Recognition and treatment of outflow tract stenosis during and after endovascular exclusion for abdominal aortic aneurysm

International Nuclear Information System (INIS)

Lu Qingsheng; Jing Zaiping; Zhao Zhiqing; Bao Junmin; Zhao Jun; Feng Xiang; Feng Rui; Huang Sheng

2003-01-01

Objective: To study the cognition and treatment of outflow tract stenosis in and after endovascular exclusion for abdominal aortic aneurysm. Methods: From Mar 1997 to Oct 2002, in 136 patients undergoing abdominal aortic aneurysm endovascular exclusion, 8 patients had outflow tract stenosis during the operation, and 3 patients had outflow tract stenosis after operation. The stenosis of 5 patients occurred at the crotch of the graft-stent. PTA was done in 7 patients and stents were placed in stenotic segment in 2 patients. 2 patients were treated with crossover operation. Results: Following up 1 month to 2 years, all patients have no lower limbs ischemia. Conclusions: The diagnosis of outflow tract stenosis during and after abdominal endovascular exclusion for aortic aneurysm must be in time. The treatment should be according to the different causes of stenosis

Primary cardiac tumor presenting as left ventricular outflow tract obstruction and complex arrhythmia.

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Fries, R; Achen, S; O'Brien, M T; Jackson, N D; Gordon, S

2017-10-01

An adult female mixed breed dog presented for recurrent collapsing episodes over several weeks. Holter evaluation revealed periods of sinus arrest and echocardiography identified a soft tissue mass with subsequent severe dynamic obstruction of the left ventricular outflow tract. The patient was euthanized five days after presentation for severe dyspnea. Necropsy revealed an irregular mass circumferentially lining the left ventricular outflow tract as well as multiple myocardial metastases. The final diagnosis was an undifferentiated pleomorphic endocardial sarcoma. Published by Elsevier B.V.

Systemic Embolization from an Unusual Intracardiac Mass in the Left Ventricular Outflow Tract

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Kelechukwu U. Okoro

2017-01-01

Full Text Available Endocarditis can affect any endocardial surface; in the vast majority of cases, the cardiac valves are involved. It is exceedingly rare to develop infective endocarditis on the endocardium of the left ventricular outflow tract due to the high velocity of blood that traverses this area. Herein, we present a rare case of left ventricular outflow tract endocarditis that likely occurred secondary to damage to the aortic valve leaflets (from healed prior aortic valve endocarditis causing a high velocity aortic valve regurgitant jet that impinged upon the interventricular septum which damaged the endocardium and resulted in a fibrotic “jet lesion.” This fibrous jet lesion served as a nidus for bacterial proliferation and vegetation formation. The high shear stress (due to high blood flow velocity through the left ventricular outflow tract likely promoted the multiple embolic events observed in this case. Our patient was successfully treated with aortic valve replacement, vegetation resection, and antibiotics.

Cardiac outflow tract malformations in chick embryos exposed to homocysteine

NARCIS (Netherlands)

M.J. Boot (Marit); R.P.M. Steegers-Theunissen (Régine); R.E. Poelmann (Robert); L. van Iperen (Liesbeth); A.C. Gittenberger-De Groot (Adriana)

2004-01-01

textabstractIncreased homocysteine concentrations have been associated with cardiac outflow tract defects. It has been hypothesized that cardiac neural crest cells were the target cells in these malformations. Cardiac neural crest cells migrate from the neural tube and contribute to the condensed

Small-sized conduits in the right ventricular outflow tract in young children: bicuspidalized homografts are a good alternative to standard conduits.

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François, Katrien; De Groote, Katya; Vandekerckhove, Kristof; De Wilde, Hans; De Wolf, Daniel; Bové, Thierry

2017-10-03

Downsizing a homograft (HG) through bicuspidalization has been used for more than 2 decades to overcome the shortage of small-sized conduits for reconstruction of the right ventricular outflow tract (RVOT) in young children. Our goal was to investigate the durability of bicuspidalized HGs compared with other small HGs. A retrospective analysis of 93 conduits ≤20 mm, implanted over 23 years, was performed. The end-points were survival, structural valve degeneration and conduit replacement. The conduits comprised 40 pulmonary HGs, 12 aortic HGs, 17 bicuspidalized HGs and 24 xenografts. The median age, mean conduit diameter and z-value at implantation were 1.4 (interquartile range 0.3-3) years, 16.5 ± 2.7 mm and 2.8 ± 1.3, respectively. Valve position was heterotopic in 59 patients and orthotopic in 34 patients. At a mean follow-up period of 7.6 ± 5.9 years, the hospital survival rate was 89%. Freedom from explant at 5 and 10 years was 83 ± 5% and 52 ± 6%, respectively. Freedom from structural valve degeneration was 79 ± 5% at 5 years and 47 ± 6% at 10 years [68 ± 8% for pulmonary HG, 42 ± 16% for bicuspidalized HG, 31 ± 15% for aortic HG and 20 ± 9% for xenografts (log rank P right ventricular outflow tract conduit in young children. However, when a small pulmonary HG is unavailable, bicuspidalization offers a valid alternative, preferable to xenograft conduits, at mid-term follow-up. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

[Isoproterenol stress test for the evaluation of the residual stenosis of the right ventricular outflow tract].

Science.gov (United States)

Suzuki, T; Fukuda, T; Kashima, I; Sato, M; Miura, M; Ueda, H; Yoshiba, S

2001-07-01

Hemodynamic changes of the right side of the heart during isoproterenol stress test were assessed and analyzed in 36 patients who underwent definitive repair of tetralogy of Fallot or double outlet right ventricle with pulmonary stenosis. Patients having atresia of the pulmonary artery were excluded from the study. 24 of the patients had previously undergone reconstruction of the right ventricular outflow tract (RVOT) with preserving the pulmonary valvar annulus (group N), whilst the remaining 12 patients had undergone transannular enlargement of RVOT with a patch (group T). Preservation of the pulmonary valvar annulus was determined when the intra-operative measurement of diameter of the pulmonary valvar annulus showed values greater than 90% of normal. In both groups, the isoproterenol infusion increased the right to left ventricular peak pressure (RVP/LVP) ratio, pressure gradient between the right ventricle and main pulmonary artery (RV-mPAP), and pressure gradient between the main pulmonary artery and peripheral pulmonary artery (m-pPAP). These values were significantly higher than those measured at rest. When comparisons were made between groups, RV-mPAP of group N was significantly higher than that of group T, both at rest and during stress test. By contrast, m-pPAP of group T was significantly higher than that of group N, both at rest and during stress test. Although no significant difference was found between the groups in RVP/LVP at rest and during stress test, RVP/LVP of both groups increased to the level of more than 0.6 after the isoproterenol infusion. These results led us to conclude that preservation of the pulmonary valvar annulus was better to be applied only to the patients who fulfilled our criterions. Additionally, in the setting of patch reconstruction of the pulmonary artery, every effort should be made so as not to leave the residual stenosis of the peripheral pulmonary artery.

Right ventricular outflow tract stent versus BT shunt palliation in Tetralogy of Fallot.

Science.gov (United States)

Quandt, Daniel; Ramchandani, Bharat; Penford, Gemma; Stickley, John; Bhole, Vinay; Mehta, Chetan; Jones, Timothy; Barron, David James; Stumper, Oliver

2017-12-01

This study sets out to compare morbidity, mortality and reintervention rates after stenting of the right ventricular outflow tract (RVOT) versus modified Blalock-Taussig shunt (mBTS) for palliation in patients with tetralogy of Fallot (ToF)-type lesions. Retrospective case review study evaluating 101 patients (64 males) with ToF lesions who underwent palliation with either mBTS (n=41) or RVOT stent (n=60) to augment pulmonary blood flow over a 10-year period. Procedure-related morbidity, mortality and reintervention rates were assessed and compared. Admission rate to paediatric intensive care unit (PICU) was lower in the RVOT stent group (22% vs 100%; pFallot-type lesions can be accomplished safely, with lower PICU admission rate, a shorter hospital length of stay and shorter duration of palliation until complete repair compared with mBTS palliation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Experimental assessment of valve performance in healthy and diseased right ventricular outflow tracts using magnetic resonance velocimetry

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Schiavone, Nicole; Elkins, Christopher; McElhinney, Doff; Eaton, John K.; Marsden, Alison

2017-11-01

Tetralogy of Fallot (ToF), the most common type of cyanotic congenital heart defect, affects 1 in every 2500 newborns annually and typically requires surgical repair of the right ventricular outflow tract (RVOT) and placement of an artificial pulmonary valve. All artificial valves are subject to dysfunction, but their longevity is highly variable. Clinical observation reveals large variations in RVOT anatomy in ToF patients, which may affect longevity. This work aims to experimentally assess the performance of artificial pulmonary valves in anatomically realistic healthy and diseased RVOT geometries using magnetic resonance velocimetry (MRV). With MRV, we can capture 3D, three-component, phase-averaged velocity fields in 3D printed RVOT geometries. The experiment is designed to ensure physiological flow rate and pressure waveforms, while the RVOT geometries are based on anatomies seen clinically in ToF patients. Two models are used in the current work: an idealized RVOT based on healthy subjects aged eleven to thirteen and a diseased geometry with a dilation of 150% in vessel diameter downstream of the pulmonary valve. We will also present preliminary rigid-wall blood flow simulations in each model, towards the ultimate goal of experimental validation of valve simulations.

Dynamic Changes of QRS Morphology of Premature Ventricular Contractions During Ablation in the Right Ventricular Outflow Tract: A Case Report.

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Yue-Chun, Li; Jia-Feng, Lin; Jia-Xuan, Lin

2015-10-01

Electrocardiographic characteristics can be useful in differentiating between right ventricular outflow tract (RVOT) and aortic sinus cusp (ASC) ventricular arrhythmias. Ventricular arrhythmias originating from ASC, however, show preferential conduction to RVOT that may render the algorithms of electrocardiographic characteristics less reliable. Even though there are few reports describing ventricular arrhythmias with ASC origins and endocardial breakout sites of RVOT, progressive dynamic changes in QRS morphology of the ventricular arrhythmias during ablation obtained were rare.This case report describes a patient with symptomatic premature ventricular contractions of left ASC origin presenting an electrocardiogram (ECG) characteristic of right ventricular outflow tract before ablation. Pacing at right ventricular outflow tract reproduced an excellent pace map. When radiofrequency catheter ablation was applied to the right ventricular outflow tract, the QRS morphology of premature ventricular contractions progressively changed from ECG characteristics of right ventricular outflow tract origin to ECG characteristics of left ASC origin.Successful radiofrequency catheter ablation was achieved at the site of the earliest ventricular activation in the left ASC. The distance between the successful ablation site of the left ASC and the site with an excellent pace map of the RVOT was 20 mm.The ndings could be strong evidence for a preferential conduction via the myocardial bers from the ASC origin to the breakout site in the right ventricular outflow tract. This case demonstrates that ventricular arrhythmias with a single origin and exit shift may exhibit QRS morphology changes.

Stent fracture, valve dysfunction, and right ventricular outflow tract reintervention after transcatheter pulmonary valve implantation: patient-related and procedural risk factors in the US Melody Valve Trial.

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McElhinney, Doff B; Cheatham, John P; Jones, Thomas K; Lock, James E; Vincent, Julie A; Zahn, Evan M; Hellenbrand, William E

2011-12-01

Among patients undergoing transcatheter pulmonary valve (TPV) replacement with the Melody valve, risk factors for Melody stent fracture (MSF) and right ventricular outflow tract (RVOT) reintervention have not been well defined. From January 2007 to January 2010, 150 patients (median age, 19 years) underwent TPV implantation in the Melody valve Investigational Device Exemption trial. Existing conduit stents from a prior catheterization were present in 37 patients (25%, fractured in 12); 1 or more new prestents were placed at the TPV implant catheterization in 51 patients. During follow-up (median, 30 months), MSF was diagnosed in 39 patients. Freedom from a diagnosis of MSF was 77±4% at 14 months (after the 1-year evaluation window) and 60±9% at 39 months (3-year window). On multivariable analysis, implant within an existing stent, new prestent, or bioprosthetic valve (combined variable) was associated with longer freedom from MSF (Pbioprosthetic valve was associated with lower risk of MSF and reintervention.

Five-year results from a prospective multicentre study of percutaneous pulmonary valve implantation demonstrate sustained removal of significant pulmonary regurgitation, improved right ventricular outflow tract obstruction and improved quality of life

DEFF Research Database (Denmark)

Hager, Alfred; Schubert, Stephan; Ewert, Peter

2017-01-01

. The EQ-5D quality of life utility index and visual analogue scale scores were both significantly improved six months post PPVI and remained so at five years. CONCLUSIONS: Five-year results following PPVI demonstrate resolved moderate or severe pulmonary regurgitation, improved right ventricular outflow...

Effect of right ventricular electrode location (outflow tract vs. apex) on mechanical Ventricular synchrony in patients that underwent pacemaker implant therapy

International Nuclear Information System (INIS)

Rincon, Oscar S; Saenz, Luis C; Salazar, Gabriel; Hernandez, Edgar

2008-01-01

Objective: to assess in depth the effect of ventricular stimulation from the right ventricular outflow tract and the apex on mechanical ventricular synchrony. Materials And Methods: cohort analytical study. 20 patients with indication of definitive pacemaker indication underwent trans thoracic echocardiogram before and after pacemaker implant with electrode implantation in the right ventricular outflow tract and in the apex (10 patients in each group). There was no structural cardiopathy, ejection fraction was ? 50%, QRS and AV conduction were normal. Mechanical ventricular asynchrony (M mode and tissue doppler) and implant and device parameters were evaluated. Statistical Analysis: results are given as mean values, standard deviation or percentages.Continuous variables were compared using Chi-square test and ANOVA. A p <0.05 value was considered statistically significant. Results: in five patients (25%) a pre-implant ventricular asynchrony was found; in seven (70%) ventricular asynchrony post-implant in the right ventricle outflow tract and in 5 (50%) in the apex. Mean interventricular pot-implant delay was 21,6 ms in the right ventricular outflow tract and 11,5 ms in the apex (p = 0,8); mean septal to lateral wall delay was 73 ms in the right ventricular outflow tract and 26 ms in the apex (p = 0,8). QRS post-implant delay was 134 ms in the right ventricular outflow tract and 140 ms in the apex (p = 0,1). No differences between implant parameters and device programming were found. Conclusions: presence of ventricular asynchrony was evidenced in patients with normal QRS and structurally healthy heart. Ventricular stimulation with pacemaker from the apex or the right ventricular outflow tract suggests acute ventricular asynchrony at least in 60% of the cases, without statistically significant difference between both groups.

An unusual case of coronary artery compression that did not preclude successful transcatheter pulmonary valve placement.

Science.gov (United States)

Schwartz, Matthew C; Felix, Donald; Iacono, Karen; Nykanen, David

2018-04-16

During transcatheter pulmonary valve placement, coronary compression observed during simultaneous right ventricular outflow tract angioplasty and coronary angiography typically contraindicates valve implantation. We present a unique patient with tetralogy of Fallot who underwent successful transcatheter Melody valve placement despite coronary compression observed during right ventricular outflow tract balloon angioplasty. © 2018 Wiley Periodicals, Inc.

Apical ballooning syndrome complicated by acute severe mitral regurgitation with left ventricular outflow obstruction – Case report

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Celermajer David S

2007-02-01

Full Text Available Abstract Background Apical ballooning syndrome (or Takotsubo cardiomyopathy is a syndrome of transient left ventricular apical ballooning. Although first described in Japanese patients, it is now well reported in the Caucasian population. The syndrome mimicks an acute myocardial infarction but is characterised by the absence of obstructive coronary disease. We describe a serious and poorly understood complication of Takotsubo cardiomyopathy. Case Presentation We present the case of a 65 year-old lady referred to us from a rural hospital where she was treated with thrombolytic therapy for a presumed acute anterior myocardial infarction. Four hours after thrombolysis she developed acute pulmonary oedema and a new systolic murmur. It was presumed she had acute mitral regurgitation secondary to a ruptured papillary muscle, ischaemic dysfunction or an acute ventricular septal defect. Echocardiogram revealed severe mitral regurgitation, left ventricular apical ballooning, and systolic anterior motion of the mitral valve with significant left ventricular outflow tract gradient (60–70 mmHg. Coronary angiography revealed no obstructive coronary lesions. She had an intra-aortic balloon pump inserted with no improvement in her parlous haemodynamic state. We elected to replace her mitral valve to correct the outflow tract gradient and mitral regurgitation. Intra-operatively the mitral valve was mildly myxomatous but there were no structural abnormalities. She had a mechanical mitral valve replacement with a 29 mm St Jude valve. Post-operatively, her left ventricular outflow obstruction resolved and ventricular function returned to normal over the subsequent 10 days. She recovered well. Conclusion This case represents a serious and poorly understood association of Takotsubo cardiomyopathy with acute pulmonary oedema, severe mitral regurgitaton and systolic anterior motion of the mitral valve with significant left ventricular outflow tract obstruction. The

Inactivation of Bmp4 from the Tbx1 Expression Domain Causes Abnormal Pharyngeal Arch Artery and Cardiac Outflow Tract Remodeling

Science.gov (United States)

Nie, Xuguang; Brown, Christopher B.; Wang, Qin; Jiao, Kai

2011-01-01

Maldevelopment of outflow tract and aortic arch arteries is among the most common forms of human congenital heart diseases. Both Bmp4 and Tbx1 are known to play critical roles during cardiovascular development. Expression of these two genes partially overlaps in pharyngeal arch areas in mouse embryos. In this study, we applied a conditional gene inactivation approach to test the hypothesis that Bmp4 expressed from the Tbx1 expression domain plays a critical role for normal development of outflow tract and pharyngeal arch arteries. We showed that inactivation of Bmp4 from Tbx1-expressing cells leads to the spectrum of deformities resembling the cardiovascular defects observed in human DiGeorge syndrome patients. Inactivation of Bmp4 from the Tbx1 expression domain did not cause patterning defects, but affected remodeling of outflow tract and pharyngeal arch arteries. Our further examination revealed that Bmp4 is required for normal recruitment/differentiation of smooth muscle cells surrounding the PAA4 and survival of outflow tract cushion mesenchymal cells. PMID:21123999

Right ventricular outflow tract systolic function correlates with exercise capacity in patients with severe right ventricle dilatation after repair of tetralogy of Fallot.

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Luo, Shuhua; Li, Jianhua; Yang, Dan; Zhou, Yaxin; An, Qi; Chen, Yucheng

2017-05-01

The relationship between exercise capacity and right ventricular (RV) components function in repaired tetralogy of Fallot patients with severely dilated right ventricles is poorly understood. The aim of this study was to characterize the exercise capacity and its relationship to RV global and components function in repaired tetralogy of Fallot patients with RV end-diastolic volume index  >150 ml/m 2 , a currently accepted threshold for pulmonary valve replacement. The medical records and results of cardiac magnetic resonance imaging and cardiopulmonary exercise testing of 25 consecutive eligible patients were reviewed. Twenty age- and gender-matched normal subjects were enrolled as cardiac magnetic resonance control. End-diastolic, end-systolic and stroke volumes, and ejection fraction (EF) were determined for the total RV and its components. Of the 25 patients, 44% maintained normal exercise capacity. RV outlet EF was higher ( P  = 0.02) and RV incisions smaller ( P  = 0.04) in patients with normal exercise capacity than those with subnormal exercise capacity. Predicted peak oxygen consumption correlated better with the RV outflow tract EF than with the EF of other components of the RV or the global EF ( r  = 0.59; P  = 0.002). Multivariate analysis showed the RV outflow tract EF to be the only independent predictor of exercise capacity (ß = 0.442; P  = 0.02). Exercise capacity is preserved in some tetralogy of Fallot patients with severe RV dilatation. RV outflow tract EF is independently associated with exercise capacity in such patients, and could be a reliable determinant of intrinsic RV performance. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Comparison between biventricular cine MRI and MR flow quantification in ascending aorta and pulmonary outflow tract for the assessment of intracardial shunt volumes

International Nuclear Information System (INIS)

Rominger, M.B.; Kluge, A.; Bachmann, G.F.; Dinkel, H.P.

2002-01-01

Purpose: Comparison between biventricular volumetric measurements and flow measurements in ascending aorta (Ao) and pulmonary outflow tract (Pu) for quantification of intracardial shunts, and evaluation of the combination of biventricular cine MRI with flow measurements for the assessment of RV and LV heart failure and valvular regurgitation (VR). Material and Methods: In 24 patients, right (RV) and left (LV) ventricular volumetric and flow measurements were performed in the Ao and Pu to assess the ratio of RV stroke volume (SV) or, respectively, pulmonary SV to LV SV or, respectively, systemic aortic SV (Qp/Qs). 34 patients without echocardiographically proven shunt or VR served as control group for measurement accuracy. Left-to-right shunt ratios were calculated from RV and LV SV, Pu and Ao SV, Pu and LV SV, and RV and Ao SV. Left ventricular VR was calculated by the difference of LV SV and Ao SV, and right ventricular VR by the difference of RV SV and Pu SV. Global systolic function was evaluated by biventricular cine MRI. Results: Intracardial shunts with Qp/Qs>1,16 can be quantified by flow measurements in Ao and Pu. Using biventricular volumetric measurements in cases without VR, requires a Qp/Qs>1.21. 17 of 18 intracardiac shunts were identified on MRI, and all 8 hemodynamically significant shunts were quantitatively confirmed. The diagnosis of complete shunt closure or absent shunt was correctly made in all 6 cases RV EF reduction was found in 6 of 24 patients. LV EF reduction was also found in 6 of 24 patients. Conclusion: Flow measurements in Ao and Pu are more accurate than biventricular cine MRI for the assessment of Qp/Qs ratios. Flow measurements in Ao and Pu combined with biventricular cine MRI enables the quantification of hemodynamic significant shunts, higher grade VR and biventricular global systolic function with a single examination. (orig.) [de

Pre-operative evaluation with MR in tetralogy of Fallot and pulmonary atresia with ventricular septal defect

International Nuclear Information System (INIS)

Holmqvist, C.; Hochbergs, P.; Bjoerkhem, G.; Brockstedt, S.; Laurin, S.

2000-01-01

To assess whether MR imaging could replace angiography in pre-operative evaluation of patients with tetralogy of Fallot and pulmonary atresia with ventricular septal defect (VSD), especially since the surgical correction was done earlier than was previously the rule. Fourteen patients with tetralogy of Fallot (n=10) or pulmonary atresia with VSD (n=4), mean age 7.5±4.4 months, were evaluated with angiocardiography and MR before definitive surgical correction. There was good diagnostic agreement between the two modalities when evaluating right ventricular outflow obstruction; 86% for valvular and 93% for supra valvular stenosis, but the agreement was somewhat lower for the sub valvular obstruction (57%). Surgery findings, however, were in favour of MR in 5 patients concerning the sub valvular right ventricular outflow tract obstruction. MR images identified all stenoses in the right and left pulmonary arteries, but overlooked one stenosis in the main pulmonary artery. MR could evaluate patency in all palliative shunts. Even in this young age group, MR imaging offers a good alternative to angiocardiography for the pre-operative evaluation of the right ventricular outflow tract, the main pulmonary artery and the proximal right and left pulmonary arteries, before definitive surgical correction of tetralogy of Fallot and pulmonary atresia with VSD

Pre-operative evaluation with MR in tetralogy of Fallot and pulmonary atresia with ventricular septal defect

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Holmqvist, C.; Hochbergs, P. [Univ. Hospital, Lund (Sweden). Dept of Diagnostic Radiology; Bjoerkhem, G. [Univ. Hospital, Lund (Sweden). Dept of Paediatrics; Brockstedt, S.; Laurin, S. [Univ. Hospital, Lund (Sweden). Dept of Diagnostic Radiology

2000-01-01

To assess whether MR imaging could replace angiography in pre-operative evaluation of patients with tetralogy of Fallot and pulmonary atresia with ventricular septal defect (VSD), especially since the surgical correction was done earlier than was previously the rule. Fourteen patients with tetralogy of Fallot (n=10) or pulmonary atresia with VSD (n=4), mean age 7.5{+-}4.4 months, were evaluated with angiocardiography and MR before definitive surgical correction. There was good diagnostic agreement between the two modalities when evaluating right ventricular outflow obstruction; 86% for valvular and 93% for supra valvular stenosis, but the agreement was somewhat lower for the sub valvular obstruction (57%). Surgery findings, however, were in favour of MR in 5 patients concerning the sub valvular right ventricular outflow tract obstruction. MR images identified all stenoses in the right and left pulmonary arteries, but overlooked one stenosis in the main pulmonary artery. MR could evaluate patency in all palliative shunts. Even in this young age group, MR imaging offers a good alternative to angiocardiography for the pre-operative evaluation of the right ventricular outflow tract, the main pulmonary artery and the proximal right and left pulmonary arteries, before definitive surgical correction of tetralogy of Fallot and pulmonary atresia with VSD.

Mechanical valve at pulmonary site in adult TOF & absent pulmonary valve

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Aayush Goyal

2017-09-01

Full Text Available Absent pulmonary valve syndrome (APVS is a rare congenital heart disease. Tetralogy of Fallot (TOF with APVS is a rare variation of TOF. These patients are commonly cyanotic at birth. Respiratory complaints predominate due to airway compression by dilated pulmonary arteries. Commonest age of presentation is infancy with anecdotal adult case-reports. Surgical treatment requires establishing unobstructed competent right ventricular outflow tract (RVOT often with monocusp or conduits. We present a novel technique of rendering RVOT competent by implanting a tilting disc mechanical prosthesis in a rare adult TOF with APVS.

The role of hemodynamics in the development of the outflow tract of the heart

NARCIS (Netherlands)

Loots, Erwin; Hillen, Berend; Veldman, Arthur E.P.

The question whether, and if so to what extent, hemodynamic forces and mechanical stimuli do modulate the morphogenesis of the vascular system is a century-old problem. It is important especially in the outflow tract where a spiraling septum develops in and after a strong bend in the tube. Spiraling

Inflammatory Pseudotumor Originating from the Right Ventricular Outflow Tract

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Mohita Singh

2016-01-01

Full Text Available Introduction. Inflammatory pseudotumor is an uncommon entity, and its cardiac origin is exceedingly rare. Case History. A previously healthy 27-year-old man was found to have a systolic murmur during preemployment screening evaluation. A transthoracic echocardiogram revealed a 4 × 2.5 cm mass originating from the right ventricle (RV outflow tract extending into the aortic root. A computed tomography guided biopsy confirmed an IgG4-related inflammatory pseudotumor. Patient was started on oral prednisone with subsequent reduction in mass size. Conclusion. Cardiac inflammatory pseudotumors are markedly rare tumors that should be considered in the differential of intracardiac tumors which otherwise includes cardiac fibromas, myxomas, and sarcomas.

Dynamic right ventricular outflow tract (infundibular) stenosis and pectus excavatum in a dog

OpenAIRE

Fournier, Tanya E.

2008-01-01

This is the first published report of a dog with dynamic right ventricular outflow tract (infundibular) stenosis, right ventricular hypertrophy, and pectus excavatum. A juvenile dog presented with a grade V/VI left base systolic heart murmur, tachycardia, and pectus excavatum. Diagnosis of the aforementioned conditions was based on radiography, electrocardiography, and echocardiography. At 9 1/2 wk of age the heart murmur was no longer audible and the right ventricular stenosis and hypertroph...

Stent migration after right ventricular outflow tract stenting in the severe cyanotic Tetralogy of Fallot case

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Tamaki Hayashi

2017-01-01

Full Text Available We report our experience with a stent migration after right ventricle outflow tract stenting and converted to patent ductus arteriosus stenting in Tetralogy of Fallot (TOF with severe infundibular stenosis. Finally, the patient achieved to TOF repair, and the migrated stent was removed without any complication.

Assessment of cardiac blood pool imaging in patients with left ventricular outflow tract stenosis

International Nuclear Information System (INIS)

Nakamura, Yutaka; Ono, Yasuo; Kohata, Tohru; Tsubata, Shinichi; Kamiya, Tetsuroh.

1993-01-01

We performed cardiac blood pool imagings with Tc-99m at rest and during supine ergometer exercise to evaluate left ventricular performance in 14 patients with left ventricular outflow tract stenosis. All catheterized patients were divided into two subgroups: 8 patients with peak systolic left ventricular to descending aortic pressure gradients of less than 50 mmHg (LPG group) and 6 patients with peak systolic gradients of more than 50 mmHg (HPG group). Control group included 10 patients without stenotic coronary lesions after Kawasaki disease. Left ventricular ejection fraction (LVEF) was obtained as systolic index; both filling fraction during the first third of diastole (1/3FF) and mean filling rate during the first third of diastole (1/3FR mean) were obtained as diastolic indices. None of the patients had abnormal findings on 201 Tl imaging. LVEF at rest in HPG group was significantly higher than those in control group, but LVEF in HPG group did not increase after exercise. It increased significantly in control group and LPG group. 1/3 FF in HPG group was significantly lower not only at rest but also during exercise. 1/3 FR mean at rest was not different significantly among the 3 groups. However, 1/3FR mean during exercise in LPG group was significantly lower; and 1/3 FR mean during exercise was significantly lower in HPG group than LPG group. The ratio of left ventricular muscular mass to left ventricular end-diastolic volume (M/V) calculated from left ventricular cineangiograms was different significantly among the 3 groups. The M/V ratio showed a correlation with LVEF and 1/3 FF both at rest and during exercise. These results would indicate that systolic function was impaired on exercise in severe left ventricular outflow tract stenosis and diastolic function was impaired on exercise in mild and severe left ventricular outflow tract stenosis. This may correlate with left ventricular hypertrophy and interaction of systolic function. (author)

Preoperative Pulmonary Valvuloplasty in Tetralogy of Fallot with Right-To-Left Shunt

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Baris Bugan

2014-12-01

Full Text Available Tetralogy of Fallot is the most common cyanotic congenital heart disease and characterized by right ventricular outflow tract obstruction, ventricular septal defect, overriding aorta, and right ventricular hypertrophy. Right ventricular outflow tract obstruction and ventricular septal defect are the major clinical components of the syndrome. Although most have undergone a corrective operation, an important minority of patients with tetralogy of Fallot have had a preoperative palliative procedure. Herein we reported a succesful palliative percutaneous balloon valvuloplasty of pulmonary stenosis at an 19-year-old female patient with tetralogy of Fallot who was considered as inoperable for corrective surgery due to right -to-left shunt.

Anatomic, histopathologic, and echocardiographic features in a dog with an atypical pulmonary valve stenosis with a fibrous band of tissue and a patent ductus arteriosus.

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Yoon, Hakyoung; Kim, Jaehwan; Nahm, Sang-Soep; Eom, Kidong

2017-07-11

Congenital pulmonary valve stenosis and patent ductus arteriosus are common congenital heart defects in dogs. However, concurrence of atypical pulmonary valve stenosis and patent ductus arteriosus is uncommon. This report describes the anatomic, histopathologic, and echocardiographic features in a dog with concomitant pulmonary valve stenosis and patent ductus arteriosus with atypical pulmonary valve dysplasia that included a fibrous band of tissue. A 1.5-year-old intact female Chihuahua dog weighing 3.3 kg presented with a continuous grade VI cardiac murmur, poor exercise tolerance, and an intermittent cough. Echocardiography indicated pulmonary valve stenosis, a thickened dysplastic valve without annular hypoplasia, and a type IIA patent ductus arteriosus. The pulmonary valve was thick line-shaped in systole and dome-shaped towards the right ventricular outflow tract in diastole. The dog suffered a fatal cardiac arrest during an attempted balloon pulmonary valvuloplasty. Necropsy revealed pulmonary valve dysplasia, commissural fusion, and incomplete opening and closing of the pulmonary valve because of a fibrous band of tissue causing adhesion between the right ventricular outflow tract and the dysplastic intermediate cusp of the valve. A fibrous band of tissue between the right ventricular outflow track and the pulmonary valve should be considered as a cause of pulmonary valve stenosis. Pulmonary valve stenosis and patent ductus arteriosus can have conflicting effects on diastolic and systolic dysfunction, respectively. Therefore, beta-blockers should always be used carefully, particularly in patients with a heart defect where there is concern about left ventricular systolic function.

Prevalence of exercise-induced left ventricular outflow tract obstruction in symptomatic patients with non-obstructive hypertrophic cardiomyopathy.

LENUS (Irish Health Repository)

Shah, J S

2008-10-01

Resting left ventricular outflow tract obstruction (LVOTO) occurs in 25% of patients with hypertrophic cardiomyopathy (HCM) and is an important cause of symptoms and disease progression. The prevalence and clinical significance of exercise induced LVOTO in patients with symptomatic non-obstructive HCM is uncertain.

Surgical treatment of tetralogy of Fallot with absent pulmonary valve syndrome.

Science.gov (United States)

Tanaka, Yuki; Miyamoto, Takashi; Naito, Yuji; Yoshitake, Shuichi

2016-06-01

The patient was a 3-month-old girl weighting 3.6 kg, diagnosed with tetralogy of Fallot and absent pulmonary valve syndrome. We surgically repaired the tetralogy of Fallot by patch closure of the ventricular septal defect, right ventricular outflow tract reconstruction using an expanded polytetrafluoroethylene monocusp patch with a bulging sinus, and removal of the bronchial obstruction by anterior translocation of the pulmonary artery using the Lecompte maneuver. © The Author(s) 2015.

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

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

1990-02-01

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

Dynamic left ventricular outflow tract obstruction complicating aortic valve replacement: A hidden malefactor revisited

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Panduranga Prashanth

2010-01-01

Full Text Available It is known that a dynamic left ventricular outflow tract (LVOT obstruction exists in patients, following aortic valve replacement (AVR and is usually considered to be benign. We present a patient with dynamic LVOT obstruction following AVR, who developed refractory cardiogenic shock and expired inspite of various treatment strategies. This phenomenon must be diagnosed early and should be considered as a serious and potentially fatal complication following AVR. The possible mechanisms and treatment options are reviewed.

Anesthetic management of Amplatzer atrial septal defect closure device embolization to right ventricular outflow tract

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S Das

2016-01-01

Full Text Available Percutaneous device closure of atrial septal defect (ASD is an alternative treatment to surgery with advantages of avoidance of surgery, short procedure time, early discharge from hospital, and lower rates of complications. However, percutaneous device closure is associated with infrequent life-threatening complications such as device embolization. We report a case device embolization of the ASD occlude device into right ventricular outflow tract resulting progressive hypoxia. The role of anesthesiologist as a team leader in managing such emergency is discussed.

An attempt to evaluate pulmonary hypertension by phase analysis of radionuclide ventriculography

International Nuclear Information System (INIS)

Masuoka, Takeshi; Toyama, Hinako; Ajisaka, Ryuuichi

1988-01-01

Using phase analysis derived from the gated blood pool imaging, the pattern of right ventricular regional contraction was examined in 5 patients with pulmonary hypertension who showed 30 mmHg of pulmonary arterial systolic pressure and 20 mmHg or more of mean pulmonary arterial pressure. All of the patients had markedly delayed phase in contraction of right ventricular outflow tract. Pulmonary arterial pressure positively correlated with both the proportion of delayed phase area to the whole right ventricle and mean phase difference between the right and left ventricles. The results suggest the usefulness of phase analysis in the non-invasive evaluation of incease in overloading of right ventricular pressure. (Namekawa, K)

Flow-related Right Ventricular - Pulmonary Arterial Pressure Gradients during Exercise.

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Wright, Stephen P; Opotowsky, Alexander R; Buchan, Tayler A; Esfandiari, Sam; Granton, John T; Goodman, Jack M; Mak, Susanna

2018-06-06

The assumption of equivalence between right ventricular and pulmonary arterial systolic pressure is fundamental to several assessments of right ventricular or pulmonary vascular hemodynamic function. Our aims were to 1) determine whether systolic pressure gradients develop across the right ventricular outflow tract in healthy adults during exercise, 2) examine the potential correlates of such gradients, and 3) consider the effect of such gradients on calculated indices of right ventricular function. Healthy untrained and endurance-trained adult volunteers were studied using right-heart catheterization at rest and during submaximal cycle ergometry. Right ventricular and pulmonary artery pressures were simultaneously transduced, and cardiac output was determined by thermodilution. Systolic pressures, peak and mean gradients, and indices of chamber, vascular, and valve function were analyzed offline. Summary data are reported as mean ± standard deviation or median [interquartile range]. No significant right ventricular outflow tract gradients were observed at rest (mean gradient = 4 [3-5] mmHg), and calculated effective orifice area was 3.6±1.0 cm2. Right ventricular systolic pressure increases during exercise were greater than that of pulmonary artery systolic pressure. Accordingly, mean gradients developed during light exercise (8 [7-9] mmHg) and increased during moderate exercise (12 [9-14] mmHg, p < 0.001). The magnitude of the mean gradient was linearly related to cardiac output (r2 = 0.70, p < 0.001). In healthy adults without pulmonic stenosis, systolic pressure gradients develop during exercise, and the magnitude is related to blood flow rate.

Prediction and characterisation of a highly conserved, remote and cAMP responsive enhancer that regulates Msx1 gene expression in cardiac neural crest and outflow tract.

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Miller, Kerry Ann; Davidson, Scott; Liaros, Angela; Barrow, John; Lear, Marissa; Heine, Danielle; Hoppler, Stefan; MacKenzie, Alasdair

2008-05-15

Double knockouts of the Msx1 and Msx2 genes in the mouse result in severe cardiac outflow tract malformations similar to those frequently found in newborn infants. Despite the known role of the Msx genes in cardiac formation little is known of the regulatory systems (ligand receptor, signal transduction and protein-DNA interactions) that regulate the tissue-specific expression of the Msx genes in mammals during the formation of the outflow tract. In the present study we have used a combination of multi-species comparative genomics, mouse transgenic analysis and in-situ hybridisation to predict and validate the existence of a remote ultra-conserved enhancer that supports the expression of the Msx1 gene in migrating mouse cardiac neural crest and the outflow tract primordia. Furthermore, culturing of embryonic explants derived from transgenic lines with agonists of the PKC and PKA signal transduction systems demonstrates that this remote enhancer is influenced by PKA but not PKC dependent gene regulatory systems. These studies demonstrate the efficacy of combining comparative genomics and transgenic analyses and provide a platform for the study of the possible roles of Msx gene mis-regulation in the aetiology of congenital heart malformation.

Performance and morphology of decellularized pulmonary valves implanted in juvenile sheep.

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Quinn, Rachael W; Hilbert, Stephen L; Bert, Arthur A; Drake, Bill W; Bustamante, Julie A; Fenton, Jason E; Moriarty, Sara J; Neighbors, Stacy L; Lofland, Gary K; Hopkins, Richard A

2011-07-01

Because of cryopreserved heart valve-mediated immune responses, decellularized allograft valves are an attractive option in children and young adults. The objective of this study was to investigate the performance and morphologic features of decellularized pulmonary valves implanted in the right ventricular outflow tract of juvenile sheep. Right ventricular outflow tract reconstructions in juvenile sheep (160±9 days) using cryopreserved pulmonary allografts (n=6), porcine aortic root bioprostheses (n=4), or detergent/enzyme-decellularized pulmonary allografts (n=8) were performed. Valve performance (echocardiography) and morphologic features (gross, radiographic, and histologic examination) were evaluated 20 weeks after implantation. Decellularization reduced DNA in valve cusps by 99.3%. Bioprosthetic valves had the largest peak and mean gradients versus decellularized valves (p=0.03; p<0.001) and cryopreserved valves (p=0.01; p=0.001), which were similar (p=0.45; p=0.40). Regurgitation was minimal and similar for all groups (p=0.16). No cusp calcification was observed in any valve type. Arterial wall calcification was present in cryopreserved and bioprosthetic grafts but not in decellularized valves. No autologous recellularization or inflammation occurred in bioprostheses, whereas cellularity progressively decreased in cryopreserved grafts. Autologous recellularization was present in decellularized arterial walls and variably extending into the cusps. Cryopreserved and decellularized graft hemodynamic performance was comparable. Autologous recellularization of the decellularized pulmonary arterial wall was consistently observed, with variable cusp recellularization. As demonstrated in this study, decellularized allograft valves have the potential for autologous recellularization. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Stenting of right ventricular outflow tract in Tetralogy of Fallot with subarterial ventricular septal defect: A word of caution

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Jonathan Lee

2017-01-01

Full Text Available We report a case of Tetralogy of Fallot with severe cyanosis who underwent a successful right ventricular outflow tract stenting. Follow-up echocardiography revealed moderate aortic regurgitation due to the impingement of the stent on the aortic valve. The patient underwent successful surgical correction at which time the stent was removed completely with a resolution of the aortic regurgitation.

Extracting cardiac shapes and motion of the chick embryo heart outflow tract from four-dimensional optical coherence tomography images

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Yin, Xin; Liu, Aiping; Thornburg, Kent L.; Wang, Ruikang K.; Rugonyi, Sandra

2012-09-01

Recent advances in optical coherence tomography (OCT), and the development of image reconstruction algorithms, enabled four-dimensional (4-D) (three-dimensional imaging over time) imaging of the embryonic heart. To further analyze and quantify the dynamics of cardiac beating, segmentation procedures that can extract the shape of the heart and its motion are needed. Most previous studies analyzed cardiac image sequences using manually extracted shapes and measurements. However, this is time consuming and subject to inter-operator variability. Automated or semi-automated analyses of 4-D cardiac OCT images, although very desirable, are also extremely challenging. This work proposes a robust algorithm to semi automatically detect and track cardiac tissue layers from 4-D OCT images of early (tubular) embryonic hearts. Our algorithm uses a two-dimensional (2-D) deformable double-line model (DLM) to detect target cardiac tissues. The detection algorithm uses a maximum-likelihood estimator and was successfully applied to 4-D in vivo OCT images of the heart outflow tract of day three chicken embryos. The extracted shapes captured the dynamics of the chick embryonic heart outflow tract wall, enabling further analysis of cardiac motion.

Dynamic left ventricular outflow tract obstruction secondary to hypovolemia in a German Shepard dog with splenic hemangiosarcoma

OpenAIRE

AOKI, Takuma; SUNAHARA, Hiroshi; SUGIMOTO, Keisuke; ITO, Tetsuro; KANAI, Eiichi; NEO, Sakurako; FUJII, Yoko; WAKAO, Yoshito

2015-01-01

Dynamic left ventricular outflow tract obstruction (DLVOTO) is a common condition in cats and humans. In this case report, a dog is described with DLVOTO secondary to severe intra-abdominal hemorrhage caused by a hemangiosarcoma. The dog was a 9-year-old, 35.7-kg, spayed female German Shepard dog that presented with a history of tachypnea and collapse. A Levine II/VI systolic murmur was present at the heart base. Abdominal ultrasonography revealed a splenic mass and a large amount of ascites....

Sub-aortic obstruction of left ventricular outflow tract secondary to benfluorex-induced endocardial fibrosis

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Catherine Szymanski

2015-12-01

Full Text Available Patients exposed to benfluorex have an increased risk of restrictive organic valvular heart disease. Aortic and mitral regurgitations caused by fibrotic valve disease are the most common features observed in exposure to fenfluramine derivatives in general and benfluorex in particular. We report here, for the first time to our knowledge, a well-documented case in which obstructive sub-aortic endocardium fibrosis within the left ventricular outflow tract is related with exposure to a drug that modifies the metabolism of serotonin. It now remains to be established whether extensive fibrosis of the myocardium in addition to well-documented valvular fibrosis may develop in patients exposed to amphetamine-derived drugs affecting the serotonin system.

Dishevelled 2 is essential for cardiac outflow tract development, somite segmentation and neural tube closure.

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Hamblet, Natasha S; Lijam, Nardos; Ruiz-Lozano, Pilar; Wang, Jianbo; Yang, Yasheng; Luo, Zhenge; Mei, Lin; Chien, Kenneth R; Sussman, Daniel J; Wynshaw-Boris, Anthony

2002-12-01

The murine dishevelled 2 (Dvl2) gene is an ortholog of the Drosophila segment polarity gene Dishevelled, a member of the highly conserved Wingless/Wnt developmental pathway. Dvl2-deficient mice were produced to determine the role of Dvl2 in mammalian development. Mice containing null mutations in Dvl2 present with 50% lethality in both inbred 129S6 and in a hybrid 129S6-NIH Black Swiss background because of severe cardiovascular outflow tract defects, including double outlet right ventricle, transposition of the great arteries and persistent truncus arteriosis. The majority of the surviving Dvl2(-/-) mice were female, suggesting that penetrance was influenced by sex. Expression of Pitx2 and plexin A2 was attenuated in Dvl2 null mutants, suggesting a defect in cardiac neural crest development during outflow tract formation. In addition, approximately 90% of Dvl2(-/-) mice have vertebral and rib malformations that affect the proximal as well as the distal parts of the ribs. These skeletal abnormalities were more pronounced in mice deficient for both Dvl1 and Dvl2. Somite differentiation markers used to analyze Dvl2(-/-) and Dvl1(-/-);Dvl2(-/-) mutant embryos revealed mildly aberrant expression of Uncx4.1, delta 1 and myogenin, suggesting defects in somite segmentation. Finally, 2-3% of Dvl2(-/-) embryos displayed thoracic spina bifida, while virtually all Dvl1/2 double mutant embryos displayed craniorachishisis, a completely open neural tube from the midbrain to the tail. Thus, Dvl2 is essential for normal cardiac morphogenesis, somite segmentation and neural tube closure, and there is functional redundancy between Dvl1 and Dvl2 in some phenotypes.

Left ventricular outflow tract arrhythmias with divergent QRS morphology: mapping of different exits and ablation strategy.

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Reithmann, Christopher; Fiek, Michael

2018-01-01

Ventricular arrhythmias (VAs) from the left ventricular outflow tract (LVOT) can have multiple exits exhibiting divergent ECG features. In a series of 131 patients with VAs with LVOT origin, 10 patients presented with divergent QRS morphologies. Multisite endo- and epicardial mapping of different exit sites was performed. The earliest ventricular activity of 23 LVOT VAs in 10 patients was detected in the endocardium of the LV in 7 patients, the aortic sinuses of Valsalva (SoV) in 3 patients, the distal coronary sinus in 6 patients, the anterior interventricular vein in 3 patients, and the posterior right ventricular outflow tract (RVOT) in 4 patients. Simultaneous elimination of two divergent QRS morphologies of LVOT VAs by ablation from a single site was achieved in 5 patients (aorto-mitral continuity in 3 patients, SoV and RVOT in each 1 patient) using a mean maximum ablation energy of 46 ± 5 W. Sequential ablation from two or three different sites, including trans-pericardial and distal coronary sinus ablation in each 2 patients, led to elimination of the divergent VA QRS morphologies in the other 5 patients. During the follow-up of 28 ± 29 months, 4 of the 10 patients had recurrence of at least one LVOT VA. A 43-year-old patient with muscular dystrophy Curschmann-Steinert had recurrence of sustained LVOT VTs and died of sudden cardiac death. Multisite mapping of different exit sites of LVOT VAs can guide ablation of intramural foci but the recurrence rate after initially successful ablation was high.

Right Ventricular Outflow Tract Tachycardia with Structural Abnormalities of the Right Ventricle and Left Ventricular Diverticulum

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Bortolo Martini

2015-01-01

Full Text Available A 43-year-old woman presented to the emergency room with a sustained ventricular tachycardia (VT. ECG showed a QRS in left bundle branch block morphology with inferior axis. Echocardiography, ventricular angiography, and cardiac magnetic resonance imaging (CMRI revealed a normal right ventricle and a left ventricular diverticulum. Electrophysiology studies with epicardial voltage mapping identified a large fibrotic area in the inferolateral layer of the right ventricular wall and a small area of fibrotic tissue at the anterior right ventricular outflow tract. VT ablation was successfully performed with combined epicardial and endocardial approaches.

Preservation of Frontal Sinus Anatomy and Outflow Tract Following Frontal Trauma with Dural Defect

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James Wei Ming Kwek, MBBS, MRCS

2015-02-01

Full Text Available Summary: Our case report describes a young male mechanic who was hit in his face by a spring while repairing a car, resulting in traumatic injury to the frontal sinus, with fractures of both the anterior and the posterior tables with dural defect and cerebrospinal fluid leak. Current guidelines recommend that comminuted and/or displaced fractures of the posterior table of the frontal sinus with dural defects should be either cranialized or obliterated. In this patient, instead of cranializing or obliterating the frontal sinus, we managed to preserve the frontal sinus anatomy and its outflow tract using a combined open bicoronal and nasoendoscopic approach. This avoids the long-term complications associated with cranialization or obliteration including mucocele formation and frontocutaneous fistula.

Nova técnica: translocação aórtica e pulmonar com preservação da valva pulmonar New technique: aortic and pulmonary translocation with preservation of pulmonary valve

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Gláucio Furlanetto

2010-03-01

Full Text Available Realizamos com sucesso novo procedimento cirúrgico, em duas crianças portadoras de transposição das grandes artérias associada a comunicação interventricular e obstrução da via de saída do ventrículo esquerdo. A cirurgia consiste na realização de translocação aórtica com a valva aórtica e as artérias coronárias para o ventrículo esquerdo, após a ampliação da via de saída desse ventrículo e da comunicação interventricular com pericárdio autólogo fixado em glutaraldeído, associada à translocação do tronco pulmonar para o ventrículo direito, conservando integralmente a valva pulmonar.We applied successfully, a new surgical technique, in two children with transposition of the great arteries with ventricular septal defect and left ventricular outflow tract obstruction, that utilized aortic translocation with the aortic valve and the coronary arteries to the left ventricle, after correction of left outflow tract obstruction and correction of the ventricular septal defect, associated to pulmonary root translocation to the right ventricle, conserving integrally the pulmonary valve.

Is there an anatomic basis for subvalvular right ventricular outflow tract obstruction after an arterial switch repair for complete transposition? A morphometric study and review

NARCIS (Netherlands)

Akiba, T.; Neirotti, R.; Becker, A. E.

1993-01-01

The study was initiated by reports on right ventricular outflow tract obstruction in complete transposition of the great arteries after an arterial switch repair. We investigated 39 heart specimens with native, unoperated transposition of the great arteries. Of these, 14 hearts had a ventricular

Infective Endocarditis Complicated by Septic Pulmonary Emboli in a Case of a Ventricular Septal Defect

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Roodpeyma

2015-11-01

Full Text Available Introduction Infective endocarditis (IE causes serious complications in patients. Congenital heart disease (CHD is an important underlying condition in children. Septic pulmonary embolism is an uncommon syndrome, and pulmonary valve IE is rare. The current study presented a case of right-sided IE with pulmonary valve involvement and its complications as pulmonary septic emboli in a child with CHD. Case Presentation A 6-year-old girl with a ventricular septal defect (VSD was presented. Echocardiography revealed large vegetation in the right ventricular outflow tract near the pulmonary valve. The patient showed clinical symptoms of lung involvement, and radiologic investigation was compatible with a diagnosis of septic pulmonary emboli. She had good response to antibacterial therapy and underwent a successful surgical closure of the heart defect. Conclusions Children with CHD are at risk of severe complications with the involvement of other organs. long-term febrile illness should be taken seriously in these children. They need hospitalization and careful evaluation.

[Percutaneous catheter-based implantation of artificial pulmonary valves in patients with congenital heart defects].

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Wyller, Vegard Bruun; Aaberge, Lars; Thaulow, Erik; Døhlen, Gaute

2011-07-01

Percutaneous catheter-based implantation of artificial heart valves is a new technique that may supplement surgery and which may be used more in the future. We here report our first experience with implantation of artificial pulmonary valves in children with congenital heart defects. Eligible patients were those with symptoms of heart failure combined with stenosis and/or insufficiency in an established artificial right ventricular outflow tract. The valve was inserted through a catheter from a vein in the groin or neck. Symptoms, echocardiography, invasive measurements and angiography were assessed for evaluation of treatment effect. Our treatment results are reported for the period April 2007-September 2009. Ten patients (seven men and three women, median age 17 years) were assessed. The procedure reduced pressure in the right ventricle (p = 0.008) and resolved the pulmonary insufficiency in all patients. The median time in hospital was two days. No patients had complications that were directly associated with the implantation procedure. One patient developed a pseudoaneurysm in the femoral artery, another had a short-lasting fever two days after the procedure and one patient experienced a stent fracture that required surgery 9 months after the implantation. After 6 months all patients had a reduced pressure gradient in the right ventricular outflow tract (p = 0.008), the pulmonary insufficiency had improved (p = 0.006) and they all reported improval of symptoms. These results persisted for at least 24 months for the four patients who were monitored until then. Percutaneous catheter-based implantation of artificial pulmonary valves improves hemodynamics in the right ventricle of selected patients with congenital heart defects. A randomized controlled study should be undertaken to provide a stronger evidence-base for usefulness of this procedure.

Quantitative assessment of pulmonary regurgitation in patients with and without right ventricular tract obstruction

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Spiewak, Mateusz, E-mail: mspiewak@ikard.pl [Department of Coronary Artery Disease and Structural Heart Diseases, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Cardiovascular Magnetic Resonance Unit, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Biernacka, Elzbieta K., E-mail: kbiernacka@ikard.pl [Department of Congenital Heart Diseases, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Malek, Lukasz A., E-mail: lmalek@ikard.pl [Cardiovascular Magnetic Resonance Unit, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Department of Interventional Cardiology and Angiology, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Misko, Jolanta, E-mail: jmisko@wp.pl [Cardiovascular Magnetic Resonance Unit, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Department of Radiology, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Kowalski, Miroslaw, E-mail: mkowalski@ikard.pl [Department of Congenital Heart Diseases, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Milosz, Barbara, E-mail: barbara-milosz@o2.pl [Cardiovascular Magnetic Resonance Unit, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Department of Radiology, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Petryka, Joanna, E-mail: joannapetryka@hotmail.com [Department of Coronary Artery Disease and Structural Heart Diseases, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Cardiovascular Magnetic Resonance Unit, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Zabicka, Magdalena, E-mail: mzabicka@onet.eu [Cardiovascular Magnetic Resonance Unit, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Dept. of Radiology, Inst. of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Ruzyllo, Witold, E-mail: wruzyllo@ikard.pl [Inst. of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland)

2011-11-15

Background: There are concerns whether there is a difference in clinical utility of pulmonary regurgitation (PR) fraction (PRF) and PR volume (PRV) in subgroups of patients with isolated PR and individuals with combined PR and right ventricular outflow tract obstruction (RVOTO). The aim of the study was to compare PRF and PRV in patients with or without RVOTO. Methods and results: 82 consecutive patients after repair of tetralogy of Fallot (TOF) who underwent cardiovascular magnetic resonance and echocardiography were studied. There was no difference in PRF between patients with moderate and severe right ventricular (RV) dilatation (32 {+-} 13% vs. 37 {+-} 12%; p = 0.18). Significant difference in PRV was observed between these groups (23 {+-} 10 ml/m{sup 2} vs. 31 {+-} 12 ml/m{sup 2}, respectively; p = 0.02). PRV had better ability than PRF in identification of severe RV dilatation, both in group with RVOTO [area under the curve (AUC) 0.82 vs. 0.72, p = 0.005] and in patients without RVOTO (AUC 0.83 vs. 0.77, p = 0.04). A strong correlation was seen between PRF and PRV both in patients with and without RVOTO [r = 0.93, p < 0.0001 and r = 0.92, p < 0.0001, respectively]. In both subgroups high variability of PRF was found in subjects with similar degree of PRV. Conclusions: PRV shows better ability than PRF in evaluating influence of PR on RV in patients after TOF repair, both in population with and without concomitant RVOTO.

Late outcome of right ventricular outflow tract repair using bicuspid pulmonary prosthesis in tetralogy of Fallot surgery repair: case report Resultado tardio da reconstrução da via de saída do ventrículo direito com prótese pulmonar bicúspide na correção da tetralogia de Fallot: relato de caso

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Miguel Angel Maluf

2009-12-01

Full Text Available We present a case of a 19 year-old female patient, with tetralogy of Fallot and hypoplastic pulmonary ring. Diagnosis was performed by echocardiography and cardiac catheterization. The surgical repair was performed at the age of 2 years old. A right ventricular outflow tract remodeling was performed using a porcine pulmonary bicuspid prosthesis. The patient presented a uneventful follow-up during 17 years. Postoperative assessment has shown: mild pulmonary insufficiency and mild pulmonary ventricle gradient, satisfactory right ventricular performance and prosthesis not presenting calcification. This is an option to correct the tetralogy of Fallot adopted by our Institution in the last two decades.É apresentado o caso de uma paciente de 19 anos de idade, sexo feminino, portadora de tetralogia de Fallot com anel pulmonar hipoplásico. O diagnóstico foi feito com ecoDopplercardiograma e cateterismo cardíaco. A correção cirúrgica foi realizada com 2 anos de idade. Para a reconstrução da valva pulmonar e via de saída do ventrículo foi utilizada prótese bivalvular pulmonar porcina. A paciente teve boa evolução clínica durante 17 anos. A avaliação pós-operatória demonstrou: discreta insuficiência pulmonar, discreto gradiente transvalvar pulmonar, desempenho do ventrículo direito preservado e prótese pulmonar sem calcificação. Esse é o procedimento adotado pela nossa Instituição para a correção da tetralogia de Fallot, nos últimos 20 anos.

Pericardial tissue valves and Gore-Tex conduits as an alternative for right ventricular outflow tract replacement in children.

Science.gov (United States)

Allen, Bradley S; El-Zein, Chawki; Cuneo, Betina; Cava, Joseph P; Barth, Mary Jane; Ilbawi, Michel N

2002-09-01

There is still no perfect conduit for reconstruction of the right ventricular outflow tract (RVOT) in children. Homografts are not always available in the appropriate size, and degenerate in a few years. This study evaluates the pericardial valve with Gore-Tex conduit as an alternative for RVOT construction. From January 1, 1993, to September 30, 1999, a pericardial tissue valve was inserted in all patients undergoing RVOT reconstruction or pulmonary valve replacement (PVR) who were large enough to accommodate a tissue valve. In patients without a native main pulmonary artery, a new technique was used to construct an RV-PA conduit out of a flat sheet of Gore-Tex, as Dacron frequently leads to stenosis. Data were collected by retrospective review, follow-up echocardiograms, and assessment by a single cardiologist. There were 48 patients, 22 undergoing a PVR alone and 26 a RV-PA valved Gore-Tex conduit. Diagnosis included tetralogy of Fallot (n = 25); truncus arteriosis (n = 9); ventricular septal defect with PA (n = 5); DORV (n = 4); D-TGA with PS (n = 2); and 1 each IAA with sub AS, VSD with PI, and PS s/p Ross procedure. Patient age ranged from 3 to 33 years and 98% were reoperations. The valve sizes ranged from 19 to 33 mm and the median hospital length of stay was 4 days. There were 2 (4.2%) perioperative and 1 (2.1%) late deaths, none related to the valve or Gore-Tex conduit. At a follow-up of 15 to 86 months (mean 43 +/- 16 months), all remaining 45 patients are New York Heart Association class I, all valves are functional, and no patient has required valve or conduit replacement or revision; more importantly, echocardiogram revealed no significant valve or conduit stenosis (mean gradient 16 +/- 8 mm Hg) and no evidence of regurgitation or structural degeneration. A pericardial tissue valve and Gore-Tex conduit provides a reliable alternative for RVOT reconstruction in pediatric patients. It is readily available, molds in the limited retrosternal space, and

Primary intimal sarcoma of the pulmonary artery 1 case report and retrospective analysis of 20 cases published in China

International Nuclear Information System (INIS)

Guo Lingchuan; Chen Yanbin

2012-01-01

Objective: To explore the clinical and histopathological features of primary, intimal sarcoma of the pulmonary artery. Methods: One case of primary intimal sarcoma of the pulmonary artery diagnosed in our hospital and 20 cases published openly in China were analysed retrospectively. Results: The clinical presentation of primary intimal sarcoma of the pulmonary artery was progressive dyspnea, cough, chest pain, syncope, bloody phlegm, fever and fatigue. From the radiological finding, its signs were of pulmonary, artery dilation, reduced pulmonary vasculature and cardiomegaly, soft tissue mass near the right ventricle outflow tract. Histological examination of intimal sarcoma of the pulmonary artery revealed a poorly differentiated mesenchymal tumor of fibroblastic or myofibroblastic differentiation, consisting of mildly atypical spindle cells with atypia, mitosis, and nuclear polymorphism. Immunohistochemical analysis showed positive staining with antibodies against vimentin, alpha-smooth muscle actin, while negative for desmin. Conclusion: Primary, intimal sarcoma of the pulmonary artery has atypical clinical and radiological manifestation with poor prognosis, its definite diagnosis depends on histopathology. (authors)

Dynamic left ventricular outflow tract obstruction secondary to hypovolemia in a German Shepard dog with splenic hemangiosarcoma.

Science.gov (United States)

Aoki, Takuma; Sunahara, Hiroshi; Sugimoto, Keisuke; Ito, Tetsuro; Kanai, Eiichi; Neo, Sakurako; Fujii, Yoko; Wakao, Yoshito

2015-09-01

Dynamic left ventricular outflow tract obstruction (DLVOTO) is a common condition in cats and humans. In this case report, a dog is described with DLVOTO secondary to severe intra-abdominal hemorrhage caused by a hemangiosarcoma. The dog was a 9-year-old, 35.7-kg, spayed female German Shepard dog that presented with a history of tachypnea and collapse. A Levine II/VI systolic murmur was present at the heart base. Abdominal ultrasonography revealed a splenic mass and a large amount of ascites. Echocardiography showed a reduced left ventricular diameter and an increased aortic velocity caused by systolic anterior motion (SAM) of the mitral valve apparatus. The heart murmur and the SAM were resolved after treatment including a splenectomy and a blood transfusion.

Quantitative assessment of pulmonary regurgitation in patients with and without right ventricular tract obstruction

International Nuclear Information System (INIS)

Spiewak, Mateusz; Biernacka, Elzbieta K.; Malek, Lukasz A.; Misko, Jolanta; Kowalski, Miroslaw; Milosz, Barbara; Petryka, Joanna; Zabicka, Magdalena; Ruzyllo, Witold

2011-01-01

Background: There are concerns whether there is a difference in clinical utility of pulmonary regurgitation (PR) fraction (PRF) and PR volume (PRV) in subgroups of patients with isolated PR and individuals with combined PR and right ventricular outflow tract obstruction (RVOTO). The aim of the study was to compare PRF and PRV in patients with or without RVOTO. Methods and results: 82 consecutive patients after repair of tetralogy of Fallot (TOF) who underwent cardiovascular magnetic resonance and echocardiography were studied. There was no difference in PRF between patients with moderate and severe right ventricular (RV) dilatation (32 ± 13% vs. 37 ± 12%; p = 0.18). Significant difference in PRV was observed between these groups (23 ± 10 ml/m 2 vs. 31 ± 12 ml/m 2 , respectively; p = 0.02). PRV had better ability than PRF in identification of severe RV dilatation, both in group with RVOTO [area under the curve (AUC) 0.82 vs. 0.72, p = 0.005] and in patients without RVOTO (AUC 0.83 vs. 0.77, p = 0.04). A strong correlation was seen between PRF and PRV both in patients with and without RVOTO [r = 0.93, p < 0.0001 and r = 0.92, p < 0.0001, respectively]. In both subgroups high variability of PRF was found in subjects with similar degree of PRV. Conclusions: PRV shows better ability than PRF in evaluating influence of PR on RV in patients after TOF repair, both in population with and without concomitant RVOTO.

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

Effect of Left Ventricular Outflow Tract Obstruction on Left Atrial Mechanics in Hypertrophic Cardiomyopathy

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Lynne K. Williams

2015-01-01

Full Text Available Left atrial (LA volumes are known to be increased in hypertrophic cardiomyopathy (HCM and are a predictor of adverse outcome. In addition, LA function is impaired and is presumed to be due to left ventricular (LV diastolic dysfunction as a result of hypertrophy and myocardial fibrosis. In the current study, we assess the incremental effect of outflow tract obstruction (and concomitant mitral regurgitation on LA function as assessed by LA strain. Patients with HCM (50 obstructive, 50 nonobstructive were compared to 50 normal controls. A subset of obstructive patients who had undergone septal myectomy was also studied. Utilising feature-tracking software applied to cardiovascular magnetic resonance images, LA volumes and functional parameters were calculated. LA volumes were significantly elevated and LA ejection fraction and strain were significantly reduced in patients with HCM compared with controls and were significantly more affected in patients with obstruction. LA volumes and function were significantly improved after septal myectomy. LVOT obstruction and mitral regurgitation appear to further impair LA mechanics. Septal myectomy results in a significant reduction in LA volumes, paralleled by an improvement in function.

Fresh Autologous Pericardium to Reconstruct the Pulmonary Valve at the Annulus When Tetralogy of Fallot Requires a Transannular Patch at Midterm.

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Pande, Shantanu; Sharma, Jugal K; Siddartha, C R; Bansal, Anubhav; Agarwal, Surendra K; Tewari, Prabhat; Kapoor, Aditya

2016-06-01

Tetralogy of Fallot often requires reconstruction of the right ventricular outflow tract with a transannular patch (TAP), but this renders the pulmonary valve incompetent and eventually leads to right ventricular dysfunction. We retrospectively evaluated the efficacy of a reconstructed pulmonary valve and annulus in 70 patients who underwent, from December 2006 through December 2010, complete correction of tetralogy of Fallot. We divided the 70 patients into 2 groups in accordance with whether they required (n=50) or did not require (n=20) a TAP. We used autologous untreated pericardium to fashion the TAP and to create both an annulus of the correct size and a competent pulmonary valve with native leaflets. We evaluated the efficiency of this procedure both functionally and anatomically. The median age of the patients was 11 years (range, 2-38 yr). There were 56 males, with no significant difference in sexual distribution between groups. The clinical follow-up was 88% for 57.5 months, and the echocardiographic follow-up was 80% for 36 months. There was no significant difference in outflow gradient or in the occurrence of pulmonary insufficiency between the TAP group (none, 31; mild, 12; moderate, 6; and severe, 1) and the No-TAP group (none, 16; moderate, 2; and severe, 2) (P=0.59). Nor was there any thickening or calcification in the constructed valves. We conclude that pulmonary valves constructed of untreated autologous pericardium performed as well as native valves after total tetralogy of Fallot correction at midterm.

[Right branch pulmonary artery stenosis with supravalvar aortic stenosis as a complication of Lecompte maneuver for tetralogy of Fallot associated with absent pulmonary valve].

Science.gov (United States)

Honda, Yoshihiro; Suzuki, Shoji; Kaga, Shigeaki; Yoshida, Yukiyo; Kimura, Mitsuhiro; Kamiya, Kentaro; Sakakibara, Kenji; Katsu, Masatake

2015-05-01

The patient was diagnosed with tetralogy of Fallot associated with absent pulmonary valve syndrome and a low birth weight of 1,912 g. He suffered from respiratory distress on day 14 and received non-invasive positive pressure ventilation. At 5 months of age and 4.1 kg, he underwent intracardiac repair including right ventricular outflow repair with a monocusp patch, patch closure of the ventricular septum defect and right pulmonary transposition to the anterior of the ascending aorta following the Lecompte maneuver for airway decompression. He was subsequently discharged to home and exhibited an uneventful clinical course with non-invasive positive pressure ventilation for 5 months postoperatively. However, right pulmonary artery and supra-aortic stenosis was noted 2 years after the operation. Computed tomography (CT) and angiography showed ascending aorta strangulation by the right pulmonary artery with right ventricular outflow regurgitation. Right pulmonary artery reconstruction using polytetrafluoroethylene graft interposition and repeat right ventricular outflow repair with bicuspid hand-sewn valves was therefore performed;the postoperative course was uneventful. Pre- and post-operative management using non-invasive positive pressure ventilation and airway decompression with pulmonary artery translocation is a useful strategy in patients exhibiting symptomatic tetralogy of Fallot associated with absent pulmonary valve syndrome in the neonatal period.

Changes in dynamic embryonic heart wall motion in response to outflow tract banding measured using video densitometry

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Stovall, Stephanie; Midgett, Madeline; Thornburg, Kent; Rugonyi, Sandra

2016-11-01

Abnormal blood flow during early cardiovascular development has been identified as a key factor in the pathogenesis of congenital heart disease; however, the mechanisms by which altered hemodynamics induce cardiac malformations are poorly understood. This study used outflow tract (OFT) banding to model increased afterload, pressure, and blood flow velocities at tubular stages of heart development and characterized the immediate changes in cardiac wall motion due to banding in chicken embryo models with light microscopy-based video densitometry. Optical videos were used to acquire two-dimensional heart image sequences over the cardiac cycle, from which intensity data were extracted along the heart centerline at several locations in the heart ventricle and OFT. While no changes were observed in the synchronous contraction of the ventricle with banding, the peristaltic-like wall motion in the OFT was significantly affected. Our data provide valuable insight into early cardiac biomechanics and its characterization using a simple light microscopy-based imaging modality.

An Unusual Aneurysm of the Main Pulmonary Artery Presenting as Acute Coronary Syndrome

International Nuclear Information System (INIS)

Kholeif, Mona A.; El Tahir, Mohamed; Kholeif, Yasser A.; El Watidy, Ahmed

2006-01-01

A 70-year old man presented with retrosternal chest pain. His electrocardiogram showed nonspecific T wave changes. Cardiac-specific troponin I (cTnI) was elevated. His condition was managed as acute coronary syndrome, following which he had two minor episodes of hemoptysis. A CT pulmonary angiogram showed no evidence of pulmonary embolism, but a large mass lesion was seen in the mediastinum. Echocardiography and cardiac MRI demonstrated a large solid mass, arising from the right ventricular outflow tract and causing compression of the main pulmonary artery (MPA). The differential diagnosis included pericardial and myocardial tumors and clotted aneurysm of the MPA. At surgery, a clotted aneurysmal sac was identified originating from the MPA and the defect was healed. Aneurysms of the MPA are rare. They most commonly present with dyspnea and chest pain. Compression of surrounding structures produces protean manifestations. A high index of suspicion coupled with imaging modalities establishes the diagnosis. Blunt trauma to the chest, at the time of an accident 4 years previously, may explain this aneurysm. The patient's presentation with chest pain was probably due to compression and/or stretching of surrounding structures. Coronary artery compression simulating acute coronary syndrome has been documented in the literature. The rise in cTnI may have been due to right ventricular strain, as a result of right ventricular outflow obstruction by the aneurysm. This has not been reported previously in the literature. The saccular morphology and narrow neck of the aneurysm predisposed to stagnation leading to clotting of the lumen and healing of the tear, which caused the diagnostic difficulty

Murine dishevelled 3 functions in redundant pathways with dishevelled 1 and 2 in normal cardiac outflow tract, cochlea, and neural tube development.

Science.gov (United States)

Etheridge, S Leah; Ray, Saugata; Li, Shuangding; Hamblet, Natasha S; Lijam, Nardos; Tsang, Michael; Greer, Joy; Kardos, Natalie; Wang, Jianbo; Sussman, Daniel J; Chen, Ping; Wynshaw-Boris, Anthony

2008-11-01

Dishevelled (Dvl) proteins are important signaling components of both the canonical beta-catenin/Wnt pathway, which controls cell proliferation and patterning, and the planar cell polarity (PCP) pathway, which coordinates cell polarity within a sheet of cells and also directs convergent extension cell (CE) movements that produce narrowing and elongation of the tissue. Three mammalian Dvl genes have been identified and the developmental roles of Dvl1 and Dvl2 were previously determined. Here, we identify the functions of Dvl3 in development and provide evidence of functional redundancy among the three murine Dvls. Dvl3(-/-) mice died perinatally with cardiac outflow tract abnormalities, including double outlet right ventricle and persistent truncus arteriosis. These mutants also displayed a misorientated stereocilia in the organ of Corti, a phenotype that was enhanced with the additional loss of a single allele of the PCP component Vangl2/Ltap (LtapLp/+). Although neurulation appeared normal in both Dvl3(-/-) and LtapLp/+ mutants, Dvl3(+/-);LtapLp/+ combined mutants displayed incomplete neural tube closure. Importantly, we show that many of the roles of Dvl3 are also shared by Dvl1 and Dvl2. More severe phenotypes were observed in Dvl3 mutants with the deficiency of another Dvl, and increasing Dvl dosage genetically with Dvl transgenes demonstrated the ability of Dvls to compensate for each other to enable normal development. Interestingly, global canonical Wnt signaling appeared largely unaffected in the double Dvl mutants, suggesting that low Dvl levels are sufficient for functional canonical Wnt signals. In summary, we demonstrate that Dvl3 is required for cardiac outflow tract development and describe its importance in the PCP pathway during neurulation and cochlea development. Finally, we establish several developmental processes in which the three Dvls are functionally redundant.

Murine dishevelled 3 functions in redundant pathways with dishevelled 1 and 2 in normal cardiac outflow tract, cochlea, and neural tube development.

Directory of Open Access Journals (Sweden)

S Leah Etheridge

2008-11-01

Full Text Available Dishevelled (Dvl proteins are important signaling components of both the canonical beta-catenin/Wnt pathway, which controls cell proliferation and patterning, and the planar cell polarity (PCP pathway, which coordinates cell polarity within a sheet of cells and also directs convergent extension cell (CE movements that produce narrowing and elongation of the tissue. Three mammalian Dvl genes have been identified and the developmental roles of Dvl1 and Dvl2 were previously determined. Here, we identify the functions of Dvl3 in development and provide evidence of functional redundancy among the three murine Dvls. Dvl3(-/- mice died perinatally with cardiac outflow tract abnormalities, including double outlet right ventricle and persistent truncus arteriosis. These mutants also displayed a misorientated stereocilia in the organ of Corti, a phenotype that was enhanced with the additional loss of a single allele of the PCP component Vangl2/Ltap (LtapLp/+. Although neurulation appeared normal in both Dvl3(-/- and LtapLp/+ mutants, Dvl3(+/-;LtapLp/+ combined mutants displayed incomplete neural tube closure. Importantly, we show that many of the roles of Dvl3 are also shared by Dvl1 and Dvl2. More severe phenotypes were observed in Dvl3 mutants with the deficiency of another Dvl, and increasing Dvl dosage genetically with Dvl transgenes demonstrated the ability of Dvls to compensate for each other to enable normal development. Interestingly, global canonical Wnt signaling appeared largely unaffected in the double Dvl mutants, suggesting that low Dvl levels are sufficient for functional canonical Wnt signals. In summary, we demonstrate that Dvl3 is required for cardiac outflow tract development and describe its importance in the PCP pathway during neurulation and cochlea development. Finally, we establish several developmental processes in which the three Dvls are functionally redundant.

Canadian Cardiovascular Society 2009 Consensus Conference on the management of adults with congenital heart disease: Outflow tract obstruction, coarctation of the aorta, tetralogy of Fallot, Ebstein anomaly and Marfan’s syndrome

Science.gov (United States)

Silversides, Candice K; Beauchesne, Luc; Bradley, Timothy; Connelly, Michael; Niwa, Koichiro; Mulder, Barbara; Webb, Gary; Colman, Jack; Therrien, Judith

2010-01-01

With advances in pediatric cardiology and cardiac surgery, the population of adults with congenital heart disease (CHD) has increased. In the current era, there are more adults with CHD than children. This population has many unique issues and needs. Since the 2001 Canadian Cardiovascular Society Consensus Conference report on the management of adults with CHD, there have been significant advances in the field of adult CHD. Therefore, new clinical guidelines have been written by Canadian adult CHD physicians in collaboration with an international panel of experts in the field. Part II of the guidelines includes recommendations for the care of patients with left ventricular outflow tract obstruction and bicuspid aortic valve disease, coarctation of the aorta, right ventricular outflow tract obstruction, tetralogy of Fallot, Ebstein anomaly and Marfan’s syndrome. Topics addressed include genetics, clinical outcomes, recommended diagnostic workup, surgical and interventional options, treatment of arrhythmias, assessment of pregnancy risk and follow-up requirements. The complete document consists of four manuscripts that are published online in the present issue of The Canadian Journal of Cardiology. The complete document and references can also be found at www.ccs.ca or www.cachnet.org. PMID:20352138

Improving left ventricular outflow tract obstruction repair in common atrioventricular canal defects.

Science.gov (United States)

Myers, Patrick O; del Nido, Pedro J; Marx, Gerald R; Emani, Sitaram; Mayer, John E; Pigula, Frank A; Baird, Christopher W

2012-08-01

Left ventricular outflow tract obstruction (LVOTO) is the second most frequent reason for reoperation after atrioventricular canal (AVC) defect repair. Limited data are available on the mechanisms of LVOTO, their treatment, and outcomes. Between 1998 and 2010, 56 consecutive children with AVC underwent 68 LVOTO procedures. The AVC was partial in 4, transitional in 9, and complete in 43. The LVOTO procedure was required in 21 patients at the primary AVC repair, and the initial LVOTO procedure in 35 patients was a late reoperation after AVC repair. During a mean follow-up of 50±41 months, 5 patients (24%) with LVOTO repair at AVC repair required a reoperation for LVOTO, and 7 patients (20%) whose initial LVOTO repair was a reoperation required a second reoperation for LVOTO repair. Overall freedom from LVOTO reoperation was 98.5% at 1 year, 92.5% at 3 years, 81% at 5 years, 72.2% at 7 years, and 52.5% at 10 and 12 years. The freedom from reoperation was neither significantly different between partial, transitional, and complete AVC (p=0.78) nor between timing of the LVOT procedure (p=0.49). Modified single-patch AVC repair was associated with a higher LVOTO reoperation rate (p=0.04). Neither the mechanisms leading to LVOTO nor the surgical techniques used were independent predictors of reoperation. LVOTO in AVC is a complex and multifactorial disease. Aggressive surgical repair has improved late outcomes; however, risk factors for reoperation and the ideal approach for repair remain to be defined. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Prickle1 mutation causes planar cell polarity and directional cell migration defects associated with cardiac outflow tract anomalies and other structural birth defects

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Brian C. Gibbs

2016-03-01

Full Text Available Planar cell polarity (PCP is controlled by a conserved pathway that regulates directional cell behavior. Here, we show that mutant mice harboring a newly described mutation termed Beetlejuice (Bj in Prickle1 (Pk1, a PCP component, exhibit developmental phenotypes involving cell polarity defects, including skeletal, cochlear and congenital cardiac anomalies. Bj mutants die neonatally with cardiac outflow tract (OFT malalignment. This is associated with OFT shortening due to loss of polarized cell orientation and failure of second heart field cell intercalation mediating OFT lengthening. OFT myocardialization was disrupted with cardiomyocytes failing to align with the direction of cell invasion into the outflow cushions. The expression of genes mediating Wnt signaling was altered. Also noted were shortened but widened bile ducts and disruption in canonical Wnt signaling. Using an in vitro wound closure assay, we showed Bj mutant fibroblasts cannot establish polarized cell morphology or engage in directional cell migration, and their actin cytoskeleton failed to align with the direction of wound closure. Unexpectedly, Pk1 mutants exhibited primary and motile cilia defects. Given Bj mutant phenotypes are reminiscent of ciliopathies, these findings suggest Pk1 may also regulate ciliogenesis. Together these findings show Pk1 plays an essential role in regulating cell polarity and directional cell migration during development.

Efecto de la localización del electrodo ventricular derecho (tracto de salida vs. ápex sobre la sincronía ventricular mecánica, en pacientes sometidos a terapia de implante de marcapaso cardiaco Effect of right ventricular electrode location (outflow tract vs. apex on mechanical ventricular synchrony in patients that underwent pacemaker implant therapy

Directory of Open Access Journals (Sweden)

Oscar S Rincón

2008-12-01

Full Text Available Objetivo: evaluar a profundidad el efecto de la estimulación ventricular desde el tracto de salida del ventrículo derecho y el ápex, sobre la sincronía ventricular mecánica. Materiales y métodos: estudio analítico de cohorte, en el que se realizó ecocardiograma transtorácico pre y post implante de marcapaso a 20 pacientes (diez por cada grupo con indicación de marcapaso definitivo, con implante del electrodo en el tracto de salida del ventrículo derecho y el ápex, sin cardiopatía estructural, fracción de eyección > 50%; QRS y conducción aurículo-ventricular normal, con el fin de evaluar la asincronía ventricular mecánica (modo M y Doppler tisular y los parámetros de implante y programación del dispositivo. Análisis estadístico: los resultados se presentan como promedios, desviación estándar o porcentajes. Las variables continuas se compararon utilizando prueba Chi cuadrado y ANOVA. Se consideró como estadísticamente significativa una p Objective: to assess in depth the effect of ventricular stimulation from the right ventricular outflow tract and the apex on mechanical ventricular synchrony. Materials and Methods: cohort analytical study. 20 patients with indication of definitive pacemaker indication underwent transthoracic echocardiogram before and after pacemaker implant with electrode implantation in the right ventricular outflow tract and in the apex (10 patients in each group. There was no structural cardiopathy, ejection fraction was > 50%, QRS and AV conduction were normal. Mechanical ventricular asynchrony (M mode and tissue doppler and implant and device parameters were evaluated. Statistical Analysis: results are given as mean values, standard deviation or percentages. Continuous variables were compared using Chi-square test and ANOVA. A p <0.05 value was considered statistically significant. Results: in five patients (25% a pre-implant ventricular asynchrony was found; in seven (70% ventricular asynchrony

Successful radiofrequency catheter ablation assisted by the CartoSound® system for outflow tract origin nonsustained ventricular tachycardia in a patient with a severely deformed thorax

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Naoaki Onishi

2014-02-01

Full Text Available We report the case of a 72-year-old man with a nonsustained ventricular tachycardia and a history of palpitations. He had a severely deformed thorax since childhood due to spinal caries. An integrated computed tomography image of the outflow tract region from the CartoSound® system revealed the detailed anatomical information around the origin of the tachycardia and that the left anterior descending coronary artery was very close (<10 mm to the target site. We carefully ablated that site with a 3.5-mm cooled-tip catheter while confirming it in the sound view, and succeeded without any complications.

Pulmonary stenosis and pulmonary regurgitation: both ends of the spectrum in residual hemodynamic impairment after tetralogy of Fallot repair

Science.gov (United States)

Park, Han Ki

2013-01-01

Repair of tetralogy of Fallot (TOF) has shown excellent outcomes. However it leaves varying degrees of residual hemodynamic impairment, with severe pulmonary stenosis (PS) and free pulmonary regurgitation (PR) at both ends of the spectrum. Since the 1980s, studies evaluating late outcomes after TOF repair revealed the adverse impacts of residual chronic PR on RV volume and function; thus, a turnaround of operational strategies has occurred from aggressive RV outflow tract (RVOT) reconstruction for complete relief of RVOT obstruction to conservative RVOT reconstruction for limiting PR. This transformation has raised the question of how much residual PS after conservative RVOT reconstruction is acceptable. Besides, as pulmonary valve replacement (PVR) increases in patients with RV deterioration from residual PR, there is concern regarding when it should be performed. Regarding residual PS, several studies revealed that PS in addition to PR was associated with less PR and a small RV volume. This suggests that PS combined with PR makes RV diastolic property to protect against dilatation through RV hypertrophy and supports conservative RVOT enlargement despite residual PS. Also, several studies have revealed the pre-PVR threshold of RV parameters for the normalization of RV volume and function after PVR, and based on these results, the indications for PVR have been revised. Although there is no established strategy, better understanding of RV mechanics, development of new surgical and interventional techniques, and evidence for the effect of PVR on RV reverse remodeling and its late outcome will aid us to optimize the management of TOF. PMID:23807889

Pulmonary stenosis and pulmonary regurgitation: both ends of the spectrum in residual hemodynamic impairment after tetralogy of Fallot repair.

Science.gov (United States)

Yoo, Byung Won; Park, Han Ki

2013-06-01

Repair of tetralogy of Fallot (TOF) has shown excellent outcomes. However it leaves varying degrees of residual hemodynamic impairment, with severe pulmonary stenosis (PS) and free pulmonary regurgitation (PR) at both ends of the spectrum. Since the 1980s, studies evaluating late outcomes after TOF repair revealed the adverse impacts of residual chronic PR on RV volume and function; thus, a turnaround of operational strategies has occurred from aggressive RV outflow tract (RVOT) reconstruction for complete relief of RVOT obstruction to conservative RVOT reconstruction for limiting PR. This transformation has raised the question of how much residual PS after conservative RVOT reconstruction is acceptable. Besides, as pulmonary valve replacement (PVR) increases in patients with RV deterioration from residual PR, there is concern regarding when it should be performed. Regarding residual PS, several studies revealed that PS in addition to PR was associated with less PR and a small RV volume. This suggests that PS combined with PR makes RV diastolic property to protect against dilatation through RV hypertrophy and supports conservative RVOT enlargement despite residual PS. Also, several studies have revealed the pre-PVR threshold of RV parameters for the normalization of RV volume and function after PVR, and based on these results, the indications for PVR have been revised. Although there is no established strategy, better understanding of RV mechanics, development of new surgical and interventional techniques, and evidence for the effect of PVR on RV reverse remodeling and its late outcome will aid us to optimize the management of TOF.

Pulmonary stenosis and pulmonary regurgitation: both ends of the spectrum in residual hemodynamic impairment after tetralogy of Fallot repair

Directory of Open Access Journals (Sweden)

Byung Won Yoo

2013-06-01

Full Text Available Repair of tetralogy of Fallot (TOF has shown excellent outcomes. However it leaves varying degrees of residual hemodynamic impairment, with severe pulmonary stenosis (PS and free pulmonary regurgitation (PR at both ends of the spectrum. Since the 1980s, studies evaluating late outcomes after TOF repair revealed the adverse impacts of residual chronic PR on RV volume and function; thus, a turnaround of operational strategies has occurred from aggressive RV outflow tract (RVOT reconstruction for complete relief of RVOT obstruction to conservative RVOT reconstruction for limiting PR. This transformation has raised the question of how much residual PS after conservative RVOT reconstruction is acceptable. Besides, as pulmonary valve replacement (PVR increases in patients with RV deterioration from residual PR, there is concern regarding when it should be performed. Regarding residual PS, several studies revealed that PS in addition to PR was associated with less PR and a small RV volume. This suggests that PS combined with PR makes RV diastolic property to protect against dilatation through RV hypertrophy and supports conservative RVOT enlargement despite residual PS. Also, several studies have revealed the pre-PVR threshold of RV parameters for the normalization of RV volume and function after PVR, and based on these results, the indications for PVR have been revised. Although there is no established strategy, better understanding of RV mechanics, development of new surgical and interventional techniques, and evidence for the effect of PVR on RV reverse remodeling and its late outcome will aid us to optimize the management of TOF.

Transcatheter balloon dilation for recurrent right ventricular outflow tract obstruction following valve-sparing repair of tetralogy of Fallot.

Science.gov (United States)

Gellis, Laura; Banka, Puja; Marshall, Audrey; Emani, Sitaram; Porras, Diego

2015-10-01

Valve-sparing repair in patients with tetralogy of Fallot (TOF) carries the risk of residual or recurrent right ventricular outflow tract (RVOT) obstruction, which is often treated with transcatheter balloon dilation (BD). The outcomes and associated complications of BD of the RVOT in this scenario remain unknown. Retrospective review of the records of the Department of Cardiology at Boston Children's Hospital from 2000 to 2013 was performed. 34 patients had initial valve-sparing repair of tetralogy of Fallot followed by BD of the RVOT during the study period. Following BD, the RVOT gradient decreased from a median of 43 mm Hg (range 13 to 79 mm Hg) to 28 mm Hg (range 0 to 73 mm Hg) (P 1 and a final RVOT gradient of ≥40 post-BD were associated with shorter freedom from reintervention (P < 0.001). BD in patients with recurrent RVOT obstruction following valve-sparing repair of TOF acutely reduces the RVOT gradient, but commonly results in increased PR and is associated with a high reintervention rate. Patients with stenosis solely at the level of the valve had a better response to this type of intervention. © 2015 Wiley Periodicals, Inc.

Outcomes of pulmonary valve replacement in 170 patients with chronic pulmonary regurgitation after relief of right ventricular outflow tract obstruction: implications for optimal timing of pulmonary valve replacement.

Science.gov (United States)

Lee, Cheul; Kim, Yang Min; Lee, Chang-Ha; Kwak, Jae Gun; Park, Chun Soo; Song, Jin Young; Shim, Woo-Sup; Choi, Eun Young; Lee, Sang Yun; Baek, Jae Suk

2012-09-11

The objectives of this study were to evaluate outcomes of pulmonary valve replacement (PVR) in patients with chronic pulmonary regurgitation (PR) and to better define the optimal timing of PVR. Although PVR is effective in reducing right ventricular (RV) volume overload in patients with chronic PR, the optimal timing of PVR is not well defined. A total of 170 patients who underwent PVR between January 1998 and March 2011 for chronic PR were retrospectively analyzed. To define the optimal timing of PVR, pre-operative and post-operative cardiac magnetic resonance imaging (MRI) data (n = 67) were analyzed. The median age at the time of PVR was 16.7 years. Follow-up completeness was 95%, and the median follow-up duration was 5.9 years. Overall and event-free survival at 10 years was 98% and 70%, respectively. Post-operative MRI showed significant reduction in RV volumes and significant improvement in biventricular function. Receiver-operating characteristic curve analysis revealed a cutoff value of 168 ml/m(2) for non-normalization of RV end-diastolic volume index (EDVI) and 80 ml/m(2) for RV end-systolic volume index (ESVI). Cutoff values for optimal outcome (normalized RV volumes and function) were 163 ml/m(2) for RV EDVI and 80 ml/m(2) for RV ESVI. Higher pre-operative RV ESVI was identified as a sole independent risk factor for suboptimal outcome. Midterm outcomes of PVR in patients with chronic PR were acceptable. PVR should be considered before RV EDVI exceeds 163 ml/m(2) or RV ESVI exceeds 80 ml/m(2), with more attention to RV ESVI. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

[Evaluation of upper urinary tract function in patients undergoing autoplastic surgery for hydronphrosis of the intrarenal pelvis].

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Kurbanaliev, R M; Usupbaev, A Ch; Kolesnichenko, I V; Sadyrbekov, N Zh; Sultanov, B M

2018-05-01

To investigate the functional state of the upper urinary tract in patients undergoing autoplastic surgery for a hydronophrosis of the intrarenal pelvis. The study comprised 78 patients with the intrarenal pelvis and impaired urinary outflow due to stricture of the ureteropelvic junction and vascular conflict (interatrial and arteriovenous narrowing), who underwent pyeloplasty using autologous tunica vaginalis. All patients underwent an incision of ureteropelvic stricture and resection of the parietal layer of the tunica vaginalis which was used to repair the obstruction site and internal stenting of the upper urinary tract. The patients were examined at baseline and during follow-up ranging from 3 months to 3 years. At three months after surgery, there was a decrease in the size of the renal pelvis and calyces with an improvement of all parameters of uro- and hemodynamics. At three years after surgery, the structural and functional parameters of the upper urinary tract were completely restored. Obstructive uropathy, resulting from the intrarenal pelvis, leads to persistently impaired urinary outflow from the upper urinary tract. Surgical intervention is the only curative treatment able to restore the urinary flow. In men with the intrarenal pelvis, the autoplastic surgery of the ureteropelvic junction obstruction using a parietal layer of the tunica vaginalis is an effective surgical modality improving renal pelvis capacity and contributing to the recovery of urinary outflow from the upper urinary tract.

Transcatheter Pulmonary Valve Replacement: Current State of Art.

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Alkashkari, Wail; Alsubei, Amani; Hijazi, Ziyad M

2018-03-15

The past couple of decades have brought tremendous advances to the field of pediatric and adult congenital heart disease (CHD). Percutaneous valve interventions are now a cornerstone of not just the congenital cardiologist treating patients with congenital heart disease, but also-and numerically more importantly-for adult interventional cardiologists treating patients with acquired heart valve disease. Transcatheter pulmonary valve replacement (tPVR) is one of the most exciting recent developments in the treatment of CHD and has evolved to become an attractive alternative to surgery in patients with right ventricular outflow tract (RVOT) dysfunction. This review aims to summarize (1) the current state of the art for tPVR, (2) the expanding indications, and (3) the technological obstacles to optimizing tPVR. Since its introduction in 2000, more than ten thousands tPVR procedures have been performed worldwide. Although the indications for tPVR have been adapted earlier from those accepted for surgical intervention, they remain incompletely defined. The new imaging modalities give better assessment of cardiac anatomy and function and determine candidacy for the procedure. The procedure has been shown to be feasible and safe when performed in patients who received pulmonary conduit and or bioprosthetic valves between the right ventricle and the pulmonary artery. Fewer selected patients post trans-annular patch repair for tetralogy of Fallot may also be candidates for this technology. Size restrictions of the currently available valves limit deployment in the majority of patients post trans-annular patch repair. Newer valves and techniques are being developed that may help such patients. Refinements and further developments of this procedure hold promise for the extension of this technology to other patient populations.

Mortalidade hospitalar na cirurgia de reconstrução da via de saída do ventrículo direito com homeonxerto pulmonar Hospital mortality in surgery for reconstruction outflow right ventricle with pulmonary homograft

Directory of Open Access Journals (Sweden)

Andrea Weirich Lenzi

2010-03-01

hospital mortality and clinical profile of patients. METHODS: Children underwent reconstruction of the outflow tract of right ventricle with pulmonary homograft. Analyzed as risk factors for the clinical, surgical and morphological aspects of the prosthesis. RESULTS: Ninety-two patients operated on between 1998 and 2005 presented mainly pulmonary atresia with ventricular septal defect and tetralogy of Fallot. Forty patients were treated in the first month of life. He needed 38 surgeries to Blalock Taussig due to clinical severity. The median age at surgery for total correction was 22 months, ranging from 1 to 157 months. Size pulmonary homograft ranging from 12 to 26 mm and length of bypass was 132 ± 37 minutes. After surgery there were seventeen deaths (18% cases on average 10.5 ± 7.5 days. The predominant cause was multiple organ failure. In the univariate analysis between the types of heart disease, they found in favor of age at surgery, size of homograft, pulmonary valve Z value, CPB time, maintaining the integrity of the homograft and pulmonary tree change. There was no statistical differencein hospital mortality between the variables and the type of heart disease. CONCLUSION: The congenital obstructive right requires surgical care in the first days of life. The total correction surgery has a risk rate of 18% but there was no association with any variable studied.

Clinical significance of a presystolic wave on Doppler examination of the left ventricular outflow tract.

Science.gov (United States)

Joshi, Kamal R; Kabirdas, Deepa; Romero-Corral, Abel; Shah, Mahek; Figueredo, Vincent M; Pressman, Gregg S

2014-11-15

A presystolic wave (PSW) is commonly seen on Doppler examination of the left ventricular outflow tract (LVOT), but is little studied. We conducted a retrospective study to assess the prevalence of the PSW, correlations with various Doppler parameters, and its clinical significance. Two hundred echocardiograms, 100 with ejection fraction (EF) >55% and 100 with EF <45%, were reviewed. Mitral inflow velocities, septal annular velocities, LVOT, and PSW velocities were measured. Major adverse cardiovascular events (MACE [death, heart failure hospitalization, atrial fibrillation, and stroke]) were compared between those with and without a PSW, in both EF groups. Mean age was 58 ± 15 years; 56% were men and 69% were African-American. PSW prevalence was similar between normal (68%) and reduced EF groups (62%). However, its velocity was less in the low EF group (37 ± 10 vs 48 ± 16 cm/s, p <0.0001). In subjects with normal EF PSW velocity correlated with mitral A velocity (rho = 0.43, p = 0.0003). In subjects with reduced EF the association with A velocity was not significant (rho = 0.22, p = 0.09), but there was a significant association with annular a' velocity (rho = 0.38, p = 0.002). Over a mean follow-up of 1.7 ± 0.3 years, 57 subjects (28%) experienced MACE. Those without a PSW had more MACE (39% vs 23%, p = 0.02); PSW absence remained predictive of MACE after adjustment for multiple variables, especially in patients with reduced EF. In conclusion, PSW is common in the LVOT. Its presence and magnitude are associated with measures of atrial contraction. Its absence is associated with increased rates of adverse events, especially in patients with low EF. Copyright © 2014 Elsevier Inc. All rights reserved.

A novel balloon assisted two-stents telescoping technique for repositioning an embolized stent in the pulmonary conduit.

Science.gov (United States)

Kobayashi, Daisuke; Gowda, Srinath T; Forbes, Thomas J

2014-08-01

A 9-year-old male, with history of pulmonary atresia and ventricular septal defect, status post complete repair with a 16 mm pulmonary homograft in the right ventricular outflow tract (RVOT) underwent 3110 Palmaz stent placement for conduit stenosis. Following deployment the stent embolized proximally into the right ventricle (RV). We undertook the choice of repositioning the embolized stent into the conduit with a transcatheter approach. Using a second venous access, the embolized stent was carefully maneuvered into the proximal part of conduit with an inflated Tyshak balloon catheter. A second Palmaz 4010 stent was deployed in the distal conduit telescoping through the embolized stent. The Tyshak balloon catheter was kept inflated in the RV to stabilize the embolized stent in the proximal conduit until it was successfully latched up against the conduit with the deployment of the overlapping second stent. One year later, he underwent Melody valve implantation in the pre-stented conduit relieving conduit insufficiency. This novel balloon assisted two-stents telescoping technique is a feasible transcatheter option to secure an embolized stent from the RV to the RVOT. © 2014 Wiley Periodicals, Inc.

Isolated pulmonary vasculitis: case report and literature review.

Science.gov (United States)

Riancho-Zarrabeitia, Leyre; Zurbano, Felipe; Gómez-Román, Javier; Martínez-Meñaca, Amaya; López, Marta; Hernández, Miguel A; Pina, Trinitario; González-Gay, Miguel A

2015-04-01

Single-organ vasculitis has been reported to affect the skin, kidneys, central nervous system, peripheral nerves, genitourinary tract, calf muscles, aorta, coronary arteries, retina, or gastrointestinal tract. However, isolated pulmonary vasculitis is a very rare entity. Our aims were to describe a case of localized pulmonary vasculitis affecting medium-sized vessels and review the literature. A patient with localized pulmonary vasculitis affecting medium-sized vessels that presented as pulmonary arterial hypertension is described. A MEDLINE database search of cases with localized pulmonary vasculitis was also conducted. A 30-year-old man presented with pulmonary hypertension due to isolated pulmonary medium-sized vessel vasculitis that was confirmed histologically. Initially he responded to corticosteroids and vasodilator treatment, but therapy eventually lost efficacy. Treatment with rituximab was not effective, and as the clinical situation worsened, lung transplant was performed. Isolated large pulmonary vessel disease, often related to Takayasu disease or giant cell arteritis, may present as pulmonary artery hypertension, thus mimicking chronic thromboembolic disease. Medium- and small-vessel pulmonary vasculitis usually develops in the context of a systemic disease. Some cases of isolated small-vessel vasculitis have been reported presenting as diffuse alveolar hemorrhage. In contrast, our case developed pulmonary artery hypertension secondary to medium-sized vessels vasculitis. To our knowledge, this is the first case of lung transplantation in isolated pulmonary vasculitis. Pulmonary isolated vasculitis is a rare cause of pulmonary hypertension but it must be taken into consideration after more common disorders are excluded. Copyright © 2014 Elsevier Inc. All rights reserved.

Right-ventricular and left-ventricular function parameters in patients with and without outflow tract patches as determined by radionuclide methods at least 10 years following surgical correction of Fallot's tetralogy in the adult individuals

International Nuclear Information System (INIS)

Seidel, P.

1988-01-01

During a period starting in 1983 and ending in April 1984 radionuclide ventriculography was performed in 26 patients subjected to surgical correction of Fallot's tetralogy after having reached adulthood. They were divided into two groups according to the surgical methods used. Patients showing no right-ventricular outflow patch were assigned to group I, while group II was made up of individuals that had received outflow tract patches of Dacron or Teflon for pressure reduction in the right ventricle. The parameters registered during radionuclide ventriculography, in which the tracer substance TC 99m was administered into a peripheral vein, included the endiastolic volume, endsystolic volume, stroke volume, global ejection fraction and cardiac index. For resting patients, these values were calculated using the first-pass technique, the determinations during exercise on the ergometer were based on equilibrium radionuclide ventriculography. It could be concluded from the results obtained here that non-invasive endocardial scintigraphy is a sensitive method that can be used both at rest and during exercise on the ergometer to detect function disorders of the right and left ventricles. (orig./MG) [de

The position of the left and right ventricular outlets during septation. A comparison of chicken and rat development

NARCIS (Netherlands)

Wagenaar, J. A.; Lamers, W. H.; Los, J. A.

1986-01-01

A comparative study was made of the relative position of the outflow tracts of chicken and rat hearts with respect to the ventricles during septation. For this purpose the position of the left and right ventricular outlet including the aortic and pulmonary valve primordia and the left and right

Anuloplastia de homoenxerto pulmonar criopreservado com anel de Delrin na atresia pulmonar com comunicação interventricular Annuloplasty of cryopreserved pulmonary homograft with Delrin stent in pulmonary atresia with ventricular septal defect

Directory of Open Access Journals (Sweden)

Ulisses Alexandre Croti

2007-05-01

Full Text Available Criança de seis anos portadora de atresia pulmonar com comunicação interventricular, submetida a correção total com um ano, empregando monoválvula de pericárdio bovino na reconstrução da via de saída do ventrículo direito. Evoluiu com importante regurgitação valvar pulmonar (RVP e disfunção do ventrículo direito. Na reoperação foi implantado homoenxerto pulmonar criopreservado (HPC com anuloplastia, utilizando anel de Delrin com o intuito de evitar distorção geométrica do conduto. Após dois anos, o ecocardiograma, semelhante ao pós-operatório imediato, demonstra RVP discreta e função ventricular direita normal, sugerindo que essa manobra pode ser utilizada como coadjuvante para otimizar o resultado do implante do HPC.A six-year-old child was suffering from pulmonary atresia with ventricular septal defect after a total correction at 1 year of age using a bovine pericardial monocusp valve in the reconstruction of the right ventricle outflow tract. The infant evolved with significant pulmonary valve regurgitation (PVR and right ventricle dysfunction. On reoperation, a cryopreserved pulmonary homograft (CPH was implanted with annuloplasty utilizing a Delrin ring with the aim of avoiding geometric distortion of the vessel. After two years, an echocardiogram proved a similar state to the immediate postoperative period with slight pulmonary valve regurgitation and normal right ventricular function suggesting that this maneuver may be used as coadjuvant treatment to optimize the result of CPH implantation.

Real-time three-dimensional color Doppler echocardiography for characterizing the spatial velocity distribution and quantifying the peak flow rate in the left ventricular outflow tract

Science.gov (United States)

Tsujino, H.; Jones, M.; Shiota, T.; Qin, J. X.; Greenberg, N. L.; Cardon, L. A.; Morehead, A. J.; Zetts, A. D.; Travaglini, A.; Bauer, F.;

4D display of the outflow track of embryonic-chick hearts (HH 14-19) using a high speed streak mode OCT

Science.gov (United States)

Ma, Siyu; Wang, Rui; Goodwin, Richard L.; Markwald, Roger R.; Borg, Thomas K.; Runyan, Raymond B.; Gao, Zhi

2013-02-01

Congenital Heart Disease (CHD) is the most common congenital malformation in newborns in the US. Although knowledge of CHD is limited, altered hemodynamic conditions are suspected as the factor that stimulates cardiovascular cell response, resulting in the heart morphology remodeling that ultimately causes CHDs. Therefore, one of recent efforts in CHD study is to develop high-speed imaging tools to correlate the rapidly changing hemodynamic condition and the morphological adaptations of an embryonic heart in vivo. We have developed a high-speed streak mode OCT that works at the center wavelength of 830 nm and is capable of providing images (292x220 μm2) of the outflow tract of an embryonic chick heart at the rate of 1000 Hz. The modality can provide a voxel resolution in the range of 10 μm3, and the spectral resolution allows a depth range of 1.63 mm. In the study reported here, each of the 4D images of an outflow tract was recorded for 2 seconds. The recording was conducted every 2 hours (HH17 to HH18), 3 hours (HH14 to HH17), and 4 hours (HH18 to HH19). Because of the fast scan speed, there is no need for postacquisition processing such as use of gating techniques to provide a fine 3D structure. In addition, more details of the outflow tract are preserved in the recorded images. The 4D images can be used in the future to determine the role of blood flow in CHD development.

Massive Outflows Associated with ATLASGAL Clumps

Science.gov (United States)

Yang, A. Y.; Thompson, M. A.; Urquhart, J. S.; Tian, W. W.

2018-03-01

We have undertaken the largest survey for outflows within the Galactic plane using simultaneously observed {}13{CO} and {{{C}}}18{{O}} data. Out of a total of 919 ATLASGAL clumps, 325 have data suitable to identify outflows, and 225 (69% ± 3%) show high-velocity outflows. The clumps with detected outflows show significantly higher clump masses ({M}clump}), bolometric luminosities ({L}bol}), luminosity-to-mass ratios ({L}bol}/{M}clump}), and peak H2 column densities ({N}{{{H}}2}) compared to those without outflows. Outflow activity has been detected within the youngest quiescent clump (i.e., 70 μ {{m}} weak) in this sample, and we find that the outflow detection rate increases with {M}clump}, {L}bol}, {L}bol}/{M}clump}, and {N}{{{H}}2}, approaching 90% in some cases (UC H II regions = 93% ± 3%; masers = 86% ± 4%; HC H II regions = 100%). This high detection rate suggests that outflows are ubiquitous phenomena of massive star formation (MSF). The mean outflow mass entrainment rate implies a mean accretion rate of ∼ {10}-4 {M}ȯ {yr}}-1, in full agreement with the accretion rate predicted by theoretical models of MSF. Outflow properties are tightly correlated with {M}clump}, {L}bol}, and {L}bol}/{M}clump} and show the strongest relation with the bolometric clump luminosity. This suggests that outflows might be driven by the most massive and luminous source within the clump. The correlations are similar for both low-mass and high-mass outflows over 7 orders of magnitude, indicating that they may share a similar outflow mechanism. Outflow energy is comparable to the turbulent energy within the clump; however, we find no evidence that outflows increase the level of clump turbulence as the clumps evolve. This implies that the origin of turbulence within clumps is fixed before the onset of star formation.

Patients' and physicians' needs, experiences and preferences in the treatment of right ventricular outflow tract dysfunction

Directory of Open Access Journals (Sweden)

Luciana Scalone

2012-06-01

Full Text Available

Background: patients with congenital heart defects, developing right ventricular outflow tract (rVoT dysfunction, can face repeated open chest interventions over their lifetime. repeating surgery increases difficulties and procedural risks, and exposes patients to burdensome and long recovery times that may induce them to postpone the treatment, with possible severe and irreversible consequences for their health. The percutaneous procedure was introduced to delay the need for open chest surgery. uncertainties still exist regarding the lifelong consequences that may result from adopting different treatment strategies. current decisions on treatment depend on patients’ clinical needs, but also on physicians’ experience and opinion, patients’ preferences, and procedural costs. The objective is to identify which treatment characteristics influence decisions on how to treat patients with rVoT dysfunction.

Methods: a literature review was conducted, followed by a discussion with a panel of experts. Ten treatment characteristics, potentially relevant for treatment, were identified and rated in a survey, according to the importance assigned to each characteristic by specialist physicians, patients and/or their caregivers.

Results: while some characteristics appear to be more important (risk of severe complications associated with intervention delays or less important (scar to both physicians and patients/caregivers, other characteristics are rated differently in importance depending on subjects consulted, e.g., risk of complications during the months post intervention was among the most important characteristics for patients/caregivers, but the fifth most important characteristic for physicians.

Conclusions: to optimize benefits and efficiency of the treatment strategies, perceptions and opinions from the different subjects involved, together with patients�

MR tomography of tetralogy of Fallot. Kernspintomographie der Fallot-Tetralogie

Energy Technology Data Exchange (ETDEWEB)

Stark, P.; Agness, M.; Holshouser, B.; Hinshaw, D. Jr. (Loma Linda Univ., CA (USA). Dept. of Radiology)

1991-08-01

We present four patients with Tetralogy of Fallot, imaged with magnetic resonance. MRI is useful in clearly depicting the dilated ascending aorta, the infundibular stenosis, ventricular septal defect, right ventricular hypertrophy and dilated bronchial arteries. The pulmonary outflow tract can be visualized better with MR imaging than with ultrasound. (orig.).

MR tomography of tetralogy of Fallot

International Nuclear Information System (INIS)

Stark, P.; Agness, M.; Holshouser, B.; Hinshaw, D. Jr.

1991-01-01

We present four patients with Tetralogy of Fallot, imaged with magnetic resonance. MRI is useful in clearly depicting the dilated ascending aorta, the infundibular stenosis, ventricular septal defect, right ventricular hypertrophy and dilated bronchial arteries. The pulmonary outflow tract can be visualized better with MR imaging than with ultrasound. (orig.) [de

Effects of chronic severe pulmonary regurgitation and percutaneous valve repair on right ventricular geometry and contractility assessed by tissue Doppler echocardiography

DEFF Research Database (Denmark)

Kjaergaard, Jesper; Iversen, Kasper K; Vejlstrup, Niels G

2010-01-01

Pulmonary regurgitation (PR) following repair of right ventricular (RV) outflow obstruction is related to slowly progressive RV dilatation and heart failure and will eventually require surgical intervention, but optimal timing of pulmonary valve replacement is challenging. Tissue Doppler based...

Studying the outflow-core interaction with ALMA Cycle 1 observations of the HH 46/47 molecular outflow

Science.gov (United States)

Zhang, Yichen; Arce, Hector G.; Mardones, Diego; Dunham, Michael; Garay, Guido; Noriega-Crespo, Alberto; Corder, Stuartt; Offner, Stella; Cabrit, Sylvie

2016-01-01

We present ALMA Cycle 1 observations of the HH 46/47 molecular outflow which is driven by a low-mass Class 0/I protostar. Previous ALMA Cycle 0 12CO observation showed outflow cavities produced by the entrainment of ambient gas by the protostellar jet and wide-angle wind. Here we present analysis of observation of 12CO, 13CO, C18O and other species using combined 12m array and ACA observations. The improved angular resolution and sensitivity allow us to detect details of the outflow structure. Specially, we see that the outflow cavity wall is composed of two or more layers of outflowing gas, which separately connect to different shocked regions along the outflow axis inside the cavity, suggesting the outflow cavity wall is composed of multiple shells entrained by a series of jet bow-shock events. The new 13CO and C18O data also allow us to trace relatively denser and slower outflow material than that traced by the 12CO. These species are only detected within about 1 to 2 km/s from the cloud velocity, tracing the outflow to lower velocities than what is possible using only the 12CO emission. Interestingly, the cavity wall of the red lobe appears at very low outflow velocities (as low as ~0.2 km/s). In addition, 13CO and C18O allow us to correct for the CO optical depth, allowing us to obtain more accurate estimates of the outflow mass, momentum and kinetic energy. Applying the optical depth correction significantly increases the previous mass estimate by a factor of 14. The outflow kinetic energy distribution shows that even though the red lobe is mainly entrained by jet bow-shocks, most of the outflow energy is being deposited into the cloud at the base of the outflow cavity rather than around the heads of the bow shocks. The estimated total mass, momentum, and energy of the outflow indicate that the outflow has the ability to disperse the parent core. We found possible evidence for a slowly moving rotating outflow in CS. Our 13CO and C18O observations also trace a

Fetal Intervention in Right Outflow Tract Obstructive Disease: Selection of Candidates and Results

Science.gov (United States)

Gómez Montes, E.; Herraiz, I.; Mendoza, A.; Galindo, A.

2012-01-01

Objectives. To describe the process of selection of candidates for fetal cardiac intervention (FCI) in fetuses diagnosed with pulmonary atresia-critical stenosis with intact ventricular septum (PA/CS-IVS) and report our own experience with FCI for such disease. Methods. We searched our database for cases of PA/CS-IVS prenatally diagnosed in 2003–2012. Data of 38 fetuses were retrieved and analyzed. FCI were offered to 6 patients (2 refused). In the remaining it was not offered due to the presence of either favourable prognostic echocardiographic markers (n = 20) or poor prognostic indicators (n = 12). Results. The outcome of fetuses with PA/CS-IVS was accurately predicted with multiparametric scoring systems. Pulmonary valvuloplasty was technically successful in all 4 fetuses. The growth of the fetal right heart and hemodynamic parameters showed a Gaussian-like behaviour with an improvement in the first weeks and slow worsening as pregnancy advanced, probably indicating a restenosis. Conclusions. The most likely type of circulation after birth may be predicted in the second trimester of pregnancy by means of combining cardiac dimensions and functional parameters. Fetal pulmonary valvuloplasty in midgestation is technically feasible and in well-selected cases may improve right heart growth, fetal hemodynamics, and postnatal outcome. PMID:22928144

New-Onset Neonatal Pulmonary Hypertension Associated with a Rhinovirus Infection

Directory of Open Access Journals (Sweden)

Nishit Patel

2012-01-01

Full Text Available A 3.5-week-old male neonate who developed an upper and lower respiratory tract rhinovirus infection that was temporally associated with the development of severe pulmonary hypertension is described. Rhinovirus has not previously been associated with pulmonary hypertension. This child developed severe pulmonary hypertension with right ventricular failure, requiring mechanical ventilation, nitric oxide inhalation and, eventually, extracorporeal membrane oxygenation.

Numerical Study on Outflows in Seyfert Galaxies I: Narrow Line Region Outflows in NGC 4151

Energy Technology Data Exchange (ETDEWEB)

Mou, Guobin; Wang, Tinggui; Yang, Chenwei, E-mail: gbmou@ustc.edu.cn [CAS Key Laboratory for Research in Galaxies and Cosmology, Department of Astronomy, University of Science and Technology of China, Hefei 230026 (China)

2017-07-20

The origin of narrow line region (NLR) outflows remains unknown. In this paper, we explore the scenario in which these outflows are circumnuclear clouds driven by energetic accretion disk winds. We choose the well-studied nearby Seyfert galaxy NGC 4151 as an example. By performing 3D hydrodynamical simulations, we are able to reproduce the radial distributions of velocity, mass outflow rate, and kinetic luminosity of NLR outflows in the inner 100 pc deduced from spatial resolved spectroscopic observations. The demanded kinetic luminosity of disk winds is about two orders of magnitude higher than that inferred from the NLR outflows, but is close to the ultrafast outflows (UFO) detected in the X-ray spectrum and a few times lower than the bolometric luminosity of the Seyfert. Our simulations imply that the scenario is viable for NGC 4151. The existence of the underlying disk winds can be confirmed by their impacts on higher density ISM, e.g., shock excitation signs, and the pressure in NLR.

Numerical Study on Outflows in Seyfert Galaxies I: Narrow Line Region Outflows in NGC 4151

International Nuclear Information System (INIS)

Mou, Guobin; Wang, Tinggui; Yang, Chenwei

2017-01-01

The origin of narrow line region (NLR) outflows remains unknown. In this paper, we explore the scenario in which these outflows are circumnuclear clouds driven by energetic accretion disk winds. We choose the well-studied nearby Seyfert galaxy NGC 4151 as an example. By performing 3D hydrodynamical simulations, we are able to reproduce the radial distributions of velocity, mass outflow rate, and kinetic luminosity of NLR outflows in the inner 100 pc deduced from spatial resolved spectroscopic observations. The demanded kinetic luminosity of disk winds is about two orders of magnitude higher than that inferred from the NLR outflows, but is close to the ultrafast outflows (UFO) detected in the X-ray spectrum and a few times lower than the bolometric luminosity of the Seyfert. Our simulations imply that the scenario is viable for NGC 4151. The existence of the underlying disk winds can be confirmed by their impacts on higher density ISM, e.g., shock excitation signs, and the pressure in NLR.

Numerical Study on Outflows in Seyfert Galaxies I: Narrow Line Region Outflows in NGC 4151

Science.gov (United States)

Mou, Guobin; Wang, Tinggui; Yang, Chenwei

2017-07-01

The origin of narrow line region (NLR) outflows remains unknown. In this paper, we explore the scenario in which these outflows are circumnuclear clouds driven by energetic accretion disk winds. We choose the well-studied nearby Seyfert galaxy NGC 4151 as an example. By performing 3D hydrodynamical simulations, we are able to reproduce the radial distributions of velocity, mass outflow rate, and kinetic luminosity of NLR outflows in the inner 100 pc deduced from spatial resolved spectroscopic observations. The demanded kinetic luminosity of disk winds is about two orders of magnitude higher than that inferred from the NLR outflows, but is close to the ultrafast outflows (UFO) detected in the X-ray spectrum and a few times lower than the bolometric luminosity of the Seyfert. Our simulations imply that the scenario is viable for NGC 4151. The existence of the underlying disk winds can be confirmed by their impacts on higher density ISM, e.g., shock excitation signs, and the pressure in NLR.

Uncorrected tetralogy of fallot in a 47 year old Nigerian man: a case ...

African Journals Online (AJOL)

This has been attributed to relatively small degrees of left ventricular outflow tract (LVOT) obstruction and/or presence of congenital aorto-pulmonary shunts. Very few cases of uncorrected TOF in adults have been reported in Africa. We report this case of uncorrected TOF in a 47 year old Nigerian man to highlight this rare ...

Management of Cardiovascular Disorders in Patients with Noonan Syndrome: A Case Report.

Science.gov (United States)

Khorgami, Mohammad Rafie; Moradian, Maryam; Omidi, Negar; Aarabi Moghadam, Mohammad Yousef

2017-10-01

The Noonan syndrome is a rare disorder, one of whose major complications is cardiovascular involvement. A wide spectrum of congenital heart diseases has been observed in this syndrome. The most common cardiac disorder is pulmonary valve stenosis, which has a progressive nature. Hypertrophic cardiomyopathy is less common, but its morbidity and mortality rates are high. We herein introduce a 12-year-old boy with the typical findings of the Noonan syndrome. His symptoms began from infancy, and there was a gradual exacerbation in his respiratory and cardiac manifestations with age. The cardiac involvement included right ventricular outflow tract and pulmonary valve stenosis, hypertrophic cardiomyopathy, and subaortic valve stenosis. Due to the progressive course of the disease, surgical repair was done. Although the patient had a difficult postoperative period, his general condition improved and he was discharged. At 3 months' follow-up, his symptoms showed improvement. Additionally, there was a reduction in the echocardiographic parameters of the outflow tract stenosis gradient as well as a significant improvement in the cardiac hemodynamic indices.

Molecular outflows in protostellar evolution

International Nuclear Information System (INIS)

Fukui, Y.; Iwata, T.; Mizuno, A.; Ogawa, H.; Kawabata, K.; Sugitani, K.

1989-01-01

Molecular outflow is an energetic mass-ejection phenomenon associated with very early stage of stellar evolution. The large kinetic energy involved in the phenomenon indicates that outflow may play an essential role in the process of star formation, particularly by extracting angular momentum. Most of the previous searches have been strongly biased toward optical or near-infrared signposts of star formation. They are not able, therefore, to provide the complete database necessary for a statistical study of the evolutionary status of molecular outflow. To overcome this difficulty, it is of vital importance to make an unbiased search of single molecular clouds for molecular outflows; here we report the final result of such a survey of the Lynds 1641 dark cloud. We show that molecular outflows are characterized by a total luminosity significantly greater than that of T Tauri stars. This indicates that molecular outflow corresponds to the main accretion phase of protostellar evolution, in which the luminosity excess is due to the gravitational energy released by dynamical mass accretion onto the protostellar core. (author)

MRI of pulmonary perfusion; MRT der Lungenperfusion

Energy Technology Data Exchange (ETDEWEB)

Fink, C. [Klinikum Grosshadern der Ludwig-Maximilians-Universitaet Muenchen (Germany). Institut fuer Klinische Radiologie; Deutsches Krebsforschungszentrum (DKFZ), Abteilung Radiologie, Heidelberg (Germany); Risse, F.; Semmler, W. [Deutsches Krebsforschungszentrum (DKFZ), Abteilung Medizinische Physik in der Radiologie, Heidelberg (Germany); Schoenberg, S.O.; Reiser, M.F. [Klinikum Grosshadern der Ludwig-Maximilians-Universitaet Muenchen (Germany). Institut fuer Klinische Radiologie; Kauczor, H.-U. [Deutsches Krebsforschungszentrum (DKFZ), Abteilung Radiologie, Heidelberg (Germany)

2006-04-15

Lung perfusion is a crucial prerequisite for effective gas exchange. Quantification of pulmonary perfusion is important for diagnostic considerations and treatment planning in various diseases of the lungs. Besides disorders of pulmonary vessels such as acute pulmonary embolism and pulmonary hypertension, these also include diseases of the respiratory tract and lung tissue as well as pulmonary tumors. This contribution presents the possibilities and technical requirements of MRI for diagnostic work-up of pulmonary perfusion. (orig.) [German] Die Perfusion der Lunge ist eine entscheidende Voraussetzung fuer einen effektiven Gasaustausch. Die Bestimmung der Lungenperfusion ist bei verschiedenen Erkrankungen der Lunge fuer Diagnostik und Therapieplanung bedeutsam. Hierzu zaehlen neben Erkrankungen der Lungengefaesse wie akute Lungenembolie und pulmonale Hypertension ebenso Erkrankungen der Atemwege, des Lungengeruests und Lungentumoren. In diesem Beitrag werden die Moeglichkeiten und technischen Voraussetzungen der MRT zur Diagnostik der Lungenperfusion dargestellt. (orig.)

Perceived health after percutaneous pulmonary valve implantation: in-depth interviews of patients and next-of-kin

Science.gov (United States)

Andresen, Brith; Andersen, Marit Helen; Lindberg, Harald; Døhlen, Gaute; Fosse, Erik

2014-01-01

Objective Percutaneous pulmonary valve implantation is an alternative to open heart surgery in selected patients with pulmonary outflow tract disorder. The technique may reduce the number of open-chest surgeries in these patients. This study was conducted to understand how the patients and their next-of-kin experienced this new treatment option. Design Qualitative explorative design with individual in-depth interviews. Setting Oslo University Hospital, the only cardiac centre in Norway offering advanced surgical and interventional treatment to patient with congenital heart defects, serving the whole Norwegian population. Participants During a 2-year period a total of 10 patients, median age 17 (7–30) and 18 next-of-kin were consecutively selected for individual in-depth interviews 3–6 months after the pulmonary valve implantation. The verbatim transcripts were analysed using a phenomenological methodology. Results Patients emphasised the importance of regaining independence and taking control of daily life shortly after the new interventional treatment. Renewed hope towards treatment options was described as ‘a light in the tunnel’. Next-of-kin emphasised the importance both for the patient and their family of resuming normal life quickly after the procedure. The physical burden was experienced as minor after the minimally invasive intervention, compared to their previous experience with surgical procedures. Main outcome measure The importance of maintaining normality in everyday life for a good family function. Conclusions The repeated surgeries during infancy and adolescence of patients with congenital heart disease represent a heavy burden both for the patient and their family. All families especially emphasised the importance of resuming normal life quickly after each procedure. The novel technique of pulmonary valve implantation is thus a favourable approach because of minor interference in daily life. PMID:25079930

Role of the 3-Vessel and Trachea View in Antenatal Detection of Tetralogy of Fallot.

Science.gov (United States)

Palatnik, Anna; Grobman, William A; Cohen, Leeber S; Dungan, Jeffrey S; Gotteiner, Nina L

2016-08-01

Prenatal diagnosis of tetralogy of Fallot remains less frequent compared to other major congenital heart defects. In this study, we examined how often the 3-vessel and trachea view was abnormal in a large series of prenatally diagnosed cases of tetralogy of Fallot. In addition, we compared its sensitivity to that of the traditional outflow tract views for detection of tetralogy of Fallot. We found that both views were abnormal in all fetuses with tetralogy of Fallot, showing reversed aortic-to-pulmonary valve and aortic arch isthmus-to-ductus arteriosus ratios in the outflow tract and 3-vessel and trachea views, respectively. However, as a single measured marker, the enlarged aortic arch isthmus on the 3-vessel and trachea view appears to be the most sensitive for tetralogy of Fallot.

Gastroesophageal reflux disease and non-digestive tract diseases.

Science.gov (United States)

Chen, Ying

2015-05-01

Over the past decade, incidence of gastroesophageal reflux disease (GERD) showed an increasing trend resulting from factors, including lifestyle and dietary habits; however, both etiology and pathological mechanisms remain controversial. GERD occurs as a result of a variety of mechanisms and there is no single factor. Symptoms of GERD are often non-typical, with a likelihood of being overlooked by non-gastroenterology professionals. Therefore, improving GERD awareness in non-gastroenterology practitioners, along with early diagnosis and treatment, provide potential benefit to clinicians and patients alike. Increasing evidence suggests GERD has specific connections with a variety of non-digestive tract conditions, may contribute an aggravating compounding effect on other diseases, prolong hospitalization, and increase subsequent medical costs. This review considers and emphasizes the association between GERD and non-digestive tract conditions, including atrial fibrillation, chronic obstructive pulmonary disease, primary pulmonary fibrosis and energy metabolism related to diet.

Do pulmonary artery catheters cause or increase tricuspid or pulmonic valvular regurgitation?

Science.gov (United States)

Sherman, S V; Wall, M H; Kennedy, D J; Brooker, R F; Butterworth, J

2001-05-01

There are few quantitative data on the extent or mechanism of pulmonary artery catheter (PAC)-induced valvular dysfunction. We hypothesized that PACs cause or worsen tricuspid and pulmonic valvular regurgitation, and tested this hypothesis by using transesophageal echocardiography. In 54 anesthetized adult patients, we measured color Doppler jet areas of tricuspid regurgitation (TR) in two planes (midesophageal [ME] 4-chamber and right ventricular inflow-outflow views) and pulmonic insufficiency (PI) in one plane (ME aortic valve long-axis view), both before and after we advanced a PAC into the pulmonary artery. Regurgitant jet areas and hemodynamic measurements were compared by using paired t-test. There were no significant changes in blood pressure or heart rate after passage of the PAC. After PAC placement, the mean PI jet area was not significantly increased. The mean TR jet area increased significantly in the right ventricular inflow-outflow view (+0.37 +/- 0.11 cm(2)) (P = 0.0014), but did not increase at the ME 4-chamber view. Seventeen percent of patients had an increase in TR jet area > or =1 cm(2); 8% of patients had an increase in PI jet area >/=1 cm(2). In patients without pulmonic or tricuspid valvular pathology, placement of a pulmonary artery catheter (PAC) worsened tricuspid regurgitation, which is consistently visualized in the right ventricular inflow-outflow view, and often not seen in the midesophageal 4-chamber view. This is consistent with malcoaptation of the anterior and posterior leaflets. PAC-induced pulmonic insufficiency was rarely detected in the midesophageal aortic valve long-axis view. We conclude that a PAC is very unlikely to be the sole cause of severe tricuspid regurgitation or pulmonic insufficiency.

Fetal Urinary Tract Anomalies: Review of Pathophysiology, Imaging, and Management.

Science.gov (United States)

Mileto, Achille; Itani, Malak; Katz, Douglas S; Siebert, Joseph R; Dighe, Manjiri K; Dubinsky, Theodore J; Moshiri, Mariam

2018-05-01

Common fetal anomalies of the kidneys and urinary tract encompass a complex spectrum of abnormalities that can be detected prenatally by ultrasound. Common fetal anomalies of the kidneys and urinary tract can affect amniotic fluid volume production with the development of oligohydramnios or anhydramnios, resulting in fetal pulmonary hypoplasia and, potentially, abnormal development of other fetal structures. We provide an overview of common fetal anomalies of the kidneys and urinary tract with an emphasis on sonographic patterns as well as pathologic and postnatal correlation, along with brief recommendations for postnatal management. Of note, we render an updated classification of fetal abnormalities of the kidneys and urinary tract based on the presence or absence of associated urinary tract dilation. In addition, we review the 2014 classification of urinary tract dilation based on the Linthicum multidisciplinary consensus panel.

Erythrocyte creatine as a marker of intravascular hemolysis due to left ventricular outflow tract obstruction in hypertrophic cardiomyopathy.

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Kubo, Toru; Okumiya, Toshika; Baba, Yuichi; Hirota, Takayoshi; Tanioka, Katsutoshi; Yamasaki, Naohito; Sugiura, Tetsuro; Doi, Yoshinori L; Kitaoka, Hiroaki

2016-03-01

Erythrocyte creatine, a marker of erythrocyte age that increases with shortening of erythrocyte survival, has been reported to be a quantitative and reliable marker for intravascular hemolysis. We hypothesized that hemolysis could also occur due to intraventricular obstruction in patients with hypertrophic cardiomyopathy (HCM). The purpose of this study was to examine the presence of subclinical hemolysis and the relation between intravascular hemolysis and intraventricular pressure gradient (IVPG). We measured erythrocyte creatine in 92 HCM patients. Twelve patients had left ventricular outflow tract obstruction (LVOTO), 4 had midventricular obstruction (MVO), and the remaining 76 were non-obstructive. Erythrocyte creatine levels ranged from 0.92 to 4.36μmol/g hemoglobin. Higher levels of erythrocyte creatine were associated with higher IVPG (r=0.437, pcreatine levels are high (≥1.8μmol/g hemoglobin), subclinical hemolysis is considered to be present. Half of LVOTO patients and no MVO patients showed high erythrocyte creatine levels. Although non-obstructive patients did not show significant intraventricular obstruction at rest, some showed high erythrocyte creatine levels. When LVOT-PG was measured during the strain phase of the Valsalva maneuver in 20 non-obstructive patients, 7 of those 20 patients showed LVOTO. In the 20 patients, there was no relation between erythrocyte creatine levels and LVOT-PG before the Valsalva maneuver (r=0.125, p=0.600), whereas there was a significant correlation between erythrocyte creatine and LVOT-PG provoked by the Valsalva maneuver (r=0.695, p=0.001). There is biochemical evidence of subclinical hemolysis in patients with HCM, and this hemolysis seems to be associated with LVOTO provoked by daily physical activities. Copyright © 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Optimal sizing for SAPIEN 3 transcatheter aortic valve replacement in patients with or without left ventricular outflow tract calcification.

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Maeno, Yoshio; Abramowitz, Yigal; Jilaihawi, Hasan; Israr, Sharjeel; Yoon, Sunghan; Sharma, Rahul P; Kazuno, Yoshio; Kawamori, Hiroyuki; Miyasaka, Masaki; Rami, Tanya; Mangat, Geeteshwar; Takahashi, Nobuyuki; Okuyama, Kazuaki; Kashif, Mohammad; Chakravarty, Tarun; Nakamura, Mamoo; Cheng, Wen; Makkar, Raj R

2017-04-07

The impact of left ventricular outflow tract calcification (LVOT-CA) on SAPIEN 3 transcatheter aortic valve replacement (S3-TAVR) is not well understood. The aims of the present study were to determine optimal device sizing for S3-TAVR in patients with or without LVOT-CA and to evaluate the influence of residual paravalvular leak (PVL) on survival after S3-TAVR in these patients. This study analysed 280 patients (LVOT-CA=144, no LVOT-CA=136) undergoing S3-TAVR. Optimal annular area sizing was defined as % annular area sizing related to lower rates of ≥mild PVL. Annular area sizing was determined as follows: (prosthesis area/CT annulus area-1)×100. Overall, ≥mild PVL was present in 25.7%. Receiver operating characteristic curve analysis for prediction of ≥mild PVL in patients with LVOT-CA showed that 7.2% annular area sizing was identified as the optimal threshold (area under the curve [AUC] 0.71). Conversely, annular area sizing for no LVOT-CA appeared unrelated to PVL (AUC 0.58). Aortic annular injury was seen in four patients (average 15.5% annular area oversizing), three of whom had LVOT-CA. Although there was no difference in one-year survival between patients with ≥mild PVL and without PVL (log-rank p=0.91), subgroup analysis demonstrated that patients with ≥moderate LVOT-CA who had ≥mild PVL had lower survival compared to patients with ≥mild PVL and none or mild LVOT-CA (log-rank p=0.010). In the setting of LVOT-CA, an optimally sized S3 valve is required to reduce PVL and to increase survival following TAVR.

Contribution of mitral valve leaflet length and septal wall thickness to outflow tract obstruction in patients with hypertrophic cardiomyopathy.

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Morant, Kareem; Mikami, Yoko; Nevis, Immaculate; McCarty, David; Stirrat, John; Scholl, David; Rajchl, Martin; Giannoccaro, Peter; Kolman, Louis; Heydari, Bobby; Lydell, Carmen; Howarth, Andrew; Grant, Andrew; White, James A

2017-08-01

We sought to examine whether elongation of the mitral valve leaflets in patients with hypertrophic cardiomyopathy (HCM) is synergistic to septal wall thickness (SWT) in the development of left ventricular outflow tract obstruction (LVOTO). HCM is a common genetic cardiac disease characterized by asymmetric septal hypertrophy and predisposition towards LVOTO. It has been reported that elongation of the mitral valve leaflets may be a primary phenotypic feature and contribute to LVOTO. However, the relative contribution of this finding versus SWT has not been studied. 152 patients (76 with HCM and 76 non-diseased age, race and BSA-matched controls) and 18 young, healthy volunteers were studied. SWT and the anterior mitral valve leaflet length (AMVLL) were measured using cine MRI. The combined contribution of these variables (SWT × AMVLL) was described as the Septal Anterior Leaflet Product (SALP). Peak LVOT pressure gradient was determined by Doppler interrogation and defined as "obstructive" if ≥ 30 mmHg. Patients with HCM were confirmed to have increased AMVLL compared with controls and volunteers (p SALP were significantly higher in patients with LVOTO (N = 17) versus without. SALP showed modest improvement in predictive accuracy for LVOTO (AUC = 0.81) among the HCM population versus SWT alone (AUC = 0.77). However, in isolated patients this variable identified patients with LVOTO despite modest SWT. Elongation of the AMVLL is a primary phenotypic feature of HCM. While incremental contributions to LVOTO appear modest at a population level, specific patients may have dominant contribution to LVOTO. The combined marker of SALP allows for maintained identification of such patients despite modest increases in SWT.

Factors influencing left ventricular outflow tract obstruction following a mitral valve-in-valve or valve-in-ring procedure, part 1.

Science.gov (United States)

Bapat, Vinnie; Pirone, Francesco; Kapetanakis, Stam; Rajani, Ronak; Niederer, Steven

2015-10-01

To determine the factors influencing left ventricular outflow tract (LVOT) area reduction after a mitral valve-in-valve (VIV) or a valve-in-ring (VIR) procedure. Transcatheter heart valves (THVs) are increasingly used in performing a VIV or a VIR procedure in high-risk patients. Although less invasive, a potential complication is LVOT obstruction. However, the factors predisposing to LVOT obstruction are ill defined. To understand the effects of the various factors, the study was carried out in three parts: To understand the effect of VIV and VIR on reduction in LVOT area with special attention to different surgical heart valve (SHV) orientations and depth of THV implant. This was carried out in porcine and cadaver hearts. To quantify aorto-mitral-annular (AMA) angle in 20 patients with or without mitral disease and to derive a static computational model to predict LVOT obstruction. To study the effect of SHV design on LVOT obstruction after VIV. This was carried out as a bench test. LVOT area reduction was similar after VIV irrespective of orientation of the mitral SHV implantation as it pinned open the SHV leaflets. Similar effect was seen after VIR. The degree of LVOT obstruction was partly determined by AMAangle and was inversely proportional. SHV design, ring design, and depth of SPAIEN XT implantation also had effect on LVOT obstruction. A possibility of LVOT obstruction should be considered when performing a VIV and VIR procedure. Type of SHV, flexible ring, less obtuse AMA angle, and depth of SAPIEN XT implant can influence the risk. © 2015 Wiley Periodicals, Inc.

HRV changes before and after radiofrequency ablation in patients with different origin of right ventricular outflow tract ventricular premature contraction

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Yi-Ming Ma

2017-04-01

Full Text Available Objective: To observe the HRV changes before and after the radiofrequency current catheter ablationventricular premature beats originated from different site of right ventricular outflow tract. Methods: A total of 102 patients with frequent RVOT-VPC admitted to our hospital were accepted radiofrequency current catheter ablation (RF. According to the origin of RVOT-VPC, it was divided into 2 groups, one is from ventricular septum, and the other one is from free wall, and in each group, male and female are observed separately. Results: (1 HRV before RF ablation: 1 rMSSD in the female patients with RVOT-VPC from free wall was significantly lower than those from septum; 2 frequency domain index (W, LF were higher than normal range, and in male patients, LF/HF1. (2 HRV after RF ablation: 1 Significant changes were found in female patients with RVOT-VPC from septum, rMSSD, PNN50, HF and LF decreased; 2 In female patients with RVOT-VPC from free wall, rMSSD decreased; 3 In male patients, there were no significant HRV changes found before and after RF ablation. (3 Heart rate changes: 1 In female patients with RVOT-VPC from septum, heart rate decreased significantly [(76.47±9.47 bpm vs (69.29±14.59 bpm]. 2 No significant changes were found in male patients. Conclusion: In patients with RVOT-PVC sympathetic and vagus excitability increased, and after catheter ablation, in female patients with RVOT-PVC originated from septum, the HRV index relating to sympathetic and vagus excitability significantly decreased.

Left ventricular outflow track obstruction and mitral valve regurgitation in a patient with takotsubo cardiomyopathy

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Yin Wu

2015-12-01

Full Text Available Introduction: Takotsubo cardiomyopathy (TCM can be complicated by left ventricular outflow tract (LVOT obstruction and severe acute mitral regurgitation (MR, leading to hemodynamic instability in an otherwise benign disorder. Despite the severity of these complications, there is a paucity of literature on the matter. Because up to 20–25% of TCM patients develop LVOT obstruction and/or MR, it is important to recognize the clinical manifestations of these complications and to adhere to specific management in order to reduce patient morbidity and mortality. We report the clinical history, imaging, treatment strategy, and clinical outcome of a patient with TCM that was complicated with severe MR and LVOT obstruction. We then discuss the pathophysiology, characteristic imaging, key clinical features, and current treatment strategy for this unique patient population. Case report: A postmenopausal woman with no clear risk factor for coronary artery disease (CAD presented to the emergency department with chest pain after an episode of mental/physical stress. Physical examination revealed MR, mild hypotension, and pulmonary vascular congestion. Her troponins were mildly elevated. Cardiac catheterization excluded obstructive CAD, but revealed severe apical hypokinesia and ballooning. Notably, multiple diagnostic tests revealed the presence of severe acute MR and LVOT obstruction. The patient was diagnosed with TCM complicated by underlying MR and LVOT obstruction, and mild hemodynamic instability. The mechanism of her LVOT and MR was attributed to systolic anterior motion of the mitral valve (SAM, which the transesophageal echocardiogram clearly showed during workup. She was treated with beta-blocker, aspirin, and ACE-I with good outcome. Nitroglycerin and inotropes were discontinued and further avoided. Conclusions: Our case illustrated LVOT obstruction and MR associated with underlying SAM in a patient with TCM. LVOT obstruction and MR are severe

Molecular outflows driven by low-mass protostars. I. Correcting for underestimates when measuring outflow masses and dynamical properties

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Dunham, Michael M. [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, MS 78, Cambridge, MA 02138 (United States); Arce, Héctor G. [Department of Astronomy, Yale University, P.O. Box 208101, New Haven, CT 06520 (United States); Mardones, Diego [Departamento de Astronomía, Universidad de Chile, Casilla 36-D, Santiago (Chile); Lee, Jeong-Eun [Department of Astronomy and Space Science, Kyung Hee University, Yongin, Gyeonggi 446-701 (Korea, Republic of); Matthews, Brenda C. [National Research Council of Canada, Herzberg Astronomy and Astrophysics, 5071 W. Saanich Road, Victoria, BC V9E 2E7 (Canada); Stutz, Amelia M. [Max-Planck-Institut für Astronomie, Königstuhl 17, D-69117, Heidelberg (Germany); Williams, Jonathan P., E-mail: mdunham@cfa.harvard.edu [Institute for Astronomy, University of Hawaii, Honolulu, HI 96822 (United States)

2014-03-01

We present a survey of 28 molecular outflows driven by low-mass protostars, all of which are sufficiently isolated spatially and/or kinematically to fully separate into individual outflows. Using a combination of new and archival data from several single-dish telescopes, 17 outflows are mapped in {sup 12}CO (2-1) and 17 are mapped in {sup 12}CO (3-2), with 6 mapped in both transitions. For each outflow, we calculate and tabulate the mass (M {sub flow}), momentum (P {sub flow}), kinetic energy (E {sub flow}), mechanical luminosity (L {sub flow}), and force (F {sub flow}) assuming optically thin emission in LTE at an excitation temperature, T {sub ex}, of 50 K. We show that all of the calculated properties are underestimated when calculated under these assumptions. Taken together, the effects of opacity, outflow emission at low velocities confused with ambient cloud emission, and emission below the sensitivities of the observations increase outflow masses and dynamical properties by an order of magnitude, on average, and factors of 50-90 in the most extreme cases. Different (and non-uniform) excitation temperatures, inclination effects, and dissociation of molecular gas will all work to further increase outflow properties. Molecular outflows are thus almost certainly more massive and energetic than commonly reported. Additionally, outflow properties are lower, on average, by almost an order of magnitude when calculated from the {sup 12}CO (3-2) maps compared to the {sup 12}CO (2-1) maps, even after accounting for different opacities, map sensitivities, and possible excitation temperature variations. It has recently been argued in the literature that the {sup 12}CO (3-2) line is subthermally excited in outflows, and our results support this finding.

Outflow Kinematics Manifested by the Hα Line: Gas Outflows in Type 2 AGNs. IV

Energy Technology Data Exchange (ETDEWEB)

Kang, Daeun; Woo, Jong-Hak; Bae, Hyun-Jin, E-mail: woo@astro.snu.ac.kr [Astronomy Program, Department of Physics and Astronomy, Seoul National University, Seoul 151-742 (Korea, Republic of)

2017-08-20

Energetic ionized gas outflows driven by active galactic nuclei (AGNs) have been studied as a key phenomenon related to AGN feedback. To probe the kinematics of the gas in the narrow-line region, [O iii] λ 5007 has been utilized in a number of studies showing nonvirial kinematic properties due to AGN outflows. In this paper, we statistically investigate whether the H α emission line is influenced by AGN-driven outflows by measuring the kinematic properties based on the H α line profile and comparing them with those of [O iii]. Using the spatially integrated spectra of ∼37,000 Type 2 AGNs at z < 0.3 selected from the Sloan Digital Sky Survey DR7, we find a nonlinear correlation between H α velocity dispersion and stellar velocity dispersion that reveals the presence of the nongravitational component, especially for AGNs with a wing component in H α . The large H α velocity dispersion and velocity shift of luminous AGNs are clear evidence of AGN outflow impacts on hydrogen gas, while relatively smaller kinematic properties compared to those of [O iii] imply that the observed outflow effect on the H α line is weaker than the case of [O iii].

Assessment of airway compression on chest radiographs in children with pulmonary tuberculosis

International Nuclear Information System (INIS)

Richter-Joubert, Lisel; Andronikou, Savvas; Workman, Lesley; Zar, Heather J.

2017-01-01

Because small, pliable paediatric airways are easily compressed by enlarged lymph nodes, detection of radiographic airway compression might be an objective criterion for diagnosing pulmonary tuberculosis. To investigate the frequency and inter-observer agreement of airway compression on chest radiographs in children with pulmonary tuberculosis compared to those with a different lower respiratory tract infection. Chest radiographs of children with suspected pulmonary tuberculosis were read by two readers according to a standardised format and a third reader when there was disagreement. Radiographs of children with proven pulmonary tuberculosis were compared to those with a different lower respiratory tract infection. We evaluated frequency and location of radiographic airway compression. Findings were correlated with human immunodeficiency virus (HIV) status and age. We assessed inter-observer agreement using kappa statistics. We reviewed radiographs of 505 children (median age 25.9 months, interquartile range [IQR] 14.3-62.2). Radiographic airway compression occurred in 54/188 (28.7%) children with proven pulmonary tuberculosis and in 24/317 (7.6%) children with other types of lower respiratory tract infection (odds ratio [OR] 4.9; 95% confidence interval [CI] 2.9-8.3). A higher frequency of radiographic airway compression occurred in infants (22/101, or 21.8%) compared to older children (56/404, or 13.9%; OR 1.7; 95% CI 1.0-3.0). We found no association between airway compression and HIV infection. Inter-observer agreement ranged from none to fair (kappa of 0.0-0.4). There is a strong association between airway compression on chest radiographs and confirmed pulmonary tuberculosis. However this finding's clinical use as an objective criterion for diagnosis of pulmonary tuberculosis in children is limited by poor inter-observer agreement. (orig.)

Assessment of airway compression on chest radiographs in children with pulmonary tuberculosis

Energy Technology Data Exchange (ETDEWEB)

Richter-Joubert, Lisel [Groote Schuur Hospital and University of Cape Town, Department of Radiology, Cape Town (South Africa); Andronikou, Savvas [Groote Schuur Hospital and University of Cape Town, Department of Radiology, Cape Town (South Africa); Bristol Royal Hospital for Children and the University of Bristol, Department of Paediatric Radiology, Bristol (United Kingdom); Workman, Lesley; Zar, Heather J. [University of Cape Town, Department of Paediatrics and Child Health and MRC Unit on Child and Adolescent Health, Red Cross War Memorial Children' s Hospital, Cape Town (South Africa)

2017-09-15

Because small, pliable paediatric airways are easily compressed by enlarged lymph nodes, detection of radiographic airway compression might be an objective criterion for diagnosing pulmonary tuberculosis. To investigate the frequency and inter-observer agreement of airway compression on chest radiographs in children with pulmonary tuberculosis compared to those with a different lower respiratory tract infection. Chest radiographs of children with suspected pulmonary tuberculosis were read by two readers according to a standardised format and a third reader when there was disagreement. Radiographs of children with proven pulmonary tuberculosis were compared to those with a different lower respiratory tract infection. We evaluated frequency and location of radiographic airway compression. Findings were correlated with human immunodeficiency virus (HIV) status and age. We assessed inter-observer agreement using kappa statistics. We reviewed radiographs of 505 children (median age 25.9 months, interquartile range [IQR] 14.3-62.2). Radiographic airway compression occurred in 54/188 (28.7%) children with proven pulmonary tuberculosis and in 24/317 (7.6%) children with other types of lower respiratory tract infection (odds ratio [OR] 4.9; 95% confidence interval [CI] 2.9-8.3). A higher frequency of radiographic airway compression occurred in infants (22/101, or 21.8%) compared to older children (56/404, or 13.9%; OR 1.7; 95% CI 1.0-3.0). We found no association between airway compression and HIV infection. Inter-observer agreement ranged from none to fair (kappa of 0.0-0.4). There is a strong association between airway compression on chest radiographs and confirmed pulmonary tuberculosis. However this finding's clinical use as an objective criterion for diagnosis of pulmonary tuberculosis in children is limited by poor inter-observer agreement. (orig.)

Large-Scale Outflows in Seyfert Galaxies

Science.gov (United States)

Colbert, E. J. M.; Baum, S. A.

1995-12-01

\\catcode`\\@=11 \\ialign{m @th#1hfil ##hfil \\crcr#2\\crcr\\sim\\crcr}}} \\catcode`\\@=12 Highly collimated outflows extend out to Mpc scales in many radio-loud active galaxies. In Seyfert galaxies, which are radio-quiet, the outflows extend out to kpc scales and do not appear to be as highly collimated. In order to study the nature of large-scale (>~1 kpc) outflows in Seyferts, we have conducted optical, radio and X-ray surveys of a distance-limited sample of 22 edge-on Seyfert galaxies. Results of the optical emission-line imaging and spectroscopic survey imply that large-scale outflows are present in >~{{1} /{4}} of all Seyferts. The radio (VLA) and X-ray (ROSAT) surveys show that large-scale radio and X-ray emission is present at about the same frequency. Kinetic luminosities of the outflows in Seyferts are comparable to those in starburst-driven superwinds. Large-scale radio sources in Seyferts appear diffuse, but do not resemble radio halos found in some edge-on starburst galaxies (e.g. M82). We discuss the feasibility of the outflows being powered by the active nucleus (e.g. a jet) or a circumnuclear starburst.

Different methods of tomography in destructive pulmonary tuberculosis

International Nuclear Information System (INIS)

Volodina, G.I.; Semenov, V.M.

1980-01-01

Altogether 203 patients (186 with destructive pulmonary tuberculosis, 11 with other forms of tuberculosis of respiratory tract organs, 6 with lung malignant tumor) were examined with the use of different modifications of tomography: longitudinal and oblique blurring, zonography, selective tomography. Standardization in the use of different methods is proposed, depending on the intensity of the main syndromes of pulmonary tissue lesions: limited shading, foci, dissemination, caverns, etc. The informativeness is greatly increased when the proposed algorithm of examination is used both at the disease onset and during the follow-up of patients with destructive pulmonary tuberculosis

Regression equations for calculation of z scores for echocardiographic measurements of right heart structures in healthy Han Chinese children.

Science.gov (United States)

Wang, Shan-Shan; Zhang, Yu-Qi; Chen, Shu-Bao; Huang, Guo-Ying; Zhang, Hong-Yan; Zhang, Zhi-Fang; Wu, Lan-Ping; Hong, Wen-Jing; Shen, Rong; Liu, Yi-Qing; Zhu, Jun-Xue

2017-06-01

Clinical decision making in children with congenital and acquired heart disease relies on measurements of cardiac structures using two-dimensional echocardiography. We aimed to establish z-score regression equations for right heart structures in healthy Chinese Han children. Two-dimensional and M-mode echocardiography was performed in 515 patients. We measured the dimensions of the pulmonary valve annulus (PVA), main pulmonary artery (MPA), left pulmonary artery (LPA), right pulmonary artery (RPA), right ventricular outflow tract at end-diastole (RVOTd) and at end-systole (RVOTs), tricuspid valve annulus (TVA), right ventricular inflow tract at end-diastole (RVIDd) and at end-systole (RVIDs), and right atrium (RA). Regression analyses were conducted to relate the measurements of right heart structures to 4body surface area (BSA). Right ventricular outflow-tract fractional shortening (RVOTFS) was also calculated. Several models were used, and the best model was chosen to establish a z-score calculator. PVA, MPA, LPA, RPA, RVOTd, RVOTs, TVA, RVIDd, RVIDs, and RA (R 2  = 0.786, 0.705, 0.728, 0.701, 0.706, 0.824, 0.804, 0.663, 0.626, and 0.793, respectively) had a cubic polynomial relationship with BSA; specifically, measurement (M) = β0 + β1 × BSA + β2 × BSA 2  + β3 × BSA. 3 RVOTFS (0.28 ± 0.02) fell within a narrow range (0.12-0.51). Our results provide reference values for z scores and regression equations for right heart structures in Han Chinese children. These data may help interpreting the routine clinical measurement of right heart structures in children with congenital or acquired heart disease. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:293-303, 2017. © 2017 Wiley Periodicals, Inc.

Measurement of Outflow Facility Using iPerfusion.

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Joseph M Sherwood

Full Text Available Elevated intraocular pressure (IOP is the predominant risk factor for glaucoma, and reducing IOP is the only successful strategy to prevent further glaucomatous vision loss. IOP is determined by the balance between the rates of aqueous humour secretion and outflow, and a pathological reduction in the hydraulic conductance of outflow, known as outflow facility, is responsible for IOP elevation in glaucoma. Mouse models are often used to investigate the mechanisms controlling outflow facility, but the diminutive size of the mouse eye makes measurement of outflow technically challenging. In this study, we present a new approach to measure and analyse outflow facility using iPerfusion™, which incorporates an actuated pressure reservoir, thermal flow sensor, differential pressure measurement and an automated computerised interface. In enucleated eyes from C57BL/6J mice, the flow-pressure relationship is highly non-linear and is well represented by an empirical power law model that describes the pressure dependence of outflow facility. At zero pressure, the measured flow is indistinguishable from zero, confirming the absence of any significant pressure independent flow in enucleated eyes. Comparison with the commonly used 2-parameter linear outflow model reveals that inappropriate application of a linear fit to a non-linear flow-pressure relationship introduces considerable errors in the estimation of outflow facility and leads to the false impression of pressure-independent outflow. Data from a population of enucleated eyes from C57BL/6J mice show that outflow facility is best described by a lognormal distribution, with 6-fold variability between individuals, but with relatively tight correlation of facility between fellow eyes. iPerfusion represents a platform technology to accurately and robustly characterise the flow-pressure relationship in enucleated mouse eyes for the purpose of glaucoma research and with minor modifications, may be applied

GALAXY OUTFLOWS WITHOUT SUPERNOVAE

Energy Technology Data Exchange (ETDEWEB)

Sur, Sharanya [Indian Institute of Astrophysics, 2nd Block, Koramangala, Bangalore 560034 (India); Scannapieco, Evan [School of Earth and Space Exploration, Arizona State University, P.O. Box 876004, Tempe-85287 (United States); Ostriker, Eve C., E-mail: sharanya.sur@iiap.res.in, E-mail: sharanya.sur@asu.edu [Department of Astrophysical Sciences, Princeton University, Princeton, NJ 08544 (United States)

2016-02-10

High surface density, rapidly star-forming galaxies are observed to have ≈50–100 km s{sup −1} line of sight velocity dispersions, which are much higher than expected from supernova driving alone, but may arise from large-scale gravitational instabilities. Using three-dimensional simulations of local regions of the interstellar medium, we explore the impact of high velocity dispersions that arise from these disk instabilities. Parametrizing disks by their surface densities and epicyclic frequencies, we conduct a series of simulations that probe a broad range of conditions. Turbulence is driven purely horizontally and on large scales, neglecting any energy input from supernovae. We find that such motions lead to strong global outflows in the highly compact disks that were common at high redshifts, but weak or negligible mass loss in the more diffuse disks that are prevalent today. Substantial outflows are generated if the one-dimensional horizontal velocity dispersion exceeds ≈35 km s{sup −1}, as occurs in the dense disks that have star-formation rate (SFR) densities above ≈0.1 M{sub ⊙} yr{sup −1} kpc{sup −2}. These outflows are triggered by a thermal runaway, arising from the inefficient cooling of hot material coupled with successive heating from turbulent driving. Thus, even in the absence of stellar feedback, a critical value of the SFR density for outflow generation can arise due to a turbulent heating instability. This suggests that in strongly self-gravitating disks, outflows may be enhanced by, but need not caused by, energy input from supernovae.

Radiologic findings of childhood lower respiratory tract infection by influenza virus

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Song, Ho Taek; Park, Choong Ki; Shin, Hee Jung; Choi, Yo Won; Jeon, Seok Chol; Hahm, Chang Kok; Hern, Ahn You [Hanyang University College of Medicine, Seoul (Korea, Republic of)

2002-08-01

After the RS (respiratory syncytial) virus, the influenza virus is the most common cause of childhood lower respiratory tract infection. We assessed the radiologic findings of childhood lower respiratory tract infection by the influenza virus. A total of 105 pediatric patients (76 males and 29 females; mean age, 2.4 years) with symptoms of respiratory tract infection were examined between March 1997 and April 2000. Nasopharyngeal aspirates were obtained and influenza virus infection was confirmed by direct or indirect immunofluorescent assays. Peribronchial infiltration, hyperinflation, atelectasis, pulmonary consolidation, and hilar lymphadenopathy were evaluated retrospectively at simple chest radiography. Bilateral perihiler peribronchial infiltration was noted in 78.1% of patients (n=82), hyperinflation in 63.8% (n=67), atelectasis in 3.8% (n=4, segmental 50%, lobar 50%), and pulmonary consolidation in 16.2% [n=17; segmental 70.6% (n=12), lobar 29.4% (n=5)]. Hilar lymphadenopathy was noted in one patient in whom there was no pleural effusion, and subglottic airway narrowing in 12 of 14 in whom the croup symptom complex was present. The major radiologic findings of influenza virus infection were bilateral perihilar peribronchial infiltration and hyperinflation. In some patients, upper respiratory tract infection was combined with subgolttic airway narrowing. Atelectasis or pleural effusion was rare.

OH outflows in star-forming regions

International Nuclear Information System (INIS)

Mirabel, I.F.; Ruiz, A.; Rodriguez, L.F.; Canto, J.; Universidad de Puer; Universidad de Puerto Rico, Rio Piedras; Universidad Nacional Autonoma de Mexico, Mexico City)

1987-01-01

The results from a survey for high-velocity OH in molecular outflows in star-forming regions are reported. High-velocity OH was detected in absorption in nine of these regions. When the telescope beam can resolve the outflows, they show similar anisotropic angular distribution as the redshifted and blueshifted CO. The OH transitions are markedly subthermal since for several sources it is found that the radiation that is being absorbed is a background continuum constituted by the cosmic component plus a small Galactic contribution. The absorbing OH appears to trace gas with higher velocities and lower densities than does the CO and, in some cases, provides information on the structure of the outflows at larger distances from the central source. At scales of 0.1 pc, the outflows are elongated in the direction of the steepest density gradient of the ambient cloud, suggesting that the large-scale collimation of the outflow is produced by the density structure of the ambient cloud. 29 references

Chronic obstructive pulmonary disease and risk of infection

DEFF Research Database (Denmark)

Lange, Peter

2009-01-01

This review article focuses on the risk of infections in patients with chronic obstructive pulmonary disease (COPD). Throughout the years there have been a number of studies describing the risk of pulmonary infections in patients with COPD, whereas only few studies have focused on the risk...... of infection outside the lungs. With increasing severity of COPD the risk of respiratory tract infection also increases. The impairment of the innate immune system is most likely responsible for both the colonization of respiratory tract with bacteria and for an increased risk of infection with new strains...... of bacteria causing acute exacerbations. Also lung infections like pneumonia, lung abscess and empyema are more often seen in patients with COPD than in healthy subjects. With regard to extrapulmonary infections, it seems that COPD patients are not at higher risk of infection compared with subjects without...

Molecular Outflows: Explosive versus Protostellar

Energy Technology Data Exchange (ETDEWEB)

Zapata, Luis A.; Rodríguez, Luis F.; Palau, Aina; Loinard, Laurent [Instituto de Radioastronomía y Astrofísica, UNAM, Apdo. Postal 3-72 (Xangari), 58089 Morelia, Michoacán, México (Mexico); Schmid-Burgk, Johannes [Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, D-53121, Bonn (Germany)

2017-02-10

With the recent recognition of a second, distinctive class of molecular outflows, namely the explosive ones not directly connected to the accretion–ejection process in star formation, a juxtaposition of the morphological and kinematic properties of both classes is warranted. By applying the same method used in Zapata et al., and using {sup 12}CO( J = 2-1) archival data from the Submillimeter Array, we contrast two well-known explosive objects, Orion KL and DR21, to HH 211 and DG Tau B, two flows representative of classical low-mass protostellar outflows. At the moment, there are only two well-established cases of explosive outflows, but with the full availability of ALMA we expect that more examples will be found in the near future. The main results are the largely different spatial distributions of the explosive flows, consisting of numerous narrow straight filament-like ejections with different orientations and in almost an isotropic configuration, the redshifted with respect to the blueshifted components of the flows (maximally separated in protostellar, largely overlapping in explosive outflows), the very-well-defined Hubble flow-like increase of velocity with distance from the origin in the explosive filaments versus the mostly non-organized CO velocity field in protostellar objects, and huge inequalities in mass, momentum, and energy of the two classes, at least for the case of low-mass flows. Finally, all the molecular filaments in the explosive outflows point back to approximately a central position (i.e., the place where its “exciting source” was located), contrary to the bulk of the molecular material within the protostellar outflows.

The energetics of AGN radiation pressure-driven outflows

Science.gov (United States)

Ishibashi, W.; Fabian, A. C.; Maiolino, R.

2018-05-01

The increasing observational evidence of galactic outflows is considered as a sign of active galactic nucleus (AGN) feedback in action. However, the physical mechanism responsible for driving the observed outflows remains unclear, and whether it is due to momentum, energy, or radiation is still a matter of debate. The observed outflow energetics, in particular the large measured values of the momentum ratio (\\dot{p}/(L/c) ˜ 10) and energy ratio (\\dot{E}_k/L ˜ 0.05), seems to favour the energy-driving mechanism; and most observational works have focused their comparison with wind energy-driven models. Here, we show that AGN radiation pressure on dust can adequately reproduce the observed outflow energetics (mass outflow rate, momentum flux, and kinetic power), as well as the scalings with luminosity, provided that the effects of radiation trapping are properly taken into account. In particular, we predict a sublinear scaling for the mass outflow rate (\\dot{M} ∝ L^{1/2}) and a superlinear scaling for the kinetic power (\\dot{E}_k ∝ L^{3/2}), in agreement with the observational scaling relations reported in the most recent compilation of AGN outflow data. We conclude that AGN radiative feedback can account for the global outflow energetics, at least equally well as the wind energy-driving mechanism, and therefore both physical models should be considered in the interpretation of future AGN outflow observations.

Comparison of valvar and right ventricular function following transcatheter and surgical pulmonary valve replacement.

Science.gov (United States)

Li, Wendy F; Pollard, Heidi; Karimi, Mohsen; Asnes, Jeremy D; Hellenbrand, William E; Shabanova, Veronika; Weismann, Constance G

2018-01-01

Trans-catheter (TC) pulmonary valve replacement (PVR) has become common practice for patients with right ventricular outflow tract obstruction (RVOTO) and/or pulmonic insufficiency (PI). Our aim was to compare PVR and right ventricular (RV) function of patients who received TC vs surgical PVR. Retrospective review of echocardiograms obtained at three time points: before, immediately after PVR, and most recent. Sixty-two patients (median age 19 years, median follow-up 25 months) following TC (N = 32) or surgical (N = 30) PVR at Yale-New Haven Hospital were included. Pulmonary valve and right ventricular function before, immediately after, and most recently after PVR. At baseline, the TC group had predominant RVOTO (74% vs 10%, P function was good throughout. At last follow-up, the TC group had preserved valve function, but the surgical group did not (moderate RVOTO: 6% vs 41%, P mild PI: 0% vs 24%, P = .003). Patients younger than 17 years at surgical PVR had the highest risk of developing PVR dysfunction, while PVR function in follow-up was similar in adults. Looking at RV size and function, both groups had a decline in RV size following PVR. However, while RV function remained stable in the TC group, there was a transient postoperative decline in the surgical group. TC PVR in patients age function in follow-up compared to surgical valves. There was a transient decline in RV function following surgical but not TC PVR. TC PVR should therefore be the first choice in children who are considered for PVR, whenever possible. © 2017 Wiley Periodicals, Inc.

QRS Width as a Predictor of Right Ventricular Remodeling After Percutaneous Pulmonary Valve Implantation.

Science.gov (United States)

Paech, C; Dähnert, I; Riede, F T; Wagner, R; Kister, T; Nieschke, K; Wagner, F; Gebauer, R A

2017-08-01

Recent data showed a right ventricular dyssynchrony in patients with tetralogy of Fallot (TOF). Percutaneous pulmonary valve implantation (PPVI) has become an important procedure to treat a pulmonary stenosis and/or regurgitation of the right ventricular outflow tract in these patients. Despite providing good results, there is still a considerable number of nonresponders to PPVI. The authors speculated that electrical dysfunction of the right ventricle plays an underestimated role in the outcome of patients after PPVI. This study aimed to investigate the influence of right ventricular electrical dysfunction, i.e., right bundle branch block (RBBB) on the RV remodeling after PPVI. The study included consecutive patients after correction of TOF with or without RBBB, who had received a PPVI previously at the Heart Center of the University of Leipzig, Germany during the period from 2012 to 2015. 24 patients were included. Patients without RBBB, i.e., with narrow QRS complexes pre-intervention, had significantly better RV function and had smaller right ventricular volumes. Patients with pre-interventionally QRS width below 150 ms showed a post-interventional remodeling of the right ventricle with the decreasing RV volumes (p = 0.001). The parameters of LV function and volume as well as RV ejection fraction remained unaffected by RBBB. The presented data indicate that the QRS width seems to be a valuable parameter in the prediction of right ventricular remodeling after PPVI, as it represents both electrical and mechanical functions of the right ventricle and may serve as an additional parameter for optimal timing of a PPVI.

The Platelia Aspergillus ELISA in diagnosis of invasive pulmonary aspergilosis (IPA).

Science.gov (United States)

Siemann, M; Koch-Dörfler, M

2001-01-01

The sensitivity of a sandwich enzyme-linked immunosorbent assay (ELISA) for detecting Aspergillus galactomannan was evaluated with 66 serum samples and 113 specimens of the respiratory tract obtained from 52 patients with pulmonary diseases. The patients were divided into five groups: proven invasive pulmonary aspergillosis (IPA) (five patients), probable IPA (seven patients), Aspergillus colonization (eight patients) or unlikely Aspergillus infection (27 patients). Another five patients with doubtful diagnostic test results are discussed in detail. The results of the Platelia Aspergillus ELISA (Sanofi Pasteur, Freiburg, Germany) in testing specimens of the respiratory tract were 90% sensitivity in proven (serum 38%), 60% in probable (serum 37%) and 71% in Aspergillus colonization (serum 0%). Furthermore, 85% of the Aspergillus spp. from positive cultures of specimens of the respiratory tract were also detected in the ELISA. A total of 57% of the culture negative specimens of patients with a least one positive culture or proven aspergillosis in a series of specimens were positive in the ELISA.

A New Look at Speeding Outflows

Science.gov (United States)

Kohler, Susanna

2018-02-01

The compact centers of active galaxies known as active galactic nuclei, or AGN are known for the dynamic behavior they exhibit as the supermassive black holes at their centers accrete matter. New observations of outflows from a nearby AGN provide a more detailed look at what happens in these extreme environments.Outflows from GiantsThe powerful radio jets of Cygnus A, which extend far beyond the galaxy. [NRAO/AUI]AGN consist of a supermassive black hole of millions to tens of billions of solar masses surrounded by an accretion disk of in-falling matter. But not all the material falling toward the black hole accretes! Some of it is flung from the AGN via various types of outflows.The most well-known of these outflows are powerful radio jets collimated and incredibly fast-moving streams of particles that blast their way out of the host galaxy and into space. Only around 10% of AGN are observed to host such jets, however and theres another outflow thats more ubiquitous.Fast-Moving AbsorbersPerhaps 30% of AGN both those with and without observed radio jets host wider-angle, highly ionized gaseous outflows known as ultra-fast outflows (UFOs). Ultraviolet and X-ray radiation emitted from the AGN is absorbed by the UFO, revealing the outflows presence: absorption lines appear in the ultraviolet and X-ray spectra of the AGN, blue-shifted due to the high speeds of the absorbing gas in the outflow.Quasar PG 1211+143, indicated by the crosshairs at the center of the image, in the color context of its surroundings. [SDSS/S. Karge]But what is the nature of UFOs? Are they disk winds? Or are they somehow related to the radio jets? And what impact do they have on the AGNs host galaxy?X-ray and Ultraviolet CooperationNew observations are now providing fresh information about one particular UFO. A team of scientists led by Ashkbiz Danehkar (Harvard-Smithsonian Center for Astrophysics) recently used the Chandra and Hubble space telescopes to make the first simultaneous observations

Interventional catheter methods for complex tetralogy of fallot and 'Critical' PS/pulmonary atresia with intact interventional septum

International Nuclear Information System (INIS)

Issenberg, H.J.

2005-01-01

TOF is generally accepted as the index lesion used for evaluating the overall quality of a congenital cardiac program. To achieve good results , the evaluation and management of TOF requires an intimate collaboration between all members of the cardiac team involved in the care of these children, especially the interventional catheterizer and the surgeon. Each program has to develop its own approach, relying on the collective strengths of their staff. Any weak link in this chain will often have a profoundly negative effect upon the patient , which may be difficult to correct later. Whereas the cathlab was the sole source of the anatomic and physiologic data for surgical planning, much of the information, especially intracardiac anatomy and physiology, can now be acquired with echocardiography, and if necessary, enhanced with MRI and CT. The role of diagnostic angiography is reserved for the elucidation of complex and small vascular structures beyond the resolution and specificity of less invasive methods, such as pulmonary artery branches, coronary arteries and arterial collaterals. This anatomy becomes particularly important when staging procedures for TOF in the infant with small pulmonary arteries or atresia, when is the greatest potential for enhancing arterial size and vascular bed growth. Our approach is to perform early correction which will insure antegrade flow into the small pulmonary arteries, by opening the outflow tract (patch or conduit), and when feasible, closing the VSD. Aortic to pulmonary arterial shunts are avoided. Direct access into the pulmonary arteries allows additional catheter-based interventions. Which may include balloon dilation and stenting, which avoiding any deformity from peripheral shunts. Aortic collaterals perfusing lung segments competing with antegrade flow into the branch pulmonary arteries may need Giannturco coil occlusion. Those with small pulmonary arteries may require multiple ballooning/stenting interventions to increase

PROTOSTELLAR OUTFLOWS IN L1340

Energy Technology Data Exchange (ETDEWEB)

Walawender, Josh [W. M. Keck Observatory, 65-1120 Mamalahoa Hwy, Kamuela, HI 96743 (United States); Wolf-Chase, Grace [Astronomy Department, Adler Planetarium, 1300 South Lake Shore Drive, Chicago, IL 60605 (United States); Smutko, Michael [Center for Interdisciplinary Exploration and Research in Astrophysics (CIERA) and Department of Physics and Astronomy, Northwestern University, 2145 Sheridan Road, Evanston, IL 60208 (United States); OLinger-Luscusk, JoAnn [California Institute of Technology, 1200 E California Blvd, Pasadena, CA 91125 (United States); Moriarty-Schieven, Gerald, E-mail: jmwalawender@keck.hawaii.edu [National Research Council—Herzberg Astronomy and Astrophysics, 5017 West Saanich Road, Victoria, BC, V9E 2E7 (Canada)

2016-12-01

We have searched the L1340 A, B, and C clouds for shocks from protostellar outflows using the H{sub 2} 2.122 μ m near-infrared line as a shock tracer. Substantial outflow activity has been found in each of the three regions of the cloud (L1340 A, L1340 B, and L1340 C). We find 42 distinct shock complexes (16 in L1340 A, 11 in L1340 B, and 15 in L1340 C). We were able to link 17 of those shock complexes into 12 distinct outflows and identify candidate source stars for each. We examine the properties ( A {sub V}, T {sub bol}, and L {sub bol}) of the source protostars and compare them to the properties of the general population of Class 0/I and flat spectral energy distribution protostars and find that there is an indication, albeit at low statistical significance, that the outflow-driving protostars are drawn from a population with lower A {sub V}, higher L {sub bol}, and lower T {sub bol} than the general population of protostars.

AGN outflows as neutrino sources: an observational test

Science.gov (United States)

Padovani, P.; Turcati, A.; Resconi, E.

2018-04-01

We test the recently proposed idea that outflows associated with Active Galactic Nuclei (AGN) could be neutrino emitters in two complementary ways. First, we cross-correlate a list of 94 "bona fide" AGN outflows with the most complete and updated repository of IceCube neutrinos currently publicly available, assembled by us for this purpose. It turns out that AGN with outflows matched to an IceCube neutrino have outflow and kinetic energy rates, and bolometric powers larger than those of AGN with outflows not matched to neutrinos. Second, we carry out a statistical analysis on a catalogue of [O III] λ5007 line profiles using a sample of 23,264 AGN at z values (˜6 and 18 per cent respectively, pre-trial) for relatively high velocities and luminosities. Our results are consistent with a scenario where AGN outflows are neutrino emitters but at present do not provide a significant signal. This can be tested with better statistics and source stacking. A predominant role of AGN outflows in explaining the IceCube data appears in any case to be ruled out.

Molecular outflows in the L1641 region of Orion

International Nuclear Information System (INIS)

Morgan, J.A.

1990-01-01

Little is known about the interaction between molecular outflows associated with young stellar objects and the parent molecular cloud that produced them. This is because molecular outflows are a recently discovered phenomenon and, so, have not had their global properties studied in great detail and molecular clouds were not mapped to sufficiently high spatial resolution to resolve the interaction. The interaction between molecular outflows and the L1641 molecular cloud is addressed by both identifying and mapping all the molecular outflows as well as the detailed structure of the cloud. Candidate molecular outflows were found from single point 12-CO observations of young stellar objects identified from the IRAS survey data. The candidate sources were then mapped to confirm their molecular outflow nature. From these maps, molecular outflow characteristics such as their morphology, orientation, and energetics were determined. In addition, the Orion molecular cloud was mapped to compare directly with the molecular outflows. The molecular outflows identified were found to have rising infrared spectra, radio continuum emission that suggests a stellar wind or optically thick H II region, and molecular line strengths that indicate that they are embedded within a very dense environment. The lack of an optical counterpart for many molecular outflows suggests that they occur at the earliest stages of stellar evolution. The lack of an optical counterpart for many molecular outflows suggest that they occur at the earliest stages of stellar evolution. The orientations of the molecular outflows appear to lie in no preferred direction and they have shapes that indicate that the molecular cloud is responsible for determining their direction and collimation

A new one-step procedure for pulmonary valve implantation of the melody valve: Simultaneous prestenting and valve implantation.

Science.gov (United States)

Boudjemline, Younes

2018-01-01

To describe a new modification, the one-step procedure, that allows interventionists to pre-stent and implant a Melody valve simultaneously. Percutaneous pulmonary valve implantation (PPVI) is the standard of care for managing patients with dysfunctional right ventricular outflow tract, and the approach is standardized. Patients undergoing PPVI using the one-step procedure were identified in our database. Procedural data and radiation exposure were compared to those in a matched group of patients who underwent PPVI using the conventional two-step procedure. Between January 2016 and January 2017, PPVI was performed in 27 patients (median age/range, 19.1/10-55 years) using the one-step procedure involving manual crimping of one to three bare metal stents over the Melody valve. The stent and Melody valve were delivered successfully using the Ensemble delivery system. No complications occurred. All patients had excellent hemodynamic results (median/range post-PPVI right ventricular to pulmonary artery gradient, 9/0-20 mmHg). Valve function was excellent. Median procedural and fluoroscopic times were 56 and 10.2 min, respectively, which significantly differed from those of the two-step procedure group. Similarly, the dose area product (DAP), and radiation time were statistically lower in the one-step group than in the two-step group (P step procedure is a safe modification that allows interventionists to prestent and implants the Melody valve simultaneously. It significantly reduces procedural and fluoroscopic times, and radiation exposure. © 2017 Wiley Periodicals, Inc.

Left ventricular outflow obstruction as a result of external cardiac compression by a mediastinal tumor; Zwezenie drogi odplywu lewej komory wywolane uciskiem przeez guz srodpiersia

Energy Technology Data Exchange (ETDEWEB)

Rydlewska-Sadowska, W.; Kowalski, M.; Borowiecka, E.; Polkowski, J.; Szaroszyk, W. [Klinika Szybkiej Diagnostyki, Zaklad Radiologii, Instytut Kardiologii, Warsaw (Poland)

1993-12-31

A case of left ventricular outflow tract stenosis resulted from compression of the heart is presented. This symptomatic cardiovascular lesion was produced by extensive growth of mediastinal tumour. Numerous noninvasive methods were necessary to establish this difficult diagnosis. The patient underwent surgery that disclosed a benign process (of neurofibroma). After tumour`s resection marked hemodynamic signs subsided. (author) 12 refs, 6 figs

SEVERE PULMONARY HYPERTENSION DUE TO SLEEP-DISORDERED BREATHING IN AN ACHONDROPLASIC CHILD

Directory of Open Access Journals (Sweden)

Vehbi Dogan

2014-03-01

Full Text Available Achondroplasia is the most common skeletal dysplasia in children. Achondroplasic patients often have respiratory problems associated with upper respiratory tract obstruction and craniaofacial dysmorphology. Chronic hypoxemia in these patients can result in pulmonary hypertension. In this report an achondroplasic child with severe day-time pulmonary hypertension is presented. [J Contemp Med 2014; 4(1.000: 41-43

Radiological evaluation of sinus valsalva rupture

Energy Technology Data Exchange (ETDEWEB)

Lee, Yul; Park, Jae Hyung; Yeon, Kyung Mo; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1984-03-15

We obtained the following results by reviewing the radiographic findings of 15 cases of Sinus valsalva rupture who were diagnosed surgically at Seoul National University Hospital since 1979. 1. Among distribution was from 15 years to 40 years with the mean age of 24 years. Among the 15 cases, 9 cases were male and 7 were female. 2. Ruptured sinus is right coronary sinus projecting to right ventricle in all 15 cases. Combined diseases are ventricular septal defect in 12 cases, Aortic Valvular heart disease in 4 cases, and narrowing of right ventricular outflow tract in 2 cases, and aneurysmal dilatation of right pulmonary artery in 1 cases. 3. Chest X-ray findings were that of left to right shunt, i.e, cardiomegaly, increased pulmonary vascularity but were normal in 3 cases. 4. Aortography showed sequential leakage of dye from right coronary sinus to right ventricle and finally to pulmonary artery in 9 cases, and in 9 cases of them the leakage is directly to right ventricular outflow tract without filling of sinus portion of the ventricle., i.e., type I. 5. The leakage was well shown in left ventricular diastolic phase and not shown in systolic phase. 6. Ventricular septal defects were not detected definitely in spite of taking left ventriculography. 7. Cine angiography is essential for detecting accurate site, degree and direction of sinus valsalva rupture and other associated cardiac abnormality.

Radiological evaluation of sinus valsalva rupture

International Nuclear Information System (INIS)

Lee, Yul; Park, Jae Hyung; Yeon, Kyung Mo; Han, Man Chung

1984-01-01

We obtained the following results by reviewing the radiographic findings of 15 cases of Sinus valsalva rupture who were diagnosed surgically at Seoul National University Hospital since 1979. 1. Among distribution was from 15 years to 40 years with the mean age of 24 years. Among the 15 cases, 9 cases were male and 7 were female. 2. Ruptured sinus is right coronary sinus projecting to right ventricle in all 15 cases. Combined diseases are ventricular septal defect in 12 cases, Aortic Valvular heart disease in 4 cases, and narrowing of right ventricular outflow tract in 2 cases, and aneurysmal dilatation of right pulmonary artery in 1 cases. 3. Chest X-ray findings were that of left to right shunt, i.e, cardiomegaly, increased pulmonary vascularity but were normal in 3 cases. 4. Aortography showed sequential leakage of dye from right coronary sinus to right ventricle and finally to pulmonary artery in 9 cases, and in 9 cases of them the leakage is directly to right ventricular outflow tract without filling of sinus portion of the ventricle., i.e., type I. 5. The leakage was well shown in left ventricular diastolic phase and not shown in systolic phase. 6. Ventricular septal defects were not detected definitely in spite of taking left ventriculography. 7. Cine angiography is essential for detecting accurate site, degree and direction of sinus valsalva rupture and other associated cardiac abnormality

Main features of the proposed NCRP respiratory tract model

International Nuclear Information System (INIS)

Phalen, R.F.; Fisher, G.L.; Moss, O.R.; Schlesinger, R.B.; Swift, D.L.

1991-01-01

The proposed NCRP respiratory tract dosimetry model regions include the naso-oro-pharyngo-laryngeal (NOPL), the tracheobronchial (TB), the pulmonary (P), and the lymph nodes (LN). Input aerosol concentrations are derived from a consideration of particle-size-dependent inspirability. Particle deposition in the respiratory tract is modelled using the mechanisms of inertial impaction, sedimentation and diffusion. The rates of absorption of particles, and transport to the blood, have been derived from clearance data from people and laboratory animals. The effect of body growth on particle deposition is considered. Particle clearance rates are assumed to be independent of age. The proposed respiratory tract model differs significantly from the 1966 Task Group Model in that (1) inspirability is considered; (2) new sub-regions of the respiratory tract are considered; (3) absorption of materials by the blood is treated in a more sophisticated fashion; and (4) body size (and thus age) is taken into account. (author)

Outflow occlusion for circulatory arrest in dogs "Outfow occlusion" para parada circulatória em cães

Directory of Open Access Journals (Sweden)

James N.B.M. de Andrade

2009-02-01

Full Text Available The purpose of this study was to evaluate the possibility of producing circulatory arrest by occlusion of the pulmonary trunk as an alternative to the venous inflow occlusion through the left hemithorax. Eight healthy mongrel dogs were divided in two groups. Group I underwent 4 minutes of outflow occlusion and Group II was submitted to 8 minutes of circulatory arrest. Outflow occlusion was performed through left thoracotomy and pericardiotomy by passing a Rumel tourniquet around the pulmonary trunk. Physical examination, electrocardiography, echocardiography, blood gas analyses, hemodynamic, and oxygen transport variables were obtained before and after the procedure. The dogs from Group I did not have any clinical, electrocardiographic, echocardiographic, or hemo-dynamic abnormalities after anesthetic recover. In the Group II, only one dog survived, which had no clinical, electrocardiographic, or echocardiographic abnormalities. In this last dog, just after releasing the occlusion, it was detected increases in the following parameters: heart rate (HR, systolic, diastolic and mean arterial blood pressure (SAP; DAP; MAP, pulmonary artery pressure (PAP, pulmonary wedge pressure (PWP, central venous pressure (CVP, cardiac output (CO, systolic index (SI, cardiac index (CI, left and right ventricular stroke work (LVSW; RVSW, oxygen delivery index (DO2, oxygen consumption index (VO2, and oxygen extraction (O2 ext. Moreover, the oxygen content of arterial and mixed venous blood (CaO2; CvO2, and the arterial and mixed venous partial pressure of oxygen (PaO2; PvO2 were decreased 5 minutes after circulatory arrest. Outflow occlusion is a feasible surgical procedure for period of 4 minutes of circulatory arrest.O objetivo deste estudo foi avaliar a possibilidade de se produzir uma parada circulatória pela oclusão do tronco pulmonar, como alternativa ao "inflow occlusion", pelo hemitórax esquerdo. Oito cães sem raça definida foram divididos em dois

Studies of Quasar Outflows

Science.gov (United States)

Arav, Nahum

2002-01-01

The main aim of this research program is to determine the ionization equilibrium and abundances in quasar outflows. Especially in the broad absorption line QSO PG 0946+301. We find that the outflow's metalicity is consistent with being solar, while the abundance ratio of phosphorus to other metals is at least ten times solar. These findings are based on diagnostics that are not sensitive to saturation and partial covering effects in the BALs (Broad Adsorption Lines), which considerably weakened previous claims for enhanced metalicity. Ample evidence for these effects is seen in the spectrum.

Young infants with severe tetralogy of Fallot: Early primary surgery versus transcatheter palliation.

Science.gov (United States)

Wilder, Travis J; Van Arsdell, Glen S; Benson, Lee; Pham-Hung, Eric; Gritti, Michael; Page, Alexandra; Caldarone, Christopher A; Hickey, Edward J

2017-11-01

Infants with severe tetralogy of Fallot may undergo (1) early primary surgical repair (EARLY) or (2) early transcatheter palliation (CATH) before delayed surgical repair. We compared these strategies with (3) elective single-stage tetralogy of Fallot repair (IDEAL). From 2000 to 2012, 453 children underwent tetralogy of Fallot repair (excluding systemic-pulmonary shunts), including 383 in the IDEAL (75%), 42 in the EARLY (9%), and 28 in the CATH (6%) groups. IDEAL repair at The Hospital for Sick Children occurs after 3 months. Risk-adjusted hazard analysis compared freedom from surgical or catheter reintervention. Somatic size, branch pulmonary artery size, and right ventricle systolic pressure were modeled using 2780 echocardiogram reports via mixed-model regression. CATH involved right ventricular outflow tract stent in 18 patients, right ventricular outflow tract balloon in 9 patients, and ductal-stent in 1 patient. Three patients died (1 per group). Risk-adjusted freedom from surgical reoperation was 89% ± 4%, 88% ± 5%, and 85% ± 6% for the IDEAL, EARLY, and CATH groups, respectively, at 10 years. Patients in the EARLY and CATH groups had similar reoperation rates, except for neonates (tetralogy of Fallot. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Knowledge Outflows from Foreign Subsidiaries

DEFF Research Database (Denmark)

Perri, Alessandra; Andersson, Ulf

This paper analyzes the MNC subsidiaries’ trade-off between the need for knowledge creation and the need for knowledge protection, and relates it to the extent of knowledge outflows generated within the host location. Combining research in International Business with Social Theory, we find...... the value of the subsidiary’s knowledge stock is very high, the need for knowledge protection restrains reciprocity mechanisms in knowledge exchanges, thus reducing the extent of knowledge outflows to the host location. This study contributes to the literature on the firm-level antecedents of FDI...... that subsidiaries that extensively draw on external knowledge sources are also more likely to generate knowledge outflows to local firms. We argue that this may be explained by the subsidiaries’ willingness to build the trust that facilitates the establishment of reciprocal knowledge linkages. However, when...

Does the X-ray outflow quasar PDS 456 have a UV outflow at 0.3c?

Science.gov (United States)

Hamann, Fred; Chartas, George; Reeves, James; Nardini, Emanuele

2018-05-01

The quasar PDS 456 (at redshift ˜0.184) has a prototype ultra-fast outflow (UFO) measured in X-rays. This outflow is highly ionized with relativistic speeds, large total column densities log NH(cm-2) > 23, and large kinetic energies that could be important for feedback to the host galaxy. A UV spectrum of PDS 456 obtained with the Hubble Space Telescope in 2000 contains one well-measured broad absorption line (BAL) at ˜1346 Å (observed) that might be Ly α at v ≈ 0.06c or N V λ1240 at v ≈ 0.08c. However, we use photoionization models and comparisons to other outflow quasars to show that these BAL identifications are problematic because other lines that should accompany them are not detected. We argue that the UV BAL is probably C IV at v ≈ 0.30c. This would be the fastest UV outflow ever reported, but its speed is similar to the X-ray outflow and its appearance overall is similar to relativistic UV BALs observed in other quasars. The C IV BAL identification is also supported indirectly by the tentative detection of another broad C IV line at v ≈ 0.19c. The high speeds suggest that the UV outflow originates with the X-ray UFO crudely 20-30 rg from the central black hole. We speculate that the C IV BAL might form in dense clumps embedded in the X-ray UFO, requiring density enhancements of only ≳0.4 dex compared to clumpy structures already inferred for the soft X-ray absorber in PDS 456. The C IV BAL might therefore be the first detection of low-ionization clumps proposed previously to boost the opacities in UFOs for radiative driving.

Right ventricular remodelling after transcatheter pulmonary valve implantation.

Science.gov (United States)

Pagourelias, Efstathios D; Daraban, Ana M; Mada, Razvan O; Duchenne, Jürgen; Mirea, Oana; Cools, Bjorn; Heying, Ruth; Boshoff, Derize; Bogaert, Jan; Budts, Werner; Gewillig, Marc; Voigt, Jens-Uwe

2017-09-01

To define the optimal timing for percutaneous pulmonary valve implantation (PPVI) in patients with severe pulmonary regurgitation (PR) after Fallot's Tetralogy (ToF) correction. PPVI among the aforementioned patients is mainly driven by symptoms or by severe right ventricular (RV) dilatation/dysfunction. The optimal timing for PPVI is still disputed. Twenty patients [age 13.9 ± 9.2 years, (range 4.3-44.9), male 70%] with severe PR (≥3 grade) secondary to previous correction of ToF, underwent Melody valve (Medtronic, Minneapolis, MN) implantation, after a pre-stent placement. Full echocardiographic assessment (traditional and deformation analysis) and cardiovascular magnetic resonance evaluation were performed before and at 3 months after the intervention. 'Favorable remodelling' was considered the upper quartile of RV size decrease (>20% in 3 months). After PPVI, indexed RV effective stroke volume increased from 38.4 ± 9.5 to 51.4 ± 10.7 mL/m 2 , (P = 0.005), while RV end-diastolic volume and strain indices decreased (123.1 ± 24.1-101.5 ± 18.3 mL/m 2 , P = 0.005 and -23.5 ± 2.5 to -21 ± 2.5%, P = 0.002, respectively). After inserting pre-PPVI clinical, RV volumetric and deformation parameters in a multiple regression model, only time after last surgical correction causing PR remained as significant regressor of RV remodelling [R 2  = 0.60, beta = 0.387, 95%CI(0.07-0.7), P = 0.019]. Volume reduction and functional improvement were more pronounced in patients treated with PPVI earlier than 7 years after last RV outflow tract (RVOT) correction, reaching close-to-normal values. Early PPVI (<7 years after last RVOT operation) is associated with a more favorable RV reverse remodelling toward normal range and should be considered, before symptoms or RV damage become apparent. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Assessment of infective urinary tract disorders

International Nuclear Information System (INIS)

Sixt, R.; Stokland, E.

1998-01-01

Urinary tracts infection (UTI) is common in children, particularly in the youngest age groups. There is a risk for progressive deterioration of renal function in these children if aggravating factors such as gross reflux and/or outflow obstruction of the urinary tract are present. In this review the pros and cons of available scintigrafic and radiological imaging techniques for the work-up of these children are presented. Ultrasound can be used in the acute phase to exclude obstruction but can not reliably show transient or permanent parenchymal lesions. The presence of reflux can be established with X-ray or direct nuclide cystography. The X-ray technique gives good morphological information and has a grading system with prognostic relevance. Both techniques are invasive and great care must be taken to keep the radiation burden down with the X-ray technique. Indirect nuclide cystography following a renographic study is non-invasive but has a lower sensitivity than direct techniques. More experience is needed with the indirect technique to evaluate the consequences of its apparently low sensitivity. Urography has a limited place in the acute work-up of urinary tract infection but can be used to look for renal scarring 1-2 years after an acute pyelonephritis. The 99m Tc dimercaptosuccinic acid (DMSA) scan can be used during the acute UTI to show pyelonephritic lesions with good accuracy and/or during the follow-up after six months to show permanent lesions. The acute DMSA scan can be omitted

Assessment of infective urinary tract disorders

Energy Technology Data Exchange (ETDEWEB)

Sixt, R.; Stokland, E. [Goteborg, Sahlgrenska Univ. Hospital/Ostra (Sweden). Dept. of Pediatric Clinical Physiology and Dept. of Pediatric Radiology

1998-06-01

Urinary tracts infection (UTI) is common in children, particularly in the youngest age groups. There is a risk for progressive deterioration of renal function in these children if aggravating factors such as gross reflux and/or outflow obstruction of the urinary tract are present. In this review the pros and cons of available scintigrafic and radiological imaging techniques for the work-up of these children are presented. Ultrasound can be used in the acute phase to exclude obstruction but can not reliably show transient or permanent parenchymal lesions. The presence of reflux can be established with X-ray or direct nuclide cystography. The X-ray technique gives good morphological information and has a grading system with prognostic relevance. Both techniques are invasive and great care must be taken to keep the radiation burden down with the X-ray technique. Indirect nuclide cystography following a renographic study is non-invasive but has a lower sensitivity than direct techniques. More experience is needed with the indirect technique to evaluate the consequences of its apparently low sensitivity. Urography has a limited place in the acute work-up of urinary tract infection but can be used to look for renal scarring 1-2 years after an acute pyelonephritis. The {sup 99m}Tc dimercaptosuccinic acid (DMSA) scan can be used during the acute UTI to show pyelonephritic lesions with good accuracy and/or during the follow-up after six months to show permanent lesions. The acute DMSA scan can be omitted.

Cumulative neutrino background from quasar-driven outflows

Energy Technology Data Exchange (ETDEWEB)

Wang, Xiawei; Loeb, Abraham, E-mail: xiawei.wang@cfa.harvard.edu, E-mail: aloeb@cfa.harvard.edu [Department of Astronomy, Harvard University, 60 Garden Street, Cambridge, MA 02138 (United States)

2016-12-01

Quasar-driven outflows naturally account for the missing component of the extragalactic γ-ray background through neutral pion production in interactions between protons accelerated by the forward outflow shock and interstellar protons. We study the simultaneous neutrino emission by the same protons. We adopt outflow parameters that best fit the extragalactic γ-ray background data and derive a cumulative neutrino background of ∼ 10{sup −7} GeV cm{sup −2} s{sup −1} sr{sup −1} at neutrino energies E {sub ν} ∼> 10 TeV, which naturally explains the most recent IceCube data without tuning any free parameters. The link between the γ-ray and neutrino emission from quasar outflows can be used to constrain the high-energy physics of strong shocks at cosmological distances.

Negative and Positive Outflow-Feedback in Nearby (U)LIRGs

Energy Technology Data Exchange (ETDEWEB)

Cazzoli, Sara, E-mail: sara@iaa.es [Instituto de Astrofisica de Andalucia (CSIC), Granada (Spain)

2017-12-15

The starburst-AGN coexistence in local (U)LIRGs makes these galaxies excellent laboratories for the study of stellar and AGN outflows and feedback. Outflows regulate star formation and AGN activity, redistributing gas, dust and metals over large scales in the interstellar and intergalactic media (negative feedback) being also considered to be able to undergo vigorous star formation (positive feedback). In this contribution, I will summarize the results from a search for outflows in a sample of nearby 38 local (U)LIRG systems observed with VIMOS/VLT integral field unit. For two galaxies of the sample I will detail the outflow properties and discuss the observational evidence for negative and positive outflow-feedback. The assessment of both negative and positive feedback effects represent a novel approach toward a comprehensive understanding of the impact of outflow feedback in the galaxy evolution.

Uses of Magnetic Resonance in Post-Surgical Evaluation of Patients with Tetralogy of Fallot

International Nuclear Information System (INIS)

Abad, Pedro; Delgado Jorge Andres; Llano Serna, Juan Fernando

2008-01-01

The number of patients with tetralogy of Fallot who survive complete reparative surgery is increasing. For this reason the late complications of this procedure, such as pulmonary regurgitation, right ventricular dysfunction, arrhythmias, pulmonary artery stenosis or pseudo aneurysms outflow tract, are becoming more common in clinical practice. Magnetic resonance imaging is the method of choice for the global evaluation of these patients because the ability to evaluate the morphology, quantifying right ventricular function and characterization of the anatomy and function of the pulmonary valve. The knowledge of the embriopathology and the anatomy of this congenital heart disease, and the different interventions, palliative or corrective and the complications are essential for the proper interpretation of the images and making therapeutic decisions.

Compact binary merger and kilonova: outflows from remnant disc

Science.gov (United States)

Yi, Tuan; Gu, Wei-Min; Liu, Tong; Kumar, Rajiv; Mu, Hui-Jun; Song, Cui-Ying

2018-05-01

Outflows launched from a remnant disc of compact binary merger may have essential contribution to the kilonova emission. Numerical calculations are conducted in this work to study the structure of accretion flows and outflows. By the incorporation of limited-energy advection in the hyper-accretion discs, outflows occur naturally from accretion flows due to imbalance between the viscous heating and the sum of the advective and radiative cooling. Following this spirit, we revisit the properties of the merger outflow ejecta. Our results show that around 10-3 ˜ 10-1 M⊙ of the disc mass can be launched as powerful outflows. The amount of unbound mass varies with the disc mass and the viscosity. The outflow-contributed peak luminosity is around 1040 ˜ 1041 erg s-1. Such a scenario can account for the observed kilonovae associated with short gamma-ray bursts, including the recent event AT2017gfo (GW170817).

Character and dynamics of the Red Sea and Persian Gulf outflows

Science.gov (United States)

Bower, Amy S.; Hunt, Heather D.; Price, James F.

2000-03-01

Historical hydrographic data and a numerical plume model are used to investigate the initial transformation, dynamics, and spreading pathways of Red Sea and Persian Gulf outflow waters where they enter the Indian Ocean. The annual mean transport of these outflows is relatively small (outflows in that they flow over very shallow sills (depth Red Sea outflow exhibits strong seasonal variability in transport. The four main results of this study are as follows. First, on the basis of observed temperature-salinity (T-S) characteristics of the outflow source and product waters we estimate that the Red Sea and Persian Gulf outflows are diluted by factors of ˜2.5 and 4, respectively, as they descend from sill depth to their depth of neutral buoyancy. The high-dilution factor for the Persian Gulf outflow results from the combined effects of large initial density difference between the outflow source water and oceanic water and low outflow transport. Second, the combination of low latitude and low outflow transport (and associated low outflow thickness) results in Ekman numbers for both outflows that are O(1). This indicates that they should be thought of as frictional density currents modified by rotation rather than geostrophic density currents modified by friction. Third, different mixing histories along the two channels that direct Red Sea outflow water into the open ocean result in product waters with significantly different densities, which probably contributes to the multilayered structure of the Red Sea product waters. In both outflows, seasonal variations in source water and oceanic properties have some effect on the T-S of the product waters, but they have only a minor impact on equilibrium depth. Fourth, product waters from both outflows are advected away from the sill region in narrow boundary currents, at least during part of the year. At other times, the product water appears more in isolated patches.

Cerebral venous outflow and cerebrospinal fluid dynamics

Directory of Open Access Journals (Sweden)

Clive B. Beggs

2014-12-01

Full Text Available In this review, the impact of restricted cerebral venous outflow on the biomechanics of the intracranial fluid system is investigated. The cerebral venous drainage system is often viewed simply as a series of collecting vessels channeling blood back to the heart. However there is growing evidence that it plays an important role in regulating the intracranial fluid system. In particular, there appears to be a link between increased cerebrospinal fluid (CSF pulsatility in the Aqueduct of Sylvius and constricted venous outflow. Constricted venous outflow also appears to inhibit absorption of CSF into the superior sagittal sinus. The compliance of the cortical bridging veins appears to be critical to the behaviour of the intracranial fluid system, with abnormalities at this location implicated in normal pressure hydrocephalus. The compliance associated with these vessels appears to be functional in nature and dependent on the free egress of blood out of the cranium via the extracranial venous drainage pathways. Because constricted venous outflow appears to be linked with increased aqueductal CSF pulsatility, it suggests that inhibited venous blood outflow may be altering the compliance of the cortical bridging veins.

ALMA OBSERVATIONS OF THE HH 46/47 MOLECULAR OUTFLOW

International Nuclear Information System (INIS)

Arce, Héctor G.; Mardones, Diego; Garay, Guido; Corder, Stuartt A.; Noriega-Crespo, Alberto; Raga, Alejandro C.

2013-01-01

The morphology, kinematics, and entrainment mechanism of the HH 46/47 molecular outflow were studied using new ALMA Cycle 0 observations. Results show that the blue and red lobes are strikingly different. We argue that these differences are partly due to contrasting ambient densities that result in different wind components having a distinct effect on the entrained gas in each lobe. A 29 point mosaic, covering the two lobes at an angular resolution of about 3'', detected outflow emission at much higher velocities than previous observations, resulting in significantly higher estimates of the outflow momentum and kinetic energy than previous studies of this source, using the CO(1-0) line. The morphology and the kinematics of the gas in the blue lobe are consistent with models of outflow entrainment by a wide-angle wind, and a simple model describes the observed structures in the position-velocity diagram and the velocity-integrated intensity maps. The red lobe exhibits a more complex structure, and there is evidence that this lobe is entrained by a wide-angle wind and a collimated episodic wind. Three major clumps along the outflow axis show velocity distribution consistent with prompt entrainment by different bow shocks formed by periodic mass ejection episodes which take place every few hundred years. Position-velocity cuts perpendicular to the outflow cavity show gradients where the velocity increases toward the outflow axis, inconsistent with outflow rotation. Additionally, we find evidence for the existence of a small outflow driven by a binary companion

Relativistic Outflows from ADAFs

Science.gov (United States)

Becker, Peter; Subramanian, Prasad; Kazanas, Demosthenes

2001-04-01

Advection-dominated accretion flows (ADAFs) have a positive Bernoulli parameter, and are therefore gravitationally bound. The Newtonian ADAF model has been generalized recently to obtain the ADIOS model that includes outflows of energy and angular momentum, thereby allowing accretion to proceed self-consistently. However, the utilization of a Newtonian gravitational potential limits the ability of this model to describe the inner region of the disk, where any relativistic outflows are likely to originate. In this paper we modify the ADIOS scenario to incorporate a seudo - Newtonian potential, which approximates the effects of general relativity. The analysis yields a unique, self - similar solution for the structure of the coupled disk/wind system. Interesting features of the new solution include the relativistic character of the outflow in the vicinity of the radius of marginal stability, which represents the inner edge of the quasi-Keplerian disk in our model. Our self - similar model may therefore help to explain the origin of relativistic jets in active galaxies. At large distances the radial dependence of the accretion rate approachs the unique form dot M ∝ r^1/2, with an associated density variation given by ρ ∝ r-1. This density variation agrees with that implied by the dependence of the X-ray hard time lags on the Fourier frequency for a number of accreting galactic black hole candidates. While intriguing, the results of our self-similar model need to be confirmed in the future by incorporating a detailed physical description of the energization mechanism that drives the outflow, which is likely to be powered by the shear of the underlying accretion disk.

Density diagnostics of ionized outflows in active galacitc nuclei

Science.gov (United States)

Mao, J.; Kaastra, J.; Mehdipour, M.; Raassen, T.; Gu, L.

2017-10-01

Ionized outflows in Active Galactic Nuclei are thought to influence their nuclear and local galactic environment. However, the distance of outflows with respect to the central engine is poorly constrained, which limits our understanding of the kinetic power by the outflows. Therefore, the impact of AGN outflows on their host galaxies is uncertain. Given the density of the outflows, their distance can be immediately obtained by the definition of the ionization parameter. Here we carry out a theoretical study of density diagnostics of AGN outflows using absorption lines from metastable levels in Be-like to F-like ions. With the new self-consistent photoionization model (PION) in the SPEX code, we are able to calculate ground and metastable level populations. This enable us to determine under what physical conditions these levels are significantly populated. We then identify characteristic transitions from these metastable levels in the X-ray band. Firm detections of absorption lines from such metastable levels are challenging for current grating instruments. The next generation of spectrometers like X-IFU onboard Athena will certainly identify the presence/absence of these density- sensitive absorption lines, thus tightly constraining the location and the kinetic power of AGN outflows.

Inner-ear circulation in humans is disrupted by extracranial venous outflow strictures: Implications for Ménière’s disease

Directory of Open Access Journals (Sweden)

Eleuterio F. Toro

2018-02-01

Full Text Available Ménière’s disease (MD is a pathology of the inner ear, the symptoms of which include tinnitus, vertigo attacks, fluctuating hearing loss, and nausea. Neither cause nor cure are currently known, though animal experiments suggest that disruption of the inner ear circulation, including venous hypertension and endolymphatic hydrops, to be hallmarks of the disease. Recent evidence for humans suggests a potential link to strictures in the extracranial venous outflow routes. The purpose of the present work is to demonstrate that the inner-ear circulation in humans is disrupted by extracranial venous outflow stricture and to discuss the implications of this finding for MD. The hypothesis linking extracranial venous outflow strictures to the altered dynamics of central nervous system (CNS fluid compartments is investigated theoretically via a global, closed-loop, multiscale mathematical model for the entire human circulation, interacting with the brain parenchyma and cerebrospinal fluid (CSF. The fluid dynamics model for the full human body includes submodels for the heart, pulmonary circulation, arterial system, microvasculature, venous system and the CSF, with a specially refined description of the inner ear vasculature. We demonstrate that extracranial venous outflow strictures disrupt inner ear circulation, and more generally, alter the dynamics of fluid compartments in the whole CNS. Specifically, as compared to a healthy control, the computational results from our model show that subjects with extracranial outflow venous strictures exhibit: altered inner ear circulation, redirection of flow to collaterals, increased intracranial venous pressure and increased intracranial pressure. Our findings are consistent with recent clinical evidence in humans that links extracranial outflow venous strictures to MD, aid the mechanistic understanding of the underlying features of the disease and lend support to recently proposed biophysically motivated

Characterization of molecular outflows in the substellar domain

International Nuclear Information System (INIS)

Phan-Bao, Ngoc; Dang-Duc, Cuong; Lee, Chin-Fei; Ho, Paul T. P.; Li, Di

2014-01-01

We report here our latest search for molecular outflows from young brown dwarfs and very low-mass stars in nearby star-forming regions. We have observed three sources in Taurus with the Submillimeter Array and the Combined Array for Research in Millimeter-wave Astronomy at 230 GHz frequency to search for CO J = 2 → 1 outflows. We obtain a tentative detection of a redshifted and extended gas lobe at about 10 arcsec from the source GM Tau, a young brown dwarf in Taurus with an estimated mass of 73 M J , which is right below the hydrogen-burning limit. No blueshifted emission around the brown dwarf position is detected. The redshifted gas lobe that is elongated in the northeast direction suggests a possible bipolar outflow from the source with a position angle of about 36°. Assuming that the redshifted emission is outflow emission from GM Tau, we then estimate a molecular outflow mass in the range from 1.9 × 10 –6 M ☉ to 2.9 × 10 –5 M ☉ and an outflow mass-loss rate from 2.7 × 10 –9 M ☉ yr –1 to 4.1 × 10 –8 M ☉ yr –1 . These values are comparable to those we have observed in the young brown dwarf ISO-Oph 102 of 60 M J in ρ Ophiuchi and the very low-mass star MHO 5 of 90 M J in Taurus. Our results suggest that the outflow process in very low-mass objects is episodic with a duration of a few thousand years and the outflow rate of active episodes does not significantly change for different stages of the formation process of very low-mass objects. This may provide us with important implications that clarify the formation process of brown dwarfs.

Complex sputum microbial composition in patients with pulmonary tuberculosis

Science.gov (United States)

2012-01-01

Background An increasing number of studies have implicated the microbiome in certain diseases, especially chronic diseases. In this study, the bacterial communities in the sputum of pulmonary tuberculosis patients were explored. Total DNA was extracted from sputum samples from 31 pulmonary tuberculosis patients and respiratory secretions of 24 healthy participants. The 16S rRNA V3 hyper-variable regions were amplified using bar-coded primers and pyro-sequenced using Roche 454 FLX. Results The results showed that the microbiota in the sputum of pulmonary tuberculosis patients were more diverse than those of healthy participants (ppulmonary tuberculosis patients and 17 of which were found in healthy participants. Furthermore, many foreign bacteria, such as Stenotrophomonas, Cupriavidus, Pseudomonas, Thermus, Sphingomonas, Methylobacterium, Diaphorobacter, Comamonas, and Mobilicoccus, were unique to pulmonary tuberculosis patients. Conclusions This study concluded that the microbial composition of the respiratory tract of pulmonary tuberculosis patients is more complicated than that of healthy participants, and many foreign bacteria were found in the sputum of pulmonary tuberculosis patients. The roles of these foreign bacteria in the onset or development of pulmonary tuberculosis shoud be considered by clinicians. PMID:23176186

An association between Helicobacter pylori and upper respiratory tract disease: Fact or fiction?

Science.gov (United States)

Kariya, Shin; Okano, Mitsuhiro; Nishizaki, Kazunori

2014-01-01

Helicobacter pylori (H. pylori) is a major cause of chronic gastritis and gastric ulcers and considerable evidence supports the notion that infection with this bacterium is also associated with gastric malignancy in addition to various other conditions including pulmonary, vascular and autoimmune disorders. Gastric juice infected with H. pylori might play an important role in upper respiratory tract infection. Although direct and/or indirect mechanisms might be involved in the association between H. pylori and upper respiratory tract diseases, the etiological role of H. pylori in upper respiratory tract disorders has not yet been fully elucidated. Although various studies over the past two decades have suggested a relationship between H. pylori and upper respiratory tract diseases, the findings are inconsistent. The present overview describes the outcomes of recent investigations into the impact of H. pylori on upper respiratory tract and adjacent lesions. PMID:24587622

The Mass Outflow Rate of the Milky Way

Science.gov (United States)

Fox, Andrew

2017-08-01

The balance between gaseous inflow and outflow regulates star formation in spiral galaxies. This paradigm can be tested in the Milky Way, but whereas the star formation rate and inflow rate have both been measured, the outflow rate has not. We propose an archival COS program to determine the Galactic outflow rate in cool gas ( 10^4 K) by surveying UV absorption line high-velocity clouds (HVCs). This project will make use of the newly updated Hubble Spectroscopic Legacy Archive, which contains a uniformly reduced sample of 233 COS G130M spectra of background AGN. The outflow rate will be determined by (1) searching for redshifted HVCs; (2) modeling the clouds with photoionization simulations to determine their masses and physical properties; (3) combining the cloud masses with their velocities and distances. We will measure how the outflow is distributed spatially across the sky, calculate its mass loading factor, and compare the line profiles to synthetic spectra extracted from new hydrodynamic simulations. The distribution of HVC velocities will inform us what fraction of the outflowing clouds will escape the halo and what fraction will circulate back to the disk, to better understand how and where gas enters and exits the Milky Way.

Female genital tract tuberculosis presenting as ovarian cancer

Directory of Open Access Journals (Sweden)

Malihe Hasanzadeh

2014-01-01

Full Text Available Background: Tuberculosis (TB is still a major worldwide concern. There is no pathognomonic clinical feature or imaging findings for definite diagnosis of extra pulmonary TB. Therefore, TB involvement of Gastrointestinal or Genitourinary tract can be easily confused with peritoneal carcinomatosis and advanced ovarian carcinoma. Our aim is to emphasize the importance of considering the disease based upon the epidemiologic clues of the patients, while interpreting the positive results for a suspicious ovarian malignancy. Cases: This paper illustrates 8 cases of ovarian or peritoneal tuberculosis, whose initial diagnoses were malignant processes of the GU tract. Conclusion: Tuberculosis ( TB should be always being considered in the differential diagnosis of advanced ovarian cancer, especially in the regions that are endemic for the disease.

DISCOVERY OF RELATIVISTIC OUTFLOW IN THE SEYFERT GALAXY Ark 564

International Nuclear Information System (INIS)

Gupta, A.; Mathur, S.; Krongold, Y.; Nicastro, F.

2013-01-01

We present Chandra High Energy Transmission Grating Spectra of the narrow-line Seyfert-1 galaxy Ark 564. The spectrum shows numerous absorption lines which are well modeled with low-velocity outflow components usually observed in Seyfert galaxies. There are, however, some residual absorption lines which are not accounted for by low-velocity outflows. Here, we present identifications of the strongest lines as Kα transitions of O VII (two lines) and O VI at outflow velocities of ∼0.1c. These lines are detected at 6.9σ, 6.2σ, and 4.7σ, respectively, and cannot be due to chance statistical fluctuations. Photoionization models with ultra-high velocity components improve the spectral fit significantly, providing further support for the presence of relativistic outflow in this source. Without knowing the location of the absorber, its mass and energy outflow rates cannot be well constrained; we find E-dot (outflow)/L bol lower limit of ≥0.006% assuming a bi-conical wind geometry. This is the first time that absorption lines with ultra-high velocities are unambiguously detected in the soft X-ray band. The presence of outflows with relativistic velocities in active galactic nuclei (AGNs) with Seyfert-type luminosities is hard to understand and provides valuable constraints to models of AGN outflows. Radiation pressure is unlikely to be the driving mechanism for such outflows and magnetohydrodynamic may be involved

Radiofrequency catheter ablation of idiopathic ventricular arrhythmias originating from intramural foci in the left ventricular outflow tract: efficacy of sequential versus simultaneous unipolar catheter ablation.

Science.gov (United States)

Yamada, Takumi; Maddox, William R; McElderry, H Thomas; Doppalapudi, Harish; Plumb, Vance J; Kay, G Neal

2015-04-01

Idiopathic ventricular arrhythmias (VAs) originating from the left ventricular outflow tract (LVOT) sometimes require catheter ablation from the endocardial and epicardial sides for their elimination, suggesting the presence of intramural VA foci. This study investigated the efficacy of sequential and simultaneous unipolar radiofrequency catheter ablation from the endocardial and epicardial sides in treating intramural LVOT VAs. Fourteen consecutive LVOT VAs, which required sequential or simultaneous irrigated unipolar radiofrequency ablation from the endocardial and epicardial sides for their elimination, were studied. The first ablation was performed at the site with the earliest local ventricular activation and best pace map on the endocardial or epicardial side. When the first ablation was unsuccessful, the second ablation was delivered on the other surface. If this sequential unipolar ablation failed, simultaneous unipolar ablation from both sides was performed. The first ablation was performed on the epicardial side in 9 VAs and endocardial side in 5 VAs. The intramural LVOT VAs were successfully eliminated by the sequential (n=9) or simultaneous (n=5) unipolar catheter ablation. Simultaneous ablation was most likely to be required for the elimination of the VAs when the distance between the endocardial and epicardial ablation sites was >8 mm and the earliest local ventricular activation time relative to the QRS onset during the VAs of sequential unipolar radiofrequency ablation and sometimes required simultaneous ablation from both the endocardial and epicardial sides. © 2015 American Heart Association, Inc.

Right ventricular outflow tract strategies for repair of tetralogy of Fallot: effect of monocusp valve reconstruction.

NARCIS (Netherlands)

Sasson, L.; Houri, S.; Raucher Sternfeld, A.; Cohen, I.; Lenczner, O.; Bove, E.L.; Kapusta, L.; Tamir, A.

2013-01-01

OBJECTIVES: The absence of a pulmonary valve (PV) after tetralogy of Fallot (TOF) repair has been shown to impact postoperative right ventricular (RV) function. The purposes of this study were to (i) compare early outcomes after PV-sparing vs transannular patching (TAP) with monocusp valve

THE ROLE OF COSMIC-RAY PRESSURE IN ACCELERATING GALACTIC OUTFLOWS

Energy Technology Data Exchange (ETDEWEB)

Simpson, Christine M.; Pakmor, Rüdiger; Pfrommer, Christoph; Springel, Volker [Heidelberger Institut für Theoretische Studien, Schloss-Wolfsbrunnenweg 35, D-69118 Heidelberg (Germany); Marinacci, Federico [Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA 02139 (United States); Glover, Simon C. O. [Zentrum für Astronomie der Universität Heidelberg, ITA, Albert-Ueberle-Str. 2, D-69120 Heidelberg (Germany); Clark, Paul C. [School of Physics and Astronomy, Queen’s Buildings, The Parade, Cardiff University, Cardiff CF24 3AA (United Kingdom); Smith, Rowan J., E-mail: Christine.Simpson@h-its.org [Jodrell Bank Centre for Astrophysics, University of Manchester, Oxford Road, Manchester M13 9PL (United Kingdom)

2016-08-20

We study the formation of galactic outflows from supernova (SN) explosions with the moving-mesh code AREPO in a stratified column of gas with a surface density similar to the Milky Way disk at the solar circle. We compare different simulation models for SN placement and energy feedback, including cosmic rays (CRs), and find that models that place SNe in dense gas and account for CR diffusion are able to drive outflows with similar mass loading as obtained from a random placement of SNe with no CRs. Despite this similarity, CR-driven outflows differ in several other key properties including their overall clumpiness and velocity. Moreover, the forces driving these outflows originate in different sources of pressure, with the CR diffusion model relying on non-thermal pressure gradients to create an outflow driven by internal pressure and the random-placement model depending on kinetic pressure gradients to propel a ballistic outflow. CRs therefore appear to be non-negligible physics in the formation of outflows from the interstellar medium.

Formation and spatial distribution of hypervelocity stars in AGN outflows

Science.gov (United States)

Wang, Xiawei; Loeb, Abraham

2018-05-01

We study star formation within outflows driven by active galactic nuclei (AGN) as a new source of hypervelocity stars (HVSs). Recent observations revealed active star formation inside a galactic outflow at a rate of ∼ 15M⊙yr-1 . We verify that the shells swept up by an AGN outflow are capable of cooling and fragmentation into cold clumps embedded in a hot tenuous gas via thermal instabilities. We show that cold clumps of ∼ 103 M⊙ are formed within ∼ 105 yrs. As a result, stars are produced along outflow's path, endowed with the outflow speed at their formation site. These HVSs travel through the galactic halo and eventually escape into the intergalactic medium. The expected instantaneous rate of star formation inside the outflow is ∼ 4 - 5 orders of magnitude greater than the average rate associated with previously proposed mechanisms for producing HVSs, such as the Hills mechanism and three-body interaction between a star and a black hole binary. We predict the spatial distribution of HVSs formed in AGN outflows for future observational probe.

Characterization of molecular outflows in the substellar domain

Energy Technology Data Exchange (ETDEWEB)

Phan-Bao, Ngoc; Dang-Duc, Cuong [Department of Physics, International University-Vietnam National University HCM, Block 6, Linh Trung Ward, Thu Duc District, Ho Chi Minh City (Viet Nam); Lee, Chin-Fei; Ho, Paul T. P. [Institute of Astronomy and Astrophysics, Academia Sinica, P.O. Box 23-141, Taipei 106, Taiwan (China); Li, Di, E-mail: pbngoc@hcmiu.edu.vn, E-mail: pbngoc@asiaa.sinica.edu.tw [National Astronomical Observatories, Chinese Academy of Science, Chaoyang District Datun Rd A20, Beijing (China)

2014-11-01

We report here our latest search for molecular outflows from young brown dwarfs and very low-mass stars in nearby star-forming regions. We have observed three sources in Taurus with the Submillimeter Array and the Combined Array for Research in Millimeter-wave Astronomy at 230 GHz frequency to search for CO J = 2 → 1 outflows. We obtain a tentative detection of a redshifted and extended gas lobe at about 10 arcsec from the source GM Tau, a young brown dwarf in Taurus with an estimated mass of 73 M {sub J}, which is right below the hydrogen-burning limit. No blueshifted emission around the brown dwarf position is detected. The redshifted gas lobe that is elongated in the northeast direction suggests a possible bipolar outflow from the source with a position angle of about 36°. Assuming that the redshifted emission is outflow emission from GM Tau, we then estimate a molecular outflow mass in the range from 1.9 × 10{sup –6} M {sub ☉} to 2.9 × 10{sup –5} M {sub ☉} and an outflow mass-loss rate from 2.7 × 10{sup –9} M {sub ☉} yr{sup –1} to 4.1 × 10{sup –8} M {sub ☉} yr{sup –1}. These values are comparable to those we have observed in the young brown dwarf ISO-Oph 102 of 60 M {sub J} in ρ Ophiuchi and the very low-mass star MHO 5 of 90 M {sub J} in Taurus. Our results suggest that the outflow process in very low-mass objects is episodic with a duration of a few thousand years and the outflow rate of active episodes does not significantly change for different stages of the formation process of very low-mass objects. This may provide us with important implications that clarify the formation process of brown dwarfs.

From Pulmonary Embolism to Inflammatory Bowel Disease; Give Tunnel Vision up.

Science.gov (United States)

Tajdini, Masih; Hosseini, Seyed Mohammad Reza

2016-01-01

Inflammatory bowel disease (IBD) is a multisystem disorder with gastrointestinal tract involvement. These patients have the higher risk for thromboembolic events compared to normal population. This report describes a unique case of pulmonary embolism as a first manifestation of inflammatory bowel disease.

Surgical Treatment of Double Outlet Right Ventricle Complicated by Pulmonary Hypertension

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Qing-Yu Wu

2017-01-01

Conclusions: PAP of patients with DORV complicated by PH can be expected to fall significantly after surgery. An arterial switch procedure can achieve excellent results in patients with transposition of the great arteries type. Higher incidence of complications may occur in patients with ventricular septal defect (VSD type before 1 year of age. For those with remote VSD type, VSD enlargement and right ventricle outflow tract reconstruction are usually required with acceptable results. The degree of aortic overriding does not influence surgical outcome.

Surfactant protein A and surfactant protein D variation in pulmonary disease

DEFF Research Database (Denmark)

Sørensen, Grith Lykke; Husby, Steffen; Holmskov, Uffe

2007-01-01

Surfactant proteins A (SP-A) and D (SP-D) have been implicated in pulmonary innate immunity. The proteins are host defense lectins, belonging to the collectin family which also includes mannan-binding lectin (MBL). SP-A and SP-D are pattern-recognition molecules with the lectin domains binding...... lavage and blood have indicated associations with a multitude of pulmonary inflammatory diseases. In addition, accumulating evidence in mouse models of infection and inflammation indicates that recombinant forms of the surfactant proteins are biologically active in vivo and may have therapeutic potential...... in controlling pulmonary inflammatory disease. The presence of the surfactant collectins, especially SP-D, in non-pulmonary tissues, such as the gastrointestinal tract and genital organs, suggest additional actions located to other mucosal surfaces. The aim of this review is to summarize studies on genetic...

Recent advances in cardiac catheterization for congenital heart disease [version 1; referees: 2 approved

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Sok-Leng Kang

2018-03-01

Full Text Available The field of pediatric and adult congenital cardiac catheterization has evolved rapidly in recent years. This review will focus on some of the newer endovascular technological and management strategies now being applied in the pediatric interventional laboratory. Emerging imaging techniques such as three-dimensional (3D rotational angiography, multi-modal image fusion, 3D printing, and holographic imaging have the potential to enhance our understanding of complex congenital heart lesions for diagnostic or interventional purposes. While fluoroscopy and standard angiography remain procedural cornerstones, improved equipment design has allowed for effective radiation exposure reduction strategies. Innovations in device design and implantation techniques have enabled the application of percutaneous therapies in a wider range of patients, especially those with prohibitive surgical risk. For example, there is growing experience in transcatheter duct occlusion in symptomatic low-weight or premature infants and stent implantation into the right ventricular outflow tract or arterial duct in cyanotic neonates with duct-dependent pulmonary circulations. The application of percutaneous pulmonary valve implantation has been extended to a broader patient population with dysfunctional ‘native’ right ventricular outflow tracts and has spurred the development of novel techniques and devices to solve associated anatomic challenges. Finally, hybrid strategies, combining cardiosurgical and interventional approaches, have enhanced our capabilities to provide care for those with the most complex of lesions while optimizing efficacy and safety.

PROTOSTELLAR OUTFLOW EVOLUTION IN TURBULENT ENVIRONMENTS

International Nuclear Information System (INIS)

Cunningham, Andrew J.; Frank, Adam; Carroll, Jonathan; Blackman, Eric G.; Quillen, Alice C.

2009-01-01

The link between turbulence in star-forming environments and protostellar jets remains controversial. To explore issues of turbulence and fossil cavities driven by young stellar outflows, we present a series of numerical simulations tracking the evolution of transient protostellar jets driven into a turbulent medium. Our simulations show both the effect of turbulence on outflow structures and, conversely, the effect of outflows on the ambient turbulence. We demonstrate how turbulence will lead to strong modifications in jet morphology. More importantly, we demonstrate that individual transient outflows have the capacity to re-energize decaying turbulence. Our simulations support a scenario in which the directed energy/momentum associated with cavities is randomized as the cavities are disrupted by dynamical instabilities seeded by the ambient turbulence. Consideration of the energy power spectra of the simulations reveals that the disruption of the cavities powers an energy cascade consistent with Burgers'-type turbulence and produces a driving scale length associated with the cavity propagation length. We conclude that fossil cavities interacting either with a turbulent medium or with other cavities have the capacity to sustain or create turbulent flows in star-forming environments. In the last section, we contrast our work and its conclusions with previous studies which claim that jets cannot be the source of turbulence.

Mounier-Kuhn Syndrome in an Elderly Female with Pulmonary Fibrosis

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Panagiotis Boglou

2016-01-01

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

Wind influence on a coastal buoyant outflow

Science.gov (United States)

Whitney, Michael M.; Garvine, Richard W.

2005-03-01

This paper investigates the interplay between river discharge and winds in forcing coastal buoyant outflows. During light winds a plume influenced by the Earth's rotation will flow down shelf (in the direction of Kelvin wave propagation) as a slender buoyancy-driven coastal current. Downwelling favorable winds augment this down-shelf flow, narrow the plume, and mix the water column. Upwelling favorable winds drive currents that counter the buoyancy-driven flow, spread plume waters offshore, and rapidly mix buoyant waters. Two criteria are developed to assess the wind influence on a buoyant outflow. The wind strength index (Ws) determines whether a plume's along-shelf flow is in a wind-driven or buoyancy-driven state. Ws is the ratio of the wind-driven and buoyancy-driven along-shelf velocities. Wind influence on across-shelf plume structure is rated with a timescale (ttilt) for the isopycnal tilting caused by wind-driven Ekman circulation. These criteria are used to characterize wind influence on the Delaware Coastal Current and can be applied to other coastal buoyant outflows. The Delaware buoyant outflow is simulated for springtime high-river discharge conditions. Simulation results and Ws values reveal that the coastal current is buoyancy-driven most of the time (∣Ws∣ Wind events, however, overwhelm the buoyancy-driven flow (∣Ws∣ > 1) several times during the high-discharge period. Strong upwelling events reverse the buoyant outflow; they constitute an important mechanism for transporting fresh water up shelf. Across-shelf plume structure is more sensitive to wind influence than the along-shelf flow. Values of ttilt indicate that moderate or strong winds persisting throughout a day can modify plume width significantly. Plume widening during upwelling events is accompanied by mixing that can erase the buoyant outflow.

Quasar outflow energetics from broad absorption line variability

Science.gov (United States)

McGraw, S. M.; Shields, J. C.; Hamann, F. W.; Capellupo, D. M.; Herbst, H.

2018-03-01

Quasar outflows have long been recognized as potential contributors to the co-evolution between supermassive black holes (SMBHs) and their host galaxies. The role of outflows in active galactic nucleus (AGN) feedback processes can be better understood by placing observational constraints on wind locations and kinetic energies. We utilize broad absorption line (BAL) variability to investigate the properties of a sample of 71 BAL quasars with P V broad absorption. The presence of P V BALs indicates that other BALs like C IV are saturated, such that variability in those lines favours clouds crossing the line of sight. We use these constraints with measurements of BAL variability to estimate outflow locations and energetics. Our data set consists of multiple-epoch spectra from the Sloan Digital Sky Survey and MDM Observatory. We detect significant (4σ) BAL variations from 10 quasars in our sample over rest-frame time-scales between ≤0.2-3.8 yr. Our derived distances for the 10 variable outflows are nominally ≲ 1-10 pc from the SMBH using the transverse-motion scenario, and ≲ 100-1000 pc from the central source using ionization-change considerations. These distances, in combination with the estimated high outflow column densities (i.e. NH ≳ 1022 cm-2), yield outflow kinetic luminosities between ˜ 0.001 and 1 times the bolometric luminosity of the quasar, indicating that many absorber energies within our sample are viable for AGN feedback.

Cardiovascular nuclear medicine in infancy and childhood

International Nuclear Information System (INIS)

Ogawa, Kyoichi; Ishii, Noboru; Miyata, Tooru; Nakamura, Takashi; Hasegawa, Mamoru

1979-01-01

Radionuclide angiocardiography and lung scanning in the diagnosis of congenital heart disease in infants and children are introduced and discussed. Recently developed radionuclide angiocardiography is a safe and useful method in the detection and quantification of intracardiac shunts, together with for the measurement of transit times, left ventricular ejection fraction and cardiac output. Lung scanning is useful in the evaluation of pulmonary blood flow distribution in the congenital heart disease such as ventricular septal defect (VSD), tetralogy of Fallot (TOF), etc. To decide the limitation of operative indication for VSD with severe pulmonary hypertension, the ratio of pulmonary blood flow distribution in upper to lower lung filed above 1.2, the right to left shunt ratio above 0.25, and deranged blood flow distribution on bilateral lungs are useful as the criteria. In the follow up study after intracardiac repair of TOF, lung scanning reflects the residua and sequalae such as pulmonary stenosis, pulmonary insufficiency, pulmonary hypertension, peripheral pulmonary stenosis and anomalous dilatation of the right ventricular outflow tract. (author)

Outflow and hot dust emission in broad absorption line quasars

Energy Technology Data Exchange (ETDEWEB)

Zhang, Shaohua; Zhou, Hongyan [Polar Research Institute of China, 451 Jinqiao Road, Shanghai 200136 (China); Wang, Huiyuan; Wang, Tinggui; Xing, Feijun; Jiang, Peng [Key Laboratory for Research in Galaxies and Cosmology, University of Science and Technology of China, Chinese Academy of Sciences, Hefei, Anhui 230026 (China); Zhang, Kai, E-mail: zhangshaohua@pric.gov.cn, E-mail: whywang@mail.ustc.edu.cn [Key Laboratory for Research in Galaxies and Cosmology, Shanghai Astronomical Observatory, Chinese Academy of Sciences, 80 Nandan Road, Shanghai 200030 (China)

2014-05-01

We have investigated a sample of 2099 broad absorption line (BAL) quasars with z = 1.7-2.2 built from the Sloan Digital Sky Survey Data Release Seven and the Wide-field Infrared Survey. This sample is collected from two BAL quasar samples in the literature and is refined by our new algorithm. Correlations of outflow velocity and strength with a hot dust indicator (β{sub NIR}) and other quasar physical parameters—such as an Eddington ratio, luminosity, and a UV continuum slope—are explored in order to figure out which parameters drive outflows. Here β{sub NIR} is the near-infrared continuum slope, which is a good indicator of the amount of hot dust emission relative to the accretion disk emission. We confirm previous findings that outflow properties moderately or weakly depend on the Eddington ratio, UV slope, and luminosity. For the first time, we report moderate and significant correlations of outflow strength and velocity with β{sub NIR} in BAL quasars. It is consistent with the behavior of blueshifted broad emission lines in non-BAL quasars. The statistical analysis and composite spectra study both reveal that outflow strength and velocity are more strongly correlated with β{sub NIR} than the Eddington ratio, luminosity, and UV slope. In particular, the composites show that the entire C IV absorption profile shifts blueward and broadens as β{sub NIR} increases, while the Eddington ratio and UV slope only affect the high and low velocity part of outflows, respectively. We discuss several potential processes and suggest that the dusty outflow scenario, i.e., that dust is intrinsic to outflows and may contribute to the outflow acceleration, is most likely.

Active galactic nucleus outflows in galaxy discs

Science.gov (United States)

Hartwig, Tilman; Volonteri, Marta; Dashyan, Gohar

2018-05-01

Galactic outflows, driven by active galactic nuclei (AGNs), play a crucial role in galaxy formation and in the self-regulated growth of supermassive black holes (BHs). AGN feedback couples to and affects gas, rather than stars, and in many, if not most, gas-rich galaxies cold gas is rotationally supported and settles in a disc. We present a 2D analytical model for AGN-driven outflows in a gaseous disc and demonstrate the main improvements, compared to existing 1D solutions. We find significant differences for the outflow dynamics and wind efficiency. The outflow is energy-driven due to inefficient cooling up to a certain AGN luminosity (˜1043 erg s-1 in our fiducial model), above which the outflow remains momentum-driven in the disc up to galactic scales. We reproduce results of 3D simulations that gas is preferentially ejected perpendicular to the disc and find that the fraction of ejected interstellar medium is lower than in 1D models. The recovery time of gas in the disc, defined as the free-fall time from the radius to which the AGN pushes the ISM at most, is remarkably short, of the order 1 Myr. This indicates that AGN-driven winds cannot suppress BH growth for long. Without the inclusion of supernova feedback, we find a scaling of the BH mass with the halo velocity dispersion of MBH ∝ σ4.8.

New Insights into the Surgical Management of Tetralogy of Fallot: Physiological Fundamentals and Clinical Relevance.

Science.gov (United States)

Bove, Thierry; François, Katrien; De Wolf, Daniel

2015-01-01

The surgical treatment of tetralogy of Fallot can be considered as a success story in the history of congenital heart diseases. Since the early outcome is no longer the main issue, the focus moved to the late sequelae of TOF repair, i.e. the pulmonary insufficiency and the secondary adaptation of the right ventricle. This review provides recent insights into the pathophysiological alterations of the right ventricle in relation to the reconstruction of the right ventricular outflow tract after repair of tetralogy of Fallot. Its clinical relevance is documented by addressing the policy changes regarding the optimal management at the time of surgical repair as well as properly defining criteria and timing for late pulmonary valve implantation.

Mid-term Outcome of 100 Consecutive Ross Procedures: Excellent Survival, But Yet to Be a Cure.

Science.gov (United States)

Zimmermann, Corina; Attenhofer Jost, Christine; Prêtre, René; Mueller, Christoph; Greutmann, Matthias; Seifert, Burkhardt; Valsangiacomo Büchel, Emanuela; Kretschmar, Oliver; Dave, Hitendu Hasmukhlal; Weber, Roland

2018-03-01

The Ross procedure offers excellent short-term outcome but the long-term durability is under debate. Reinterventions and follow-up of 100 consecutive patients undergoing Ross Procedure at our centre (1993-2011) were analysed. Follow-up was available for 96 patients (97%) with a median duration of 5.3 (0.1-17.1) years. Median age of the patient cohort was 15.2 (0.04-58.4) years with 76 males. 93% had underlying congenital aortic stenosis. Root replacement technique was applied in all. The most common valved conduits used for reconstruction of the right ventricular outflow tract were homografts (66 patients) and bovine jugular vein (Contegra R ) graft (31 patients). Additional procedures included Ross-Konno procedure (14%), resection of subaortic stenosis/myectomy (11%) and reduction plasty of the ascending aorta (25%). One patient died within the first 30 days (1%). Late deaths occurred in 4 patients (4%) 0.5-4.5 years postoperatively: causes included pulmonary hypertension due to endocardial fibroelastosis (2), subarachnoid haemorrhage (1) and sudden cardiac death (1). Five-year survival was 93.6 (95% CI 88.1-99.1)%. Moderate or severe aortic (autograft) regurgitation needing reoperation occurred in 8 patients with a 5-year freedom from autograft reoperation of 98.5 (95.6-100)%. Five-year freedom from reintervention (surgery or catheter based) on the right ventricular outflow tract conduit was 91.5 (85.5-96.5)%. Univariate predictors of this reinterventions were smaller graft size (p = 0.03) and use of a Contegra R graft (p = 0.04). Ross procedure can be performed with low mortality and good survival in the long term. Most of the reinterventions are related to the neo-right ventricular outflow tract and may be partly attributed to the lack of growth. While the Ross Procedure remains an invaluable option for aortic valve disease in children, new solutions for the neo-pulmonary valve as well as for the less often occurring problems on the autograft are

OUTFLOW AND HOT DUST EMISSION IN HIGH-REDSHIFT QUASARS

International Nuclear Information System (INIS)

Wang, Huiyuan; Xing, Feijun; Wang, Tinggui; Zhou, Hongyan; Zhang, Kai; Zhang, Shaohua

2013-01-01

Correlations of hot dust emission with outflow properties are investigated, based on a large z ∼ 2 non-broad absorption line quasar sample built from the Wide-field Infrared Survey and the Sloan Digital Sky Survey data releases. We use the near-infrared slope and the infrared to UV luminosity ratio to indicate the hot dust emission relative to the emission from the accretion disk. In our luminous quasars, these hot dust emission indicators are almost independent of the fundamental parameters, such as luminosity, Eddington ratio and black hole mass, but moderately dependent on the blueshift and asymmetry index (BAI) and FWHM of C IV lines. Interestingly, the latter two correlations dramatically strengthen with increasing Eddington ratio. We suggest that, in high Eddington ratio quasars, C IV regions are dominated by outflows so the BAI and FWHM (C IV) can reliably reflect the general properties and velocity of outflows, respectively. In low Eddington ratio quasars, on the other hand, C IV lines are primarily emitted by virialized gas so the BAI and FWHM (C IV) become less sensitive to outflows. Therefore, the correlations for the highest Eddington ratio quasars are more likely to represent the true dependence of hot dust emission on outflows and the correlations for the entire sample are significantly diluted by the low Eddington ratio quasars. Our results show that an outflow with a large BAI or velocity can double the hot dust emission on average. We suggest that outflows either contain hot dust in themselves or interact with the dusty interstellar medium or torus

The Simbol-X Perspective on the Physics of Quasar Outflows

Science.gov (United States)

Giustini, M.; Cappi, M.; Vignali, C.; Palumbo, G. G. C.; Fiore, F.; Malaguti, G.

2009-05-01

There is increasing evidence that quasar outflows may play a key role in providing the feedback between AGN/QSOs and their surrounding (and feeding) media, in regulating the central supermassive black hole growth and the galaxy formation and, on larger scales, in shaping the growth of cosmic structures (see e.g. [1]). X-ray observations of quasar outflows are crucial to probe their innermost parts and assess the global energetics entrained in the outflow by studying its most extreme (in terms of velocity, ionization state, mass outflow rate) phases. Simbol-X-with its high effective area in the Fe K energy band and above-will allow the detection and the characterization of powerful outflows in bright, nearby AGN and notably also in moderately faint AGN, thus shedding light on feedback processes in these objects.

ALMA Studies of the Disk-Jet-Outflow Connection

Science.gov (United States)

Dougados, Catherine; Louvet, F.; Mardones, D.; Cabrit, S.

2017-06-01

I will describe in this contribution recent results obtained with ALMA on the origin of the disk/jet/outflow connexion in T Tauri stars. I will first present ALMA observations of the disk associated with the jet source Th 28, which question previous jet rotation measurements in this source and the implications drawn from them. I will then discuss Cycle 2 ALMA observations of the disk and small scale CO outflow associated with the prototypical edge-on HH 30 source. The unprecedented angular resolution of this dataset brings new constraints on the origin of the CO outflows in young stars.

Alignment between Protostellar Outflows and Filamentary Structure

Energy Technology Data Exchange (ETDEWEB)

Stephens, Ian W.; Dunham, Michael M.; Myers, Philip C.; Pokhrel, Riwaj; Sadavoy, Sarah I.; Lee, Katherine I.; Goodman, Alyssa A. [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA (United States); Vorobyov, Eduard I. [Institute of Fluid Mechanics and Heat Transfer, TU Wien, Vienna, A-1060 (Austria); Tobin, John J. [Homer L. Dodge Department of Physics and Astronomy, University of Oklahoma, 440 W. Brooks Street, Norman, OK 73019 (United States); Pineda, Jaime E. [Max-Planck-Institut für extraterrestrische Physik, Giessenbachstrasse 1, 85748 Garching (Germany); Offner, Stella S. R. [Department of Astronomy, University of Massachusetts, Amherst, MA 01003 (United States); Kristensen, Lars E. [Centre for Star and Planet Formation, Niels Bohr Institute and Natural History Museum of Denmark, University of Copenhagen, Øster Voldgade 5-7, DK-1350 Copenhagen K (Denmark); Jørgensen, Jes K. [Niels Bohr Institute and Center for Star and Planet Formation, Copenhagen University, DK-1350 Copenhagen K. (Denmark); Bourke, Tyler L. [SKA Organization, Jodrell Bank Observatory, Lower Withington, Macclesfield, Cheshire SK11 9DL (United Kingdom); Arce, Héctor G. [Department of Astronomy, Yale University, New Haven, CT 06520 (United States); Plunkett, Adele L., E-mail: ian.stephens@cfa.harvard.edu [European Southern Observatory, Av. Alonso de Cordova 3107, Vitacura, Santiago de Chile (Chile)

2017-09-01

We present new Submillimeter Array (SMA) observations of CO(2–1) outflows toward young, embedded protostars in the Perseus molecular cloud as part of the Mass Assembly of Stellar Systems and their Evolution with the SMA (MASSES) survey. For 57 Perseus protostars, we characterize the orientation of the outflow angles and compare them with the orientation of the local filaments as derived from Herschel observations. We find that the relative angles between outflows and filaments are inconsistent with purely parallel or purely perpendicular distributions. Instead, the observed distribution of outflow-filament angles are more consistent with either randomly aligned angles or a mix of projected parallel and perpendicular angles. A mix of parallel and perpendicular angles requires perpendicular alignment to be more common by a factor of ∼3. Our results show that the observed distributions probably hold regardless of the protostar’s multiplicity, age, or the host core’s opacity. These observations indicate that the angular momentum axis of a protostar may be independent of the large-scale structure. We discuss the significance of independent protostellar rotation axes in the general picture of filament-based star formation.

Rare Case of Duodenal Metastasis From Pulmonary Squamous Cell Carcinoma

Directory of Open Access Journals (Sweden)

Zain Memon DO

2017-10-01

Full Text Available Pulmonary squamous cell carcinoma is the second most common non–small cell malignancy of the lung. It commonly metastasizes to the adrenal glands, bone, liver, brain, and kidneys. Most occurrences of metastatic squamous cell carcinoma involving the gastrointestinal tract originate from primary lung tumors. Metastasis to the duodenum, however, is exceedingly rare, with very few cases of stomach or duodenal involvement described in the literature. We report the case of a patient with stage IV pulmonary squamous cell carcinoma metastasizing to the duodenum with an uncommon presentation to add to the paucity of literature available regarding this rare finding.

Misalignment of Magnetic Fields and Outflows in Protostellar Cores

OpenAIRE

Hull, Charles L. H.; Plambeck, Richard L.; Bolatto, Alberto D.; Bower, Geoffrey C.; Carpenter, John M.; Crutcher, Richard M.; Fiege, Jason D.; Franzmann, Erika; Hakobian, Nicholas S.; Heiles, Carl; Houde, Martin; Hughes, A. Meredith; Jameson, Katherine; Kwon, Woojin; Lamb, James W.

2013-01-01

We present results of λ1.3 mm dust-polarization observations toward 16 nearby, low-mass protostars, mapped with ~2."5 resolution at CARMA. The results show that magnetic fields in protostellar cores on scales of ~1000 AU are not tightly aligned with outflows from the protostars. Rather, the data are consistent with scenarios where outflows and magnetic fields are preferentially misaligned (perpendicular), or where they are randomly aligned. If one assumes that outflows emerge along the rotati...

Explosive Outflows from Forming Massive Stars

OpenAIRE

Bally, J.; Ginsburg, A.; Kasliwal, M. M.

2016-01-01

AO imaging of the near IR [Fe ii] and H_2 lines and ALMA CO J = 2 − 1 data confirms the explosive nature of the BN/KL outflow in Orion. N-body interactions in compact groups may be responsible for the production of powerful, explosive protostellar outflows and luminous infrared flares. The Orion event may have been triggered by a protostellar merger. First results of a search for Orion-like events in 200 nearby galaxies with the SPitzer InfraRed Intensive Transients Survey (SPIRITS) are brief...

Simulation of California's Major Reservoirs Outflow Using Data Mining Technique

Science.gov (United States)

Yang, T.; Gao, X.; Sorooshian, S.

2014-12-01

The reservoir's outflow is controlled by reservoir operators, which is different from the upstream inflow. The outflow is more important than the reservoir's inflow for the downstream water users. In order to simulate the complicated reservoir operation and extract the outflow decision making patterns for California's 12 major reservoirs, we build a data-driven, computer-based ("artificial intelligent") reservoir decision making tool, using decision regression and classification tree approach. This is a well-developed statistical and graphical modeling methodology in the field of data mining. A shuffled cross validation approach is also employed to extract the outflow decision making patterns and rules based on the selected decision variables (inflow amount, precipitation, timing, water type year etc.). To show the accuracy of the model, a verification study is carried out comparing the model-generated outflow decisions ("artificial intelligent" decisions) with that made by reservoir operators (human decisions). The simulation results show that the machine-generated outflow decisions are very similar to the real reservoir operators' decisions. This conclusion is based on statistical evaluations using the Nash-Sutcliffe test. The proposed model is able to detect the most influential variables and their weights when the reservoir operators make an outflow decision. While the proposed approach was firstly applied and tested on California's 12 major reservoirs, the method is universally adaptable to other reservoir systems.

Modeling jet and outflow feedback during star cluster formation

Energy Technology Data Exchange (ETDEWEB)

Federrath, Christoph [Monash Centre for Astrophysics, School of Mathematical Sciences, Monash University, VIC 3800 (Australia); Schrön, Martin [Department of Computational Hydrosystems, Helmholtz Centre for Environmental Research-UFZ, Permoserstr. 15, D-04318 Leipzig (Germany); Banerjee, Robi [Hamburger Sternwarte, Gojenbergsweg 112, D-21029 Hamburg (Germany); Klessen, Ralf S., E-mail: christoph.federrath@monash.edu [Universität Heidelberg, Zentrum für Astronomie, Institut für Theoretische Astrophysik, Albert-Ueberle-Strasse 2, D-69120 Heidelberg (Germany)

2014-08-01

Powerful jets and outflows are launched from the protostellar disks around newborn stars. These outflows carry enough mass and momentum to transform the structure of their parent molecular cloud and to potentially control star formation itself. Despite their importance, we have not been able to fully quantify the impact of jets and outflows during the formation of a star cluster. The main problem lies in limited computing power. We would have to resolve the magnetic jet-launching mechanism close to the protostar and at the same time follow the evolution of a parsec-size cloud for a million years. Current computer power and codes fall orders of magnitude short of achieving this. In order to overcome this problem, we implement a subgrid-scale (SGS) model for launching jets and outflows, which demonstrably converges and reproduces the mass, linear and angular momentum transfer, and the speed of real jets, with ∼1000 times lower resolution than would be required without the SGS model. We apply the new SGS model to turbulent, magnetized star cluster formation and show that jets and outflows (1) eject about one-fourth of their parent molecular clump in high-speed jets, quickly reaching distances of more than a parsec, (2) reduce the star formation rate by about a factor of two, and (3) lead to the formation of ∼1.5 times as many stars compared to the no-outflow case. Most importantly, we find that jets and outflows reduce the average star mass by a factor of ∼ three and may thus be essential for understanding the characteristic mass of the stellar initial mass function.

Two separate outflows in the dual supermassive black hole system NGC 6240.

Science.gov (United States)

Müller-Sánchez, F; Nevin, R; Comerford, J M; Davies, R I; Privon, G C; Treister, E

2018-04-01

Theoretical models and numerical simulations have established a framework of galaxy evolution in which galaxies merge and create dual supermassive black holes (with separations of one to ten kiloparsecs), which eventually sink into the centre of the merger remnant, emit gravitational waves and coalesce. The merger also triggers star formation and supermassive black hole growth, and gas outflows regulate the stellar content 1-3 . Although this theoretical picture is supported by recent observations of starburst-driven and supermassive black hole-driven outflows 4-6 , it remains unclear how these outflows interact with the interstellar medium. Furthermore, the relative contributions of star formation and black hole activity to galactic feedback remain unknown 7-9 . Here we report observations of dual outflows in the central region of the prototypical merger NGC 6240. We find a black-hole-driven outflow of [O III] to the northeast and a starburst-driven outflow of Hα to the northwest. The orientations and positions of the outflows allow us to isolate them spatially and study their properties independently. We estimate mass outflow rates of 10 and 75 solar masses per year for the Hα bubble and the [O III] cone, respectively. Their combined mass outflow is comparable to the star formation rate 10 , suggesting that negative feedback on star formation is occurring.

Supravalvular aortic stenosis with sudden cardiac death

Directory of Open Access Journals (Sweden)

Pradeep Vaideeswar

2015-01-01

Full Text Available Sudden cardiac death (SCD most commonly results from previously undiagnosed congenital, acquired, or hereditary cardiac diseases. Congenital aortic valvular, subvalvular, and supravalvular disease with left ventricular outflow tract obstruction is an important preventable cause of sudden death. This report documents sudden death presumably due to acute myocardial ischemia in a young male with an undiagnosed supravalvular aortic stenosis (SVAS due to a rare association of isolation of coronary sinuses of Valsalva. Congenital supravalvular pulmonary stenosis and mitral valvular dysplasia were also present.

Cosmic ray driven outflows in an ultraluminous galaxy

Science.gov (United States)

Fujita, Akimi; Mac Low, Mordecai-Mark

2018-06-01

In models of galaxy formation, feedback driven both by supernova (SN) and active galactic nucleus is not efficient enough to quench star formation in massive galaxies. Models of smaller galaxies have suggested that cosmic rays (CRs) play a major role in expelling material from the star-forming regions by diffusing SN energy to the lower density outskirts. We therefore run gas dynamical simulations of galactic outflows from a galaxy contained in a halo with 5 × 1012 M⊙ that resembles a local ultraluminous galaxy, including both SN thermal energy and a treatment of CRs using the same diffusion approximation as Salem & Bryan. We find that CR pressure drives a low-density bubble beyond the edge of the shell swept up by thermal pressure, but the main bubble driven by SN thermal pressure overtakes it later, which creates a large-scale biconical outflow. CRs diffusing into the disc are unable to entrain its gas in the outflows, yielding a mass-loading rate of only ˜ 0.1 per cent with varied CR diffusion coefficients. We find no significant difference in mass-loading rates in SN-driven outflows with or without CR pressure. Our simulations strongly suggest that it is hard to drive a heavily mass-loaded outflow with CRs from a massive halo potential, although more distributed star formation could lead to a different result.

THE ORION FINGERS: NEAR-IR SPECTRAL IMAGING OF AN EXPLOSIVE OUTFLOW

Energy Technology Data Exchange (ETDEWEB)

Youngblood, Allison; Bally, John [Department of Astrophysical and Planetary Sciences, University of Colorado, UCB 389, Boulder, CO 80309 (United States); Ginsburg, Adam, E-mail: allison.youngblood@colorado.edu [ESO Headquarters, Karl-Schwarzschild-Strasse 2, D-85748 Garching bei München (Germany)

2016-06-01

We present near-IR (1.1–2.4 μ m) position–position–velocity cubes of the 500 year old Orion BN/KL explosive outflow with spatial resolution 1″ and spectral resolution 86 km s{sup −1}. We construct integrated intensity maps free of continuum sources of 15 H{sub 2} and [Fe ii] lines while preserving kinematic information of individual outflow features. Included in the detected H{sub 2} lines are the 1-0 S(1) and 1-0 Q(3) transitions, allowing extinction measurements across the outflow. Additionally, we present dereddened flux ratios for over two dozen outflow features to allow for the characterization of the true excitation conditions of the BN/KL outflow. All of the ratios show the dominance of the shock excitation of the H{sub 2} emission, although some features exhibit signs of fluorescent excitation from stellar radiation or J-type shocks. We also detect tracers of the PDR/ionization front north of the Trapezium stars in [O i] and [Fe ii] and analyze other observed outflows not associated with the BN/KL outflow.

MULTIPLE FAST MOLECULAR OUTFLOWS IN THE PRE-PLANETARY NEBULA CRL 618

Energy Technology Data Exchange (ETDEWEB)

Lee, Chin-Fei; Huang, Po-Sheng [Academia Sinica Institute of Astronomy and Astrophysics, P.O. Box 23-141, Taipei 106, Taiwan (China); Sahai, Raghvendra [Jet Propulsion Laboratory, MS 183-900, California Institute of Technology, Pasadena, CA 91109 (United States); Sánchez Contreras, Carmen [Astrobiology Center (CSIC-INTA), ESAC Campus, E-28691 Villanueva de la Canada, Madrid (Spain); Tay, Jeremy Jian Hao [Department of Physics, National University of Singapore, 2 Science Drive 3, Singapore 117542 (Singapore)

2013-11-01

CRL 618 is a well-studied pre-planetary nebula. It has multiple highly collimated optical lobes, fast molecular outflows along the optical lobes, and an extended molecular envelope that consists of a dense torus in the equator and a tenuous round halo. Here we present our observations of this source in CO J = 3-2 and HCN J = 4-3 obtained with the Submillimeter Array at up to ∼0.''3 resolutions. We spatially resolve the fast molecular outflow region previously detected in CO near the central star and find it to be composed of multiple outflows that have similar dynamical ages and are oriented along the different optical lobes. We also detect fast molecular outflows further away from the central star near the tips of the extended optical lobes and a pair of equatorial outflows inside the dense torus. We find that two episodes of bullet ejections in different directions are needed, one producing the fast molecular outflows near the central star and one producing the fast molecular outflows near the tips of the extended optical lobes. One possibility to launch these bullets is a magneto-rotational explosion of the stellar envelope.

[A case of pulmonary abscess in which Haemophilus parainfluenzae and Streptococcus intermedius were isolated by percutaneous needle aspiration].

Science.gov (United States)

Miyamoto, Atsushi; Tsuboi, Eiyasu; Takaya, Hisashi; Sugino, Keishi; Sakamoto, Susumu; Kawabata, Masateru; Kishi, Kazuma; Narui, Koji; Homma, Sakae; Nakatani, Tatsuo; Nakata, Koichiro; Yoshimura, Kunihiko

2006-08-01

Some microbes, including the Bacteroides species, Staphylococcus aureus and Streptococcus milleri groups, can cause pulmonary abscess. Haemophilus parainfluenzae is usually categorized as one of the normal flora which colonizes in the ears and the nasopharynx, and it has been long considered that H. parainfluenzae has little pathogenicity in the lower respiratory tract and lung parenchymal. In this report, we present a case of pulmonary abscess caused by both H. parainfluenzae and Streptococcus intermedius. The patient was a 75-year-old man who had had total esophageo-gastrectomy because of esophageal cancer. He presented with purulent sputum, and chest X-ray film showed a dense consolidation in the right upper lung field. CT-guided transcutaneous fine needle aspiration was performed as a diagnostic procedure. Since both H. parainfluenzae and S. intermedius had been isolated from the lesion, pulmonary abscess caused by these two pathogens was diagnosed. The patient was treated with panipenem/betamipron, and his symptoms and pulmonary infiltrates on the chest X-ray film improved thereafter. So far, very few cases have been reported in which H. parainfluenzae caused lower respiratory tract infection. Although S. intermedius is known as one of the pathogens of pulmonary abscess, it is possible that H. parainfluenzae could also be pathogenic in infectious diseases of the lung.

Expression of cardiac neural crest and heart genes isolated by modified differential display.

Science.gov (United States)

Martinsen, Brad J; Groebner, Nathan J; Frasier, Allison J; Lohr, Jamie L

2003-08-01

The invasion of the cardiac neural crest (CNC) into the outflow tract (OFT) and subsequent outflow tract septation are critical events during vertebrate heart development. We have performed four modified differential display screens in the chick embryo to identify genes that may be involved in CNC, OFT, secondary heart field, and heart development. The screens included differential display of RNA isolated from three different axial segments containing premigratory cranial neural crest cells; of RNA from distal outflow tract, proximal outflow tract, and atrioventricular tissue of embryonic chick hearts; and of RNA isolated from left and right cranial tissues, including the early heart fields. These screens have resulted in the identification of the five cDNA clones presented here, which are expressed in the cardiac neural crest, outflow tract and developing heart in patterns that are unique in heart development.

[Fluctuant pulmonary nodules as presentation of a MALT lymphoma].

Science.gov (United States)

Dolz Aspas, R; Toyas Miazza, C; Ruiz Ruiz, F; Morales Rull, J L; Pérez Calvo, J I

2003-11-01

Mucosa associated lymphoid tissue (MALT) lymphomas are a group of non- Hodgkin"s lymphomas of low malignancy degree. The most frequent location is the gastrointestinal tract. Its primary pulmonary presentation is unusual and heterogeneous from point of view radiological. Woman 61 years old with antecedents of vitiligo, gastric ulcus, cirrhosis by VHC, that go into the hospital by sudden disnea, thoracic paint with pleural characterises and fever of 38.5 degrees C, Her thorax radiography and thoracic TAC showed nodes that affect to different pulmonary lobes. The cytology by PAAF confirms their malignant nature. In subsequent radiological controls it was notice the nodels took away completely and returns in different pulmonary place in each recurrence. The presentation like fluctuant pulmonary nodes is exceptional in a MALT lymphoma. It was described a higher incidence of VHC infection and tumour. The evidence of chronic hepatitis by virus C disease, and local chronic inflammatory process as well as autoimmune disorders may be considerate like a factor that contribute to MALT lymphoma.

The Resolved Outflow from 3C 48

Science.gov (United States)

Shih, Hsin-Yi; Stockton, Alan

2014-10-01

We investigate the properties of the high-velocity outflow driven by the young radio jet of 3C 48, a compact-steep-spectrum source. We use the Space Telescope Imaging Spectrograph on board the Hubble Space Telecope to obtain (1) low-resolution UV and optical spectra and (2) multi-slit medium-resolution spectra of the ionized outflow. With supporting data from ground-based spectrographs, we are able to accurately measure the ratios of diagnostic emission lines such as [O III] λ5007, [O III] λ3727, [N II] λ6548, Hα, Hβ, [Ne V] λ3425, and [Ne III] λ3869. We fit the observed emission-line ratios using a range of ionization models, powered by active galactic nucleus (AGN) radiation and shocks, produced by the MAPPINGS code. We have determined that AGN radiation is likely the dominant ionization source. The outflow's density is estimated to be in the range n = 103-104 cm-3, the mass is ~6 × 106 M ⊙, and the metallicity is likely equal to or higher than solar. Compared with the typical outflows associated with more evolved radio jets, this young outflow is denser, less massive, and more metal rich. Multi-slit observations allow us to construct a two-dimensional velocity map of the outflow that shows a wide range of velocities with distinct velocity components, suggesting a wide-angle clumpy outflow. Based in part on observations made with the NASA/ESA Hubble Space Telescope, obtained at the Space Telescope Science Institute, which is operated by the Association of Universities for Research in Astronomy, Inc., under NASA contract NAS 5-26555. These observations are associated with program GO-11574. Some of the data presented herein were obtained at the W. M. Keck Observatory, which is operated as a scientific partnership among the California Institute of Technology, the University of California and the National Aeronautics and Space Administration. The Observatory was made possible by the generous financial support of the W. M. Keck Foundation. Some of the

Polyhexamethylene guanidine phosphate aerosol particles induce pulmonary inflammatory and fibrotic responses.

Science.gov (United States)

Kim, Ha Ryong; Lee, Kyuhong; Park, Chang We; Song, Jeong Ah; Shin, Da Young; Park, Yong Joo; Chung, Kyu Hyuck

2016-03-01

Polyhexamethylene guanidine (PHMG) phosphate was used as a disinfectant for the prevention of microorganism growth in humidifiers, without recognizing that a change of exposure route might cause significant health effects. Epidemiological studies reported that the use of humidifier disinfectant containing PHMG-phosphate can provoke pulmonary fibrosis. However, the pulmonary toxicity of PHMG-phosphate aerosol particles is unknown yet. This study aimed to elucidate the toxicological relationship between PHMG-phosphate aerosol particles and pulmonary fibrosis. An in vivo nose-only exposure system and an in vitro air-liquid interface (ALI) co-culture model were applied to confirm whether PHMG-phosphate induces inflammatory and fibrotic responses in the respiratory tract. Seven-week-old male Sprague-Dawley rats were exposed to PHMG-phosphate aerosol particles for 3 weeks and recovered for 3 weeks in a nose-only exposure chamber. In addition, three human lung cells (Calu-3, differentiated THP-1 and HMC-1 cells) were cultured at ALI condition for 12 days and were treated with PHMG-phosphate at set concentrations and times. The reactive oxygen species (ROS) generation, airway barrier injuries and inflammatory and fibrotic responses were evaluated in vivo and in vitro. The rats exposed to PHMG-phosphate aerosol particles in nanometer size showed pulmonary inflammation and fibrosis including inflammatory cytokines and fibronectin mRNA increase, as well as histopathological changes. In addition, PHMG-phosphate triggered the ROS generation, airway barrier injuries and inflammatory responses in a bronchial ALI co-culture model. Those results demonstrated that PHMG-phosphate aerosol particles cause pulmonary inflammatory and fibrotic responses. All features of fibrogenesis by PHMG-phosphate aerosol particles closely resembled the pathology of fibrosis that was reported in epidemiological studies. Finally, we expected that PHMG-phosphate infiltrated into the lungs in the form of

Evolution of the outflow activity of protostars

International Nuclear Information System (INIS)

Bontemps, Sylvain

1996-01-01

After a first part describing the formation of low-mass stars (sites of stellar formation, protostellar evolution) and matter outflows from young objects (molecular flows and their origin, optical and radio jets, outflow mechanisms), this research thesis discusses the evolution of molecular flows by reprinting a published article (Evolution of outflow activity around low-mass embedded young stellar objects), and by outlining some remaining issues (differences between clouds of stellar formation, morphological evolution of molecular flows). The author then discusses the continuous radio centimetre emission: origin, systematic search for Class 0 objects by using the VLA (Very Large Array radio interferometer), presentation of a new Class 0 protostar (HH24MMS). The author reports the study of H_2 emission in the infrared: generalities on protostellar shocks, infrared jet by HH24MMS, H_2 emission at 10 microns by using the ISOCAM camera [fr

Assessment of Pulmonary Artery Stiffness of Repaired Congenital Heart Disease Patients

Science.gov (United States)

Lee, Namheon; Banerjee, Rajit; Taylor, Michael; Hor, Kan

2012-10-01

Surgical correction or palliation of congenital heart disease (CHD) often requires augmenting the main pulmonary artery (MPA) with non-native material or placing a cylindrical graft. The degree to which this intervention affects PA compliance is largely unknown. In this study, the MPA stiffness characteristics were assessed by its compliance, distensibility, and pressure-strain modulus. Coregistered velocity encoded phase-contrast MRI and cardiac catheterization data were available for a cohort of repaired CHD patients (n=8) and controls (n=3). All patients were repaired with either an RV-PA conduit or a RV outflow tract patch. We measured the MPA area change by MRI and MPA pressure during the cath. The measurements were taken through or just distal to the conduit. The MPA compliance and distensibility for the patients were significantly lower than the controls: compliance (9.8±10.8 vs 28.3±7.7mm^2/mmHg, p<0.05), distensibility (2.2±1.5 vs 6.6±2.1%Area change/mmHg, p=0.05). The patients had a significantly higher pressure-strain modulus (152.3±116.4mmHg, p<0.05) than the controls (35.8±10.6mmHg). The abnormally elevated PA stiffness due to the rigidity of the conduit or patch material may cause a compliance mismatch resulting in high stress levels contributing to the observed progressive PA dilatation. This may be a factor in the progressive RV dilatation seen in this cohort of repaired CHD patients.

Amplatzer angled duct occluder for closure of patent ductus arteriosus larger than the aorta in an infant.

Science.gov (United States)

Vijayalakshmi, I B; Chitra, N; Rajasri, R; Prabhudeva, A N

2005-01-01

Transcatheter closure of patent ductus arteriosus (PDA) by Amplatzer duct occluder is the treatment of choice. However, closure of very large ducts in infants with low weight is a challenge for the interventionalist because a large device may obstruct the aorta or left pulmonary artery. Difficulty is also encountered in advancing the device around the curve of the right ventricular outflow tract toward the pulmonary artery; this curve is tight, more or less at a right angle in infants, leading to kinking of the sheath, which increases fluoroscopic time. This is the first reported case of a very large PDA (8.7 mm), larger than the aorta (8.2 mm), successfully closed by an Amplatzer angled duct occluder in an infant weighing 5 kg.

Mass outflow in the nearby proto-planetary system, Beta Pictoris

International Nuclear Information System (INIS)

Bruhweiler, F.C.; Grady, C.A.; Kondo, Yoji

1991-01-01

Previous spectral studies of circumstallar dust around the nearby, candidate proto-planetary system, Beta Pictoris, has detected only infalling gas. The lack of detectable mass outflow has been critical in the interpretation of the origin of the circumstellar gas and in our understanding of the evolutionary status of the Beta Pictoris system. IUE high-dispersion spectra are presented which show, in addition to infall, the presence of mass outflow, with a maximum observed outflow velocity of -60 km/s, and a corresponding instantaneous outflow rate of 1.1 x 10 to the -14th solar mass/yr, or 1.1 x 10 to the -11th Jupiter mass/yr. This mass outflow rate and terminal velocity are comparable to the magnitudes of mass infall rates and terminal velocities observed from late 1986 through early 1988. The implications of these observations on our understanding of the mechanisms producing infall from the surrounding circumstellar disk are discussed, as are the implications for our understanding of the evolutionary status of the Beta Pic system. 23 refs

Tetralogy of Fallot: General Principles of Management.

Science.gov (United States)

Downing, Tacy E; Kim, Yuli Y

2015-11-01

Repaired tetralogy of Fallot (TOF) is one of the most common diagnoses encountered when caring for adults with congenital heart disease. Although long-term survival after childhood TOF repair is excellent, morbidity is common and most patients require reintervention in adulthood. This review provides an overview of key surveillance and management issues for adults with TOF, including residual right ventricular outflow tract disease and timing of pulmonary valve replacement, arrhythmias and risk stratification, left-sided heart disease and heart failure, and pregnancy management. Copyright © 2015 Elsevier Inc. All rights reserved.

THE TURBULENT ORIGIN OF OUTFLOW AND SPIN MISALIGNMENT IN MULTIPLE STAR SYSTEMS

Energy Technology Data Exchange (ETDEWEB)

Offner, Stella S. R.; Lee, Katherine I.; Arce, Héctor G.; Fielding, Drummond B. [Department of Astronomy, University of Massachusetts, Amherst, MA 01003 (United States); Dunham, Michael M., E-mail: soffner@astro.umass.edu [Harvard-Smithsonian Center for Astrophysics, Cambridge, MA 02138 (United States)

2016-08-10

The protostellar outflows of wide-separation forming binaries frequently appear misaligned. We use magneto-hydrodynamic simulations to investigate the alignment of protostellar spin and molecular outflows for forming binary pairs. We show that the protostellar pairs, which form from turbulent fragmentation within a single parent core, have randomly oriented angular momentum. Although the pairs migrate to closer separations, their spins remain partially misaligned. We produce {sup 12}CO(2-1) synthetic observations of the simulations and characterize the outflow orientation in the emission maps. The CO-identified outflows exhibit a similar random distribution and are also statistically consistent with the observed distribution of molecular outflows. We conclude that the observed misalignment provides a clear signature of binary formation via turbulent fragmentation. The persistence of misaligned outflows and stellar spins following dynamical evolution may provide a signature of binary origins for more evolved multiple star systems.

THE TURBULENT ORIGIN OF OUTFLOW AND SPIN MISALIGNMENT IN MULTIPLE STAR SYSTEMS

International Nuclear Information System (INIS)

Offner, Stella S. R.; Lee, Katherine I.; Arce, Héctor G.; Fielding, Drummond B.; Dunham, Michael M.

2016-01-01

The protostellar outflows of wide-separation forming binaries frequently appear misaligned. We use magneto-hydrodynamic simulations to investigate the alignment of protostellar spin and molecular outflows for forming binary pairs. We show that the protostellar pairs, which form from turbulent fragmentation within a single parent core, have randomly oriented angular momentum. Although the pairs migrate to closer separations, their spins remain partially misaligned. We produce 12 CO(2-1) synthetic observations of the simulations and characterize the outflow orientation in the emission maps. The CO-identified outflows exhibit a similar random distribution and are also statistically consistent with the observed distribution of molecular outflows. We conclude that the observed misalignment provides a clear signature of binary formation via turbulent fragmentation. The persistence of misaligned outflows and stellar spins following dynamical evolution may provide a signature of binary origins for more evolved multiple star systems.

PROTOSTELLAR OUTFLOW HEATING IN A GROWING MASSIVE PROTOCLUSTER

Energy Technology Data Exchange (ETDEWEB)

Wang Ke; Wu Yuefang; Zhang Huawei [Department of Astronomy, School of Physics, Peking University, Beijing 100871 (China); Zhang Qizhou [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States); Li Huabai, E-mail: kwang@cfa.harvard.edu [Max-Planck Institute for Astronomy, Koenigstuhl 17, D-69117 Heidelberg (Germany)

2012-02-15

The dense molecular clump P1 in the infrared dark cloud complex G28.34+0.06 harbors a massive protostellar cluster at its extreme youth. Our previous Submillimeter Array observations revealed several jet-like CO outflows emanating from the protostars, indicative of intense accretion and potential interaction with ambient natal materials. Here, we present the Expanded Very Large Array spectral line observations toward P1 in the NH{sub 3} (J,K) = (1,1), (2,2), (3,3) lines, as well as H{sub 2}O and class I CH{sub 3}OH masers. Multiple NH{sub 3} transitions reveal the heated gas widely spread in the 1 pc clump. The temperature distribution is highly structured; the heated gas is offset from the protostars, and morphologically matches the outflows very well. Hot spots of spatially compact, spectrally broad NH{sub 3} (3,3) emission features are also found coincident with the outflows. A weak NH{sub 3} (3,3) maser is discovered at the interface between an outflow jet and the ambient gas. These findings suggest that protostellar heating may not be effective in suppressing fragmentation during the formation of massive cores.

PROTOSTELLAR OUTFLOW HEATING IN A GROWING MASSIVE PROTOCLUSTER

International Nuclear Information System (INIS)

Wang Ke; Wu Yuefang; Zhang Huawei; Zhang Qizhou; Li Huabai

2012-01-01

The dense molecular clump P1 in the infrared dark cloud complex G28.34+0.06 harbors a massive protostellar cluster at its extreme youth. Our previous Submillimeter Array observations revealed several jet-like CO outflows emanating from the protostars, indicative of intense accretion and potential interaction with ambient natal materials. Here, we present the Expanded Very Large Array spectral line observations toward P1 in the NH 3 (J,K) = (1,1), (2,2), (3,3) lines, as well as H 2 O and class I CH 3 OH masers. Multiple NH 3 transitions reveal the heated gas widely spread in the 1 pc clump. The temperature distribution is highly structured; the heated gas is offset from the protostars, and morphologically matches the outflows very well. Hot spots of spatially compact, spectrally broad NH 3 (3,3) emission features are also found coincident with the outflows. A weak NH 3 (3,3) maser is discovered at the interface between an outflow jet and the ambient gas. These findings suggest that protostellar heating may not be effective in suppressing fragmentation during the formation of massive cores.

A SEARCH FOR 95 GHz CLASS I METHANOL MASERS IN MOLECULAR OUTFLOWS

Energy Technology Data Exchange (ETDEWEB)

Gan, Cong-Gui; Chen, Xi; Shen, Zhi-Qiang [Key Laboratory for Research in Galaxies and Cosmology, Shanghai Astronomical Observatory, Chinese Academy of Sciences, 80 Nandan RD, Shanghai 200030 (China); Xu, Ye; Ju, Bing-Gang, E-mail: cggan@shao.ac.cn [Key Laboratory of Radio Astronomy, Chinese Academy of Sciences (China)

2013-01-20

We have observed a sample of 288 molecular outflow sources including 123 high-mass and 165 low-mass sources in order to search for class I methanol masers at the 95 GHz transition and to investigate the relationship between outflow characteristics and class I methanol maser emission with the Purple Mountain Observatory 13.7 m radio telescope. Our survey detected 62 sources with 95 GHz methanol masers above a 3{sigma} detection limit, which includes 47 high-mass sources and 15 low-mass sources. Therefore, the detection rate is 38% for high-mass outflow sources and 9% for low-mass outflow sources, suggesting that class I methanol masers are relatively easily excited in high-mass sources. There are 37 newly detected 95 GHz methanol masers (including 27 high-mass and 10 low-mass sources), 19 of which are newly identified (i.e., first identification) class I methanol masers (including 13 high-mass and 6 low-mass sources). A statistical analysis of the distributions of maser detections with the outflow parameters reveals that the maser detection efficiency increases with the outflow properties (e.g., mass, momentum, kinetic energy, mechanical luminosity of outflows, etc.). Systematic investigations of the relationships between the intrinsic luminosity of methanol masers and the outflow properties (including mass, momentum, kinetic energy, bolometric luminosity, and mass-loss rate of the central stellar sources) indicate a positive correlation. This further supports the theory that class I methanol masers are collisionally pumped and associated with shocks when outflows interact with the surrounding ambient medium.

MicroRNA-124 controls the proliferative, migratory, and inflammatory phenotype of pulmonary vascular fibroblasts.

Science.gov (United States)

Wang, Daren; Zhang, Hui; Li, Min; Frid, Maria G; Flockton, Amanda R; McKeon, B Alexandre; Yeager, Michael E; Fini, Mehdi A; Morrell, Nicholas W; Pullamsetti, Soni S; Velegala, Sivareddy; Seeger, Werner; McKinsey, Timothy A; Sucharov, Carmen C; Stenmark, Kurt R

2014-01-03

Pulmonary hypertensive remodeling is characterized by excessive proliferation, migration, and proinflammatory activation of adventitial fibroblasts. In culture, fibroblasts maintain a similar activated phenotype. The mechanisms responsible for generation/maintenance of this phenotype remain unknown. We hypothesized that aberrant expression of microRNA-124 (miR-124) regulates this activated fibroblast phenotype and sought to determine the signaling pathways through which miR-124 exerts effects. We detected significant decreases in miR-124 expression in fibroblasts isolated from calves and humans with severe pulmonary hypertension. Overexpression of miR-124 by mimic transfection significantly attenuated proliferation, migration, and monocyte chemotactic protein-1 expression of hypertensive fibroblasts, whereas anti-miR-124 treatment of control fibroblasts resulted in their increased proliferation, migration, and monocyte chemotactic protein-1 expression. Furthermore, the alternative splicing factor, polypyrimidine tract-binding protein 1, was shown to be a direct target of miR-124 and to be upregulated both in vivo and in vitro in bovine and human pulmonary hypertensive fibroblasts. The effects of miR-124 on fibroblast proliferation were mediated via direct binding to the 3' untranslated region of polypyrimidine tract-binding protein 1 and subsequent regulation of Notch1/phosphatase and tensin homolog/FOXO3/p21Cip1 and p27Kip1 signaling. We showed that miR-124 directly regulates monocyte chemotactic protein-1 expression in pulmonary hypertension/idiopathic pulmonary arterial hypertension fibroblasts. Furthermore, we demonstrated that miR-124 expression is suppressed by histone deacetylases and that treatment of hypertensive fibroblasts with histone deacetylase inhibitors increased miR-124 expression and decreased proliferation and monocyte chemotactic protein-1 production. Stable decreases in miR-124 expression contribute to an epigenetically reprogrammed, highly

Absorption of DTPA from the respiratory tracts of Beagle dogs

International Nuclear Information System (INIS)

Dudley, R.E.; Muggenburg, B.A.; Cuddihy, R.G.

1978-01-01

Absorption of diethylenetriaminepentaacetic acid (DTPA) from the nasopharyngeal (NP), tracheobronchial (TB) and pulmonary (P) regions of Beagle dogs was determined because of the current interest in aerosolized DTPA as a method for removal of internally deposited radionuclides. Radiolabeled DTPA was instilled into the NP, TB and P regions of Beagle dogs and its subsequent translocation was followed for 48 hours. Results revealed that 16, 48 and 90% of the instilled DTPA was absorbed into the circulatory system from the NP, TB and P regions, respectively. A comparison was also made between NP absorption of aerosolized DTPA and DTPA instilled into the nasopharynx. Nasopharyngeal absorption of aerosolized DTPA, 23%, was slightly higher than that of instilled DTPA. Diethylenetriaminepentaacetic acid deposited in the respiratory tract remained in the body longer than intravenously injected DTPA. These findings indicate that substantial absorption of DTPA occurs from all regions of the respiratory tract and that DTPA need not be deposited deep within the respiratory tract to produce systemic absorption of DTPA for the removal of internally deposited radioactive isotopes

AGN feedback in action? - outflows and star formation in type 2 AGNs

Science.gov (United States)

Woo, Jong-Hak

2017-01-01

We present the statistical constraints on the ionized gas outflows and their connection to star formation, using a large sample of ~110,000 AGNs and star-forming galaxies at z dispersion of star forming galaxies can be entirely accounted by the gravitational potential of host galaxies, AGNs clearly show non-gravitational kinematics, which is comparable to or stronger than the virial motion caused by the gravitational potential. Second, the distribution in the [OIII] velocity - velocity dispersion diagram dramatically expands toward large values with increasing AGN luminosity, implying that the outflows are AGN-driven. Third, the fraction of AGNs with a signature of outflow kinematics, steeply increases with AGN luminosity and Eddington ratio. In particular, the majority of luminous AGNs presents strong non-gravitational kinematics in the [OIII] profile. Interestingly, we find that the specific star formation of non-outflow AGNs is much lower than that of strong outflow AGNs, while the star formation rate of strong outflow AGNs is comparable to that of star forming galaxies. We interpret this trend as a delayed AGN feedback as it takes dynamical time for the outflows to suppress star formation in galactic scales.

A young bipolar outflow from IRAS 15398-3359

Science.gov (United States)

Bjerkeli, P.; Jørgensen, J. K.; Brinch, C.

2016-03-01

Context. Changing physical conditions in the vicinity of protostars allow for a rich and interesting chemistry to occur. Heating and cooling of the gas allows molecules to be released from and frozen out on dust grains. These changes in physics, traced by chemistry as well as the kinematical information, allows us to distinguish between different scenarios describing the infall of matter and the launching of molecular outflows and jets. Aims: We aim to determine the spatial distribution of different species that are of different chemical origin. This is to examine the physical processes in play in the observed region. From the kinematical information of the emission lines we aim to determine the nature of the infalling and outflowing gas in the system. We also aim to determine the physical properties of the outflow. Methods: Maps from the Submillimeter Array (SMA) reveal the spatial distribution of the gaseous emission towards IRAS 15398-3359. The line radiative transfer code LIME is used to construct a full 3D model of the system taking all relevant components and scales into account. Results: CO, HCO+, and N2H+ are detected and shown to trace the motions of the outflow. For CO, the circumstellar envelope and the surrounding cloud also have a profound impact on the observed line profiles. N2H+ is detected in the outflow, but is suppressed towards the central region, perhaps because of the competing reaction between CO and H3+ in the densest regions as well as the destruction of N2H+ by CO. N2D+ is detected in a ridge south-west of the protostellar condensation and is not associated with the outflow. The morphology and kinematics of the CO emission suggests that the source is younger than ~1000 years. The mass, momentum, momentum rate, mechanical luminosity, kinetic energy, and mass-loss rate are also all estimated to be low. A full 3D radiative transfer model of the system can explain all the kinematical and morphological features in the system.

Multiple monopolar outflows driven by massive protostars in IRAS 18162-2048

Energy Technology Data Exchange (ETDEWEB)

Fernández-López, M. [Department of Astronomy, University of Illinois at Urbana-Champaign, 1002 West Green Street, Urbana, IL 61801 (United States); Girart, J. M. [Institut de Ciencies de l' Espai (CSIC-IEEC), Campus UAB, Facultat de Ciencies, Torre C5-parell 2, E-08193 Bellaterra, Catalunya (Spain); Curiel, S.; Fonfría, J. P. [Instituto de Astronomía, Universidad Nacional Autónoma de México (UNAM), Apartado Postal 70-264, 04510 México, DF (Mexico); Zapata, L. A. [Centro de Radioastronomía y Astrofísica, UNAM, Apartado Postal 3-72, Morelia, Michoacán 58089 (Mexico); Qiu, K., E-mail: manferna@illinois.edu, E-mail: girart@ieec.cat [School of Astronomy and Space Science, Nanjing University, Nanjing 210093 (China)

2013-11-20

In this article, we present Combined Array for Research in Millimeter-wave Astronomy (CARMA) 3.5 mm observations and SubMillimeter Array (SMA) 870 μm observations toward the high-mass star-forming region IRAS 18162-2048, which is the core of the HH 80/81/80N system. Molecular emission from HCN, HCO{sup +}, and SiO traces two molecular outflows (the so-called northeast and northwest outflows). These outflows have their origin in a region close to the position of MM2, a millimeter source known to harbor two protostars. For the first time we estimate the physical characteristics of these molecular outflows, which are similar to those of 10{sup 3}-5 × 10{sup 3} L {sub ☉} protostars, and suggest that MM2 harbors high-mass protostars. High-angular resolution CO observations show an additional outflow due southeast. Also for the first time, we identify its driving source, MM2(E), and see evidence of precession. All three outflows have a monopolar appearance, but we link the NW and SE lobes, and explain their asymmetric shape as being a consequence of possible deflection.

A Rare Case of Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia

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Godwin Ofikwu

2015-01-01

Full Text Available Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH is a rare clinical condition with only about 100 cases reported in the literature. It is characterized by primary hyperplasia of pulmonary neuroendocrine cells (PNECs which are specialized epithelial cells located throughout the entire respiratory tract, from the trachea to the terminal airways. DIPNECH appears in various forms that include diffuse proliferation of scattered neuroendocrine cells, small nodules, or a linear proliferation. It is usually seen in middle-aged, nonsmoking women with symptoms of cough, dyspnea, and wheezing. We present a 45-year-old, nonsmoking woman who presented with symptoms of DIPNECH associated with bilateral pulmonary nodules and left hilar adenopathy. Of interest, DIPNECH in our patient was associated with metastatic pulmonary carcinoids, papillary carcinoma of the left breast, oncocytoma and angiomyolipoma of her left kidney, and cortical nodules suggestive of tuberous sclerosis. She had video assisted thoracoscopic surgery (VATS, modified radical mastectomy with reconstruction, and radical nephrectomy. She is currently symptom-free most of the time with over two years of follow-up.

Stable right ventricular size and function during short-term follow-up in patients with pulmonary regurgitation after tetralogy of Fallot repair

International Nuclear Information System (INIS)

Śpiewak, M.; Małek, Ł.A.; Petryka, J.; Biernacka, E.K.; Hoffman, P.; Demkow, M.; Miśko, J.; Rużyłło, W.

2013-01-01

Aim: To assess changes in ventricular size and function over time in conservatively treated adult patients with repaired tetralogy of Fallot (TOF) and significant pulmonary regurgitation (PR). Materials and methods: Patients with repaired TOF who had undergone more than one cardiac magnetic resonance study were identified. To confine the cause of ventricular size and function deviation to PR, patients with residual ventricular septal defect, more than mild regurgitation at a valve other than the pulmonary valve, and known coronary artery disease were excluded. Results: The final analysis included 27 adults with PR fraction >20%. During a follow-up of mean 2.1 ± 0.8 years, there was no change in right ventricular (RV) end-diastolic volume (EDV; 162.1 ± 27.6 versus 164 ± 29.6 ml/m 2 , p = 0.5). Left ventricular (LV) EDV showed a small decrease (85.1 ± 16.2 versus 81.5 ± 14.1 ml/m 2 , p = 0.02). The mean PR fraction, PR volume, and peak RV outflow tract gradient did not change. Additionally, both RV ejection fraction (EF) and LVEF remained stable over the follow-up period (48.1 ± 6.5 versus 48.4 ± 6.7%, p = 0.83, and 57.3 ± 5.4 versus 57.2 ± 5.1 %, p = 0.91, respectively). Only two asymptomatic patients (7.4% of the study group) developed symptoms and the remaining did not deteriorate. Conclusion: The RVEDV, RVEF, and LVEF remained stable over a mean follow-up of approximately 2 years in the majority of adult patients after TOF repair with significant PR and a wide range of RVEDV

Secondary renal amyloidosis in a patient of pulmonary tuberculosis and common variable immunodeficiency

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Balwani Manish R

2015-04-01

Full Text Available Common variable immunodeficiency (CVID usually manifests in the second or third decade of life with recurrent bacterial infections and hypoglobulinemia. Secondary renal amyloidosis with history of pulmonary tuberculosis is rare in CVID, although T cell dysfunction has been reported in few CVID patients. A 40-year-old male was admitted to our hospital with a 3-month history of recurrent respiratory infections and persistent pitting pedal edema. His past history revealed 3 to 5 episodes of recurrent respiratory tract infections and diarrhoea each year since last 20 years. He had been successfully treated for sputum positive pulmonary tuberculosis 8 years back. Laboratory studies disclosed high erythrocyte sedimentation rate (ESR, hypoalbuminemia and nephrotic range proteinuria. Serum immunoglobulin levels were low. CD4/CD8 ratio and CD3 level was normal. C3 and C4 complement levels were normal. Biopsy revealed amyloid A (AA positive secondary renal amyloidosis. Glomeruli showed variable widening of mesangial regions with deposition of periodic schiff stain (PAS pale positive of pink matrix showing apple green birefringence on Congo-red staining. Immunohistochemistry was AA stain positive. Immunofluorescence microscopy revealed no staining with anti-human IgG, IgM, IgA, C3, C1q, kappa and lambda light chains antisera. Patient was treated symptomatically for respiratory tract infection and was discharged with low dose angiotensin receptor blocker. An old treated tuberculosis and chronic inflammation due to recurrent respiratory tract infections were thought to be responsible for AA amyloidosis. Thus pulmonary tuberculosis should be considered in differential diagnosis of secondary causes of AA renal amyloidosis in patients of CVID especially in endemic settings.

Tailored interventions to improve antibiotic use for lower respiratory tract infections in hospitals: a cluster-randomized, controlled trial.

NARCIS (Netherlands)

Schouten, J.A.; Hulscher, M.E.J.L.; Trap-Liefers, J.; Akkermans, R.P.; Kullberg, B.J.; Grol, R.P.T.M.; Meer, J.W.M. van der

2007-01-01

BACKGROUND: Limited data exist on the most effective approach to increase the quality of antibiotic use for lower respiratory tract infections at hospitals. METHODS: One thousand nine hundred six patients with community-acquired pneumonia or an exacerbation of chronic obstructive pulmonary disease

Superposed epoch analysis of O+ auroral outflow during sawtooth events and substorms

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Nowrouzi, N.; Kistler, L. M.; Lund, E. J.; Cai, X.

2017-12-01

Sawtooth events are repeated injection of energetic particles at geosynchronous orbit. Studies have shown that 94% of sawtooth events occurred during magnetic storm times. The main factor that causes a sawtooth event is still an open question. Simulations have suggested that heavy ions like O+ may play a role in triggering the injections. One of the sources of the O+ in the Earth's magnetosphere is the nightside aurora. O+ ions coming from the nightside auroral region have direct access to the near-earth magnetotail. A model (Brambles et al. 2013) for interplanetary coronal mass ejection driven sawtooth events found that nightside O+ outflow caused the subsequent teeth of the sawtooth event through a feedback mechanism. This work is a superposed epoch analysis to test whether the observed auroral outflow supports this model. Using FAST spacecraft data from 1997-2007, we examine the auroral O+ outflow as a function of time relative to an injection onset. Then we determine whether the profile of outflow flux of O+ during sawtooth events is different from the outflow observed during isolated substorms. The auroral region boundaries are estimated using the method of (Andersson et al. 2004). Subsequently the O+ outflow flux inside these boundaries are calculated and binned as a function of superposed epoch time for substorms and sawtooth "teeth". In this way, we will determine if sawtooth events do in fact have greater O+ outflow, and if that outflow is predominantly from the nightside, as suggested by the model results.

Dissecting the Butterfly: Dual Outflows in the Dual AGN NGC 6240

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Mueller Sanchez, Francisco; Comerford, Julie; Nevin, Rebecca; Davies, Richard; Treister, Ezequiel; Privon, George

2018-01-01

Current theories of galaxy evolution invoke some kind of feedback (from the stars or the supermassive black hole) to explain the properties of galaxies. However, numerical simulations and observations have not been able to evaluate the real impact of feedback in galaxies. This is largely because most studies have focused on studying stellar feedback or AGN feedback alone, instead of considering the combined effect of both. In fact, this is an unexplored territory for observations due to the difficulty of separating the contribution from the two sources.In this contribution I present the discovery of a dual outflow of different species of gas in the prototypical merging galaxy NGC 6240 using HST imaging, long-slit and integral-eld spectroscopy: an AGN-driven outflow of highly-ionized gas to the northeast and a starburst-driven outflow of ionized hydrogen to the northwest. The AGN outflow extends up to 4 kpc along a position angle of 56 degrees, has a conical shape with an opening angle of 52 degrees and a maximum line-of-sight velocity of 350 km/s. The WFC3 images also reveal a bubble of Halpha emission in the northwest, which has no counterpart in [O III], consistent with a scenario in which the starburst is ionizing and driving outflowing winds which inflate the bubble at an expansion velocity of 380 km/s. Assuming a spherical geometry for the starburst-driven bubble and a conical geometry for the AGN-driven outflow, we estimate mass outflow rates of 26 Msun/yr and 62 Msun/yr, respectively. We conclude that the AGN contribution to the evolution of the merger remnant and the formation of outflowing winds is signicant in the central 5 kpc of NGC 6240.

Ionized and Neutral Outflows in the QUEST QSOs

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Veilleux, Sylvain

2011-10-01

The role of galactic winds in gas-rich mergers is of crucial importance to understand galaxy and SMBH evolution. In recent months, our group has had three major scientific breakthroughs in this area: {1} The discovery with Herschel of massive molecular {OH-absorbing} outflows in several ULIRGs, including the nearest quasar, Mrk 231. {2} The independent discovery from mm-wave interferometric observations in the same object of a spatially resolved molecular {CO-emitting} wind with estimated mass outflow rate 3x larger than the star formation rate and spatially coincident with blueshifted neutral {Na ID-absorbing} gas in optical long-slit spectra. {3} The unambiguous determination from recent Gemini/IFU observations that the Na ID outflow in this object is wide-angle, thus driven by a QSO wind rather than a jet. This powerful outflow may be the long-sought "smoking gun" of quasar mechanical feedback purported to transform gas-rich mergers. However, our Herschel survey excludes all FIR-faint {UV-bright} "classic" QSOs by necessity. So here we propose a complementary FUV absorption-line survey of all FIR-bright -and- FIR-faint QSOs from the same parent sample. New {19 targets} and archival {11} spectra will be used to study, for the first time, the gaseous environments of QSOs as a function of host properties and age across the merger sequence ULIRG -> QSO. These data will allow us to distinguish between ionized & neutral quasar-driven outflows, starburst-driven winds, and tidal debris around the mergers. They will also be uniquely suited for a shallow but broad study of the warm & warm-hot intergalactic media, complementary to on-going surveys that are deeper but narrower.

Pathology of Neuroendocrine Tumours of the Female Genital Tract.

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Howitt, Brooke E; Kelly, Paul; McCluggage, W Glenn

2017-09-01

Neuroendocrine tumours are uncommon or rare at all sites in the female genital tract. The 2014 World Health Organisation (WHO) Classification of neuroendocrine tumours of the endometrium, cervix, vagina and vulva has been updated with adoption of the terms low-grade neuroendocrine tumour and high-grade neuroendocrine carcinoma. In the endometrium and cervix, high-grade neoplasms are much more prevalent than low-grade and are more common in the cervix than the corpus. In the ovary, low-grade tumours are more common than high-grade carcinomas and the term carcinoid tumour is still used in WHO 2014. The term ovarian small-cell carcinoma of pulmonary type is included in WHO 2014 for a tumour which in other organs is termed high small-cell neuroendocrine carcinoma. Neuroendocrine tumours at various sites within the female genital tract often occur in association with other neoplasms and more uncommonly in pure form.

Banking cryopreserved heart valves in Europe: assessment of a 5-year operation in an international tissue bank in Brussels.

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Goffin, Y; Grandmougin, D; Van Hoeck, B

1996-01-01

The heart valve bank of the European Homograft Bank has been set up in 1988 to meet the growing demand of cardiac surgeons for various sized and quality controlled cryopreserved homografts. Heart valve donors less than 60 years of age were classified in 3 categories: multiorgan donors with non transplantable hearts, recipients of cardiac transplantation and non beating heart cadavers with a warm ischemic time of less than 6 hours. Past history and biology were checked for transmissible diseases. Preparation, progressive freezing and storage in liquid nitrogen vapors, and quality control were according to the standards of the Belgian Ministry of Health. From end January 1989 to end May 1994, 989 homograft valves were cryopreserved (514 pulmonary, 475 aortic and 3 mitral) whereas 962 valves were discarded. The first cause of rejection being a major macroscopic lesion (41.48%). 138 hearts accepted at inspection were contaminated and 43 cases remained so after antibiotics. 38 cases were positive for hepatitis B or C. Complication at distribution and thawing included 10 instances of bag rupture and 15 of transversal fracture through the wall of the conduit. 477 aortic, 474 pulmonary valves as well as one mitral were implanted between May 1989 and May 1994, either for left or right ventricular outflow tract reconstruction. In the left ventricular outflow tract series 111 aortic and 23 pulmonary homograft valves were used in cases of native endocarditis, prosthetic endocarditis or recurrent endocarditis after homograft implantation. 9.6% of the requests could no be satisfied. Regular follow up information was available from 382 implants-40.1% only. The assessment of 5 years operation of the heart valve bank indicates: 1) the efficiency of selecting, cryopreserving and allocating quality controlled homograft valves from a large pool of donor hearts provided by a network of hospitals; 2) the difficulty of obtaining regular follow up information on the implants.

Outflow and Accretion Physics in Active Galactic Nuclei

Science.gov (United States)

McGraw, Sean Michael

2016-09-01

This dissertation focuses on placing observational constraints on outflows and accretion disks in active galactic nuclei (AGN) for the purpose of better understanding the physics of super-massive black holes (SMBHs) and their evolution with the host galaxy over cosmic time. Quasar outflows and their importance in SMBH-host galaxy co-evolution can be further understood by analyzing broad absorption lines (BALs) in rest-frame UV spectra that trace a range of wind conditions. We quantify the properties of the flows by conducting BAL variability studies using multiple-epoch spectra acquired primarily from MDM Observatory and from the Sloan Digital Sky Survey. Iron low-ionization BALs (FeLoBALs) are a rare type of outflow that may represent a transient phase in galaxy evolution, and we analyze the variations in 12 FeLoBAL quasars with redshifts between 0.7 ≤ z ≤ 1.9 and rest frame timescales between ˜10 d to 7.6 yr. We investigate BAL variability in 71 quasar outflows that exhibit P V absorption, a tracer of high column density gas (i.e. NH ≥ 1022 cm -2), in order to quantify the energies and momenta of the flows. We also characterize the variability patterns of 26 quasars with mini-BALs, an interesting class of absorbers that may represent a distinct phase in the evolution of outflows. Low-luminosity AGN (LLAGN) are important objects to study since their prominence in the local Universe suggest a possible evolution from the quasar era, and their low radiative outputs likely indicate a distinct mode of accretion onto the SMBH. We probe the accretion conditions in the LLAGN NGC 4203 by estimating the SMBH mass, which is obtained by modeling the 2-dimensional velocity field of the nebular gas using spectra from the Hubble Space Telescope. We detect significant BAL and mini-BAL variability in a subset of quasars from each of our samples, with measured rest-frame variability time-scales from days to years and over multiple years on average. Variable wavelength

An X-Ray/SDSS Sample: Observational Characterization of The Outflowing Gas

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Perna, Michele; Brusa, M.; Lanzuisi, G.; Mignoli, M.

2016-10-01

Powerful ionised AGN-driven outflows, commonly detected both locally and at high redshift, are invoked to contribute to the co-evolution of SMBH and galaxies through feedback phenomena. Our recent works (Brusa+2015; 2016; Perna+2015a,b) have shown that the XMM-COSMOS targets with evidence of outflows collected so far ( 10 sources) appear to be associated with low X-ray kbol corrections (Lbol /LX ˜ 18), in spite of their spread in obscuration, in the locations on the SFR-Mstar diagram, in their radio emission. A higher statistical significance is required to validate a connection between outflow phenomena and a X-ray loudness. Moreover, in order to validate their binding nature to the galaxy fate, it is crucial to correctly determine the outflow energetics. This requires time consuming integral field spectroscopic (IFS) observations, which are, at present, mostly limited to high luminosity objectsThe study of SDSS data offers a complementary strategy to IFS efforts. I will present physical and demographic characterization of the AGN-galaxy system during the feedback phase obtained studying a sample of 500 X-ray/SDSS AGNs, at zdispersion) and X-ray properties (intrinsic X-ray luminosity, obscuration and X-ray kbol correction), to determine what drives ionised winds. Several diagnostic line ratios have been used to infer the physical properties of the ionised outflowing gas. The knowledge of these properties can reduce the actual uncertainties in the outflow energetics by a factor of ten, pointing to improve our understanding of the AGN outflow phenomenon and its impact on galaxy evolution.

Challenging Combination; Pseudocoarctation with Subaortic and Subpulmonic Stenosis

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Ahmet Kirbas

2014-03-01

Full Text Available Combined left and right ventricular outflow tract obstruction is an extremely rare congenital anomaly. Pseudocoarctation (PcoA, also known as kinking or buckling of the aorta, is an uncommon anomaly of the aorta. A 4-year-old girl presented to our hospital with progressive complaints of exertional dyspnea and intermittent dizziness for about one year. She was diagnosed with severe combined left and  right ventricular outflow tract obstructions associated with pseudocoarctation of the aorta. Echocardiographic estimated peek pressure gradients across the right and left ventricular outflow tracts were 151 mmHg and 109 mmHg respectively. There was no significant pressure gradient across the pseudocoarctaion. Aggressive surgical myomectomy for both outflow tracts, combined with reconstruction of right ventricular outflow tract using pericardial patch and iatrogenic ventricular septal defect (VSD closure using PTFE  patch was performed. No intervention was done for pseudocoarctation of the aorta (PcoA. Association of PCoA with different types of cardiac anomalies has been reported. However to our knowledge, combined left and right ventricular outflow obstruction associated with PCoA has not been described before.

Relative outflow enhancements during major geomagnetic storms – Cluster observations

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A. Schillings

2017-12-01

Full Text Available The rate of ion outflow from the polar ionosphere is known to vary by orders of magnitude, depending on the geomagnetic activity. However, the upper limit of the outflow rate during the largest geomagnetic storms is not well constrained due to poor spatial coverage during storm events. In this paper, we analyse six major geomagnetic storms between 2001 and 2004 using Cluster data. The six major storms fulfil the criteria of Dst  < −100 nT or Kp  > 7+. Since the shape of the magnetospheric regions (plasma mantle, lobe and inner magnetosphere are distorted during large magnetic storms, we use both plasma beta (β and ion characteristics to define a spatial box where the upward O+ flux scaled to an ionospheric reference altitude for the extreme event is observed. The relative enhancement of the scaled outflow in the spatial boxes as compared to the data from the full year when the storm occurred is estimated. Only O+ data were used because H+ may have a solar wind origin. The storm time data for most cases showed up as a clearly distinguishable separate peak in the distribution toward the largest fluxes observed. The relative enhancement in the outflow region during storm time is 1 to 2 orders of magnitude higher compared to less disturbed time. The largest relative scaled outflow enhancement is 83 (7 November 2004 and the highest scaled O+ outflow observed is 2  ×  1014 m−2 s−1 (29 October 2003.

Low-energy ion outflow modulated by the solar wind energy input

Science.gov (United States)

Li, Kun; Wei, Yong; Andre, Mats; Eriksson, Anders; Haaland, Stein; Kronberg, Elena; Nilsson, Hans; Maes, Lukas

2017-04-01

Due to the spacecraft charging issue, it has been difficult to measure low-energy ions of ionospheric origin in the magnetosphere. A recent study taking advantage of the spacecraft electric potential has found that the previously 'hidden' low-energy ions is dominant in the magnetosphere. This comprehensive dataset of low-energy ions allows us to study the relationship between the ionospheric outflow and energy input from the solar wind (ɛ). In this study, we discuss the ratios of the solar wind energy input to the energy of the ionospheric outflow. We show that the ɛ controls the ionospheric outflow when the ɛ is high, while the ionospheric outflow does not systematically change with the ɛ when the ɛ is low.

The nanoparticle corona in the deep lung : pulmonary surfactant adsorption and its role in nano-bio interactions

OpenAIRE

Räsch, Simon Sebastian

2016-01-01

Nanoparticles (NPs) for drug delivery to the respiratory tract are of considerable interest, for the treatment of chronic and acute pulmonary and systemic disorders, promising the potential for sustained release and targeted delivery. Although the targets for these formulations are usually cells, the NPs, once inhaled, first encounter a non-cellular barrier in the deep lung: the pulmonary surfactant (PS). This is a lipid-protein mixture which covers the alveoli and enables gas exchange as a r...

Transport pathways for Asian pollution outflow over the Pacific: Interannual and seasonal variations

Science.gov (United States)

Liu, Hongyu; Jacob, Daniel J.; Bey, Isabelle; Yantosca, Robert M.; Duncan, Bryan N.; Sachse, Glen W.

2003-10-01

The meteorological pathways contributing to Asian pollution outflow over the Pacific are examined with a global three-dimensional model analysis of CO observations from the Transport and Chemical Evolution over the Pacific (TRACE-P) aircraft mission (February-April 2001). The model is used also to place the TRACE-P observations in an interannual (1994-2001) and seasonal context. The major process driving Asian pollution outflow in spring is frontal lifting ahead of southeastward-moving cold fronts (the leading edge of cold surges) and transport in the boundary layer behind the cold fronts. Orographic lifting over central and eastern China combines with the cold fronts to promote the transport of Chinese pollution to the free troposphere. Outflow of seasonal biomass burning in Southeast Asia during spring takes place mostly by deep convection but also by northeastward transport and frontal lifting, mixing with the anthropogenic outflow. Boundary layer outflow over the western Pacific is largely devoid of biomass burning influence. European and African (biomass burning) plumes in Asian outflow during TRACE-P were weak (pollution signal. Spring 2001 (La Niña) was characterized by unusually frequent cold surge events in the Asian Pacific rim and strong convection in Southeast Asia, leading to unusually strong boundary layer outflow of anthropogenic emissions and convective outflow of biomass burning emissions in the upper troposphere. The Asian outflow flux of CO to the Pacific is found to vary seasonally by a factor of 3-4 (maximum in March and minimum in summer). The March maximum results from frequent cold surge events and seasonal biomass burning emissions.

Right-ventricular and left-ventricular function parameters in patients with and without outflow tract patches as determined by radionuclide methods at least 10 years following surgical correction of Fallot's tetralogy in the adult individuals. Nuklearmedizinische Bestimmung der rechts- und linksventrikulaeren Funktionsparameter von Patienten ohne und mit Ausflusstraktpatch - mindestens 10 Jahre nach operativer Korrektur der Fallot'schen Tetralogie im Erwachsenenalter

Energy Technology Data Exchange (ETDEWEB)

Seidel, P.

1988-12-15

During a period starting in 1983 and ending in April 1984 radionuclide ventriculography was performed in 26 patients subjected to surgical correction of Fallot's tetralogy after having reached adulthood. They were divided into two groups according to the surgical methods used. Patients showing no right-ventricular outflow patch were assigned to group I, while group II was made up of individuals that had received outflow tract patches of Dacron or Teflon for pressure reduction in the right ventricle. The parameters registered during radionuclide ventriculography, in which the tracer substance TC 99m was administered into a peripheral vein, included the endiastolic volume, endsystolic volume, stroke volume, global ejection fraction and cardiac index. For resting patients, these values were calculated using the first-pass technique, the determinations during exercise on the ergometer were based on equilibrium radionuclide ventriculography. It could be concluded from the results obtained here that non-invasive endocardial scintigraphy is a sensitive method that can be used both at rest and during exercise on the ergometer to detect function disorders of the right and left ventricles. (orig./MG).

Plasma Outflows: Known Knowns, Known Unknowns, and The Unknown

Science.gov (United States)

Moore, T. E.

2012-01-01

A brief summary is given of i) what we know from observing ionospheric outflows and ii) how outflow parameterizations are being used in global simulations to evaluate their effects on magnetospheric dynamics. Then, a list of unanswered questions and issues to be resolved is given, followed by a description of the known future mission plans expressed in the Heliophysics Roadmap, such as Origin of Near-Earth Plasmas (ONEP), and Ion-Neutral Coupling in the Atmosphere (INCA). Finally, a set of requirements for definitive plasma outflow observations are identified, along with possible methods for fulfilling them in future missions. Since results of the current Heliophysics Decadal Survey are expected soon, it is hoped that future plans can be summarized and discussed without speculation at the GEM 2012 meeting.

The outflow speed of the coma of Halley's comet

International Nuclear Information System (INIS)

Combi, M.R.

1989-01-01

Data concerning the outflow speed of the coma of Comet Halley are studied in relation to a generalization of the coupled pure-gas-dynamic/Monte Carlo model of Combi and Smyth (1988) to include the dusty-gas dynamics of the inner coma. Measurements made by the Giotto neutral-gas spectrometer, IR water observations from the Kuiper Airborne Observatory, and Doppler radio line profiles of HCN and OH are used to examine the radial dependence of the outflow speed, the asymmetry in the outflow speed, and the overall heliocentric distance dependence of the Doppler profiles, respectively. The results suggest that the model makes it possible to understand the gross long-term behavior and radial structure of the dynamics of the cometary coma. 23 refs

Determinants of Foreign Direct Investments Outflow From a Developing Country: the Case of Turkey

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Gokhan Onder

2013-09-01

Full Text Available Foreign direct investments (FDI outflows of Turkey have remarkably been raising over the last decade. This rapid increase brings about the need for questioning the determinants of FDI outflows. The aim of this paper is to estimate the factors affecting outflow FDI from Turkey from 2002 to 2011 by using Prais-Winsten regression analysis. According to estimation results, population, infrastructure, percapita gross domestic product of the host country, and home country exports to the host country are the factors having positive effects on outflow FDI. We found, on the other hand, that the annual inflation rate of the host country, its tax rate collected from commercial profit, and its distance from Turkey have a negative relation with investment outflows. Moreover our results show that while investment outflows to developed countries are in the form of horizontal investments, investment outflows to developing countries are in the form of vertical investments.

CLASSICAL T TAURI-LIKE OUTFLOW ACTIVITY IN THE BROWN DWARF MASS REGIME

International Nuclear Information System (INIS)

Whelan, E. T.; Ray, T. P.; Podio, L.; Bacciotti, F.; Randich, S.

2009-01-01

Over the last number of years, spectroscopic studies have strongly supported the assertion that protostellar accretion and outflow activity persist to the lowest masses. Indeed, previous to this work, the existence of three brown dwarf (BD) outflows had been confirmed by us. In this paper, we present the results of our latest investigation of BD outflow activity and report on the discovery of two new outflows. Observations to date have concentrated on studying the forbidden emission line (FEL) regions of young BDs and in all cases data have been collected using the UV-Visual Echelle Spectrometer (UVES) on the ESO Very Large Telescope. Offsets in the FEL regions are recovered using spectro-astrometry. Here, ISO-Oph 32 is shown to drive a blueshifted outflow with a radial velocity of 10-20 km s -1 and spectro-astrometric analysis constrains the position angle of this outflow to 240 0 ± 7 0 . The BD candidate, ISO-ChaI 217 is found to have a bipolar outflow bright in several key forbidden lines (V RAD = -20 km s -1 , +40 km s -1 ) and with a P.A. of 193 0 -209 0 . A striking feature of the ISO-ChaI 217 outflow is the strong asymmetry between the red- and blueshifted lobes. This asymmetry is revealed in the relative brightness of the two lobes (redshifted lobe is brighter), the factor of 2 difference in radial velocity (the redshifted lobe is faster) and the difference in the electron density (again higher in the red lobe). Such asymmetries are common in jets from low-mass protostars and the observation of a marked asymmetry at such a low mass ( sun ) supports the idea that BD outflow activity is scaled down from low-mass protostellar activity. Also note that although asymmetries are unexceptional, it is uncommon for the redshifted lobe to be the brightest as some obscuration by the accretion disk is assumed. This phenomenon has only been observed in one other source, the classical T Tauri (CTTS) star RW Aur. The physical mechanism responsible for the brightening of

Mitral valve replacement complicated by iatrogenic left ventricular outflow obstruction and paravalvular leak: case report and review of literature.

Science.gov (United States)

Lee, Justin Z; Tey, Kai R; Mizyed, Ahmad; Hennemeyer, Charles T; Janardhanan, Rajesh; Lotun, Kapildeo

2015-10-09

Left ventricular outflow tract (LVOT) obstruction and paravalvular leak (PVL) are relatively uncommon, but are serious complications of prosthetic valve replacement. We present a case that displays the unique therapeutic challenges of treating a patient who developed both LVOT obstruction and mitral PVL after undergoing surgical aortic and mitral valve replacement (MVR). We also describe the use of alcohol septal ablation and albumin-glutaraldehyde (BioGlue) for septal ablation to percutaneously treat the patient's LVOT obstruction, followed by use of an Amplatzer vascular plug for percutaneous closure of an antero-medial mitral PVL associated with severe regurgitation. Percutaneous interventional management of these entities may be considered as an initial therapeutic option, especially in high-risk patients with significant morbidity and mortality of repeat surgical operations.

Unveiling the molecular bipolar outflow of the peculiar red supergiant VY Canis Majoris

Science.gov (United States)

Shinnaga, Hiroko; Claussen, Mark J.; Lim, Jeremy; Dinh-van-Trung; Tsuboi, Masato

2003-04-01

We carried out polarimetric spectral-line imaging of the molecular outflow of the peculiar red supergiant VY Canis Majoris in SiO J=1-0 line in the ground vibrational state, which contains highly linearly-polarized velocity components, using the Very Large Array. We succeeded in unveiling the highly linearly polarized bipolar outflow for the first time at subarcsecond spatial resolution. The results clearly show that the direction of linear polarization of the brightest maser components is parallel to the outflow axis. The results strongly suggest that the linear polarization of the SiO maser is closely related to the outflow phenomena of the star. Furthermore, the results indicate that the linear polarization observed in the optical and infrared also occur due to the outflow phenomena.

MR and CT imaging of pulmonary valved conduits in children and adolescents: normal appearance and complications

Energy Technology Data Exchange (ETDEWEB)

Tenisch, Estelle V.; Alamo, Leonor T.; Gudinchet, Francois [Lausanne University Hospital, Department of Medical Imaging, Lausanne (Switzerland); Sekarski, Nicole [Lausanne University Hospital, Department of Pediatrics, Lausanne (Switzerland); Hurni, Michel [Lausanne University Hospital, Department of Cardiovascular Surgery, Lausanne (Switzerland)

2014-12-15

The Contegra registered is a conduit made from the bovine jugular vein and then interposed between the right ventricle and the pulmonary artery. It is used for cardiac malformations in the reconstruction of right ventricular outflow tract. To describe both normal and pathological appearances of the Contegra registered in radiological imaging, to describe imaging of complications and to define the role of CT and MRI in postoperative follow-up. Forty-three examinations of 24 patients (17 boys and 7 girls; mean age: 10.8 years old) with Contegra registered conduits were reviewed. Anatomical description and measurements of the conduits were performed. Pathological items examined included stenosis, dilatation, plicature or twist, thrombus or vegetations, calcifications and valvular regurgitation. Findings were correlated to the echographic gradient through the conduit when available. CT and MR work-up showed Contegra registered stenosis (n = 12), dilatation (n = 9) and plicature or twist (n = 7). CT displayed thrombus or vegetations in the Contegra registered in three clinically infected patients. Calcifications of the conduit were present at CT in 12 patients and valvular regurgitation in three patients. The comparison between CT and/or MR results showed a good correlation between the echographic gradient and the presence of stenosis in the Contegra registered. CT and MR bring additional information about permeability and postoperative anatomy especially when echocardiography is inconclusive. Both techniques depict the normal appearance of the conduit, and allow comparison and precise evaluation of changes in the postoperative follow-up. (orig.)

UNRAVELLING THE COMPLEX STRUCTURE OF AGN-DRIVEN OUTFLOWS. II. PHOTOIONIZATION AND ENERGETICS

Energy Technology Data Exchange (ETDEWEB)

Karouzos, Marios; Woo, Jong-Hak [Astronomy Program, Department of Physics and Astronomy, Seoul National University, Seoul 151-742 (Korea, Republic of); Bae, Hyun-Jin, E-mail: woo@astro.snu.ac.kr [Department of Astronomy and Center for Galaxy EVolution Research, Yonsei University, Seoul 120-749 (Korea, Republic of)

2016-12-20

Outflows have been shown to be prevalent in galaxies hosting luminous active galactic nuclei (AGNs); they present a physically plausible way to couple the AGN energy output with the interstellar medium of their hosts. Despite their prevalence, accurate characterization of these outflows has been challenging. In the second of a series of papers, we use Gemini Multi-Object Spectrograph integral field unit (IFU) data of six local ( z  < 0.1) and moderate-luminosity Type 2 AGNs to study the ionization properties and energetics of AGN-driven outflows. We find strong evidence connecting the extreme kinematics of the ionized gas to the AGN photoionization. The kinematic component related to the AGN-driven outflow is clearly separated from other kinematic components, such as virial motions or rotation, on the velocity and velocity dispersion diagram. Our spatially resolved kinematic analysis reveals that 30 to 90% of the total mass and kinetic energy of the outflow is contained within the central kpc of the galaxy. The spatially integrated mass and kinetic energy of the gas entrained in the outflow correlate well with the AGN bolometric luminosity and results in energy conversion efficiencies between 0.01% and 1%. Intriguingly, we detect ubiquitous signs of ongoing circumnuclear star formation. Their small size, the centrally contained mass and energy, and the universally detected circumnuclear star formation cast doubts on the potency of these AGN-driven outflows as agents of galaxy-scale negative feedback.

Impact of positive chest X-ray findings and blood cultures on adverse outcomes following hospitalized pneumococcal lower respiratory tract infection

DEFF Research Database (Denmark)

Skovgaard, Marlene; Schønheyder, Henrik Carl; Benfield, Thomas

2013-01-01

Little is known about the clinical presentation and outcome of pneumococcal lower respiratory tract infection (LRTI) without positive chest X-ray findings and blood cultures. We investigated the prognostic impact of a pulmonary infiltrate and bacteraemia on the clinical course of hospitalized...

Multi-phase outflows as probes of AGN accretion history

Science.gov (United States)

Nardini, Emanuele; Zubovas, Kastytis

2018-05-01

Powerful outflows with a broad range of properties (such as velocity, ionization, radial scale and mass loss rate) represent a key feature of active galactic nuclei (AGN), even more so since they have been simultaneously revealed also in individual objects. Here we revisit in a simple analytical framework the recent remarkable cases of two ultraluminous infrared quasars, IRAS F11119+3257 and Mrk 231, which allow us to investigate the physical connection between multi-phase AGN outflows across the ladder of distance from the central supermassive black hole (SMBH). We argue that any major deviations from the standard outflow propagation models might encode unique information on the past SMBH accretion history, and briefly discuss how this could help address some controversial aspects of the current picture of AGN feedback.

Multipoint analysis of the spatio-temporal coherence of dayside O+ outflows with Cluster

Directory of Open Access Journals (Sweden)

P. Puhl-Quinn

2004-07-01

Full Text Available The spatial distribution of ionospheric ion outflow from the dayside cusp/cleft has previously been studied in great detail with numerous satellite missions, but only statistically. Between July and November 2001, the orbit configuration of the Cluster multi-satellite system close to its perigee (4 Earth radii allows for delay times between spacecraft of about 4 and 35min in crossing the cusp/cleft. This enables for the first time to assess the spatial and temporal coherence of O+ ion outflow on time scales of the order of the satellite time lag. After presenting two contrasting events in detail, O+ velocities and outflow intensities from three spacecraft, available on 18 events, all with a similar orbit, have been cross-correlated to quantify the degree of coherence in the outflow. The main result from the analysis is that, although dayside outflows are a permanent feature, steady-state conditions are surprisingly never achieved. In particular, a significant variability is found for convection drift and local outflow intensities on small time scales. This variability of local intensities is not found to depend on the total strenghth of the outflow, which is much more stable and increases with the dynamic solar wind pressure.

ON THE ORIGIN OF THE MOLECULAR OUTFLOWS IN IRAS 16293–2422

Energy Technology Data Exchange (ETDEWEB)

Girart, Josep M.; Palau, Aina; Torrelles, José M. [Institut de Ciències de l' Espai, (CSIC-IEEC), Campus UAB, Facultat de Ciències, C5p 2, E-08193 Bellaterra, Catalonia (Spain); Estalella, Robert [Departament d' Astronomia i Meteorologia, Institut de Ciències del Cosmos (UB-IEEC), Martí i Franquès, Universitat de Barcelona, E-08028 Barcelona, Catalonia (Spain); Rao, Ramprasad, E-mail: girart@ice.cat [Institute of Astronomy and Astrophysics, Academia Sinica, 645 N. Aohoku Pl., Hilo, HI 96720 (United States)

2014-01-01

We present CO 3-2, SiO 8-7, C{sup 34}S 7-6, and 878 μm dust continuum subarcsecond angular resolution observations with the Submillimeter Array (SMA) toward the IRAS 16293–2422 (I16293) multiple low-mass protostellar system. The C{sup 34}S emission traces the 878 μm dust continuum well, and in addition clearly shows a smooth velocity gradient along the major axis of component I16293A. CO shows emission at moderate high velocities arising from two bipolar outflows, which appear to be perpendicular with respect to each other. The high sensitivity and higher angular resolution of these observations allows us to pinpoint well the origin of these two outflows at the center of component I16293A. Interestingly, the most compact outflow appears to point toward I16293B. Our data show that the previously reported monopolar blueshifted CO outflow associated with component I16293B seems to be part of the compact outflow arising from component I16293A. In addition, the SiO emission is also tracing this compact outflow: on the one hand, the SiO emission appears to have a jet-like morphology along the southern redshifted lobe; on the other hand, the SiO emission associated with the blueshifted northern lobe traces a well-defined arc on the border of component I16293B facing I16293A. The blueshifted CO lobe of the compact outflow splits into two lobes around the position of this SiO arc. All these results lead us to propose that the compact outflow from component I16293A is impacting on the circumstellar gas around component I16293B, possibly being diverged as a consequence of the interaction.

Coffin-Siris syndrome with the rarest constellation of congenital cardiac defects: A case report with review of literature

Directory of Open Access Journals (Sweden)

Lalita Nemani

2014-01-01

Full Text Available We report a case of type-A Coffin-Siris syndrome (CSS with a unique constellation of congenital heart defects. A 17-year-old Indian boy was referred to our hospital for central cyanosis with features of right heart failure. The cardiac abnormalities included biventricular outflow tract obstruction, small atrial septal defect (ASD, subaortic ventricular septal defect, drainage of left superior venacava to left atrial appendage, and aortic arch anomaly. Patient underwent successful right ventricular infundibular resection, subaortic membrane resection, closure of atrial and ventricular septal defect, rerouting left superior vena cava to left pulmonary artery and aortic valve replacement.

Coffin-Siris syndrome with the rarest constellation of congenital cardiac defects: A case report with review of literature.

Science.gov (United States)

Nemani, Lalita; Barik, Ramachandra; Patnaik, Amar Narayana; Mishra, Ramesh C; Rao, Amaresh M; Kapur, Pragati

2014-09-01

We report a case of type-A Coffin-Siris syndrome (CSS) with a unique constellation of congenital heart defects. A 17-year-old Indian boy was referred to our hospital for central cyanosis with features of right heart failure. The cardiac abnormalities included biventricular outflow tract obstruction, small atrial septal defect (ASD), subaortic ventricular septal defect, drainage of left superior venacava to left atrial appendage, and aortic arch anomaly. Patient underwent successful right ventricular infundibular resection, subaortic membrane resection, closure of atrial and ventricular septal defect, rerouting left superior vena cava to left pulmonary artery and aortic valve replacement.

The digital aqueous humor outflow meter: an alternative tool for screening of the human eye outflow facility

Directory of Open Access Journals (Sweden)

Vassilios P Kozobolis

2010-08-01

Full Text Available Vassilios P Kozobolis, Eleftherios I Paschalis, Nikitas C Foudoulakis, Stavrenia C Koukoula, Georgios LabirisDepartment of Ophthalmology and Eye Institute of Thrace, Democritus University of Thrace, Alexandroupolis, GreecePurpose: To develop, characterize, and validate a prototype digital aqueous humor outflow tonographer (DAHOM.Material and methods: The DAHOM was developed, characterized, and validated in three phases. Phase 1 involved construction of the sensor. This was broadly based on the fundamental design of a typical Schiotz tonographer with a series of improvements, including corneal indentation, which was converted to an electrical signal via a linear variable differential transducer, an analog signal which was converted to digital via ADC circuitry, and digital data acquisition and processing which was made possible by a serial port interface. Phase 2 comprised development of software for automated assessment of the outflow facility. Automated outflow facility assessment incorporated a series of fundamental improvements in comparison with traditional techniques, including software-based filtering of ripple noise and extreme variations, rigidity impact analysis, and evaluation of the impact of patient age, central corneal thickness, and ocular axial length. Phase 3 comprised characterization and validation of DAHOM, for which we developed an experimental setup using porcine cadaver eyes. DAHOM’s repeatability was evaluated by means of Cronbach’s alpha and intraclass correlation coefficient. The level of agreement with a standard Schiotz tonographer was evaluated by means of paired t-tests and Bland-Altman analysis in human eyes.Results: The experimental setup provided the necessary data for the characterization of DAHOM. A fourth order polynomial equation provided excellent fit (R square >0.999. DAHOM demonstrated high repeatability (Cronbach’s alpha ≥0.997; intraclass correlation coefficient ≥0.987 and an adequate level of

The impact of remittances outflows on the economy of Poland

OpenAIRE

LASTOVETSKA ROKSOLANA ORESTIVNA

2015-01-01

The impact of remittances outflows on the economy of Poland is analyzed in the article. Based on historical data the vector autoregression model (VAR) was built to examine the effects of the sharp rise in the volume of remittances outflows. The model results are presented for the next macroeconomic indicators: GDP, inflation, interest rate and exchange rate.

Generation of shockwave and vortex structures at the outflow of a boiling water jet

Science.gov (United States)

Alekseev, M. V.; Lezhnin, S. I.; Pribaturin, N. A.; Sorokin, A. L.

2014-12-01

Results of numerical simulation for shock waves and generation of vortex structures during unsteady outflow of boiling liquid jet are presented. The features of evolution of shock waves and vortex structures formation during unsteady outflow of boiling water are compared with corresponding structures during unsteady gas outflow.

Silo outflow of soft frictionless spheres

Science.gov (United States)

Ashour, Ahmed; Trittel, Torsten; Börzsönyi, Tamás; Stannarius, Ralf

2017-12-01

Outflow of granular materials from silos is a remarkably complex physical phenomenon that has been extensively studied with simple objects like monodisperse hard disks in two dimensions (2D) and hard spheres in 2D and 3D. For those materials, empirical equations were found that describe the discharge characteristics. Softness adds qualitatively new features to the dynamics and to the character of the flow. We report a study of the outflow of soft, practically frictionless hydrogel spheres from a quasi-2D bin. Prominent features are intermittent clogs, peculiar flow fields in the container, and a pronounced dependence of the flow rate and clogging statistics on the container fill height. The latter is a consequence of the ineffectiveness of Janssen's law: the pressure at the bottom of a bin containing hydrogel spheres grows linearly with the fill height.

Significance of changes of levels of plasma proBNP1-76 in patients with chronic pulmonary heart disease

International Nuclear Information System (INIS)

Li Guizhong; Xu Hua; Cao Jun; Jiang Wei; Pang Yongzheng; Tang Chaoshu

2003-01-01

Objective: To investigate the significance of the changes levels of plasma proBNP 1-76 in patients with COPD and chronic pulmonary heart disease. Methods: Plasma proBNP 1-76 levels were determined with radioimmunoassay in patients with CHPD (n=23), COPD (n=24) and 32 controls. Results: The concentrations of plasma proBNP 1-76 in patients with chronic obstructive pulmonary disease were significantly increased (vs controls, p 1-76 (r=0.541, p 1-76 , right inferior pulmonary artery diameter, right ventricle out flow tract diameter and right ventricle anterior wall thickness in patients with chronic pulmonary heart disease were increased significantly (vs COPD patients and controls, p 1-76 (r=0.477, p 1-76 is an early marker of right ventricular hypertrophy and right ventricular dysfunction, measurement of which is useful in the management of patients with chronic pulmonary heart disease in daily practice

Metabolism of model organic pollutants in canine respiratory tract mucosa slices

International Nuclear Information System (INIS)

Thornton-Manning, J.R.; Gerde, P.; Chen, S.T.; Dahl, A.R.

1994-01-01

The high incidence of human bronchial tumors has been correlated with the high fractional deposition of inhaled particles in the bronchi. Polycyclic aromatic hydrocarbons (PAHs) are frequently bound to airborne particles due to their low vapor pressures. It is thought that tumorigenicity may result from the release and subsequent bioactivation of these particle-associated organic compounds in the respiratory tract. Previous studies at ITRI examined the clearance of organic toxicants from various regions of the canine respiratory tract. Their results indicated that, while clearance of a highly lipophilic PAH such as benzo(a)pyrene (BaP) from the thin alveolar epithelium took only a few minutes, clearance through the thicker epithelium of the conducting airways took hours. Slower, diffusion-limited clearance results in higher concentrations of lipophilic compounds in the epithelium of the bronchi. Hence, the ability of these tissues to metabolize organic compounds to water-soluble metabolites or reactive intermediates may be extremely important in their clearance from the respiratory tract and the potential susceptibility of this region of the respiratory tract to cancer. The purpose of the present study was to evaluate the ability of bronchial mucosa to metabolize a model organic pulmonary carcinogen, BaP, to reactive and nonreactive metabolites and to evaluate the diffusion of the parent compound and metabolites through the bronchial mucosa

A Rare Cause of Pulmonary Nodules

Directory of Open Access Journals (Sweden)

Michael Tsuyoshi Chew

2016-10-01

Full Text Available Crohn’s disease is a chronic, idiopathic autoimmune disorder that primarily targets the gastrointestinal (GI system. It is characterized by transmural inflammation of the GI tract that can occur anywhere from the mouth to the anus. Not infrequently, the disease may also have extraintestinal manifestations (EIMs that can affect almost any organ system. It is estimated that EIMs affect up to 36% of patients with Crohn’s disease, but the incidence and prevalence of pulmonary involvement are variable in the literature and may be as low as 0.4%. There are few case reports documenting pulmonary manifestations, as they are often overlooked, especially if respiratory symptoms are present before the diagnosis of GI manifestations, as in the present case. A 44-year-old otherwise healthy woman presented with nonspecific respiratory complaints, recurrent pneumonias, and multiple computed tomography images showing diffuse, migratory, nodular, and consolidative parenchymal lung disease, with a largely unremarkable infectious and rheumatologic evaluation. Lung biopsy revealed necrotizing and nonnecrotizing granulomas, raising concern for sarcoidosis. Subsequent imaging revealed an incidental mass in the cecum. Biopsy of the cecum lesion revealed acute cryptitis, crypt abscess, and a single poorly formed granuloma, suggesting the possibility of Crohn’s disease. In this report, we present a patient whose pulmonary manifestations ultimately led to the diagnosis of Crohn’s disease.

Another piece of the puzzle: The fast H I outflow in Mrk 231

Science.gov (United States)

Morganti, Raffaella; Veilleux, Sylvain; Oosterloo, Tom; Teng, Stacy H.; Rupke, David

2016-09-01

We present the detection, performed with the Westerbork Synthesis Radio Telescope (WSRT) and the Karl Jansky Very Large Array (VLA), of a fast H I 21 cm outflow in the ultra-luminous infrared galaxy Mrk 231. The outflow is observed as shallow H I absorption blueshifted ~1300 km s-1 with respect to the systemic velocity and located against the inner kpc of the radio source. The outflowing gas has an estimated column density between 5 and 15 × 1018Tspin cm-2. We derive the Tspin to lie in the range 400-2000 K and the corresponding H I densities are nHI ~ 10-100 cm-3. Our results complement previous findings and confirm the multiphase nature of the outflow in Mrk 231. Although effects of the interaction between the radio plasma and the surrounding medium cannot be ruled out, the energetics and the lack of a clear kpc-scale jet suggest that the most likely origin of the H I outflow is a wide-angle nuclear wind, as earlier proposed to explain the neutral outflow traced by Na I and molecular gas in this source. Our results suggest that an H I component is present in fast outflows regardless of the acceleration mechanism (wind vs. jet driven) and that it must be connected with common properties of the pre-interaction gas involved. Considering the observed similarity of their column densities, the H I outflow likely represents the inner part of the broad wind identified on larger scales in atomic Na I. The mass outflow rate of the H I outflow (between 8 and 18 M⊙ yr-1) does not appear to be as large as that observed in molecular gas, partly owing to the smaller sizes of the outflowing region sampled by the H I absorption. These characteristics are commonly seen in other cases of outflows driven by the active galactic nucleus (AGN) suggesting that the H I may represent a short intermediate phase in the rapid cooling of the gas. The results further confirm H I as a good tracer for AGN-driven outflows not only in powerful radio sources. We also obtained deeper continuum

CORONAL MASS EJECTION INDUCED OUTFLOWS OBSERVED WITH HINODE/EIS

International Nuclear Information System (INIS)

Jin, M.; Ding, M. D.; Chen, P. F.; Fang, C.; Imada, S.

2009-01-01

We investigate the outflows associated with two halo coronal mass ejections (CMEs) that occurred on 2006 December 13 and 14 in NOAA 10930, using the Hinode/EIS observations. Each CME was accompanied by an EIT wave and coronal dimmings. Dopplergrams in the dimming regions are obtained from the spectra of seven EIS lines. The results show that strong outflows are visible in the dimming regions during the CME eruption at different heights from the lower transition region to the corona. It is found that the velocity is positively correlated with the photospheric magnetic field, as well as the magnitude of the dimming. We estimate the mass loss based on height-dependent EUV dimmings and find it to be smaller than the CME mass derived from white-light observations. The mass difference is attributed partly to the uncertain atmospheric model, and partly to the transition region outflows, which refill the coronal dimmings.

Effects of Energetic Ion Outflow on Magnetospheric Dynamics

Science.gov (United States)

Kistler, L. M.; Mouikis, C.; Lund, E. J.; Menz, A.; Nowrouzi, N.

2016-12-01

There are two dominant regions of energetic ion outflow: the nightside auroral region and the dayside cusp. Processes in these regions can accelerate ions up to keV energies. Outflow from the nightside has direct access to the plasma sheet, while outflow from the cusp is convected over the polar cap and into the lobes. The cusp population can enter the plasma sheet from the lobe, with higher energy ions entering further down the tail than lower energy ions. During storm times, the O+ enhanced plasma sheet population is convected into the inner magnetosphere. The plasma that does not get trapped in the inner magnetosphere convects to the magnetopause where reconnection is taking place. An enhanced O+ population can change the plasma mass density, which may have the effect of decreasing the reconnection rate. In addition O+ has a larger gyroradius than H+ at the same velocity or energy. Because of this, there are larger regions where the O+ is demagnetized, which can lead to larger acceleration because the O+ can move farther in the direction of the electric field. In this talk we will review results from Cluster, Van Allen Probes, and MMS, on how outflow from the two locations affects magnetospheric dynamics. We will discuss whether enhanced O+ from either population has an effect on the reconnection rate in the tail or at the magnetopause. We will discuss how the two populations impact the inner magnetosphere during storm times. And finally, we will discuss whether either population plays a role in triggering substorms, particularly during sawtooth events.

Primary pulmonary malignant melanoma: a clinicopathologic study of two cases.

Science.gov (United States)

Gong, Li; Liu, Xiao-Yan; Zhang, Wen-Dong; Zhu, Shao-Jun; Yao, Li; Han, Xiu-Juan; Lan, Miao; Li, Yan-Hong; Zhang, Wei

2012-09-19

Malignant melanoma involving the respiratory tract is nearly always metastatic in origin, and primary tumors are very rare. To our knowledge, about 30 cases have been reported in the English literature, one of which involved multiple brain metastases. Here, we report two cases of primary pulmonary malignant melanoma. The first case, which occurred in a 52-year-old Chinese female patient who died 4 months after the initial diagnosis, involved rapid intrapulmonary and intracranial metastases. The second patient, a 65-year-old female, underwent surgical excision, and clinical examination, histopathological characteristics, and immunohistochemical features supported the diagnosis of pulmonary malignant melanoma. No evidence for recurrence and/or metastasis has been found more than one year after the initial surgery. To establish the diagnosis of primary pulmonary malignant melanoma, any extrapulmonary origin must be excluded by detailed examination. Moreover, the tumor should be removed surgically whether it occurs as a single lesion or multiple lesions. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1480477335765055.

Primary pulmonary malignant melanoma: a clinicopathologic study of two cases

Directory of Open Access Journals (Sweden)

Gong Li

2012-09-01

Full Text Available Abstract Malignant melanoma involving the respiratory tract is nearly always metastatic in origin, and primary tumors are very rare. To our knowledge, about 30 cases have been reported in the English literature, one of which involved multiple brain metastases. Here, we report two cases of primary pulmonary malignant melanoma. The first case, which occurred in a 52-year-old Chinese female patient who died 4 months after the initial diagnosis, involved rapid intrapulmonary and intracranial metastases. The second patient, a 65-year-old female, underwent surgical excision, and clinical examination, histopathological characteristics, and immunohistochemical features supported the diagnosis of pulmonary malignant melanoma. No evidence for recurrence and/or metastasis has been found more than one year after the initial surgery. To establish the diagnosis of primary pulmonary malignant melanoma, any extrapulmonary origin must be excluded by detailed examination. Moreover, the tumor should be removed surgically whether it occurs as a single lesion or multiple lesions. Virtual slide The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1480477335765055.

Chronic pulmonary disease - a multifacted disease complex in the horse

International Nuclear Information System (INIS)

Clarke, A.F.

1987-01-01

This paper reviews chronic pulmonary disease (CPD) as an insidiously developing disease capable of being manifest in many degrees. Horses may suffer mild, sub-clinical degrees of lower respiratory tract inflammation or small airway disease withouth showing symptoms at rest. This form of disease becomes manifest as poor performance when these horses take part in athletic competition. Factors relating to the aetiology, diagnosis, treatment and prevention of all degrees of small airway disease of horses are discussed. 30 refs

A SYSTEMATIC SEARCH FOR MOLECULAR OUTFLOWS TOWARD CANDIDATE LOW-LUMINOSITY PROTOSTARS AND VERY LOW LUMINOSITY OBJECTS

Energy Technology Data Exchange (ETDEWEB)

Schwarz, Kamber R.; Shirley, Yancy L. [Steward Observatory, 933 N. Cherry Ave., Tucson, AZ 85721 (United States); Dunham, Michael M. [Department of Astronomy, Yale University, P.O. Box 208101, New Haven, CT 06520 (United States)

2012-10-01

We present a systematic single-dish search for molecular outflows toward a sample of nine candidate low-luminosity protostars and 30 candidate very low luminosity objects (VeLLOs; L{sub int} {<=} 0.1 L{sub Sun }). The sources are identified using data from the Spitzer Space Telescope cataloged by Dunham et al. toward nearby (D < 400 pc) star-forming regions. Each object was observed in {sup 12}CO and {sup 13}CO J = 2 {yields} 1 simultaneously using the sideband separating ALMA Band-6 prototype receiver on the Heinrich Hertz Telescope at 30'' resolution. Using five-point grid maps, we identify five new potential outflow candidates and make on-the-fly maps of the regions surrounding sources in the dense cores B59, L1148, L1228, and L1165. Of these new outflow candidates, only the map of B59 shows a candidate blue outflow lobe associated with a source in our survey. We also present larger and more sensitive maps of the previously detected L673-7 and the L1251-A-IRS4 outflows and analyze their properties in comparison to other outflows from VeLLOs. The accretion luminosities derived from the outflow properties of the VeLLOs with detected CO outflows are higher than the observed internal luminosity of the protostars, indicating that these sources likely had higher accretion rates in the past. The known L1251-A-IRS3 outflow is detected but not re-mapped. We do not detect clear, unconfused signatures of red and blue molecular wings toward the other 31 sources in the survey indicating that large-scale, distinct outflows are rare toward this sample of candidate protostars. Several potential outflows are confused with the kinematic structure in the surrounding core and cloud. Interferometric imaging is needed to disentangle large-scale molecular cloud kinematics from these potentially weak protostellar outflows.

A SYSTEMATIC SEARCH FOR MOLECULAR OUTFLOWS TOWARD CANDIDATE LOW-LUMINOSITY PROTOSTARS AND VERY LOW LUMINOSITY OBJECTS

International Nuclear Information System (INIS)

Schwarz, Kamber R.; Shirley, Yancy L.; Dunham, Michael M.

2012-01-01

We present a systematic single-dish search for molecular outflows toward a sample of nine candidate low-luminosity protostars and 30 candidate very low luminosity objects (VeLLOs; L int ≤ 0.1 L ☉ ). The sources are identified using data from the Spitzer Space Telescope cataloged by Dunham et al. toward nearby (D 12 CO and 13 CO J = 2 → 1 simultaneously using the sideband separating ALMA Band-6 prototype receiver on the Heinrich Hertz Telescope at 30'' resolution. Using five-point grid maps, we identify five new potential outflow candidates and make on-the-fly maps of the regions surrounding sources in the dense cores B59, L1148, L1228, and L1165. Of these new outflow candidates, only the map of B59 shows a candidate blue outflow lobe associated with a source in our survey. We also present larger and more sensitive maps of the previously detected L673-7 and the L1251-A-IRS4 outflows and analyze their properties in comparison to other outflows from VeLLOs. The accretion luminosities derived from the outflow properties of the VeLLOs with detected CO outflows are higher than the observed internal luminosity of the protostars, indicating that these sources likely had higher accretion rates in the past. The known L1251-A-IRS3 outflow is detected but not re-mapped. We do not detect clear, unconfused signatures of red and blue molecular wings toward the other 31 sources in the survey indicating that large-scale, distinct outflows are rare toward this sample of candidate protostars. Several potential outflows are confused with the kinematic structure in the surrounding core and cloud. Interferometric imaging is needed to disentangle large-scale molecular cloud kinematics from these potentially weak protostellar outflows.

Incision of the Jezero Crater Outflow Channel by Fluvial Sediment Transport

Science.gov (United States)

Holo, S.; Kite, E. S.

2017-12-01

Jezero crater, the top candidate landing site for the Mars 2020 rover, once possessed a lake that over-spilled and eroded a large outflow channel into the Eastern rim. The Western deltaic sediments that would be the primary science target of the rover record a history of lake level, which is modulated by the inflow and outflow channels. While formative discharges for the Western delta exist ( 500 m3/s), little work has been done to see if these flows are the same responsible for outflow channel incision. Other models of the Jezero outflow channel incision assume that a single rapid flood (incision timescales of weeks), with unknown initial hydraulic head and no discharge into the lake (e.g. from the inflow channels or the subsurface), incised an open channel with discharge modulated by flow over a weir. We present an alternate model where, due to an instability at the threshold of sediment motion, the incision of the outflow channel occurs in concert with lake filling. In particular, we assume a simplified lake-channel-valley system geometry and that the channel is hydraulically connected to the filling/draining crater lake. Bed load sediment transport and water discharge through the channel are quantified using the Meyer-Peter and Mueller relation and Manning's law respectively. Mass is conserved for both water and sediment as the lake level rises/falls and the channel incises. This model does not resolve backwater effects or concavity in the alluvial system, but it does capture the non-linear feedbacks between lake draining, erosion rate, channel flow rate, and slope relaxation. We identify controls on incision of the outflow channel and estimate the time scale of outflow channel formation through a simple dynamical model. We find that the observed 300m of channel erosion can be reproduced in decades to centuries of progressive bed load as the delta forming flows fill the lake. This corresponds to time scales on the order of or smaller than the time scale

Gadolinium labeled pharmaceuticals as potential MRI contrast agents for liver and biliary tract

International Nuclear Information System (INIS)

Najafi, A.; Amparo, E.G.; Johnson, R.F. Jr.

1987-01-01

Three gadolinium-labeled compounds, potential nuclear magnetic resonance (NMR) imaging contrast agents for liver and biliary tract, were studied: 1) Gd-DISIDA, 2) Gd-DTPA-Liposomes, and 3) Gd-DTPA dihexadecylamide (Gd-diamide). In each case, ''Carrier Added'' Gd-153 with specific activity of about 5uCi/mg was used. Each labeled compound was evaluated in experimental animals. Gd-DISIDA proved unsatisfactory because of in vivo instability. Gd-DTPA-Liposomes demonstrated strong toxic effects probably due to pulmonary embolism when large amounts of this compound was administered intravenously. Gd-diamide showed good uptake in the hepatocytes with subsequent excretion into the biliary tract. Several rabbits were imaged in a 0.6T NMR imaging system before and after injection of Gd-diamide. Pulse sequences were chosen that would yield T1-weighted images and permit calculation of T1 relaxation times. This compound produced significant shortening of the T1 relaxation times of the liver and observable increase in intensity on the T1-weighted images. Gd-diamide shows promise as potential NMR contrast agent for liver and biliary tract imaging. (author)

The HST-pNFL program: Mapping the Fluorescent Emission of Galactic Outflows

Science.gov (United States)

Heckman, Timothy

2017-08-01

Galactic outflows associated with star formation are believed to play a crucial role in the evolution of galaxies and the IGM. Most of our knowledge about outflows has come from down-the-barrel UV absorption spectroscopy of star-forming galaxies. However, absorption-line data alone provide only indirect information about the radial structure of the gas flows, which introduces large systematic uncertainties in some of the most important quantities, such as the outflow rate, the mass loading factor, and the momentum, metal, and energy fluxes. Recent spectroscopic observations of star-forming galaxies with large (projected physical) apertures have revealed non-resonant (fluorescent) emission in the UV, e.g., FeII* and SiII*, that can be naturally produced by spatially extended emission from the same outflowing material traced in absorption. Encouraged by the most recent observations of FeII* emission by the SDSS-IV/eBOSS survey (Zhu et al. 2015), we propose a pilot program to use narrow-band filter UVIS F280N images to map the extended FeII* 2626 and 2613 fluorescent emission in a carefully-chosen sample of 4 starburst galaxies at z=0.065, and COS G130M to obtain down-the- barrel spectra for SiII absorption and SiII* emission. This HST pilot program can provide unique information about the spatial structure of galactic outflows and can potentially lead to a revolution in our understanding of outflow physics and its impact on galaxies and the IGM.

Ionized Gas Outflows from the MAGNUM Survey: NGC 1365 and NGC 4945

Energy Technology Data Exchange (ETDEWEB)

Venturi, Giacomo; Marconi, Alessandro [Dipartimento di Fisica e Astronomia, Università degli Studi di Firenze, Sesto Fiorentino (Italy); Osservatorio Astrofisico di Arcetri (INAF), Firenze (Italy); Mingozzi, Matilde [Osservatorio Astrofisico di Arcetri (INAF), Firenze (Italy); Dipartimento di Fisica e Astronomia, Università di Bologna, Bologna (Italy); Carniani, Stefano [Cavendish Laboratory, Department of Physics, University of Cambridge, Cambridge (United Kingdom); Kavli Institute for Cosmology, University of Cambridge, Cambridge (United Kingdom); Cresci, Giovanni [Osservatorio Astrofisico di Arcetri (INAF), Firenze (Italy); Risaliti, Guido [Dipartimento di Fisica e Astronomia, Università degli Studi di Firenze, Sesto Fiorentino (Italy); Osservatorio Astrofisico di Arcetri (INAF), Firenze (Italy); Mannucci, Filippo, E-mail: gventuri@arcetri.astro.it [Osservatorio Astrofisico di Arcetri (INAF), Firenze (Italy)

2017-11-24

AGN feedback, acting through strong outflows accelerated in the nuclear region of AGN hosts, is invoked as a key ingredient for galaxy evolution by many models to explain the observed BH-galaxy scaling relations. Recently, some direct observational evidence of radiative mode feedback in action has been finally found in quasars at z >1.5. However, it is not possible to study outflows in quasars at those redshifts on small scales (≲100 pc), as spatial information is limited by angular resolution. This is instead feasible in nearby active galaxies, which are ideal laboratories to explore outflow structure and properties, as well as the effects of AGN on their host galaxies. In this proceeding we present preliminary results from the MAGNUM survey, which comprises nearby Seyfert galaxies observed with the integral field spectrograph VLT/MUSE. We focus on two sources, NGC 1365 and NGC 4945, that exhibit double conical outflows extending on distances >1 kpc. We disentangle the dominant contributions to ionization of the various gas components observed in the central ~5.3 kpc of NGC 1365. An attempt to infer outflow 3D structure in NGC 4945 is made via simple kinematic modeling, suggesting a hollow cone geometry.

Brain Circuitry Supporting Multi-Organ Autonomic Outflow in Response to Nausea.

Science.gov (United States)

Sclocco, Roberta; Kim, Jieun; Garcia, Ronald G; Sheehan, James D; Beissner, Florian; Bianchi, Anna M; Cerutti, Sergio; Kuo, Braden; Barbieri, Riccardo; Napadow, Vitaly

2016-02-01

While autonomic outflow is an important co-factor of nausea physiology, central control of this outflow is poorly understood. We evaluated sympathetic (skin conductance level) and cardiovagal (high-frequency heart rate variability) modulation, collected synchronously with functional MRI (fMRI) data during nauseogenic visual stimulation aimed to induce vection in susceptible individuals. Autonomic data guided analysis of neuroimaging data, using a stimulus-based (analysis windows set by visual stimulation protocol) and percept-based (windows set by subjects' ratings) approach. Increased sympathetic and decreased parasympathetic modulation was associated with robust and anti-correlated brain activity in response to nausea. Specifically, greater autonomic response was associated with reduced fMRI signal in brain regions such as the insula, suggesting an inhibitory relationship with premotor brainstem nuclei. Interestingly, some sympathetic/parasympathetic specificity was noted. Activity in default mode network and visual motion areas was anti-correlated with parasympathetic outflow at peak nausea. In contrast, lateral prefrontal cortical activity was anti-correlated with sympathetic outflow during recovery, soon after cessation of nauseogenic stimulation. These results suggest divergent central autonomic control for sympathetic and parasympathetic response to nausea. Autonomic outflow and the central autonomic network underlying ANS response to nausea may be an important determinant of overall nausea intensity and, ultimately, a potential therapeutic target. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Extreme Gaseous Outflows in Radio-Loud Narrow-Line Seyfert 1 Galaxies

Science.gov (United States)

Komossa, S.; Xu, D. W.; Wagner, A. Y.

2018-04-01

We present four radio-loud NLS1 galaxies with extreme emission-line shifts, indicating radial outflow velocities of the ionized gas of up to 2450 km/s, above the escape velocity of the host galaxies. The forbidden lines show strong broadening, up to 2270 km/s. An ionization stratification (higher line shift at higher ionization potential) implies that we see a large-scale outflow rather than single, localized jet-cloud interactions. Similarly, the paucity of zero-velocity [OIII]λ5007 emitting gas implies the absence of a second narrow-line region (NLR) component at rest, and therefore a large part of the high-ionization NLR is affected by the outflow. Given the radio loudness of these NLS1 galaxies, the observations are consistent with a pole on view onto their central engines, so that the effects of polar outflows are maximized. In addition, a very efficient driving mechanism is required, to reach the high observed velocities. We explore implications from recent hydrodynamic simulations of the interaction between fast winds or jets with the large-scale NLR. Overall, the best agreement with observations (and especially the high outflow speeds of the [NeV] emitting gas) can be reached if the NLS1 galaxies are relatively young sources with lifetimes not much exceeding 1 Myr. These systems represent sites of strong feedback at NLR scales at work, well below redshift one.

Radio Jets as Driving Mechanism of Fast Outflows: The HI View

NARCIS (Netherlands)

Morganti, Raffaella; Maccagni, Filippo; Oosterloo, Tom; Schulz, Robert; Santoro, Francesco

2017-01-01

The complex and multi-phase nature of gas outflows is one of the properties highlighted by the work in recent years on AGN-driven outflows. In particular, the cold gas is found to play a more important role than previously expected. Surprisingly, HI has been shown to be a good tracer of fast

Misalignment of outflow axes in the proto-multiple systems in Perseus

DEFF Research Database (Denmark)

Lee, Katherine I.; Dunham, Michael M.; Myers, Philip C.

2016-01-01

We investigate the alignment between outflow axes in nine of the youngest binary/multiple systems in the Perseus Molecular Cloud. These systems have typical member spacing larger than 1000 au. For outflow identification, we use 12CO(2-1) and 12CO(3-2) data from a large survey with the Submillimet...

An Unusual Left Ventricular Outflow Pseudoaneurysm: Usefulness of Echocardiography and Multidetector Computed Tomography for Surgical Repair

International Nuclear Information System (INIS)

Da Col, Uberto; Ramoni, Enrico; Di Bella, Isidoro; Ragni, Temistocle

2009-01-01

Left ventricular outflow tract (LVOT) pseudoaneurysm is a rare but potentially lethal complication, mainly after aortic root endocarditis or surgery. Usually it originates from a dehiscence in the mitral-aortic intervalvular fibrosa and it arises posteriorly to the aortic root. Due to these anatomical features, its imaging assessment is challenging and surgical repair requires complex procedures. An unusual case of LVOT pseudoaneurysm is described. It was detected by transthoracic ecocardiography 7 months after aortic root replacement for acute endocarditis. Multidetector computed tomography (MDCT) confirmed the presence of a pouch located between the aortic root and the right atrium. Computed tomography also detected the origin of the pseudoaneurysm from the muscular interventricular septum of the LVOT, rather below the aortic valve plane. It was repaired with an extracardiac surgical approach, sparing the aortic root bioprosthesis previously implanted. The high-resolution three-dimensional details provided by the preoperative MDCT allowed us to plan a simple and effective surgical strategy.

Magnetic Topology and Ion Outflow in Mars' Magnetotail

Science.gov (United States)

Mitchell, D. L.; Xu, S.; McFadden, J. P.; Hara, T.; Luhmann, J. G.; Mazelle, C. X.; Andersson, L.; DiBraccio, G. A.; Connerney, J. E. P.

2017-12-01

Planetary ion outflow down the Martian magnetotail could be an important atmospheric loss mechanism. This process depends on magnetic connectivity to the day-side ionosphere and on acceleration of ions to escape velocity. The Mars Atmosphere and Volatile Evolution (MAVEN) mission has obtained comprehensive ion, electron, and magnetic field data in Mars' magnetotail. The spacecraft is in a 75°-inclination, elliptical orbit that samples altitudes from 150 to 6200 km. As the orbit precesses, it sweeps through the tail at a variety of altitudes in this range. Data from the Solar Wind Electron Analyzer (SWEA) and Magnetometer (MAG) are used to determine the magnetic field topology in the tail at high cadence (every 2-4 seconds), and in particular whether field lines are open, closed, or draped, and if open whether they have access to the day-side or night-side ionosphere. Simultaneous observations by the Supra-Thermal and Thermal Ion Composition (STATIC) instrument and the Langmuir Probe and Waves (LPW) experiment are used to measure the density, composition, and velocity of planetary plasma on these field lines. We find that magnetic topology in the tail is complex and variable, and is influenced by the IMF polarity and the orientation of Mars' crustal magnetic fields with respect to the Sun. We find that planetary ion outflow occurs on both open and draped field lines. On open field lines, outflow tends to occur parallel to the field line, with colder, denser, and slower outflow on field lines connected to the day-side ionosphere (Fig. 1). On these same field lines (after correction for the spacecraft potential) a shift in the position of the He-II photoelectron feature indicates a 1-Volt parallel electric potential directed away from the planet. Except for H+ and occasionally O+, this potential is insufficient by itself to accelerate planetary ions to escape velocity. Outflow is warmer, less dense, and faster moving on draped field lines. In this case, the ion bulk

Quantitation of uveoscleral outflow in normotensive and glaucomatous Beagles by 3H-labeled dextran

International Nuclear Information System (INIS)

Barrie, K.P.; Gum, G.G.; Samuelson, D.A.; Gelatt, K.N.

1985-01-01

In uveoscleral outflow, aqueous humor leaves the anterior chamber and passes caudally through the trabecular meshwork and the sclerociliary cleft to enter the supraciliary and suprachoroidal spaces. The fluid is then absorbed by choroidal and scleral circulations. Using 3 H-labeled dextran, uveoscleral outflow was quantitated in normotensive and glaucomatous Beagles under general anesthesia. The intrascleral plexus was isolated and 3 H-labeled dextran was injected into the anterior chamber. Intrascleral plexus contents were sampled every 5 minutes over a 30- to 60-minute period. The eyes were enucleated, sectioned, and prepared for scintillation counting. Uveoscleral outflow accounted for 15% and 3% of the total aqueous humor outflow in the normotensive dogs and in the advanced glaucomatous dogs, respectively. In the advanced glaucomatous Beagle, conventional and uveoscleral outflow pathways were reduced and contributed to the etiopathogenesis of glaucoma

Ultrafast outflows disappear in high-radiation fields

Science.gov (United States)

Pinto, C.; Alston, W.; Parker, M. L.; Fabian, A. C.; Gallo, L. C.; Buisson, D. J. K.; Walton, D. J.; Kara, E.; Jiang, J.; Lohfink, A.; Reynolds, C. S.

2018-05-01

Ultrafast outflows (UFOs) are the most extreme winds launched by active galactic nuclei (AGN) due to their mildly relativistic speeds (˜0.1-0.3c) and are thought to significantly contribute to galactic evolution via AGN feedback. Their nature and launching mechanism are however not well understood. Recently, we have discovered the presence of a variable UFO in the narrow-line Seyfert 1 IRAS 13224-3809. The UFO varies in response to the brightness of the source. In this work we perform flux-resolved X-ray spectroscopy to study the variability of the UFO and found that the ionization parameter is correlated with the luminosity. In the brightest states the gas is almost completely ionized by the powerful radiation field and the UFO is hardly detected. This agrees with our recent results obtained with principal component analysis. We might have found the tip of the iceberg: the high ionization of the outflowing gas may explain why it is commonly difficult to detect UFOs in AGN and possibly suggest that we may underestimate their actual feedback. We have also found a tentative correlation between the outflow velocity and the luminosity, which is expected from theoretical predictions of radiation-pressure-driven winds. This trend is rather marginal due to the Fe XXV-XXVI degeneracy. Further work is needed to break such degeneracy through time-resolved spectroscopy.

DISCOVERY OF AN EXTREMELY WIDE-ANGLE BIPOLAR OUTFLOW IN AFGL 5142

Energy Technology Data Exchange (ETDEWEB)

Liu, Tie; Kim, Kee-Tae; Lee, Chang-Won; Cho, Se-Hyung [Korea Astronomy and Space Science Institute 776, Daedeokdae-ro, Yuseong-gu, Daejeon, 305-348 (Korea, Republic of); Zhang, Qizhou [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States); Wu, Yuefang [Department of Astronomy, Peking University, Beijing 100871 (China); Goldsmith, Paul F. [Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, CA 91109 (United States); Li, Di [National Astronomical Observatories, Chinese Academy of Science, A20 Datun Road, Chaoyang District, Beijing 100012 (China); Liu, Sheng-Yuan; Chen, Huei-Ru [Institute of Astronomy and Astrophysics, Academia Sinica, Taipei, Taiwan (China); Tatematsu, Ken’ichi [National Astronomical Observatory of Japan, 2-21-1 Osawa, Mitaka, Tokyo 181-8588 (Japan); Wang, Ke [European Southern Observatory, Karl-Schwarzschild-Str. 2, D-85748 Garching bei München (Germany); Lee, Jeong-Eun [School of Space Research, Kyung Hee University, Yongin-Si, Gyeonggi-Do 446-701 (Korea, Republic of); Qin, Sheng-Li [Department of Astronomy, Yunnan University, and Key Laboratory of Astroparticle Physics of Yunnan Province, Kunming 650091 (China); Mardones, Diego, E-mail: liutiepku@gmail.com [Departamento de Astronomía, Universidad de Chile, Casilla 36-D, Santiago (Chile)

2016-06-10

Most bipolar outflows are associated with individual young stellar objects and have small opening angles. Here we report the discovery of an extremely wide-angle (∼180°) bipolar outflow (“EWBO”) in a cluster forming region AFGL 5142 from low-velocity emission of the HCN (3–2) and HCO{sup +} (3–2) lines. This bipolar outflow is along a north-west to south-east direction with a line of sight flow velocity of about 3 km s{sup −1} and is spatially connected to the high-velocity jet-like outflows. It seems to be a collection of low-velocity material entrained by the high-velocity outflows due to momentum feedback. The total ejected mass and mass loss rate due to both high-velocity jet-like outflows and the “EWBO” are ∼24.5 M {sub ⊙} and ∼1.7 × 10{sup −3} M {sub ⊙} yr{sup −1}, respectively. Global collapse of the clump is revealed by the “blue profile” in the HCO{sup +} (1–0) line. A hierarchical network of filaments was identified in NH{sub 3} (1, 1) emission. Clear velocity gradients of the order of 10 km s{sup −1} pc{sup −1} are found along filaments, indicating gas inflow along the filaments. The sum of the accretion rate along filaments and mass infall rate along the line of sight is ∼3.1 × 10{sup −3} M {sub ⊙} yr{sup −1}, which exceeds the total mass loss rate, indicating that the central cluster is probably still gaining mass. The central cluster is highly fragmented and 22 condensations are identified in 1.1 mm continuum emission. The fragmentation process seems to be determined by thermal pressure and turbulence. The magnetic field may not play an important role in fragmentation.

Champagne flutes and brandy snifters: modelling protostellar outflow-cloud chemical interfaces

Science.gov (United States)

Rollins, R. P.; Rawlings, J. M. C.; Williams, D. A.; Redman, M. P.

2014-10-01

A rich variety of molecular species has now been observed towards hot cores in star-forming regions and in the interstellar medium. An increasing body of evidence from millimetre interferometers suggests that many of these form at the interfaces between protostellar outflows and their natal molecular clouds. However, current models have remained unable to explain the origin of the observational bias towards wide-angled `brandy snifter' shaped outflows over narrower `champagne flute' shapes in carbon monoxide imaging. Furthermore, these wide-angled systems exhibit unusually high abundances of the molecular ion HCO+. We present results from a chemodynamic model of such regions where a rich chemistry arises naturally as a result of turbulent mixing between cold, dense molecular gas and the hot, ionized outflow material. The injecta drives a rich and rapid ion-neutral chemistry in qualitative and quantitative agreement with the observations. The observational bias towards wide-angled outflows is explained naturally by the geometry-dependent ion injection rate causing rapid dissociation of CO in the younger systems.

A young bipolar outflow from IRAS 15398-3359

DEFF Research Database (Denmark)

Bjerkeli, Per; Jørgensen, Jes Kristian; Brinch, Christian

2016-01-01

emission towards IRAS 15398-3359. The lineradiative transfer code LIME is used to construct a full 3D model of thesystem taking all relevant components and scales into account. Results: CO, HCO+, and N2H+ aredetected and shown to trace the motions of the outflow. For CO, thecircumstellar envelope...... and the surrounding cloud also have a profoundimpact on the observed line profiles. N2H+ isdetected in the outflow, but is suppressed towards the central region,perhaps because of the competing reaction between CO andH3+ in the densest regions as well as thedestruction of N2H+ by CO.N2D+ is detected in a ridge south...

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.

X-ray evidence for ultra-fast outflows in AGNs

Science.gov (United States)

Tombesi, Francesco; Sambruna, Rita; Braito, Valentina; Reeves, James; Reynolds, Christopher; Cappi, Massimo

2012-07-01

X-ray evidence for massive, highly ionized, ultra-fast outflows (UFOs) has been recently reported in a number of AGNs through the detection of blue-shifted Fe XXV/XXVI absorption lines. We present the results of a comprehensive spectral analysis of a large sample of 42 local Seyferts and 5 radio galaxies observed with XMM-Newton and Suzaku. We assessed the global detection significance of the absorption lines and performed a detailed photo-ionization modeling. We find that UFOs are common phenomena, being present in >40% of the sources. Their outflow velocity distribution is in the range ˜0.03--0.3c, with mean value of ˜0.14c. The ionization parameter is very high, in the range logξ˜3--6 erg~s^{-1}~cm, and the associated column densities are also large, in the range ˜10^{22}--10^{24} cm^{-2}. Their location is constrained at ˜0.0003--0.03pc (˜10^2--10^4 r_s) from the central black hole, consistent with what is expected for accretion disk winds/outflows. The mass outflow rates are in the interval ˜0.01--1M_{⊙}~yr^{-1} and the associated mechanical power is high, in the range ˜10^{43}--10^{45} erg/s. Therefore, UFOs are capable to provide a significant contribution to the AGN cosmological feedback and their study can provide important clues on the connection between accretion disks, winds and jets.

Clinical use of ultrashort-lived radionuclide krypton-81m for noninvasive analysis of right ventricular performance in normal subjects and patients with right ventricular dysfunction

International Nuclear Information System (INIS)

Nienaber, C.A.; Spielmann, R.P.; Wasmus, G.; Mathey, D.G.; Montz, R.; Bleifeld, W.H.

1985-01-01

The ultrashort-lived radionuclide krypton-81m, eluted in 5% dextrose from a bedside rubidium-81m generator, was intravenously infused for rapid imaging of the right-sided heart chambers in the right anterior oblique projection adjusted for optimal right atrioventricular separation. Left-sided heart and lung background was minimized by rapid decay and efficient exhalation of krypton-81m, requiring no algorithm for background correction. A double region of interest method decreased the variability in the assessment of ejection fraction to 5%. In 10 normal subjects, 11 patients with pulmonary hypertension, 4 patients with right ventricular outflow tract obstruction and 4 patients with right ventricular infarction, right ventricular ejection fraction determined by krypton-81m equilibrium blood pool imaging ranged from 14 to 76%. The correlation between these values and those determined by cineangiography according to Simpson's rule was close: r . 0.93 for all data points, r . 0.92 for studies at rest and r . 0.93 for exercise studies. Exercise-related changes in right ventricular function revealed a disturbed functional reserve with pulmonary hypertension and right ventricular infarction, whereas in compensated right ventricular outflow tract obstruction there was a physiologic increase in ejection fraction with exercise. Thus, equilibrium-gated right ventricular imaging using ultrashort-lived krypton-81m is a simple, accurate and reproducible method with potential for serial assessment of right ventricular ejection fraction in a variety of right ventricular anatomic and functional abnormalities, both at rest and during exercise. Advantages of this method include an extremely low radiation dose to patients and clear right atrioventricular separation without the need to correct for background activity

Financial Crisis, Capital Outflows, and Policy Responses: Examples from East Asia

Science.gov (United States)

Rajan, Ramkishen S.

2007-01-01

Financial crises seem to have become the norm rather than the exception since 1992. The author examines the impact of a crisis of confidence and resultant capital outflows from a small and open economy and the possible policy options in response to such outflows, using simple tools and definitions that will be familiar to any money and banking or…

THE SINS/zC-SINF SURVEY of z {approx} 2 GALAXY KINEMATICS: OUTFLOW PROPERTIES

Energy Technology Data Exchange (ETDEWEB)

Newman, Sarah F.; Genzel, Reinhard [Department of Astronomy, Campbell Hall, University of California, Berkeley, CA 94720 (United States); Foerster-Schreiber, Natascha M.; Buschkamp, Peter; Davies, Ric; Eisenhauer, Frank; Kurk, Jaron; Lutz, Dieter [Max-Planck-Institut fuer extraterrestrische Physik (MPE), Giessenbachstr.1, D-85748 Garching (Germany); Griffin, Kristen Shapiro [Space Sciences Research Group, Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 (United States); Mancini, Chiara; Renzini, Alvio [Osservatorio Astronomico di Padova, Vicolo dellOsservatorio 5, Padova, I-35122 (Italy); Lilly, Simon J.; Carollo, C. Marcella; Peng, Yingjie [Institute of Astronomy, Department of Physics, Eidgenoessische Technische Hochschule, ETH Zuerich, CH-8093 (Switzerland); Bouche, Nicolas [Institut de Recherche en Astrophysique et Planetologie (IRAP), Universite de Toulouse, UPS-OMP, IRAP, 14, avenue Edouard Berlin, F-31400 Toulouse (France); Burkert, Andreas [Department fuer Physik, Universitaets-Sternwarte Ludwig-Maximilians-Universitaet (USM), Scheinerstr. 1, Muenchen, D-81679 (Germany); Cresci, Giovanni [Istituto Nazionale di AstrofisicaOsservatorio Astronomico di Arcetri, Largo Enrico Fermi 5, I-50125 Firenze (Italy); Genel, Shy [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States); Hicks, Erin K. S. [Department of Astronomy, University of Washington, Box 351580, U.W., Seattle, WA 98195-1580 (United States); Naab, Thorsten, E-mail: sfnewman@berkeley.edu [Max-Planck Institute for Astrophysics, Karl Schwarzschildstrasse 1, D-85748 Garching (Germany); and others

2012-12-10

Using SINFONI H{alpha}, [N II], and [S II] AO data of 27 z {approx} 2 star-forming galaxies (SFGs) from the SINS and zC-SINF surveys, we explore the dependence of outflow strength (via the broad flux fraction) on various galaxy parameters. For galaxies that have evidence for strong outflows, we find that the broad emission is spatially extended to at least the half-light radius ({approx}a few kpc). Decomposition of the [S II] doublet into broad and narrow components suggests that this outflowing gas probably has a density of {approx}10-100 cm{sup -3}, less than that of the star-forming gas (600 cm{sup -3}). There is a strong correlation of the H{alpha} broad flux fraction with the star formation surface density of the galaxy, with an apparent threshold for strong outflows occurring at 1 M{sub Sun} yr{sup -1} kpc{sup -2}. Above this threshold, we find that SFGs with log m{sub *} > 10 have similar or perhaps greater wind mass-loading factors ({eta} = M-dot{sub out}/SFR) and faster outflow velocities than lower mass SFGs, suggesting that the majority of outflowing gas at z {approx} 2 may derive from high-mass SFGs. The mass-loading factor is also correlated with the star formation rate (SFR), galaxy size, and inclination, such that smaller, more star-forming, and face-on galaxies launch more powerful outflows. We propose that the observed threshold for strong outflows and the observed mass loading of these winds can be explained by a simple model wherein break-out of winds is governed by pressure balance in the disk.

Delayed or No Feedback? Gas Outflows in Type 2 AGNs. III

Energy Technology Data Exchange (ETDEWEB)

Woo, Jong-Hak; Son, Donghoon; Bae, Hyun-Jin, E-mail: woo@astro.snu.ac.kr, E-mail: hjbae@galaxy.yonsei.ac.kr [Astronomy Program, Department of Physics and Astronomy, Seoul National University, Seoul 151-742 (Korea, Republic of)

2017-04-20

We present gas kinematics based on the [O iii] λ 5007 line and their connection to galaxy gravitational potential, active galactic nucleus (AGN) energetics, and star formation, using a large sample of ∼110,000 AGNs and star-forming (SF) galaxies at z < 0.3. Gas and stellar velocity dispersions are comparable to each other in SF galaxies, indicating that the ionized gas kinematics can be accounted by the gravitational potential of host galaxies. In contrast, AGNs clearly show non-gravitational kinematics, which is comparable to or stronger than the virial motion caused by the gravitational potential. The [O iii] velocity–velocity dispersion (VVD) diagram dramatically expands toward high values as a function of AGN luminosity, implying that the outflows are AGN-driven, while SF galaxies do not show such a trend. We find that the fraction of AGNs with a signature of outflow kinematics, steeply increases with AGN luminosity and Eddington ratio. In particular, the majority of luminous AGNs presents strong non-gravitational kinematics in the [O iii] profile. AGNs with strong outflow signatures show on average similar specific star formation rates (sSFRs) to those of star-forming galaxies. In contrast, AGNs with weak or no outflows have an order of magnitude lower sSFRs, suggesting that AGNs with current strong outflows do now show any negative AGN feedback and that it may take dynamical time to impact on star formation over galactic scales.

Evidence for ultrafast outflows in radio-quiet AGNs - III. Location and energetics

Science.gov (United States)

Tombesi, F.; Cappi, M.; Reeves, J. N.; Braito, V.

2012-05-01

Using the results of a previous X-ray photoionization modelling of blueshifted Fe K absorption lines on a sample of 42 local radio-quiet AGNs observed with XMM-Newton, in this Letter we estimate the location and energetics of the associated ultrafast outflows (UFOs). Due to significant uncertainties, we are essentially able to place only lower/upper limits. On average, their location is in the interval ˜0.0003-0.03 pc (˜ 102-104rs) from the central black hole, consistent with what is expected for accretion disc winds/outflows. The mass outflow rates are constrained between ˜0.01 and 1 M⊙ yr-1, corresponding to >rsim5-10 per cent of the accretion rates. The average lower/upper limits on the mechanical power are log? 42.6-44.6 erg s-1. However, the minimum possible value of the ratio between the mechanical power and bolometric luminosity is constrained to be comparable or higher than the minimum required by simulations of feedback induced by winds/outflows. Therefore, this work demonstrates that UFOs are indeed capable to provide a significant contribution to the AGN cosmological feedback, in agreement with theoretical expectations and the recent observation of interactions between AGN outflows and the interstellar medium in several Seyfert galaxies.

Ionized Gas Outflows from the MAGNUM Survey: NGC 1365 and NGC 4945

Directory of Open Access Journals (Sweden)

Giacomo Venturi

2017-11-01

Full Text Available AGN feedback, acting through strong outflows accelerated in the nuclear region of AGN hosts, is invoked as a key ingredient for galaxy evolution by many models to explain the observed BH-galaxy scaling relations. Recently, some direct observational evidence of radiative mode feedback in action has been finally found in quasars at z >1.5. However, it is not possible to study outflows in quasars at those redshifts on small scales (≲100 pc, as spatial information is limited by angular resolution. This is instead feasible in nearby active galaxies, which are ideal laboratories to explore outflow structure and properties, as well as the effects of AGN on their host galaxies. In this proceeding we present preliminary results from the MAGNUM survey, which comprises nearby Seyfert galaxies observed with the integral field spectrograph VLT/MUSE. We focus on two sources, NGC 1365 and NGC 4945, that exhibit double conical outflows extending on distances >1 kpc. We disentangle the dominant contributions to ionization of the various gas components observed in the central ~5.3 kpc of NGC 1365. An attempt to infer outflow 3D structure in NGC 4945 is made via simple kinematic modeling, suggesting a hollow cone geometry.

Diagnostic imaging of digestive tract involvement in cystic fibrosis. Part 2: pancreatic and gastrointestinal disease

International Nuclear Information System (INIS)

Berrocal, T.; Prieto, C.; Miralles, M.; Pozo, G. del; Martinez, A.; Manzanares, J.

1998-01-01

Cystic fibrosis (CF) is the most common fatal, autosomal recessive disease among the white population. Although recurrent pulmonary infections and pulmonary insufficiency are the major causes of morbidity and mortality, gastrointestinal symptoms generally present earlier and may suggest the diagnosis in the newborn or even prior to birth. The changes are attributed to the secretion of an abnormally thick mucous into the intestinal lumen, leading to the hallmark of diseases of the digestive tract: obstruction. This can be detected at birth in the form of mecanium ileus, ileal atresia, mecanium peritonitis and mecomiun plug, or present later on in childhood and adolescence as distal bowel obstruction syndrome or fibrosing colonopathy. This thick mucous can also trigger intussusception or acute appendicitis. Pancreatic insufficiency or pancreatic enzyme replacement therapy is the direct cause of most of these disorders. Plain radiography is of the utmost utility in assessing the digestive tract in CF. When the disease is detected in a newborn, the recommended approach is to perform plain abdominal X-ray, followed by barium enema, always accompanied by ultrasound. In older children and adolescents, enema and ultrasound are usually sufficient, although computed tomography and magnetic resonance may sometimes be necessary. (Author) 52 refs

Fast Molecular Outflows in Luminous Galaxy Mergers: Evidence for Quasar Feedback from Herschel

Science.gov (United States)

Veilleux, S.; Melendez, M.; Sturm, E.; Garcia-Carpio, J.; Fischer, J.; Gonzalez-Alfonso, E.; Contursi, A.; Lutz, D.; Poglitsch, A.; Davies, R.;

The dependence of galactic outflows on the properties and orientation of zCOSMOS galaxies at z ∼ 1

International Nuclear Information System (INIS)

Bordoloi, R.; Lilly, S. J.; Hardmeier, E.; Carollo, C. M.; Contini, T.; Kneib, J.-P.; Fevre, O. Le; Garilli, B.; Mainieri, V.; Renzini, A.; Scodeggio, M.; Zamorani, G.; Bardelli, S.; Bolzonella, M.; Bongiorno, A.; Caputi, K.; Cucciati, O.; De la Torre, S.; De Ravel, L.; Iovino, A.

2014-01-01

We present an analysis of cool outflowing gas around galaxies, traced by Mg II absorption lines in the coadded spectra of a sample of 486 zCOSMOS galaxies at 1 ≤ z ≤ 1.5. These galaxies span a range of stellar masses (9.45 ≤ log 10 [M * /M ☉ ] ≤ 10.7) and star formation rates (0.14 ≤ log 10 [SFR/M ☉ yr –1 ] ≤ 2.35). We identify the cool outflowing component in the Mg II absorption and find that the equivalent width of the outflowing component increases with stellar mass. The outflow equivalent width also increases steadily with the increasing star formation rate of the galaxies. At similar stellar masses, the blue galaxies exhibit a significantly higher outflow equivalent width as compared to red galaxies. The outflow equivalent width shows strong correlation with the star formation surface density (Σ SFR ) of the sample. For the disk galaxies, the outflow equivalent width is higher for the face-on systems as compared to the edge-on ones, indicating that for the disk galaxies, the outflowing gas is primarily bipolar in geometry. Galaxies typically exhibit outflow velocities ranging from –150 km s –1 ∼–200 km s –1 and, on average, the face-on galaxies exhibit higher outflow velocity as compared to the edge-on ones. Galaxies with irregular morphologies exhibit outflow equivalent width as well as outflow velocities comparable to face on disk galaxies. These galaxies exhibit mass outflow rates >5-7 M ☉ yr –1 and a mass loading factor (η = M-dot out /SFR) comparable to the star formation rates of the galaxies.

FEATURES OF OUTFLOW OF INTRAOCULAR LIQUID AFTER AN EKSIMERLAZER SKLEREKTOMY (PILOT STUDY

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E. A. Korchuganova

2017-01-01

Full Text Available Modern approaches to surgical glaucoma treatment is based on the safe and effective methods. In recent years, great attention is paid to the techniques of stimulating uveoscleral path outtake aqueous humor from the eye. Uveoscleral space in the extended outflow pathways is dominant and constitutes about 72%. Sclera is a field of the greatest interest, as the end stages of the outflow of aqueous humor via the uveoscleral path. The aim of the study was to investigate the influence of excimer laser sclerectomy on the drainage function of the eye and development of a mathematical model based on the permeability of the sclera of the amount of laser ablation at a defined area of laser exposure and the level of IOP. Studies were conducted on 12 human cadaver eyes isolated person. The domestic excimer laser “MicroScan Vizum” with a wavelength of 193нм (0,193 µm was used for the thinning of sclera. In the experiment used a special computer program provided ablation of scleral tissue, the scleral bed forming a rectangular shape with a size 7,0x5,0 mm. the Depth of influence started from 100 microns to 600 microns in increments of 50 µn. The exposure was carried out at a constant perfusion pressure of 25 mm Hg After each impact was measured of the coefficient ease the outflow. A correlation was established between the factor and effective features, i.e., between the excimer laser deep sclerectomy (µm and ratio of lightness outflow (mm3/min/mm Hg.St. Thinning of the sclera leads to an improvement of its permeability and increasing the coefficient ease the outflow. A mathematical model, allowing to achieve the desired ratio of lightness outflow experiment by excimer laser sclerectomy was developed. The mathematical model has the form of the regression equation.The sclera is a promising object for further developments in the surgical treatment of glaucoma. Laser ablation of the sclera leads to an improvement of outflow via the uveoscleral path and

Hypertrophic Cardiomyopathy After a Single Dose of Dexamethasone in a Preterm Infant

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Yusuf Kale

2015-08-01

Full Text Available Dexamethasone is widely used in preterm infants with severe pulmonary disease. Hypertrophic cardiomyopathy (HCM is a transient side effect observed after multiple doses of dexamethasone. We report a preterm infant with myocardial hypertrophy after a single dose of dexamethasone (0.5 mg/kg used to treat laryngeal edema secondary to prolonged intubation. A benign course was observed without left ventricular outflow tract obstruction and with recovery within 4 weeks. Myocardial effects of dexamethasone may be independent of dose and duration of treatment. The risk/benefit ratio must be carefully considered before using even a single dose of dexamethasone in preterm infants.

The Gaseous Environments of Quasars: Outflows, Feedback & Cold Mode Accretion

Science.gov (United States)

Chen, Chen; Hamann, Fred

2018-06-01

The early stages of massive galaxy evolution can involve galaxy-scale outflows driven by a starburst or a central quasar and cold-mode accretion (infall) that adds to the mass buildup in the galaxies. I will describe three related studies that use quasar absorption lines to measure outflows, infall, and the general gaseous environments of quasars across a range of spatial scales. The three studies are: 1) High-resolution spectroscopy with Keck-HIRES and VLT-UVES to study associated absorption lines (AALs) that have redshifts greater than the emission redshifts indicating infall and/or rich multi-component AAL complexes that might be interstellar clouds in the host galaxies that have been shredded and dispersed by a fast unseen quasar-driven wind. The data provide strong constraints on the gas kinematics, spatial structure, column densities, metallicities, and energetics. 2) A complete inventory of high-velocity CIV 1548,1550 mini-BAL outflows in quasars using high-resolution high signal-to-noise spectra in the public VLT-UVES and Keck-HIRES archives. This sensitive mini-BAL survey fills an important niche between previous work on narrow absorption lines (NALs) and the much-studied broad absorption lines (BALs) to build a more complete picture of quasar outflows. I will report of the mini-BAL statistics, the diversity of lines detected, and some tests for correlations with the quasar properties. We find, for example, that mini-BALs at v > 4000 km/s in at least 10% of 511 quasars studied, including 1% at v > 0.1 c. Finally, 3) Use the much larger database of NALs measured in 262,449 BOSS quasars by York et al. (in prep.) to study their potential relationships to the quasars and, specifically, their origins in quasar outflows. This involves primarily comparisons of the incidence and properties of NALs at different velocity shifts to other measured properties of the quasars such as BAL outflows, emission line characteristics, radio-loudness, and red colors. We find

Statistics of high-altitude and high-latitude O+ ion outflows observed by Cluster/CIS

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A. Korth

2005-07-01

Full Text Available The persistent outflows of O+ ions observed by the Cluster CIS/CODIF instrument were studied statistically in the high-altitude (from 3 up to 11 RE and high-latitude (from 70 to ~90 deg invariant latitude, ILAT polar region. The principal results are: (1 Outflowing O+ ions with more than 1keV are observed above 10 RE geocentric distance and above 85deg ILAT location; (2 at 6-8 RE geocentric distance, the latitudinal distribution of O+ ion outflow is consistent with velocity filter dispersion from a source equatorward and below the spacecraft (e.g. the cusp/cleft; (3 however, at 8-12 RE geocentric distance the distribution of O+ outflows cannot be explained by velocity filter only. The results suggest that additional energization or acceleration processes for outflowing O+ ions occur at high altitudes and high latitudes in the dayside polar region. Keywords. Magnetospheric physics (Magnetospheric configuration and dynamics, Solar wind-magnetosphere interactions

The effect of outflowing water coolant with supercritical parameters on a barrier

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Alekseev Maksim

2017-01-01

Full Text Available The outflow of supercritical coolant with different initial parameters and its impact on the barrier have been numerically simulated. Spatial and axial distributions of pressure and steam quality are presented. The force acting on the barrier at different parameters of the outflow has been calculated.

Quenching star formation with quasar outflows launched by trapped IR radiation

Science.gov (United States)

Costa, Tiago; Rosdahl, Joakim; Sijacki, Debora; Haehnelt, Martin G.

2018-06-01

We present cosmological radiation-hydrodynamic simulations, performed with the code RAMSES-RT, of radiatively-driven outflows in a massive quasar host halo at z = 6. Our simulations include both single- and multi-scattered radiation pressure on dust from a quasar and are compared against simulations performed with thermal feedback. For radiation pressure-driving, we show that there is a critical quasar luminosity above which a galactic outflow is launched, set by the equilibrium of gravitational and radiation forces. While this critical luminosity is unrealistically high in the single-scattering limit for plausible black hole masses, it is in line with a ≈ 3 × 10^9 M_⊙ black hole accreting at its Eddington limit, if infrared (IR) multi-scattering radiation pressure is included. The outflows are fast (v ≳ 1000 km s^{-1}) and strongly mass-loaded with peak mass outflow rates ≈ 10^3 - 10^4 M_⊙ yr^{-1}, but short-lived (star formation in the bulge. We hence argue that radiation pressure-driven feedback may be an important ingredient in regulating star formation in compact starbursts, especially during the quasar's `obscured' phase.

Long-Term Results of Stent Placement in Patients with Outflow Block After Living-Donor-Liver Transplantation

Energy Technology Data Exchange (ETDEWEB)

Fujimori, Masashi, E-mail: fujimorim@clin.medic.mie-u.ac.jp [Mie University School of Medicine, Department of Radiology (Japan); Yamakado, Koichiro, E-mail: yamakado47@gmail.com; Takaki, Haruyuki, E-mail: takaki-h@clin.medic.mie-u.ac.jp [Hyogo College of Medicine, Department of Radiology (Japan); Nakatsuka, Atsuhiro, E-mail: nakatuka@clin.medic.mie-u.ac.jp; Uraki, Junji, E-mail: junji@clin.medic.mie-u.ac.jp; Yamanaka, Takashi, E-mail: t-yama@clin.medic.mie-u.ac.jp; Hasegawa, Takaaki, E-mail: hasegawat@clin.medic.mie-u.ac.jp; Sugino, Yuichi, E-mail: ysugino23@clin.medic.mie-u.ac.jp; Nakajima, Ken, E-mail: k-nakajima@clin.medic.mie-u.ac.jp; Matsushita, Naritaka, E-mail: n-matsushita@clin.medic.mie-u.ac.jp [Mie University School of Medicine, Department of Radiology (Japan); Mizuno, Shugo, E-mail: mizunos@clin.medic.mie-u.ac.jp [Mie University School of Medicine, Hepatobiliary Pancreatic and Transplant Surgery (Japan); Sakuma, Hajime, E-mail: sakuma.mie@gmail.com [Mie University School of Medicine, Department of Radiology (Japan); Isaji, Shuji, E-mail: isaji-s@clin.medic.mie-u.ac.jp [Mie University School of Medicine, Hepatobiliary Pancreatic and Transplant Surgery (Japan)

2016-04-15

PurposeTo evaluate long-term results of stent placement retrospectively in patients with outflow block after living-donor-liver transplantation (LDLT).Materials and MethodsFor this institutional review board approved retrospective study conducted during 2002–2012, stents were placed in outflow veins in 15 patients (11.3 %, 15/133) (12 men; 3 female) in whom outflow block developed after LDLT. Their mean age was 52.3 years ± 15.3 (SD) (range, 4–69 years). Venous stenosis with a pressure gradient ≥5 mmHg (outflow block) was observed in the inferior vena cava in seven patients, hepatic vein in seven patients, and both in one patient. Technical success, change in a pressure gradient and clinical manifestations, and complications were evaluated. Overall survival of 15 patients undergoing outflow block stenting was compared with that of 116 patients without outflow block after LDLT.ResultsStents were placed across the outflow block veins without complications, lowering the pressure gradient ≤ 3 mmHg in all patients (100 %, 15/15). Clinical manifestations improved in 11 patients (73.3 %, 11/15), and all were discharged from the hospital. However, they did not improve in the other 4 patients (26.7 %, 4/15) who died in the hospital 1.0–3.7 months after stenting (mean, 2.0 ± 1.2 months). No significant difference in 5-year survival rates was found between patients with and without outflow block after LDLT (61.1 vs. 72.2 %, p = .405).ConclusionStenting is a feasible, safe, and useful therapeutic option to resolve outflow block following LDLT, providing equal survival to that of patients without outflow block.

CLUSTERED STAR FORMATION AND OUTFLOWS IN AFGL 2591

International Nuclear Information System (INIS)

Sanna, A.; Carrasco-González, C.; Menten, K. M.; Brunthaler, A.; Reid, M. J.; Moscadelli, L.; Rygl, K. L. J.

2012-01-01

We report on a detailed study of the water maser kinematics and radio continuum emission toward the most massive and young object in the star-forming region AFGL 2591. Our analysis shows at least two spatial scales of multiple star formation, one projected across 0.1 pc on the sky and another one at about 2000 AU from a ZAMS star of about 38 M ☉ . This young stellar object drives a powerful jet- and wind-driven outflow system with the water masers associated to the outflow walls, previously detected as a limb-brightened cavity in the NIR band. At about 1300 AU to the north of this object a younger protostar drives two bow shocks, outlined by arc-like water maser emission, at 200 AU either side of the source. We have traced the velocity profile of the gas that expands along these arc-like maser structures and compared it with the jet-driven outflow model. This analysis suggests that the ambient medium around the northern protostar is swept up by a jet-driven shock (>66 km s –1 ) and perhaps a lower-velocity (∼10 km s –1 ) wind with an opening angle of about 20° from the jet axis.

CLUSTERED STAR FORMATION AND OUTFLOWS IN AFGL 2591

Energy Technology Data Exchange (ETDEWEB)

Sanna, A.; Carrasco-Gonzalez, C.; Menten, K. M.; Brunthaler, A. [Max-Planck-Institut fuer Radioastronomie, Auf dem Huegel 69, 53121 Bonn (Germany); Reid, M. J. [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States); Moscadelli, L. [INAF, Osservatorio Astrofisico di Arcetri, Largo E. Fermi 5, 50125 Firenze (Italy); Rygl, K. L. J., E-mail: asanna@mpifr-bonn.mpg.de [IFSI-INAF, Istituto di Fisica dello Spazio Interplanetario, Via del Fosso del Cavaliere 100, 00133 Roma (Italy)

2012-02-01

We report on a detailed study of the water maser kinematics and radio continuum emission toward the most massive and young object in the star-forming region AFGL 2591. Our analysis shows at least two spatial scales of multiple star formation, one projected across 0.1 pc on the sky and another one at about 2000 AU from a ZAMS star of about 38 M{sub Sun }. This young stellar object drives a powerful jet- and wind-driven outflow system with the water masers associated to the outflow walls, previously detected as a limb-brightened cavity in the NIR band. At about 1300 AU to the north of this object a younger protostar drives two bow shocks, outlined by arc-like water maser emission, at 200 AU either side of the source. We have traced the velocity profile of the gas that expands along these arc-like maser structures and compared it with the jet-driven outflow model. This analysis suggests that the ambient medium around the northern protostar is swept up by a jet-driven shock (>66 km s{sup -1}) and perhaps a lower-velocity ({approx}10 km s{sup -1}) wind with an opening angle of about 20 Degree-Sign from the jet axis.

Reconstructing Global-scale Ionospheric Outflow With a Satellite Constellation

Science.gov (United States)

Liemohn, M. W.; Welling, D. T.; Jahn, J. M.; Valek, P. W.; Elliott, H. A.; Ilie, R.; Khazanov, G. V.; Glocer, A.; Ganushkina, N. Y.; Zou, S.

2017-12-01

The question of how many satellites it would take to accurately map the spatial distribution of ionospheric outflow is addressed in this study. Given an outflow spatial map, this image is then reconstructed from a limited number virtual satellite pass extractions from the original values. An assessment is conducted of the goodness of fit as a function of number of satellites in the reconstruction, placement of the satellite trajectories relative to the polar cap and auroral oval, season and universal time (i.e., dipole tilt relative to the Sun), geomagnetic activity level, and interpolation technique. It is found that the accuracy of the reconstructions increases sharply from one to a few satellites, but then improves only marginally with additional spacecraft beyond 4. Increased dwell time of the satellite trajectories in the auroral zone improves the reconstruction, therefore a high-but-not-exactly-polar orbit is most effective for this task. Local time coverage is also an important factor, shifting the auroral zone to different locations relative to the virtual satellite orbit paths. The expansion and contraction of the polar cap and auroral zone with geomagnetic activity influences the coverage of the key outflow regions, with different optimal orbit configurations for each level of activity. Finally, it is found that reconstructing each magnetic latitude band individually produces a better fit to the original image than 2-D image reconstruction method (e.g., triangulation). A high-latitude, high-altitude constellation mission concept is presented that achieves acceptably accurate outflow reconstructions.

Comparison of peak flow velocity through the left ventricular outflow tract and effective orifice area indexed to body surface area in Golden Retriever puppies to predict development of subaortic stenosis in adult dogs.

Science.gov (United States)

Javard, Romain; Bélanger, Marie-Claude; Côté, Etienne; Beauchamp, Guy; Pibarot, Philippe

2014-12-15

To evaluate the usefulness of Doppler-derived peak flow velocity through the left ventricular outflow tract (LVOT Vmax) and effective orifice area indexed to body surface area (EOAi) in puppies to predict development of subaortic stenosis (SAS) in the same dogs as adults. Prospective, longitudinal, observational study. 38 Golden Retrievers. Cardiac auscultation and echocardiography were performed on 2- to 6-month-old puppies, then repeated at 12 to 18 months. Subaortic stenosis was diagnosed when LVOT Vmax was ≥ 2.3 m/s in adult dogs with left basilar systolic murmurs. All puppies with EOAi 2.3 m/s in puppyhood was 63% sensitive and 100% specific for SAS in adulthood. In puppies, LVOT Vmax was more strongly associated with a future diagnosis of SAS (area under the curve [AUC], 0.89) than was EOAi (AUC, 0.80). In puppies, the combination of LVOT Vmax and EOAi yielded slightly higher sensitivity (69%) and specificity (100%) for adult SAS than did LVOT Vmax alone. In unaffected and affected dogs, LVOT Vmax increased significantly from puppyhood to adulthood but EOAi did not. In Golden Retriever puppies, LVOT Vmax > 2.3 m/s and EOAi < 1.46 cm(2)/m(2) were both associated with a diagnosis of SAS at adulthood. The combination of these 2 criteria may result in higher sensitivity for SAS screening. Unlike LVOT Vmax, EOAi did not change during growth in either unaffected Golden Retrievers or those with SAS.

The outflows accelerated by the magnetic fields and radiation force of accretion disks

Energy Technology Data Exchange (ETDEWEB)

Cao, Xinwu, E-mail: cxw@shao.ac.cn [Key Laboratory for Research in Galaxies and Cosmology, Shanghai Astronomical Observatory, Chinese Academy of Sciences, 80 Nandan Road, Shanghai, 200030 (China)

2014-03-01

The inner region of a luminous accretion disk is radiation-pressure-dominated. We estimate the surface temperature of a radiation-pressure-dominated accretion disk, Θ=c{sub s}{sup 2}/r{sup 2}Ω{sub K}{sup 2}≪(H/r){sup 2}, which is significantly lower than that of a gas-pressure-dominated disk, Θ ∼ (H/r){sup 2}. This means that the outflow can be launched magnetically from the photosphere of the radiation-pressure-dominated disk only if the effective potential barrier along the magnetic field line is extremely shallow or no potential barrier is present. For the latter case, the slow sonic point in the outflow will probably be in the disk, which leads to a slow circular dense flow above the disk. This implies that hot gas (probably in the corona) is necessary for launching an outflow from the radiation-pressure-dominated disk, which provides a natural explanation for the observational evidence that the relativistic jets are related to hot plasma in some X-ray binaries and active galactic nuclei. We investigate the outflows accelerated from the hot corona above the disk by the magnetic field and radiation force of the accretion disk. We find that with the help of the radiation force, the mass loss rate in the outflow is high, which leads to a slow outflow. This may be why the jets in radio-loud narrow-line Seyfert galaxies are in general mildly relativistic compared with those in blazars.

Atmospheric outflow of nutrients to the Bay of Bengal: Impact of anthropogenic sources..

Digital Repository Service at National Institute of Oceanography (India)

Srinivas, B.; Sarin, M.M.; Sarma, V.V.S.S.

outflow show pronounced temporal variability. The inorganic nitrogen (NH4 + -N: ~90% of NInorg) dominates the total soluble nitrogen (NTot). Although the contribution of organic nitrogen is not significant, the mass ratio of NOrg/NTotin the outflow varied...

Hemangioma of the prostate - an unusual cause of lower urinary tract symptoms: Case report

Directory of Open Access Journals (Sweden)

Horn Thomas

2011-04-01

Full Text Available Abstract Background Hemangioma of the prostate gland is extremely rare and only a few cases have been reported. There have been several cases of hemangioma of posterior urethra, urinary bladder and periprostatic plexus in the literature, all presenting with hematuria or hematospermia. Diagnosis of prostatic hemangioma is difficult due to its rarity and unspecific symptoms such as hematuria, hematospermia or lower urinary tract symptoms. It cannot be detected by conventional examinations such as cystoscopy or standard rectal ultrasonography. Case presentation We present a case of prostatic hemangioma in an 84-year old male presenting with lower urinary tract symptoms. Bleeding has not been a feature in our case and diagnosis was not made until after operation. The patient was treated as a case of bladder neck outflow obstruction with transurethral resection of prostate gland and simultaneous bladder neck incisions. A period of self-catheterization was instituted due to postoperative urinary retention as the result of detrusor insufficiency. Conclusion Hemangioma of prostate gland is extremely rare and symptomatic prostatic hemangioma should be treated either by transurethral resection of prostate or laser evaporation.

X-ray evidence for ultra-fast outflows in Seyfert galaxies

Science.gov (United States)

Tombesi, Francesco; Braito, Valentina; Reeves, James; Cappi, Massimo; Dadina, Mauro

2012-07-01

X-ray evidence for massive, highly ionized, ultra-fast outflows (UFOs) has been recently reported in a number of AGNs through the detection of blue-shifted Fe XXV/XXVI absorption lines. We present the results of a comprehensive spectral analysis of a large sample of 42 local Seyferts observed with XMM-Newton. Similar results are also obtained from a Suzaku analysis of 5 radio galaxies. We find that UFOs are common phenomena, being present in >40% of the sources. Their outflow velocity distribution is in the range ˜0.03--0.3c, with mean value of ˜0.14c. The ionization parameter is very high, in the range logξ˜3--6 erg~s^{-1}~cm, and the associated column densities are also large, in the range ˜10^{22}--10^{24} cm^{-2}. Their location is constrained at ˜0.0003--0.03pc (˜10^2--10^4 r_s) from the central black hole, consistent with what is expected for accretion disk winds/outflows. The mass outflow rates are in the interval ˜0.01--1M_{⊙}~yr^{-1}. The associated mechanical power is also high, in the range ˜10^{43}--10^{45} erg/s, which indicates that UFOs are capable to provide a significant contribution to the AGN cosmological feedback.

A Massive X-ray Outflow From The Quasar PDS 456

Science.gov (United States)

Reeves, J. N.; O'Brien, P. T.; Ward, M. J.

2003-01-01

We report on XMM-Newton spectroscopic observations of the luminous, radio-quiet quasar PDS 456. The hard X-ray spectrum of PDS 456 shows a deep absorption trough (constituting 50% of the continuum) at energies above 7 keV in the quasar rest frame, which can be attributed to a series of blue-shifted K-shell absorption edges due to highly ionized iron. The higher resolution soft X-ray grating RGS spectrum exhibits a broad absorption line feature near 1 keV, which can be modeled by a blend of L-shell transitions from highly ionized iron (Fe XVII - XXIV). An extreme outflow velocity of approx. 50000 km/s is required to model the K and L shell iron absorption present in the XMM-Newton data. Overall, a large column density (N(sub H) = 5 x 10(exp 23)/sq cm) of highly ionized gas (log xi = 2.5) is required in PDS 456. A large mass outflow rate of approx. 10 solar mass/year (assuming a conservative outflow covering factor of 0.1 steradian) is derived, which is of the same order as the overall mass accretion rate in PDS 456. This represents a substantial fraction (approx. 10%) of the quasar energy budget, whilst the large column and outflow velocity place PDS 456 towards the extreme end of the broad absorption line quasar population.

Energetic molecular outflow near AFGL 961: millimeter-wave and infrared observations

International Nuclear Information System (INIS)

Lada, C.J.; Gautier, T.N. III

1982-01-01

We report detailed millimeter-wave and near-infrared spectroscopy of the dynamically active region around the infrared source AFGL 961, near the Rosette nebula. Millimeter-wave 12 CO observations are used to study the high-velocity molecular flow around AFGL 961. These observations show that the high-velocity flow has a maximum extent of at least 6' or 2.9 pc at the distance of AFGL 961. The flow is found to be anisotropic, with redshifted high-velocity emission considerably more extended than blueshifted high-velocity emission. However, the flow does not appear to be as highly collimated as some other sources of high-velocity bipolar outflow. We also find the emission profiles to be asymmetric in velocity such that the integrated intensity of the redshifted high-velocity emission is on average 2.5 times greater than that of the blueshifted emission. The mass of the gas involved in the flow is determined to be approximately 19 M/sub sun/, and the kinetic energy of this gas is estimated to be about 8 x 10 46 ergs. These observations are interpreted as evidence that an energetic bipolar outflow of molecular gas is occurring near AFGL 961. The momentum of the outflowing molecular gas is large, and it is shown that this places strong constraints on possible physical mechanisms which may be driving the outflow. The near-infrared spectrum of AFGL 961 from 1.4-2.4 μm was obtained in order to study the conditions immediately around the infrared source which may be driving the molecular outflow

Soft X-ray Emission from Large-Scale Galactic Outflows in Seyfert Galaxies

Science.gov (United States)

Colbert, E. J. M.; Baum, S.; O'Dea, C.; Veilleux, S.

1998-01-01

Kiloparsec-scale soft X-ray nebulae extend along the galaxy minor axes in several Seyfert galaxies, including NGC 2992, NGC 4388 and NGC 5506. In these three galaxies, the extended X-ray emission observed in ROSAT HRI images has 0.2-2.4 keV X-ray luminosities of 0.4-3.5 x 10(40) erg s(-1) . The X-ray nebulae are roughly co-spatial with the large-scale radio emission, suggesting that both are produced by large-scale galactic outflows. Assuming pressure balance between the radio and X-ray plasmas, the X-ray filling factor is >~ 10(4) times as large as the radio plasma filling factor, suggesting that large-scale outflows in Seyfert galaxies are predominantly winds of thermal X-ray emitting gas. We favor an interpretation in which large-scale outflows originate as AGN-driven jets that entrain and heat gas on kpc scales as they make their way out of the galaxy. AGN- and starburst-driven winds are also possible explanations if the winds are oriented along the rotation axis of the galaxy disk. Since large-scale outflows are present in at least 50 percent of Seyfert galaxies, the soft X-ray emission from the outflowing gas may, in many cases, explain the ``soft excess" X-ray feature observed below 2 keV in X-ray spectra of many Seyfert 2 galaxies.

Selective scanning of the right ventricle with the ultrashort-lived isotope krypton-81m

International Nuclear Information System (INIS)

Horn, M.; Witztum, K.; Neveu, C.; Perkins, G.

1985-01-01

The measurement of right ventricular function using /sup 99m/Tc gated blood-pool imaging is hampered by the difficulty in separating the right ventricle from the left heart as well as from the right atrium. Krypton-81m, an ultrashort-lived isotope (t/sub 1/2/, 13 sec) with a single 190-keV gamma ray, can be infused into the venous circulation to yield stable count rates over the right heart. The authors have developed a technique for delivering a continuous infusion of /sup 81m/Kr via an antecubital vein for gated right ventricle (RV) equilibrium studies. Preliminary rest studies have been performed in 15 normal subjects ranging in age from 23 to 62 years. Right-heart structures including the right atrium, tricuspid valve, right ventricle, pulmonic valve, and pulmonary outflow tract are clearly identifiable. Essentially no counts are present over the left heart. RV ejection fractions in this group averaged 48.3 (+/- 5.7)%. Changes in pulmonary blood flow distribution from supine to upright position, which may be an index of pulmonary arterial pressures, are also easily demonstrated

Identification of MicroRNA-124 as a Major Regulator of Enhanced Endothelial Cell Glycolysis in Pulmonary Arterial Hypertension via PTBP1 (Polypyrimidine Tract Binding Protein) and Pyruvate Kinase M2.

Science.gov (United States)

Caruso, Paola; Dunmore, Benjamin J; Schlosser, Kenny; Schoors, Sandra; Dos Santos, Claudia; Perez-Iratxeta, Carol; Lavoie, Jessie R; Zhang, Hui; Long, Lu; Flockton, Amanda R; Frid, Maria G; Upton, Paul D; D'Alessandro, Angelo; Hadinnapola, Charaka; Kiskin, Fedir N; Taha, Mohamad; Hurst, Liam A; Ormiston, Mark L; Hata, Akiko; Stenmark, Kurt R; Carmeliet, Peter; Stewart, Duncan J; Morrell, Nicholas W

2017-12-19

Pulmonary arterial hypertension (PAH) is characterized by abnormal growth and enhanced glycolysis of pulmonary artery endothelial cells. However, the mechanisms underlying alterations in energy production have not been identified. Here, we examined the miRNA and proteomic profiles of blood outgrowth endothelial cells (BOECs) from patients with heritable PAH caused by mutations in the bone morphogenetic protein receptor type 2 ( BMPR2 ) gene and patients with idiopathic PAH to determine mechanisms underlying abnormal endothelial glycolysis. We hypothesized that in BOECs from patients with PAH, the downregulation of microRNA-124 (miR-124), determined with a tiered systems biology approach, is responsible for increased expression of the splicing factor PTBP1 (polypyrimidine tract binding protein), resulting in alternative splicing of pyruvate kinase muscle isoforms 1 and 2 (PKM1 and 2) and consequently increased PKM2 expression. We questioned whether this alternative regulation plays a critical role in the hyperglycolytic phenotype of PAH endothelial cells. Heritable PAH and idiopathic PAH BOECs recapitulated the metabolic abnormalities observed in pulmonary artery endothelial cells from patients with idiopathic PAH, confirming a switch from oxidative phosphorylation to aerobic glycolysis. Overexpression of miR-124 or siRNA silencing of PTPB1 restored normal proliferation and glycolysis in heritable PAH BOECs, corrected the dysregulation of glycolytic genes and lactate production, and partially restored mitochondrial respiration. BMPR2 knockdown in control BOECs reduced the expression of miR-124, increased PTPB1 , and enhanced glycolysis. Moreover, we observed reduced miR-124, increased PTPB1 and PKM2 expression, and significant dysregulation of glycolytic genes in the rat SUGEN-hypoxia model of severe PAH, characterized by reduced BMPR2 expression and endothelial hyperproliferation, supporting the relevance of this mechanism in vivo. Pulmonary vascular and

Procalcitonin guided antibiotic therapy and hospitalization in patients with lower respiratory tract infections: a prospective, multicenter, randomized controlled trial

Directory of Open Access Journals (Sweden)

Henzen Christoph

2007-07-01

Full Text Available Abstract Background: Lower respiratory tract infections like acute bronchitis, exacerbated chronic obstructive pulmonary disease and community-acquired pneumonia are often unnecessarily treated with antibiotics, mainly because of physicians' difficulties to distinguish viral from bacterial cause and to estimate disease-severity. The goal of this trial is to compare medical outcomes, use of antibiotics and hospital resources in a strategy based on enforced evidence-based guidelines versus procalcitonin guided antibiotic therapy in patients with lower respiratory tract infections. Methods and design: We describe a prospective randomized controlled non-inferiority trial with an open intervention. We aim to randomize over a fixed recruitment period of 18 months a minimal number of 1002 patients from 6 hospitals in Switzerland. Patients must be >18 years of age with a lower respiratory tract infections Discussion: Use of and prolonged exposure to antibiotics in lower respiratory tract infections is high. The proposed trial investigates whether procalcitonin-guidance may safely reduce antibiotic consumption along with reductions in hospitalization costs and antibiotic resistance. It will additionally generate insights for improved prognostic assessment of patients with lower respiratory tract infections. Trial registration: ISRCTN95122877

Large sea ice outflow into the Nares Strait in 2007

DEFF Research Database (Denmark)

Kwok, R.; Pedersen, L.T.; Gudmandsen, Preben

2010-01-01

Sea ice flux through the Nares Strait is most active during the fall and early winter, ceases in mid- to late winter after the formation of ice arches along the strait, and re-commences after breakup in summer. In 2007, ice arches failed to form. This resulted in the highest outflow of Arctic sea...... at Fram Strait. Clearly, the ice arches control Arctic sea ice outflow. The duration of unobstructed flow explains more than 84% of the variance in the annual area flux. In our record, seasonal stoppages are always associated with the formation of an arch near the same location in the southern Kane Basin...... ice in the 13-year record between 1997 and 2009. The 2007 area and volume outflows of 87 x 10(3) km(2) and 254 km(3) are more than twice their 13-year means. This contributes to the recent loss of the thick, multiyear Arctic sea ice and represents similar to 10% of our estimates of the mean ice export...

Fluid outflows from Venus impact craters - Analysis from Magellan data

Science.gov (United States)

Asimow, Paul D.; Wood, John A.

1992-01-01

Many impact craters on Venus have unusual outflow features originating in or under the continuous ejecta blankets and continuing downhill into the surrounding terrain. These features clearly resulted from flow of low-viscosity fluids, but the identity of those fluids is not clear. In particular, it should not be assumed a priori that the fluid is an impact melt. A number of candidate processes by which impact events might generate the observed features are considered, and predictions are made concerning the rheological character of flows produce by each mechanism. A sample of outflows was analyzed using Magellan images and a model of unconstrained Bingham plastic flow on inclined planes, leading to estimates of viscosity and yield strength for the flow materials. It is argued that at least two different mechanisms have produced outflows on Venus: an erosive, channel-forming process and a depositional process. The erosive fluid is probably an impact melt, but the depositional fluid may consist of fluidized solid debris, vaporized material, and/or melt.

Geometry of anisotropic CO outflows

International Nuclear Information System (INIS)

Liseau, R.; Sandell, G.; Helsinki Univ., Observatory, Finland)

1986-01-01

A simple geometrical model for the space motions of the bipolar high-velocity CO outflows in regions of recent, active star formation is proposed. It is assumed that the velocity field of the neutral gas component can be represented by large-scale uniform motions. From observations of the spatial distribution and from the characteristics of the line shape of the high-velocity molecular gas emission the geometry of the line-emitting regions can be inferred, i.e., the direction in space and the collimating angle of the flow. The model has been applied to regions where a check on presently obtained results is provided by independent optical determinations of the motions of Herbig-Haro objects associated with the CO flows. These two methods are in good agreement and, furthermore, the results obtained provide convincingly strong evidence for the physical association of CO outflows and Herbig-Haro objects. This also supports the common view that a young stellar central source is responsible for the active phenomena observed in its environmental neighborhood. It is noteworthy that within the framework of the model the determination of the flow geometry of the high-velocity gas from CO measurements is independent of the distance to the source and, furthermore, can be done at relatively low spatial resolution. 32 references

Lung scintiscanning in corrective surgery of congenital heart disease, 2

International Nuclear Information System (INIS)

Endo, Kaoru

1981-01-01

Lung scintiscanning was performed to investigate the distribution of pulmonary blood flow before and after surgery in 30 patients with tetralogy of Fallot. Uniformity of lung scintigram and the derangement of the distribution pattern were observed preoperatively and postoperatively. The results were as follows: 1) Preoperatively, uniformity of lung scintigram was 27.7 - 100% (average 63.4%). It is more necessary to construct the outflow tract in most cases, when the PA/Ao diameter ratio was lower than 0.5 and uniformity of lung scintigram was under 50%. Besides, preoperative uniformity of lung scintigram correlated with the degree of polycythemia. In 3 cases who died after corrective surgery, the value of uniformity of lung scintigram was as low as 33.3 - 61.1%. 2) Preoperative pulmonary blood flow disturbances were found in 50% of 30 cases. In all of the cases without pulmonary blood flow disturbances, total correction was successfully performed. On the other hand, in cases with pulmonary blood flow disturbances, the result of total correction was not satisfactory. 3) In cases with the slight and moderately deranged distribution preoperatively, postoperative follow up study by scintiscanning at 1 to 2 months after surgery showed considerately more improvement of pulmonary blood flow. (author)

Lung scintiscanning in corrective surgery of congenital heart disease, 2. Tetralogy of Fallot

Energy Technology Data Exchange (ETDEWEB)

Endo, K. (Iwate Medical Coll., Morioka (Japan). School of Medicine)

1981-06-01

Lung scintiscanning was performed to investigate the distribution of pulmonary blood flow before and after surgery in 30 patients with tetralogy of Fallot. Uniformity of lung scintigram and the derangement of the distribution pattern were observed preoperatively and postoperatively. The results were as follows: 1) Preoperatively, uniformity of lung scintigram was 27.7 - 100% (average 63.4%). It is more necessary to construct the outflow tract in most cases, when the PA/Ao diameter ratio was lower than 0.5 and uniformity of lung scintigram was under 50%. Besides, preoperative uniformity of lung scintigram correlated with the degree of polycythemia. In 3 cases who died after corrective surgery, the value of uniformity of lung scintigram was as low as 33.3 - 61.1%. 2) Preoperative pulmonary blood flow disturbances were found in 50% of 30 cases. In all of the cases without pulmonary blood flow disturbances, total correction was successfully performed. On the other hand, in cases with pulmonary blood flow disturbances, the result of total correction was not satisfactory. 3) In cases with the slight and moderately deranged distribution preoperatively, postoperative follow up study by scintiscanning at 1 to 2 months after surgery showed considerately more improvement of pulmonary blood flow.

Successful treatment of lower urinary tract obstruction with peritoneal-amniotic and vesicoamniotic shunting

Directory of Open Access Journals (Sweden)

Ümit Korucuoğlu

2014-01-01

Full Text Available Lower urinary tract obstruction (LUTO which is most commonly caused by posterior urethral valves or urethral atresia, is often associated with high perinatal mortality and morbidity and long-term childhood renal dysfunction or even renal failure. LUTO is an uncommon clinical entity that can be diagnosed by ultrasonographic examination and is particularly presented by enlarged bladder, hydronephrosis, hydroureter and oligohydramnios. Despite being a rare pathology of the genitourinary tract, detection rates of it is higher than other congenital abnormalities with ultrasonography. Moreover, ultrasonography has become the most widely used diagnostic tool in the diagnosis of LUTO. Pulmonary hypoplasia resulting from severe oligohydramnios is the most common cause of death. Bladder drainage has a critical role on perinatal survival in fetuses with LUTO especially in those predicted to have a poor prognosis. Further interventions and observations of renal therapies may be required in childhood.

Increasing dwell time of mitomycin C in the upper tract with a reverse thermosensitive polymer.

Science.gov (United States)

Wang, Agnes J; Goldsmith, Zachariah G; Neisius, Andreas; Astroza, Gaston M; Oredein-McCoy, Olugbemisola; Iqbal, Muhammad W; Simmons, W Neal; Madden, John F; Preminger, Glenn M; Inman, Brant A; Lipkin, Michael E; Ferrandino, Michael N

2013-03-01

Abstract Background and Purpose: Topical chemotherapy for urothelial cancer is dependent on adequate contact time of the chemotherapeutic agent with the urothelium. To date, there has not been a reliable method of maintaining this contact for renal or ureteral urothelial carcinoma. We evaluated the safety and feasibility of using a reverse thermosensitive polymer to improve dwell times of mitomycin C (MMC) in the upper tract. Using a porcine model, four animals were treated ureteroscopically with both upper urinary tracts receiving MMC mixed with iodinated contrast. One additional animal received MMC percutaneously. The treatment side had ureteral outflow blocked with a reverse thermosensitive polymer plug. MMC dwell time was monitored fluoroscopically and intrarenal pressures measured. Two animals were euthanized immediately, and three animals were euthanized 5 days afterward. In control kidneys, drainage occurred at a mean of 5.3±0.58 minutes. Intrarenal pressures stayed fairly stable: 9.7±14.0 cm H20. In treatment kidneys, dwell time was extended to 60 minutes, when the polymer was washed out. Intrarenal pressures in the treatment kidneys peaked at 75.0±14.7 cm H20 and reached steady state at 60 cm H20. Pressures normalized after washout of the polymer with cool saline. Average washout time was 11.8±9.6 minutes. No histopathologic differences were seen between the control and treatment kidneys, or with immediate compared with delayed euthanasia. A reverse thermosensitive polymer can retain MMC in the upper urinary tract and appears to be safe from our examination of intrarenal pressures and histopathology. This technique may improve the efficacy of topical chemotherapy in the management of upper tract urothelial carcinoma.

Effects of gender and age on development of concurrent extrapulmonary tuberculosis in patients with pulmonary tuberculosis: a population based study.

Science.gov (United States)

Lin, Chun-Yu; Chen, Tun-Chieh; Lu, Po-Liang; Lai, Chung-Chih; Yang, Yi-Hsin; Lin, Wei-Ru; Huang, Pei-Ming; Chen, Yen-Hsu

2013-01-01

Most cases of adult-onset tuberculosis (TB) result from reactivation of a pre-existing Mycobacterium tuberculosis infection. Mycobacterium tuberculosis usually invades the respiratory tract and most patients develop intrapulmonary TB; however, some patients develop concurrent pulmonary and extra-pulmonary TB. The purpose of the present study was to identify the demographic and clinical factors associated with an increased risk of concurrent extra-pulmonary diseases in patients with pulmonary TB. We compared patients who had isolated pulmonary TB with patients who had concurrent pulmonary and extra-pulmonary TB. We initially analyzed one-million randomly selected subjects from the population-based Taiwan National Health Insurance database. Based on analysis of 5414 pulmonary TB patients in this database, women were more likely than men to have concurrent extra-pulmonary TB (OR: 1.30, p = 0.013). A separate analysis of the Kaohsiung Medical University Hospital database, which relied on sputum culture-proven pulmonary TB, indicated that women were more likely than men to have concurrent extra-pulmonary TB (OR: 1.62, p = 0.039). There was no significant gender difference in extra-pulmonary TB for patients younger than 45 years in either database. However, for patients 45 years and older, women were more likely than men to have concurrent extra-pulmonary TB (insurance database: 9.0% vs. 6.8%, p = 0.016, OR: 1.36; hospital database: 27.3% vs. 16.0%, p = 0.008, OR = 1.98). Our results indicate that among patients who have pulmonary TB, older females have an increased risk for concurrent extra-pulmonary TB.

Turbulent mixing layers in supersonic protostellar outflows, with application to DG Tauri

Science.gov (United States)

White, M. C.; Bicknell, G. V.; Sutherland, R. S.; Salmeron, R.; McGregor, P. J.

2016-01-01

Turbulent entrainment processes may play an important role in the outflows from young stellar objects at all stages of their evolution. In particular, lateral entrainment of ambient material by high-velocity, well-collimated protostellar jets may be the cause of the multiple emission-line velocity components observed in the microjet-scale outflows driven by classical T Tauri stars. Intermediate-velocity outflow components may be emitted by a turbulent, shock-excited mixing layer along the boundaries of the jet. We present a formalism for describing such a mixing layer based on Reynolds decomposition of quantities measuring fundamental properties of the gas. In this model, the molecular wind from large disc radii provides a continual supply of material for entrainment. We calculate the total stress profile in the mixing layer, which allows us to estimate the dissipation of turbulent energy, and hence the luminosity of the layer. We utilize MAPPINGS IV shock models to determine the fraction of total emission that occurs in [Fe II] 1.644 μm line emission in order to facilitate comparison to previous observations of the young stellar object DG Tauri. Our model accurately estimates the luminosity and changes in mass outflow rate of the intermediate-velocity component of the DG Tau approaching outflow. Therefore, we propose that this component represents a turbulent mixing layer surrounding the well-collimated jet in this object. Finally, we compare and contrast our model to previous work in the field.

GAS OUTFLOWS IN SEYFERT GALAXIES: EFFECTS OF STAR FORMATION VERSUS AGN FEEDBACK

Energy Technology Data Exchange (ETDEWEB)

Melioli, C.; Pino, E. M. de Gouveia Dal, E-mail: claudio.melioli@iag.usp.br, E-mail: dalpino@iag.usp.br [Department of Astronomy (IAG-USP), University of Sao Paulo (Brazil)

2015-10-20

Large-scale, weakly collimated outflows are very common in galaxies with large infrared luminosities. In complex systems in particular, where intense star formation (SF) coexists with an active galactic nucleus (AGN), it is not clear yet from observations whether the SF, the AGN, or both are driving these outflows. Accreting supermassive black holes are expected to influence their host galaxies through kinetic and radiative feedback processes, but in a Seyfert galaxy, where the energy emitted in the nuclear region is comparable to that of the body of the galaxy, it is possible that stellar activity is also playing a key role in these processes. In order to achieve a better understanding of the mechanisms driving the gas evolution especially at the nuclear regions of these galaxies, we have performed high-resolution three-dimensional hydrodynamical simulations with radiative cooling considering the feedback from both SF regions, including supernova (Type I and II) explosions and an AGN jet emerging from the central region of the active spiral galaxy. We computed the gas mass lost by the system, separating the role of each of these injection energy sources on the galaxy evolution, and found that at scales within 1 kpc an outflow can be generally established considering intense nuclear SF only. The jet alone is unable to drive a massive gas outflow, although it can sporadically drag and accelerate clumps of the underlying outflow to very high velocities.

Atmospheric transport and outflow of polycyclic aromatic hydrocarbons from China

Energy Technology Data Exchange (ETDEWEB)

Chang Lang; Shu Tao; Wenxin Liu; Yanxu Zhang; Staci Simonich [Peking University, Beijing (China). Laboratory for Earth Surface Processes, College of Environmental Sciences

2008-07-15

A potential receptor influence function (PRIF) model, based on air mass forward trajectory calculations, was applied to simulate the atmospheric transport and outflow of polycyclic aromatic hydrocarbons (PAHs) emitted from China. With a 10 day atmospheric transport time, most neighboring countries and regions, as well as remote regions, were influenced by PAH emissions from China. Of the total annual PAH emission of 114 Gg, 92.7% remained within the boundary of mainland China. The geographic distribution of PRIFs within China was similar to the geographic distribution of the source regions, with high values in the North China Plain, Sichuan Basin, Shanxi, and Guizhou province. The Tarim basin and Sichuan basin had unfavorable meteorological conditions for PAH outflow. Of the PAH outflow from China (8092 tons or 7.1% of the total annual PAH emission), approximately 69.9% (5655 tons) reached no further than the offshore environment of mainland China and the South China Sea. Approximate 227, 71, 746, and 131 tons PAHs reached North Korea, South Korea, Russia-Mongolia region, and Japan, respectively, 2-4 days after the emission. Only 1.4 tons PAHs reached North America after more than 9 days. Interannual variation in the eastward PAH outflow was positively correlated to cold episodes of El Nino/Southern Oscillation. However, trans-Pacific atmospheric transport of PAHs from China was correlated to Pacific North America index (PNA) which is associated with the strength and position of westerly winds. 38 refs., 4 figs.

Remarkable case of uncorrected type IC tricuspid atresia with adaptive pulmonary trunk dilatation to allow prolonged survival: Case report and CT fly-through

Directory of Open Access Journals (Sweden)

Zeke J. McKinney

2017-06-01

Full Text Available A remarkable case of a surgically uncorrected Type IC (no great artery transposition, no pulmonary stenosis tricuspid atresia surviving to adulthood is presented. This is a case of an adult female of 30 years of age with an atretic tricuspid valve, an atrial septal defect, a large ventricular septal defect, and a dilated pulmonary trunk. Surgical correction was never conducted on this heart with a significant congenital cardiac defect, and yet the individual survived into a fourth decade. Without surgical correction, survival to adulthood in tricuspid atresia is exceedingly rare. Survival depends on a high degree of ventricular shunting with limited pulmonary outflow obstruction. The resistance of this obstruction must be both low enough to maintain increased pulmonary blood flow and high enough to prevent systemic-level pressures upon the pulmonary vasculature. The unique finding of a significantly dilated pulmonary trunk is described, which presumably allowed this individual to survive to adulthood. This complex physiology is described and augmented with high-resolution images of this cardiac specimen. These were made possible by the application of a plastination process prior to obtaining high-resolution multi-slice computed tomography imaging studies. The result is a study comprised of multiplanar and three-dimensional data detailing the anatomic features of the specimen, which were then used to create reconstructions of the specimen for visualization of the anatomy. An understanding of the development and morphology of tricuspid atresia is essential for successful surgical correction in new patients with this congenital malformation. Keywords: Tricuspid atresia, Pulmonary blood flow, Pulmonary hypertension, Plastination, CT

VY Canis Majoris: Observational Studies of the Outflow

Science.gov (United States)

Harwit, M.

2001-12-01

A number of recent studies carried out with the Infrared Space Observatory, ISO, and the Submillimeter Wave Astronomy Satellite, SWAS, provide new information on the chemical composition of the dust and the geometry of the outflow. With ISO, we have obtained a near-, mid-, and far-infrared spectrum of VY CMa that shows the strong preponderance of amorphous, as contrasted to crystalline, silicates. The sharp spectral slope in the near-infrared suggests the presence also of iron grains. While an excellent theoretical fit to the data is obtained, we emphasize that this is far from unique. A resolution of ambiguities will require a self-consistent model that considers not only radiative transfer, but also plausible elemental abundances, laboratory studies of chemical condensation sequences, and gas dynamics. With SWAS we have obtained a high-resolution spectrum of the 557GHz ground state transition of ortho-water. The spectral profile enables us to rule out a number of outflow geometries proposed in the literature. With ISO we also obtained the intensities and velocity structure of several other spectral lines of water. Most of these lines must be optically thick but effectively thin, a circumstance that permits us to make use of recent gas-dynamic models to locate the radial position in the outflow where individual lines are emitted.

Ammonia toroid aligned perpendicular to the HH 1 and HH 2 bipolar outflow

International Nuclear Information System (INIS)

Torrelles, J.M.; Canto, J.; Rodriguez, L.F.; Ho, P.T.P.; Moran, J.M.; Universidad Nacional Autonoma de Mexico, Mexico City)

1985-01-01

The ammonia emission from the region containing the Herbig-Haro objects 1 and 2, which mark the presence of a bipolar outflow, was mapped. The ammonia observations delineate an elongated structure aligned perpendicular to the bipolar outflow. This ammonia condensation is centered between HH 1 and HH 2 and coincides with the recently discovered central radio continuum source. This continuum source has no optical counterpart. The ammonia spectrum at the position of the continuum source shows a remarkable splitting. Based on the orientation of the bipolar outflow, which is known to be oriented nearly perpendicular to the line of sight, and on theoretical considerations, it is concluded that the ammonia source is part of a toroid, viewed edge-on, in slow expansion driven by the wind pressure of the central source. This toroid may be the focusing mechanism for the bipolar outflow. Searches for ammonia condensations in the vicinity of other HH objects may help localize the energy sources of these systems. 26 references

Infall and outflow motions towards a sample of massive star-forming regions from the RMS survey

Science.gov (United States)

Cunningham, N.; Lumsden, S. L.; Moore, T. J. T.; Maud, L. T.; Mendigutía, I.

2018-06-01

We present the results of an outflow and infall survey towards a distance-limited sample of 31 massive star-forming regions drawn from the Red MSX source (RMS) survey. The presence of young, active outflows is identified from SiO (8-7) emission and the infall dynamics are explored using HCO+/H13CO+ (4-3) emission. We investigate if the infall and outflow parameters vary with source properties, exploring whether regions hosting potentially young active outflows show similarities or differences with regions harbouring more evolved, possibly momentum-driven, `fossil' outflows. SiO emission is detected towards approximately 46 per cent of the sources. When considering sources with and without an SiO detection (i.e. potentially active and fossil outflows, respectively), only the 12CO outflow velocity shows a significant difference between samples, indicating SiO is more prevalent towards sources with higher outflow velocities. Furthermore, we find the SiO luminosity increases as a function of the Herschel 70 μm to WISE 22 μm flux ratio, suggesting the production of SiO is prevalent in younger, more embedded regions. Similarly, we find tentative evidence that sources with an SiO detection have a smaller bolometric luminosity-to-mass ratio, indicating SiO (8-7) emission is associated with potentially younger regions. We do not find a prevalence towards sources displaying signatures of infall in our sample. However, the higher energy HCO+ transitions may not be the best suited tracer of infall at this spatial resolution in these regions.

From bipolar to quadrupolar - The collimation processes of the Cepheus A outflow

Science.gov (United States)

Torrelles, Jose M.; Verdes-Montenegro, Lourdes; Ho, Paul T. P.; Rodriguez, Luis F.; Canto, Jorge

1993-01-01

Results of new K-band observations of the (1, 1) and (2, 2) ammonia lines toward Cepheus A are reported. The lines are mapped with approximately 2 arcsec of angular resolution and 0.3 km/s of velocity resolution. A sensitivity of 10 mJy has been achieved. The observations reveal details of the spatial and kinematics structure of the ambient high-density gas. It is suggested that the interstellar high-density gas is diverting and redirecting the outflow in the sense that the quadrupolar structure of the molecular outflow is produced by the interaction with the ammonia condensationss, with Cep A-1 and Cep A-3 splitting in two halves, respectively the blue- and redshifted lobes of an east-west bipolar molecular outflow.

Fading AGN Candidates: AGN Histories and Outflow Signatures

International Nuclear Information System (INIS)

Keel, William C.; Maksym, W. Peter; Lintott, Chris J.; Bennert, Vardha N.; Scott, Bryan; Showley, Charles; Flatland, Kelsi; Chojnowski, S. Drew; Moiseev, Alexei; Smirnova, Aleksandrina; Schawinski, Kevin; Sartori, Lia F.; Urry, C. Megan; Pancoast, Anna; Schirmer, Mischa

2017-01-01

We consider the energy budgets and radiative history of eight fading active galactic nuclei (AGNs), identified from an energy shortfall between the requirements to ionize very extended (radius > 10 kpc) ionized clouds and the luminosity of the nucleus as we view it directly. All show evidence of significant fading on timescales of ≈50,000 yr. We explore the use of minimum ionizing luminosity Q ion derived from photoionization balance in the brightest pixels in H α at each projected radius. Tests using presumably constant Palomar–Green QSOs, and one of our targets with detailed photoionization modeling, suggest that we can derive useful histories of individual AGNs, with the caveat that the minimum ionizing luminosity is always an underestimate and subject to uncertainties about fine structure in the ionized material. These consistency tests suggest that the degree of underestimation from the upper envelope of reconstructed Q ion values is roughly constant for a given object and therefore does not prevent such derivation. The AGNs in our sample show a range of behaviors, with rapid drops and standstills; the common feature is a rapid drop in the last ≈2×10 4 yr before the direct view of the nucleus. The e -folding timescales for ionizing luminosity are mostly in the thousands of years, with a few episodes as short as 400 yr. In the limit of largely obscured AGNs, we find additional evidence for fading from the shortfall between even the lower limits from recombination balance and the maximum luminosities derived from far-infrared fluxes. We compare these long-term light curves, and the occurrence of these fading objects among all optically identified AGNs, to simulations of AGN accretion; the strongest variations over these timespans are seen in models with strong and local (parsec-scale) feedback. We present Gemini integral-field optical spectroscopy, which shows a very limited role for outflows in these ionized structures. While rings and loops of emission

Fading AGN Candidates: AGN Histories and Outflow Signatures

Energy Technology Data Exchange (ETDEWEB)

Keel, William C.; Maksym, W. Peter [Department of Physics and Astronomy, University of Alabama, Box 870324, Tuscaloosa, AL 35487 (United States); Lintott, Chris J. [Astrophysics, Oxford University and Adler Planetarium, 1300 S. Lakeshore Drive, Chicago, IL 60605 (United States); Bennert, Vardha N.; Scott, Bryan; Showley, Charles; Flatland, Kelsi [Physics Department, California Polytechnic State University, San Luis Obispo, CA 93407 (United States); Chojnowski, S. Drew [Department of Astronomy, New Mexico State University, P.O. Box 30001, MSC 4500, Las Cruces, NM 88003-8001 (United States); Moiseev, Alexei; Smirnova, Aleksandrina [Special Astrophysical Observatory, Russian Academy of Sciences, Nizhny Arkhyz, 369167 (Russian Federation); Schawinski, Kevin; Sartori, Lia F. [Institute for Astronomy, ETH Zürich, Wolfgang-Pauli-Straße 27, CH-8093 Zurich (Switzerland); Urry, C. Megan [Department of Physics, Yale University, P.O. Box 208120, New Haven, CT 06520-8120 (United States); Pancoast, Anna [Center for Astrophysics, 60 Garden St., Cambridge, MA 02138 (United States); Schirmer, Mischa, E-mail: wkeel@ua.edu [Gemini Observatory, La Serena (Chile)

2017-02-01

We consider the energy budgets and radiative history of eight fading active galactic nuclei (AGNs), identified from an energy shortfall between the requirements to ionize very extended (radius > 10 kpc) ionized clouds and the luminosity of the nucleus as we view it directly. All show evidence of significant fading on timescales of ≈50,000 yr. We explore the use of minimum ionizing luminosity Q {sub ion} derived from photoionization balance in the brightest pixels in H α at each projected radius. Tests using presumably constant Palomar–Green QSOs, and one of our targets with detailed photoionization modeling, suggest that we can derive useful histories of individual AGNs, with the caveat that the minimum ionizing luminosity is always an underestimate and subject to uncertainties about fine structure in the ionized material. These consistency tests suggest that the degree of underestimation from the upper envelope of reconstructed Q {sub ion} values is roughly constant for a given object and therefore does not prevent such derivation. The AGNs in our sample show a range of behaviors, with rapid drops and standstills; the common feature is a rapid drop in the last ≈2×10{sup 4} yr before the direct view of the nucleus. The e -folding timescales for ionizing luminosity are mostly in the thousands of years, with a few episodes as short as 400 yr. In the limit of largely obscured AGNs, we find additional evidence for fading from the shortfall between even the lower limits from recombination balance and the maximum luminosities derived from far-infrared fluxes. We compare these long-term light curves, and the occurrence of these fading objects among all optically identified AGNs, to simulations of AGN accretion; the strongest variations over these timespans are seen in models with strong and local (parsec-scale) feedback. We present Gemini integral-field optical spectroscopy, which shows a very limited role for outflows in these ionized structures. While rings and

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

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

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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.

Hot Accretion onto Black Holes with Outflow

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Park Myeong-Gu

2018-01-01

Full Text Available Classic Bondi accretion flow can be generalized to rotating viscous accretion flow. Study of hot accretion flow onto black holes show that its physical charateristics change from Bondi-like for small gas angular momentum to disk-like for Keperian gas angular momentum. Especially, the mass accretion rate divided by the Bondi accretion rate is proportional to the viscosity parameter alpha and inversely proportional to the gas angular momentum divided by the Keplerian angular momentum at the Bondi radius for gas angular momentum comparable to the Keplerian value. The possible presence of outflow will increase the mass inflow rate at the Bondi radius but decrease the mass accretion rate across the black hole horizon by many orders of magnitude. This implies that the growth history of supermassive black holes and their coevolution with host galaxies will be dramatically changed when the accreted gas has angular momentum or develops an outflow.

MHOs toward HMOs: A Search for Molecular Hydrogen Emission-Line Objects toward High-mass Outflows

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Wolf-Chase, Grace [Astronomy Department Adler Planetarium 1300 S. Lake Shore Drive Chicago, IL 60605 (United States); Arvidsson, Kim [Trull School of Sciences and Mathematics Schreiner University 2100 Memorial Blvd. Kerrville, TX 78028 (United States); Smutko, Michael, E-mail: gwolfchase@adlerplanetarium.org [Center for Interdisciplinary Exploration and Research in Astrophysics (CIERA), and Dept. of Physics and Astronomy, Northwestern University, 2131 Tech Drive, Evanston, IL 60208 (United States)

2017-07-20

We present the results of a narrow-band near-infrared imaging survey for Molecular Hydrogen emission-line Objects (MHOs) toward 26 regions containing high-mass protostellar candidates and massive molecular outflows. We have detected a total of 236 MHOs, 156 of which are new detections, in 22 out of the 26 regions. We use H{sub 2} 2.12 μ m/H{sub 2} 2.25 μ m flux ratios, together with morphology, to separate the signatures of fluorescence associated with photo-dissociation regions (PDRs) from shocks associated with outflows in order to identify the MHOs. PDRs have typical low flux ratios of ∼1.5–3, while the vast majority of MHOs display flux ratios typical of C-type shocks (∼6–20). A few MHOs exhibit flux ratios consistent with expected values for J-type shocks (∼3–4), but these are located in regions that may be contaminated with fluorescent emission. Some previously reported MHOs have low flux ratios, and are likely parts of PDRs rather than shocks indicative of outflows. We identify a total of 36 outflows across the 22 target regions where MHOs were detected. In over half these regions, MHO arrangements and fluorescent structures trace features present in CO outflow maps, suggesting that the CO emission traces a combination of dynamical effects, which may include gas entrained in expanding PDRs as well as bipolar outflows. Where possible, we link MHO complexes to distinct outflows and identify candidate driving sources.

Cloud Formation and Water Transport on Mars after Major Outflow Events

Science.gov (United States)

Santiago, D. L.; Colaprete, A.; Kreslavsky, M.; Kahre, M. A.; Asphaug, E.

2012-01-01

The triggering of a robust water cycle on Mars might have been caused by the gigantic flooding events evidenced by outflow channels. We use the Ames Mars General Circulation Model (MGCM) to test this hypothesis, studying how these presumably abrupt eruptions of water might have affected the climate of Mars in the past. We model where the water ultimately went as part of a transient atmospheric water cycle, to answer questions including: (1) Can sudden introductions of large amounts of water on the Martian surface lead to a new equilibrated water cycle? (2) What are the roles of water vapor and water ice clouds to sudden changes in the water cycle on Mars? (3) How are radiative feedbacks involved with this? (4) What is the ultimate fate of the outflow water? (5) Can we tie certain geological features to outflow water redistributed by the atmosphere?

Evidence for Ultra-Fast Outflows in Radio-Quiet AGNs: III - Location and Energetics

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Tombesi, F.; Cappi, M.; Reeves, J. N.; Braito, V.

2012-01-01

Using the results of a previous X-ray photo-ionization modelling of blue-shifted Fe K absorption lines on a sample of 42 local radio-quiet AGNs observed with XMM-Newton, in this letter we estimate the location and energetics of the associated ultrafast outflows (UFOs). Due to significant uncertainties, we are essentially able to place only lower/upper limits. On average, their location is in the interval approx.0.0003-0.03pc (approx.10(exp 2)-10(exp 4)tau(sub s) from the central black hole, consistent with what is expected for accretion disk winds/outflows. The mass outflow rates are constrained between approx.0.01- 1 Stellar Mass/y, corresponding to approx. or >5-10% of the accretion rates. The average lower-upper limits on the mechanical power are logE(sub K) approx. or = 42.6-44.6 erg/s. However, the minimum possible value of the ratio between the mechanical power and bolometric luminosity is constrained to be comparable or higher than the minimum required by simulations of feedback induced by winds/outflows. Therefore, this work demonstrates that UFOs are indeed capable to provide a significant contribution to the AGN r.osmological feedback, in agreement with theoretical expectations and the recent observation of interactions between AGN outflows and the interstellar medium in several Seyferts galaxies .

Kinetic modeling of auroral ion outflows observed by the VISIONS sounding rocket

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Albarran, R. M.; Zettergren, M. D.

2017-12-01

The VISIONS (VISualizing Ion Outflow via Neutral atom imaging during a Substorm) sounding rocket was launched on Feb. 7, 2013 at 8:21 UTC from Poker Flat, Alaska, into an auroral substorm with the objective of identifying the drivers and dynamics of the ion outflow below 1000km. Energetic ion data from the VISIONS polar cap boundary crossing show evidence of an ion "pressure cooker" effect whereby ions energized via transverse heating in the topside ionosphere travel upward and are impeded by a parallel potential structure at higher altitudes. VISIONS was also instrumented with an energetic neutral atom (ENA) detector which measured neutral particles ( 50-100 eV energy) presumably produced by charge-exchange with the energized outflowing ions. Hence, inferences about ion outflow may be made via remotely-sensing measurements of ENAs. This investigation focuses on modeling energetic outflowing ion distributions observed by VISIONS using a kinetic model. This kinetic model traces large numbers of individual particles, using a guiding-center approximation, in order to allow calculation of ion distribution functions and moments. For the present study we include mirror and parallel electric field forces, and a source of ion cyclotron resonance (ICR) wave heating, thought to be central to the transverse energization of ions. The model is initiated with a steady-state ion density altitude profile and Maxwellian velocity distribution characterizing the initial phase-space conditions for multiple particle trajectories. This project serves to advance our understanding of the drivers and particle dynamics in the auroral ionosphere and to improve data analysis methods for future sounding rocket and satellite missions.

Urinary Tract Infection (UTI)

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... Home A-Z Health Topics Urinary tract infections Urinary tract infections > A-Z Health Topics Urinary tract infections (PDF, ... Embed Subscribe To receive Publications email updates Submit Urinary tract infections Urinary tract infections (UTIs) are most often caused ...

SPECTROSCOPIC OBSERVATIONS OF CONTINUOUS OUTFLOWS AND PROPAGATING WAVES FROM NOAA 10942 WITH EXTREME ULTRAVIOLET IMAGING SPECTROMETER/HINODE

International Nuclear Information System (INIS)

Nishizuka, N.; Hara, H.

2011-01-01

We focused on 'sit-and-stare' observations of an outflow region at the edge of active region NOAA 10942 on 2007 February 20 obtained by the Extreme ultraviolet Imaging Spectrometer on board Hinode. We analyzed the data above the base of the outflow and found both continuous outflows and waves, which propagate from the base of the outflow. The spectra at the base of the outflow and at higher locations show different properties. The line profiles show blue-side asymmetry at the base of the outflow where nonthermal broadening becomes large because of fast upflows generated by heating events. On the other hand, at higher locations line profiles are symmetric and the intensity disturbances vary in phase with the velocity disturbances. The correlations between the intensity and velocity disturbances become noticeable at higher locations, so this indicates evidence of (at least locally) upward propagating slow-mode waves along the outflow. We also found a transient oscillation of different period in the wavelet spectrum. This indicates that a different wave is additionally observed during a limited period. High cadence spectroscopic observations revealed intermittent signatures of nonthermal velocities. Each of them seems to correspond to the base of the propagating disturbances. Furthermore, a jet was captured by the sit-and-stare observations across the slit. The similarity of line profiles of the outflow and the jet may indicate that the flows and waves originate in unresolved explosive events in the lower atmosphere of the corona.

Brugada-like Precordial ST Elevation on ECG by Anterior Mediastinal Infective Mass Lesion

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Yuji Nakazato

2003-07-01

Full Text Available Several causes are known to induce the right precordial ST elevation mimicking Brugada syndrome. Right ventricular outflow area is assumed to be responsible for such ECG changes. We experienced a case of anterior mediastinal infective mass lesion with a Brugada-like ECG. A 52-year-old female, who has pulmonary stenosis and recurrent episodes of right ventricular heart failure, complained of high fever, abdominal discomfort, and edema. On physical examination, jugular vein dilation, hepatomegaly, and facial and leg edema were noted. Leucocytosis was also noted on blood examination. An ECG showed right ventricular hypertrophy, incomplete right bundle branch block pattern and marked ST elevation on precordial leads mimicking Brugada syndrome. Magnetic resonance imaging revealed an abnormal mass shadow located on the anterior mediastinum and compressing the right ventricle (Figure 1A. Trans-thoracic echocardiography also showed the high echogenic mass lesion at the anterior side of right ventricle and the vicinity of pulmonary valve. After treatment with antibiotics, the mass lesion gradually shrunk. Concomitantly, the ST elevation disappeared with improvement of inflammatory markers (Figure 1B. The symptoms suggesting right ventricular failure were also ameliorated. The mechanism of Brugada-like ST elevation in this patient was considered to be compression, by the abnormal infective mass, of the right ventricular outflow tract with/without focal pericardial inflammation.

[Nitrofurantoin--clinical relevance in uncomplicated urinary tract infections].

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Stock, Ingo

2014-07-01

The nitrofuran derivative nitrofurantoin has been used for more than 60 years for the antibacterial therapy of uncomplicated urinary tract infections (UTI). Despite its long application, this antibiotic retained good activity against Escherichia coli and some other pathogens of uncomplicated urinary tract infections such as Staphylococcus saprophyticus and Enterococcus species. Nitrofurantoin therapy has been shown to be accompanied by numerous adverse drug effects. Among these, there are also serious side effects such as pulmonary reactions and polyneuropathy, which mainly occur in long-term use. Recent studies, however, have shown a good efficacy and tolerability of short-term nitrofurantoin therapy comparable to previous established standard therapeutic regimens applying cotrimoxazole or quinolones. Because of these data and the alarming resistance rates of uropathogenic Escherichia coli to cotrimoxazole and quinolones that have been increased markedly in several countries, the clinical significance ofnitrofurantoin has been raised again. In many current treatment guidelines, e. g., the international clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women published by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases, nitrofurantoin has been recommended as one first-line antibiotic of empiric antibacterial treatment of uncomplicated cystitis in otherwise healthy women. In Germany, however, nitrofurantoin should only be applied if more effective and less risky antibiotics cannot be used. Nitrofurantoin is contraindicated in the last three months of pregnancy and in patients suffering from renal impairment of each degree. Despite compatibility concerns, nitrofurantoin has also been recommended for the re-infection prophylaxis of recurrent uncomplicated urinary tract infections in Germany and several other countries.

Physical Processes for Driving Ionospheric Outflows in Global Simulations

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Moore, Thomas Earle; Strangeway, Robert J.

2009-01-01

We review and assess the importance of processes thought to drive ionospheric outflows, linking them as appropriate to the solar wind and interplanetary magnetic field, and to the spatial and temporal distribution of their magnetospheric internal responses. These begin with the diffuse effects of photoionization and thermal equilibrium of the ionospheric topside, enhancing Jeans' escape, with ambipolar diffusion and acceleration. Auroral outflows begin with dayside reconnexion and resultant field-aligned currents and driven convection. These produce plasmaspheric plumes, collisional heating and wave-particle interactions, centrifugal acceleration, and auroral acceleration by parallel electric fields, including enhanced ambipolar fields from electron heating by precipitating particles. Observations and simulations show that solar wind energy dissipation into the atmosphere is concentrated by the geomagnetic field into auroral regions with an amplification factor of 10-100, enhancing heavy species plasma and gas escape from gravity, and providing more current carrying capacity. Internal plasmas thus enable electromagnetic driving via coupling to the plasma, neutral gas and by extension, the entire body " We assess the Importance of each of these processes in terms of local escape flux production as well as global outflow, and suggest methods for their implementation within multispecies global simulation codes. We complete 'he survey with an assessment of outstanding obstacles to this objective.

The Critical Role of Pulmonary Arterial Compliance in Pulmonary Hypertension

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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

Characterizing the origin and impact of the most extreme molecular outflows in the nearby universe

Science.gov (United States)

Gowardhan, Avani; Riechers, Dominik A.; Spoon, Henrik; Farrah, Duncan

2018-01-01

Observations over the last decade have revealed that feedback in the form of molecular gas outflows is ubiquitous in local ultra luminous infrared galaxies (ULIRGs). Such outflows can clear the nuclear environments of gas and dust, quench star formation and active galactic nuclei (AGN) growth, and they are a key step in the evolution of dust-obscured AGN to optically luminous quasars. We here present multi-spectral line observations of feedback in the two most powerful molecular gas outflows in the local universe. We spatially resolve the outflows to determine their kinematics and structure and find that they can drive out the molecular gas and quench star formation within ~ few Myr. Applying mid-IR diagnostics to constrain the relative contributions of AGN and nuclear starburst activity, we find that starburst activity plays a significant role in driving the outflow. We discuss the implications for future studies of feedback in the local universe and obscured AGN at high redshift, which is a key target population for JWST and ALMA over the next decade.

Inferring Polar Ion Outflows from Topside Ionograms

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Sojka, J. J.; Rice, D. D.; Eccles, V.; Schunk, R. W.; David, M.; Benson, R. F.; James, H. G.

2017-12-01

The high-latitude topside ionosphere is dominated by O+ ions from the F-region peak around 300 km to over 1000 km altitude. The O+ profile shape provides information on the thermal structure, field aligned plasma dynamics, and outflows into the magnetosphere. Topside electron density profiles (EDP) are either obtained from topside sounders or Incoherent Scatter Radars. There is a large archive of topside sounder ionograms and hand scaled EDPs from the Alouette and ISIS satellites between 1962 and 1990. Recent NASA data enhancement efforts have augmented these EDP archives by producing digital topside ionograms both from the 7-track analog telemetry tapes and from 35 mm topside film ionograms. Rice et al [2017] in their 35 mm ionogram recovery emphasized high latitude ionograms taken during disturbed conditions. The figure below contrasts ISIS-II EDPs extracted from 35 mm films before and during a major storm (Dst -200nT) on 9 April 1972 (left panel: quiet period before the storm; right panel: during the peak of the storm). Both satellite passes used for these EDPs were centered on the Resolute Bay location that in 1972 was close to the magnetic pole. They begin at auroral latitudes around 2100 MLT and end on the dayside around 0900MLT. We will present results of how ionospheric models replicate both the quiet and disturbed conditions shown in the figure. Three types of models will be contrasted: an empirical ionosphere (IRI), a physics based ionospheric model (TDIM), and a fluid-based polar-wind model (PW). During the storm pass, when it is expected that substantial heating is present, the ISIS-II topside EDPs provide severe constraints on the usage of these models. These constraints enable estimates of the outflow fluxes as well as the heating that has occurred. The comparisons with the empirical model establish how well the pre-storm topside is modeled and identifies the challenges as the storm magnitude increases. The physics-based TDIM does have storm drivers

Centrifuge modeling of one-step outflow tests for unsaturated parameter estimations

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H. Nakajima

2006-01-01

Full Text Available Centrifuge modeling of one-step outflow tests were carried out using a 2-m radius geotechnical centrifuge, and the cumulative outflow and transient pore water pressure were measured during the tests at multiple gravity levels. Based on the scaling laws of centrifuge modeling, the measurements generally showed reasonable agreement with prototype data calculated from forward simulations with input parameters determined from standard laboratory tests. The parameter optimizations were examined for three different combinations of input data sets using the test measurements. Within the gravity level examined in this study up to 40g, the optimized unsaturated parameters compared well when accurate pore water pressure measurements were included along with cumulative outflow as input data. With its capability to implement variety of instrumentations under well controlled initial and boundary conditions and to shorten testing time, the centrifuge modeling technique is attractive as an alternative experimental method that provides more freedom to set inverse problem conditions for the parameter estimation.

Centrifuge modeling of one-step outflow tests for unsaturated parameter estimations

Science.gov (United States)

Nakajima, H.; Stadler, A. T.

2006-10-01

Centrifuge modeling of one-step outflow tests were carried out using a 2-m radius geotechnical centrifuge, and the cumulative outflow and transient pore water pressure were measured during the tests at multiple gravity levels. Based on the scaling laws of centrifuge modeling, the measurements generally showed reasonable agreement with prototype data calculated from forward simulations with input parameters determined from standard laboratory tests. The parameter optimizations were examined for three different combinations of input data sets using the test measurements. Within the gravity level examined in this study up to 40g, the optimized unsaturated parameters compared well when accurate pore water pressure measurements were included along with cumulative outflow as input data. With its capability to implement variety of instrumentations under well controlled initial and boundary conditions and to shorten testing time, the centrifuge modeling technique is attractive as an alternative experimental method that provides more freedom to set inverse problem conditions for the parameter estimation.

Observations of the Evolution of Ion Outflow During a Sawtooth Event

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Lund, E. J.; Nowrouzi, N.; Kistler, L. M.; Cai, X.; Frey, H. U.

2015-12-01

Sawtooth oscillations are one of several convection modes known to exist in the magnetosphere. Recent simulations have suggested that O+^+ ions transported from the high-latitude ionosphere to the magnetotail can drive sawtooth events. We present observational case studies of sawtooth events using data from FAST near the noon-midnight meridional plane, Cluster in the magnetotail, GOES and LANL energetic particle sensors at geosynchronous orbit, and ACE solar wind data to investigate the evolution of ion outflow during sawtooth events and the question of whether O+^+ outflow from one tooth helps to drive subsequent teeth. We find that oxygen enters the tail from the lobes after each tooth onset, the oxygen fraction in the magnetotail often increases after a tooth onset, and that the oxygen fraction of outflowing ions increases after a tooth event both in the cusp and on the nightside. However, a significant amount of low energy oxygen (≲1 keV) can end up in the dayside inner magnetosphere.

Coastal circulations driven by river outflow in a variable-density 1.5-layer model

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McCreary, J.P.; Zhang, S.; Shetye, S.R.

A variable-density, 1.5-layer model is used to investigate the dynamics of the fresher-water plumes generated by river outflow. Solutions are found in a north-south channel, and the transport M sub(tau) and salinity S sub(tau) of the outflow...

Invasive and noninvasive assessment of pulmonic regurgitation: clinical, angiographic, phonocardiographic, echocardiographic, and Doppler ultrasound correlations.

Science.gov (United States)

Chandraratna, P A; Wilson, D; Imaizumi, T; Ritter, W S; Aronow, W S

1982-06-01

Three patients with pulmonic regurgitation and no evidence of pulmonary hypertension were investigated. These patients had low pitched diastolic murmurs which increased on inspiration, evidence of connective tissue disease as manifested by lax joints and hyperextensible skin, and marked hilar dance which extended up to the peripheral vessels. Suprasternal echocardiography revealed dilatation and increased systolic expansion of the right pulmonary artery (RPA) (25% and 28%, respectively) in two patients; the third patient had a normal RPA dimension in diastole and a marked increase in diameter (88%) in systole. Thus, these three patients demonstrated hyperdistensibility of the RPA. The spectral signal from the pulsed doppler echocardiograph showed evidence of turbulent blood flow in diastole (wide dispersion of the dots) in the right ventricular outflow tract in all three patients. This pattern was indicative of pulmonic regurgitation. In summary, the combined use of echocardiography and Doppler ultrasound is useful in the evaluation of patients with pulmonic regurgitation.

Anatomical Basis for the Cardiac Interventional Electrophysiologist

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Damián Sánchez-Quintana

2015-01-01

Full Text Available The establishment of radiofrequency catheter ablation techniques as the mainstay in the treatment of tachycardia has renewed new interest in cardiac anatomy. The interventional arrhythmologist has drawn attention not only to the gross anatomic details of the heart but also to architectural and histological characteristics of various cardiac regions that are relevant to the development or recurrence of tachyarrhythmias and procedural related complications of catheter ablation. In this review, therefore, we discuss some anatomic landmarks commonly used in catheter ablations including the terminal crest, sinus node region, Koch’s triangle, cavotricuspid isthmus, Eustachian ridge and valve, pulmonary venous orifices, venoatrial junctions, and ventricular outflow tracts. We also discuss the anatomical features of important structures in the vicinity of the atria and pulmonary veins, such as the esophagus and phrenic nerves. This paper provides basic anatomic information to improve understanding of the mapping and ablative procedures for cardiac interventional electrophysiologists.

Doubly committed subarterial ventricular septal defect with prolapsed right coronary cusp with moderate aortic regurgitation

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Redoy Ranjan

2017-11-01

Full Text Available A 4 year old girl was presented with the respiratory tract infection, breathlessness after taking meal, failure to thrive, abnormal movement of the chest on left side overlying the area of heart and systolic murmur. She developed these symptoms gradually for the last 3.5 years. Echocardiography revealed doubly committed subarterial ventricular septal defect with moderate aortic regurgitation. The size of the ventricular septal defect was 7 x 9 mm at the left ventricular outflow tract. The right coronary cusp of the aortic valve was prolapsed. Left atrium and left ventricle were dilated. The pulmonary artery systolic pressure was 35 mm Hg. The ventricular septal defect was closed with the standard surgical procedure using cardiopulmonary bypass followed by aortotomy and right atriotomy. Immediate post-operative period of this case was uneventful and the patient was discharged on 9th post-operative day. Follow-up echocardiography showed no residual ventricular septal defect or aortic regurgitation and the ventricular function was good.

Pulmonary tuberculosis in patients with idiopathic pulmonary fibrosis

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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.

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

SPATIALLY RESOLVED OBSERVATIONS OF THE BIPOLAR OPTICAL OUTFLOW FROM THE BROWN DWARF 2MASS J12073347–3932540

International Nuclear Information System (INIS)

Whelan, E. T.; Ray, T. P.; Comeron, F.; Bacciotti, F.; Kavanagh, P. J.

2012-01-01

Studies of brown dwarf (BD) outflows provide information pertinent to questions on BD formation, as well as allowing outflow mechanisms to be investigated at the lowest masses. Here new observations of the bipolar outflow from the 24 M JUP BD 2MASS J12073347–3932540 are presented. The outflow was originally identified through the spectro-astrometric analysis of the [O I]λ6300 emission line. Follow-up observations consisting of spectra and [S II], R-band and I-band images were obtained. The new spectra confirm the original results and are used to constrain the outflow position angle (P.A.) at ∼65°. The [O I]λ6300 emission line region is spatially resolved and the outflow is detected in the [S II] images. The detection is firstly in the form of an elongation of the point-spread function (PSF) along the direction of the outflow P.A. Four faint knot-like features (labeled A-D) are also observed to the southwest of 2MASS J12073347–3932540 along the same P.A. suggested by the spectra and the elongation in the PSF. Interestingly, D, the feature furthest from the source, is bow shaped with the apex pointing away from 2MASS J12073347–3932540. A color-color analysis allows us to conclude that at least feature D is part of the outflow under investigation while A is likely a star or galaxy. Follow-up observations are needed to confirm the origin of B and C. This is a first for a BD, as BD optical outflows have to date only been detected using spectro-astrometry. This result also demonstrates for the first time that BD outflows can be collimated and episodic.

Herbig-haro objects and mid-infrared outflows in the VELA C molecular cloud

International Nuclear Information System (INIS)

Zhang, Miaomiao; Wang, Hongchi; Henning, Thomas

2014-01-01

We have performed a deep [S II] λλ6717/6731 wide field Herbig-Haro (HH) object survey toward the Vela C molecular cloud with a sky coverage of about 2 deg 2 . In total, 18 new HH objects, HH 1090-1107, are discovered and the two previously known HH objects, HH 73-74, are also detected in our [S II] images. We also present an investigation of mid-infrared outflows in the Vela C molecular cloud using the Wide-field Infrared Survey Explorer images taken from AllWISE data release. Using the method suggested by Zhang and Wang, 11 extended green objects (EGOs) are identified to be the mid-infrared outflows, including 6 new mid-infrared outflows that have not been detected previously at other wavelengths and 5 mid-infrared counterparts of the HH objects detected in this work. Using the AllWISE Source Catalog and the source classification scheme suggested by Koenig et al., we have identified 56 young stellar object (YSO) candidates in the Vela C molecular cloud. The possible driving sources of the HH objects and EGOs are discussed based on the morphology of HH objects and EGOs and the locations of HH objects, EGOs and YSO candidates. Finally we associate 12 HH objects and 5 EGOs with 10 YSOs and YSO candidates. The median length of the outflows in Vela C is 0.35 pc and the outflows seem to be oriented randomly.

A challenging case of invasive pulmonary aspergillosis after near-drowning: a case report and literature review.

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Jenks, Jeffrey D; Preziosi, Michael

2015-09-01

Near-drowning, a relatively common event, is often complicated by subsequent pneumonia. While endogenous and exogenous bacteria are typical pathogens, rarely fungi are as well. We report a complicated case of invasive pulmonary aspergillosis in a 30-year-old man after a near-drowning event. We also review the medical literature for similar cases. All cases of invasive pulmonary aspergillosis after near-drowning reported in the literature involve Aspergillus fumigatus . The majority of cases involved submersion in stagnant water after a motor vehicle accident (MVA). Treatment varied considerably, with amphotericin B used in the majority of cases. Morbidity was considerable with prolonged hospitalization occurring in every case, and mortality occurring in fifty percent of the reported cases. Although a rare complication of near-drowning, invasive pulmonary aspergillosis can occur and lead to significant morbidity and mortality. After near-drowning A. fumigatus isolated from the respiratory tract should be assumed to be a true pathogen and treated accordingly.

Outflows from black hole hyperaccretion systems: short and long-short gamma-ray bursts and `quasi-supernovae'

Science.gov (United States)

Song, Cui-Ying; Liu, Tong; Li, Ang

2018-06-01

The detections of some long gamma-ray bursts (LGRBs) relevant to mergers of neutron star (NS)-NS or black hole (BH)-NS, as well as some short gamma-ray bursts (SGRBs) probably produced by collapsars, muddle the boundary of two categories of gamma-ray bursts (GRBs). In both cases, a plausible candidate of central engine is a BH surrounded by a hyperaccretion disc with strong outflows, launching relativistic jets driven by Blandford-Znajek mechanism. In the framework of compact binary mergers, we test the applicability of the BH hyperaccretion inflow-outflow model on powering observed GRBs. We find that, for a low outflow ratio, ˜ 50 per cent, post-merger hyperaccretion processes could power not only all SGRBs but also most of LGRBs. Some LGRBs might originate from merger events in the BH hyperaccretion scenario, at least on the energy requirement. Moreover, kilonovae might be produced by neutron-rich outflows, and their luminosities and time-scales significantly depend on the outflow strengths. GRBs and their associated kilonovae are competitive with each other on the disc mass and total energy budgets. The stronger the outflow, the more similar the characteristics of kilonovae to supernovae (SNe). This kind of `nova' might be called `quasi-SN'.

Martian outflow channels: How did their source aquifers form, and why did they drain so rapidly?

Science.gov (United States)

Rodriguez, J Alexis P; Kargel, Jeffrey S; Baker, Victor R; Gulick, Virginia C; Berman, Daniel C; Fairén, Alberto G; Linares, Rogelio; Zarroca, Mario; Yan, Jianguo; Miyamoto, Hideaki; Glines, Natalie

2015-09-08

Catastrophic floods generated ~3.2 Ga by rapid groundwater evacuation scoured the Solar System's most voluminous channels, the southern circum-Chryse outflow channels. Based on Viking Orbiter data analysis, it was hypothesized that these outflows emanated from a global Hesperian cryosphere-confined aquifer that was infused by south polar meltwater infiltration into the planet's upper crust. In this model, the outflow channels formed along zones of superlithostatic pressure generated by pronounced elevation differences around the Highland-Lowland Dichotomy Boundary. However, the restricted geographic location of the channels indicates that these conditions were not uniform. Furthermore, some outflow channel sources are too high to have been fed by south polar basal melting. Using more recent mission data, we argue that during the Late Noachian fluvial and glacial sediments were deposited into a clastic wedge within a paleo-basin located in the southern circum-Chryse region, which at the time was completely submerged under a primordial northern plains ocean [corrected]. Subsequent Late Hesperian outflow channels were sourced from within these geologic materials and formed by gigantic groundwater outbursts driven by an elevated hydraulic head from the Valles Marineris region. Thus, our findings link the formation of the southern circum-Chryse outflow channels to ancient marine, glacial, and fluvial erosion and sedimentation.

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.

Relativistic Outflows from Advection-dominated Accretion Disks around Black Holes

Science.gov (United States)

Becker, Peter A.; Subramanian, Prasad; Kazanas, Demosthenes

2001-05-01

Advection-dominated accretion flows (ADAFs) have a positive Bernoulli parameter and are therefore gravitationally unbound. The Newtonian ADAF model has been generalized recently to obtain the ADIOS model that includes outflows of energy and angular momentum, thereby allowing accretion to proceed self-consistently. However, the utilization of a Newtonian gravitational potential limits the ability of this model to describe the inner region of the disk, where any relativistic outflows are likely to originate. In this paper we modify the ADIOS scenario to incorporate a pseudo-Newtonian potential, which approximates the effects of general relativity. The analysis yields a unique, self-similar solution for the structure of the coupled disk/wind system. Interesting features of the new solution include the relativistic character of the outflow in the vicinity of the radius of marginal stability, which represents the inner edge of the quasi-Keplerian disk in our model. Hence, our self-similar solution may help to explain the origin of relativistic jets in active galaxies. At large distances the radial dependence of the accretion rate approaches the unique form M~r1/2, with an associated density variation given by ρ~r-1. This density variation agrees with that implied by the dependence of the hard X-ray time lags on the Fourier frequency for a number of accreting galactic black hole candidates. While intriguing, the predictions made using our self-similar solution need to be confirmed in the future using a detailed model that includes a physical description of the energization mechanism that drives the outflow, which is likely to be powered by the shear of the underlying accretion disk.

PROPER MOTIONS OF YOUNG STELLAR OUTFLOWS IN THE MID-INFRARED WITH SPITZER (IRAC). I. THE NGC 1333 REGION

International Nuclear Information System (INIS)

Raga, A. C.; Noriega-Crespo, A.; Carey, S. J.; Arce, H. G.

2013-01-01

We use two 4.5 μm Spitzer (IRAC) maps of the NGC 1333 region taken over a ∼7 yr interval to determine proper motions of its associated outflows. This is a first successful attempt at obtaining proper motions of stellars' outflow from Spitzer observations. For the outflow formed by the Herbig-Haro objects HH7, 8, and 10, we find proper motions of ∼9-13 km s –1 , which are consistent with previously determined optical proper motions of these objects. We determine proper motions for a total of eight outflows, ranging from ∼10 to 100 km s –1 . The derived proper motions show that out of these eight outflows, three have tangential velocities ≤20 km s –1 . This result shows that a large fraction of the observed outflows have low intrinsic velocities and that the low proper motions are not merely a projection effect.

Bipolar molecular outflows: T Tauri stars and Herbig-Haro objects

International Nuclear Information System (INIS)

Choe, S.U.

1984-01-01

The relations of Herbig-Haro objects to the observed bipolar molecular outflows with T Tauri stars are studied. An evaporation disk model is proposed to obtain the shape of the disk where gas evaporates and to explain the collimation of the central T Tauri wind. In this case the collimation angle is about 10 0 . The collimated T Tauri wind making a form of de Laval nozzle viscously interacts with the surrounding medium. This interaction enhances the second collimation (about 40 0 ) of the resulting flow, mixing stellar and disk winds with external molecular gas. These viscous outflows are observed in the bipolar molecular outflow of the T Tauri stars. It is also proposed in the model that a Kelvin-Helmholtz instability in the throat of the de Laval nozzle produces clumps, which can be accelerated by the ram pressure of the collimated wind up to the wind speed. The clumps eventually pass through a shock in the outlfow, which results from its encounter with the ambient cloud. The clumps are then moving faster than the surrounding flow. These clumps are identified with Herbig-Haro objects

Understanding satellite-based monthly-to-seasonal reservoir outflow estimation as a function of hydrologic controls

Science.gov (United States)

Bonnema, Matthew; Sikder, Safat; Miao, Yabin; Chen, Xiaodong; Hossain, Faisal; Ara Pervin, Ismat; Mahbubur Rahman, S. M.; Lee, Hyongki

2016-05-01

Growing population and increased demand for water is causing an increase in dam and reservoir construction in developing nations. When rivers cross international boundaries, the downstream stakeholders often have little knowledge of upstream reservoir operation practices. Satellite remote sensing in the form of radar altimetry and multisensor precipitation products can be used as a practical way to provide downstream stakeholders with the fundamentally elusive upstream information on reservoir outflow needed to make important and proactive water management decisions. This study uses a mass balance approach of three hydrologic controls to estimate reservoir outflow from satellite data at monthly and annual time scales: precipitation-induced inflow, evaporation, and reservoir storage change. Furthermore, this study explores the importance of each of these hydrologic controls to the accuracy of outflow estimation. The hydrologic controls found to be unimportant could potentially be neglected from similar future studies. Two reservoirs were examined in contrasting regions of the world, the Hungry Horse Reservoir in a mountainous region in northwest U.S. and the Kaptai Reservoir in a low-lying, forested region of Bangladesh. It was found that this mass balance method estimated the annual outflow of both reservoirs with reasonable skill. The estimation of monthly outflow from both reservoirs was however less accurate. The Kaptai basin exhibited a shift in basin behavior resulting in variable accuracy across the 9 year study period. Monthly outflow estimation from Hungry Horse Reservoir was compounded by snow accumulation and melt processes, reflected by relatively low accuracy in summer and fall, when snow processes control runoff. Furthermore, it was found that the important hydrologic controls for reservoir outflow estimation at the monthly time scale differs between the two reservoirs, with precipitation-induced inflow being the most important control for the Kaptai

Four-dimensional ultrasonography of the fetal heart with spatiotemporal image correlation.

Science.gov (United States)

Gonçalves, Luís F; Lee, Wesley; Chaiworapongsa, Tinnakorn; Espinoza, Jimmy; Schoen, Mary Lou; Falkensammer, Peter; Treadwell, Marjorie; Romero, Roberto

2003-12-01

This study was undertaken to describe a new technique for the examination of the fetal heart using four-dimensional ultrasonography with spatiotemporal image correlation (STIC). Volume data sets of the fetal heart were acquired with a new cardiac gating technique (STIC), which uses automated transverse and longitudinal sweeps of the anterior chest wall. These volumes were obtained from 69 fetuses: 35 normal, 16 with congenital anomalies not affecting the cardiovascular system, and 18 with cardiac abnormalities. Dynamic multiplanar slicing and surface rendering of cardiac structures were performed. To illustrate the STIC technique, two representative volumes from a normal fetus were compared with volumes obtained from fetuses with the following congenital heart anomalies: atrioventricular septal defect, tricuspid stenosis, tricuspid atresia, and interrupted inferior vena cava with abnormal venous drainage. Volume datasets obtained with a transverse sweep were utilized to demonstrate the cardiac chambers, moderator band, interatrial and interventricular septae, atrioventricular valves, pulmonary veins, and outflow tracts. With the use of a reference dot to navigate the four-chamber view, intracardiac structures could be simultaneously studied in three orthogonal planes. The same volume dataset was used for surface rendering of the atrioventricular valves. The aortic and ductal arches were best visualized when the original plane of acquisition was sagittal. Volumes could be interactively manipulated to simultaneously visualize both outflow tracts, in addition to the aortic and ductal arches. Novel views of specific structures were generated. For example, the location and extent of a ventricular septal defect was imaged in a sagittal view of the interventricular septum. Furthermore, surface-rendered images of the atrioventricular valves were employed to distinguish between normal and pathologic conditions. Representative video clips were posted on the Journal's Web

Investigations of Short-Timescale Outflow Variability in Quasars of the Sloan Digital Sky Survey

Science.gov (United States)

Hemler, Zachary; Grier, Catherine; Brandt, William; Hall, Patrick; Schneider, Donald; Shen, Yue; Fernandez-Trincado, Jose; SDSS-RM Collaboration

2018-01-01

Quasar outflows are hypothesized to regulate the growth of a quasar's host galaxy and the supermassive black hole (SMBH) itself. Thus, understanding the physics of these outflows is imperative to understanding galactic evolution. The physical properties of these outflows, such as density, radial distance from the SMBH, and kinetic energy can be investigated by measuring both the strength and shape variability of broad absorption lines (BALs) in quasar spectra. However, the accuracy of physical properties calculated using BAL variability methods is limited by the time resolution of the observations. Recent spectral data from the Sloan Digital Sky Survey Reverberation Mapping program (SDSS-RM) provides a novel opportunity to investigate the short-term BAL variability of many quasars at many epochs. The SDSS-RM program took many epochs of spectra for a large sample of quasars over a period of several years, many of which exhibit BALs. The median rest-frame time resolution of these observations is roughly 2 days, in contrast to previous large-sample studies, which typically have time spacing on the order of hundred of days. We are using the SDSS-RM dataset to conduct a BAL variability study that will further constrain outflow properties and provide significant insights into the variability mechanisms of quasar outflows. We are searching for variability in BALs on timescales of less than 2 days among our sample of 22 quasars and determining whether this behavior is common among quasars. We are also investigating the general short-term (less than 10 days) variability characteristics of the entire sample. We will present preliminary results from this study and the possible implications to our understanding of quasar outflows.

DIRECT IMAGING OF A COMPACT MOLECULAR OUTFLOW FROM A VERY LOW LUMINOSITY OBJECT: L1521F-IRS

Energy Technology Data Exchange (ETDEWEB)

Takahashi, Satoko [Joint ALMA Observatory, Alonso de Cordova 3107, Vitacura, Santiago (Chile); Ohashi, Nagayoshi [Academia Sinica Institute of Astronomy and Astrophysics, P.O. Box 23-141, Taipei 10617, Taiwan (China); Bourke, Tyler L., E-mail: satoko.takahashi@nao.ac.jp [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States)

2013-09-01

Studying the physical conditions of very low luminosity objects (VeLLOs; L{sub bol} < 0.1 L{sub Sun }) is important for understanding the earliest evolutionary stage of protostars and brown dwarfs. We report interferometric observations of the VeLLO L1521F-IRS, in {sup 12}CO (2-1) line emission and the 1.3 mm continuum emission, using the Submillimeter Array. With the {sup 12}CO (2-1) high-resolution observations, we have spatially resolved a compact but poorly collimated molecular outflow associated with L1521F-IRS for the first time. The blueshifted and redshifted lobes are aligned along the east and west side of L1521F-IRS with a lobe size of Almost-Equal-To 1000 AU. The estimated outflow mass, maximum outflow velocity, and outflow force are (9.0-80) Multiplication-Sign 10{sup -4} M{sub Sun }, 7.2 km s{sup -1}, and (7.4-66) Multiplication-Sign 10{sup -7} M{sub Sun} km s{sup -1} yr{sup -1}, respectively. The estimated outflow parameters such as size, mass, and momentum rate are similar to values derived for other VeLLOs, and are located at the lower end of values compared to previously studied outflows associated with low- to high-mass star-forming regions. Low-velocity less collimated (1.5 km s{sup -1}/1200 AU) and higher-velocity compact (4.0 km s{sup -1}/920 AU) outflow components are suggested by the data. These velocity structures are not consistent with those expected in the jet-driven or wind-driven outflow models, perhaps suggesting a remnant outflow from the first hydrostatic core as well as an undeveloped outflow from the protostar. Detection of an infrared source and compact millimeter continuum emission suggests the presence of the protostar, while its low bolometric luminosity (0.034-0.07 L{sub Sun }) and small outflow suggests that L1521F is in the earliest protostellar stage (<10{sup 4} yr) and contains a substellar mass object. The bolometric (or internal) luminosity of L1521F-IRS suggests that the current mass accretion rate is an order of

Influence of vesicoureteral reflux and urinary tract infection on renal growth in children with upper urinary tract duplication

International Nuclear Information System (INIS)

Hannerz, L.; Wikstad, I.; Celsi, G.; Aperia, A.; St. Goeran's Children's Hospital, Stockholm

1989-01-01

The growth of the renal parenchyma was examined in children with duplicated outflow systems, vesicoureteral reflux (VUR), urinary tract infection (UTI) and no sign of obstruction. Ten patients with reflux occurring only in the caudal system (group A) and 4 patients with reflux both to the caudal and the apical system (group B) were studied shortly after their first UTI (study 1) and then 1.5 to 9 years later (study 2). The frequency of UTI was relatively high during the follow-up period. At urography, renal length and renal area were normal in group A in studies 1 and 2. Parenchymal thickness of the apical pole (APT/L) did not differ from normal values in any of the studies. Parenchymal thickness of the caudal pole (CPT/L) was significantly smaller than normal in both studies. There was also a significant decrease in CPT/L between study 1 and 2. UTI during the first year of life was associated with a greater reduction in CPT/L. The determination of renal length and renal area in children with a duplicated ureter, VUR and UTI, does not identify subjects at risk of developing renal growth retardation while serial determinations of parenchymal thickness appear to be an appropriate method. (orig.)

Urinary Tract Health

Science.gov (United States)

... related to the urinary tract health of women: Urinary Tract Infections (UTIs) and Urinary Incontinence (UI). For information on a range of urinary tract health issues for women, men, and children, visit the National Kidney and Urologic Diseases Information ...

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.

ERUPTIVE VARIABLE STARS AND OUTFLOWS IN SERPENS NW

Energy Technology Data Exchange (ETDEWEB)

Hodapp, Klaus W. [Institute for Astronomy, University of Hawaii, 640 N. Aohoku Place, Hilo, HI 96720 (United States); Chini, Rolf; Watermann, Ramon; Lemke, Roland, E-mail: hodapp@ifa.hawaii.edu [Ruhr Universitaet Bochum, Astronomisches Institut, Universitaetsstrasse 150, D-44801 Bochum (Germany)

2012-01-01

We study the outflow activity, photometric variability, and morphology of three very young stellar objects in the Serpens NW star-forming region: OO Serpentis, EC 37 (V370 Ser), and EC 53 (V371 Ser). High spatial resolution Keck/NIRC2 laser guide star adaptive optics images obtained in 2007 and 2009 in broadband K and in a narrowband filter centered on the 1-0 S(1) emission line of H{sub 2} allow us to identify the outflows from all three objects. We also present new, seeing-limited data on the photometric evolution of the OO Ser reflection nebula and re-analyze previously published data. We find that OO Ser declined in brightness from its outburst peak in 1995 to about 2003, but that this decline has recently stopped and actually reversed itself in some areas of the reflection nebula. The morphology and proper motions of the shock fronts MHO 2218 near EC 37 suggest that they all originate in EC 37 and that this is an outflow seen nearly along its axis. We identify an H{sub 2} jet emerging from the cometary nebula EC 53. The star illuminating EC 53 is periodically variable with a period of 543 days and has a close-by, non-variable companion at a projected distance of 92 AU. We argue that the periodic variability is the result of accretion instabilities triggered by another very close, not directly observable, binary companion and that EC 53 can be understood in the model of a multiple system developing into a hierarchical configuration.

Anomalies of Pulmonary Circulation as a Cause of Hemoptysis: A Series of Unusual Cases and Review of the Literature

Directory of Open Access Journals (Sweden)

Kamini Gupta

2015-05-01

Full Text Available The expectoration of blood originating from the lower respiratory tract, called hemoptysis, is a common clinical condition with many potential etiologies. Massive hemoptysis is life threatening and needs urgent intervention. Multidetector computed tomography (MDCT is a useful non-invasive imaging modality for the initial assessment of hemoptysis. Using MDCT with multiplanar reformatted images has improved the diagnosis and management of hemoptysis by providing a more precise depiction of bronchial and non-bronchial systemic arteries than conventional computed tomography (CT. In 95% of hemoptysis cases, the systemic arterial system is the origin of bleeding and pulmonary vascular anomalies are a rare cause. Among these, pulmonary arteriovenous malformation, hereditary hemorrhagic telangiectasia, and Osler-Weber-Rendu disease are well known entities. However, primary anomalies affecting pulmonary vessels in the mediastinum or diseases secondarily affecting the pulmonary vessels are unusual causes. Here we present three cases where patients had pulmonary vascular anomalies causing hemoptysis. These patients had decreased pulmonary arterial pressures leading to bronchial and systemic arterial hypertrophy and development of bronchopulmonary collaterals. Secondary CT signs in the parenchyma and mediastinum (mosaic attenuation, ground glass haze, subpleural interstitial thickening, and hypertrophied bronchial arteries were similar in all patients. Hence, evaluation of the MDCT images for primary abnormality led to the diagnosis.

[Clinical efficacy of preferred use of high-frequency oscillatory ventilation in treatment of neonatal pulmonary hemorrhage].

Science.gov (United States)

Wang, Hua; Du, Li-Zhong; Tang, Jun; Wu, Jin-Lin; Mu, De-Zhi

2015-03-01

To investigate the clinical efficacy and safety of preferred use of high-frequency oscillatory ventilation (HFOV) in the treatment of neonatal pulmonary hemorrhage. The clinical efficacy of preferred use of HFOV (preferred use group) and rescue use of HFOV after conventional mechanical ventilation proved ineffective (rescue use group) in the treatment of 26 cases of neonatal pulmonary hemorrhage was retrospectively analyzed. The oxygenation index (OI), pulmonary hemorrhage time, hospitalization time, ventilation time, oxygen therapy time, complications, and outcome of the two groups were compared. Compared with the rescue use group, the preferred use group had significantly lower IO values at 1, 6, 12, 24, 48, and 72 hours after treatment (Phemorrhage, and digestive tract hemorrhage between the two groups (P>0.05). Compared with those in the rescue use group, children who survived in the preferred use group had significantly shorter pulmonary hemorrhage time, hospitalization time, ventilation time, and oxygen therapy time (P<0.05). Compared with the rescue use of HFOV, preferred use of HFOV can better improve oxygenation function, reduce the incidence of VAP, shorten the course of disease, and increase cure rate while not increasing the incidence of adverse effects.

Body Burden of Dichlorodiphenyl Dichloroethene (DDE and Childhood Pulmonary Function

Directory of Open Access Journals (Sweden)

Pallavi P. Balte

2017-11-01

Full Text Available Longitudinal studies have shown that early life exposure to dichlorodiphenyl dichloroethene (DDE can lead to growth reduction during childhood and adolescence. In addition, DDE exposure has been linked to respiratory tract infections and an increased risk of asthma in children. Our aim was to understand the relationships between DDE exposure and pulmonary function in children, and, particularly, whether associations are mediated by the height of the children. We used data from an environmental epidemiologic study conducted in central Germany in children aged 8-10 years. The pulmonary function (forced vital capacity, FVC, and forced expiratory volume in one second, FEV1 were measured in three consecutive years. Blood DDE levels were measured at 8 and 10 years. We used linear mixed models for repeated measurements and path analyses to assess the association between blood levels of DDE and pulmonary function measurements. All models were adjusted for confounders. Linear mixed approaches and modelling concurrent effects showed no significant associations. The path analytical models demonstrated that DDE measured at eight years had significant, inverse, indirect, and total effects on FVC at ten years (n = 328; −0.18 L per μg/L of DDE and FEV1 (n = 328; −0.17 L per μg/L of DDE, mediated through effects of DDE on height and weight. The DDE burden reduces pulmonary function through its diminishing effects on height and weight in children. Further studies are required to test these associations in other samples, preferably from a region with ongoing, high DDT application.

Human cerebral venous outflow pathway depends on posture and central venous pressure

DEFF Research Database (Denmark)

Gisolf, J; van Lieshout, J J; van Heusden, K

2004-01-01

and central venous pressure (CVP) on the distribution of cerebral outflow over the internal jugular veins and the vertebral plexus, using a mathematical model. Input to the model was a data set of beat-to-beat cerebral blood flow velocity and CVP measurements in 10 healthy subjects, during baseline rest......Internal jugular veins are the major cerebral venous outflow pathway in supine humans. In upright humans the positioning of these veins above heart level causes them to collapse. An alternative cerebral outflow pathway is the vertebral venous plexus. We set out to determine the effect of posture...... and a Valsalva manoeuvre in the supine and standing position. The model, consisting of 2 jugular veins, each a chain of 10 units containing nonlinear resistances and capacitors, and a vertebral plexus containing a resistance, showed blood flow mainly through the internal jugular veins in the supine position...

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.

The gastrointestinal tract and ventilator-associated pneumonia.

Science.gov (United States)

Kallet, Richard H; Quinn, Thomas E

2005-07-01

The gastrointestinal tract is believed to play an important role in ventilator-associated pneumonia (VAP), because during critical illness the stomach often is colonized with enteric Gram-negative bacteria. These are the same bacteria that frequently are isolated from the sputum of patients with VAP. Interventions such as selective decontamination of the digestive tract (SDD), use of sucralfate for stress ulcer prophylaxis, and enteral feeding strategies that preserve gastric pH, or lessen the likelihood of pulmonary aspiration, are used to decrease the incidence of VAP. A review of both meta-analyses and large randomized controlled trials providing Level I evidence on these topics has led to the following conclusions. First, SDD substantially decreases the incidence of VAP and may have a modest positive effect on mortality. However, there is strong contravening evidence that SDD promotes infections by Gram-positive bacteria. In the context of an emerging public health crisis from the steady rise in drug-resistant Gram-positive bacteria, we cannot endorse the general use of SDD to prevent VAP. Rather, therapy should be focused on strategies other than antibiotic prophylaxis. Second, in patients who are at risk for clinically important gastrointestinal bleeding, a histamine-2 receptor antagonist should be used for stress ulcer prophylaxis, rather than sucralfate, because histamine-2 receptor antagonist provides substantially better protection without substantially increasing the risk of VAP. Third, post-pyloric enteral feeding may reduce the incidence of VAP.

The pressure gradient in the human respiratory tract

Directory of Open Access Journals (Sweden)

Chovancová Michaela

2014-03-01

Full Text Available Respiratory airways cause resistance to air flow during inhalation and exhalation. The pressure gradient is necessary to transport the air from the mount (or nose to pulmonary alveoli. The knowledge of pressure gradient (i.e. respiratory airways resistance is also needed to solve the question of aerosol deposition in the human respiratory tract. The obtained data will be used as boundary conditions for CFD simulations of aerosol transport. Understanding of aerosol transport in the human lungs can help us to determine the health hazard of harmful particles. On the other hand it can be used to set the conditions for transport of medication to the desirable place. This article deals with the description of the mathematical equations defining the pressure gradient and resistance in the bronchial three and describes the geometry used in the calculation.

Data-Model and Inter-Model Comparisons of the GEM Outflow Events Using the Space Weather Modeling Framework

Science.gov (United States)

Welling, D. T.; Eccles, J. V.; Barakat, A. R.; Kistler, L. M.; Haaland, S.; Schunk, R. W.; Chappell, C. R.

2015-12-01

Two storm periods were selected by the Geospace Environment Modeling Ionospheric Outflow focus group for community collaborative study because of its high magnetospheric activity and extensive data coverage: the September 27 - October 4, 2002 corotating interaction region event and the October 22 - 29 coronal mass ejection event. During both events, the FAST, Polar, Cluster, and other missions made key observations, creating prime periods for data-model comparison. The GEM community has come together to simulate this period using many different methods in order to evaluate models, compare results, and expand our knowledge of ionospheric outflow and its effects on global dynamics. This paper presents Space Weather Modeling Framework (SWMF) simulations of these important periods compared against observations from the Polar TIDE, Cluster CODIF and EFW instruments. Emphasis will be given to the second event. Density and velocity of oxygen and hydrogen throughout the lobes, plasma sheet, and inner magnetosphere will be the focus of these comparisons. For these simulations, the SWMF couples the multifluid version of BATS-R-US MHD to a variety of ionospheric outflow models of varying complexity. The simplest is outflow arising from constant MHD inner boundary conditions. Two first-principles-based models are also leveraged: the Polar Wind Outflow Model (PWOM), a fluid treatment of outflow dynamics, and the Generalized Polar Wind (GPW) model, which combines fluid and particle-in-cell approaches. Each model is capable of capturing a different set of energization mechanisms, yielding different outflow results. The data-model comparisons will illustrate how well each approach captures reality and which energization mechanisms are most important. Inter-model comparisons will illustrate how the different outflow specifications affect the magnetosphere. Specifically, it is found that the GPW provides increased heavy ion outflow over a broader spatial range than the alternative

MRI and three dimensional ultrasonography in the assessment of pulmonary hypoplasia in fetuses with urinary tract anomalies

Directory of Open Access Journals (Sweden)

Mariam Raafat

2016-12-01

Conclusion: There is a good concordance between 3D-US and MRI in the evaluation of PH in fetuses with UTM. MRI could be reserved for borderline cases of pulmonary hypoplasia and the difficult diagnostic situations.

The Role of Ionospheric Outflow Preconditioning in Determining Storm Geoeffectiveness

Science.gov (United States)

Welling, D. T.; Liemohn, M. W.; Ridley, A. J.

2012-12-01

It is now well accepted that ionospheric outflow plays an important role in the development of the plasma sheet and ring current during geomagnetic storms. Furthermore, even during quiet times, ionospheric plasma populates the magnetospheric lobes, producing a reservoir of hydrogen and oxygen ions. When the Interplanetary Magnetic Field (IMF) turns southward, this reservoir is connected to the plasma sheet and ring current through magnetospheric convection. Hence, the conditions of the ionosphere and magnetospheric lobes leading up to magnetospheric storm onset have important implications for storm development. Despite this, there has been little research on this preconditioning; most global simulations begin just before storm onset, neglecting preconditioning altogether. This work explores the role of preconditioning in determining the geoeffectiveness of storms using a coupled global model system. A model of ionospheric outflow (the Polar Wind Outflow Model, PWOM) is two-way coupled to a global magnetohydrodynamic model (the Block-Adaptive Tree Solar wind Roe-type Upwind Scheme, BATS-R-US), which in turn drives a ring current model (the Ring current Atmosphere interactions Model, RAM). This unique setup is used to simulate an idealized storm. The model is started at many different times, from 1 hour before storm onset to 12 hours before. The effects of storm preconditioning are examined by investigating the total ionospheric plasma content in the lobes just before onset, the total ionospheric contribution in the ring current just after onset, and the effects on Dst, magnetic elevation angle at geosynchronous, and total ring current energy density. This experiment is repeated for different solar activity levels as set by F10.7 flux. Finally, a synthetic double-dip storm is constructed to see how two closely spaced storms affect each other by changing the preconditioning environment. It is found that preconditioning of the magnetospheric lobes via ionospheric

Flow splitting in numerical simulations of oceanic dense-water outflows

Science.gov (United States)

Marques, Gustavo M.; Wells, Mathew G.; Padman, Laurie; Özgökmen, Tamay M.

2017-05-01

Flow splitting occurs when part of a gravity current becomes neutrally buoyant and separates from the bottom-trapped plume as an interflow. This phenomenon has been previously observed in laboratory experiments, small-scale water bodies (e.g., lakes) and numerical studies of small-scale systems. Here, the potential for flow splitting in oceanic gravity currents is investigated using high-resolution (Δx = Δz = 5 m) two-dimensional numerical simulations of gravity flows into linearly stratified environments. The model is configured to solve the non-hydrostatic Boussinesq equations without rotation. A set of experiments is conducted by varying the initial buoyancy number B0 =Q0N3 /g‧2 (where Q0 is the volume flux of the dense water flow per unit width, N is the ambient stratification and g‧ is the reduced gravity), the bottom slope (α) and the turbulent Prandtl number (Pr). Regardless of α or Pr, when B0 ≤ 0.002 the outflow always reaches the deep ocean forming an underflow. Similarly, when B0 ≥ 0.13 the outflow always equilibrates at intermediate depths, forming an interflow. However, when B0 ∼ 0.016, flow splitting always occurs when Pr ≥ 10, while interflows always occur for Pr = 1. An important characteristic of simulations that result in flow splitting is the development of Holmboe-like interfacial instabilities and flow transition from a supercritical condition, where the Froude number (Fr) is greater than one, to a slower and more uniform subcritical condition (Fr internal hydraulic jump and consequent mixing enhancement. Although our experiments do not take into account three-dimensionality and rotation, which are likely to influence mixing and the transition between flow regimes, a comparison between our results and oceanic observations suggests that flow splitting may occur in dense-water outflows with weak ambient stratification, such as Antarctic outflows.

Outflows in the narrow-line region of bright Seyfert galaxies - I. GMOS-IFU data

Science.gov (United States)

Freitas, I. C.; Riffel, R. A.; Storchi-Bergmann, T.; Elvis, M.; Robinson, A.; Crenshaw, D. M.; Nagar, N. M.; Lena, D.; Schmitt, H. R.; Kraemer, S. B.

2018-05-01

We present two-dimensional maps of emission-line fluxes and kinematics, as well as of the stellar kinematics of the central few kpc of five bright nearby Seyfert galaxies - Mrk 6, Mrk 79, Mrk 348, Mrk 607, and Mrk 1058 - obtained from observations with the Gemini Multi-Object Spectrograph Integral Field Unit on the Gemini North Telescope. The data cover the inner 3.5 arcsec × 5.0 arcsec - corresponding to physical scales in the range 0.6 × 0.9-1.5 × 2.2 kpc2 - at a spatial resolution ranging from 110 to 280 pc with a spectral coverage of 4300-7100 Å and velocity resolution of ≈90 km s-1. The gas excitation is Seyfert like everywhere but show excitation gradients that are correlated with the gas kinematics, reddening and/or the gas density. The gas kinematics show in all cases two components: a rotation one similar to that observed in the stellar velocity field, and an outflow component. In the case of Mrk607, the gas is counter-rotating relative to the stars. Enhanced gas velocity dispersion is observed in association with the outflows according to two patterns: at the locations of the highest outflow velocities along the ionization axis or perpendicularly to it in a strip centred at the nucleus that we attribute to an equatorial outflow. Bipolar outflows are observed in Mrk 348 and Mrk 79, while in Mrk 1058 only the blueshifted part is clearly observed, while in cases of Mrk 6 and Mrk 607, the geometry of the outflow needs further constraints from modelling to be presented in a forthcoming study, where the mass flow rate and powers will also be obtained.

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...

GEOMETRIC AND KINEMATIC STRUCTURE OF THE OUTFLOW/ENVELOPE SYSTEM OF L1527 REVEALED BY SUBARCSECOND-RESOLUTION OBSERVATION OF CS

Energy Technology Data Exchange (ETDEWEB)

Oya, Yoko; López-Sepulcre, Ana; Watanabe, Yoshimasa; Yamamoto, Satoshi [Department of Physics, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033 (Japan); Sakai, Nami [The Institute of Physical and Chemical Research (RIKEN), Wako, Saitama 351-0198 (Japan); Lefloch, Bertrand; Ceccarelli, Cecilia, E-mail: oya@taurus.phys.s.u-tokyo.ac.jp [Universite Grenoble Alpes, IPAG, F-38000 Grenoble (France)

2015-10-10

Subarcsecond-resolution images of the rotational line emissions of CS and c-C{sub 3}H{sub 2} obtained toward the low-mass protostar IRAS 04368+2557 in L1527 with the Atacama Large Millimeter/submillimeter Array are investigated to constrain the orientation of the outflow/envelope system. The distribution of CS consists of an envelope component extending from north to south and a faint butterfly shaped outflow component. The kinematic structure of the envelope is well reproduced by a simple ballistic model of an infalling rotating envelope. Although the envelope has a nearly edge-on configuration, we find that the western side of the envelope faces the observer. This configuration is opposite to the direction of the large-scale (∼10{sup 4} AU) outflow suggested previously from the {sup 12}CO (J = 3–2) observation, and to the morphology of infrared reflection near the protostar (∼200 AU). The latter discrepancy could originate from high extinction by the outflow cavity of the western side, or may indicate that the outflow axis is not parallel to the rotation axis of the envelope. Position–velocity diagrams show the accelerated outflow cavity wall, and its kinematic structure in the 2000 AU scale is explained by a standard parabolic model with the inclination angle derived from the analysis of the envelope. The different orientation of the outflow between the small and large scale implies a possibility of precession of the outflow axis. The shape and the velocity of the outflow in the vicinity of the protostar are compared with those of other protostars.

THE NATURE AND FREQUENCY OF OUTFLOWS FROM STARS IN THE CENTRAL ORION NEBULA CLUSTER

Energy Technology Data Exchange (ETDEWEB)

O’Dell, C. R. [Department of Physics and Astronomy, Vanderbilt University, Box 1807-B, Nashville, TN 37235 (United States); Ferland, G. J. [Department of Physics and Astronomy, University of Kentucky, Lexington, KY 40506 (United States); Henney, W. J. [Instituto de Radioastronomía y Astrofísica, Universidad Nacional Autónoma de México, Apartado Postal 3-72, 58090 Morelia, Michoacán, México (Mexico); Peimbert, M. [Instituto de Astronomia, Universidad Nacional Autónoma de México, Apdo, Postal 70-264, 04510 México D. F., México (Mexico); García-Díaz, Ma. T. [Instituto de Astronomia, Universidad Nacional Autónoma de México, Km 103 Carretera Tijuana-Ensenada, 22860 Ensenada, B.C., México (Mexico); Rubin, Robert H., E-mail: cr.odell@vanderbilt.edu [NASA/Ames Research Center, Moffett Field, CA 94035-0001 (United States)

2015-10-15

Recent Hubble Space Telescope images have allowed the determination with unprecedented accuracy of motions and changes of shocks within the inner Orion Nebula. These originate from collimated outflows from very young stars, some within the ionized portion of the nebula and others within the host molecular cloud. We have doubled the number of Herbig–Haro objects known within the inner Orion Nebula. We find that the best-known Herbig–Haro shocks originate from relatively few stars, with the optically visible X-ray source COUP 666 driving many of them. While some isolated shocks are driven by single collimated outflows, many groups of shocks are the result of a single stellar source having jets oriented in multiple directions at similar times. This explains the feature that shocks aligned in opposite directions in the plane of the sky are usually blueshifted because the redshifted outflows pass into the optically thick photon-dominated region behind the nebula. There are two regions from which optical outflows originate for which there are no candidate sources in the SIMBAD database.

THE NATURE AND FREQUENCY OF OUTFLOWS FROM STARS IN THE CENTRAL ORION NEBULA CLUSTER

International Nuclear Information System (INIS)

O’Dell, C. R.; Ferland, G. J.; Henney, W. J.; Peimbert, M.; García-Díaz, Ma. T.; Rubin, Robert H.

2015-01-01

Recent Hubble Space Telescope images have allowed the determination with unprecedented accuracy of motions and changes of shocks within the inner Orion Nebula. These originate from collimated outflows from very young stars, some within the ionized portion of the nebula and others within the host molecular cloud. We have doubled the number of Herbig–Haro objects known within the inner Orion Nebula. We find that the best-known Herbig–Haro shocks originate from relatively few stars, with the optically visible X-ray source COUP 666 driving many of them. While some isolated shocks are driven by single collimated outflows, many groups of shocks are the result of a single stellar source having jets oriented in multiple directions at similar times. This explains the feature that shocks aligned in opposite directions in the plane of the sky are usually blueshifted because the redshifted outflows pass into the optically thick photon-dominated region behind the nebula. There are two regions from which optical outflows originate for which there are no candidate sources in the SIMBAD database

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

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

FEATURES OF OUTFLOW OF INTRAOCULAR LIQUID AFTER AN EKSIMERLAZER SKLEREKTOMY (PILOT STUDY)

OpenAIRE

E. A. Korchuganova; O. A. Rumyantseva; S. B. Gudkova

2017-01-01

Modern approaches to surgical glaucoma treatment is based on the safe and effective methods. In recent years, great attention is paid to the techniques of stimulating uveoscleral path outtake aqueous humor from the eye. Uveoscleral space in the extended outflow pathways is dominant and constitutes about 72%. Sclera is a field of the greatest interest, as the end stages of the outflow of aqueous humor via the uveoscleral path. The aim of the study was to investigate the influence of excimer la...

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)

TRACING OUTFLOWS AND ACCRETION: A BIMODAL AZIMUTHAL DEPENDENCE OF Mg II ABSORPTION

International Nuclear Information System (INIS)

Kacprzak, Glenn G.; Churchill, Christopher W.; Nielsen, Nikole M.

2012-01-01

We report a bimodality in the azimuthal angle distribution of gas around galaxies as traced by Mg II absorption: halo gas prefers to exist near the projected galaxy major and minor axes. The bimodality is demonstrated by computing the mean azimuthal angle probability distribution function using 88 spectroscopically confirmed Mg II-absorption-selected galaxies [W r (2796) ≥ 0.1 Å] and 35 spectroscopically confirmed non-absorbing galaxies [W r (2796) r (2796) r (2796) distribution for gas along the major axis is likely skewed toward weaker Mg II absorption than for gas along the projected minor axis. These combined results are highly suggestive that the bimodality is driven by gas accreted along the galaxy major axis and outflowing along the galaxy minor axis. Adopting these assumptions, we find that the opening angle of outflows and inflows to be 100° and 40°, respectively. We find that the probability of detecting outflows is ∼60%, implying that winds are more commonly observed.

The Upshear Environment-Outflow Interface of a Sheared, Rapidly Intensifying Tropical Cyclone

Science.gov (United States)

Ryglicki, D.; Doyle, J. D.; Jin, Y.; Hodyss, D.; Viner, K.

2017-12-01

An idealized, simulated tropical cyclone (TC) which undergoes rapid intensification in moderate vertical wind shear is shown to exhibit structural similarities to observed TCs of this class. Due to a complex vortex tilt evolution, enhanced convection causes enhanced outflow from the TC which subsequently serves to block and to divert environmental flow around the TC. This allows for the TC to come back into vertical alignment and undergo rapid intensification. A trajectory analysis indicates that blocking is limited to a narrow range of heights, indicating that the vertical profile of environmental winds is a key factor for permitting this evolution. Satellite observations indicate the presence of upper-level arcs extending upshear beyond the TC. Synthetic satellite imagery of the simulated TC indicates this is the termination of the outflow. Using a Helmholtz decomposition, it is found that the divergent component of the outflow extends 1000 km upshear into the environment, potentially explaining the 1000-km clearing seen in satellite observations.

[Tracheobronchial and pulmonary parenchymatous congenital abnormalities requiring surgical treatment in adults].

Science.gov (United States)

Mordant, P; De Dominicis, F; Berna, P; Riquet, M

2012-04-01

Most tracheobronchial and parenchymatous congenital abnormalities of the respiratory system are diagnosed in early life. However, some lesions may be initially silent and diagnosed only in adulthood. These cases included congenital abnormalies of the tracheobronchial tract (tracheal and/or bronchial stenosis, bronchogenic cysts, bronchial atresia, oesotracheal fistula, oesobronchial fistula, and tracheal diverticulum), and lung parenchyma itself (pulmonary sequestration, congenital cystic adenomatoïd malformation, lobar emphysema, lobar or lung hypoplasia). To avoid dreadful complications, these rare cases deserve surgical management, and must be known by chest physicians and surgeons. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

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)

A 3D view of the outflow in the Orion Molecular Cloud 1 (OMC-1)

DEFF Research Database (Denmark)

Nissen, H.D.; Cunningham, N.J.; Sherson, Maiken Gustafsson

2012-01-01

and proper motion data for near-IR emission of molecular hydrogen to obtain the first 3-dimensional (3D) structure of the OMC-1 outflow. Our work illustrates a new diagnostic tool for studies of star formation that will be exploited in the near future with the advent of high spatial resolution spectro...... Observatory, the Anglo-Australian Observatory and the Subaru Telescope. These data give the 3D velocity of ejecta yielding a 3D reconstruction of the outflows. This allows one to view the material from different vantage points in space giving considerable insight into the geometry. Our analysis indicates......The fast outflow emerging from a region associated with massive star formation in the Orion Molecular Cloud 1 (OMC-1), located behind the Orion Nebula, appears to have been set in motion by an explosive event. Here we study the structure and dynamics of outflows in OMC-1. We combine radial velocity...

Differential Canalograms Detect Outflow Changes from Trabecular Micro-Bypass Stents and Ab Interno Trabeculectomy.

Science.gov (United States)

Parikh, Hardik A; Loewen, Ralitsa T; Roy, Pritha; Schuman, Joel S; Lathrop, Kira L; Loewen, Nils A

2016-11-04

Recently introduced microincisional glaucoma surgeries that enhance conventional outflow offer a favorable risk profile over traditional surgeries, but can be unpredictable. Two paramount challenges are the lack of an adequate training model for angle surgeries and the absence of an intraoperative quantification of surgical success. To address both, we developed an ex vivo training system and a differential, quantitative canalography method that uses slope-adjusted fluorescence intensities of two different chromophores to avoid quenching. We assessed outflow enhancement by trabecular micro-bypass (TMB) implantation or by ab interno trabeculectomy (AIT). In this porcine model, TMB resulted in an insignificant (p > 0.05) outflow increase of 13 ± 5%, 14 ± 8%, 9 ± 3%, and 24 ± 9% in the inferonasal, superonasal, superotemporal, and inferotemporal quadrant, respectively. AIT caused a 100 ± 50% (p = 0.002), 75 ± 28% (p = 0.002), 19 ± 8%, and 40 ± 21% increase in those quadrants. The direct gonioscopy and tactile feedback provided a surgical experience that was very similar to that in human patients. Despite the more narrow and discontinuous circumferential drainage elements in the pig with potential for underperformance or partial stent obstruction, unequivocal patterns of focal outflow enhancement by TMB were seen in this training model. AIT achieved extensive access to outflow pathways beyond the surgical site itself.

The near-infrared outflow and cavity of the proto-brown dwarf candidate ISO-Oph 200

Science.gov (United States)

Whelan, E. T.; Riaz, B.; Rouzé, B.

2018-03-01

In this Letter a near-infrared integral field study of a proto-brown dwarf candidate is presented. A 0.''5 blue-shifted outflow is detected in both H2 and [Fe II] lines at Vsys = (–35 ± 2) km s-1 and Vsys = (–51 ± 5) km s-1 respectively. In addition, slower ( ±10 km s-1) H2 emission is detected out to <5.''4, in the direction of both the blue and red-shifted outflow lobes but along a different position angle to the more compact faster emission. It is argued that the more compact emission is a jet and the extended H2 emission is tracing a cavity. The source extinction is estimated at Av = 18 ± 1 mag and the outflow extinction at Av = 9 ± 0.4 mag. The H2 outflow temperature is calculated to be 1422 ± 255 K and the electron density of the [Fe II] outflow is measured at 10 000 cm-3. Furthermore, the mass outflow rate is estimated at Ṁout [H2] = 3.8 × 10-10 M⊙ yr-1 and Ṁout[Fe II] = 1 × 10-8 M⊙ yr-1. Ṁout[Fe II] takes a Fe depletion of 88% into account. The depletion is investigated using the ratio of the [Fe II] 1.257 μm and [P II] 1.188 μm lines. Using the Paβ and Brγ lines and a range in stellar mass and radius Ṁacc is calculated to be (3–10) × 10-8 M⊙ yr-/1. Comparing these rates puts the jet efficiency in line with predictions of magneto-centrifugal models of jet launching in low mass protostars. This is a further case of a brown dwarf outflow exhibiting analogous properties to protostellar jets. Based on Observations collected with SINFONI at the Very Large Telescope on Cerro Paranal (Chile), operated by the European Southern Observatory (ESO). Program ID: 097.C-0732(A).

Fibroma (fibrous Hamartoma) of the right ventricle, causing of obstruction of the exit tract: reports of a case

International Nuclear Information System (INIS)

Lombardi J, Pier F; Mendez D, Lupo R; Echeverria C, Rafael; Lozano H, Edward C; Montes, David; Perez G, Jesus

2003-01-01

Most part of benign cardiac tumors are myxomas, they affect usually adults and are generally located in the atrial cavities. Fibromas, which are the second most common cardiac tumors, are rare. These are considered characteristic tumors during infancy and adolescence. A case of a 16 years old female patient with symptoms of advanced congestive cardiac failure is reported. An echocardiographyc diagnostic of an obstructive mass in the right ventricular outflow tract was made. The tumor was successfully enucleated. The pathologic specimen showed a fibro-myxoid macroscopical aspect; the microscopic study was consistent with a fibroblastic tumor with lax stroma and elongated cells, positive for interstitial collagen bundles (Masson's trichrome). The tumor cells had a positive reactivity to Vimentine and a negative one for factor VIII

LOW-ALTITUDE RECONNECTION INFLOW-OUTFLOW OBSERVATIONS DURING A 2010 NOVEMBER 3 SOLAR ERUPTION

Energy Technology Data Exchange (ETDEWEB)

Savage, Sabrina L.; Holman, Gordon; Su, Yang [NASA/Goddard Space Flight Center, Oak Ridge Associated Universities, 8800 Greenbelt Road, Code 671, Greenbelt, MD 20771 (United States); Reeves, Katharine K. [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street MS 58, Cambridge, MA 02138 (United States); Seaton, Daniel B. [Royal Observatory of Belgium-SIDC, Avenue Circulaire 3, B-1180 Brussels (Belgium); McKenzie, David E. [Department of Physics, Montana State University, P.O. Box 173840, Bozeman, MT 59717-3840 (United States)

2012-07-20

For a solar flare occurring on 2010 November 3, we present observations using several SDO/AIA extreme-ultraviolet (EUV) passbands of an erupting flux rope followed by inflows sweeping into a current sheet region. The inflows are soon followed by outflows appearing to originate from near the termination point of the inflowing motion-an observation in line with standard magnetic reconnection models. We measure average inflow plane-of-sky speeds to range from {approx}150 to 690 km s{sup -1} with the initial, high-temperature inflows being the fastest. Using the inflow speeds and a range of Alfven speeds, we estimate the Alfvenic Mach number which appears to decrease with time. We also provide inflow and outflow times with respect to RHESSI count rates and find that the fast, high-temperature inflows occur simultaneously with a peak in the RHESSI thermal light curve. Five candidate inflow-outflow pairs are identified with no more than a minute delay between detections. The inflow speeds of these pairs are measured to be {approx}10{sup 2} km s{sup -1} with outflow speeds ranging from {approx}10{sup 2} to 10{sup 3} km s{sup -1}-indicating acceleration during the reconnection process. The fastest of these outflows are in the form of apparently traveling density enhancements along the legs of the loops rather than the loop apexes themselves. These flows could possibly either be accelerated plasma, shocks, or waves prompted by reconnection. The measurements presented here show an order of magnitude difference between the retraction speeds of the loops and the speed of the density enhancements within the loops-presumably exiting the reconnection site.

LOW-ALTITUDE RECONNECTION INFLOW-OUTFLOW OBSERVATIONS DURING A 2010 NOVEMBER 3 SOLAR ERUPTION

International Nuclear Information System (INIS)

Savage, Sabrina L.; Holman, Gordon; Su, Yang; Reeves, Katharine K.; Seaton, Daniel B.; McKenzie, David E.

2012-01-01

For a solar flare occurring on 2010 November 3, we present observations using several SDO/AIA extreme-ultraviolet (EUV) passbands of an erupting flux rope followed by inflows sweeping into a current sheet region. The inflows are soon followed by outflows appearing to originate from near the termination point of the inflowing motion—an observation in line with standard magnetic reconnection models. We measure average inflow plane-of-sky speeds to range from ∼150 to 690 km s –1 with the initial, high-temperature inflows being the fastest. Using the inflow speeds and a range of Alfvén speeds, we estimate the Alfvénic Mach number which appears to decrease with time. We also provide inflow and outflow times with respect to RHESSI count rates and find that the fast, high-temperature inflows occur simultaneously with a peak in the RHESSI thermal light curve. Five candidate inflow-outflow pairs are identified with no more than a minute delay between detections. The inflow speeds of these pairs are measured to be ∼10 2 km s –1 with outflow speeds ranging from ∼10 2 to 10 3 km s –1 —indicating acceleration during the reconnection process. The fastest of these outflows are in the form of apparently traveling density enhancements along the legs of the loops rather than the loop apexes themselves. These flows could possibly either be accelerated plasma, shocks, or waves prompted by reconnection. The measurements presented here show an order of magnitude difference between the retraction speeds of the loops and the speed of the density enhancements within the loops—presumably exiting the reconnection site.

Inquilinus limosus in pulmonary disease: case report and review of the literature.

Science.gov (United States)

McHugh, Kelsey E; Rhoads, Daniel D; Wilson, Deborah A; Highland, Kristin B; Richter, Sandra S; Procop, Gary W

2016-12-01

Inquilinus limosus is a slow growing, gram-negative, oxidase-positive, non-fermentative bacillus that is rarely isolated from clinical samples. When clinically identified, I. limosus is almost exclusively isolated from the respiratory tracts of patients with cystic fibrosis (CF). We report the first case of I. limosus isolation from a pulmonary specimen in an individual without a diagnosis of CF. A review of the English-language literature has been made and shows 33 cases (excluding the present report) in which I. limosus was isolated from the respiratory tracts of patients. Our patient, at 60years of age, is more than two decades older than the any previously reported patient. Similar to previous reports, the I. limosus isolated from her lungs demonstrated intrinsic multidrug resistance. The pathogenicity, clinical relevance, and optimal therapeutic management of I. limosus remains largely unknown due to its infrequent recovery from clinical samples. Copyright © 2016 Elsevier Inc. All rights reserved.

Effect of clear cutting on snow accumulation and water outflow at Fraser, Colorado

Directory of Open Access Journals (Sweden)

C. A. Troendle

1997-01-01

Full Text Available This paper compares of snowpack accumulation and ablation, evapotranspiration, and water outflow from clearcut and forested plots within a high elevation (2900 m mixed conifer forest at the Fraser Experimental Forest near Fraser, Colorado, USA. Also presented is a method for defining contributing area where outflow is measured from unbounded plots. Plots were monitored from 1980 to 1990 and again in 1993. The clearcut plot was harvested in late 1984. Evapotranspiration (ET of the forested plot at zero discharge (ETo was estimated at 426 mm while the ET was 500 mm at the mean precipitation of 596 mm. ET was dependent on precipitation with about 28% of precipitation input in excess of 426 mm contributing to increased ET, while the remainder contributed to increased outflow. During the six monitored post-harvest years, Peak Water Equivalent of the snowpack averaged 36% higher on the cut plot than on the control, and the mean discharge increased from 85 mm to 356 mm. Area estimates were obtained from the slopes of the regression of outflow on precipitation inputs. Hydrologic parameters corresponded closely to those previously determined at Fraser Experimental Forest using other methods, lending credence to the validity of the area estimates.

Outflows, dusty cores, and a burst of star formation in the North America and Pelican nebulae

Energy Technology Data Exchange (ETDEWEB)

Bally, John [Department of Astrophysical and Planetary Sciences, University of Colorado, UCB 389, Boulder, CO 80309 (United States); Ginsburg, Adam [European Southern Observatory, Karl-Schwarzschild-Str. 2, D-85748 Garching bei Munchen (Germany); Probst, Ron [National Optical Astronomy Observatory, 950 North Cherry Avenue, Tucson, AZ 85719 (United States); Reipurth, Bo [Institute for Astronomy and NASA Astrobiology Institute, University of Hawaii at Manoa, 640 North A' ohoku Place, Hilo, HI 96720 (United States); Shirley, Yancy L. [Steward Observatory, University of Arizona, 933 North Cherry Avenue, Tucson, AZ 85721 (United States); Stringfellow, Guy S., E-mail: John.Bally@colorado.edu, E-mail: aginsburg@eso.org, E-mail: probst@noao.edu, E-mail: reipurth@ifa.hawaii.edu, E-mail: yshirley@as.arizona.edu, E-mail: Guy.Stringfellow@colorado.edu [Center for Astrophysics and Space Astronomy, University of Colorado, UCB 389, Boulder, CO 80309 (United States)

2014-12-01

We present observations of near-infrared 2.12 μm molecular hydrogen outflows emerging from 1.1 mm dust continuum clumps in the North America and Pelican Nebula (NAP) complex selected from the Bolocam Galactic Plane Survey (BGPS). Hundreds of individual shocks powered by over 50 outflows from young stars are identified, indicating that the dusty molecular clumps surrounding the NGC 7000/IC 5070/W80 H II region are among the most active sites of ongoing star formation in the solar vicinity. A spectacular X-shaped outflow, MHO 3400, emerges from a young star system embedded in a dense clump more than a parsec from the ionization front associated with the Pelican Nebula (IC 5070). Suspected to be a binary, the source drives a pair of outflows with orientations differing by 80°. Each flow exhibits S-shaped symmetry and multiple shocks indicating a pulsed and precessing jet. The 'Gulf of Mexico', located south of the North America Nebula (NGC 7000), contains a dense cluster of molecular hydrogen objects (MHOs), Herbig-Haro (HH) objects, and over 300 young stellar objects (YSOs), indicating a recent burst of star formation. The largest outflow detected thus far in the North America and Pelican Nebula complex, the 1.6 parsec long MHO 3417 flow, emerges from a 500 M {sub ☉} BGPS clump and may be powered by a forming massive star. Several prominent outflows such as MHO 3427 appear to be powered by highly embedded YSOs only visible at λ > 70 μm. An 'activity index' formed by dividing the number of shocks by the mass of the cloud containing their source stars is used to estimate the relative evolutionary states of Bolocam clumps. Outflows can be used as indicators of the evolutionary state of clumps detected in millimeter and submillimeter dust continuum surveys.

An approach to assess the Particulate Matter exposure for the population living around a cement plant: modelling indoor air and particle deposition in the respiratory tract

Energy Technology Data Exchange (ETDEWEB)

Sánchez-Soberón, Francisco; Mari, Montse; Kumar, Vikas [Environmental Engineering Laboratory, Departament d' Enginyeria Quimica, Universitat Rovira i Virgili, Av. Països Catalans 26, 43007 Tarragona, Catalonia (Spain); Rovira, Joaquim [Environmental Engineering Laboratory, Departament d' Enginyeria Quimica, Universitat Rovira i Virgili, Av. Països Catalans 26, 43007 Tarragona, Catalonia (Spain); Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Catalonia (Spain); Nadal, Martí [Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Catalonia (Spain); Schuhmacher, Marta, E-mail: marta.schuhmacher@urv.cat [Environmental Engineering Laboratory, Departament d' Enginyeria Quimica, Universitat Rovira i Virgili, Av. Països Catalans 26, 43007 Tarragona, Catalonia (Spain); Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Catalonia (Spain)

2015-11-15

In this paper we studied the exposure to three size fractions of outdoor particulate matter (PM{sub 10}, PM{sub 2.5}, and PM{sub 1}) collected in an area influenced by a cement plant. For that purpose, three groups of population were evaluated (children, adults and retired) in two seasons (summer and winter). Outdoor measured PM concentrations, as well as physiological parameters and activity patterns of the three groups of population were used as input data in two different models. The first one was an indoor air quality model, used to elucidate indoor PM concentrations in different microenvironments. The second one was a dosimetry model, used to evaluate the internal exposure and the distribution of the different PM fractions in the respiratory tract. Results from the indoor air quality model showed that special attention must be paid to the finest particles, since they penetrate indoors in a greater degree. Highest pulmonary doses for the three PM sizes were reported for retired people, being this a result of the high amount of time in outdoor environments exercising lightly. For children, the exposure was mainly influenced by the time they also spend outdoors, but in this case due to heavy intensity activities. It was noticed that deposition of fine particles was more significant in the pulmonary regions of children and retired people in comparison with adults, which has implications in the expected adverse health effects for those vulnerable groups of population. - Highlights: • PM deposition in the respiratory tract was evaluated for three population groups. • Activity patterns and different microenvironments were used in our calculation. • Outdoor activities are the main contributors to PM deposited mass. • Children experienced the highest deposition dose in the pulmonary region. • Retired registered the highest deposited mass in the respiratory tract as a whole.

An approach to assess the Particulate Matter exposure for the population living around a cement plant: modelling indoor air and particle deposition in the respiratory tract

International Nuclear Information System (INIS)

Sánchez-Soberón, Francisco; Mari, Montse; Kumar, Vikas; Rovira, Joaquim; Nadal, Martí; Schuhmacher, Marta

2015-01-01

In this paper we studied the exposure to three size fractions of outdoor particulate matter (PM 10 , PM 2.5 , and PM 1 ) collected in an area influenced by a cement plant. For that purpose, three groups of population were evaluated (children, adults and retired) in two seasons (summer and winter). Outdoor measured PM concentrations, as well as physiological parameters and activity patterns of the three groups of population were used as input data in two different models. The first one was an indoor air quality model, used to elucidate indoor PM concentrations in different microenvironments. The second one was a dosimetry model, used to evaluate the internal exposure and the distribution of the different PM fractions in the respiratory tract. Results from the indoor air quality model showed that special attention must be paid to the finest particles, since they penetrate indoors in a greater degree. Highest pulmonary doses for the three PM sizes were reported for retired people, being this a result of the high amount of time in outdoor environments exercising lightly. For children, the exposure was mainly influenced by the time they also spend outdoors, but in this case due to heavy intensity activities. It was noticed that deposition of fine particles was more significant in the pulmonary regions of children and retired people in comparison with adults, which has implications in the expected adverse health effects for those vulnerable groups of population. - Highlights: • PM deposition in the respiratory tract was evaluated for three population groups. • Activity patterns and different microenvironments were used in our calculation. • Outdoor activities are the main contributors to PM deposited mass. • Children experienced the highest deposition dose in the pulmonary region. • Retired registered the highest deposited mass in the respiratory tract as a whole.

Atmospheric pollutant outflow from southern Asia: a review

Science.gov (United States)

Lawrence, M. G.; Lelieveld, J.

2010-11-01

Southern Asia, extending from Pakistan and Afghanistan to Indonesia and Papua New Guinea, is one of the most heavily populated regions of the world. Biofuel and biomass burning play a disproportionately large role in the emissions of most key pollutant gases and aerosols there, in contrast to much of the rest of the Northern Hemisphere, where fossil fuel burning and industrial processes tend to dominate. This results in polluted air masses which are enriched in carbon-containing aerosols, carbon monoxide, and hydrocarbons. The outflow and long-distance transport of these polluted air masses is characterized by three distinct seasonal circulation patterns: the winter monsoon, the summer monsoon, and the monsoon transition periods. During winter, the near-surface flow is mostly northeasterly, and the regional pollution forms a thick haze layer in the lower troposphere which spreads out over millions of square km between southern Asia and the Intertropical Convergence Zone (ITCZ), located several degrees south of the equator over the Indian Ocean during this period. During summer, the heavy monsoon rains effectively remove soluble gases and aerosols. Less soluble species, on the other hand, are lifted to the upper troposphere in deep convective clouds, and are then transported away from the region by strong upper tropospheric winds, particularly towards northern Africa and the Mediterranean in the tropical easterly jet. Part of the pollution can reach the tropical tropopause layer, the gateway to the stratosphere. During the monsoon transition periods, the flow across the Indian Ocean is primarily zonal, and strong pollution plumes originating from both southeastern Asia and from Africa spread across the central Indian Ocean. This paper provides a review of the current state of knowledge based on the many observational and modeling studies over the last decades that have examined the southern Asian atmospheric pollutant outflow and its large scale effects. An outlook

An radiography study of pediatric pulmonary cryptococcosis

International Nuclear Information System (INIS)

Yeon, Kyung Mo; Kim, In One

1981-01-01

Cryptococcosis is a cosmopolitan mycotic disease caused by a yeast like fungus, Cryptococcus neoformans. Respiratory tract, as portal of entry, is the initial focus of infection. Initial pulmonary lesion may heal with or without dissemination of the disease. Authors reviewed 8 cases of confirmed cryptococcosis during Jan. 1973 to June 1981 at Seoul National University Hospital. The results are as follows: Majority of the cases are below 5 years old. The most common symptoms are fever, abdominal pain and distension, and respiratory symptoms in only 2 cases. The involved organs are liver, lymph node, spleen, meninges, and skin in the order of frequency. Chest P-A roentgenograms show both hilar enlargement with perihilar and basilar, linear and small nodular infiltrations. Miliary nodular lesions and mediastinal lymphadenopathy were also noted

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.

PROFILE OF PULMONARY INFECTIONS IN RENAL TRANSPLANT PATIENTS

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Sundararajaperumal Anandhakrishnan

2018-01-01

Full Text Available BACKGROUND Renal transplantation is a successful therapy for patients with end-stage kidney disease. In a country like India, where tuberculosis is highly prevalent, it poses immense diagnostic challenge. Proper knowledge about the microbiological spectrum would help to start appropriate therapy empirically, awaiting confirmation. The aim of the study is to study the microbiological profile of lower respiratory tract infections in renal transplant recipients. MATERIALS AND METHODS Consecutive patients who presented to the transplant clinic with cardinal respiratory symptoms and fever were screened radiologically and an attempt to make a microbiological diagnosis was done with sputum or bronchial wash wherever needed. Setting- Prospective observational study conducted in the Department of Nephrology, Transplant Clinic, Rajiv Gandhi Government General Hospital and Madras Medical College. Post-renal transplant patients were followed up for 2 years between October 2014 - October 2016 and the development of pulmonary infection and the number of episodes were systematically recorded. RESULTS A total of 32 episodes of pulmonary infections were observed in 29 patients (23 males and 6 females. Bronchial wash had higher diagnostic yield than sputum. Triple drug immunosuppression comprising cyclosporine, prednisolone and azathioprine (75.8% and episodes of acute graft rejection requiring pulse methylprednisolone (37.93% were important prerequisites for developing pulmonary infection. Pseudomonas 12 (3%, Klebsiella 8 (25% and Mycobacterium tuberculosis 8 (25% were the most common organisms recovered. CONCLUSION Aggressive diagnostic modalities should be carried out for establishing the diagnosis. Empirical regimens should cover for Pseudomonas and Klebsiella. Tuberculosis should be sought for keenly. Mixed infections were also common in the study.

Further studies of the role of dense molecular clouds around outflow sources

International Nuclear Information System (INIS)

Verdes-Montenegro, L.; Torrelles, J.M.; Rodriguez, L.F.; Anglada, G.; Lopez, R.

1989-01-01

The (J,K) = (1,1) and (2,2) ammonia inversion transitions toward six regions with active star formation and evidence of gas outflows have been observed. Ammonia emission has been detected and mapped in five of these regions: AFGL 5142, AFGL 5157, AFGL 6366S, HHL 73, and S140N. NH3 (2,2) emission was detected toward the peak of the NH3 (1,1) core of AFGL 5157 and S140N. A rotational temperature of T(R) (2,2;1,1) = about 16 K was estimated for the two regions. Two new H2O masers of intense emission, S(nu) greater or equal 40 Jy, were detected toward the ammonia cores of AFGL 5142 and AFGL 5157. It is clear that the dense NH3 gas is closely associated with the star formation activities, since the ammonia cores in all peak close to the centers of activity. In particular, the AFGL 5157 ammonia condensation coincides with the geometrical center of a bipolar molecular outflow, suggesting that the exciting source is embedded in the ammonia core. In contrast, the molecular outflow in the AFGL 6366S region is located at the southeast edge of the NH3 condensation, suggesting that the exciting source is outside the ammonia core and that the morphology of the outflow may be influenced by the interaction with the dense ambient gas. 52 refs

Oral hygiene in patients with chronic obstructive pulmonary disease

DEFF Research Database (Denmark)

Pedersen, Preben Ulrich; Uhrenfeldt, Lisbeth; Larsen, Palle

2017-01-01

SCOPING REVIEW OBJECTIVE: It is hypothesized that systematic oral hygiene may reduce airway infections in patients with chronic obstructive pulmonary disease (COPD). Before considering doing a systematic review, a scoping review is necessary to explore and map literature on the subject and identify......-invasive interventions that have been carried out to improve oral hygiene and relieve and/or reduce respiratory tract infections, exacerbation and/or hospital readmission in patients with diagnosed with COPD. A further objective is to undertake a comprehensive search to identify qualitative literature reporting...... on the experiences of oral hygiene in people diagnosed with COPD and/or their relatives and/or healthcare providers (HCPs).Specifically, the scoping review questions are as follows....

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 ...

Reversal of reflex pulmonary vasoconstriction induced by main pulmonary arterial distension.

Science.gov (United States)

Juratsch, C E; Grover, R F; Rose, C E; Reeves, J T; Walby, W F; Laks, M M

1985-04-01

Distension of the main pulmonary artery (MPA) induces pulmonary hypertension, most probably by neurogenic reflex pulmonary vasoconstriction, although constriction of the pulmonary vessels has not actually been demonstrated. In previous studies in dogs with increased pulmonary vascular resistance produced by airway hypoxia, exogenous arachidonic acid has led to the production of pulmonary vasodilator prostaglandins. Hence, in the present study, we investigated the effect of arachidonic acid in seven intact anesthetized dogs after pulmonary vascular resistance was increased by MPA distention. After steady-state pulmonary hypertension was established, arachidonic acid (1.0 mg/min) was infused into the right ventricle for 16 min; 15-20 min later a 16-mg bolus of arachidonic acid was injected. MPA distension was maintained throughout the study. Although the infusion of arachidonic acid significantly lowered the elevated pulmonary vascular resistance induced by MPA distension, the pulmonary vascular resistance returned to control levels only after the bolus injection of arachidonic acid. Notably, the bolus injection caused a biphasic response which first increased the pulmonary vascular resistance transiently before lowering it to control levels. In dogs with resting levels of pulmonary vascular resistance, administration of arachidonic acid in the same manner did not alter the pulmonary vascular resistance. It is concluded that MPA distension does indeed cause reflex pulmonary vasoconstriction which can be reversed by vasodilator metabolites of arachidonic acid. Even though this reflex may help maintain high pulmonary vascular resistance in the fetus, its function in the adult is obscure.

Pneumoconiosis and liver cirrhosis are not risk factors for tuberculosis in patients with pulmonary infection

Energy Technology Data Exchange (ETDEWEB)

Wu, H.P.; Pan, Y.H.; Hua, C.C.; Shieh, H.B.; Jiang, B.Y.; Yu, T.J. [Chang Gung Memorial Hospital, Chilung (Taiwan)

2007-05-15

It is unclear whether patients with liver cirrhosis and coal miners with pneumoconiosis are at increased risk of developing pulmonary tuberculosis (TB). Furthermore, little is known of the likelihood of pneumonia in patients with bronchiectasis, haemodialysis, diabetes mellitus or advanced lung cancer being due to TB. To answer these questions, patients with these clinical comorbidities were analysed. The study was retrospective and included 264 TB patients, 478 non-TB pneumonia patients, and as negative controls, 438 subjects without pneumonia. The parameters analysed were age, gender and the presence of pneumoconiosis, bronchiectasis, liver cirrhosis, haemodialysis, diabetes mellitus and advanced lung cancer. Male gender was the only significant factor increasing the risk of pulmonary TB. When compared with non-TB pneumonia and control patients, the odds ratios were 1.862 and 2.182, respectively. Patients with liver cirrhosis did not show an increased risk of pulmonary TB after regression analysis. Pneumoconiosis resulted in a 2.260 (P = 0.003) odds ratio for pulmonary TB, compared with the controls. However, there was no difference in pneurmoconiosis between TB and non-TB pneumonia patients. Patients with bronchiectasis, lung cancer and those receiving haemodialysis had a lower risk for pulmonary TB in lower respiratory tract infection, with odds ratios of 0.342, 0.311 and 0.182, respectively. Physicians should first consider non-TB bacterial infection rather than Mycobacterium tuberculosis infection in pneumonia in patients with bronchiectasis, lung cancer or those receiving haemodialysis.

Geometrically Thick Obscuration by Radiation-driven Outflow from Magnetized Tori of Active Galactic Nuclei

Energy Technology Data Exchange (ETDEWEB)

Chan, Chi-Ho [Racah Institute of Physics, Hebrew University of Jerusalem, Jerusalem 91904 (Israel); Krolik, Julian H. [Department of Physics and Astronomy, Johns Hopkins University, Baltimore, MD 21218 (United States)

2017-07-01

Near-Eddington radiation from active galactic nuclei (AGNs) has significant dynamical influence on the surrounding dusty gas, plausibly furnishing AGNs with geometrically thick obscuration. We investigate this paradigm with radiative magnetohydrodynamics simulations. The simulations solve the magnetohydrodynamics equations simultaneously with the infrared (IR) and ultraviolet (UV) radiative transfer (RT) equations; no approximate closure is used for RT. We find that our torus, when given a suitable sub-Keplerian angular momentum profile, spontaneously evolves toward a state in which its opening angle, density distribution, and flow pattern change only slowly. This “steady” state lasts for as long as there is gas resupply toward the inner edge. The torus is best described as a midplane inflow and a high-latitude outflow. The outflow is launched from the torus inner edge by UV radiation and expands in solid angle as it ascends; IR radiation continues to drive the wide-angle outflow outside the central hole. The dusty outflow obscures the central source in soft X-rays, the IR, and the UV over three-quarters of solid angle, and each decade in column density covers roughly equal solid angle around the central source; these obscuration properties are similar to what observations imply.

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 ...

Dependence of Ca outflow and depression of frog myocardium contraction on ryodipine concentration.

Science.gov (United States)

Narusevicius, E; Gendviliene, V; Macianskiene, R; Hmelj-Dunai, G; Velena, A; Duburs, G

1988-02-01

The effect of ryodipine on calcium outflow from tissues, on contraction force, the duration of action potentials and the relaxation phase time-constant in the contraction cycles of myocardial strips was studied using frog heart preparations. It was found that calcium outflow (delta Ca) as a function on ryodipine concentration can be represented as: (formula; see text) A linear correlation exists between Ca2+, contraction blocking and the shortening of the action potential in the presence of various ryodipine concentrations. Ryodipine (10(-5) mol/l) decreased the relaxation time-constant by about 20% as compared to controls. It was concluded that calcium outflow from myocardial tissues in response to ryodipine is due to blockade of calcium entry into the cells and their output through the Na+--Ca2+ exchange system. Frog heart myocardial contractions are essentially under the control of calcium entry through sarcolemmal calcium channels.

NEW PERSPECTIVE ON GALAXY OUTFLOWS FROM THE FIRST DETECTION OF BOTH INTRINSIC AND TRAVERSE METAL-LINE ABSORPTION

Energy Technology Data Exchange (ETDEWEB)

Kacprzak, Glenn G.; Cooke, Jeff [Swinburne University of Technology, Victoria 3122 (Australia); Martin, Crystal L.; Ho, Stephanie H. [Physics Department, University of California, Santa Barbara, CA 93106 (United States); Bouché, Nicolas; LeReun, Audrey; Schroetter, Ilane [CNRS, Institut de Recherche en Astrophysique et Planétologie (IRAP) de Toulouse, 14 Avenue E. Belin, F-31400 Toulouse (France); Churchill, Christopher W.; Klimek, Elizabeth, E-mail: gkacprzak@astro.swin.edu.au [New Mexico State University, Las Cruces, NM 88003 (United States)

2014-09-01

We present the first observation of a galaxy (z = 0.2) that exhibits metal-line absorption back-illuminated by the galaxy (down-the-barrel) and transversely by a background quasar at a projected distance of 58 kpc. Both absorption systems, traced by Mg II, are blueshifted relative to the galaxy systemic velocity. The quasar sight line, which resides almost directly along the projected minor axis of the galaxy, probes Mg I and Mg II absorption obtained from the Keck/Low Resolution Imaging Spectrometer as well as Lyα, Si II, and Si III absorption obtained from the Hubble Space Telescope/Cosmic Origins Spectrograph. For the first time, we combine two independent models used to quantify the outflow properties for down-the-barrel and transverse absorption. We find that the modeled down-the-barrel deprojected outflow velocities range between V {sub dtb} = 45-255 km s{sup –1}. The transverse bi-conical outflow model, assuming constant-velocity flows perpendicular to the disk, requires wind velocities V {sub outflow} = 40-80 km s{sup –1} to reproduce the transverse Mg II absorption kinematics, which is consistent with the range of V {sub dtb}. The galaxy has a metallicity, derived from Hα and N II, of [O/H] = –0.21 ± 0.08, whereas the transverse absorption has [X/H] = –1.12 ± 0.02. The galaxy star formation rate is constrained between 4.6-15 M {sub ☉} yr{sup –1} while the estimated outflow rate ranges between 1.6-4.2 M {sub ☉} yr{sup –1} and yields a wind loading factor ranging between 0.1-0.9. The galaxy and gas metallicities, the galaxy-quasar sight-line geometry, and the down-the-barrel and transverse modeled outflow velocities collectively suggest that the transverse gas originates from ongoing outflowing material from the galaxy. The ∼1 dex decrease in metallicity from the base of the outflow to the outer halo suggests metal dilution of the gas by the time it reached 58 kpc.

Better Than Nothing: A Rational Approach for Minimizing the Impact of Outflow Strategy on Cerebrovascular Simulations.

Science.gov (United States)

Chnafa, C; Brina, O; Pereira, V M; Steinman, D A

2018-02-01

Computational fluid dynamics simulations of neurovascular diseases are impacted by various modeling assumptions and uncertainties, including outlet boundary conditions. Many studies of intracranial aneurysms, for example, assume zero pressure at all outlets, often the default ("do-nothing") strategy, with no physiological basis. Others divide outflow according to the outlet diameters cubed, nominally based on the more physiological Murray's law but still susceptible to subjective choices about the segmented model extent. Here we demonstrate the limitations and impact of these outflow strategies, against a novel "splitting" method introduced here. With our method, the segmented lumen is split into its constituent bifurcations, where flow divisions are estimated locally using a power law. Together these provide the global outflow rate boundary conditions. The impact of outflow strategy on flow rates was tested for 70 cases of MCA aneurysm with 0D simulations. The impact on hemodynamic indices used for rupture status assessment was tested for 10 cases with 3D simulations. Differences in flow rates among the various strategies were up to 70%, with a non-negligible impact on average and oscillatory wall shear stresses in some cases. Murray-law and splitting methods gave flow rates closest to physiological values reported in the literature; however, only the splitting method was insensitive to arbitrary truncation of the model extent. Cerebrovascular simulations can depend strongly on the outflow strategy. The default zero-pressure method should be avoided in favor of Murray-law or splitting methods, the latter being released as an open-source tool to encourage the standardization of outflow strategies. © 2018 by American Journal of Neuroradiology.

Sub-arcsecond imaging of Arp 299-A at 150 MHz with LOFAR: Evidence for a starburst-driven outflow

Science.gov (United States)

Ramírez-Olivencia, N.; Varenius, E.; Pérez-Torres, M.; Alberdi, A.; Pérez, E.; Alonso-Herrero, A.; Deller, A.; Herrero-Illana, R.; Moldón, J.; Barcos-Muñoz, L.; Martí-Vidal, I.

2018-03-01

We report on the first sub-arcsecond (0.44 × 0.41 arcsec2) angular resolution image at 150 MHz of the A-nucleus in the luminous infrared galaxy Arp 299, from International Low Frequency Array (LOFAR) Telescope observations. The most remarkable finding is that of an intriguing two-sided, filamentary structure emanating from the A-nucleus, which we interpret as an outflow that extends up to at least 14 arcsec from the A-nucleus in the N-S direction ( ≈5 kpc deprojected size) and accounts for almost 40% of the extended emission of the entire galaxy system. We also discuss HST/NICMOS [FeII] 1.64 μm and H2 2.12 μm images of Arp 299-A, which show similar features to those unveiled by our 150 MHz LOFAR observations, providing strong morphological support for the outflow scenario. Finally, we discuss unpublished Na I D spectra that confirm the outflow nature of this structure. From energetic arguments, we rule out the low-luminosity active galactic nucleus in Arp 299-A as a driver for the outflow. On the contrary, the powerful, compact starburst in the central regions of Arp 299-A provides plenty of mechanical energy to sustain an outflow, and we conclude that the intense supernova (SN) activity in the nuclear region of Arp 299-A is driving the observed outflow. We estimate that the starburst wind can support a mass-outflow rate in the range (11-63 M⊙ yr-1) at speeds of up to 370-890 km s-1, and is relatively young, with an estimated kinematic age of 3-7 Myr. Those results open an avenue to the use of low-frequency (150 MHz), sub-arcsecond imaging with LOFAR to detect outflows in the central regions of local luminous infrared galaxies.

Patterns Of Antimicrobial Use For Respiratory Tract Infections In Elderly Patients

International Nuclear Information System (INIS)

Taha, H.M.; Rasheedy, D.; Mahmoud, A.H.

2013-01-01

Background: Elderly patients are prone to respiratory tract infections (RTIs) both; acute bronchitis and pneumonia. A large proportion of the antibiotics prescribed are unlikely to provide clinical benefit to patients. There is an increased need to decrease excess antibiotic use in elderly to minimize antibiotic resistance. Objective: To describe patterns of antimicrobial use for respiratory tract infections (RTIs) among elderly Patients and methods: A cross sectional study was conducted on one hundred elderly patients, aged > 60 years, both males and females to describe patterns of antimicrobial use for respiratory tract infections (RTIs) among elderly patients. RTIs, categorized as acute bronchitis, and pneumonia, were studied for appropriateness of antimicrobial use, type of antibiotics used, and factors associated with their use. We rated antibiotic use as appropriate (when an effective drug was used), inappropriate (when a more effective drug was indicated), or unjustified (when use of any antimicrobial was not indicated). Results: Of 100 patients with RTI, overall treatment was appropriate in 79% of episodes, inappropriate in 9%, and unjustified in 12%. For acute bronchitis, treatment was appropriate in 85% and unjustified in 15% of cases. For pneumonia, treatment was appropriate in 55% of episodes. Among the most commonly used antimicrobials, B.Lactam + macrolides their use were unjustified in 41% of cases. There were statistical significant differences in the patterns of antibiotic use when stratified by age, gender, and co- morbid conditions including chronic obstructive pulmonary disease. Conclusion: Antimicrobials are unjustifiably used for 12% of RTIs and 15% of cases of acute bronchitis, thus suggesting a need for programs to improve antibiotic prescribing at hospitals.

Unicameral bone cyst: radiographic assessment of venous outflow by cystography as a prognostic index.

Science.gov (United States)

Ramirez, Ana; Abril, Juan Carlos; Touza, Alberto

2012-11-01

The aim of this study was to determine the benefits of cystography in the management of a simple bone cyst, its implication in the final result of the treatment after corticoid intracystic injections, and the presence of secondary effects. We retrospectively reviewed 42 patients diagnosed with a simple bone cyst. Cystography was performed before the corticoid injection. The presence or absence of loculation intracyst and the existence and number of venous outflows were determined. According to the venous drainage, cysts were classified as type 0 when a venous outflow did not exist and as type 1 when there was a rapid venous outflow (unicameral bone cyst with absent loculation in 16 cases (37.3%), whereas the lesion showed multiloculation in 26 cases (62.7%). There was no statistical difference between loculation intracyst (present or absent) and the final outcomes of the 42 cysts treated with a steroid injection (P=0.9). Cystography showed a negative venogram in 10 cases (23.8%), whereas the cysts showed a rapid venous outflow in 32 cases (76.2%). On the basis of Neer's classification, all patients with a negative venogram achieved complete healing of the cyst. Patients with a rapid venous outflow achieved complete healing in 14 cases (Neer I). In two patients, the healing was incomplete at the end of the follow-up period (Neer IV). In most cases (21 cysts), healing was partial (Neer II). Five patients showed a recurrence after initial healing of the cyst (Neer III) (P<0.05). The number or the size of veins did not affect healing of a bone cyst (P=0.6). Two patients with a rapid venous outflow showed a generalized hypertrichosis after the first injection of corticosteroids. Sex and age at the initiation of the first injection were not significant factors of healing (P=0.4). The average follow-up time was 59 months (24-60 months). Cystography provides morphological and functional information of simple bone cyst. It is a useful test before the administration of

Pulmonary infection by Rhodococcus equi presenting with positive Ziehl-Neelsen stain in a patient with human immunodeficiency virus: a case report

OpenAIRE

Spiliopoulou, Anastasia; Assimakopoulos, Stelios F; Foka, Antigoni; Kolonitsiou, Fevronia; Lagadinou, Maria; Petinaki, Efthimia; Anastassiou, Evangelos D; Spiliopoulou, Iris; Marangos, Markos

2014-01-01

Introduction Patients with human immunodeficiency virus carry a significant risk of contracting opportunistic infections. The worldwide increased incidence of tuberculosis has instituted pulmonary tuberculosis as an important diagnostic consideration in patients with human immunodeficiency virus presenting with lower respiratory tract infection. A positive result on the readily-available Ziehl-Neelsen stain usually leads to the initiation of antituberculous treatment, since tuberculosis may e...

Advection-dominated Inflow/Outflows from Evaporating Accretion Disks.

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Turolla; Dullemond

2000-03-01

In this Letter we investigate the properties of advection-dominated accretion flows (ADAFs) fed by the evaporation of a Shakura-Sunyaev accretion disk (SSD). In our picture, the ADAF fills the central cavity evacuated by the SSD and extends beyond the transition radius into a coronal region. We find that, because of global angular momentum conservation, a significant fraction of the hot gas flows away from the black hole, forming a transsonic wind, unless the injection rate depends only weakly on radius (if r2sigma&d2;~r-xi, xiBernoulli number of the inflowing gas is negative if the transition radius is less, similar100 Schwarzschild radii, so matter falling into the hole is gravitationally bound. The ratio of inflowing to outflowing mass is approximately 1/2, so in these solutions the accretion rate is of the same order as in standard ADAFs and much larger than in advection-dominated inflow/outflow models. The possible relevance of evaporation-fed solutions to accretion flows in black hole X-ray binaries is briefly discussed.

The multi-phase winds of Markarian 231: from the hot, nuclear, ultra-fast wind to the galaxy-scale, molecular outflow

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Feruglio, C.; Fiore, F.; Carniani, S.; Piconcelli, E.; Zappacosta, L.; Bongiorno, A.; Cicone, C.; Maiolino, R.; Marconi, A.; Menci, N.; Puccetti, S.; Veilleux, S.

2015-11-01

Mrk 231 is a nearby ultra-luminous IR galaxy exhibiting a kpc-scale, multi-phase AGN-driven outflow. This galaxy represents the best target to investigate in detail the morphology and energetics of powerful outflows, as well as their still poorly-understood expansion mechanism and impact on the host galaxy. In this work, we present the best sensitivity and angular resolution maps of the molecular disk and outflow of Mrk 231, as traced by CO(2-1) and (3-2) observations obtained with the IRAM/PdBI. In addition, we analyze archival deep Chandra and NuSTAR X-ray observations. We use this unprecedented combination of multi-wavelength data sets to constrain the physical properties of both the molecular disk and outflow, the presence of a highly-ionized ultra-fast nuclear wind, and their connection. The molecular CO(2-1) outflow has a size of 1 kpc, and extends in all directions around the nucleus, being more prominent along the south-west to north-east direction, suggesting a wide-angle biconical geometry. The maximum projected velocity of the outflow is nearly constant out to 1 kpc, thus implying that the density of the outflowing material must decrease from the nucleus outwards as r-2. This suggests that either a large part of the gas leaves the flow during its expansion or that the bulk of the outflow has not yet reached out to 1 kpc, thus implying a limit on its age of 1 Myr. Mapping the mass and energy rates of the molecular outflow yields dot {M} OF = [500-1000] M⊙ yr-1 and Ėkin,OF = [7-10] × 1043 erg s-1. The total kinetic energy of the outflow is Ekin,OF is of the same order of the total energy of the molecular disk, Edisk. Remarkably, our analysis of the X-ray data reveals a nuclear ultra-fast outflow (UFO) with velocity -20 000 km s-1, dot {M}UFO = [0.3-2.1] M⊙ yr-1, and momentum load dot {P}UFO/ dot {P}rad = [0.2-1.6]. We find Ėkin,UFO Ėkin,OF as predicted for outflows undergoing an energy conserving expansion. This suggests that most of the UFO

Right ventricular involvement in cardiac sarcoidosis demonstrated with cardiac magnetic resonance.

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Smedema, Jan-Peter; van Geuns, Robert-Jan; Ainslie, Gillian; Ector, Joris; Heidbuchel, Hein; Crijns, Harry J G M

2017-11-01

Cardiac involvement in sarcoidosis is reported in up to 30% of patients. Left ventricular involvement demonstrated by contrast-enhanced cardiac magnetic resonance has been well validated. We sought to determine the prevalence and distribution of right ventricular late gadolinium enhancement in patients diagnosed with pulmonary sarcoidosis. We prospectively evaluated 87 patients diagnosed with pulmonary sarcoidosis with contrast-enhanced cardiac magnetic resonance for right ventricular involvement. Pulmonary artery pressures were non-invasively evaluated with Doppler echocardiography. Patient characteristics were compared between the groups with and without right ventricular involvement, and right ventricular enhancement was correlated with pulmonary hypertension, ventricular mass, volume, and systolic function. Left ventricular late gadolinium enhancement was demonstrated in 30 patients (34%). Fourteen patients (16%) had right ventricular late gadolinium enhancement, with sole right ventricular enhancement in only two patients. The pattern of right ventricular enhancement consisted of right ventricular outflow tract enhancement in 1 patient, free wall enhancement in 8 patients, ventricular insertion point enhancement in 10 patients, and enhancement of the right side of the interventricular septum in 11 patients. Pulmonary arterial hypertension correlated with the presence of right ventricular enhancement (P Right ventricular enhancement correlated with systolic ventricular dysfunction (P Right ventricular enhancement was present in 16% of patients diagnosed with pulmonary sarcoidosis and in 48% of patients with left ventricular enhancement. The presence of right ventricular enhancement correlated with pulmonary arterial hypertension, right ventricular systolic dysfunction, hypertrophy, and dilation. © 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

Balloon Pulmonary Angioplasty in Chronic Thromboembolic Pulmonary Hypertension: New Horizons in the Interventional Management of Pulmonary Embolism.

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Rivers-Bowerman, Michael D; Zener, Rebecca; Jaberi, Arash; de Perrot, Marc; Granton, John; Moriarty, John M; Tan, Kong T

2017-09-01

Chronic thromboembolic pulmonary hypertension (CTEPH) is an underdiagnosed potential complication of acute or recurrent pulmonary thromboembolic disease. Multiple studies suggest that up to 5% of patients with acute pulmonary thromboembolic disease go on to develop CTEPH. The prognosis of untreated CTEPH is poor, but advances in medical and surgical treatments over the past few decades have improved patient outcomes. The gold standard and curative treatment for CTEPH is pulmonary endarterectomy; however, some patients are inoperable and others who have undergone pulmonary endarterectomy experience persistent or recurrent pulmonary hypertension despite medical therapy. In recent years, balloon pulmonary angioplasty has emerged as a primary and adjunctive treatment for these CTEPH patients at expert or specialized centers. This review outlines an approach to balloon pulmonary angioplasty for CTEPH, including clinical presentation and evaluation; patient selection and indications; treatment planning; equipment and technique; overcoming technical challenges; recognition and management of complications; postprocedural care and clinical follow-up; and expected outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

Molecular Outflow and Feedback in an Obscured Quasar at z˜1.5 Revealed by ALMA

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Brusa, Marcella

2017-11-01

We imaged with ALMA and ARGOS/LUCI the molecular gas and the dust and stellar continuum in XID2028, an obscured QSO at z=1.593, where the presence of a massive outflow in the ionized gas component traced by the [O III]5007 emission has been resolved up to 10 kpc. This target does represent a unique test case to study QSO 'feedback in action' at the peak epoch of AGN- galaxy coevolution. The QSO has been detected both in the CO(5-4) transition and in the 1.3mm continuum, with emissions confined in the central ( consumption conditions in XID2028, possibly due to feedback effects on the host galaxy. Finally, we observe an asymmetric profile of the CO(5-4) line, which suggests the presence of high velocity gas up to 700 km/s. An image of the blueshfited and redshifted CO wings provides the first detection of a spatially resolved, galaxy-scale molecular outflow at high-z, extended in opposite directions with the approaching component spatially coincident with the ionised gas outflow. The resolved, molecular outflow appear to be cospatial with the component observed int the ionised gas. XID2028 therefore represents the first example of molecular and ionised kpc scales outflows at high-z.

Outflow monitoring of a pneumatic ventricular assist device using external pressure sensors.

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Kang, Seong Min; Her, Keun; Choi, Seong Wook

2016-08-25

In this study, a new algorithm was developed for estimating the pump outflow of a pneumatic ventricular assist device (p-VAD). The pump outflow estimation algorithm was derived from the ideal gas equation and determined the change in blood-sac volume of a p-VAD using two external pressure sensors. Based on in vitro experiments, the algorithm was revised to consider the effects of structural compliance caused by volume changes in an implanted unit, an air driveline, and the pressure difference between the sensors and the implanted unit. In animal experiments, p-VADs were connected to the left ventricles and the descending aorta of three calves (70-100 kg). Their outflows were estimated using the new algorithm and compared to the results obtained using an ultrasonic blood flow meter (UBF) (TS-410, Transonic Systems Inc., Ithaca, NY, USA). The estimated and measured values had a Pearson's correlation coefficient of 0.864. The pressure sensors were installed at the external controller and connected to the air driveline on the same side as the external actuator, which made the sensors easy to manage.

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

Factors affecting on the particle deposition in the respiratory tract

International Nuclear Information System (INIS)

Kubota, Yoshihisa

1991-01-01

The deposition pattern of inhaled particles in the respiratory tracts is affected by anatomical structure of the respiratory tracts and respiratory pattern of animals, which are modified by many factors as animal species, physiological and psychological conditions, age, sex, smoking drug, lung diseases, etc. In human, studies have been focused on the initial lung deposition of particles and have made it clear that the respiratory pattern, gender, and diseases may have influence on the deposition pattern. On the other hand, there was little knowledge on the initial lung deposition of particles in laboratory animals. Recently, Raabe et al. have reported the initial lung deposition of 169 Yb-aluminosilicate particles in mice, rats, hamsters, guinea pigs and rabbits. The authors have also investigated the lung deposition of latex particles with different sizes and 198 Au-colloid in rats whose respiratory volumes during the inhalation were monitored by body plethysmography. These experiments indicated that the deposition of inhaled particles in distal lung e.g. small bronchiolar and alveolar region, was much lower in laboratory animals than that of human. This species difference may be due to smaller diameter of respiratory tract and/or shallower breathing and higher respiratory rate of laboratory animals. The experimental animals in which respiratory diseases were induced artificially have been used to investigate the modification factors on the deposition pattern of inhaled particles. As respiratory diseases, emphysema was induced in rats, hamsters, beagle dogs in some laboratories and pulmonary delayed type hypersensitivity reaction in rats was in our laboratory. The initial lung deposition of particles in these animals was consistently decreased in comparison with normals, regardless of the animal species and the type of disease. (author)

Preliminary studies of pulmonary perfusion scanning in patients with pulmonary hypertension

International Nuclear Information System (INIS)

Shi Rongfang; Liu Xiujie; Wang Yanqun

1986-01-01

A comparative analysis of pulmonary perfusion scanning through cardiac catheterization of 57 patients including 32 patients with congenital heart disease, 8 patients with chronic pulmonary thromboembolism and 7 patients with primary pulmonary hypertension is reported. The lung scintigram obtained with In-113m or Tc-99m-MAA represents the distribution of pulmonary blood. It has been found that the lung scintigram was abnormal in patients of congenital heart disease with pulmonary hypertension (i. e. pulmonary artery pressure between 41-80 mmHg) and the extent of radoiactive regional defects is proportional to the level of pulmonary hypertension. The results of the analysis indicated that pulmonary perfusion scanning being a noninvasive technique would be a useful method in evaluating the level of pulmonary hypertension in patients with left to right shunt before and after surgical operation

The response of relativistic outflowing gas to the inner accretion disk of a black hole.

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Parker, Michael L; Pinto, Ciro; Fabian, Andrew C; Lohfink, Anne; Buisson, Douglas J K; Alston, William N; Kara, Erin; Cackett, Edward M; Chiang, Chia-Ying; Dauser, Thomas; De Marco, Barbara; Gallo, Luigi C; Garcia, Javier; Harrison, Fiona A; King, Ashley L; Middleton, Matthew J; Miller, Jon M; Miniutti, Giovanni; Reynolds, Christopher S; Uttley, Phil; Vasudevan, Ranjan; Walton, Dominic J; Wilkins, Daniel R; Zoghbi, Abderahmen

2017-03-01

The brightness of an active galactic nucleus is set by the gas falling onto it from the galaxy, and the gas infall rate is regulated by the brightness of the active galactic nucleus; this feedback loop is the process by which supermassive black holes in the centres of galaxies may moderate the growth of their hosts. Gas outflows (in the form of disk winds) release huge quantities of energy into the interstellar medium, potentially clearing the surrounding gas. The most extreme (in terms of speed and energy) of these-the ultrafast outflows-are the subset of X-ray-detected outflows with velocities higher than 10,000 kilometres per second, believed to originate in relativistic (that is, near the speed of light) disk winds a few hundred gravitational radii from the black hole. The absorption features produced by these outflows are variable, but no clear link has been found between the behaviour of the X-ray continuum and the velocity or optical depth of the outflows, owing to the long timescales of quasar variability. Here we report the observation of multiple absorption lines from an extreme ultrafast gas flow in the X-ray spectrum of the active galactic nucleus IRAS 13224-3809, at 0.236 ± 0.006 times the speed of light (71,000 kilometres per second), where the absorption is strongly anti-correlated with the emission of X-rays from the inner regions of the accretion disk. If the gas flow is identified as a genuine outflow then it is in the fastest five per cent of such winds, and its variability is hundreds of times faster than in other variable winds, allowing us to observe in hours what would take months in a quasar. We find X-ray spectral signatures of the wind simultaneously in both low- and high-energy detectors, suggesting a single ionized outflow, linking the low- and high-energy absorption lines. That this disk wind is responding to the emission from the inner accretion disk demonstrates a connection between accretion processes occurring on very different

Genital and Urinary Tract Defects

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... conditions > Genital and urinary tract defects Genital and urinary tract defects E-mail to a friend Please fill ... and extra fluids. What problems can genital and urinary tract defects cause? Genital and urinary tract defects affect ...

Cellular automaton model in the fundamental diagram approach reproducing the synchronized outflow of wide moving jams

International Nuclear Information System (INIS)

Tian, Jun-fang; Yuan, Zhen-zhou; Jia, Bin; Fan, Hong-qiang; Wang, Tao

2012-01-01

Velocity effect and critical velocity are incorporated into the average space gap cellular automaton model [J.F. Tian, et al., Phys. A 391 (2012) 3129], which was able to reproduce many spatiotemporal dynamics reported by the three-phase theory except the synchronized outflow of wide moving jams. The physics of traffic breakdown has been explained. Various congested patterns induced by the on-ramp are reproduced. It is shown that the occurrence of synchronized outflow, free outflow of wide moving jams is closely related with drivers time delay in acceleration at the downstream jam front and the critical velocity, respectively. -- Highlights: ► Velocity effect is added into average space gap cellular automaton model. ► The physics of traffic breakdown has been explained. ► The probabilistic nature of traffic breakdown is simulated. ► Various congested patterns induced by the on-ramp are reproduced. ► The occurrence of synchronized outflow of jams depends on drivers time delay.

Molecular Gas toward the Gemini OB1 Molecular Cloud Complex. II. CO Outflow Candidates with Possible WISE Associations

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Li, Yingjie; Li, Fa-Cheng; Xu, Ye; Wang, Chen; Du, Xin-Yu; Yang, Wenjin; Yang, Ji

2018-03-01

We present a large-scale survey of CO outflows in the Gem OB1 molecular cloud complex and its surroundings, using the Purple Mountain Observatory Delingha 13.7 m telescope. A total of 198 outflow candidates were identified over a large area (∼58.5 square degrees), of which 193 are newly detected. Approximately 68% (134/198) are associated with the Gem OB1 molecular cloud complex, including clouds GGMC 1, GGMC 2, BFS 52, GGMC 3, and GGMC 4. Other regions studied are: the Local arm (Local Lynds, West Front), Swallow, Horn, and Remote cloud. Outflow candidates in GGMC 1, BFS 52, and Swallow are mainly located at ring-like or filamentary structures. To avoid excessive uncertainty in distant regions (≳3.8 kpc), we only estimated the physical parameters for clouds in the Gem OB1 molecular cloud complex and in the Local arm. In those clouds, the total kinetic energy and the energy injection rate of the identified outflow candidates are ≲1% and ≲3% of the turbulent energy and the turbulent dissipation rate of each cloud, indicating that the identified outflow candidates cannot provide enough energy to balance turbulence of their host cloud at the scale of the entire cloud (several to dozens of parsecs). The gravitational binding energy of each cloud is ≳135 times the total kinetic energy of the identified outflow candidates within the corresponding cloud, indicating that the identified outflow candidates cannot cause major disruptions to the integrity of their host cloud at the scale of the entire cloud.

Kidneys and Urinary Tract