minimal graphs

    International Nuclear Information System (INIS)

    Pacelli Bessa, G.; Montenegro, J.F.

    2007-09-01

    Based on Markvorsen and Palmer's work on mean time exit and isoperimetric inequalities we establish slightly better isoperimetric inequalities and mean time exit estimates for minimal graphs in N x R. We also prove isoperimetric inequalities for submanifolds of Hadamard spaces with tamed second fundamental form. (author)

  17. A Defense of Semantic Minimalism

    Science.gov (United States)

    Kim, Su

    2012-01-01

    Semantic Minimalism is a position about the semantic content of declarative sentences, i.e., the content that is determined entirely by syntax. It is defined by the following two points: "Point 1": The semantic content is a complete/truth-conditional proposition. "Point 2": The semantic content is useful to a theory of…

  18. Torsional Rigidity of Minimal Submanifolds

    DEFF Research Database (Denmark)

    Markvorsen, Steen; Palmer, Vicente

    2006-01-01

    We prove explicit upper bounds for the torsional rigidity of extrinsic domains of minimal submanifolds $P^m$ in ambient Riemannian manifolds $N^n$ with a pole $p$. The upper bounds are given in terms of the torsional rigidities of corresponding Schwarz symmetrizations of the domains in warped...

  19. The debate on minimal deterrence

    International Nuclear Information System (INIS)

    Arbatov, A.; Karp, R.C.; Toth, T.

    1993-01-01

    Revitalization of debates on minimal nuclear deterrence at the present time is induced by the end of the Cold War and a number of unilateral and bilateral actions by the great powers to curtail nuclear arms race and reduce nuclear weapons arsenals

  20. LLNL Waste Minimization Program Plan

    International Nuclear Information System (INIS)

    1990-01-01

    This document is the February 14, 1990 version of the LLNL Waste Minimization Program Plan (WMPP). The Waste Minimization Policy field has undergone continuous changes since its formal inception in the 1984 HSWA legislation. The first LLNL WMPP, Revision A, is dated March 1985. A series of informal revision were made on approximately a semi-annual basis. This Revision 2 is the third formal issuance of the WMPP document. EPA has issued a proposed new policy statement on source reduction and recycling. This policy reflects a preventative strategy to reduce or eliminate the generation of environmentally-harmful pollutants which may be released to the air, land surface, water, or ground water. In accordance with this new policy new guidance to hazardous waste generators on the elements of a Waste Minimization Program was issued. In response to these policies, DOE has revised and issued implementation guidance for DOE Order 5400.1, Waste Minimization Plan and Waste Reduction reporting of DOE Hazardous, Radioactive, and Radioactive Mixed Wastes, final draft January 1990. This WMPP is formatted to meet the current DOE guidance outlines. The current WMPP will be revised to reflect all of these proposed changes when guidelines are established. Updates, changes and revisions to the overall LLNL WMPP will be made as appropriate to reflect ever-changing regulatory requirements. 3 figs., 4 tabs

  1. Minimizing TLD-DRD differences

    International Nuclear Information System (INIS)

    Riley, D.L.; McCoy, R.A.; Connell, W.D.

    1987-01-01

    When substantial differences exist in exposures recorded by TLD's and DRD's, it is often necessary to perform an exposure investigation to reconcile the difference. In working with several operating plants, the authors have observed a number of causes for these differences. This paper outlines these observations and discusses procedures that can be used to minimize them

  2. Acquiring minimally invasive surgical skills

    NARCIS (Netherlands)

    Hiemstra, Ellen

    2012-01-01

    Many topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and evaluation of minimally invasive surgical skills in a training setting and in practice in the operating room.

  3. Pulmonary Edema: Classification, Mechanisms of Development, Diagnosis

    Directory of Open Access Journals (Sweden)

    V. V. Moroz

    2009-01-01

    Full Text Available Pulmonary edema remains a topical problem of modern reanimatology. In clinical practice, there is a need for continuous monitoring of the content of extravascular water in the lung and the pulmonary vascular permeability index for the timely detection and treatment of pulmonary edema. This literature review considers the minor mechanisms of pulmonary extravas-cular water exchange in health and in different types of pulmonary edema (acute lung injury, pneumonia, sepsis, postoperative period, burns, injuries etc., as well as the most accessible current (irradiation and dilution studies permitting an estimate of the level of pulmonary extravascular water and the pulmonary vascular permeability index in clinical practice. Key words: pulmonary edema, acute lung injury, pulmonary extravascular water, pulmonary vascular permeability index.

  4. Pulmonary nocardiosis with osteomyelitis

    International Nuclear Information System (INIS)

    Bechet, R.; Granier, P.; Mourad, M.; Dufranc, A.; Adoue, D.

    2007-01-01

    We report a case of a 49-year-old female who developed a bronchopneumonia associated with atelectasis of the upper right lobe and back pain of bone origin. Bronchoscopy revealed an endobronchial mass at the origin of the right upper lobe bronchus. Scintigraphy showed three paravertebral spots of the seventh and eighth thoracic vertebrae, without any radiological modification. Culture of lung tissue obtained by trans-parietal punction under CT scan control became positive to Nocardia belonging to the pneumoniae complex. Positive diagnosis of pulmonary nocardiosis associated with two rare localizations was set, one was an endobronchial mass, the other was osteomyelitis of the posterior chest wall. The patient was treated with Trimethoprim ulfamethoxazole and recovered completely. (author)

  5. Mast Cell Inhibition Improves Pulmonary Vascular Remodeling in Pulmonary Hypertension

    NARCIS (Netherlands)

    Bartelds, Beatrijs; van Loon, Rosa Laura E.; Mohaupt, Saffloer; Wijnberg, Hans; Dickinson, Michael G.; Takens, Janny; van Albada, Mirjam; Berger, Rolf M. F.; Boersma, B.

    Background: Pulmonary arterial hypertension (PAH) is a progressive angioproliferative disease with high morbidity and mortality. Although the histopathology is well described, its pathogenesis is largely unknown. We previously identified the increased presence of mast cells and their markers in a

  6. Hazardous waste minimization tracking system

    International Nuclear Information System (INIS)

    Railan, R.

    1994-01-01

    Under RCRA section 3002 9(b) and 3005f(h), hazardous waste generators and owners/operators of treatment, storage, and disposal facilities (TSDFs) are required to certify that they have a program in place to reduce the volume or quantity and toxicity of hazardous waste to the degree determined to be economically practicable. In many cases, there are environmental, as well as, economic benefits, for agencies that pursue pollution prevention options. Several state governments have already enacted waste minimization legislation (e.g., Massachusetts Toxic Use Reduction Act of 1989, and Oregon Toxic Use Reduction Act and Hazardous Waste Reduction Act, July 2, 1989). About twenty six other states have established legislation that will mandate some type of waste minimization program and/or facility planning. The need to address the HAZMIN (Hazardous Waste Minimization) Program at government agencies and private industries has prompted us to identify the importance of managing The HAZMIN Program, and tracking various aspects of the program, as well as the progress made in this area. The open-quotes WASTEclose quotes is a tracking system, which can be used and modified in maintaining the information related to Hazardous Waste Minimization Program, in a manageable fashion. This program maintains, modifies, and retrieves information related to hazardous waste minimization and recycling, and provides automated report generating capabilities. It has a built-in menu, which can be printed either in part or in full. There are instructions on preparing The Annual Waste Report, and The Annual Recycling Report. The program is very user friendly. This program is available in 3.5 inch or 5 1/4 inch floppy disks. A computer with 640K memory is required

  7. 18F-FDG PET/CT 结合 HRCT 对肺微浸润性腺癌的诊断价值%Diagnostic value of combined 18 F-FDG PET/CT and HRCT for minimally invasive pulmonary adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    彭辽河; 胡晓燕; 周旋; 邱大胜; 李杰

    2014-01-01

    目的:18 F-FDG PET/CT结合 HRCT 对肺微浸润性腺癌(minimally invasive adenocarcinoma ,MIA)的诊断价值。方法搜集经手术病理证实28例肺 MIA 患者的18 F-FDG PET/CT 及 HRCT 影像资料,患者均先行18 F-FDG PET/CT显像,后行HRCT扫描检查,分析其形态学表现及放射性分布,同时测量其SUVmax值,分析PET/CT、HRCT、PET/CT结合 HRCT三者的准确率。结果28例患者中,18 F-FDG PET 显像有19例出现高于肺本底的局灶性异常放射性摄取增高影,以SUVmax>2.5为标准,诊断MIA的灵敏度为32.1%(9/28)。HRCT 病灶显示磨玻璃密度结节27例(96.4%),其中单纯磨玻璃密度结节10例,混杂磨玻璃密度结节17例,单纯实性密度结节1例;病灶出现边缘分叶征18例(64.3%),毛刺征20例(71.4%),空泡征或支气管充气征21例(75%),胸膜凹陷征12例(42.9%),血管集束征10例(35.7%),圆形结节征13例(46.4%)。PET/CT、HRCT、PET/CT结合 HRCT 三者的准确率分别为71.4%、82.1%和96.4%。结论18 F-FDG PET/CT诊断MIA易出现假阴性,PET/CT结合HRCT有利于提高诊断准确率。%Objective To evaluate the diagnostic value of combined 18 F-FDG PET/CT and HRCT for minimally invasive adenocarcinoma(MIA) .Methods The 18F-FDG PET/CT images of 28 cases with pathologically confirmed MIA were studied .All were followed up by HRCT study .The morphological and radioactive findings of the lesions were reviewed , and the maximum standard uptake values (SUVmax) were measured .The diagnostic accuracy of PET/CT ,HRCT ,and combined PET/CT and HRCT were analyzed .The synergistic effect of combined PET/CT and HRCT were investigated . Results 18 F-FDG PET imaging showed local abnormal radioactive uptake in 19 of 28 cases .When SUVmax of 2 .5 was employed as criteria in the diagnosis of MIA ,the sensitivity of 18 F-FDG PET imaging was 32 .1% .Of the total of 28 ca

  8. Nuclear scan of pulmonary hemorrhage in radiopathic pulmonary hemosiderosis

    International Nuclear Information System (INIS)

    Miller, T.; Tanaka, T.

    1979-01-01

    Idiopathic pulmonary hemosiderosis, a disease of unknown etiology most often occuring in children, is characterized by recurring episodes of alveolar consolidation. Exacerbations of pulmonary hemorrhage coincide with episodes of alveolar filling; repeated episodes lead to progressive interstitial fibrosis and eventually to corpulmonale. Serial nuclear scans of the lungs after injection of radiolabeled red blood cells should parallel the pathologic and radiographic findings. We observed the accumulation of radiolabeled red blood cells in the lungs on scan images, a finding not previously reported

  9. Pulmonary endarterectomy in the management of chronic thromboembolic pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    David Jenkins

    2017-03-01

    Full Text Available Chronic thromboembolic pulmonary hypertension (CTEPH is a type of pulmonary hypertension, resulting from fibrotic transformation of pulmonary artery clots causing chronic obstruction in macroscopic pulmonary arteries and associated vascular remodelling in the microvasculature. Pulmonary endarterectomy (PEA offers the best chance of symptomatic and prognostic improvement in eligible patients; in expert centres, it has excellent results. Current in-hospital mortality rates are 90% at 1 year and >70% at 10 years. However, PEA, is a complex procedure and relies on a multidisciplinary CTEPH team led by an experienced surgeon to decide on an individual's operability, which is determined primarily by lesion location and the haemodynamic parameters. Therefore, treatment of patients with CTEPH depends largely on subjective judgements of eligibility for surgery by the CTEPH team. Other controversies discussed in this article include eligibility for PEA versus balloon pulmonary angioplasty, the new treatment algorithm in the European Society of Cardiology/European Respiratory Society guidelines and the definition of an “expert centre” for the management of this condition.

  10. [Pulmonary function in patients with infiltrative pulmonary tuberculosis].

    Science.gov (United States)

    Nefedov, V B; Popova, L A; Shergina, E A

    2007-01-01

    Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/VC%, PEF, MEF25, MEF50, MEF75, TLC, TGV, pulmonary residual volume (PRV), R(aw), R(in),, R(ex), DLCO-SB, DLCO-SS, PaO2, and PaCO2 were determined in 103 patients with infiltrative pulmonary tuberculosis. Pulmonary dysfunction was detected in 83.5% of the patients. Changes were found in lung volumes and capacities in 63.1%, impaired bronchial patency and pulmonary gas exchange dysfunction were in 60.2 and 41.7%, respectively. The changes in pulmonary volumes and capacities appeared as increased PRV, decreased VC and FVC, and decreased and increased TGV and TLC; impaired bronchial patency presented as decreased PEF, MEF25, MEF50, MEF75, FEV1/VC% and increased R(aw) R(in), and R(ex); pulmonary gas exchange dysfunction manifested itself as reduced DLCO-SB, DLCO-SS, and PaO2 and decreased and increased PaCO2. The magnitude of the observed functional changes was generally slight. Significant disorders were observed rarely and very pronounced ones were exceptional.

  11. [Pulmonary function in patients with disseminated pulmonary tuberculosis].

    Science.gov (United States)

    Nefedov, V B; Shergina, E A; Popova, L A

    2007-01-01

    Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/VC%, PEF, MEF25%, MEF50%, MEF75%, TLS, TGV, pulmonary residual volume (PRV), Raw, Rin, Rex, DLCO-SB, DLCO-SS, PaO2, and PaCO2 were determined in 29 patients with disseminated pulmonary tuberculosis. Pulmonary dysfunction was detected in 93.1% of the patients. Changes were found in lung volumes and capacities in 65.5%, impaired bronchial patency and pulmonary gas exchange dysfunction were in 79.3 and 37.9%, respectively. The changes in pulmonary volumes and capacities appeared as increased PRV, decreased VC, FVC, and TLS, decreased and increased TGV; impaired bronchial patency presented as decreased PEF, MEF25%, MEF50%, MEF75%, and FEV1/VC% and increased Raw, Rin, and Rex; pulmonary gas exchange dysfunction manifested itself as reduced DLCO-SS and PaO2 and decreased and increased PaCO2. The observed functional changes varied from slight to significant and pronounced with a preponderance of small disorders, a lower detection rate of significant disorders, and rare detection of very pronounced ones.

  12. Pulmonary artery pulse pressure and wave reflection in chronic pulmonary thromboembolism and primary pulmonary hypertension.

    Science.gov (United States)

    Castelain, V; Hervé, P; Lecarpentier, Y; Duroux, P; Simonneau, G; Chemla, D

    2001-03-15

    The purpose of this time-domain study was to compare pulmonary artery (PA) pulse pressure and wave reflection in chronic pulmonary thromboembolism (CPTE) and primary pulmonary hypertension (PPH). Pulmonary artery pressure waveform analysis provides a simple and accurate estimation of right ventricular afterload in the time-domain. Chronic pulmonary thromboembolism and PPH are both responsible for severe pulmonary hypertension. Chronic pulmonary thromboembolism and PPH predominantly involve proximal and distal arteries, respectively, and may lead to differences in PA pressure waveform. High-fidelity PA pressure was recorded in 14 patients (7 men/7 women, 46 +/- 14 years) with CPTE (n = 7) and PPH (n = 7). We measured thermodilution cardiac output, mean PA pressure (MPAP), PA pulse pressure (PAPP = systolic - diastolic PAP) and normalized PAPP (nPAPP = PPAP/MPAP). Wave reflection was quantified by measuring Ti, that is, the time between pressure upstroke and the systolic inflection point (Pi), deltaP, that is, the systolic PAP minus Pi difference, and the augmentation index (deltaP/PPAP). At baseline, CPTE and PPH had similar cardiac index (2.4 +/- 0.4 vs. 2.5 +/- 0.5 l/min/m2), mean PAP (59 +/- 9 vs. 59 +/- 10 mm Hg), PPAP (57 +/- 13 vs. 53 +/- 13 mm Hg) and nPPAP (0.97 +/- 0.16 vs. 0.89 +/- 0.13). Chronic pulmonary thromboembolism had shorter Ti (90 +/- 17 vs. 126 +/- 16 ms, p PPAP (0.26 +/- 0.01 vs. 0.09 +/- 0.07, p < 0.01). Our study indicated that: 1) CPTE and PPH with severe pulmonary hypertension had similar PA pulse pressure, and 2) wave reflection is elevated in both groups, and CPTE had increased and anticipated wave reflection as compared with PPH, thus suggesting differences in the pulsatile component of right ventricular afterload.

  13. Anaesthetic management of the child with co-existing pulmonary disease.

    Science.gov (United States)

    Lauer, R; Vadi, M; Mason, L

    2012-12-01

    Children with co-existing pulmonary disease have a wide range of clinical manifestations with significant implications for anaesthetists. Although there are a number of pulmonary diseases in children, this review focuses on two of the most common pulmonary disorders, asthma and bronchopulmonary dysplasia (BPD). These diseases share the physiology of bronchoconstriction and variably decreased flow in the airways, but also have unique physiological consequences. The anaesthetist can make a difference in outcomes with proper preoperative evaluation and appropriate preparation for surgery in the context of a team approach to perioperative care with implementation of a stepwise approach to disease management. An understanding of the importance of minimizing the risk for bronchoconstriction and having the tools at hand to treat it when necessary is paramount in the care of these patients. Unique challenges exist in the management of pulmonary hypertension in BPD patients. This review covers medical treatment, intraoperative management, and postoperative care for both patient populations.

  14. Percutaneous Stent-Graft Repair of a Mycotic Pulmonary Artery Pseudoaneurysm

    International Nuclear Information System (INIS)

    Chou Meichun; Liang Hueilung; Pan Huayban; Yang Chienfang

    2006-01-01

    Ruptured mycotic pulmonary pseudoaneurysm is a lethal complication. Emergent surgical repair is usually recommended, but still associated with a high mortality rate. We present a patient in whom mycotic pulmonary pseudoaneurysm was a complication after surgical lobectomy 2 weeks earlier. This patient had suffered from repeated massive hemoptysis. After emergent surgical repair of the ruptured pulmonary artery stump, another episode of massive hemorrhage occurred. The pulmonary arteriogram revealed a segmental stenosis and a large, wide-necked, lobulated pseudoaneurysm at the left proximal pulmonary artery. We deployed a balloon-expandable stent-graft (48 mm in length mounted on a 12 mm x 40 mm angioplasty balloon) across the stenotic segment and the neck of the pulmonary pseudoaneurysm. Hemostasis was achieved immediately and, under a 4-week antibiotic treatment, patient was transferred to a local hospital for medical care. This case report demonstrates the benefit of minimally invasive endovascular therapy in a critically ill patient. A literature review of the etiology and management of mycotic pulmonary pseudoaneurysm is included

  15. Cardiovascular function in pulmonary emphysema.

    Science.gov (United States)

    Visca, Dina; Aiello, Marina; Chetta, Alfredo

    2013-01-01

    Chronic obstructive pulmonary disease (COPD) and chronic cardiovascular disease, such as coronary artery disease, congestive heart failure, and cardiac arrhythmias, have a strong influence on each other, and systemic inflammation has been considered as the main linkage between them. On the other hand, airflow limitation may markedly affect lung mechanics in terms of static and dynamic hyperinflation, especially in pulmonary emphysema, and they can in turn influence cardiac performance as well. Skeletal mass depletion, which is a common feature in COPD especially in pulmonary emphysema patients, may have also a role in cardiovascular function of these patients, irrespective of lung damage. We reviewed the emerging evidence that highlights the role of lung mechanics and muscle mass impairment on ventricular volumes, stroke volume, and stroke work at rest and on exercise in the presence of pulmonary emphysema. Patients with emphysema may differ among COPD population even in terms of cardiovascular function.

  16. Occupational chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Omland, Oyvind; Würtz, Else Toft; Aasen, Tor Børvig

    2014-01-01

    Occupational-attributable chronic obstructive pulmonary disease (COPD) presents a substantial health challenge. Focusing on spirometric criteria for airflow obstruction, this review of occupational COPD includes both population-wide and industry-specific exposures....

  17. Etiopathogenesis of neurogenic pulmonary edema

    Czech Academy of Sciences Publication Activity Database

    Šedý, Jiří

    2010-01-01

    Roč. 160, 5-6 (2010), s. 152-154 ISSN 0043-5341 Institutional research plan: CEZ:AV0Z50390512 Keywords : neurogenic pulmonary edema * intracranial pressure * sympathetic system Subject RIV: FH - Neurology

  18. Pulmonary embolism and nuclear medicine

    International Nuclear Information System (INIS)

    Peltier, P.; Planchon, B.; Faucal, P. de; Touze, M.D.; Dupas, B.

    1988-01-01

    Risks related to pulmonary embolism require use of diagnostic procedures with good sensitivity, and the potential complications of effective anticoagulant therapy require procedures with good specificity. Clinical signs are not more accurate for diagnosis of pulmonary than are ECG, blood gas and chest X ray examinations. Perfusion-ventilation scintigraphy has good diagnostic accuracy approaching that of pulmonary angiography which remains the gold standard. Since pulmonary embolism is usually a complication of deep venous thrombosis, distal clot detection should be associated with lung explorations. Plethysmography, ultrasonography, doppler studies and scintigraphy of the lower limbs could provide data supplementing those of contrast venography. The value and role of these examinations are analyzed and discussed in terms of different clinical situations [fr

  19. Liver Disease and Pulmonary Hypertension

    Science.gov (United States)

    Facebook Twitter Instagram YouTube About PHA Contact Join Careers Store My Account Donate Patients About PH Diagnosis Treatments Newly ... areas © 2017 Pulmonary Hypertension Association. All Rights Reserved. Facebook Twitter Instagram YouTube

  20. Pulmonary manifestations from systemic vasculitides

    International Nuclear Information System (INIS)

    Reuter, M.; Both, M.; Schnabel, A.

    2007-01-01

    Pulmonary vasculitides predominantly involve the small arterioles, capillaries and venules and include Wegener's granulomatosis, microscopic polyangiitis and the Churg-Strauss syndrome. Takayasu's arteriitis is a large vessel disease and may affect the main pulmonary arteries causing stenoses and occlusions. Knowledge of the natural course of disease and of clinical manifestations of pulmonary disease is helpful for an understanding of imaging findings. For this reason this article gives an overview not only of radiologic findings in chest X-ray and high resolution CT of the lungs but as well of clinical aspects of pulmonary vasculitides. Next to determination of disease extension the determination of disease activity is in the foreground of diagnostic imaging in vasculitides. Within this context principals of immunosuppressive therapy will be recognized. (orig.)

  1. CT of diffuse pulmonary diseases

    International Nuclear Information System (INIS)

    Itoh, Harumi; Murata, Kiyoshi; Todo, Giro

    1987-01-01

    While the theory of chest radiographic interpretation in diagnosing diffuse pulmonary diseases has not yet been established, X-ray computed tomography (CT), having intrinsic high contrast resolution and improved spatial resolution, has proved to offer important imformation concerning the location and invasion of diffuse pulmonary lesions. This study related to CT-pathologic correlation, focusing on perivascular interstitial space and secondary pulmonary lobule at macroscopic levels. The perivascular interstitial space was thickened as a result of the infiltration of cancer, granulomas, and inflammatory cells. This finding appeared as irregular contour of the blood vessel on CT. Centrilobular nodules were distributed at the tip of the bronchus or pulmonary artery on CT. The distance from the terminal and respiratory bronchioles to the lobular border was 2 to 3 mm. Lobular lesions were delineated as clear margin on CT. Contribution of these CT features to chest radiographic interpretation must await further studies. (Namekawa, K.)

  2. Nontuberculous pulmonary mycobacteriosis in Denmark

    DEFF Research Database (Denmark)

    Andréjak, Claire; Thomsen, Vibeke Ø; Johansen, Isik Somuncu

    2010-01-01

    RATIONALE: Few population-based data are available regarding nontuberculous mycobacteria (NTM) pulmonary disease epidemiology and prognosis. OBJECTIVES: To examine NTM pulmonary colonization incidence, disease incidence, and prognostic factors. METHODS: All adults in Denmark with at least one NTM......-positive pulmonary specimen during 1997 to 2008 were identified using national medical databases and were categorized as having possible or definite NTM disease or colonization. MEASUREMENTS AND MAIN RESULTS: We calculated annual age-standardized NTM incidence rates and adjusted hazard ratios (HR) of death...... associated with patient age, sex, comorbidity, NTM species, and NTM disease status. Of 1,282 adults with 2,666 NTM-positive pulmonary specimens, 335 (26%) had definite NTM disease, 238 (19%) possible disease, and 709 (55%) colonization only. NTM incidence rates decreased until 2002, followed by an increase...

  3. Total anomalous pulmonary venous return

    Science.gov (United States)

    ... pulmonary venous return, x-ray References Fraser CD, Kane LC. Congenital heart disease. In: Townsend CM Jr, ... 62. Review Date 10/17/2017 Updated by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, ...

  4. Nonviral pulmonary delivery of siRNA.

    Science.gov (United States)

    Merkel, Olivia M; Kissel, Thomas

    2012-07-17

    target site. In addition, the ideal carrier would be biodegradable (to address difficulties with repeated administration for the treatment of chronic diseases) and would contain targeting moieties to enhance uptake by specific cell types. None of the currently available polymer- and lipid-based formulations meet every one of these requirements, but we introduce here several promising new approaches, including a biodegradable, nonimmunogenic polyester. We also discuss imaging techniques for following the biodistribution according to the administration route. This tracking is crucial for better understanding the translocation and clearance of nanoformulated siRNA subsequent to pulmonary delivery. In the literature, the success of pulmonary siRNA delivery is evaluated solely by relief from or prophylaxis against a disease; side effects are not studied in detail. It also remains unclear which cell types in the lung eventually take up siRNA. These are critical issues for the translational use of pulmonary siRNA formulations; accordingly, we present a flow cytometry technique that can be utilized to differentiate transfected cell populations in a mouse model that expresses transgenic enhanced green fluorescence protein (EGFP). This technique, in which different cell types are identified on the basis of their surface antigen expression, may eventually help in the development of safer carriers with minimized side effects in nontargeted tissues.

  5. Rhabdomyosarcoma of the pulmonary artery

    International Nuclear Information System (INIS)

    Barth, J.; Lehmann, H.; Thermann, M.; Horny, H.P.; Stein, H.; Kiel Univ.; Kiel Univ.; Kiel Univ.

    1982-01-01

    A case of a 55-year-old man with the histological diagnosis rhabdomyosarcoma of the left pulmonary artery has been seen. Lung scanning and pulmonary arteriography are the clues for the diagnostical procedure. 55 cases from the literature are reviewed and clinical findings of the early and late stages of the diseases are discussed. Surgical treatment is the therapy of choice if ever possible; aggressive chemotherapy might be an acceptable alternative. (orig.) [de

  6. Minimalism and the Pragmatic Frame

    Directory of Open Access Journals (Sweden)

    Ana Falcato

    2016-02-01

    Full Text Available In the debate between literalism and contextualism in semantics, Kent Bach’s project is often taken to stand on the latter side of the divide. In this paper I argue this is a misleading assumption and justify it by contrasting Bach’s assessment of the theoretical eliminability of minimal propositions arguably expressed by well-formed sentences with standard minimalist views, and by further contrasting his account of the division of interpretative processes ascribable to the semantics and pragmatics of a language with a parallel analysis carried out by the most radical opponent to semantic minimalism, i.e., by occasionalism. If my analysis proves right, the sum of its conclusions amounts to a refusal of Bach’s main dichotomies.

  7. Liquid breathing - Prevention of pulmonary arterial-venous shunting during acceleration.

    Science.gov (United States)

    Sass, D. J.; Ritman, E. L.; Caskey, P. E.; Banchero, N.; Wood, E. H.

    1972-01-01

    Dependent pulmonary atelectasis, arterial-venous shunting, and downward displacement of the heart caused by the gravitational-inertial force environment were prevented in dogs breathing oxygenated liquid fluorocarbon in a whole-body water-immersion respirator. Partial closure of the major airways during part of the expiratory phase of liquid respiration was a significant problem initially but was minimized in subsequent studies.

  8. Principle of minimal work fluctuations.

    Science.gov (United States)

    Xiao, Gaoyang; Gong, Jiangbin

    2015-08-01

    Understanding and manipulating work fluctuations in microscale and nanoscale systems are of both fundamental and practical interest. For example, in considering the Jarzynski equality 〈e-βW〉=e-βΔF, a change in the fluctuations of e-βW may impact how rapidly the statistical average of e-βW converges towards the theoretical value e-βΔF, where W is the work, β is the inverse temperature, and ΔF is the free energy difference between two equilibrium states. Motivated by our previous study aiming at the suppression of work fluctuations, here we obtain a principle of minimal work fluctuations. In brief, adiabatic processes as treated in quantum and classical adiabatic theorems yield the minimal fluctuations in e-βW. In the quantum domain, if a system initially prepared at thermal equilibrium is subjected to a work protocol but isolated from a bath during the time evolution, then a quantum adiabatic process without energy level crossing (or an assisted adiabatic process reaching the same final states as in a conventional adiabatic process) yields the minimal fluctuations in e-βW, where W is the quantum work defined by two energy measurements at the beginning and at the end of the process. In the classical domain where the classical work protocol is realizable by an adiabatic process, then the classical adiabatic process also yields the minimal fluctuations in e-βW. Numerical experiments based on a Landau-Zener process confirm our theory in the quantum domain, and our theory in the classical domain explains our previous numerical findings regarding the suppression of classical work fluctuations [G. Y. Xiao and J. B. Gong, Phys. Rev. E 90, 052132 (2014)].

  9. Optimizing Processes to Minimize Risk

    Science.gov (United States)

    Loyd, David

    2017-01-01

    NASA, like the other hazardous industries, has suffered very catastrophic losses. Human error will likely never be completely eliminated as a factor in our failures. When you can't eliminate risk, focus on mitigating the worst consequences and recovering operations. Bolstering processes to emphasize the role of integration and problem solving is key to success. Building an effective Safety Culture bolsters skill-based performance that minimizes risk and encourages successful engagement.

  10. Minimal Length, Measurability and Gravity

    Directory of Open Access Journals (Sweden)

    Alexander Shalyt-Margolin

    2016-03-01

    Full Text Available The present work is a continuation of the previous papers written by the author on the subject. In terms of the measurability (or measurable quantities notion introduced in a minimal length theory, first the consideration is given to a quantum theory in the momentum representation. The same terms are used to consider the Markov gravity model that here illustrates the general approach to studies of gravity in terms of measurable quantities.

  11. [Minimally invasive coronary artery surgery].

    Science.gov (United States)

    Zalaquett, R; Howard, M; Irarrázaval, M J; Morán, S; Maturana, G; Becker, P; Medel, J; Sacco, C; Lema, G; Canessa, R; Cruz, F

    1999-01-01

    There is a growing interest to perform a left internal mammary artery (LIMA) graft to the left anterior descending coronary artery (LAD) on a beating heart through a minimally invasive access to the chest cavity. To report the experience with minimally invasive coronary artery surgery. Analysis of 11 patients aged 48 to 79 years old with single vessel disease that, between 1996 and 1997, had a LIMA graft to the LAD performed through a minimally invasive left anterior mediastinotomy, without cardiopulmonary bypass. A 6 to 10 cm left parasternal incision was done. The LIMA to the LAD anastomosis was done after pharmacological heart rate and blood pressure control and a period of ischemic pre conditioning. Graft patency was confirmed intraoperatively by standard Doppler techniques. Patients were followed for a mean of 11.6 months (7-15 months). All patients were extubated in the operating room and transferred out of the intensive care unit on the next morning. Seven patients were discharged on the third postoperative day. Duplex scanning confirmed graft patency in all patients before discharge; in two patients, it was confirmed additionally by arteriography. There was no hospital mortality, no perioperative myocardial infarction and no bleeding problems. After follow up, ten patients were free of angina, in functional class I and pleased with the surgical and cosmetic results. One patient developed atypical angina on the seventh postoperative month and a selective arteriography confirmed stenosis of the anastomosis. A successful angioplasty of the original LAD lesion was carried out. A minimally invasive left anterior mediastinotomy is a good surgical access to perform a successful LIMA to LAD graft without cardiopulmonary bypass, allowing a shorter hospital stay and earlier postoperative recovery. However, a larger experience and a longer follow up is required to define its role in the treatment of coronary artery disease.

  12. Minimal massive 3D gravity

    International Nuclear Information System (INIS)

    Bergshoeff, Eric; Merbis, Wout; Hohm, Olaf; Routh, Alasdair J; Townsend, Paul K

    2014-01-01

    We present an alternative to topologically massive gravity (TMG) with the same ‘minimal’ bulk properties; i.e. a single local degree of freedom that is realized as a massive graviton in linearization about an anti-de Sitter (AdS) vacuum. However, in contrast to TMG, the new ‘minimal massive gravity’ has both a positive energy graviton and positive central charges for the asymptotic AdS-boundary conformal algebra. (paper)

  13. Construction schedules slack time minimizing

    Science.gov (United States)

    Krzemiński, Michał

    2017-07-01

    The article presents two copyright models for minimizing downtime working brigades. Models have been developed for construction schedules performed using the method of work uniform. Application of flow shop models is possible and useful for the implementation of large objects, which can be divided into plots. The article also presents a condition describing gives which model should be used, as well as a brief example of optimization schedule. The optimization results confirm the legitimacy of the work on the newly-developed models.

  14. Acquiring minimally invasive surgical skills

    OpenAIRE

    Hiemstra, Ellen

    2012-01-01

    Many topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and evaluation of minimally invasive surgical skills in a training setting and in practice in the operating room. This thesis has led to an enlarged insight in the organization of surgical skills training during residency training of surgical medical specialists.

  15. Treatment of pediatric pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Amy Hawkins

    2009-06-01

    Full Text Available Amy Hawkins, Robert TullohDepartment of Congenital Heart Disease, Bristol Royal Hospital for Children, Bristol UKAbstract: Pulmonary hypertension was once thought to be a rare condition and only managed in specialized centers. Now however, with the advent of echocardiography, it is found in many clinical scenarios, in the neonate with chronic lung disease, in the acute setting in the intensive care unit, in connective tissue disease and in cardiology pre- and postoperatively. We have a better understanding of the pathological process and have a range of medication which is starting to be able to palliate this previously fatal condition. This review describes the areas that are known in this condition and those that are less familiar. The basic physiology behind pulmonary hypertension and pulmonary vascular disease is explained. The histopathologic process and the various diagnostic tools are described and are followed by the current and future therapy at our disposal.Keywords: pulmonary hypertension, congenital heart disease, pulmonary vascular resistance, pulmonary vasodilators

  16. Lung imaging in pulmonary disease

    International Nuclear Information System (INIS)

    Taplin, G.V.; Chopra, S.K.

    1976-01-01

    Although it has been recognized for several years that chronic obstructive pulmonary disease (COPD) can cause lung perfusion defects which may simulate pulmonary embolism, relatively little use has been made of either the radioxenon or the radioaerosol inhalation lung imaging procedures until the last few years as a means of distinguishing pulmonary embolism (P.E.) from COPD is reported. Recent experience is reported with the use of both of these procedures in comparison with pulmonary function tests for the early detection of COPD in population studies and also in P.E. suspects. Equal emphasis is given to simultaneous aerosol ventilation-perfusion (V/P) imaging in the differential diagnosis of P.E. Finally, this paper is concerned with new developments in regional lung diffusion imaging following the inhalation of radioactive gases and rapidly absorbed radioaerosols. Their experimental basis is presented and their potential clinical applications in pulmonary embolism are discussed. As a result of these investigations, a functional (V/P) diagnosis of pulmonary embolism in patients may be possible in the near future with a sequential radioaerosol inhalation procedure alone

  17. Pulmonary agenesis: two cases reported

    Directory of Open Access Journals (Sweden)

    Denis Yaraví Solano-Vázquez

    2014-11-01

    Full Text Available Background: Pulmonary agenesis is a rare anomaly (1 in 15 000 live births which consists in a total absence or severe hypoplasia of one or both lungs. The clinical spectrum of the unilateral agenesis could vary from early and severe respiratory distress, recurrent pneumonia to being an incidental finding. The prognosis is based on the presence of associated congenital abnormalities. Material and methods: We present two cases of unilateral pulmonary agenesis in patients at Tlaxcala’s Children Hospital during 2012. Results: Report details the case of a one-month old boy with left pulmonary agenesis and interatrial communication and mild pulmonary arterial hypertension. He had two resolved pneumonia incidents. The other case was a one-month old girl with right pulmonary agenesis, associated to multiple heart malformations who evolved to respiratory failure, heart failure and death.Conclusions: Pulmonary agenesis is a rare anomaly. Its outcome and prognosis varies with the hemodynamics related to its location and associated malformations.

  18. Balloon pulmonary angioplasty: a treatment option for inoperable patients with chronic thromboembolic pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Aiko eOgawa

    2015-02-01

    Full Text Available In chronic thromboembolic pulmonary hypertension, stenoses or obstructions of the pulmonary arteries due to organized thrombi can cause an elevation in pulmonary artery resistance, which in turn can result in pulmonary hypertension. Chronic thromboembolic pulmonary hypertension can be cured surgically by pulmonary endarterectomy; however, patients deemed unsuitable for pulmonary endarterectomy due to lesion, advanced age, or comorbidities have a poor prognosis and limited treatment options. Recently, advances have been made in balloon pulmonary angioplasty for these patients, and this review highlights this recent progress.

  19. [Invasive pulmonary aspergillosis].

    Science.gov (United States)

    Blanchard, E; Gabriel, F; Jeanne-Leroyer, C; Servant, V; Dumas, P-Y

    2018-02-01

    Invasive pulmonary aspergillosis (IPA) is an important cause of morbidity and mortality in a wide range of patients. Early recognition and diagnosis have become a major focus in improving the management and outcomes of this life-threatening disease. IPA typically occurs during a period of severe and prolonged neutropenia. However, solid organ transplant recipients, patients under immunosuppressive therapy or hospitalized in intensive care units are also at risk. The diagnosis is suspected in the presence of a combination of clinical, biological and CT scan evidence. The microbiological diagnostic strategy should be adapted to the patient's profile. Conventional methods with culture and species identification remain the standard but early diagnosis has been improved by the use of biomarkers such as galactomannan antigen in serum or in bronchoalveolar lavage. The epidemiology of IPA should change with the increased use of antifungal prophylactic regimens and the arrival of targeted therapies. Other microbiological tools, such as PCR and other biomarkers, are currently being assessed. IPA must be considered in a wide range of patients. Its prognosis remains poor despite progress in the microbiological diagnosis and therapeutic management. Copyright © 2018 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  20. Preliminary observations on the effect of hypoxic and hyperbaric stress on pulmonary gas exchange in breath-hold divers.

    Science.gov (United States)

    Garbella, Erika; Piarulli, Andrea; Fornai, Edo; Pingitore, Alessandro; Prediletto, Renato

    2011-06-01

    To evaluate pulmonary alveolar-capillary membrane integrity and ventilation/perfusion mismatch after breath-hold diving. Pulmonary diffusing capacity to carbon monoxide (DLCO) and nitric oxide (DLNO), haemoglobin (Hb) and haematocrit (Hct) were measured in six elite divers before and at 2, 10 and 25 minutes after a maximal breath-hold dive to a depth of 10 metres' sea water. Compared to pre-dive, DLCO showed a slight increase at 2 minutes in five subjects and a tendency to decrease at 25 minutes (P < 0.001) in all subjects. DLNO showed an increase at 10 minutes in three divers and a slight decrease at 25 minutes in five subjects. There was a small but significant (P < 0.001) increase in Hb and Hct at 2 minutes, possibly affecting the DLCO measurements. An early but transient increase in DLCO in five divers may reflect the central shift in blood volume during a breath-hold dive. The late parallel decrease in DLCO and DLNO likely reflects alveolar-capillary distress (interstitial oedema). The DLNO increase in three subjects at 10 minutes may suggest ventilation/perfusion mismatch.

  1. Measurement of regional pulmonary blood volume in patients with increased pulmonary blood flow or pulmonary arterial hypertension

    International Nuclear Information System (INIS)

    Wollmer, P.; Rozcovek, A.; Rhodes, C.G.; Allan, R.M.; Maseri, A.

    1984-01-01

    The effects of chronic increase in pulmonary blood flow and chronic pulmonary hypertension on regional pulmonary blood volume was measured in two groups of patients. One group of patients had intracardiac, left-to-right shunts without appreciable pulmonary hypertension, and the other consisted of patients with Eisenmenger's syndrome or primary pulmonary hypertension, i.e. patients with normal or reduced blood flow and severe pulmonary hypertension. A technique based on positron tomography was used to measure lung density (by transmission scanning) and regional pulmonary blood volume (after inhalation of /sup 11/CO). The distribution of pulmonary blood volume was more uniform in patients with chronic increase in pulmonary blood flow than in normal subjects. There were also indications of an absolute increase in intrapulmonary blood volume by about 15%. In patients with chronic pulmonary arterial hypertension, the distribution of pulmonary blood volume was also abnormally uniform. There was, however, no indication that overall intrapulmonary blood volume was substantially different from normal subjects. The abnormally uniform distribution of pulmonary blood volume can be explained by recruitment and/or dilatation of vascular beds. Intrapulmonary blood volume appears to be increased in patients with intracardiac, left-to-right shunts. With the development of pulmonary hypertension, intrapulmonary blood volume falls, which may be explained by reactive changes in the vasculature and/or obliteration of capillaries

  2. Minimal families of curves on surfaces

    KAUST Repository

    Lubbes, Niels

    2014-01-01

    A minimal family of curves on an embedded surface is defined as a 1-dimensional family of rational curves of minimal degree, which cover the surface. We classify such minimal families using constructive methods. This allows us to compute the minimal

  3. Pulmonary arterial hypertension secondary to chronic thromboemboli

    International Nuclear Information System (INIS)

    Crysikopoulos, H.; Forrest, J.V.; Olson, L.K.; Roberts, A.C.

    1989-01-01

    The authors report their experience in 150 patients with pulmonary arterial hypertension secondary to chronic pulmonary embolism (CPE). Plain film findings are variable, commonly nonspecific. Occasionally nonuniformity of pulmonary perfusion or truncation of central pulmonary arteries suggest CPE. Multiple, large, unmatched perfusion defects are the most common scintigraphic observations. CT can exclude conditions mimicking CPE, particularly fibrosing mediastinitis. Pulmonary arteriography depicts the location and distribution of emboli. CPE is becoming an increasingly important entity to recognize because of available surgical treatment. Thromboendarterectomy may improve functional status and survival. The diagnosis should be considered in any patient with pulmonary arterial hypertension

  4. Evaluation of Pulmonary Hypertension with CMR: Pulmonary Hypertension 
Patients and Healthy Volunteers Control Study

    Directory of Open Access Journals (Sweden)

    Meng WANG

    2016-05-01

    Full Text Available Background and objective The clinical course of pulmonary hypertension (PH is one of progressive deterioration interspersed with episodes of acute decompensation. It is difficult to predict when patients will die because death may come either suddenly or slowly due to progressive heart failure. The aim of this study is to investigate morphology, function and hemodynamics in PH, compared with healthy people, and to investigate the clinical value of detection of PH by use of cardiac magnetic resonance (CMR parameters. Methods CMR was performed in 56 PH patients collected from Tianjin Medical University General Hospital from January 2012 to December 2014 and 22 healthy controls. The following parameters were calculated: right ventricle (RV end-diastolic volume (EDV, end-systolic volume (ESV, ejection fraction (EF, myocardial mass (MM, RV fractional area change (RVFAC, interventricular septal curvature (CIVS, left ventricular free wall curvature (CFW, and CIVS/CFW, main pulmonary artery (MPA positive peak velocity, maximal area, minimal area and distensibility. Comparisons of CMR measurements between PH patients and controls were analyzed by using the student t-tests. Receiver operating characteristic (ROC curve analysis was used to compare the PH diagnostic abilities for four parameters (MPA positive peak velocity, distensibility, curvature ratio, and RVFAC and combined CMR parameter. P<0.05 was considered significant. Results Compared with healthy controls, RV morphology, function and hemodynamics of PH group declined and deteriorate obviously. The ROC curve analysis showed that among the four parameters distensibility of MPA had the highest AUC value (AUC=0.95. Additionally, combined CMR parameter (positive peak velocity+distensibility+curvature ratio+RVFAC had even higher AUC (AUC=0.988. Conclusion Comprehensive CMR parameters is conducive to accurately reflect the overall state RV-pulmonary circulation in patients with PH.

  5. Pregnancy Complicated with Maternal Pulmonary Hypertension and Placenta Accreta

    Directory of Open Access Journals (Sweden)

    Jeng-Hsiu Hung

    2007-06-01

    Full Text Available Pregnancy is contraindicated in cases of maternal pulmonary hypertension, a highly morbid disease affecting young women of childbearing age. The rate of heart failure increases gradually with the severity of pulmonary hypertension. In certain instances, the severity of maternal pulmonary hypertension in rheumatic heart diseases can be higher than in congenital heart diseases. Placenta accreta is an important cause of bleeding in the second half of pregnancy and in labor. In severe cases, hysterectomy is the only way to manage the bleeding during cesarean section. A 33-year-old gravida, G2P0AA1, suffering from rheumatic heart disease with mitral valve stenosis and pulmonary hypertension, was referred to our high-risk pregnancy center at 10+3 weeks of gestation due to lower abdominal pain and brownish vaginal bleeding. She had received 2 mitral valve replacements in Shenzhen, China, at the ages of 22 and 26, respectively. Ultrasound scan of the abdomen at 12+2 gestational weeks showed that the internal cervix was completely covered with the placenta, and a retroplacental hypoechoic space measuring 35 × 13 mm was observed at the upper posterior margin of the placenta. On color Doppler scan, an area of lacunar lake flow was observed in the hypoechoic space of the placenta and a spiral artery with low blood flow resistance was detected. The pulsation of the placental flow was synchronized with the maternal pulse rate. Team specialists, including neonatologists, pulmonary physicians, pediatric cardiologists, hema-tologists, anesthesiologists, psychiatrists and social workers, as well as high-risk obstetricians were consulted in an effort to minimize fetal and maternal morbidity and mortality. At 29+2 weeks, the patient developed preeclampsia and delivered a healthy newborn by cesarean section, the uterus being preserved by square compression sutures. The gravida tolerated the procedures and was discharged in stable condition.

  6. Minimal families of curves on surfaces

    KAUST Repository

    Lubbes, Niels

    2014-11-01

    A minimal family of curves on an embedded surface is defined as a 1-dimensional family of rational curves of minimal degree, which cover the surface. We classify such minimal families using constructive methods. This allows us to compute the minimal families of a given surface.The classification of minimal families of curves can be reduced to the classification of minimal families which cover weak Del Pezzo surfaces. We classify the minimal families of weak Del Pezzo surfaces and present a table with the number of minimal families of each weak Del Pezzo surface up to Weyl equivalence.As an application of this classification we generalize some results of Schicho. We classify algebraic surfaces that carry a family of conics. We determine the minimal lexicographic degree for the parametrization of a surface that carries at least 2 minimal families. © 2014 Elsevier B.V.

  7. Pulmonary arteriography by digital subtraction angiographic method in cyanotic heart disease with pulmonary stenosis or pulmonary atresia

    International Nuclear Information System (INIS)

    Kobayashi, Junjiro; Hirose, Hajime; Nakano, Susumu

    1985-01-01

    Pulmonary arteriography was performed by digital subtraction angiographic (DSA) method in 10 patients with cyanotic heart disease associated with pulmonary stenosis or pulmonary atresia. Ten patients consisted of five patients with tetralogy of Fallot, three with single ventricle and pulmonary stenosis, and two with pseudotruncus arteriosus. Hepato-clavicular position was taken in four patients. Pulmonary artery and its main branches were opacified and recognized clearly, and their diameter could be measured accurately with a small amount of contrast medium. There was a good correlation between the diameter of pulmonary artery measured by DSA and that measured by conventional pulmonary arteriography. DSA is a useful method for evaluating the size and the stenosis of pulmonary artery especially in small cyanotic infants. (author)

  8. LLNL Waste Minimization Program Plan

    International Nuclear Information System (INIS)

    1990-05-01

    This document is the February 14, 1990 version of the LLNL Waste Minimization Program Plan (WMPP). Now legislation at the federal level is being introduced. Passage will result in new EPA regulations and also DOE orders. At the state level the Hazardous Waste Reduction and Management Review Act of 1989 was signed by the Governor. DHS is currently promulgating regulations to implement the new law. EPA has issued a proposed new policy statement on source reduction and recycling. This policy reflects a preventative strategy to reduce or eliminate the generation of environmentally-harmful pollutants which may be released to the air, land surface, water, or ground water. In accordance with this policy new guidance to hazardous waste generators on the elements of a Waste Minimization Program was issued. This WMPP is formatted to meet the current DOE guidance outlines. The current WMPP will be revised to reflect all of these proposed changes when guidelines are established. Updates, changes and revisions to the overall LLNL WMPP will be made as appropriate to reflect ever-changing regulatory requirements

  9. Symmetry breaking for drag minimization

    Science.gov (United States)

    Roper, Marcus; Squires, Todd M.; Brenner, Michael P.

    2005-11-01

    For locomotion at high Reynolds numbers drag minimization favors fore-aft asymmetric slender shapes with blunt noses and sharp trailing edges. On the other hand, in an inertialess fluid the drag experienced by a body is independent of whether it travels forward or backward through the fluid, so there is no advantage to having a single preferred swimming direction. In fact numerically determined minimum drag shapes are known to exhibit almost no fore-aft asymmetry even at moderate Re. We show that asymmetry persists, albeit extremely weakly, down to vanishingly small Re, scaling asymptotically as Re^3. The need to minimize drag to maximize speed for a given propulsive capacity gives one possible mechanism for the increasing asymmetry in the body plans seen in nature, as organisms increase in size and swimming speed from bacteria like E-Coli up to pursuit predator fish such as tuna. If it is the dominant mechanism, then this signature scaling will be observed in the shapes of motile micro-organisms.

  10. Differential pulmonary and cardiac effects of pulmonary exposure to a panel of particulate matter-associated metals

    International Nuclear Information System (INIS)

    Wallenborn, J. Grace; Schladweiler, Mette J.; Richards, Judy H.; Kodavanti, Urmila P.

    2009-01-01

    Biological mechanisms underlying the association between particulate matter (PM) exposure and increased cardiovascular health effects are under investigation. Water-soluble metals reaching systemic circulation following pulmonary exposure are likely exerting a direct effect. However, it is unclear whether specific PM-associated metals may be driving this. We hypothesized that exposure to equimolar amounts of five individual PM-associated metals would cause differential pulmonary and cardiac effects. We exposed male WKY rats (14 weeks old) via a single intratracheal instillation (IT) to saline or 1 μmol/kg body weight of zinc, nickel, vanadium, copper, or iron in sulfate form. Responses were analyzed 4, 24, 48, or 96 h after exposure. Pulmonary effects were assessed by bronchoalveolar lavage fluid levels of total cells, macrophages, neutrophils, protein, albumin, and activities of lactate dehydrogenase, γ-glutamyl transferase, and n-acetyl glucosaminidase. Copper induced earlier pulmonary injury/inflammation, while zinc and nickel produced later effects. Vanadium or iron exposure induced minimal pulmonary injury/inflammation. Zinc, nickel, or copper increased serum cholesterol, red blood cells, and white blood cells at different time points. IT of nickel and copper increased expression of metallothionein-1 (MT-1) in the lung. Zinc, nickel, vanadium, and iron increased hepatic MT-1 expression. No significant changes in zinc transporter-1 (ZnT-1) expression were noted in the lung or liver; however, zinc increased cardiac ZnT-1 at 24 h, indicating a possible zinc-specific cardiac effect. Nickel exposure induced an increase in cardiac ferritin 96 h after IT. This data set demonstrating metal-specific cardiotoxicity is important in linking metal-enriched anthropogenic PM sources with adverse health effects.

  11. Negative-Pressure Pulmonary Edema.

    Science.gov (United States)

    Bhattacharya, Mallar; Kallet, Richard H; Ware, Lorraine B; Matthay, Michael A

    2016-10-01

    Negative-pressure pulmonary edema (NPPE) or postobstructive pulmonary edema is a well-described cause of acute respiratory failure that occurs after intense inspiratory effort against an obstructed airway, usually from upper airway infection, tumor, or laryngospasm. Patients with NPPE generate very negative airway pressures, which augment transvascular fluid filtration and precipitate interstitial and alveolar edema. Pulmonary edema fluid collected from most patients with NPPE has a low protein concentration, suggesting hydrostatic forces as the primary mechanism for the pathogenesis of NPPE. Supportive care should be directed at relieving the upper airway obstruction by endotracheal intubation or cricothyroidotomy, institution of lung-protective positive-pressure ventilation, and diuresis unless the patient is in shock. Resolution of the pulmonary edema is usually rapid, in part because alveolar fluid clearance mechanisms are intact. In this review, we discuss the clinical presentation, pathophysiology, and management of negative-pressure or postobstructive pulmonary edema. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  12. Aerobic exercise in pulmonary rehabilitation

    Directory of Open Access Journals (Sweden)

    Thiago Brasileiro de Vasconcelos

    2013-01-01

    Full Text Available The aim of this study was to conduct a literature review on the usefulness of aerobic exercise in pulmonary rehabilitation. This is an exploratory study of literature through the electronic databases Medline, Lilacs, Scielo, Pubmed and Google Scholar, published between 1996 and 2012, conducted during the period February to May 2012 with the following keywords: COPD, pulmonary rehabilitation, aerobic exercises, physical training, quality of life. The change in pulmonary function and dysfunction of skeletal muscles that result in exercise intolerance and reduced fitness and may cause social isolation, depression, anxiety and addiction. The training exercise is the most important component of the program of pulmonary rehabilitation where the aerobic training provides consistent results in clinical improvement in levels of exercise tolerance and decreased dyspnea generating more benefits to the body, reducing the chance of cardiovascular disease and improves quality and expectation of life. We demonstrated that the use of aerobic exercise in pulmonary rehabilitation program, allows an improvement of motor skills, decreased muscle fatigue and deconditioning, reducing sedentary lifestyle; however, has little or no effect on the reduction of strength and atrophy muscle.

  13. AEROBIC EXERCISE IN PULMONARY REHABILITATION

    Directory of Open Access Journals (Sweden)

    Thiago Brasileiro de Vasconcelos

    2013-05-01

    Full Text Available The aim of this study was to conduct a literature review on the usefulness of aerobic exercise in pulmonary rehabilitation. This is an exploratory study of literature through the electronic databases Medline, Lilacs, Scielo, Pubmed and Google Scholar, published between 1996 and 2012, conducted during the period February to May 2012 with the following keywords: COPD, pulmonary rehabilitation, aerobic exercises, physical training, quality of life. The change in pulmonary function and dysfunction of skeletal muscles that result in exercise intolerance and reduced fitness and may cause social isolation, depression, anxiety and addiction. The training exercise is the most important component of the program of pulmonary rehabilitation where the aerobic training provides consistent results in clinical improvement in levels of exercise tolerance and decreased dyspnea generating more benefits to the body, reducing the chance of cardiovascular disease and improves quality and expectation of life. We demonstrated that the use of aerobic exercise in pulmonary rehabilitation program, allows an improvement of motor skills, decreased muscle fatigue and deconditioning, reducing sedentary lifestyle; however, has little or no effect on the reduction of strength and atrophy muscle.

  14. DNA Damage and Pulmonary Hypertension

    Science.gov (United States)

    Ranchoux, Benoît; Meloche, Jolyane; Paulin, Roxane; Boucherat, Olivier; Provencher, Steeve; Bonnet, Sébastien

    2016-01-01

    Pulmonary hypertension (PH) is defined by a mean pulmonary arterial pressure over 25 mmHg at rest and is diagnosed by right heart catheterization. Among the different groups of PH, pulmonary arterial hypertension (PAH) is characterized by a progressive obstruction of distal pulmonary arteries, related to endothelial cell dysfunction and vascular cell proliferation, which leads to an increased pulmonary vascular resistance, right ventricular hypertrophy, and right heart failure. Although the primary trigger of PAH remains unknown, oxidative stress and inflammation have been shown to play a key role in the development and progression of vascular remodeling. These factors are known to increase DNA damage that might favor the emergence of the proliferative and apoptosis-resistant phenotype observed in PAH vascular cells. High levels of DNA damage were reported to occur in PAH lungs and remodeled arteries as well as in animal models of PH. Moreover, recent studies have demonstrated that impaired DNA-response mechanisms may lead to an increased mutagen sensitivity in PAH patients. Finally, PAH was linked with decreased breast cancer 1 protein (BRCA1) and DNA topoisomerase 2-binding protein 1 (TopBP1) expression, both involved in maintaining genome integrity. This review aims to provide an overview of recent evidence of DNA damage and DNA repair deficiency and their implication in PAH pathogenesis. PMID:27338373

  15. Laparoscopic colonic resection in inflammatory bowel disease: minimal surgery, minimal access and minimal hospital stay.

    LENUS (Irish Health Repository)

    Boyle, E

    2008-11-01

    Laparoscopic surgery for inflammatory bowel disease (IBD) is technically demanding but can offer improved short-term outcomes. The introduction of minimally invasive surgery (MIS) as the default operative approach for IBD, however, may have inherent learning curve-associated disadvantages. We hypothesise that the establishment of MIS as the standard operative approach does not increase patient morbidity as assessed in the initial period of its introduction into a specialised unit, and that it confers earlier postoperative gastrointestinal recovery and reduced hospitalisation compared with conventional open resection.

  16. Study of pulmonary dysfunctions in liver cirrhosis

    Directory of Open Access Journals (Sweden)

    Amr M. Helmy

    2014-10-01

    Conclusion: Liver cirrhosis is associated with unique pulmonary complications. The early identification of pulmonary dysfunctions in cirrhotic patients is crucial as it affects the prognosis and guides the future management by speeding up orthotopic liver transplantation (OLT recommendations.

  17. Lymphangioleiomyomatosis and tuberous sclerosis with pulmonary involvement

    International Nuclear Information System (INIS)

    Pedrosa, I.; Saiz, A.; Bustos, A.; Hernando, F.

    2000-01-01

    We present two cases of pulmonary lumphangioleiomyomatosis and one case of tuberous sclerosis with pulmonary involvement describing the most characteristic features according to plain chest X-ray and high-resolution computed tomography (HRCT). (Author) 14 refs

  18. Effects of posture on postoperative pulmonary function

    DEFF Research Database (Denmark)

    Nielsen, K G; Holte, Kathrine; Kehlet, H

    2003-01-01

    effect on postoperative pulmonary function in the sitting or standing position compared with the supine. Thus, avoidance of the supine position may improve postoperative pulmonary function. Three of six studies showed a positive effect on postoperative pulmonary function of the lateral side compared......BACKGROUND: Pulmonary morbidity is still a relevant complication to major surgery despite improvements in surgical technique and anaesthetic methods. Postoperative posture may be a pathogenic factor, but the effects of changes in postoperative posture on pulmonary function have not been reviewed...... with the supine. Thus, the lateral position has limited effects on pulmonary function. CONCLUSION: Changes of postoperative position from supine to sitting or standing are of major importance in the interpretation of postoperative pulmonary outcome studies and in future strategies to improve pulmonary outcome....

  19. PULMONARY HEMORRHAGE. ENDOSCOPIC DIAGNOSIS AND TREATMENT

    Directory of Open Access Journals (Sweden)

    A. M. Gasanov

    2016-01-01

    Full Text Available In the article, we report the incidence and etiology of pulmonary hemorrhage, and modern classifications according to the literature data. Methods of endoscopic diagnosis and treatment of pulmonary hemorrhage are analyzed.

  20. Sickle Cell Disease and Pulmonary Hypertension

    Science.gov (United States)

    ... My doctor wants to screen me for pulmonary hypertension. Why is this? Sickle cell disease (SCD), a ... What are some of the symptoms of pulmonary hypertension? Because they are somewhat general symptoms, the characteristics ...

  1. Hereditary Hemorrhagic Telangiectasia (HHT) and Pulmonary Hypertension

    Science.gov (United States)

    ... has said these might be symptoms of pulmonary hypertension. How does this relate to my HHT? About ... differences are significant. In HHT-associated pulmonary arterial hypertension, abnormal blood flow through the blood vessels in ...

  2. Lung Transplantation in Patients with Pulmonary Hypertension

    Science.gov (United States)

    ... 00:00 Lung Transplantation in Patients with Pulmonary Hypertension Consensus Statements Issued by the Scientific Leadership Council ... a treatment option for selected patients with pulmonary hypertension (PH) when medical therapy is no longer effective. ...

  3. Congenital diaphragmatic hernia-associated pulmonary hypertension.

    Science.gov (United States)

    Harting, Matthew T

    2017-06-01

    Congenital diaphragmatic hernia (CDH) is a complex entity wherein a diaphragmatic defect allows intrathoracic herniation of intra-abdominal contents and both pulmonary parenchymal and vascular development are stifled. Pulmonary pathology and pathophysiology, including pulmonary hypoplasia and pulmonary hypertension, are hallmarks of CDH and are associated with disease severity. Pulmonary hypertension (PH) is sustained, supranormal pulmonary arterial pressure, and among patients with CDH (CDH-PH), is driven by hypoplastic pulmonary vasculature, including alterations at the molecular, cellular, and tissue levels, along with pathophysiologic pulmonary vasoreactivity. This review addresses the basic mechanisms, altered anatomy, definition, diagnosis, and management of CDH-PH. Further, emerging therapies targeting CDH-PH and PH are explored. Published by Elsevier Inc.

  4. Epidemiology of idiopathic pulmonary fibrosis

    Directory of Open Access Journals (Sweden)

    Ley B

    2013-11-01

    Full Text Available Brett Ley, Harold R Collard Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, California, USA Abstract: Idiopathic pulmonary fibrosis is a chronic fibrotic lung disease of unknown cause that occurs in adults and has a poor prognosis. Its epidemiology has been difficult to study because of its rarity and evolution in diagnostic and coding practices. Though uncommon, it is likely underappreciated both in terms of its occurrence (ie, incidence, prevalence and public health impact (ie, health care costs and resource utilization. Incidence and mortality appear to be on the rise, and prevalence is expected to increase with the aging population. Potential risk factors include occupational and environmental exposures, tobacco smoking, gastroesophageal reflux, and genetic factors. An accurate understanding of its epidemiology is important, especially as novel therapies are emerging. Keywords: idiopathic pulmonary fibrosis, epidemiology, incidence, prevalence, mortality, risk factors

  5. Pulmonary involvement of secondary syphilis.

    Science.gov (United States)

    Ogawa, Yoshihiko; Imai, Yuichiro; Yoshihara, Shingo; Fujikura, Hiroyuki; Hirai, Nobuyasu; Sato, Masatoshi; Ogawa, Taku; Uno, Kenji; Kasahara, Kei; Yano, Hisakazu; Mikasa, Keiichi

    2018-01-01

    Pulmonary involvement in secondary syphilis is considered a rare occurrence; however, the number of cases has increased in the 2000s. This is likely due to the increased use of computed tomography scans and molecular diagnostic testing. We report a case of an HIV-positive man with pleural chest pain and bilateral subpleural nodules on chest computed tomography. His rapid plasma reagin and Treponema pallidum hemagglutination tests were positive, and the specimen of one of the pulmonary nodules obtained by transthoracic biopsy was positive for the polA gene of Treponema pallidum. Since clinical manifestations of syphilis are highly variable, clinicians should bear in mind that pleural chest pain with bilateral subpleural nodules can be caused by pulmonary syphilis.

  6. Pulmonary angiography with lopamidol 370

    International Nuclear Information System (INIS)

    Braun, S.D.; Saeed, M.; Perlmutt, L.M.; Newman, G.E.; Illescas, F.F.; Cohan, R.H.; Dunnick, N.R.

    1986-01-01

    Fifty-one consecutive patients who underwent pulmonary angiography with iopamidol, 370 mg/ml, were studied prospectively. Patients were asked to grade any heat or pain felt on injection, and were observed for coughing. Right atrial and pulmonary artery pressures were obtained before the first and after the final contrast agent injection. Pressure changes were compared with those in a consecutive group of 25 patients who underwent examinations performed with Na-meglumine diatrizoate, 370 mg/ml. Film quality was evaluated for patient motion. Iopamidol generated marked discomfort in only three patients. Pressure changes were largely unremarkable. In no case was there any significant motion artifact secondary to coughing. Iopamidol is a safe, well-tolerated contrast agent for pulmonary angiography. It improves image quality by nearly eliminating coughing

  7. [Pulmonary infections in patients with rheumatoid arthritis].

    Science.gov (United States)

    Takayanagi, Noboru; Tsuchiya, Yutaka; Tokunaga, Daidou; Miyahara, Yousuke; Yamaguchi, Shouzaburo; Saito, Hiroo; Ubukata, Mikio; Kurashima, Kazuyoshi; Yanagisawa, Tsutomu; Sugita, Yutaka

    2007-06-01

    We studied 149 rheumatoid arthritis (RA) patients (mean age 68.0 years; 68 men, 81 women) with pulmonary infections. The mean age at the onset of RA and the duration of RA was 57.2 +/- 15.2 years and 10.9 +/- 11.5 years, respectively. Pulmonary infections included nontuberculous mycobacteriosis in 59 patients (Mycobacterium avium complex infection, 50 cases : Mycobacterium kansasii infection, 4 cases; others, 5 cases), pneumonia in 46 patients, pulmonary tuberculosis in 28 patients, pulmonary aspergillosis in 12 patients, pulmonary cryptococcosis in 5 patients, Pneumocystis jiroveci pneumonia in 5 patients, lung abscess in 9 patients, exacerbation of bronchiectasis in 7 patients, and empyema in 4 patients. One hundred percent of patients with exacerbation of bronchiectasis, 91.7% of patients with pulmonary aspergillosis, 87% of patients with pneumonia, and 81.4% of patients with nontuberculous mycobacteriosis had underlying lung diseases. The pulmonary infections during therapy with steroids were pulmonary tuberculosis (78.6%), pneumonia (65.2%), and pulmonary aspergillosis (58.3%), while the pulmonary infections during methotrexate treatment were Pneumocystis jiroveci pneumonia (80%), pulmonary cryptococcosis (40%), and pulmonary tuberculosis (28.6%). Pulmonary infections in RA patients who were taking TNFalpha inhibitors included 1 patient each with nontuberculous mycobacteriosis, pneumonia, pulmonary tuberculosis, and Pneumocystis jiroveci pneumonia. Among the RA patients with lung abscess, malignancy was noted in 55.6%, and diabetes mellitus in 22.2%. Pseudomonas aeruginosa was the second-most-common cause of pneumonia and cause of all exacerbations of bronchiectasis. As well as immunosuppressive medications (steroids, methotrexate, TNFalpha inhibitors) and systemic comorbid diseases, underlying lung diseases could be one of the risk factor for pulmonary infections in patients with RA. The dominant risk factor for each pulmonary infection in patients with RA

  8. Minimally invasive aortic valve replacement

    DEFF Research Database (Denmark)

    Foghsgaard, Signe; Schmidt, Thomas Andersen; Kjaergard, Henrik K

    2009-01-01

    In this descriptive prospective study, we evaluate the outcomes of surgery in 98 patients who were scheduled to undergo minimally invasive aortic valve replacement. These patients were compared with a group of 50 patients who underwent scheduled aortic valve replacement through a full sternotomy...... operations were completed as mini-sternotomies, 4 died later of noncardiac causes. The aortic cross-clamp and perfusion times were significantly different across all groups (P replacement...... is an excellent operation in selected patients, but its true advantages over conventional aortic valve replacement (other than a smaller scar) await evaluation by means of randomized clinical trial. The "extended mini-aortic valve replacement" operation, on the other hand, is a risky procedure that should...

  9. Minimization over randomly selected lines

    Directory of Open Access Journals (Sweden)

    Ismet Sahin

    2013-07-01

    Full Text Available This paper presents a population-based evolutionary optimization method for minimizing a given cost function. The mutation operator of this method selects randomly oriented lines in the cost function domain, constructs quadratic functions interpolating the cost function at three different points over each line, and uses extrema of the quadratics as mutated points. The crossover operator modifies each mutated point based on components of two points in population, instead of one point as is usually performed in other evolutionary algorithms. The stopping criterion of this method depends on the number of almost degenerate quadratics. We demonstrate that the proposed method with these mutation and crossover operations achieves faster and more robust convergence than the well-known Differential Evolution and Particle Swarm algorithms.

  10. Strategies to Minimize Antibiotic Resistance

    Directory of Open Access Journals (Sweden)

    Sang Hee Lee

    2013-09-01

    Full Text Available Antibiotic resistance can be reduced by using antibiotics prudently based on guidelines of antimicrobial stewardship programs (ASPs and various data such as pharmacokinetic (PK and pharmacodynamic (PD properties of antibiotics, diagnostic testing, antimicrobial susceptibility testing (AST, clinical response, and effects on the microbiota, as well as by new antibiotic developments. The controlled use of antibiotics in food animals is another cornerstone among efforts to reduce antibiotic resistance. All major resistance-control strategies recommend education for patients, children (e.g., through schools and day care, the public, and relevant healthcare professionals (e.g., primary-care physicians, pharmacists, and medical students regarding unique features of bacterial infections and antibiotics, prudent antibiotic prescribing as a positive construct, and personal hygiene (e.g., handwashing. The problem of antibiotic resistance can be minimized only by concerted efforts of all members of society for ensuring the continued efficiency of antibiotics.

  11. A minimally invasive smile enhancement.

    Science.gov (United States)

    Peck, Fred H

    2014-01-01

    Minimally invasive dentistry refers to a wide variety of dental treatments. On the restorative aspect of dental procedures, direct resin bonding can be a very conservative treatment option for the patient. When tooth structure does not need to be removed, the patient benefits. Proper treatment planning is essential to determine how conservative the restorative treatment will be. This article describes the diagnosis, treatment options, and procedural techniques in the restoration of 4 maxillary anterior teeth with direct composite resin. The procedural steps are reviewed with regard to placing the composite and the variety of colors needed to ensure a natural result. Finishing and polishing of the composite are critical to ending with a natural looking dentition that the patient will be pleased with for many years.

  12. Management of cataract with macular oedema due to diabetes mellitus Type-II and hypertension with grid laser prior to surgery and intra-vitreal bevacizumab (avastin) peroperatively

    International Nuclear Information System (INIS)

    Wahab, S.; Ahmed, J.

    2010-01-01

    To study the visual outcome in patients subjected to cataract extraction with prior grid laser and intraoperative intravitreal bevacizumab injection. Methods: This prospective case series comprised of 38 patients subjected to phacoemulsification and in the bag intraocular lens implantation at Al-Noor Eye Hospital and Sindh Govt Lyari General Hospital Karachi from January 2007 to December 2008. All the patients had prior macular grid treatment and intra-operative injection of intra-vitreal Avastin. Diabetes mellitus duration, preoperative glycosylated haemoglobin (HbA1c) level and other systemic and local complications of diabetes were recorded. The patients were clinically assessed with bio microscopic examination preoperatively, and postoperatively on day 1, week 1, and in months 1, 2, 3 and 6 respectively. Visual acuity and state of macular oedema was clinically assessed and documented. Results: Out of thirty-eight patients, eighteen were males and 20 were females. Mean duration of diabetes was 9.92 +- 5.5 years (Range 4-16) while that of hypertension was 7.87 +- 3.66 years (Range = 2-15). HbA1c level was 8.36% +- 1.93% (range 6.3 - 12.3). Thirty-one (81.5%) patients had HbA1c level 8.0% or above indicating a poor control. At 6 months of follow up best corrected distant visual acuity of 6/6 to 6/9 was achieved in 23(60.5 %), 6/12 in 11(28.9%) and 6/24 in 4(10.5%) cases while best corrected near acuity of N/6 was achieved in 22(57.8%) N/8 in 12(31.4%) and N/12 in 4(10.5%) cases. At 6 months follow up visual acuity declined in two cases because of uncontrolled diabetes and hypertension. Conclusion: Cataract surgery in diabetic patients with macular oedema and hypertension has a good visual outcome if prior macular grid laser is performed and intra-vitreal anti VEGF is injected during surgery. (author)

  13. Re-evaluation of a novel approach for quantitative myocardial oedema detection by analysing tissue inhomogeneity in acute myocarditis using T2-mapping.

    Science.gov (United States)

    Baeßler, Bettina; Schaarschmidt, Frank; Treutlein, Melanie; Stehning, Christian; Schnackenburg, Bernhard; Michels, Guido; Maintz, David; Bunck, Alexander C

    2017-12-01

    To re-evaluate a recently suggested approach of quantifying myocardial oedema and increased tissue inhomogeneity in myocarditis by T2-mapping. Cardiac magnetic resonance data of 99 patients with myocarditis were retrospectively analysed. Thirthy healthy volunteers served as controls. T2-mapping data were acquired at 1.5 T using a gradient-spin-echo T2-mapping sequence. T2-maps were segmented according to the 16-segments AHA-model. Segmental T2-values, segmental pixel-standard deviation (SD) and the derived parameters maxT2, maxSD and madSD were analysed and compared to the established Lake Louise criteria (LLC). A re-estimation of logistic regression models revealed that all models containing an SD-parameter were superior to any model containing global myocardial T2. Using a combined cut-off of 1.8 ms for madSD + 68 ms for maxT2 resulted in a diagnostic sensitivity of 75% and specificity of 80% and showed a similar diagnostic performance compared to LLC in receiver-operating-curve analyses. Combining madSD, maxT2 and late gadolinium enhancement (LGE) in a model resulted in a superior diagnostic performance compared to LLC (sensitivity 93%, specificity 83%). The results show that the novel T2-mapping-derived parameters exhibit an additional diagnostic value over LGE with the inherent potential to overcome the current limitations of T2-mapping. • A novel quantitative approach to myocardial oedema imaging in myocarditis was re-evaluated. • The T2-mapping-derived parameters maxT2 and madSD were compared to traditional Lake-Louise criteria. • Using maxT2 and madSD with dedicated cut-offs performs similarly to Lake-Louise criteria. • Adding maxT2 and madSD to LGE results in further increased diagnostic performance. • This novel approach has the potential to overcome the limitations of T2-mapping.

  14. Amiodarone pulmonary toxicity: Case report

    Directory of Open Access Journals (Sweden)

    Vasić Nada

    2014-01-01

    Full Text Available Introduction. Amiodarone, an antiarrhythmic drug, which contains iodine compound, has a tendency to accumulate in some organs including the lungs. This is age, drug dosage and therapy duration dependent. Case Outline. We present a case of a 73-year-old man, a smoker, who was admitted as emergency case due to severe dyspnea, tachypnea with signs of cyanosis and respiratory insufficiency. Chest x-ray revealed bilateral diffuse pulmonary shadows in the middle and upper parts of the lungs, similar to those in tuberculosis. His illness history showed chronic obstructive pulmonary disease, arterial hypertension, and atrial fibrillation which has been treated with amiodarone for six years. Sputum smears were negative for mycobacteria, and by the diagnostic elimination method for specific, non-specific and malignant disease the diagnosis of amiodarone pulmonary toxicity was made. Fiberoptic bronchoscopy and pathohistological findings of bronchiolitis obliterans organizing pneumonia confirmed the diagnosis. As the first therapeutic approach, amiodarone therapy was stopped. Then, systemic therapy with methylprednisolone 21 (sodium succinate 40 mg i.v. daily during the first two weeks was initiated and continued with daily dose of methylprednisolone 30 mg orally during the next three months. The patient showed a marked subjective improvement during the first week, which was followed by the improvement of respiratory function and withdrawal of pulmonary changes with complete radiographic and CT resolution after eight months. Conclusion. Amiodarone pulmonary toxicity should be taken into consideration, especially in elderly patients with respiratory symptoms and pulmonary changes, even if only a low dose of amiodarone is administred over a longer time period.

  15. Waste minimization in analytical methods

    International Nuclear Information System (INIS)

    Green, D.W.; Smith, L.L.; Crain, J.S.; Boparai, A.S.; Kiely, J.T.; Yaeger, J.S. Schilling, J.B.

    1995-01-01

    The US Department of Energy (DOE) will require a large number of waste characterizations over a multi-year period to accomplish the Department's goals in environmental restoration and waste management. Estimates vary, but two million analyses annually are expected. The waste generated by the analytical procedures used for characterizations is a significant source of new DOE waste. Success in reducing the volume of secondary waste and the costs of handling this waste would significantly decrease the overall cost of this DOE program. Selection of appropriate analytical methods depends on the intended use of the resultant data. It is not always necessary to use a high-powered analytical method, typically at higher cost, to obtain data needed to make decisions about waste management. Indeed, for samples taken from some heterogeneous systems, the meaning of high accuracy becomes clouded if the data generated are intended to measure a property of this system. Among the factors to be considered in selecting the analytical method are the lower limit of detection, accuracy, turnaround time, cost, reproducibility (precision), interferences, and simplicity. Occasionally, there must be tradeoffs among these factors to achieve the multiple goals of a characterization program. The purpose of the work described here is to add waste minimization to the list of characteristics to be considered. In this paper the authors present results of modifying analytical methods for waste characterization to reduce both the cost of analysis and volume of secondary wastes. Although tradeoffs may be required to minimize waste while still generating data of acceptable quality for the decision-making process, they have data demonstrating that wastes can be reduced in some cases without sacrificing accuracy or precision

  16. Reexpansion pulmonary edema following thoracentesis

    Directory of Open Access Journals (Sweden)

    Ansuman Mukhopadhyay

    2016-01-01

    Full Text Available Reexpansion pulmonary edema is an uncommon complication of the treatment of lung atelectasis, pleural effusion or pneumothorax and pathogenesis is unknown. An elderly male patient presented to us with right-sided pleural effusion. 2 h after thoracentesis, he felt chest discomfort and increased breathlessness. His chest examination showed right-sided crackles. Chest radiograph showed right-sided heterogeneous opacity in right lower zone consistent with unilateral pulmonary edema. He was managed conservatively along with bilevel positive airway pressure ventilator support. His condition improved gradually and was discharged successfully after 2 days.

  17. Pulmonary Function in Ulcerative Colitis

    OpenAIRE

    A.H. Faghihi-Kashani; A. Kabir; S.A. Javad-Moosavi

    2008-01-01

    Background:Pulmonary involvement in ulcerative colitis (UC) is thought to be rare. There is not a definite document about the question that "Is the lung a target organ in inflammatory bowel disease?"The aim of the present study is to compare lung function between cases with UC and healthy controls. This study will also be of interest about searching the outbreak of pulmonary function abnormalities in a sample of Iranian patients with UC and factors associated with severity of UC. Me...

  18. Pulmonary complications of cystic fibrosis

    International Nuclear Information System (INIS)

    Ng, M.Y.; Flight, W.; Smith, E.

    2014-01-01

    The life expectancy of patients with cystic fibrosis (CF) has steadily increased over recent decades with a corresponding increase in the frequency of complications of the disease. Radiologists are increasingly involved with managing and identifying the pulmonary complications of CF. This article reviews the common manifestations of CF lung disease as well as updating radiologists with a number of less well-known complications of the condition. Early and accurate detection of the pulmonary effects of CF are increasingly important to prevent irreversible lung damage and give patients the greatest possibility of benefiting from the new therapies becoming available, which correct the underlying defect causing CF

  19. [Special beds. Pulmonary therapy system].

    Science.gov (United States)

    Calixto Rodríguez, Joaquín; Rodríguez Martínez, Xavier; Marín i Vivó, Gemma; Paunellas Albert, Josep

    2008-10-01

    To be bedridden reduces one's capacity to move and produces muscular debility that affects the respiratory system leading to a decreased effectiveness in expectoration, the ability to spit up sputum. The pulmonary therapy system integrated in a bed is the result of applying motorized elements to the articulation points of the bad in order to achieve safe positions at therapeutic angles, which improve the breathing-perfusion (blood flow) relationship. This system also makes it possible to apply vibration waves to the patient which favor the elimination of bronchial-pulmonary secretions, the rehabilitation of the bedridden patient and decrease the work load for nursing personnel.

  20. Cyclophosphamide-induced pulmonary toxicity

    International Nuclear Information System (INIS)

    Siemann, D.W.; Macler, L.; Penney, D.P.

    1986-01-01

    Unlike radiation effects, pulmonary toxicity following drug treatments may develop soon after exposure. The dose-response relationship between Cyclophosphamide and lung toxicity was investigated using increased breathing frequency assays used successfully for radiation induced injury. The data indicate that release of protein into the alveolus may play a significant role in Cy induced pulmonary toxicity. Although the mechanism responsible for the increased alveolar protein is as yet not identified, the present findings suggest that therapeutic intervention to inhibit protein release may be an approach to protect the lungs from toxic effects. (UK)