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Sample records for pulmonary va24 vb11

  1. 30 CFR 57.22202 - Main fans (I-A, I-B, I-C, II-A, III, V-A, and V-B mines).

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Main fans (I-A, I-B, I-C, II-A, III, V-A, and V... Main fans (I-A, I-B, I-C, II-A, III, V-A, and V-B mines). (a) Main fans shall be— (1) Installed on the... mines, provided with an automatic signal device to give an alarm when the fan stops. The signal device...

  2. Mapping of the antigenic and allergenic epitopes of Lol p VB using gene fragmentation.

    Science.gov (United States)

    Ong, E K; Knox, R B; Singh, M B

    1995-03-01

    The recombinant proteins of Lol p VA and Lol p VB expressed in E. coli reacted with IgE antibodies from sera of allergic patients and mAbs FMC A7 and PpV1. Cross-absorption analyses using these recombinant proteins showed that Lol p VA and Lol p VB possess both similar and unique IgE binding determinants. Gene fragmentation was utilized to localize the antigenic and allergenic determinants of Lol p VB. When full-length cDNA of Lol p VB was digested into three fragments and expressed as the fusions from the glutathione transferase of pGEX vectors, fragments Met1-Val196 and Asp197-Val339 bound IgE while fragment Met1-Pro96 did not. The data suggest that there are at least two IgE binding determinants in Lol p VB. In addition, only fragment Met1-Val196 reacted with mAb PpV1. The localization of these determinants was further resolved using random fragment expression libraries. The mAb PpV1 determinant was near the N-terminal region of Lol p VB molecule. The IgE binding determinants were distributed in the central region: region I (amino acids 111-195) and II (199-254). These IgE binding determinants are conserved in Lol p VA.

  3. VA/Q distribution during heavy exercise and recovery in humans: implications for pulmonary edema

    Science.gov (United States)

    Schaffartzik, W.; Poole, D. C.; Derion, T.; Tsukimoto, K.; Hogan, M. C.; Arcos, J. P.; Bebout, D. E.; Wagner, P. D.

    1992-01-01

    Ventilation-perfusion (VA/Q) inequality has been shown to increase with exercise. Potential mechanisms for this increase include nonuniform pulmonary vasoconstriction, ventilatory time constant inequality, reduced large airway gas mixing, and development of interstitial pulmonary edema. We hypothesized that persistence of VA/Q mismatch after ventilation and cardiac output subside during recovery would be consistent with edema; however, rapid resolution would suggest mechanisms related to changes in ventilation and blood flow per se. Thirteen healthy males performed near-maximal cycle ergometry at an inspiratory PO2 of 91 Torr (because hypoxia accentuates VA/Q mismatch on exercise). Cardiorespiratory variables and inert gas elimination patterns were measured at rest, during exercise, and between 2 and 30 min of recovery. Two profiles of VA/Q distribution behavior emerged during heavy exercise: in group 1 an increase in VA/Q mismatch (log SDQ of 0.35 +/- 0.02 at rest and 0.44 +/- 0.02 at exercise; P less than 0.05, n = 7) and in group 2 no change in VA/Q mismatch (n = 6). There were no differences in anthropometric data, work rate, O2 uptake, or ventilation during heavy exercise between groups. Group 1 demonstrated significantly greater VA/Q inequality, lower vital capacity, and higher forced expiratory flow at 25-75% of forced vital capacity for the first 20 min during recovery than group 2. Cardiac index was higher in group 1 both during heavy exercise and 4 and 6 min postexercise. However, both ventilation and cardiac output returned toward baseline values more rapidly than did VA/Q relationships. Arterial pH was lower in group 1 during exercise and recovery. We conclude that greater VA/Q inequality in group 1 and its persistence during recovery are consistent with the hypothesis that edema occurs and contributes to the increase in VA/Q inequality during exercise. This is supported by observation of greater blood flows and acidosis and, presumably therefore

  4. Aplicação de métodos de calibração multivariada para a determinação simultânea de riboflavina (VB2, tiamina (VB1, piridoxina (VB6 e nicotinamida (VPP UV spectrophotrometry and chemometrics methods for simultaneous determinations of riboflavin (VB2, thiamine (VB1, pyridoxine (VB6 and nicotinamide (VPP

    Directory of Open Access Journals (Sweden)

    Rosângela C. Barthus

    2007-01-01

    Full Text Available In this work, the artificial neural networks (ANN and partial least squares (PLS regression were applied to UV spectral data for quantitative determination of thiamin hydrochloride (VB1, riboflavin phosphate (VB2, pyridoxine hydrochloride (VB6 and nicotinamide (VPP in pharmaceutical samples. For calibration purposes, commercial samples in 0.2 mol L-1 acetate buffer (pH 4.0 were employed as standards. The concentration ranges used in the calibration step were: 0.1 - 7.5 mg L-1 for VB1, 0.1 - 3.0 mg L-1 for VB2, 0.1 - 3.0 mg L-1 for VB6 and 0.4 - 30.0 mg L-1 for VPP. From the results it is possible to verify that both methods can be successfully applied for these determinations. The similar error values were obtained by using neural network or PLS methods. The proposed methodology is simple, rapid and can be easily used in quality control laboratories.

  5. A Rab11A/myosin Vb/Rab11-FIP2 complex frames two late recycling steps of langerin from the ERC to the plasma membrane.

    Science.gov (United States)

    Gidon, Alexandre; Bardin, Sabine; Cinquin, Bertrand; Boulanger, Jerome; Waharte, François; Heliot, Laurent; de la Salle, Henri; Hanau, Daniel; Kervrann, Charles; Goud, Bruno; Salamero, Jean

    2012-06-01

    A large body of knowledge relating to the constitution of Rab GTPase/Rab effector complexes and their impact on both membrane domain organization and overall membrane trafficking has been built up in recent years. However in the context of the live cell there are still many questions that remain to be answered, such as where and when these complexes assemble and where they perform their primary function(s). We describe here the dynamic processes that take place in the final steps of the Rab11A dependent recycling pathway, in the context of the membrane platform constituted by Myosin Vb, Rab11A, and Rab11-FIP2. We first confirm that a series of previously reported observations obtained during the study of a number of trafficking cargoes also apply to langerin. Langerin is a cargo molecule that traffics through Rab11A-positive membrane domains of the endosomal recycling pathway. In order to explore the relative dynamics of this set of partners, we make extensive use of a combinatory approach of Live-FRET, fast FRAP video, fast confocal and TIRF microscopy modalities. Our data show that the Myosin Vb/Rab11A/Rab11-FIP2 platform is spatially involved in the regulation of langerin trafficking at two distinct sites within live cells, first at the sorting site in the endosomal recycling compartment (ERC) where transport vesicles are formed, and subsequently, in a strict time-defined order, at the very late stage of docking/tethering and fusion of these langerin recycling vesicles to the plasma membrane. © 2012 John Wiley & Sons A/S.

  6. Radial velocity observations of VB10

    Science.gov (United States)

    Deshpande, R.; Martin, E.; Zapatero Osorio, M. R.; Del Burgo, C.; Rodler, F.; Montgomery, M. M.

    2011-07-01

    VB 10 is the smallest star known to harbor a planet according to the recent astrometric study of Pravdo & Shaklan [1]. Here we present near-infrared (J-band) radial velocity of VB 10 performed from high resolution (R~20,000) spectroscopy (NIRSPEC/KECK II). Our results [2] suggest radial velocity variability with amplitude of ~1 km/s, a result that is consistent with the presence of a massive planet companion around VB10 as found via long-term astrometric monitoring of the star by Pravdo & Shaklan. Employing an entirely different technique we verify the results of Pravdo & Shaklan.

  7. [Pulmonary function in patients with focal pulmonary tuberculosis].

    Science.gov (United States)

    Nefedov, V B; Popova, L A; Shergina, E A

    2008-01-01

    Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/VC%, PEF, MEF25, MEF50, MEF75, TLC, TGV, pulmonary residual volume (PRV), Raw, Rin, Rcx, DLCO-SB, DLCO-SS/VA, PaO2, and PaCO2 were determined in 40 patients with focal pulmonary tuberculosis. Changes were found in lung volumes and capacities in 75%, impaired bronchial patency and pulmonary gas exchange dysfunction were in 57.5 and 25%, respectively. The lung volume and capacity changes appeared mainly as increased TGV and PRV; impaired bronchial patency presented as decreased MEF50, MEF75, and FEV1/VC%; pulmonary gas exchange dysfunction manifested itself as reduced DLCO-SB, PaO2, and PaCO2. The magnitude of the observed functional changes was generally slight. TGV and PRL increased up to 148-187 and 142-223% of the normal values, respectively; MEF50, MEF75, FEV1/VC%, and DLCO decreased to 59-24, 58-26, 78-57, and 78-67% of the normal values and PaO2 and PaCO2 did to 79-69 and 34-30 cm Hg.

  8. Inertial Navigation System Aiding Using Vision

    Science.gov (United States)

    2013-03-01

    abp a + Cba d dt ( pa ) + d dt ( rbba ) (2.11) vb = d dt ( rbba ) + Cba (Ω a... abp a + va) (2.12) where ddt (r b ba) accounts for the relative velocity betwwen the a-frame and b-frame, CbaΩaabp a is the instantaneous velocity of p...frame. Taking another time derivative of Eq. 2.12 results in: d dt ( vb ) , ab = d2 dt2 rbba + d dt [ Cba (Ω a abp a + va) ] (2.13) = r̈bba + dCba

  9. [Value-based health care (VbHC): Whence and wither].

    Science.gov (United States)

    Raspe, Heiner

    2018-02-01

    Since about 2005 VbHC has become a prominent movement on the border between population medicine and health economics. The "value" it is aiming at is defined as health care "outcomes per dollar spent". The text focuses on the work of two prominent proponents: M.E. Porter and J.A.M. Gray. It considers background and central elements of VbHC and discusses similarities and differences between the two authors. Especially the differences raise questions that will hopefully play a role in the German discussion that is still in its infancy. Three complex topics seem to be particularly relevant: the relationship between VbHC and evidence-based health care, the question of who is to benefit from VbHC (total, diseased, patient population?), and the role of moral values especially the value of solidarity with the severely ill and socially deprived. Copyright © 2018. Published by Elsevier GmbH.

  10. Caspase-11 Plays a Protective Role in Pulmonary Acinetobacter baumannii Infection.

    Science.gov (United States)

    Wang, Wei; Shao, Yue; Li, Shengjun; Xin, Na; Ma, Tingxian; Zhao, Chenghai; Song, Min

    2017-10-01

    Activation of caspase-11 by some Gram-negative bacteria triggers the caspase-1/interleukin 1β (IL-1β) pathway, independent of canonical inflammasomes. Acinetobacter baumannii is a Gram-negative, conditionally pathogenic bacterium that can cause severe pulmonary infection in hospitalized patients. A. baumannii was revealed to activate canonical and noncanonical inflammasome pathways in bone marrow-derived macrophages (BMDMs). Pulmonary infection of caspase-11 -/- mice with A. baumannii showed that caspase-11 deficiency impaired A. baumannii clearance, exacerbated pulmonary pathological changes, and enhanced susceptibility to A. baumannii These data indicate that the caspase-11-mediated innate immune response plays a crucial role in defending against A. baumannii . Copyright © 2017 American Society for Microbiology.

  11. [Status of vitamin A, vitamin B2, iron and an-oxidantive activity in anemic pregnant women in China].

    Science.gov (United States)

    Yang, Fang; Ma, Ai-Guo; Zhang, Xiu-Zhen; Jiang, Dian-Chen

    2006-05-01

    To investigate the status of vitamin A(VA), vitamin B2 (VB2), iron and anoxidative function in anemic and non-anemic pregnant women. 426 anemic and 36 non-anemic pregnant women were included in the study. The survey of 24-hour's diet recall of pregnant women was made to evaluate intake of iron, VB2, folic acid, etc by the nutrition software provided by Beijing 301 hospital, iron and VA were measured by Radioimmunoassay (RIA) and by high-pressure liquid chromatography. VB2 status was detected using the assay for erythrocyte glutathione reductase (Egr; EC 1.6.4.2) activity. SOD and GSH-Px activities and MDA were determined using commercial kits. Peripheral blood erythrocyte membrane fluidity was detected by using 1,6-diphenyl-1,3,5-hexatriene as a probe, the degree of fluorescence polarization (P) at 25 degrees C of disrupted cells plasma membranes were compared for a variety of systems. Median intakes of protein and vitamin C met the current Chinese RNIs for pregnancy, whereas intakes of(VA) and VB2 were well below the recommendations. Intake of iron were above 90%, but the main sources of iron are vegetables. Plasma VA (1.25 micromol/L) and iron (20.57 microg/L) were lower, BGRAC (1.79) was higher than that in non-anemia group (VA 1.57 micromol/L, SF 33.16 microg/L, BGRAC 1.52). The level of plasma SOD (77.1U/ml) and the activity of GSH-Px (61.9U) were lower than those in non-anemia group (92.2U/ml, 71.6U, P membrane (P = 0.2622, eta = 2.7465) fluidity were higher than those non-anemia group(MDA = 3.78 nmol/ ml, P = 0.2360, eta = 2.3658). Plasam VA, VB2 and iron, antioxidantcapacity and erythrocyte membrane fluidity were decreased in the anemic pregnant women.

  12. Assessment of anatomic relation between pulmonary perfusion and morphology in pulmonary emphysema with breath-hold SPECT-CT fusion images

    International Nuclear Information System (INIS)

    Suga, Kazuyoshi; Kawakami, Yasuhiko; Iwanaga, Hideyuki; Hayashi, Noriko; Seto, Akiko; Matsunaga, Naofumi

    2008-01-01

    Anatomic relation between pulmonary perfusion and morphology in pulmonary emphysema was assessed on deep-inspiratory breath-hold (DIBrH) perfusion single-photon emission computed tomography (SPECT)-CT fusion images. Subjects were 38 patients with pulmonary emphysema and 11 non-smoker controls, who successfully underwent DIBrH and non-BrH perfusion SPECT using a dual-headed SPECT system during the period between January 2004 and June 2006. DIBrH SPECT was three-dimensionally co-registered with DIBrH CT to comprehend the relationship between lung perfusion defects and CT low attenuation areas (LAA). By comparing the appearance of lung perfusion on DIBrH with non-BrH SPECT, the correlation with the rate constant for the alveolar-capillary transfer of carbon monoxide (DLCO/VA) was compared between perfusion abnormalities on these SPECTs and LAA on CT. DIBrH SPECT provided fairly uniform perfusion in controls, but significantly enhanced perfusion heterogeneity when compared with non-BrH SPECT in pulmonary emphysema patients (P<0.001). The reliable DIBrH SPECT-CT fusion images confirmed more extended perfusion defects than LAA on CT in majority (73%) of patients. Perfusion abnormalities on DIBrH SPECT were more closely correlated with DLCO/VA than LAA on CT (P<0.05). DIBrH SPECT identifies affected lungs with perfusion abnormality better than does non-BrH SPECT in pulmonary emphysema. DIBrH SPECT-CT fusion images are useful for more accurately localizing affected lungs than morphologic CT alone in this disease. (author)

  13. Topiramate Protects Pericytes from Glucotoxicity: Role for Mitochondrial CA VA in Cerebromicrovascular Disease in Diabetes.

    Science.gov (United States)

    Patrick, Ping; Price, Tulin O; Diogo, Ana L; Sheibani, Nader; Banks, William A; Shah, Gul N

    Hyperglycemia in diabetes mellitus causes oxidative stress and pericyte depletion from the microvasculature of the brain thus leading to the Blood-Brain Barrier (BBB) disruption. The compromised BBB exposes the brain to circulating substances, resulting in neurotoxicity and neuronal cell death. The decline in pericyte numbers in diabetic mouse brain and pericyte apoptosis in high glucose cultures are caused by excess superoxide produced during enhanced respiration (mitochondrial oxidative metabolism of glucose). Superoxide is precursor to all Reactive Oxygen Species (ROS) which, in turn, cause oxidative stress. The rate of respiration and thus the ROS production is regulated by mitochondrial carbonic anhydrases (mCA) VA and VB, the two isoforms expressed in the mitochondria. Inhibition of both mCA: decreases the oxidative stress and restores the pericyte numbers in diabetic brain; and reduces high glucose-induced respiration, ROS, oxidative stress, and apoptosis in cultured brain pericytes. However, the individual role of the two isoforms has not been established. To investigate the contribution of mCA VA in ROS production and apoptosis, a mCA VA overexpressing brain pericyte cell line was engineered. These cells were exposed to high glucose and analyzed for the changes in ROS and apoptosis. Overexpression of mCA VA significantly increased pericyte ROS and apoptosis. Inhibition of mCA VA with topiramate prevented increases both in glucose-induced ROS and pericyte death. These results demonstrate, for the first time, that mCA VA regulates the rate of pericyte respiration. These findings identify mCA VA as a novel and specific therapeutic target to protect the cerebromicrovascular bed in diabetes.

  14. VB Platinum Tile & Carpet, Inc. Information Sheet

    Science.gov (United States)

    VB Platinum Tile & Carpet, Inc. (the Company) is located in Bristow, Virginia. The settlement involves renovation activities conducted at a property constructed prior to 1978, located in Washington, DC.

  15. MEDICIS(ASTEC-V2) sensitivity calculations for investigation of the crust formation in VB-U5 and VB-U6 VULCANO tests

    International Nuclear Information System (INIS)

    Stefanova, A.; Grudev, P.; Gencheva, R.

    2011-01-01

    This paper presents the results from sensitivity calculations made with MEDICIS(ASTECv2) for investigation of the crust formation during the Molten Corium-Concrete Interaction(MCCI) in VB-U5 and VB-U6 VULCANO tests. All calculations are made with MEDICIS computer code. The main goal of these analyses is to assess how the assumptions for crust formation or not formation influence over the concrete ablation. Three calculations have been done for each one of the experiments with different crust thickness and lock of crust formation at the bottom, side and upper surface. (authors)

  16. Estimation of pulmonary vascular resistance in patients with pulmonary fibrosis by phase-contrast magnetic resonance imaging

    International Nuclear Information System (INIS)

    Ayukawa, Yuichiro; Murayama, Sadayuki; Tsuchiya, Nanae; Yara, Satomi; Fujita, Jiro

    2011-01-01

    The aim of this study was to assess pulmonary vascular resistance (PVR) in patients with pulmonary fibrosis (PF) by phase-contrast magnetic resonance imaging (MRI). Subjects were 11 healthy volunteers and 11 patients with PF. Using phase-contrast MRI, we measured pulmonary arterial blood flow and calculated the parameters of PVR. Parameters were compared between volunteers and patients using unpaired t-tests. The diagnostic capability of the parameters was evaluated by receiver operating characteristic (ROC) curve analysis. Patients underwent respiratory function tests (RFTs) and chest computed tomography (CT), and they were correlated with MRI parameters. Most MRI parameters were significantly different between volunteers and patients (t-test P values were <0.05 in 9 of 10 parameters). Regarding the RFT and CT visual score, only the %DLco/VA and acceleration time and the CT visual score and average flow volume had significant correlation [r=-0.667 (P=0.024) and r=-0.6 (P=0.031)], respectively. Our findings suggest that PVR derived from phase-contrast MRI is significantly higher in patients with PF than in volunteers. However, all but two of these parameters may not correlate with the severity of PF. (author)

  17. Higher Capacity, Improved Conductive Matrix VB2/Air Batteries (Postprint)

    Science.gov (United States)

    2016-02-18

    gravimetric capacity five-fold higher than the 2 e− oxidation of the widely used zinc alkaline anode. One challenge to the implementation of VB2/air...VB2 has an intrinsic gravimetric capacity five fold higher than the 2 e− oxidation of the widely used zinc alkaline anode. One challenge to the...to ameliorate this effect through advanced anode configurations with an improved conductive matrix. Materials and Methods Anodes were prepared using

  18. In aftermath of financial investigation Phoenix VA employee demoted after her testimony

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2013-03-01

    Full Text Available No abstract available. Article truncated after 150 words. A previous Southwest Journal of Pulmonary and Critical Care Journal editorial commented on fiscal mismanagement at the Department of Veterans Affairs (VA Medical Center in Phoenix (1. Now Paula Pedene, the former Phoenix VA public affairs officer, claims she was demoted for testimony she gave to the VA Inspector General’s Office (OIG regarding that investigation (2. In 2011, the OIG investigated the Phoenix VA for excess spending on private care of patients (3. The report blamed systemic failures for controls so weak that $56 million in medical fees were paid during 2010 without adequate review. The report particularly focused on one clinician assigned by the Chief of Staff to review hundreds of requests per week and the intensive care unit physicians for transferring patients to chronic ventilator units (1,3. After the investigation, the director and one of the associate directors left the VA and the chief of staff was promoted …

  19. Pulmonary interstitial emphysema in neonates -reporting of 11 cases

    International Nuclear Information System (INIS)

    Alvares, Beatriz Regina; Santos Mezzacappa, Maria Aparecida dos; Marba, Sergio Tadeu Martins

    1997-01-01

    The present paper relates the radiologic and clinical aspects of pulmonary interstitial emphysema in 11 infants submitted to assisted ventilation. The radiologic diagnosis was made using the classification of Boothroyd and Barson (levels I to III). A prevalence of pulmonary interstitial emphysema of levels II and III was observed in masculine premature infants with hyaline membrane disease and intrauterine pneumonia. Mortality was high and occurred in the infants with advanced levels of the disease. The authors emphasize the importance of early radiologic diagnosis of this condition during the treatment of premature infants submitted to assisted ventilation. (author)

  20. 76 FR 52230 - Establishment of Class E Airspace; Forest, VA

    Science.gov (United States)

    2011-08-22

    ...-0378; Airspace Docket No. 11-AEA-11] Establishment of Class E Airspace; Forest, VA AGENCY: Federal... at Forest, VA, to accommodate the new Area Navigation (RNAV) Global Positioning System (GPS) Standard... published in the Federal Register a notice of proposed rulemaking to establish Class E airspace at Forest...

  1. Effect of pulmonary hyperinflation on central blood volume

    DEFF Research Database (Denmark)

    Mijacika, Tanja; Kyhl, Kasper; Frestad, Daria

    2017-01-01

    (11±7%) above the total lung capacity. All cardiac chambers decreased in volume and despite a heart rate increase of 24±29 bpm (39±50%), pulmonary blood flow decreased by 2783±1820mL (43±20%). The pulmonary transit time remained unchanged at 7.5±2.2s and pulmonary blood volume decreased by 354±176m...

  2. Professional ASPNET 35 SP1 Edition In C# and VB

    CERN Document Server

    Evjen, Bill; Rader, Devin

    2009-01-01

    Professional ASP.NET 3.5 SP1 In C# and VB. ASP.NET 3.5 brings the power of Visual Studio® 2008 along with the multitude of language improvements in C# 2008 and Visual Basic® 2008 as well as powerful new technology called LINQ, together with the ASP.NET 2.0 Framework you already know and love. Packed with valuable coverage of ASP.NET 3.5 SP1, this essential resource offers both C# and VB examples throughout the book, and shares new and updated content on the ADO.NET Entity Framework, ADO.NET Dynamic Data, and ADO.NET Data Services. While ASP.NET 3.5 boasts server controls like the ListView and

  3. 78 FR 66265 - Drawbridge Operation Regulation; Elizabeth River, Eastern Branch, Norfolk, VA

    Science.gov (United States)

    2013-11-05

    ... Operation Regulation; Elizabeth River, Eastern Branch, Norfolk, VA AGENCY: Coast Guard, DHS. ACTION: Notice... Elizabeth River Eastern Branch, mile 1.1, at Norfolk, VA. This deviation is necessary to facilitate... maintenance. The Norfolk Southern 5 railroad Bridge, at mile 1.1, across the Elizabeth River (Eastern Branch...

  4. Injection Molding Parameters Calculations by Using Visual Basic (VB) Programming

    Science.gov (United States)

    Tony, B. Jain A. R.; Karthikeyen, S.; Alex, B. Jeslin A. R.; Hasan, Z. Jahid Ali

    2018-03-01

    Now a day’s manufacturing industry plays a vital role in production sectors. To fabricate a component lot of design calculation has to be done. There is a chance of human errors occurs during design calculations. The aim of this project is to create a special module using visual basic (VB) programming to calculate injection molding parameters to avoid human errors. To create an injection mold for a spur gear component the following parameters have to be calculated such as Cooling Capacity, Cooling Channel Diameter, and Cooling Channel Length, Runner Length and Runner Diameter, Gate Diameter and Gate Pressure. To calculate the above injection molding parameters a separate module has been created using Visual Basic (VB) Programming to reduce the human errors. The outcome of the module dimensions is the injection molding components such as mold cavity and core design, ejector plate design.

  5. Treatment of pulmonary hypertension in idiopathic pulmonary fibrosis: shortfall in efficacy or trial design?

    Directory of Open Access Journals (Sweden)

    Nathan SD

    2014-07-01

    Full Text Available Steven D Nathan, Christopher S King Advanced Lung Disease Clinic, Inova Fairfax Hospital, Falls Church, VA, USA Abstract: Idiopathic pulmonary fibrosis (IPF is a disease that carries a high mortality. Pulmonary hypertension (PH frequently complicates the course of patients with IPF and is associated with significantly worse outcomes. Whether PH is a surrogate or driver of these worse outcomes remains unanswered, but the presence of PH represents an attractive target for therapy. This review delves into the various pulmonary vasoactive agents that have been subjected to study in IPF, the pitfalls of some of these prior studies, and attempts to lay a foundation for future study designs targeting PH in IPF. Keywords: phenotype, interstitial lung disease

  6. Partial anomalous pulmonary venous return in Turner syndrome.

    Science.gov (United States)

    van den Hoven, Allard T; Chelu, Raluca G; Duijnhouwer, Anthonie L; Demulier, Laurent; Devos, Daniel; Nieman, Koen; Witsenburg, Maarten; van den Bosch, Annemien E; Loeys, Bart L; van Hagen, Iris M; Roos-Hesselink, Jolien W

    2017-10-01

    The aim of this study is to describe the prevalence, anatomy, associations and clinical impact of partial anomalous pulmonary venous return in patients with Turner syndrome. All Turner patients who presented at our Turner clinic, between January 2007 and October 2015 were included in this study and underwent ECG, echocardiography and advanced imaging such as cardiac magnetic resonance or computed tomography as part of their regular clinical workup. All imaging was re-evaluated and detailed anatomy was described. Partial anomalous pulmonary venous return was diagnosed in 24 (25%) out of 96 Turner patients included and 14 (58%) of these 24 partial anomalous pulmonary venous return had not been reported previously. Right atrial or ventricular dilatation was present in 11 (46%) of 24 partial anomalous pulmonary venous return patients. When studied with advanced imaging modalities and looked for with specific attention, PAPVR is found in 1 out of 4 Turner patients. Half of these patients had right atrial and/or ventricular dilatation. Evaluation of pulmonary venous return should be included in the standard protocol in all Turner patients. Copyright © 2017. Published by Elsevier B.V.

  7. Biosynthesis of actinorhodin and related antibiotics: discovery of alternative routes for quinone formation encoded in the act gene cluster.

    Science.gov (United States)

    Okamoto, Susumu; Taguchi, Takaaki; Ochi, Kozo; Ichinose, Koji

    2009-02-27

    All known benzoisochromanequinone (BIQ) biosynthetic gene clusters carry a set of genes encoding a two-component monooxygenase homologous to the ActVA-ORF5/ActVB system for actinorhodin biosynthesis in Streptomyces coelicolor A3(2). Here, we conducted molecular genetic and biochemical studies of this enzyme system. Inactivation of actVA-ORF5 yielded a shunt product, actinoperylone (ACPL), apparently derived from 6-deoxy-dihydrokalafungin. Similarly, deletion of actVB resulted in accumulation of ACPL, indicating a critical role for the monooxygenase system in C-6 oxygenation, a biosynthetic step common to all BIQ biosyntheses. Furthermore, in vitro, we showed a quinone-forming activity of the ActVA-ORF5/ActVB system in addition to that of a known C-6 monooxygenase, ActVA-ORF6, by using emodinanthrone as a model substrate. Our results demonstrate that the act gene cluster encodes two alternative routes for quinone formation by C-6 oxygenation in BIQ biosynthesis.

  8. COPD, COOP and BREATH at the VA

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2011-02-01

    Full Text Available No abstract available. Article truncated at 150 words. The February 2011 Pulmonary Journal Club reviews a study by Rice and colleagues (1 of high-risk COPD patients (click here for Pulmonary Journal Club. This review was authored by Kevin Park who also authored an ACP Journal Club review (2. In Rice’s study a single educational session, an individualized care plan, and monthly case-manager telephone calls, resulted in a 41% decrease in hospitalizations and emergency room visits and a nonsignficant trend toward decreased mortality.Rice’s study was supported and conducted in the Veterans Integrated Service Network (VISN 23 (Minnesota, Iowa, Nebraska and the Dakotas. The COPD patients in this study were recruited and followed primarily using the VA computer system. The study represents a potential model of data-based management leading to improved patient outcomes. The authors; Robert Petzel MD, then VISN 23 Director (now Veterans Healthcare Administration Undersecretary; and Janet Murphy, then VISN Primary Care Service Line CEO (now VISN …

  9. Beginning ASPNET 4 in VB 2010

    CERN Document Server

    MacDonald, Matthew

    2010-01-01

    The most up-to-date and comprehensive introductory ASP.NET book you'll find on any shelf, Beginning ASP.NET 4 in VB 2010 guides you through Microsoft's latest technology for building dynamic web sites. This book will enable you to build dynamic web pages on the fly, and assumes only the most basic knowledge of Visual Basic. The book provides exhaustive coverage of ASP.NET, guiding you from your first steps right up to the most advanced techniques, such as querying databases from within a web page and tuning your site for optimal performance. Within these pages, you'll find tips for best practi

  10. 24 CFR 3282.11 - Preemption and reciprocity.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Preemption and reciprocity. 3282.11 Section 3282.11 Housing and Urban Development Regulations Relating to Housing and Urban Development... and reciprocity. (a) No State manufactured home standard regarding manufactured home construction and...

  11. 76 FR 44288 - Establishment of Class E Airspace; New Market, VA

    Science.gov (United States)

    2011-07-25

    ...-380; Airspace Docket No. 11-AEA-12] Establishment of Class E Airspace; New Market, VA AGENCY: Federal... proposes to establish Class E Airspace at New Market, VA, to accommodate the additional airspace needed for the Standard Instrument Approach Procedures developed for New Market Airport. This action would...

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

    Science.gov (United States)

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

    2018-05-01

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

  13. 24 CFR 971.11 - HOPE VI developments.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false HOPE VI developments. 971.11... § 971.11 HOPE VI developments. Developments with HOPE VI implementation grants that have approved HOPE... with reasonable revitalization plans. Future HUD actions to approve or deny proposed HOPE VI...

  14. Pulmonary manifestation of leptospirosis: Clinical and experimental correlation

    International Nuclear Information System (INIS)

    Im, J.G.; Yeon, K.M.; Han, M.C.; Kim, C.W.; Chang, W.H.; Lee, J.S.

    1987-01-01

    Pulmonary radiographic findings were noted in 24 (56%) of 43 patients with leptospirosis, proved by positive serology. Three radiographic patterns were evident: (1) small nodular densities (n = 11), (2) patchy or confluent consolidation (n = 4), and (3) diffuse ill-defined groundglass density (n = 9). Abnormalities were bilateral, nonlobar, and peripheral. Pulmonary abnormalities all resolved within 10 days, except in three patients who died. Artificial infection was induced through intraperitoneal injection of Leptospira interohemorrhagiae into 20 guinea pigs. The lungs from the guinea pigs initially showed petechial hemorrhage which progressed to large confluent ares of hemorrhage. The typical pulmonary radiographic findings of leptopirosis are compatible with the multifocal pulmonary hemorrhage seen in the guinea pigs

  15. VA Education Benefits: Actions Taken, but Outreach and Oversight Could Be Improved. Report to the Ranking Member, Subcommittee on Military Personnel, Committee on Armed Services, House of Representatives. GAO-11-256

    Science.gov (United States)

    Bertoni, Daniel

    2011-01-01

    The U.S. Department of Veterans Affairs (VA) provided $9 billion in education benefits to service-members and veterans in fiscal year 2010, mostly through the new Post-9/11 GI Bill. In providing education benefits, VA relies on State Approving Agencies (SAA) to approve schools; and on schools to report students' enrollment status. US Government…

  16. Pulmonary function testing in HTLV-I and HTLV-II infected humans: a cohort study

    Directory of Open Access Journals (Sweden)

    Garratty George

    2003-07-01

    Full Text Available Abstract Background HTLV-I infection has been linked to lung pathology and HTLV-II has been associated with an increased incidence of pneumonia and acute bronchitis. However it is unknown whether HTLV-I or -II infection alters pulmonary function. Methods We performed pulmonary function testing on HTLV-I, HTLV-II and HTLV seronegative subjects from the HTLV outcomes study (HOST, including vital capacity (VC, forced expiratory volume in one second (FEV1, and diffusing lung capacity for carbon monoxide (DLCO corrected for hemoglobin and lung volume. Multivariable analysis adjusted for differences in age, gender, race/ethnicity, height and smoking history. Results Mean (standard deviation pulmonary function values among the 257 subjects were as follows: FVC = 3.74 (0.89 L, FEV1 = 2.93 (0.67 L, DLCOcorr = 23.82 (5.89 ml/min/mmHg, alveolar ventilation (VA = 5.25 (1.20 L and DLCOcorr/VA = 4.54 (0.87 ml/min/mmHg/L. There were no differences in FVC, FEV1 and DLCOcorr/VA by HTLV status. For DLCOcorr, HTLV-I and HTLV-II subjects had slightly lower values than seronegatives, but neither difference was statistically significant after adjustment for confounding. Conclusions There was no difference in measured pulmonary function and diffusing capacity in generally healthy HTLV-I and HTLV-II subjects compared to seronegatives. These results suggest that previously described HTLV-associated abnormalities in bronchoalveolar cells and fluid may not affect pulmonary function.

  17. Comparison of outcomes for veterans receiving dialysis care from VA and non-VA providers.

    Science.gov (United States)

    Wang, Virginia; Maciejewski, Matthew L; Patel, Uptal D; Stechuchak, Karen M; Hynes, Denise M; Weinberger, Morris

    2013-01-18

    Demand for dialysis treatment exceeds its supply within the Veterans Health Administration (VA), requiring VA to outsource dialysis care by purchasing private sector dialysis for veterans on a fee-for-service basis. It is unclear whether outcomes are similar for veterans receiving dialysis from VA versus non-VA providers. We assessed the extent of chronic dialysis treatment utilization and differences in all-cause hospitalizations and mortality between veterans receiving dialysis from VA versus VA-outsourced providers. We constructed a retrospective cohort of veterans in 2 VA regions who received chronic dialysis treatment financed by VA between January 2007 and December 2008. From VA administrative data, we identified veterans who received outpatient dialysis in (1) VA, (2) VA-outsourced settings, or (3) both ("dual") settings. In adjusted analyses, we used two-part and logistic regression to examine associations between dialysis setting and all-cause hospitalization and mortality one-year from veterans' baseline dialysis date. Of 1,388 veterans, 27% received dialysis exclusively in VA, 47% in VA-outsourced settings, and 25% in dual settings. Overall, half (48%) were hospitalized and 12% died. In adjusted analysis, veterans in VA-outsourced settings incurred fewer hospitalizations and shorter hospital stays than users of VA due to favorable selection. Dual-system dialysis patients had lower one-year mortality than veterans receiving VA dialysis. VA expenditures for "buying" outsourced dialysis are high and increasing relative to "making" dialysis treatment within its own system. Outcomes comparisons inform future make-or-buy decisions and suggest the need for VA to consider veterans' access to care, long-term VA savings, and optimal patient outcomes in its placement decisions for dialysis services.

  18. Modulation of CD11c+ lung dendritic cells in respect to TGF-β in experimental pulmonary fibrosis.

    Science.gov (United States)

    Chakraborty, Kaustav; Chatterjee, Soumya; Bhattacharyya, Arindam

    2017-09-01

    Idiopathic pulmonary fibrosis (IPF) is a deadly, progressive lung disease with very few treatment options till now. Bleomycin-induced pulmonary fibrosis (BIPF) is a commonly used mice model in IPF research. TGF-β1 has been shown to play a key role in pulmonary fibrosis (PF). Dendritic cell (DC) acts as a bridge between innate and adaptive immune systems. The coexistence of chronic inflammation sustained by mature DCs with fibrosis suggests that inflammatory phenomenon has key importance in the pathogenesis of pulmonary fibrosis. Here, we investigated the modulation of DCs phenotypic maturation, accumulation in lung tissue, and expression of other lung DC subsets in respect to TGF-β in PF. First, we established BIPF model in mice and blocked TGF-β expression by the use of inhibitor SB431542. Accumulation of lung CD11c+ DCs is significantly higher in both inflammatory and fibrotic phases of the disease but that percentages got reduced in the absence of TGF-β. TGF-β initiates up-regulation of costimulatory molecules CD86 and CD80 in the inflammatory phases of the disease but not so at fibrotic stage. Expression of lung DC subset CD11c+CD103+ is significantly increased in inflammatory phase and also in fibrotic phase of BIPF. Blocking of TGF-β causes decreased expression of CD11c+CD103+ DCs. Another important lung DC subset CD11c+CD11b+ expression is suppressed by the absence of TGF-β after bleomycin administration. CD11c+CD103+ DCs might have anti-inflammatory as well as anti-fibrotic nature in PF. All these data demonstrate differential modulation of CD11c+ lung DCs by TGF-β in experimental PF. © 2017 International Federation for Cell Biology.

  19. Comparison of outcomes for veterans receiving dialysis care from VA and non-VA providers

    Directory of Open Access Journals (Sweden)

    Wang Virginia

    2013-01-01

    Full Text Available Abstract Background Demand for dialysis treatment exceeds its supply within the Veterans Health Administration (VA, requiring VA to outsource dialysis care by purchasing private sector dialysis for veterans on a fee-for-service basis. It is unclear whether outcomes are similar for veterans receiving dialysis from VA versus non-VA providers. We assessed the extent of chronic dialysis treatment utilization and differences in all-cause hospitalizations and mortality between veterans receiving dialysis from VA versus VA-outsourced providers. Methods We constructed a retrospective cohort of veterans in 2 VA regions who received chronic dialysis treatment financed by VA between January 2007 and December 2008. From VA administrative data, we identified veterans who received outpatient dialysis in (1 VA, (2 VA-outsourced settings, or (3 both (“dual” settings. In adjusted analyses, we used two-part and logistic regression to examine associations between dialysis setting and all-cause hospitalization and mortality one-year from veterans’ baseline dialysis date. Results Of 1,388 veterans, 27% received dialysis exclusively in VA, 47% in VA-outsourced settings, and 25% in dual settings. Overall, half (48% were hospitalized and 12% died. In adjusted analysis, veterans in VA-outsourced settings incurred fewer hospitalizations and shorter hospital stays than users of VA due to favorable selection. Dual-system dialysis patients had lower one-year mortality than veterans receiving VA dialysis. Conclusions VA expenditures for “buying” outsourced dialysis are high and increasing relative to “making” dialysis treatment within its own system. Outcomes comparisons inform future make-or-buy decisions and suggest the need for VA to consider veterans’ access to care, long-term VA savings, and optimal patient outcomes in its placement decisions for dialysis services.

  20. Isolation and characterization of exopolysaccharide produced by Vibrio harveyi strain VB23.

    Science.gov (United States)

    Bramhachari, P V; Dubey, S K

    2006-11-01

    The aim of the study was to isolate and characterize exopolysaccharide (EPS) produced by Vibrio harveyi strain VB23. Growth and EPS production by V. harveyi strain VB23, was studied in mineral salts medium supplemented with NaCl (1.5%) and glucose (0.2%). The rate of EPS production in batch cultures was highest during the late log phase of growth when compared with stationary growth phase. The exopolymer was recovered from the culture supernatant by using a cold ethanol precipitation-dialysis procedure. Chemical analyses of EPS revealed that it is primarily composed of neutral sugars, uronic acids, proteins and sulfates. The purified EPS revealed prominent functional reactive groups, such as hydroxyl, carboxylic and amides, which correspond to a typical heteropolymeric polysaccharide and the EPS, also possessed good emulsification activity. The gas chromatographic analysis of an alditol acetate-derivatized sample of EPS revealed that it is composed primarily of galactose and glucose. Minor components found were rhamnose, fucose, ribose, arabinose, xylose and mannose. The EPS produced by V. harveyi strain VB23 is a heteropolysaccharide possessing good emulsification activity. EPS was readily isolated from culture supernatants, which suggests that the EPS was a slime-like EPS. This is the first report of EPS characterization in luminous V. harveyi bacteria, which describes the isolation and characterization of an EPS expressed by V. harveyi. The results of the study contributes significantly towards an understanding of the chemical composition and applications of the EPS in environmental biotechnology and bioremediation.

  1. KENO-VA-PVM KENO-VA-SM, KENO5A for Parallel Processors

    International Nuclear Information System (INIS)

    Ramon, Javier; Pena, Jorge

    2002-01-01

    1 - Description of program or function: This package contains versions KENO-Va-SM (Shared Memory version) and KENO-Va-PVM (Parallel Virtual Machine version) based on SCALE-4.1. KENO-Va three-dimensional Boltzmann transport equation for neutron multiplying systems. The primary purpose of KENO-Va is to determine k-effective. Other calculated quantities include lifetime and generation time, energy-dependent leakages, energy- and region-dependent absorptions, fissions, fluxes, and fission densities. 2 - Method of solution: KENO-Va employs the Monte Carlo technique

  2. Pulmonary functions in patients with subclinical hypothyroidism.

    Science.gov (United States)

    Cakmak, Gulfidan; Saler, Tayyibe; Saglam, Zuhal Aydan; Yenigun, Mustafa; Ataoglu, Esra; Demir, Tuncalp; Temiz, Levent Umit

    2011-10-01

    To determine whether alterations in pulmonary function takes place in subclinical hypothyroidism by examining the diffusion lung capacity and muscle strength of such patients. This is a descriptive study conducted in 2009 at Haseki Training and Research Hospital, Istanbul, Turkey. Hundred and twenty-six patients with subclinical hypothyroidism and 58 age and sex matched individuals were recruited. Simple spirometry tests were performed, and pulmonary diffusion capacity (DLco) and muscle strength were measured. ScH patients showed a significant reduciton of the following pulmonary function tests (% predicted value) as compared with control subjects: FVC, FEV1, FEV1%, FEF25-75, FEF25-75%, DLco, DLco/VA, Pimax, Pimax% and Pemax%. These data indicate that pulmonary functions are effected in subclinical hypothyrodism. Therefore patients with or who are at high risk of having subclinical hypothyroidism, should be subjected to evaluation of pulmonary functions with simple spirometry.

  3. Comparison of INTAKE24 (an Online 24-h Dietary Recall Tool) with Interviewer-Led 24-h Recall in 11-24 Year-Old.

    Science.gov (United States)

    Bradley, Jennifer; Simpson, Emma; Poliakov, Ivan; Matthews, John N S; Olivier, Patrick; Adamson, Ashley J; Foster, Emma

    2016-06-09

    Online dietary assessment tools offer a convenient, low cost alternative to traditional dietary assessment methods such as weighed records and face-to-face interviewer-led 24-h recalls. INTAKE24 is an online multiple pass 24-h recall tool developed for use with 11-24 year-old. The aim of the study was to undertake a comparison of INTAKE24 (the test method) with interviewer-led multiple pass 24-h recalls (the comparison method) in 180 people aged 11-24 years. Each participant completed both an INTAKE24 24-h recall and an interviewer-led 24-h recall on the same day on four occasions over a one-month period. The daily energy and nutrient intakes reported in INTAKE24 were compared to those reported in the interviewer-led recall. Mean intakes reported using INTAKE24 were similar to the intakes reported in the interviewer-led recall for energy and macronutrients. INTAKE24 was found to underestimate energy intake by 1% on average compared to the interviewer-led recall with the limits of agreement ranging from minus 49% to plus 93%. Mean intakes of all macronutrients and micronutrients (except non-milk extrinsic sugars) were within 4% of the interviewer-led recall. Dietary assessment that utilises technology may offer a viable alternative and be more engaging than paper based methods, particularly for children and young adults.

  4. Implementation of RS-485 Communication between PLC and PC of Distributed Control System Based on VB

    Science.gov (United States)

    Lian Zhang, Chuan; Da Huang, Zhi; Qing Zhou, Gui; Chong, Kil To

    2015-05-01

    This paper focuses on achieving RS-485 communication between programmable logical controller (PLC) and PC based on visual basic 6.0 (VB6.0) on an experimental automatic production line. Mitsubishi FX2N PLCs and a PC are chosen as slave stations and main station, respectively. Monitoring software is developed using VB6.0 for data input/output, flow control and online parameters setting. As a result, all functions are fulfilled with robust performance. It is concluded from results that one PC can monitor several PLCs using RS-485 communication.

  5. Pro ASP.NET 4 in VB 2010

    CERN Document Server

    MacDonald, Matthew; Freeman, Adam; Szpuszta, Mario; Agarwal, Vidya Vrat

    2010-01-01

    ASP.NET 4 is the latest version of Microsoft's revolutionary ASP.NET technology. It is the principal standard for creating dynamic web pages on the Windows platform. Pro ASP.NET 4 in VB 2010 raises the bar for high-quality, practical advice on learning and deploying Microsoft's dynamic web solution. This new edition is updated with everything you need to come to grips with the latest version of ASP.NET, including coverage of ASP.NET MVC, ASP.NET AJAX 4, ASP.NET Dynamic Data, and Silverlight 3. Seasoned .NET professionals Matthew MacDonald and Mario Szpuszta explain how you can get the most fro

  6. Evaluation of therapeutic potential of VB-001, a leave-on formulation, for the treatment of moderate adherent dandruff.

    Science.gov (United States)

    Bhattacharyya, Anamika; Jain, Nilu; Prasad, Sudhanand; Jain, Shilpi; Yadav, Vishal; Ghosh, Shamik; Sengupta, Shiladitya

    2017-05-03

    Dandruff is a common scalp condition characterized by excessive scaling and itch. Aberrant colonization of the scalp by commensal Malassezia spp. is a major contributor in the multifactorial etiology of dandruff. Literature based understanding of Malassezia linked pathophysiology of dandruff allowed us to comprehend a strategy to potentiate the efficacy of a known antifungal agent used in dandruff therapy. The aim of this study was to determine the efficacy and skin safety of VB-001 antidandruff leave-on formulation in comparison with marketed antidandruff ZPTO shampoo in patients with moderate adherent dandruff of the scalp. Healthy males or females aged ≥ 15 years and ≤ 65 with a clinical diagnosis of moderate adherent dandruff of the scalp were recruited for the study to monitor the effects of topical VB-001 versus those of marketed antidandruff ZPTO shampoo. 168 subjects were randomized to the treatment (VB-001, n = 84) and control (ZPTO shampoo, n = 84) groups. The efficacy of each product was evaluated by comparing proportion of subjects who have shown reduction in flaking by ASFS (adherent scalp flaking score) and pruritus by IGA (investigator global assessment) score. VB-001 imparted consistently better reduction in ASFS and enabled early reduction of pruritus in comparison to marketed ZPTO shampoo. VB-001, a leave-on formulation with ingredients chosen to selectively disturb the Malassezia niche on dandruff scalp by denying extra nutritional benefits to the microbe, provides unique advantages over existing best in class ZPTO shampoo therapy. It has the potential to emerge as an attractive novel treatment for moderate adherent dandruff. CTRI Registration number: CTRI/2013/01/003283 . Registered on: 02/01/2013.

  7. Quantitative CT analysis of small pulmonary vessels in lymphangioleiomyomatosis

    International Nuclear Information System (INIS)

    Ando, Katsutoshi; Tobino, Kazunori; Kurihara, Masatoshi; Kataoka, Hideyuki; Doi, Tokuhide; Hoshika, Yoshito; Takahashi, Kazuhisa; Seyama, Kuniaki

    2012-01-01

    Backgrounds: Lymphangioleiomyomatosis (LAM) is a destructive lung disease that share clinical, physiologic, and radiologic features with chronic obstructive pulmonary disease (COPD). This study aims to identify those features that are unique to LAM by using quantitative CT analysis. Methods: We measured total cross-sectional areas of small pulmonary vessels (CSA) less than 5 mm 2 and 5–10 mm 2 and calculated percentages of those lung areas (%CSA), respectively, in 50 LAM and 42 COPD patients. The extent of cystic destruction (LAA%) and mean parenchymal CT value were also calculated and correlated with pulmonary function. Results: The diffusing capacity for carbon monoxide/alveolar volume (DL CO /VA %predicted) was similar for both groups (LAM, 44.4 ± 19.8% vs. COPD, 45.7 ± 16.0%, p = 0.763), but less tissue damage occurred in LAM than COPD (LAA% 21.7 ± 16.3% vs. 29.3 ± 17.0; p CO /VA %predicted, %CSA and mean parenchymal CT value were still greater for LAM than COPD (p < 0.05). Conclusions: Quantitative CT analysis revealing a correlation between cystic destruction and CSA in COPD but not LAM indicates that this approach successfully reflects different mechanisms governing the two pathologic courses. Such determinations of small pulmonary vessel density may serve to differentiate LAM from COPD even in patients with severe lung destruction.

  8. Comparison of INTAKE24 (an Online 24-h Dietary Recall Tool with Interviewer-Led 24-h Recall in 1124 Year-Old

    Directory of Open Access Journals (Sweden)

    Jennifer Bradley

    2016-06-01

    Full Text Available Online dietary assessment tools offer a convenient, low cost alternative to traditional dietary assessment methods such as weighed records and face-to-face interviewer-led 24-h recalls. INTAKE24 is an online multiple pass 24-h recall tool developed for use with 1124 year-old. The aim of the study was to undertake a comparison of INTAKE24 (the test method with interviewer-led multiple pass 24-h recalls (the comparison method in 180 people aged 1124 years. Each participant completed both an INTAKE24 24-h recall and an interviewer-led 24-h recall on the same day on four occasions over a one-month period. The daily energy and nutrient intakes reported in INTAKE24 were compared to those reported in the interviewer-led recall. Mean intakes reported using INTAKE24 were similar to the intakes reported in the interviewer-led recall for energy and macronutrients. INTAKE24 was found to underestimate energy intake by 1% on average compared to the interviewer-led recall with the limits of agreement ranging from minus 49% to plus 93%. Mean intakes of all macronutrients and micronutrients (except non-milk extrinsic sugars were within 4% of the interviewer-led recall. Dietary assessment that utilises technology may offer a viable alternative and be more engaging than paper based methods, particularly for children and young adults.

  9. Maximum power per VA control of vector controlled interior ...

    Indian Academy of Sciences (India)

    Thakur Sumeet Singh

    2018-04-11

    Apr 11, 2018 ... Department of Electrical Engineering, Indian Institute of Technology Delhi, New ... The MPVA operation allows maximum-utilization of the drive-system. ... Permanent magnet motor; unity power factor; maximum VA utilization; ...

  10. CD4 lymphocyte counts and serum p24 antigen of no diagnostic value in monitoring HIV-infected patients with pulmonary symptoms

    DEFF Research Database (Denmark)

    Orholm, M; Nielsen, T L; Nielsen, Jens Ole

    1990-01-01

    The diagnostic value of the CD4 cell counts and the HIV p24 antigen were evaluated in a consecutive series of 105 HIV-infected patients experiencing 128 episodes of pulmonary symptoms which required bronchoscopy. One-third of patients with opportunistic infection (OI) had CD4 counts greater than 0....... In conclusion, the CD4 cell counts and the presence of p24 antigen in serum had a very limited predictive value for the presence of OI in HIV-infected patients with pulmonary symptoms....

  11. CD4 lymphocyte counts and serum p24 antigen of no diagnostic value in monitoring HIV-infected patients with pulmonary symptoms

    DEFF Research Database (Denmark)

    Orholm, M; Nielsen, T L; Nielsen, Jens Ole

    1990-01-01

    The diagnostic value of the CD4 cell counts and the HIV p24 antigen were evaluated in a consecutive series of 105 HIV-infected patients experiencing 128 episodes of pulmonary symptoms which required bronchoscopy. One-third of patients with opportunistic infection (OI) had CD4 counts greater than ....... In conclusion, the CD4 cell counts and the presence of p24 antigen in serum had a very limited predictive value for the presence of OI in HIV-infected patients with pulmonary symptoms.......The diagnostic value of the CD4 cell counts and the HIV p24 antigen were evaluated in a consecutive series of 105 HIV-infected patients experiencing 128 episodes of pulmonary symptoms which required bronchoscopy. One-third of patients with opportunistic infection (OI) had CD4 counts greater than 0.......200 x 10(9)/l, and 60% of patients without OI had CD4 counts less than 0.200 x 10(9)/l; 47 and 42% of patients with and without OI, respectively, had detectable p24 antigen in serum. Only 36% of the patients with OI presented the combination of CD4 cells less than 0.200 x 10(9)/l and p24 in serum...

  12. 78 FR 41174 - Self-Regulatory Organizations; BOX Options Exchange LLC; Notice of Filing and Immediate...

    Science.gov (United States)

    2013-07-09

    ... Trade Management Software (``TMS'') Fee under Section V.B. The Exchange proposes to rename Section V.A... Exchange is proposing to remove Section V.B. ``Back Office Trade Management Software (``TMS'')'' from the Fee Schedule. The TMS Software is optional software to which BOX Participants may subscribe in order...

  13. Synthesis of dimethyl-1,1 guanylguanidine-{sup 14}C-2,4 (dimethyl-1-1 biguanide) hydrochloride; Synthese du chlorhydrate de dimethyl-1,1 guanylguanidine {sup 14}C-2,4 (dimethyl-1-1 biguanide)

    Energy Technology Data Exchange (ETDEWEB)

    Herbert, M; Pichat, L [Commissariat a l' Energie Atomique, Saclay (France).Centre d' Etudes Nucleaires

    1961-07-01

    A description of the synthesis of dimethyl-1,1 guanylguanidine-{sup 14}C-2,4 hydrochloride passing through the {sup 14}C{sub 2} dicyandiamide. The overall yield with respect to Ba{sup 14}CO{sub 3} is 38 per cent. (author) [French] Description de la synthese du chlorhydrate de dimethyl-1,1 guanylguanidine {sup 14}C-2,4 par l'intermediaire de la dicyandiamide {sup 14}C{sub 2}. Le rendement global par rapport a {sup 14}CO{sub 3}Ba est de 38 pour cent. (auteur)

  14. Pulmonary infection in AIDS

    International Nuclear Information System (INIS)

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

    1998-01-01

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

  15. Clinical analysis of 11 cases with pulmonary fungal infection after liver transplantation%肝移植术后肺部真菌感染11例临床分析

    Institute of Scientific and Technical Information of China (English)

    陈建斌; 魏思东; 陈国勇; 孙建军; 汤高枫; 袁振华

    2015-01-01

    目的 探讨肝移植术后肺部真菌感染的临床特点、诊断及治疗措施.方法 回顾性分析了74例2013年10月至2014年10月在郑州人民医院肝移植术后出现肺部真菌感染的11例患者的临床资料,采取个体化的治疗和管理,并对临床数据进行总结分析.结果 在74例肝移植病例中,肺部真菌感染受者占14.9%(11/74).11例肝移植术后肺部真菌感染患者中,8例治愈,治愈率为72.7%;3例死亡,病死率为27.3%.结论 肝移植术后肺部真菌感染的患者均无典型的临床特点,容易干扰临床诊断,应引起肝移植中心医师的足够重视,尽早鉴定菌种并根据药敏试验使用敏感抗菌药物是成功救治肝移植术后肺部真菌感染的关键.%Objective To investigate clinical feature, diagnosis, and treatment of pulmonary fungal infection after liver transplantation.Methods This is a retrospective analysis of the clinical data of11 patients who underwent pulmonary fungal infections after liver transplantation from October2013 to October2014 in Zhengzhou People''s Hospital. The patients appeared to take individualized treatment and management, and the clinical data were analyzed.Results Among the74 cases of liver transplantation patients which affected by pulmonary fungal infection accounted for14.9%(11/74). Among11 cases of pulmonary fungal infection after liver transplantation patients, eight patients were cured, the cure rate was72.7%. A total of3 patients died, and the mortality rate was 27.3%.Conclusion Patients with pulmonary fungal infection after liver transplantation showed no typical clinical features, which was easy to interfere the clinical diagnosis. For patients with suspected pulmonary fungal infection sputum(and) blood culture should be done as soon as possible to identify species of fungal, and using drugs in accordance with sensitive antimicrobial susceptibility test is the key to the successful treatment of pulmonary fungal infections in patients

  16. Topographic distribution of pulmonary ventilation and perfusion in the horse

    International Nuclear Information System (INIS)

    Amis, T.C.; Pascoe, J.R.; Hornof, W.

    1984-01-01

    The regional distribution of ventilation to perfusion ratios (VA/Q) in the lungs of 8 healthy standing Thoroughbred geldings (4.4 +/- 1.5 years, 465.7 +/- 46.6 kg) was studied, using steady-state inhalation and IV infusion of the radioactive gas krypton-81m. The VA/Q was uniformly distributed within a vertical lung strip centered over the 9th rib on the right side. Ventilation per unit of alveolar volume (V/VA) assessed from the clearance of inhaled radioactive gas in 5 horses increased from 0.49 +/- 0.13 (arbitrary units) in nondependent lung zones to 1.45 +/- 0.16 in dependent lung zones. Seemingly, a vertical gradient of pulmonary ventilation exists in the horse that is matched by a similar gradient of perfusion

  17. Topographic distribution of pulmonary ventilation and perfusion in the horse

    Energy Technology Data Exchange (ETDEWEB)

    Amis, T.C.; Pascoe, J.R.; Hornof, W.

    1984-08-01

    The regional distribution of ventilation to perfusion ratios (VA/Q) in the lungs of 8 healthy standing Thoroughbred geldings (4.4 +/- 1.5 years, 465.7 +/- 46.6 kg) was studied, using steady-state inhalation and IV infusion of the radioactive gas krypton-81m. The VA/Q was uniformly distributed within a vertical lung strip centered over the 9th rib on the right side. Ventilation per unit of alveolar volume (V/VA) assessed from the clearance of inhaled radioactive gas in 5 horses increased from 0.49 +/- 0.13 (arbitrary units) in nondependent lung zones to 1.45 +/- 0.16 in dependent lung zones. Seemingly, a vertical gradient of pulmonary ventilation exists in the horse that is matched by a similar gradient of perfusion.

  18. OneVA Pharmacy

    Data.gov (United States)

    Department of Veterans Affairs — The OneVA Pharmacy application design consists of 3 main components: VistA Medication Profile screen, Health Data Record Clinical Data Service (HDR/CDS), and OneVA...

  19. Comparing Catheter-associated Urinary Tract Infection Prevention Programs Between VA and Non-VA Nursing Homes

    Science.gov (United States)

    Mody, Lona; Greene, M. Todd; Saint, Sanjay; Meddings, Jennifer; Trautner, Barbara W.; Wald, Heidi L.; Crnich, Christopher; Banaszak-Holl, Jane; McNamara, Sara E.; King, Beth J.; Hogikyan, Robert; Edson, Barbara; Krein, Sarah L.

    2018-01-01

    OBJECTIVE The impact of healthcare system integration on infection prevention programs is unknown. Using catheter-associated urinary tract infection (CAUTI) prevention as an example, we hypothesize that U.S. Department of Veterans Affairs (VA) nursing homes have a more robust infection prevention infrastructure due to integration and centralization compared with non-VA nursing homes. SETTING VA and non-VA nursing homes participating in the “AHRQ Safety Program for Long-term Care” collaborative. METHODS Nursing homes provided baseline information about their infection prevention programs to assess strengths and gaps related to CAUTI prevention. RESULTS A total of 353 (71%; 47 VA, 306 non-VA) of 494 nursing homes from 41 states responded. VA nursing homes reported more hours/week devoted to infection prevention-related activities (31 vs. 12 hours, P<.001), and were more likely to have committees that reviewed healthcare-associated infections. Compared with non-VA facilities, a higher percentage of VA nursing homes reported tracking CAUTI rates (94% vs. 66%, P<.001), sharing CAUTI data with leadership (94% vs. 70%, P=.014) and nursing personnel (85% vs. 56%, P=.003). However, fewer VA nursing homes reported having policies for appropriate catheter use (64% vs. 81%, P=.004) and catheter insertion (83% vs. 94%, P=.004). CONCLUSIONS Among nursing homes participating in an AHRQ-funded collaborative, VA and non-VA nursing homes differed in their approach to CAUTI prevention. Best practices from both settings should be applied universally to create an optimal infection prevention program within emerging integrated healthcare systems. PMID:27917728

  20. Intrinsic thermoelectric power of group VB metals

    Directory of Open Access Journals (Sweden)

    Gunadhor Singh Okram

    2012-03-01

    Full Text Available We have reinvestigated the thermopower of group VB metals in polycrystalline forms in the temperature range of 6-300K, taking into account the critical nature of the sample surface and heat treatment especially for niobium. Strikingly small magnitude, negative sign, phonon drag dip and superconductivity not reported previously were observed in surface-cleaned single crystalline Nb. However, while thermopower magnitudes are small, mixed signs were found in the polycrystalline V, Nb and Ta samples. These properties were therefore interpreted as their intrinsic properties and were briefly discussed taking into account of the existing theory by fitting also the data that give the Fermi energies of 10.94 eV, 5.08 eV and 1.86eV, respectively.

  1. C-11-labeled octadecylamine, a potential agent for positron tomographic pulmonary metabolism studies

    International Nuclear Information System (INIS)

    Washburn, L.C.; Wallace, R.T.; Byrd, B.L.; Sun, T.T.; Coffey, J.L.; Hubner, K.F.

    1984-01-01

    C-11-Labeled straight-chain primary aliphatic amines are rapidly and selectively sequestered by lung endothelial cells, making these agents potentially useful for positron tomographic studies of the lung as a metabolic organ. However, because amines having straight chains containing 4 to 13 carbon atoms are rapidly catabolized in vivo with loss of radiolabel, quantitation of pulmonary concentration is difficult. The authors have studied the effect of structural changes on the uptake and retention of primary aliphatic amines in rat lung and found that the metabolic loss form the lung decreased with increasing length of the straight carbon chain. In fact, the lung concentration of octadecylamine, a straight-chain amine with 18 carbon atoms, was constant between 1 and 30 minutes after intravenous administration. This highly insoluble amine was solubilized using 3% aqueous human serum albumin. Unilateral, radiation-induced lung injury in the rat was used as a model to study the potential of C-11-labeled octadecylamine. Radiation-damaged (3000 and 5000 Rads) lungs had significantly lower 15-minute uptakes of the labeled amine than the corresponding nonirradiated lungs. However, at 8000 Rads the concentration in both lungs was greatly suppressed, indicating that the decrease in metabolism becomes systemic at high radiation doses. These results suggest that C-11-labeled octadecylamine is a potentially useful agent for quantitative evaluation of pulmonary metabolism by positron tomography

  2. Professional ASP.NET 4 in C# and VB

    CERN Document Server

    Evjen, Bill; Rader, Devin

    2010-01-01

    This book was written to introduce you to the features and capabilities that ASP.NET 4 offers, as well as to give you an explanation of the foundation that ASP.NET provides. We assume you have a general understanding of Web technologies, such as previous versions of ASP.NET, Active Server Pages 2.0/3.0, or JavaServer Pages. If you understand the basics of Web programming, you should not have much trouble following along with this book's content. If you are brand new to ASP.NET, be sure to check out Beginning ASP.NET 4: In C# and VB by Imar Spaanjaars (Wiley Publishing, Inc., 2010) to help you

  3. Quantitative CT analysis of small pulmonary vessels in lymphangioleiomyomatosis

    Energy Technology Data Exchange (ETDEWEB)

    Ando, Katsutoshi, E-mail: kando@juntendo.ac.jp [Department of Internal Medicine, Division of Respiratory Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421 (Japan); The Study Group of Pneumothorax and Cystic Lung Diseases, 4-8-1 Seta, Setagaya-Ku, Tokyo 158-0095 (Japan); Tobino, Kazunori [Department of Respiratory Medicine, Iizuka Hospital, 3-83 Yoshio-Machi, Iizuka-City, Fukuoka 820-8505 (Japan); The Study Group of Pneumothorax and Cystic Lung Diseases, 4-8-1 Seta, Setagaya-Ku, Tokyo 158-0095 (Japan); Kurihara, Masatoshi; Kataoka, Hideyuki [Pneumothorax Center, Nissan Tamagawa Hospital, 4-8-1 Seta, Setagaya-Ku, Tokyo 158-0095 (Japan); The Study Group of Pneumothorax and Cystic Lung Diseases, 4-8-1 Seta, Setagaya-Ku, Tokyo 158-0095 (Japan); Doi, Tokuhide [Fukuoka Clinic, 7-18-11 Umeda, Adachi-Ku, Tokyo 123-0851 (Japan); Hoshika, Yoshito [Department of Internal Medicine, Division of Respiratory Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421 (Japan); The Study Group of Pneumothorax and Cystic Lung Diseases, 4-8-1 Seta, Setagaya-Ku, Tokyo 158-0095 (Japan); Takahashi, Kazuhisa [Department of Internal Medicine, Division of Respiratory Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421 (Japan); Seyama, Kuniaki [Department of Internal Medicine, Division of Respiratory Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421 (Japan); The Study Group of Pneumothorax and Cystic Lung Diseases, 4-8-1 Seta, Setagaya-Ku, Tokyo 158-0095 (Japan)

    2012-12-15

    Backgrounds: Lymphangioleiomyomatosis (LAM) is a destructive lung disease that share clinical, physiologic, and radiologic features with chronic obstructive pulmonary disease (COPD). This study aims to identify those features that are unique to LAM by using quantitative CT analysis. Methods: We measured total cross-sectional areas of small pulmonary vessels (CSA) less than 5 mm{sup 2} and 5–10 mm{sup 2} and calculated percentages of those lung areas (%CSA), respectively, in 50 LAM and 42 COPD patients. The extent of cystic destruction (LAA%) and mean parenchymal CT value were also calculated and correlated with pulmonary function. Results: The diffusing capacity for carbon monoxide/alveolar volume (DL{sub CO}/VA %predicted) was similar for both groups (LAM, 44.4 ± 19.8% vs. COPD, 45.7 ± 16.0%, p = 0.763), but less tissue damage occurred in LAM than COPD (LAA% 21.7 ± 16.3% vs. 29.3 ± 17.0; p < 0.05). Pulmonary function correlated negatively with LAA% (p < 0.001) in both groups, yet the correlation with %CSA was significant only in COPD (p < 0.001). When the same analysis was conducted in two groups with equal levels of LAA% and DL{sub CO}/VA %predicted, %CSA and mean parenchymal CT value were still greater for LAM than COPD (p < 0.05). Conclusions: Quantitative CT analysis revealing a correlation between cystic destruction and CSA in COPD but not LAM indicates that this approach successfully reflects different mechanisms governing the two pathologic courses. Such determinations of small pulmonary vessel density may serve to differentiate LAM from COPD even in patients with severe lung destruction.

  4. 75 FR 78806 - Agency Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

    Science.gov (United States)

    2010-12-16

    ... Payment Request for the VA Funding Fee Payment System (VA FFPS); a Computer Generated Funding Fee Receipt.... 2900-0474.'' SUPPLEMENTARY INFORMATION: Title: Create Payment Request for the VA Funding Fee Payment System (VA FFPS); a Computer Generated Funding Fee Receipt, VA Form 26-8986. OMB Control Number: 2900...

  5. Prospective Analysis of Pulmonary Hypertension in Extremely Low Birth Weight Infants

    Science.gov (United States)

    Bhat, Ramachandra; Salas, Ariel A.; Foster, Chris; Carlo, Waldemar A.

    2012-01-01

    OBJECTIVES: Pulmonary hypertension is associated with bronchopulmonary dysplasia in extremely low birth weight (ELBW) infants and contributes to morbidity and mortality. The objective was to determine the prevalence of pulmonary hypertension among ELBW infants by screening echocardiography and evaluate subsequent outcomes. METHODS: All ELBW infants admitted to a regional perinatal center were evaluated for pulmonary hypertension with echocardiography at 4 weeks of age and subsequently if clinical signs suggestive of right-sided heart failure or severe lung disease were evident. Management was at discretion of the clinician, and infants were evaluated until discharge from the hospital or pre-discharge death occurred. RESULTS: One hundred forty-five ELBW infants (birth weight: 755 ± 144 g; median gestational age: 26 weeks [interquartile range: 24–27]) were screened from December 2008 to February 2011. Overall, 26 (17.9%) were diagnosed with pulmonary hypertension at any time during hospitalization (birth weight: 665 ± 140 g; median gestational age: 26 weeks [interquartile range: 24–27]): 9 (6.2%) by initial screening (early pulmonary hypertension) and 17 (11.7%) who were identified later (late pulmonary hypertension). Infants with pulmonary hypertension were more likely to receive oxygen treatment on day 28 compared with those without pulmonary hypertension (96% vs 75%, P Pulmonary hypertension is relatively common, affecting at least 1 in 6 ELBW infants, and persists to discharge in most survivors. Routine screening of ELBW infants with echocardiography at 4 weeks of age identifies only one-third of the infants diagnosed with pulmonary hypertension. Further research is required to determine optimal detection and intervention strategies. PMID:22311993

  6. The Geometric-VaR Backtesting Method

    DEFF Research Database (Denmark)

    Wei, Wei; Pelletier, Denis

    2014-01-01

    This paper develops a new test to evaluate Value af Risk (VaR) forecasts. VaR is a standard risk measure widely utilized by financial institutions and regulators, yet estimating VaR is a challenging problem, and popular VaR forecast relies on unrealistic assumptions. Hence, assessing...

  7. Incorporation Between AHP and N-TSP for Plant Surveillance Routing with Multiple Constraints

    International Nuclear Information System (INIS)

    Djoko Hari Nugroho

    2002-01-01

    This paper observed plant on-line surveillance routing for maintenance management with multiple constraints using TSP (Traveling Salesman Problem). In the research N-TSP (nomadic TSP) type was used. In this case, on-line surveillance could be implemented on moving robot. Route for preventive maintenance management was observed sequentially per stage using multiple constraints (a) distance between components, and (b) failure probability of components using AHP (Analytical Hierarchy Process). Simulation was observed utilizing DURESS as a complex system. The simulation result showed that the route with single constraint distance between components represents the sequence of 1 - 6 - 2 - 4 - 3 - 5. Routing for DURESS with multiple constraints using incorporation of AHP and TSP showed that the first priority in the route is flow sensor FB2 with the value of comparation of 0.1042. The next priority is sequentially FB1, FA2, FA1, FA, FB, VB, VA, VA1, VA2, VB1, VB2, pump B, pump A, FR1, FR2, reservoir 2, and reservoir 1. Numerical experiment obtained that the incorporation between AHP and N-TSP has successfully constructed the surveillance routing with multiple constraints. (author)

  8. 78 FR 59771 - Proposed Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

    Science.gov (United States)

    2013-09-27

    ... Payment Request for the VA Funding Fee Payment System (VA FFPS); a Computer Generated Funding Fee Receipt.... Title: Create Payment Request for the VA Funding Fee Payment System (VA FFPS); A Computer Generated... through the Federal Docket Management System (FDMS) at www.Regulations.gov or to Nancy J. Kessinger...

  9. Comparison of high resolution computed tomography and pulmonary function tests in diagnosis of mild emphysema

    International Nuclear Information System (INIS)

    Kuwano, Kazuyoshi; Matsuba, Kenichi; Ikeda, Togo

    1989-01-01

    To assess the ability of high resolution CT scan and pulmonary function tests in detecting and grading mild emphysema, we correlated the high resolution CT scan and pulmonary function tests with the pathologic grade of emphysema and the destructive index of lung specimens from 42 patients undergoing thoracotomy for solitary pulmonary nodules. Using the high resolution CT scan, we could identify the pathologic grade of mild and moderate emphysema. By measuring diffusing capacity per unit alveolar gas volume (DLco/VA), it seemed to be possible to detect the mildest degree of alveolar destruction assessed by the destructive index, which was not detected by high resolution CT scan. The reason for these results seemed to be that we assessed the severity of emphysema by detecting the air space enlargement on high resolution CT scan images caused by the destruction of alveolar walls, which were detectable by measuring DLco/VA. We conclude that it is possible to detect mild emphysema using the combination of high resolution CT scan and pulmomary function tests. (author)

  10. VA Vascular Injury Study (VAVIS): VA-DoD extremity injury outcomes collaboration.

    Science.gov (United States)

    Shireman, Paula K; Rasmussen, Todd E; Jaramillo, Carlos A; Pugh, Mary Jo

    2015-02-03

    Limb injuries comprise 50-60% of U.S. Service member's casualties of wars in Afghanistan and Iraq. Combat-related vascular injuries are present in 12% of this cohort, a rate 5 times higher than in prior wars. Improvements in medical and surgical trauma care, including initial in-theatre limb salvage approaches (IILS) have resulted in improved survival and fewer amputations, however, the long-term outcomes such as morbidity, functional decline, and risk for late amputation of salvaged limbs using current process of care have not been studied. The long-term care of these injured warfighters poses a significant challenge to the Department of Defense (DoD) and Department of Veterans Affairs (VA). The VA Vascular Injury Study (VAVIS): VA-DoD Extremity Injury Outcomes Collaborative, funded by the VA, Health Services Research and Development Service, is a longitudinal cohort study of Veterans with vascular extremity injuries. Enrollment will begin April, 2015 and continue for 3 years. Individuals with a validated extremity vascular injury in the Department of Defense Trauma Registry will be contacted and will complete a set of validated demographic, social, behavioral, and functional status measures during interview and online/ mailed survey. Primary outcome measures will: 1) Compare injury, demographic and geospatial characteristics of patients with IILS and identify late vascular surgery related limb complications and health care utilization in Veterans receiving VA vs. non-VA care, 2) Characterize the preventive services received by individuals with vascular repair and related outcomes, and 3) Describe patient-reported functional outcomes in Veterans with traumatic vascular limb injuries. This study will provide key information about the current process of care for Active Duty Service members and Veterans with polytrauma/vascular injuries at risk for persistent morbidity and late amputation. The results of this study will be the first step for clinicians in VA and

  11. 75 FR 61252 - Proposed Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

    Science.gov (United States)

    2010-10-04

    ... Payment Request for the VA Funding Fee Payment System (VA FFPS); A Computer Generated Funding Fee Receipt... Payment Request for the VA Funding Fee Payment System (VA FFPS); A Computer Generated Funding Fee Receipt... information through the Federal Docket Management System (FDMS) at http://www.Regulations.gov or to Nancy J...

  12. 75 FR 61859 - Proposed Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

    Science.gov (United States)

    2010-10-06

    ... Payment Request for the VA Funding Fee Payment System (VA FFPS); A Computer Generated Funding Fee Receipt... Payment Request for the VA Funding Fee Payment System (VA FFPS); A Computer Generated Funding Fee Receipt... information through the Federal Docket Management System (FDMS) at http://www.Regulations.gov or to Nancy J...

  13. VA announces aggressive new approach to produce rapid improvements in VA medical centers

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2018-02-01

    Full Text Available No abstract available. Article truncated at 150 words. The U.S. Department of Veterans Affairs (VA announced steps that it is taking as part of an aggressive new approach to produce rapid improvements at VA’s low-performing medical facilities nationwide (1. VA defines its low-performing facilities as those medical centers that receive the lowest score in its Strategic Analytics for Improvement and Learning (SAIL star rating system, or a one-star rating out of five. The SAIL star rating was initiated in 2016 and uses a variety of measures including mortality, length of hospital stay, readmission rates, hospital complications, physician productivity and efficiency. A complete listing of the VA facilities, their star ratings and the metrics used to determine the ratings is available through the end of fiscal year 2017 (2. Based on the latest ratings, the VA currently has 15 one-star facilities including Denver, Loma Linda, and Phoenix in the Southwest (Table 1. Table 1. VA facilities with one-star ratings …

  14. Bainite transformation and TRIP effect in 20Mn2SiVB steel

    International Nuclear Information System (INIS)

    Huo Yanqiu; Long Xiuhui; Zhou Zhenhua; Li Jianguo

    2006-01-01

    Transformation-induced plasticity (TRIP) steel is a relatively new type of automotive steel known for its combination of high-strength and high ductility which was developed in the 1990s. 20Mn2SiVB steel is a kind of TRIP steel with low-carbon and low-alloying contents and high-strength. Specimens of a tested 20Mn2SiVB steel austenitized at 920 deg. C and austempered at 420 deg. C in a salt bath at different time are investigated. The microstructure obtained is studied by means of optical microscopy, scanning electron microscopy and X-ray diffraction. The results show that bainitic ferrite precipitates at the boundary of the austenite first, and with the prolongation of the isothermal time, the amount of bainitic ferrite increase. Then the ferrite decollates the austenite grain and lath-shaped bainitic ferrite with little island-shaped austenite forms during the holding time. The microstructure contains carbide-free bainite, granular bainite, retained austenite and martensite in the process of bainite transformation. Tensile test of the different treated specimens indicates that a better comprehensive property can be gained after austenized at 920 deg. C following austempered at 420 deg. C for 5 min, a certain TRIP effect can be also obtained under this condition

  15. 48 CFR 853.215-70 - VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA.

    Science.gov (United States)

    2010-10-01

    ..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used for...

  16. Attenuated right ventricular energetics evaluated using {sup 11}C-acetate PET in patients with pulmonary hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Yoshinaga, Keiichiro [Hokkaido University Graduate School of Medicine, Department of Molecular Imaging, Sapporo, Hokkaido (Japan); Ohira, Hiroshi; Tsujino, Ichizo; Sato, Takahiro; Nishimura, Masaharu [Hokkaido University Graduate School of Medicine, First Department of Medicine, Sapporo (Japan); Oyama-Manabe, Noriko [Hokkaido University Hospital, Diagnostic and Interventional Radiology, Sapporo (Japan); Mielniczuk, Lisa; Beanlands, Rob S.B. [Ottawa Heart Institute, Division of Cardiology, Ottawa, Ontario (Canada); Katoh, Chietsugu; Kasai, Katsuhiko [Hokkaido University Graduate School of Medicine, Faculty of Health Science, Sapporo (Japan); Manabe, Osamu; Tomiyama, Yuuki; Tamaki, Nagara [Hokkaido University Graduate School of Medicine, Department of Nuclear Medicine, Sapporo (Japan); Fujii, Satoshi [Nagoya City University Graduate School of Pharmaceutical Sciences, Nagoya (Japan); Ito, Yoichi M. [Hokkaido University Graduate School of Medicine, Department of Biostatistics, Sapporo (Japan)

    2014-06-15

    The right ventricle (RV) has a high capacity to adapt to pressure or volume overload before failing. However, the mechanisms of RV adaptation, in particular RV energetics, in patients with pulmonary hypertension (PH) are still not well understood. We aimed to evaluate RV energetics including RV oxidative metabolism, power and efficiency to adapt to increasing pressure overload in patients with PH using {sup 11}C-acetate PET. In this prospective study, 27 patients with WHO functional class II/III PH (mean pulmonary arterial pressure 39.8 ± 13.5 mmHg) and 9 healthy individuals underwent {sup 11}C-acetate PET. {sup 11}C-acetate PET was used to simultaneously measure oxidative metabolism (k{sub mono}) for the left ventricle (LV) and RV. LV and RV efficiency were also calculated. The RV ejection fraction in PH patients was lower than in controls (p = 0.0054). There was no statistically significant difference in LV k{sub mono} (p = 0.09). In contrast, PH patients showed higher RV k{sub mono} than did controls (0.050 ± 0.009 min{sup -1} vs. 0.030 ± 0.006 min{sup -1}, p < 0.0001). PH patients exhibited significantly increased RV power (p < 0.001) and hence increased RV efficiency compared to controls (0.40 ± 0.14 vs. 0.017 ± 0.12 mmHg.mL.min/g, p = 0.001). The RV oxidative metabolic rate was increased in patients with PH. Patients with WHO functional class II/III PH also had increased RV power and efficiency. These findings may indicate a myocardial energetics adaptation response to increasing pulmonary arterial pressure. (orig.)

  17. The 15q24/25 Susceptibility Variant for Lung Cancer and Chronic Obstructive Pulmonary Disease Is Associated with Emphysema

    NARCIS (Netherlands)

    Lambrechts, Diether; Buysschaert, Ian; Zanen, Pieter; Coolen, Johan; Lays, Natacha; Cuppens, Harry; Groen, Harry J. M.; Dewever, Walter; van Klaveren, Rob J.; Verschakelen, Johny; Wijmenga, Cisca; Postma, Dirkje S.; Decramer, Marc; Janssens, Wim

    2010-01-01

    Rationale: Genome-wide association studies have identified genetic variants in the nicotinic acetylcholine receptor (nAChR) on chromosome 15q24/25 as a risk for nicotine dependence, lung cancer, and chronic obstructive pulmonary disease (COPD). Assessment of bronchial obstruction by spirometry,

  18. Pulmonary complications in renal transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jung Bin; Choi, Yo Won; Jeon, Seok Chol; Park, Choong Ki; Lee, Seung Rho; Hahm, Chang Kok; Joo, Kyung Bin [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2003-04-01

    To evaluate the radiographic and CT findings of pulmonary complications other than pulmonary edema arising from renal transplantation. Among 393 patients who had undergone renal transplantation at our hospital during a previous ten-year period, 23 with pulmonary complications other than pulmonary edema were included in this study. The complications involved were infection caused by CMV (n=6), bacteria (n=4), fungus (n=4), tuberculosis (n=2), varicella (n=1) or chlamydia (n=1), and malignancy involving lung cancer (n=4) or Kaposi's sarcoma (n=1). Two chest radiologists reviewed all images. The complications manifesting mainly as pulmonary nodules were lung cancer (4/4), tuberculosis (1/2), and Kaposi's sarcoma (1/1). Pulmonary consolidation was a main feature in bacterial infection (4/4), fungal infection (3/4), tuberculosis (1/2), chlamydial infection (1/1), and varicellar pneumonia (1/1). Ground-glass attenuation was a main CT feature in CMV pneumonia (4/6), and increased interstitial making was a predominant radiographic feature in CMV pneumonia (2/6). The main radiologic features described above can be helpful for differential diagnosis of the pulmonary complications of renal transplantation.

  19. Synthesis of 11C-methylated inulin as a radiopharmaceutical for imaging brain edema and pulmonary edema

    International Nuclear Information System (INIS)

    Hara, Toshihiko; Iio, Masaaki; Inagaki, Keizo

    1988-01-01

    11 C-methylated inulin, supposedly useful for imaging of brain edema and pulmonary edema, was prepared using cyclotron produced 11 CO 2 . The synthesis consists of the production of 11 C-methyl iodide and its coupling with inulin alkoxide sodium in dimethylsulfoxide as solvent. 11 C labeled inulin was purified by alcohol precipitation. The radiochemical yield of pure 11 C-inulin was 34% of 11 CO 2 30 min after the end of bombardment. The blood clearance and body distribution of 11 C was observed in rabbits after i.v. injection of 11 C-inulin. The blood clearance curve was composed of a sum of three exponential functions. The gamma camera image showed that the 11 C activity in blood moved quickly to kidneys and urine and a small dose of radioactivity remained persistently in edematous tissues, i.e. the edematous lung tissues produced by oleic acid treatment. (orig.)

  20. Management of Severe Hemoptysis from Pulmonary Aspergilloma Using Endovascular Embolization

    International Nuclear Information System (INIS)

    Corr, Peter

    2006-01-01

    Purpose. To determine the effectiveness of endovascular embolization as a temporizing measure in the management of severe hemoptysis caused by intracavitary pulmonary aspergilloma. Methods. Patients presenting with hemoptysis, estimated to be more than 300 ml in the preceding 24 hr, in whom a radiological diagnosis of pulmonary aspergilloma was made on chest radiographs and/or computed tomography of the chest were subjected to bronchial and systemic arteriography and embolization using triacryl microspheres. Results. Twelve patients with upper lobe intracavitary aspergillomas were managed with embolization. In 11 patients hemoptysis stopped within 24 hr and with no recurrence over the next 4 weeks. In 1 patient hemoptysis persisted and an upper lobe lobectomy was performed. Conclusion. Embolization of bronchial and systemic arteries is an effective method for treating acute severe hemoptysis from intracavitary aspergillomas, allowing the patient time to recover for definitive surgical management

  1. Vacuum-assisted breast biopsy: A comparison of 11-gauge and 8-gauge needles in benign breast disease

    Directory of Open Access Journals (Sweden)

    Kraemer Bernhard

    2008-05-01

    Full Text Available Abstract Background Minimal invasive breast biopsy is standard care for the diagnosis of suspicious breast lesions. There are different vacuum biopsy (VB systems in use. The aim of the study was to determine the differences between the 8-gauge and the 11-gauge needle with respect to a diagnostic reliability, b complication rate and c subjective perception of pain when used for vacuum-assisted breast biopsy. Methods Between 01/2000 and 09/2004, 923 patients at St. Josefs-Hospital Wiesbaden underwent VB using the Mammotome® (Ethicon Endosurgery, Hamburg. Depending on preoperative detection, the procedure was performed under sonographic or mammographic guidance under local anaesthesia. All patients included in the study were followed up both clinically and using imaging techniques one week after the VB and a second time after a median of 41 months. Excisional biopsy on the ipsilateral breast was an exclusion criteria. Subjective pain scores were recorded on a scale of 0 – 10 (0 = no pain, 10 = unbearable pain. The mean age of the patients was 53 years (30 – 88. Results 123 patients were included in the study in total. 48 patients were biopsied with the 8-gauge needle and 75 with the 11-gauge needle. The use of the 8-gauge needle did not show any significant differences to the 11-gauge needle with regard to diagnostic reliability, complication rate and subjective perception of pain. Conclusion Our data show that there are no relevant differences between the 8-gauge and 11-gauge needle when used for VB. Under sonographic guidance, the use of the 8-gauge needle is recommended for firm breast tissue due to its sharp scalpel point and especially for complete removal of benign lesions. We did not find any advantages in the use of the larger 8-gauge needle compared to the 11-gauge needle in the mammography setting. The utilisation costs of the 8-gauge needle are somewhat higher.

  2. Do Older Rural and Urban Veterans Experience Different Rates of Unplanned Readmission to VA and Non-VA Hospitals?

    Science.gov (United States)

    Weeks, William B.; Lee, Richard E.; Wallace, Amy E.; West, Alan N.; Bagian, James P.

    2009-01-01

    Context: Unplanned readmission within 30 days of discharge is an indicator of hospital quality. Purpose: We wanted to determine whether older rural veterans who were enrolled in the VA had different rates of unplanned readmission to VA or non-VA hospitals than their urban counterparts. Methods: We used the combined VA/Medicare dataset to examine…

  3. 24 CFR 55.11 - Applicability of subpart C decision making process.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Applicability of subpart C decision making process. 55.11 Section 55.11 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development FLOODPLAIN MANAGEMENT Application of Executive Order on Floodplain Management § 55.11 Applicability of subpart C...

  4. Transcatheter occlusion of secundum atrial septal defect in elderly patients with pulmonary hypertension

    International Nuclear Information System (INIS)

    Hu Jian; Zhang Qi; Ding Fenghua; Yang Zhenkun; Zhang Ruiyan; Zhang Jiansheng; Shen Weifeng

    2008-01-01

    Objective: To evaluate the effect and safety of transcatheter occlusion for secundum atrial septal defect (ASD)in elderly patients with pulmonary hypertension. Methods: Thirty four patients underwent transcatheter occlusion of ASD from January 2002 to December 2006. Fifteen of them aged over 65 and accompanied with pulmonary hypertension (pulmonary hypertension group). All patients received thoracic cardiodynamic ultrasonography and 12 leads ECG before and 1 d, 1 mon, 3 mon, 6 mon, 12 mon after the procedure. Under the guidance of fluoroscopy and transthoracic cardio-ultrasonography, Amplatzer occluders was implanted for the atrial septal defect. Results: The successful rate of placement of the Amplatzer occluder was 100% and no complication was found during the procedure and follow-up period. There were significant differences between pulmonary hypertension group and non-pulmonary hypertension group in age (66.7 ± 5.0y vs 24.1 ± 9.0 y, P<0.001), classification of heart function (NYHA) (2.8 ± 0.7 vs 1.7 ± 0.7, P<0.001), diameter of ASD(30.5 ± 3.2 mm vs 14.2 ± 4.0 mm, P<0.001), size of Amplatzer occluder(35.3 ± 4.5 mm vs 18.2 ± 4.4 mm, P<0.001), systolic pulmonary artery pressure(65.2 ± 11.2 mmHg vs 29.5 ± 3.3 mmHg, P<0.001)and mean pulmonary artery pressure (31.5 ± 4.6 mmHg vs 17.9 ± 1.1 mmHg, P<0.001). After transcatheter closure of ASD, the parameters the systolic pulmonary artery pressure (36.6 ± 11.4 mmHg)and mean pulmonary artery pressure (21.6 ± 4.3 mmHg)decreased significantly in pulmonary hypertension group compared with those before procedure, and the classification of heart function (NYHA)improved (from 2.8 ± 0.7 to 1.8 ± 0.8, P<0.001). Conclusion: Transcatheter occlusion of secundum ASD in elderly patients with pulmonary hypertension is safe and effective. (authors)

  5. Virtual bronchoscopy-guided transbronchial biopsy for aiding the diagnosis of peripheral lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Iwano, Shingo, E-mail: iwano45@med.nagoya-u.ac.jp [Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Shouwa-ku, Nagoya 4668550, Aichi (Japan); Imaizumi, Kazuyoshi [Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Shouwa-ku, Nagoya 4668550 (Japan); Okada, Tohru [Research Center for Charged Particle Therapy, National Institute of Radiological Science, 4-9-1 Anagawa, Inage-ku, Chiba 2638555 (Japan); Hasegawa, Yoshinori [Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Shouwa-ku, Nagoya 4668550 (Japan); Naganawa, Shinji [Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Shouwa-ku, Nagoya 4668550, Aichi (Japan)

    2011-07-15

    Objective: The aim of this study was to evaluate the clinical value of virtual bronchoscopy (VB) in aiding diagnosis of peripheral lung cancer by transbronchial biopsy (TBB). In addition, we sought to systematically analyze the factors that affect the diagnostic sensitivity of VB-guided TBB for the evaluation of peripheral lung cancers. Materials and methods: A hundred and twenty-two peripheral lung cancers from 122 patients (82 men and 40 women, 38-84 years; median 68.5 years) who were performed VB-guided TBB were evaluated retrospectively. VB was reconstructed from 1- or 0.5-mm slice thickness images of multi-detector CT (MDCT). Experienced pulmonologists inserted the conventional and ultrathin bronchoscopes into the target bronchus under direct vision following the VB image. Results: A definitive diagnosis was established by VB-guided TBB in 96 lesions (79%). The diagnostic sensitivity of small pulmonary lesions {<=}30 mm in maximal diameter (71%) was significantly lower than that of lesions >30 mm (91%, p = 0.008). For small pulmonary lesions {<=}30 mm (n = 76), internal opacity of the lesion was the independent predictor of diagnostic sensitivity by VB-guided TBB, and the non-solid type lung cancers were significantly lower than the solid type and part-solid type lung cancers for diagnostic sensitivity (odds ratio = 0.161; 95% confidence interval = 0.033-0.780; p = 0.023). Conclusion: Use of an ultrathin bronchoscope and simulation with VB reconstructed by high quality MDCT images is thought to improve pathological diagnosis of peripheral lung cancers, especially for solid and partly solid types. For small pulmonary lesions {<=}30 mm, the lesion internal opacity is a significant factor for predicting the diagnostic sensitivity, and the sensitivity was low for small non-solid type of lung cancers.

  6. Measurement of regional pulmonary function with carbon-11-labeled CO/sub 2/ and CO. Studies of radioactive gas clearance curve

    Energy Technology Data Exchange (ETDEWEB)

    Kimura, K; Rikitake, T; Hasegawa, S [Tsukuba Univ., Sakura, Ibaraki Japan; Matsumoto, T; Tateno, Y

    1979-06-01

    Carbon dioxide and carbon monoxide labelled with carbon-11 have been produced in the remotecontrolled system for a large scale production of short lived radioactive substance with cyclotron in National Institute of Radiological Sciences. The single breath measurement with /sup 11/CO/sub 2/ and /sup 11/CO, using inhalation system and a coincidence positron camera combined with an on-line computer system (TOSBAC 3400 Model 31) has been employed to evaluate regional pulmonary blood flow and diffusing capacity in three normal volunteers and seven patients with chronic obstructive pulmonary disease (COPD), old lung tuberculosis and benign tumor. Regional clearance rate constant (lambda) and distribution index (lambda i/lambda t) were calculated from monoexponential removal curves measured by external counting over the chest in supine position. This process was performed in a short period of breath-holding (10 - 20 sec.) after a single breath of these radioactive gases mixed with room air. These parameters were calculated for each lung fields divided into four zones (bilateral upper and lower lung region). In our method, the activity of the inspired mixture were 5 - 35 mCi/L and each value in lung fields, divided into four zones, can be measured with time interval for one second. While the clearance rate of /sup 11/CO/sub 2/ seemed to be mainly limited by pulmonary blood flow, it was considered that the rate of /sup 11/CO were limited by not only the diffusing capacity but also the perfusion in each lung fields. In normal subjects, the distribution of regional clearance rate was showed approximately even for /sup 11/CO/sub 2/ and /sup 11/CO. It was caused of the measurement in supine position. In contrast, the distribution of these parameter was showed uneven in patients with lung disease, particularly with COPD.

  7. Non-VA Hospital System (NVH)

    Data.gov (United States)

    Department of Veterans Affairs — The Veterans Health Administration (VHA) pays for care provided to VA beneficiaries in non-VA hospitals through its contract hospitalization program as mandated by...

  8. Accessing VA Healthcare During Large-Scale Natural Disasters.

    Science.gov (United States)

    Der-Martirosian, Claudia; Pinnock, Laura; Dobalian, Aram

    2017-01-01

    Natural disasters can lead to the closure of medical facilities including the Veterans Affairs (VA), thus impacting access to healthcare for U.S. military veteran VA users. We examined the characteristics of VA patients who reported having difficulty accessing care if their usual source of VA care was closed because of natural disasters. A total of 2,264 veteran VA users living in the U.S. northeast region participated in a 2015 cross-sectional representative survey. The study used VA administrative data in a complex stratified survey design with a multimode approach. A total of 36% of veteran VA users reported having difficulty accessing care elsewhere, negatively impacting the functionally impaired and lower income VA patients.

  9. Effect of Pr6O11 doping in electrical and microstructural properties of SnO2-based varistors

    Directory of Open Access Journals (Sweden)

    Hervê Stangler Irion

    2014-04-01

    Full Text Available The influence of the dopant Pr6O11 was investigated with regard to the electrical and microstructural properties of the system (98.95-x%SnO2.1.0%CoO.0.05%Ta2O5.x%Pr6O11, where x = 0.05%, 0.10%, 0.30% and 0.50% in mol. Pr6O11 doping modifies the electrical behavior of the ceramics. The electrical parameters were: α = 8.0, EB = 319 V cm-1 and Vb = 0.66 V barrier-1 for the system without Pr6O11 and α = 17.0, EB = 853 V cm-1 and Vb = 1.15 V barrier-1 with the addition of 0.10% in mol Pr6O11. The system with 0.05% in mol Pr6O11 had the same non-linearity coefficient α as the system with 0.10% in mol. However, breakdown electrical field and voltage per barrier rates were lower (EB = 708 V cm-1 and Vb = 0.98 V barrier-1. The low rates in the breakdown electrical field enabled the varistor systems under study to be used in protection systems for low-voltage energy grids. In the case of Pr6O11 concentrations above 0.10% in mol, the presence of the dopant became deleterious to the varistor’s electrical characteristics. This effect was due to an increase in praseodymium stannate (Pr2Sn2O7 secondary phase. The crystalline phase coupled to the cassiterite (SnO2 phase was found with XRD and SEM/EDS and quantified by Rietveld’s refining method.

  10. Imaging of muscarinic acetylcholine receptors using (+)N-[11C]methyl-3-piperidyl benzilate (11C-3NMPB) in vascular dementia and Alzheimer's disease

    International Nuclear Information System (INIS)

    Saito, Hirohiko

    2006-01-01

    In order to clarify the integrity of muscarinic acetylcholine receptor (mAChR) in vascular dementia (VaD) and Alzheimer's disease (AD), PET imaging with (+) N-[ 11 C]methyl-3-piperidyl benzilate ( 11 C-3NMPB) was performed in 12 patients with VaD, 11 patients with AD, and 7 normal controls (NC group). The mAChR binding was compared by the ratios compared with the cerebellum which were calculated from the regions of interest (ROI), and by three-dimensional statistic analysis. Compared with the NC group, mAChR was not significantly reduced in any ROI in AD patients. In those with VaD due to cortical lesions, mAChR was reduced in the infarcted areas. On the other hand, mAChR was significantly reduced in the thalamus and anterior cingulated gyrus, but not in other cerebral cortices in patients with VaD due to subcortical lesions. Accordingly, it is suggested that the mAChR is preserved in the cerebral cortices in patients with VaD due to subcortical lesions as well as in AD patients. (author)

  11. A study on pulmonary hilar and mediastinal lymphoscintigraphy

    International Nuclear Information System (INIS)

    Matsuo, Michimasa; Ushio, Keiji; Nishiyama, Shoji; Kono, Michio; Takada, Yoshiki

    1979-01-01

    A routine examination of pulmonary hilar and mediastinal lymphoscintigraphy is tried in this study in order to visualize pulmonary hilar and mediastinal lymphnodes routinely. A method is as follows; 30 - 50 μCi of 198 Au-colloid (0.3 - 0.5 ml of total volume) is injected through the needle of flexible bronchofiberscope into the mucosal membrane or submucosal membrane of the bilateral B 8 or B 9 bronchi. This method was applied to 11 cases of suspected pulmonary carcinoma and gave good results. In case of bronchitis, lung abscess and chronic pneumonia, carinal lymphnodes (which are expected to be as the inferior tracheo-bronchial lymphnodes) and one or more right mediastinal lymphnodes (which are expected to be as the right superior tracheo-bronchial or right paratracheal lymphnodes) were clearly visualized from 24 to 27 hours after the injection. In these cases the pulmonary hilar and mediastinal lymphnodes were expected to be intact on x-rays and CT findings. Among cases of pulmonary carcinoma or lymphangitis carcinomatosa, on the contrary, right mediastinal lymphnodes were not visualized in case with the right hilar lymphnodes involvement, and furthermore neither carinal nor right mediastinal lymphnodes were visualized in case with carinal lymphnodes involvements on X-rays, CT, operation or autopsy findings. From these results, the pulmonary hilar and mediastinal lymphoscintigraphy may give the useful information for the treatment planning, and follow up study of the cases of pulmonary and mediastinal malignant tumors. (author)

  12. VA office of inspector general releases scathing report of Phoenix VA

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2014-08-01

    Full Text Available No abstract available. Article truncated at 150 words. The long-awaited Office of Inspector General’s (OIG report on the Phoenix VA Health Care System (PVAHCS was released on August 27, 2014 (1. The report was scathing in its evaluation of VA practices and leadership. Five questions were investigated: 1.Were there clinically significant delays in care? 2. Did PVAHCS omit the names of veterans waiting for care from its Electronic Wait List (EWL? 3. Were PVAHCS personnel not following established scheduling procedures? 4. Did the PVAHCS culture emphasize goals at the expense of patient care? 5. Are scheduling deficiencies systemic throughout the VA? In each case, the OIG found that the allegations were true. Despite initial denials, the OIG report showed that former PVAHCS director Sharon Helman, associate director Lance Robinson, hospital administration director Brad Curry, chief of staff Darren Deering and other senior executives were aware of delays in care and unofficial wait lists. Perhaps most disturbing is ...

  13. Clinical assessment of transcatheter closure of patent ductus arteriosus with severe pulmonary hypertention using Amplatzer occluder

    Energy Technology Data Exchange (ETDEWEB)

    Xiumin, Han; Xianyang, Zhu; Yuwei, Zhang; Yan, Jin; Dong' an, Deng; Chanju, Hou; Wei, Quan [Shenyang General Hospital, PLA, Shenyang (China)

    2004-04-01

    Objective: To evaluate the application of transcatheter closure of patent ductus arteriosus (PDA) with severe pulmonary hypertention using the Amplatzer occluder device. Methods: Fifty-one cases of PDA with severe pulmonary hypertention were treated by transcatheter closure with Amplatzer occluder. Patients mean age was 9.4 years (ranging 3 months to 60 years) and the mean weight was (18.7 {+-} 13.8) kg (ranging 5.0 to 65.0 kg). The mean PDA diameter at its narrowest segment was (7.0 {+-} 2.4) (ranging 3.0 to 15.0) mm. The achievement of permanent transcatheter closure was decided according to the change of the pulmonary arterial pressure, aortic pressure and oxygen saturation. Results: The devices were successfully placed in all patients except one failure owing to the resistance of pulmonary hypertention. The systolic pulmonary pressure decreased from (84.7 {+-} 13.5) (range 70 to 137) to mmHg to (46.1 {+-} 14.9) (24 to 109) mmHg, and the mean pulmonary pressure decreased from (65.0 {+-} 11.5) (42 to 97) mmHg to (31.3 {+-} 11.6) (14 to 69) mmHg. Complete angiographic closure was seen 10 minutes after the device deployment in 30 out of 50 patients (60%), while trivial to small leak was present in 20 (40%). Complete echocardiographic closure was demonstrated in 49 out of 50 patients (98%) at 10 min, and 100% at 6-month follow-up in all patients. There were no PDA recanalization and migration of devices after the complete occlusion during following up. Conclusion: Transcatheter closure of patent ductus arteriosus with severe pulmonary hypertention by using the Amplatzer occluder is a safe and effective interventional method with excellent short-term and middle-term results. (authors)

  14. Clinical assessment of transcatheter closure of patent ductus arteriosus with severe pulmonary hypertention using Amplatzer occluder

    International Nuclear Information System (INIS)

    Han Xiumin; Zhu Xianyang; Zhang Yuwei; Jin Yan; Deng Dong'an; Hou Chanju; Quan Wei

    2004-01-01

    Objective: To evaluate the application of transcatheter closure of patent ductus arteriosus (PDA) with severe pulmonary hypertention using the Amplatzer occluder device. Methods: Fifty-one cases of PDA with severe pulmonary hypertention were treated by transcatheter closure with Amplatzer occluder. Patients mean age was 9.4 years (ranging 3 months to 60 years) and the mean weight was (18.7 ± 13.8) kg (ranging 5.0 to 65.0 kg). The mean PDA diameter at its narrowest segment was (7.0 ± 2.4) (ranging 3.0 to 15.0) mm. The achievement of permanent transcatheter closure was decided according to the change of the pulmonary arterial pressure, aortic pressure and oxygen saturation. Results: The devices were successfully placed in all patients except one failure owing to the resistance of pulmonary hypertention. The systolic pulmonary pressure decreased from (84.7 ± 13.5) (range 70 to 137) to mmHg to (46.1 ± 14.9) (24 to 109) mmHg, and the mean pulmonary pressure decreased from (65.0 ± 11.5) (42 to 97) mmHg to (31.3 ± 11.6) (14 to 69) mmHg. Complete angiographic closure was seen 10 minutes after the device deployment in 30 out of 50 patients (60%), while trivial to small leak was present in 20 (40%). Complete echocardiographic closure was demonstrated in 49 out of 50 patients (98%) at 10 min, and 100% at 6-month follow-up in all patients. There were no PDA recanalization and migration of devices after the complete occlusion during following up. Conclusion: Transcatheter closure of patent ductus arteriosus with severe pulmonary hypertention by using the Amplatzer occluder is a safe and effective interventional method with excellent short-term and middle-term results. (authors)

  15. 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

  16. Causes of death in two rural demographic surveillance sites in Bangladesh, 2004–2010: automated coding of verbal autopsies using InterVA-4

    Directory of Open Access Journals (Sweden)

    Nurul Alam

    2014-10-01

    Full Text Available Objective: Population-based information on causes of death (CoD by age, sex, and area is critical for countries with limited resources to identify and address key public health issues. This study analysed the demographic surveillance and verbal autopsy (VA data to estimate age- and sex-specific mortality rates and cause-specific mortality fractions in two well-defined rural populations within the demographic surveillance system in Abhoynagar and Mirsarai subdistricts, located in different climatic zones. Design: During 2004–2010, the sample demographic surveillance system registered 1,384 deaths in Abhoynagar and 1,847 deaths in Mirsarai. Trained interviewers interviewed the main caretaker of the deceased with standard VA questionnaires to record signs and symptoms of diseases or conditions that led to death and health care experiences before death. The computer-automated InterVA-4 method was used to analyse VAs to determine probable CoD. Results: Age- and sex-specific death rates revealed a higher neonatal mortality rate in Abhoynagar than Mirsarai, and death rates and sex ratios of male to female death rates were higher in the ages after infancy. Communicable diseases (CDs accounted for 16.7% of all deaths in Abhoynagar and 21.2% in Mirsarai – the difference was due mostly to more deaths from acute respiratory infections, pneumonia, and tuberculosis in Mirsarai. Non-communicable diseases (NCDs accounted for 56.2 and 55.3% of deaths in each subdistrict, respectively, with leading causes being stroke (16.5–19.3%, neoplasms (13.2% each, cardiac diseases (8.9–11.6%, chronic obstructive pulmonary diseases (5.1–6.3%, diseases of the digestive system (3.1–4.1%, and diabetes (2.8–3.5%, together accounting for 49.2–51.2% points of the NCD deaths in the two subdistricts. Injury and other external causes accounted for another 7.5–7.7% deaths, with self-harm being higher among females in Abhoynagar. Conclusions: The computer

  17. 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.

  18. Assessing the quality of VA Human Research Protection Programs: VA vs. affiliated University Institutional Review Board.

    Science.gov (United States)

    Tsan, Min-Fu; Nguyen, Yen; Brooks, Robert

    2013-04-01

    We compared the Human Research Protection Program (HRPP) quality indicator data of the Department of Veterans Affairs (VA) facilities using their own VA institutional review boards (IRBs) with those using affiliated university IRBs. From a total of 25 performance metrics, 13 did not demonstrate statistically significant differences, while 12 reached statistically significance differences. Among the 12 with statistically significant differences, facilities using their own VA IRBs performed better on four of the metrics, while facilities using affiliate IRBs performed better on eight. However, the absolute difference was small (0.2-2.7%) in all instances, suggesting that they were of no practical significance. We conclude that it is acceptable for facilities to use their own VA IRBs or affiliated university IRBs as their IRBs of record.

  19. Effects of inspired CO2, hyperventilation, and time on VA/Q inequality in the dog

    Science.gov (United States)

    Tsukimoto, K.; Arcos, J. P.; Schaffartzik, W.; Wagner, P. D.; West, J. B.

    1992-01-01

    In a recent study by Tsukimoto et al. (J. Appl. Physiol. 68: 2488-2493, 1990), CO2 inhalation appeared to reduce the size of the high ventilation-perfusion ratio (VA/Q) mode commonly observed in anesthetized mechanically air-ventilated dogs. In that study, large tidal volumes (VT) were used during CO2 inhalation to preserve normocapnia. To separate the influences of CO2 and high VT on the VA/Q distribution in the present study, we examined the effect of inspired CO2 on the high VA/Q mode using eight mechanically ventilated dogs (4 given CO2, 4 controls). The VA/Q distribution was measured first with normal VT and then with increased VT. In the CO2 group at high VT, data were collected before, during, and after CO2 inhalation. With normal VT, there was no difference in the size of the high VA/Q mode between groups [10.5 +/- 3.5% (SE) of ventilation in the CO2 group, 11.8 +/- 5.2% in the control group]. Unexpectedly, the size of the high VA/Q mode decreased similarly in both groups over time, independently of the inspired PCO2, at a rate similar to the fall in cardiac output over time. The reduction in the high VA/Q mode together with a simultaneous increase in alveolar dead space (estimated by the difference between inert gas dead space and Fowler dead space) suggests that poorly perfused high VA/Q areas became unperfused over time. A possible mechanism is that elevated alveolar pressure and decreased cardiac output eliminate blood flow from corner vessels in nondependent high VA/Q regions.

  20. Pulmonary alveolar proteinosis: Quantitative CT and pulmonary functional correlations

    Energy Technology Data Exchange (ETDEWEB)

    Guan, Yubao, E-mail: yubaoguan@163.com [Department of Radiology, the First Affiliated Hospital of Guangzhou Medical College, Guangzhou 510120 (China); State Key Laboratory of Respiratory Disease, Guangzhou 510120 (China); Zeng, Qingsi [Department of Radiology, the First Affiliated Hospital of Guangzhou Medical College, Guangzhou 510120 (China); Yang, Haihong; Zheng, Jinping; Li, Shiyue; Gao, Yi [State Key Laboratory of Respiratory Disease, Guangzhou 510120 (China); Deng, Yu [Department of Radiology, the First Affiliated Hospital of Guangzhou Medical College, Guangzhou 510120 (China); Mei, Jiang [State Key Laboratory of Respiratory Disease, Guangzhou 510120 (China); He, Jianxing, E-mail: jianxing63@163.com [State Key Laboratory of Respiratory Disease, Guangzhou 510120 (China); Zhong, Nanshan, E-mail: nanshan@vip.163.com [State Key Laboratory of Respiratory Disease, Guangzhou 510120 (China)

    2012-09-15

    Objective: We assessed the relationship between quantitative computer tomography (qCT) and the pulmonary function test (PFT) or blood gas analysis in pulmonary alveolar proteinosis (PAP) patients, as well as the utility of these analyses to monitor responses to whole lung lavage (WLL) therapy. Methods: Thirty-eight PAP patients simultaneously received a CT scan and PFT. Fifteen of these patients, undergoing sequential WLL for a total of 20 lavages, also underwent chest CT scans and blood gas analysis before and after WLL, and 14 of 15 patients underwent simultaneous PFT analysis. Differences between the qCT and PFT results were analyzed by canonical correlation. Results: PAP patients with low predicted values for FVC, FEV1, D{sub LCO} and D{sub LCO}/VA indicated small airspace volume and mean lung inflation, low airspace volume/total lung volume ratio and high mean lung density. Correlation and regression analysis revealed a strong correlation between D{sub LCO} and PaO{sub 2} values with CT results. The qCT results indicated that WLL significantly decreased lung weights and mean lung densities, and improved the total airspace volume/total lung volume ratios and mean lung inflations. Conclusion: Quantitative CT may be a sensitive tool for measuring the response of PAP patients to medical interventions such as WLL.

  1. Characteristics Associated With Utilization of VA and Non-VA Care Among Iraq and Afghanistan Veterans With Post-Traumatic Stress Disorder.

    Science.gov (United States)

    Finley, Erin P; Mader, Michael; Bollinger, Mary J; Haro, Elizabeth K; Garcia, Hector A; Huynh, Alexis K; Pugh, Jacqueline A; Pugh, Mary Jo

    2017-11-01

    Post-traumatic stress disorder (PTSD) affects nearly one-fifth of Iraq and Afghanistan Veterans (IAV). The Department of Veterans Affairs (VA) has invested in making evidence-based psychotherapies for PTSD available at every VA facility nationwide; however, an unknown number of veterans opt to receive care in the community rather than with VA. We compared PTSD care utilization patterns among Texas IAV with PTSD, an ethnically, geographically, and economically diverse group. To identify IAV in Texas with service-connected disability for PTSD, we used a crosswalk of VA administrative data from the Operation Enduring Freedom/Operation Iraqi Freedom Roster and service-connected disability data from the Veterans Benefits Administration. We then surveyed a random sample of 1,128 veterans from the cohort, stratified by sex, rurality, and past use/nonuse of any VA care. Respondents were classified into current utilization groups (VA only, non-VA only, dual care, and no professional PTSD treatment) on the basis of reported PTSD care in the prior 12 months. Responses were weighted to account for sample stratification and for response rate within each strata. Utilization group characteristics were compared to the population mean using the one sample Z-test for proportions, or the t-test for means. A multinomial logistic regression model was used to identify survey variables significantly associated with current utilization group. 249 IAV completed the survey (28.4% response rate). Respondents reported receiving PTSD care: in the VA only (58.3%); in military or community-based settings (including private practitioners) (non-VA only, 8.7%); and in both VA and non-VA settings (dual care, 14.5%). The remainder (18.5%) reported no professional PTSD care in the prior year. Veterans ineligible for Department of Defense care, uncomfortable talking about their problems, and opposed to medication were more likely to receive non-VA care only, whereas those with lower household income

  2. Small RNA sequence analysis of adenovirus VA RNA-derived miRNAs reveals an unexpected serotype-specific difference in structure and abundance.

    Directory of Open Access Journals (Sweden)

    Wael Kamel

    Full Text Available Human adenoviruses (HAds encode for one or two highly abundant virus-associated RNAs, designated VA RNAI and VA RNAII, which fold into stable hairpin structures resembling miRNA precursors. Here we show that the terminal stem of the VA RNAs originating from Ad4, Ad5, Ad11 and Ad37, all undergo Dicer dependent processing into virus-specific miRNAs (so-called mivaRNAs. We further show that the mivaRNA duplex is subjected to a highly asymmetric RISC loading with the 3'-strand from all VA RNAs being the favored strand, except for the Ad37 VA RNAII, where the 5'-mivaRNAII strand was preferentially assembled into RISC. Although the mivaRNA seed sequences are not fully conserved between the HAds a bioinformatics prediction approach suggests that a large fraction of the VA RNAII-, but not the VA RNAI-derived mivaRNAs still are able to target the same cellular genes. Using small RNA deep sequencing we demonstrate that the Dicer processing event in the terminal stem of the VA RNAs is not unique and generates 3'-mivaRNAs with a slight variation of the position of the 5' terminal nucleotide in the RISC loaded guide strand. Also, we show that all analyzed VA RNAs, except Ad37 VA RNAI and Ad5 VA RNAII, utilize an alternative upstream A start site in addition to the classical +1 G start site. Further, the 5'-mivaRNAs with an A start appears to be preferentially incorporated into RISC. Although the majority of mivaRNA research has been done using Ad5 as the model system our analysis demonstrates that the mivaRNAs expressed in Ad11- and Ad37-infected cells are the most abundant mivaRNAs associated with Ago2-containing RISC. Collectively, our results show an unexpected variability in Dicer processing of the VA RNAs and a serotype-specific loading of mivaRNAs into Ago2-based RISC.

  3. Detection of pulmonary metastases in a patient with synovial cell sarcoma using In-111 labeled monoclonal antibody 19-24

    International Nuclear Information System (INIS)

    Swift, J.E.; Blend, M.J.; Bekerman, C.; Das Gupta, T.K.; Greager, J.A.

    1990-01-01

    A 35-year-old man was diagnosed in 1984 as having a synovial cell sarcoma of his right wrist without evidence of metastatic spread. The patient underwent regional hyperthermic chemoperfusion, wide-field excision, post-operative radiation therapy and systemic adjuvant chemotherapy. In 1986 and in 1987, because of new lesions found on chest radiographs, the patient underwent bilateral staging thoracotomies with resection of pulmonary metastases, followed by chemotherapy and radiotherapy. Later in 1987, a chest radiograph showed a large left hilar mass and multiple bilateral pulmonary nodules. Computerized tomography of the chest demonstrated a left hilar mass and two nodules in the right lower lung, raising the possibility of recurrent pulmonary metastatic cancer. As a diagnostic procedure, In-111 labeled monoclonal antibody (Mab) 19-24, produced against a human malignant fibrous histiocytoma, was infused intravenously, and 48-hour images revealed focal areas of increased uptake corresponding to the lesions seen on CT. At surgery, the lesions were confirmed to be synovial cell sarcoma. Imaging with Mabs specific for sarcoma may be particularly useful in sarcoma patients in whom there is clinical uncertainty regarding the nature of pulmonary lesions. In this case, the Mab was useful in distinguishing tumor deposits from postsurgical scarring and helped to guide subsequent surgery and treatment

  4. KENO V.a Primer: A Primer for Criticality Calculations with SCALE/KENO V.a Using CSPAN for Input

    International Nuclear Information System (INIS)

    Busch, R.D.

    2003-01-01

    The SCALE (Standardized Computer Analyses for Licensing Evaluation) computer software system developed at Oak Ridge National Laboratory (ORNL) is widely used and accepted around the world for criticality safety analyses. The well-known KENO V.a three-dimensional Monte Carlo criticality computer code is the primary criticality safety analysis tool in SCALE. The KENO V.a primer is designed to help a new user understand and use the SCALE/KENO V.a Monte Carlo code for nuclear criticality safety analyses. It assumes that the user has a college education in a technical field. There is no assumption of familiarity with Monte Carlo codes in general or with SCALE/KENO V.a in particular. The primer is designed to teach by example, with each example illustrating two or three features of SCALE/KENO V.a that are useful in criticality analyses. The primer is based on SCALE 4.4a, which includes the Criticality Safety Processor for Analysis (CSPAN) input processor for Windows personal computers (PCs). A second edition of the primer, which uses the new KENO Visual Editor, is currently under development at ORNL and is planned for publication in late 2003. Each example in this first edition of the primer uses CSPAN to provide the framework for data input. Starting with a Quickstart section, the primer gives an overview of the basic requirements for SCALE/KENO V.a input and allows the user to quickly run a simple criticality problem with SCALE/KENO V.a. The sections that follow Quickstart include a list of basic objectives at the beginning that identifies the goal of the section and the individual SCALE/KENO V.a features which are covered in detail in the example problems in that section. Upon completion of the primer, a new user should be comfortable using CSPAN to set up criticality problems in SCALE/KENO V.a

  5. 77 FR 33089 - OPSAIL 2012 Virginia, Port of Hampton Roads, VA

    Science.gov (United States)

    2012-06-05

    ...] RIN 1625-AA00, AA08, AA11 OPSAIL 2012 Virginia, Port of Hampton Roads, VA AGENCY: Coast Guard, DHS... of Hampton Roads, Virginia for Operation Sail (OPSAIL) 2012 Virginia activities. This regulation is..., Hampton Roads, the James River and Elizabeth River. DATES: This rule is effective from June 6, 2012 to...

  6. 77 FR 19957 - OPSAIL 2012 Virginia, Port of Hampton Roads, VA

    Science.gov (United States)

    2012-04-03

    ...-0174] RIN 1625-AA00, AA01, AA08, AA11, AA87 OPSAIL 2012 Virginia, Port of Hampton Roads, VA AGENCY... temporary regulations in the Port of Hampton Roads, Virginia for Operation Sail (OPSAIL) 2012 Virginia... portions of Chesapeake Bay, Hampton Roads, the James River and Elizabeth River. DATES: Comments and related...

  7. Impact of morphologic characteristics of central pulmonary thromboemboli in massive pulmonary embolism.

    Science.gov (United States)

    Podbregar, Matej; Krivec, Bojan; Voga, Gorazd

    2002-09-01

    To assess the impact of morphologically different central pulmonary artery thromboemboli in patients with massive pulmonary emboli (MPEs) on short-term outcome. A prospective registry of consecutive patients. An 11-bed closed medical ICU at a 860-bed community general hospital Forty-seven patients with shock or hypotension due to MPE and central pulmonary thromboemboli detected by transesophageal echocardiography who were treated with thrombolysis between January 1994 and April 2000. Patients were divided into two groups according to the following characteristics of the detected thromboemboli: group 1, thrombi with one or more long, mobile parts; and group 2, immobile thrombi. Right heart catheterization was performed. The incidence of both types of thromboemboli was comparable. Groups 1 and 2 showed no differences in demographic data, risk factors for pulmonary embolism, length of preceding clinical symptoms, percentage of patients in shock, hemodynamic variables, serum lactate levels on hospital admission, and treatment. Seven fatal cases due to obstructive shock and right heart failure were present in group 2, but none were present in group 1 (7 of 23 patients vs 0 of 24 patients, respectively; p < 0.05). At 12 h, the cardiac index was lower in group 2 than in group 1 (2.6 +/- 1.0 vs 3.1 +/- 0.9 L/min/m(2), respectively; p < 0.05), and the central venous pressure (15.0 +/- 6.2 vs 12.5 +/- 3.7 mm Hg, respectively; p < 0.05) and total pulmonary resistance (12.9 +/- 5.9 vs 8.6 +/- 2.7 mm Hg/L/min/m(2), respectively; p < 0.001) were higher in group 2 compared to group 1. On hospital admission, inclusion in group 2 (p < 0.03; hazard ratio, 9.53; 95% confidence interval [CI], 1.19 to 76.47) and preexisting chronic medical or neurologic disease (p < 0.01; hazard ratio, 16.4; 95% CI, 1.97 to 136.3) were independent predictors of 30-day mortality. On hospital admission, morphology of the thromboemboli and the presence of pre-existing chronic medical or neurologic disease

  8. 76 FR 70345 - Drawbridge Operation Regulations; Elizabeth River, Eastern Branch, Norfolk, VA

    Science.gov (United States)

    2011-11-14

    ... DEPARTMENT OF HOMELAND SECURITY Coast Guard 33 CFR Part 117 [Docket No. USCG-2011-1022] Drawbridge Operation Regulations; Elizabeth River, Eastern Branch, Norfolk, VA AGENCY: Coast Guard, DHS. ACTION: Notice... periodic maintenance. The Norfolk Southern 5 Bridge, at mile 1.1, across the Elizabeth River (Eastern...

  9. Marketing Factors Affecting Leasing Selection in Bosnia and Herzegovina: Case Study on VB Leasing

    Directory of Open Access Journals (Sweden)

    Almir Ljeskovica

    2014-06-01

    Full Text Available In constantly changing environment all types of companies need some support from various types of funding institutions. Companies use their own resources to finance some projects or purchases but also take loans, mostly from banks to have additional support or in case of lack of money. Beside small, medium, as well as big companies, physical persons also use different types of financing to achieve their goals and fulfil their needs. Financing companies need to recognize the criteria on which prospective customers establish their financing selection decision. Planning a proper marketing strategy in order to attract new customers is of crucial importance in identifying these criteria. The main purpose of the study is to identify which factors affects people to choose leasing services. For data collection and analyse both, qualitative and quantitative study is conducted. Data for this study were collected through surveys delivered to 65 VB Leasing users from Sarajevo region. Out of 65, 57 useful responses were accepted for further analysis. Also interview was done with director of VB Leasing for qualitative study in order to get more insights in this topic. Findings of the study show what are the important factors for leasing selection and these information can support leasing managers in designing marketing strategies for perspective customers.

  10. Report of VA Medical Training Programs

    Data.gov (United States)

    Department of Veterans Affairs — The Report of VA Medical Training Programs Database is used to track medical center health services trainees and VA physicians serving as faculty. The database also...

  11. Changing Patterns of Glucose-Lowering Medication Use in VA Nursing Home Residents With Diabetes, 2005 to 2011.

    Science.gov (United States)

    Lee, Sei J; Stijacic-Cenzer, Irena; Barnhart, Caroline; McClymont, Keelan; Steinman, Michael A

    2015-10-01

    Although nursing home (NH) residents make up a large and growing proportion of Americans with diabetes mellitus, little is known about how glucose-lowering medications are used in this population. We sought to examine glucose-lowering medication use in Veterans Affairs (VA) NH residents with diabetes between 2005 and 2011. Retrospective cohort study, using linked laboratory, pharmacy, administrative, and NH Minimum Dataset (MDS) 2.0 databases in 123 VA NHs. A total of 9431 long-stay (>90 days) VA NH residents older than 65 followed for 52,313 person-quarters. We identified receipt of glucose-lowering medications, including insulin, metformin, sulfonylureas, thiazolidinediones, and others (alpha-glucosidase inhibitors, meglitinides, glucagonlike peptide-1 analogs, dipeptidyl peptidase-4 inhibitors and amylin analogs) per quarter. The rates of sulfonylurea use in long-stay NH residents dropped dramatically from 24% in 2005 to 12% in 2011 (P use (10% to 2%, P use in 2007 (4% to Metformin use was stable, ranging between 7% and 9% (P = .24). Insulin use increased slightly from 30% to 32% (P Use of other classes of glucose-lowering medications was stable (P = .22) and low, remaining below 1.3%. Between 2005 and 2011, there were dramatic declines in use of sulfonylureas and thiazolidinediones in VA NH residents, suggesting that prescribing practices can be quickly changed in this setting. Published by Elsevier Inc.

  12. Effect of sedation with detomidine and butorphanol on pulmonary gas exchange in the horse.

    Science.gov (United States)

    Nyman, Görel; Marntell, Stina; Edner, Anna; Funkquist, Pia; Morgan, Karin; Hedenstierna, Göran

    2009-05-07

    Sedation with alpha2-agonists in the horse is reported to be accompanied by impairment of arterial oxygenation. The present study was undertaken to investigate pulmonary gas exchange using the Multiple Inert Gas Elimination Technique (MIGET), during sedation with the alpha2-agonist detomidine alone and in combination with the opioid butorphanol. Seven Standardbred trotter horses aged 3-7 years and weighing 380-520 kg, were studied. The protocol consisted of three consecutive measurements; in the unsedated horse, after intravenous administration of detomidine (0.02 mg/kg) and after subsequent butorphanol administration (0.025 mg/kg). Pulmonary function and haemodynamic effects were investigated. The distribution of ventilation-perfusion ratios (VA/Q) was estimated with MIGET. During detomidine sedation, arterial oxygen tension (PaO2) decreased (12.8 +/- 0.7 to 10.8 +/- 1.2 kPa) and arterial carbon dioxide tension (PaCO2) increased (5.9 +/- 0.3 to 6.1 +/- 0.2 kPa) compared to measurements in the unsedated horse. Mismatch between ventilation and perfusion in the lungs was evident, but no increase in intrapulmonary shunt could be detected. Respiratory rate and minute ventilation did not change. Heart rate and cardiac output decreased, while pulmonary and systemic blood pressure and vascular resistance increased. Addition of butorphanol resulted in a significant decrease in ventilation and increase in PaCO2. Alveolar-arterial oxygen content difference P(A-a)O2 remained impaired after butorphanol administration, the VA/Q distribution improved as the decreased ventilation and persistent low blood flow was well matched. Also after subsequent butorphanol no increase in intrapulmonary shunt was evident. The results of the present study suggest that both pulmonary and cardiovascular factors contribute to the impaired pulmonary gas exchange during detomidine and butorphanol sedation in the horse.

  13. Effect of sedation with detomidine and butorphanol on pulmonary gas exchange in the horse

    Directory of Open Access Journals (Sweden)

    Morgan Karin

    2009-05-01

    Full Text Available Abstract Background Sedation with α2-agonists in the horse is reported to be accompanied by impairment of arterial oxygenation. The present study was undertaken to investigate pulmonary gas exchange using the Multiple Inert Gas Elimination Technique (MIGET, during sedation with the α2-agonist detomidine alone and in combination with the opioid butorphanol. Methods Seven Standardbred trotter horses aged 3–7 years and weighing 380–520 kg, were studied. The protocol consisted of three consecutive measurements; in the unsedated horse, after intravenous administration of detomidine (0.02 mg/kg and after subsequent butorphanol administration (0.025 mg/kg. Pulmonary function and haemodynamic effects were investigated. The distribution of ventilation-perfusion ratios (VA/Q was estimated with MIGET. Results During detomidine sedation, arterial oxygen tension (PaO2 decreased (12.8 ± 0.7 to 10.8 ± 1.2 kPa and arterial carbon dioxide tension (PaCO2 increased (5.9 ± 0.3 to 6.1 ± 0.2 kPa compared to measurements in the unsedated horse. Mismatch between ventilation and perfusion in the lungs was evident, but no increase in intrapulmonary shunt could be detected. Respiratory rate and minute ventilation did not change. Heart rate and cardiac output decreased, while pulmonary and systemic blood pressure and vascular resistance increased. Addition of butorphanol resulted in a significant decrease in ventilation and increase in PaCO2. Alveolar-arterial oxygen content difference P(A-aO2 remained impaired after butorphanol administration, the VA/Q distribution improved as the decreased ventilation and persistent low blood flow was well matched. Also after subsequent butorphanol no increase in intrapulmonary shunt was evident. Conclusion The results of the present study suggest that both pulmonary and cardiovascular factors contribute to the impaired pulmonary gas exchange during detomidine and butorphanol sedation in the horse.

  14. Who died of what in rural KwaZulu-Natal, South Africa: a cause of death analysis using InterVA-4

    Directory of Open Access Journals (Sweden)

    Joël Mossong

    2014-10-01

    Full Text Available Background: For public health purposes, it is important to see whether men and women in different age groups die of the same causes in South Africa. Objective: We explored sex- and age-specific patterns of causes of deaths in a rural demographic surveillance site in northern KwaZulu-Natal in South Africa over the period 2000–2011. Design: Deaths reported through the demographic surveillance were followed up by a verbal autopsy (VA interview using a standardised questionnaire. Causes of death were assigned likelihoods using the publicly available tool InterVA-4. Cause-specific mortality fractions were determined by age and sex. Results: Over the study period, a total of 5,416 (47% and 6,081 (53% deaths were recorded in men and women, respectively. Major causes of death proportionally affecting more women than men were (all p<0.0001: human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS (20.1% vs. 13.6%, other and unspecified cardiac disease (5.9% vs. 3.2%, stroke (4.5% vs. 2.7%, reproductive neoplasms (1.7% vs. 0.4%, diabetes (2.4% vs. 1.2%, and breast neoplasms (0.4% vs. 0%. Major causes of deaths proportionally affecting more men than women were (all p<0.0001 assault (6.1% vs. 1.7%, pulmonary tuberculosis (34.5% vs. 30.2%, road traffic accidents (3.0% vs. 1.0%, intentional self-harm (1.3% vs. 0.3%, and respiratory neoplasms (2.5% vs. 1.5%. Causes of death due to communicable diseases predominated in all age groups except in older persons. Conclusions: While mortality during the 2000s was dominated by tuberculosis and HIV/AIDS, we found substantial sex-specific differences both for communicable and non-communicable causes of death, some which can be explained by a differing sex-specific age structure. InterVA-4 is likely to be a valuable tool for investigating causes of death patterns in other similar Southern African settings.

  15. Influence of pulmonary emphysema on COPD assessment test-oriented categorization in GOLD document.

    Science.gov (United States)

    Suzuki, Toshio; Tada, Yuji; Kawata, Naoko; Ikari, Jun; Kasahara, Yasunori; Sakurai, Yoriko; Iesato, Ken; Nishimura, Rintaro; West, James; Tatsumi, Koichiro

    2015-01-01

    The COPD assessment test (CAT) score is a key component of the multifactorial assessment of COPD in the Global initiative for chronic Obstructive Lung Disease (GOLD) guidelines of 2014. Nevertheless, little is known regarding the differences among COPD categories in terms of clinical parameters such as pulmonary function or radiological findings. Thus, our aims in this study were to evaluate the associations between CAT scores and pulmonary clinical parameters, and to investigate factors that could discriminate between a "less symptomatic group" (categories A and C) and a "more symptomatic group" (categories B and D) among stable COPD patients. We enrolled 200 outpatients at Chiba University Hospital. Study subjects were assessed by CAT, pulmonary function testing, and multidetector computed tomography (MDCT). We assessed possible correlations between these indices. CAT scores were negatively correlated with percentage of the forced expiratory volume in 1 second predicted value (FEV1 %predicted) and percentage of the diffusing capacity for carbon monoxide per liter of lung volume predicted value (DLCO/VA [%predicted]) results and positively correlated with low attenuation volume percentage (LAV%) and residual volume to total lung capacity ratios (RV/TLC). In the "more symptomatic group" (category B or D), the mean DLCO/VA (%predicted) was significantly lower and the mean LAV% and RV/TLC was significantly higher than those in the "less symptomatic group" (category A or C), respectively. Interestingly, those in category B had higher mean LAV% compared to those in category C. CAT scores were significantly correlated with pulmonary function parameters and emphysematous changes on MDCT. The new GOLD classification system would be a step toward a phenotypic approach, especially taking into account the degree of emphysema and hyperinflation.

  16. Solid lipid nanoparticles for pulmonary delivery of insulin.

    Science.gov (United States)

    Liu, Jie; Gong, Tao; Fu, Hualin; Wang, Changguang; Wang, Xiuli; Chen, Qian; Zhang, Qin; He, Qin; Zhang, Zhirong

    2008-05-22

    Growing attention has been given to the potential of pulmonary route as an alternative for non-invasive systemic delivery of therapeutic agents. In this study, novel nebulizer-compatible solid lipid nanoparticles (SLNs) for pulmonary drug delivery of insulin were developed by reverse micelle-double emulsion method. The influences of the amount of sodium cholate (SC) and soybean phosphatidylcholine (SPC) on the deposition properties of the nanoparticles were investigated. Under optimal conditions, the entrapment delivery (ED), respirable fraction (RF) and nebulization efficiency (NE) of SLNs could reach 96.53, 82.11 and 63.28%, respectively, and Ins-SLNs remained stable during nebulization. Fasting plasma glucose level was reduced to 39.41% and insulin level was increased to approximately 170 microIU/ml 4h after pulmonary administration of 20 IU/kg Ins-SLNs. A pharmacological bioavailability of 24.33% and a relative bioavailability of 22.33% were obtained using subcutaneous injection as a reference. Incorporating fluorescent-labelled insulin into SLNs, we found that the SLNs were effectively and homogeneously distributed in the lung alveoli. These findings suggested that SLNs could be used as a potential carrier for pulmonary delivery of insulin by improving both in vitro and in vivo stability as well as prolonging hypoglycemic effect, which inevitably resulted in enhanced bioavailability.

  17. VaR Methodology Application for Banking Currency Portfolios

    Directory of Open Access Journals (Sweden)

    Daniel Armeanu

    2007-02-01

    Full Text Available VaR has become the standard measure that financial analysts use to quantify market risk. VaR measures can have many applications, such as in risk management, to evaluate the performance of risk takers and for regulatory requirements, and hence it is very important to develop methodologies that provide accurate estimates. In particular, the Basel Committee on Banking Supervision at the Bank for International Settlements imposes to financial institutions such as banks and investment firms to meet capital requirements based on VaR estimates. In this paper we determine VaR for a banking currency portfolio and respect rules of National Bank of Romania regarding VaR report.

  18. Pulmonary Contusion in Mechanically Ventilated Subjects After Severe Trauma.

    Science.gov (United States)

    Dhar, Sakshi Mathur; Breite, Matthew D; Barnes, Stephen L; Quick, Jacob A

    2018-03-13

    Pulmonary contusions are thought to worsen outcomes. We aimed to evaluate the effects of pulmonary contusion on mechanically ventilated trauma subjects with severe thoracic injuries and hypothesized that contusion would not increase morbidity. We conducted a single-center, retrospective review of 163 severely injured trauma subjects (injury severity score ≥ 15) with severe thoracic injury (chest abbreviated injury score ≥ 3), who required mechanical ventilation for >24 h at a verified Level 1 trauma center. Subject data were analyzed for those with radiographic documentation of pulmonary contusion and those without. Statistical analysis was performed to determine the effects of coexisting pulmonary contusion in severe thoracic trauma. Pulmonary contusion was present in 91 subjects (55.8%), whereas 72 (44.2%) did not have pulmonary contusions. Mean chest abbreviated injury score (3.54 vs 3.47, P = .53) and mean injury severity score (32.6 vs 30.2, P = .12) were similar. There was no difference in mortality (11 [12.1%] vs 9 [12.5%], P > .99) or length of stay (16.29 d vs 17.29 d, P = .60). Frequency of ventilator-associated pneumonia was comparable (43 [47.3%] vs 32 [44.4%], P = .75). Subjects with contusions were more likely to grow methicillin-sensitive Staphylococcus aureus in culture (33 vs 10, P = .004) as opposed to Pseudomonas aeruginosa in culture (6 vs 13, P = .003). Overall, no significant differences were noted in mortality, length of stay, or pneumonia rates between severely injured trauma subjects with and without pulmonary contusions. Copyright © 2018 by Daedalus Enterprises.

  19. Two Major Bile Acids in the Hornbills, (24R,25S)-3α,7α,24-Trihydroxy-5β-cholestan-27-oyl Taurine and Its 12α-Hydroxy Derivative.

    Science.gov (United States)

    Satoh, Rika; Ogata, Hiroaki; Saito, Tetsuya; Zhou, Biao; Omura, Kaoru; Kurabuchi, Satoshi; Mitamura, Kuniko; Ikegawa, Shigeo; Hagey, Lee R; Hofmann, Alan F; Iida, Takashi

    2016-06-01

    Two major bile acids were isolated from the gallbladder bile of two hornbill species from the Bucerotidae family of the avian order Bucerotiformes Buceros bicornis (great hornbill) and Penelopides panini (Visayan tarictic hornbill). Their structures were determined to be 3α,7α,24-dihydroxy-5β-cholestan-27-oic acid and its 12α-hydroxy derivative, 3α,7α,12α,24-tetrahydroxy-5β-cholestan-27-oic acid (varanic acid, VA), both present in bile as their corresponding taurine amidates. The four diastereomers of varanic acid were synthesized and their assigned structures were confirmed by X-ray crystallographic analysis. VA and its 12-deoxy derivative were found to have a (24R,25S)-configuration. 13 additional hornbill species were also analyzed by HPLC and showed similar bile acid patterns to B. bicornis and P. panini. The previous stereochemical assignment for (24R,25S)-VA isolated from the bile of varanid lizards and the Gila monster should now be revised to the (24S,25S)-configuration.

  20. The WHO 2016 verbal autopsy instrument: An international standard suitable for automated analysis by InterVA, InSilicoVA, and Tariff 2.0.

    Directory of Open Access Journals (Sweden)

    Erin K Nichols

    2018-01-01

    Full Text Available Verbal autopsy (VA is a practical method for determining probable causes of death at the population level in places where systems for medical certification of cause of death are weak. VA methods suitable for use in routine settings, such as civil registration and vital statistics (CRVS systems, have developed rapidly in the last decade. These developments have been part of a growing global momentum to strengthen CRVS systems in low-income countries. With this momentum have come pressure for continued research and development of VA methods and the need for a single standard VA instrument on which multiple automated diagnostic methods can be developed.In 2016, partners harmonized a WHO VA standard instrument that fully incorporates the indicators necessary to run currently available automated diagnostic algorithms. The WHO 2016 VA instrument, together with validated approaches to analyzing VA data, offers countries solutions to improving information about patterns of cause-specific mortality. This VA instrument offers the opportunity to harmonize the automated diagnostic algorithms in the future.Despite all improvements in design and technology, VA is only recommended where medical certification of cause of death is not possible. The method can nevertheless provide sufficient information to guide public health priorities in communities in which physician certification of deaths is largely unavailable. The WHO 2016 VA instrument, together with validated approaches to analyzing VA data, offers countries solutions to improving information about patterns of cause-specific mortality.

  1. High prevalence of occult left heart disease in scleroderma-pulmonary hypertension.

    Science.gov (United States)

    Fox, Benjamin D; Shimony, Avi; Langleben, David; Hirsch, Andrew; Rudski, Lawrence; Schlesinger, Robert; Eisenberg, Mark J; Joyal, Dominique; Hudson, Marie; Boutet, Kim; Serban, Alexandrina; Masetto, Ariel; Baron, Murray

    2013-10-01

    Our study aimed to determine the prevalence of occult left-heart disease in patients with scleroderma and pulmonary hypertension. In patients with pulmonary hypertension (mean pulmonary artery pressure (mean PAP)≥25 mmHg), differentiation between pre- and post-capillary pulmonary hypertension has been made according to pulmonary artery wedge pressure (PAWP) less than or more than 15 mmHg, respectively. We performed a retrospective chart review of 107 scleroderma patients. All patients with suspected pulmonary hypertension had routine right or left heart catheterisation with left ventricular end-diastolic pressure (LVEDP) measurement pre-/post-fluid challenge. We extracted demographic, haemodynamic and echocardiographic data. Patients were classified into one of four groups: haemodynamically normal (mean PAP15 mmHg); occult PVH (mean PAP≥25 mmHg, PAWP≤15 mmHg, LVEDP>15 mmHg before or after fluid challenge); and pulmonary arterial hypertension (PAH) (mean PAP≥25 mmHg, PAWP≤15 mmHg and LVEDP≤15 mmHg before or after fluid challenge). 53 out of 107 patients had pulmonary hypertension. Based on the PAWP-based definition, 29 out of 53 had PAH and 24 out of 53 had PVH. After considering the resting and post-fluid-challenge LVEDP, 11 PAH patients were reclassified as occult PVH. The occult PVH group was haemodynamically, echocardiographically and demographically closer to the PVH group than the PAH group. PVH had high prevalence in our scleroderma-pulmonary hypertension population. Distinguishing PAH from PVH with only PAWP may result in some PVH patients being misclassified as having PAH.

  2. Signatures of molecular recognition from the topography of ...

    Indian Academy of Sciences (India)

    Administrator

    cules through non-covalent bonding such as hydro- gen bonding ... tion exhibit complementarity of certain properties ... of molecular recognition has been given in terms of .... VA and VB correspond to the monomer MESP in the composite.

  3. KiVa Anti-Bullying Program in Italy: Evidence of Effectiveness in a Randomized Control Trial.

    Science.gov (United States)

    Nocentini, Annalaura; Menesini, Ersilia

    2016-11-01

    The present study aims to evaluate the effectiveness of the KiVa anti-bullying program in Italy through a randomized control trial of students in grades 4 and 6. The sample involved 2042 students (51 % female; grade 4, mean age = 8.85; ds = 0.43; grade 6, mean age = 10.93; ds = 0.50); 13 comprehensive schools were randomly assigned into intervention (KiVa) or control (usual school provision) conditions. Different outcomes (bullying, victimization, pro-bullying attitudes, pro-victim attitudes, empathy toward victims), analyses (longitudinal mixed model with multiple-item scales; longitudinal prevalence of bullies and victims using Olweus' single question), and estimates of effectiveness (Cohen's d; odds ratios) were considered in order to compare the Italian results with those from other countries. Multilevel models showed that KiVa reduced bullying and victimization and increased pro-victim attitudes and empathy toward the victim in grade 4, with effect sizes from 0.24 to 0.40. In grade 6, KiVa reduced bullying, victimization, and pro-bullying attitudes; the effects were smaller as compared to grade 4, yet significant (d ≥ 0.20). Finally, using Olweus dichotomous definition of bullies and victims, results showed that the odds of being a victim were 1.93 times higher for a control student than for a KiVa student in grade 4. Overall, the findings provide evidence of the effectiveness of the program in Italy; the discussion will focus on factors that influenced successfully the transportability of the KiVa program in Italy.

  4. Has the VA Become a White Elephant?

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2016-11-01

    Full Text Available No abstract available. Article truncated at 150 words. As I write this Dennis Wagner is publishing a series of articles in the Arizona Republic describing his quest to find out if care at VA hospitals have improved over the last 2 years (1. To begin the article Wagner describes the fable of the King of Siam who presented albino pachyderms to his enemies knowing they would be bankrupted because the cost of food and care outweighed all usefulness. A modern expression derives from this parable: the white elephant. The Department of Veterans Affairs (VA has prided itself on being a leader in healthcare. It is the largest healthcare system in the US, implemented the first electronic medical record, and more than 70 percent of all US doctors have received training in the VA healthcare system (2. This year the VA is celebrating the 70th anniversary of its partnership with US medical schools. Beginning in 1946, the VA partnered ...

  5. Cord blood Vα24-Vβ11 natural killer T cells display a Th2-chemokine receptor profile and cytokine responses.

    Directory of Open Access Journals (Sweden)

    Susanne Harner

    Full Text Available BACKGROUND: The fetal immune system is characterized by a Th2 bias but it is unclear how the Th2 predominance is established. Natural killer T (NKT cells are a rare subset of T cells with immune regulatory functions and are already activated in utero. To test the hypothesis that NKT cells are part of the regulatory network that sets the fetal Th2 predominance, percentages of Vα24(+Vβ11(+ NKT cells expressing Th1/Th2-related chemokine receptors (CKR were assessed in cord blood. Furthermore, IL-4 and IFN-γ secreting NKT cells were quantified within the single CKR(+ subsets. RESULTS: Cord blood NKT cells expressed the Th2-related CCR4 and CCR8 at significantly higher frequencies compared to peripheral blood NKT cells from adults, while CXCR3(+ and CCR5(+ cord blood NKT cells (Th1-related were present at lower percentages. Within CD4(negCD8(neg (DN NKT cells, the frequency of IL-4 producing NKT cells was significantly higher in cord blood, while frequencies of IFN-γ secreting DN NKT cells tended to be lower. A further subanalysis showed that the higher percentage of IL-4 secreting DN NKT cells was restricted to CCR3(+, CCR4(+, CCR5(+, CCR6(+, CCR7(+, CCR8(+ and CXCR4(+ DN subsets in cord blood. This resulted in significantly decreased IFN-γ /IL-4 ratios of CCR3(+, CCR6(+ and CCR8(+ cord blood DN NKT cells. Sequencing of VA24AJ18 T cell receptor (TCR transcripts in sorted cord blood Vα2411 cells confirmed the invariant TCR alpha-chain ruling out the possibility that these cells represent an unusual subset of conventional T cells. CONCLUSIONS: Despite the heterogeneity of cord blood NKT cells, we observed a clear Th2-bias at the phenotypic and functional level which was mainly found in the DN subset. Therefore, we speculate that NKT cells are important for the initiation and control of the fetal Th2 environment which is needed to maintain tolerance towards self-antigens as well as non-inherited maternal antigens.

  6. Differences in the effects of Asian dust on pulmonary function between adult patients with asthma and those with asthma–chronic obstructive pulmonary disease overlap syndrome

    Science.gov (United States)

    Watanabe, Masanari; Noma, Hisashi; Kurai, Jun; Sano, Hiroyuki; Ueda, Yasuto; Mikami, Masaaki; Yamamoto, Hiroyuki; Tokuyasu, Hirokazu; Kato, Kazuhiro; Konishi, Tatsuya; Tatsukawa, Toshiyuki; Shimizu, Eiji; Kitano, Hiroya

    2016-01-01

    Background Asian dust (AD) exposure exacerbates pulmonary dysfunction in patients with asthma. Asthma–chronic obstructive pulmonary disease overlap syndrome (ACOS), characterized by coexisting symptoms of asthma and chronic obstructive pulmonary disease, is considered a separate disease entity. Previously, we investigated the effects of AD on pulmonary function in adult patients with asthma. Here, we present the findings of our further research on the differences in the effects of AD exposure on pulmonary function between patients with asthma alone and those with ACOS. Methods Between March and May 2012, we conducted a panel study wherein we monitored daily peak expiratory flow (PEF) values in 231 adult patients with asthma. These patients were divided into 190 patients with asthma alone and 41 patients with ACOS in this study. Daily AD particle levels were measured using light detection and ranging systems. Two heavy AD days (April 23 and 24) were determined according to the Japan Meteorological Agency definition. A linear mixed model was used to estimate the association between PEF and AD exposure. Results Increments in the interquartile range of AD particles (0.018 km−1) led to PEF changes of −0.50 L/min (95% confidence interval, −0.98 to −0.02) in patients with asthma alone and −0.11 L/min (−0.11 to 0.85) in patients with ACOS. The PEF changes after exposure to heavy AD were −2.21 L/min (−4.28 to −0.15) in patients with asthma alone and −2.76 L/min (−6.86 to 1.35) in patients with ACOS. In patients with asthma alone, the highest decrease in PEF values was observed on the heavy AD day, with a subsequent gradual increase over time. Conclusion Our results suggest that the effects of AD exposure on pulmonary function differ between patients with asthma alone and ACOS, with the former exhibiting a greater likelihood of decreased pulmonary function after AD exposure. PMID:26869784

  7. VaST: A variability search toolkit

    Science.gov (United States)

    Sokolovsky, K. V.; Lebedev, A. A.

    2018-01-01

    Variability Search Toolkit (VaST) is a software package designed to find variable objects in a series of sky images. It can be run from a script or interactively using its graphical interface. VaST relies on source list matching as opposed to image subtraction. SExtractor is used to generate source lists and perform aperture or PSF-fitting photometry (with PSFEx). Variability indices that characterize scatter and smoothness of a lightcurve are computed for all objects. Candidate variables are identified as objects having high variability index values compared to other objects of similar brightness. The two distinguishing features of VaST are its ability to perform accurate aperture photometry of images obtained with non-linear detectors and handle complex image distortions. The software has been successfully applied to images obtained with telescopes ranging from 0.08 to 2.5 m in diameter equipped with a variety of detectors including CCD, CMOS, MIC and photographic plates. About 1800 variable stars have been discovered with VaST. It is used as a transient detection engine in the New Milky Way (NMW) nova patrol. The code is written in C and can be easily compiled on the majority of UNIX-like systems. VaST is free software available at http://scan.sai.msu.ru/vast/.

  8. Pulmonary artery pulse pressure and wave reflection in chronic pulmonary thromboembolism and primary pulmonary hypertension.

    Science.gov (United States)

    Castelain, V; Hervé, P; Lecarpentier, Y; Duroux, P; Simonneau, G; Chemla, D

    2001-03-15

    The purpose of this time-domain study was to compare pulmonary artery (PA) pulse pressure and wave reflection in chronic pulmonary thromboembolism (CPTE) and primary pulmonary hypertension (PPH). Pulmonary artery pressure waveform analysis provides a simple and accurate estimation of right ventricular afterload in the time-domain. Chronic pulmonary thromboembolism and PPH are both responsible for severe pulmonary hypertension. Chronic pulmonary thromboembolism and PPH predominantly involve proximal and distal arteries, respectively, and may lead to differences in PA pressure waveform. High-fidelity PA pressure was recorded in 14 patients (7 men/7 women, 46 +/- 14 years) with CPTE (n = 7) and PPH (n = 7). We measured thermodilution cardiac output, mean PA pressure (MPAP), PA pulse pressure (PAPP = systolic - diastolic PAP) and normalized PAPP (nPAPP = PPAP/MPAP). Wave reflection was quantified by measuring Ti, that is, the time between pressure upstroke and the systolic inflection point (Pi), deltaP, that is, the systolic PAP minus Pi difference, and the augmentation index (deltaP/PPAP). At baseline, CPTE and PPH had similar cardiac index (2.4 +/- 0.4 vs. 2.5 +/- 0.5 l/min/m2), mean PAP (59 +/- 9 vs. 59 +/- 10 mm Hg), PPAP (57 +/- 13 vs. 53 +/- 13 mm Hg) and nPPAP (0.97 +/- 0.16 vs. 0.89 +/- 0.13). Chronic pulmonary thromboembolism had shorter Ti (90 +/- 17 vs. 126 +/- 16 ms, p PPAP (0.26 +/- 0.01 vs. 0.09 +/- 0.07, p < 0.01). Our study indicated that: 1) CPTE and PPH with severe pulmonary hypertension had similar PA pulse pressure, and 2) wave reflection is elevated in both groups, and CPTE had increased and anticipated wave reflection as compared with PPH, thus suggesting differences in the pulsatile component of right ventricular afterload.

  9. Technology Reference Model (TRM) Reports: VA Category Mapping Report

    Data.gov (United States)

    Department of Veterans Affairs — The One VA Enterprise Architecture (OneVA EA) is a comprehensive picture of the Department of Veterans Affairs' (VA) operations, capabilities and services and the...

  10. Visionary leadership and the future of VA health system.

    Science.gov (United States)

    Bezold, C; Mayer, E; Dighe, A

    1997-01-01

    As the U.S. Department of Veterans Affairs (VA) makes the change over to Veterans Integrated Service Network (VISNs) the need for new and better leadership is warranted if VA wants to not only survive, but thrive in the emerging twenty-first century healthcare system. VA can prepare for the future and meet the challenges facing them by adopting a system of visionary leadership. The use of scenarios and vision techniques are explained as they relate to VA's efforts to move toward their new system of VISNs. The four scenarios provide snapshots of possible futures for the U.S. healthcare system as well as the possible future role and mission of VA--from VA disappearing to its becoming a premier virtual organization.

  11. 38 CFR 61.11 - Applications for capital grants.

    Science.gov (United States)

    2010-07-01

    ... (CONTINUED) VA HOMELESS PROVIDERS GRANT AND PER DIEM PROGRAM § 61.11 Applications for capital grants. (a) To apply for a capital grant, an applicant must obtain from VA a capital grant application package and... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Applications for capital...

  12. ESTIMASI NILAI VaR PORTOFOLIO MENGGUNAKAN FUNGSI ARCHIMEDEAN COPULA

    Directory of Open Access Journals (Sweden)

    AULIA ATIKA PRAWIBTA SUHARTO

    2017-01-01

    Full Text Available Value at Risk explains the magnitude of the worst losses occurred in financial products investments with a certain level of confidence and time interval. The purpose of this study is to estimate the VaR of portfolio using Archimedean Copula family. The methods for calculating the VaR are as follows: (1 calculating the stock return; (2 calculating descriptive statistics of return; (3 checking for the nature of autocorrelation and heteroscedasticity effects on stock return data; (4 checking for the presence of extreme value by using Pareto tail; (5 estimating the parameters of Achimedean Copula family; (6 conducting simulations of Archimedean Copula; (7 estimating the value of the stock portfolio VaR. This study uses the closing price of TLKM and GGRM. At 90% the VaR obtained using Clayton, Gumbel, Frank copulas are 0.9562%, 1.0189%, 0.9827% respectively. At 95% the VaR obtained using Clayton, Gumbel, Frank copulas are 1.2930%, 1.2522%, 1.3152% respectively. At 99% the VaR obtained using Clayton, Gumbel, Frank copulas are 2.0327%, 1.9164%, is 1.8678% respectively. In conclusion estimation of VaR using Clayton copula yields the highest VaR.

  13. Sodium-sulfur battery development. Phase VB final report, October 1, 1981--February 28, 1985

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1985-04-01

    This report describes the technical progress made under Contract No. DE-AM04-79CH10012 between the U.S. Department of Energy, Ford Aerospace & Communications Corporations and Ford Motor Company, for the period 1 October 1981 through 28 February 1985, which is designated as Phase VB of the Sodium-Sulfur Battery Development Program. During this period, Ford Aerospace held prime technical responsibility and Ford Motor Company carried out supporting research. Ceramatec, Inc., was a major subcontractor to Ford Aerospace for electrolyte development and production.

  14. Evaluation of pulmonary gas distribution by the 133Xe washout curve

    International Nuclear Information System (INIS)

    Sato, Masao; Katsuragawa, Shigehiko

    1989-01-01

    The pulmonary mixing index (PMI) and ΔN 2 derived from an N 2 washout curve by the multiple-breath method, and the K 1 /K 4 ratio (K 1 , K 4 are the rate constant of washout obtained from the fast space and slow space, respectively) derived from regional 133 Xe washout curves were evaluated in 12 healthy subjects and 22 subjects with pulmonary disease, who included 12 subjects with chronic obstructive pulmonary disease (COPD), 5 subjects with pulmonary fibrosis (PF) and 5 subjects with bronchial asthma (BA). The results were as follows: 1) PMI was 0.68±0.31% (mean±SD) in the PF group, 1.34±0.40% in the BA group and 8.63±5.01% in the COPD group. The ΔN 2 was 0.20±0.11%, 0.64±0.24% and 5.96±4.21%, respectively. 2) The K 1 /K 4 ratio in the right lung was linearly correlated with that of the left lung (r=0.84, p 1 /K 4 ratio (mean±SE) in healthy subjects was lowest in the basal region of the right lung. 4) The regional gas distribution score (RGDS) derived from the regional K 1 /K 4 ratios was 18.8±0.9 (mean±SE) in the healthy 12 subjects, 19.0±1.2 in the PF group, 11.8±1.8 in the BA group and 6.5±0.6 in the COPD group. It was concluded that RGDS was more sensitive and useful parameter than PMI and ΔN 2 for detecting the disturbance of pulmonary gas distribution. (author)

  15. Electrocardiographic findings in Emergency Department patients with pulmonary embolism.

    Science.gov (United States)

    Richman, Peter B; Loutfi, Hassan; Lester, Steven J; Cambell, Patricia; Matthews, Jessica; Friese, Jeremy; Wood, Joseph; Kasper, David; Chen, Frederick; Mandell, Mark

    2004-08-01

    To assess the pre-study, null hypothesis that there is no difference in the electrocardiogram (EKG) findings for Emergency Department (ED) patients who rule in vs. rule out for suspected pulmonary embolism, a retrospective review of a cohort of patients with pulmonary embolism and their controls was conducted in an academic, suburban ED. Patients who were evaluated in the ED during a one-year study period for symptoms suggestive of pulmonary embolism were eligible for inclusion. All patients with pulmonary embolism and sex- and age-matched controls comprised the final study groups. Two board-certified cardiologists reviewed each patient's EKG. There were 350 eligible patients identified; 49 patients with pulmonary embolism and 49 controls were entered into the study. The most common rhythm observed in both groups was normal sinus rhythm (67.3% cases vs. 68.6 % controls; p = 1.0). Abnormalities believed to be associated with pulmonary embolism occurred with similar frequency in both case and control groups (sinus tachycardia [18.8 % vs. 11.8%, respectively; p = 0.40]), incomplete right bundle branch block (4.2% vs. 0.0%, respectively; p = 0.24), complete right bundle branch block (4.2% vs. 6.0, respectively; p = 1.0), S1Q3T3 pattern (2.1 vs. 0.0, respectively; p = 0.49), S1Q3 pattern (0.0 vs. 0.0), and extreme right axis (0.0 vs. 0.0). New EKG changes were identified more frequently for patients with pulmonary embolism (33.3% vs. 12.5% controls; p = 0.03), but specific findings were rarely different between cases and controls. In our cohort of ED patients, we did not identify EKG features that are likely to help distinguish patients with pulmonary embolism from those who rule out for the disease.

  16. Minimal impairment in pulmonary function following laparoscopic surgery

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  17. An inducible mouse model for microvillus inclusion disease reveals a role for myosin Vb in apical and basolateral trafficking

    NARCIS (Netherlands)

    Schneeberger, Kerstin; Vogel, Georg F; Teunissen, Hans; van Ommen, Domenique D; Begthel, Harry; El Bouazzaoui, Layla; van Vugt, Anke H M; Beekman, Jeffrey M; Klumperman, Judith; Müller, Thomas; Janecke, Andreas; Gerner, Patrick; Huber, Lukas A; Hess, Michael W; Clevers, Hans; van Es, Johan H; Nieuwenhuis, Edward E S; Middendorp, Sabine

    2015-01-01

    Microvillus inclusion disease (MVID) is a rare intestinal enteropathy with an onset within a few days to months after birth, resulting in persistent watery diarrhea. Mutations in the myosin Vb gene (MYO5B) have been identified in the majority of MVID patients. However, the exact pathophysiology of

  18. Aluminum-Oxide Temperatures on the Mark VB, VE, VR, 15, and Mark 25 Assemblies

    International Nuclear Information System (INIS)

    Aleman, S.E.

    2001-01-01

    The task was to compute the maximum aluminum-oxide and oxide-coolant temperatures of assemblies cladded in 99+ percent aluminum. The assemblies considered were the Mark VB, VE, V5, 15 and 25. These assemblies consist of nested slug columns with individual uranium slugs cladded in aluminum cans. The CREDIT code was modified to calculate the oxide film thickness and the aluminum-oxide temperature at each axial increment. This information in this report will be used to evaluate the potential for cladding corrosion of the Mark 25 assembly

  19. Headache diagnoses among Iraq and Afghanistan war veterans enrolled in VA: a gender comparison.

    Science.gov (United States)

    Carlson, Kathleen F; Taylor, Brent C; Hagel, Emily M; Cutting, Andrea; Kerns, Robert; Sayer, Nina A

    2013-01-01

    To examine the prevalence and correlates of headache diagnoses, by gender, among Iraq and Afghanistan War Veterans who use Department of Veterans Affairs (VA) health care. Understanding the health care needs of recent Veterans, and how these needs differ between women and men, is a priority for the VA. The potential for a large burden of headache disorders among Veterans seeking VA services exists but has not been examined in a representative sample. We conducted a historical cohort study using national VA inpatient and outpatient data from fiscal year 2011. Participants were all (n = 470,215) Iraq and Afghanistan War Veteran VA users in 2011; nearly 13% were women. We identified headache diagnoses using International Classification of Diseases (ICD-9) diagnosis codes assigned during one or more VA inpatient or outpatient encounters. Descriptive analyses included frequencies of patient characteristics, prevalence and types of headache diagnoses, and prevalence of comorbid diagnoses. Prevalence ratios (PR) with 95% confidence intervals (CI) were used to estimate associations between gender and headache diagnoses. Multivariate models adjusted for age and race. Additional models also adjusted for comorbid diagnoses. In 2011, 56,300 (11.9%) Veterans received a headache-related diagnosis. While controlling for age and race, headache diagnoses were 1.61 times more prevalent (95% CI = 1.58-1.64) among women (18%) than men (11%). Most of this difference was associated with migraine diagnoses, which were 2.66 times more prevalent (95% CI = 2.59-2.73) among women. Cluster and post-traumatic headache diagnoses were less prevalent in women than in men. These patterns remained the same when also controlling for comorbid diagnoses, which were common among both women and men with headache diagnoses. The most prevalent comorbid diagnoses examined were depression (46% of women with headache diagnoses vs 40% of men), post-traumatic stress disorder (38% vs 58%), and back

  20. 38 CFR 1.203 - Information to be reported to VA Police.

    Science.gov (United States)

    2010-07-01

    ... reported to VA Police. 1.203 Section 1.203 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... be reported to VA Police. Information about actual or possible violations of criminal laws related to... occurs on VA premises, will be reported by VA management officials to the VA police component with...

  1. SlaVaComp: Konvertierungstool (= SlaVaComp Fonts Converter

    Directory of Open Access Journals (Sweden)

    Simon Skilevic

    2013-12-01

    Full Text Available Der vorliegende Beitrag informiert über ein Tool, das im Rahmen eines Freiburger Projekts zur historischen Korpuslinguistik entwickelt wurde und dazu dient, kirchenslavische Texte, die ohne Einsatz von Unicode digitalisiert wurden, ohne Verlust von Information bzw. Formatierung ins Unicode-Format zu überführen. Das Tool heißt SlaVaComp-Konvertierer. Es eignet sich für die Konvertierung aller idiosynkratischen Fonts und kann somit nicht nur in der Paläoslavistik, sondern in allen historisch arbeitenden Philologien eingesetzt werden. ____________________ This paper presents a fonts converter that was developed as a part of the Freiburg project on historical corpus linguistics. The tool named SlaVaComp-Konvertierer converts Church Slavonic texts digitized with non-Unicode fonts into the Unicode format without any loss of information contained in the original file and without damage to the original formatting. It is suitable for the conversion of all idiosyncratic fonts—not only Church Slavonic—and therefore can be used not only in Palaeoslavistic, but also in all historical and philological studies.

  2. 76 FR 34248 - Equestrian Stables at Meadowood Special Recreation Management Area, VA; Information Sharing Meeting

    Science.gov (United States)

    2011-06-13

    ...), located in Lorton, VA, and collect comments, suggestions and ideas from the public pertaining to the... individual during normal business hours. The FIRS is available 24 hours a day, 7 days a week, to leave a message or question with the above individual. You will receive a reply during normal business hours...

  3. Poststroke Rehabilitation and Restorative Care Utilization: A Comparison Between VA Community Living Centers and VA-contracted Community Nursing Homes.

    Science.gov (United States)

    Jia, Huanguang; Pei, Qinglin; Sullivan, Charles T; Cowper Ripley, Diane C; Wu, Samuel S; Bates, Barbara E; Vogel, W Bruce; Bidelspach, Douglas E; Wang, Xinping; Hoffman, Nannette

    2016-03-01

    Effective poststroke rehabilitation care can speed patient recovery and minimize patient functional disabilities. Veterans affairs (VA) community living centers (CLCs) and VA-contracted community nursing homes (CNHs) are the 2 major sources of institutional long-term care for Veterans with stroke receiving care under VA auspices. This study compares rehabilitation therapy and restorative nursing care among Veterans residing in VA CLCs versus those Veterans in VA-contracted CNHs. Retrospective observational. All Veterans diagnosed with stroke, newly admitted to the CLCs or CNHs during the study period who completed at least 2 Minimum Data Set assessments postadmission. The outcomes were numbers of days for rehabilitation therapy and restorative nursing care received by the Veterans during their stays in CLCs or CNHs as documented in the Minimum Data Set databases. For rehabilitation therapy, the CLC Veterans had lower user rates (75.2% vs. 76.4%, P=0.078) and fewer observed therapy days (4.9 vs. 6.4, Pcare, CLC Veterans had higher user rates (33.5% vs. 30.6%, Pcare days (9.4 vs. 5.9, Pcare (coefficient=5.48±0.37, Pcare both before and after risk adjustment.

  4. A CASE OF IDIOPATHIC PULMONARY ARTERIAL HYPERTENSION IN MALE

    OpenAIRE

    Poongavanam Paranthaman; Ramani Bala Subra Manian; Thenrajan Balaji; Jayakrishnan Jayakumar; Govindaraj Ranjani

    2016-01-01

    Primary Pulmonary Hypertension is a rare disease occurring in 1-2 per million population. It is 2-4 times more common in female. Idiopathic or primary pulmonary hypertension is defined as a disorder with no identifiable cause in which resting mean pulmonary artery pressure in adults is above 25 mmHg and 30 mmHg with exercise. Idiopathic or primary pulmonary hypertension is diagnosed after ruling out all the possible secondary causes of pulmonary hypertension. We are presenting a ...

  5. Whistle-blower accuses VA inspector general of a "whitewash"

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2014-09-01

    Full Text Available No abstract available. Article truncated after 150 words. Yesterday, Dr. Sam Foote, the initial whistle-blower at the Phoenix VA, criticized the Department of Veterans Affairs inspector general's (VAOIG report on delays in healthcare at the Phoenix VA at a hearing before the House Committee of Veterans Affairs (1,2. Foote accused the VAOIG of minimizing bad patient outcomes and deliberately confusing readers, downplaying the impact of delayed health care at Phoenix VA facilities. "At its best, this report is a whitewash. At its worst, it is a feeble attempt at a cover-up," said Foote. Foote earlier this year revealed that as many as 40 Phoenix patients died while awaiting care and that the Phoenix VA maintained secret waiting lists while under-reporting patient wait times for appointments. His disclosures triggered the national VA scandal. Richard Griffin, the acting VAOIG, said that nearly 300 patients died while on backlogged wait lists in the Phoenix VA Health Care System, a much higher ...

  6. Helman defends decision to pull VA sponsorship of Veterans day parade

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2013-04-01

    Full Text Available No abstract available. Article truncated after 150 words. Sharon Helman, Phoenix VA Director, defended her decision to cancel VA sponsorship of the annual Phoenix Veterans Day Parade in a 4/10/13 email to VA employees. Helman said that VA sponsorship was cancelled because of “…priorities in the organization (specifically access, and heightened awareness over liability concerns which VA Legal Counsel brought forward”. She concluded her letter by warning “… that all media inquiries should be forwarded to Paul Coupaud, Acting Public Affairs Officer”. VA officials initially said fear of litigation prompted the review of VA support. Last year, a float carrying wounded Veterans in a Midland, Texas, parade collided with a freight train, killing four and injuring 17. Crash victims and their families filed lawsuits in Texas against Union Pacific Railroad and the float owner. The VA was not a defendant, and the VA has not issued any national directives on liability as a result of the tragedy.In…

  7. Evaluation of pulmonary artery flow in acute massive pulmonary thromboembolism with MRI

    International Nuclear Information System (INIS)

    Li Yongzhong; Li Kuncheng; Zhao Xigang; Zhao Hong

    2004-01-01

    Objective: To probe into the value of MR imaging in evaluating the pulmonary artery hemodynamics and pulmonary artery pressure in acute massive pulmonary embolism. Methods: MR studies were performed in 21 patients with acute massive pulmonary embolism (diagnosed by contrast enhanced MR pulmonary angiography) and 20 healthy volunteers. The pulmonary artery hemodynamic parameters, such as the diameters of main and right pulmonary artery, peak velocity, average velocity, flow volume, flow patterns, and ejection acceleration time in main pulmonary artery were measured. The findings in patients and volunteers were compared. The hemodynamic parameters in patients were correlated with mean pulmonary artery pressure acquired with right heart catheterization. Results: The diameters of main pulmonary artery (2.93 vs 2.52 cm) and right pulmonary artery (2.49 vs 1.92 cm) in patients and volunteers showed significant differences (t=3.55, P<0.01 and t=4.19, P<0.01, respectively); Peak velocity (85.29 vs 100.63 cm/s), average velocity (11.00 vs 17.12 cm/s), flow volume (89.15 vs 98.96 ml/s), and ejection acceleration time (105.09 vs 163.85 ms) in main pulmonary artery were significantly different between patients and volunteers (t values were 2.89, 6.37, 2.21, and 9.46, respectively; P values were 0.01, <0.01, 0.03, and <0.01, respectively). The peak velocity-time curve of main pulmonary artery acquired with velocity encoded cine of MR in patients demonstrated earlier and lower peak velocity as well as abnormal retrograde flow. In addition, linear correlations were seen between the mean pulmonary pressure and the diameter of main pulmonary artery (r=0.62, P=0.001), diameter of right pulmonary artery (r=0.63, P=0.001), and ejection acceleration time (r=-0.55, P=0.005). Conclusion: MR imaging is a promising technique not only for the detection of pulmonary thromboemboli but also for the evaluation of hemodynamic parameters in pulmonary hypertension. (author)

  8. Orbital Exponent Optimization in Elementary VB Calculations of the Chemical Bond in the Ground State of Simple Molecular Systems

    Science.gov (United States)

    Magnasco, Valerio

    2008-01-01

    Orbital exponent optimization in the elementary ab-initio VB calculation of the ground states of H[subscript 2][superscript +], H[subscript 2], He[subscript 2][superscript +], He[subscript 2] gives a fair description of the exchange-overlap component of the interatomic interaction that is important in the bond region. Correct bond lengths and…

  9. Rosette nanotubes show low acute pulmonary toxicity in vivo

    Directory of Open Access Journals (Sweden)

    W Shane Journeay

    2008-10-01

    Full Text Available W Shane Journeay1, Sarabjeet S Suri1, Jesus G Moralez2, Hicham Fenniri2, Baljit Singh11Immunology Research Group, Toxicology Graduate Program and Department of Veterinary Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, S7N 5B4, Canada; 2National Institute of Nanotechnology, National Research Council (NINT-NRC and Department of Chemistry, University of Alberta, 11421 Saskatchewan Drive, Edmonton, AB, T6G 2M9, CanadaAbstract: Nanotubes are being developed for a large variety of applications ranging from electronics to drug delivery. Common carbon nanotubes such as single-walled and multi-walled carbon nanotubes have been studied in the greatest detail but require solubilization and removal of catalytic contaminants such as metals prior to being introduced to biological systems for medical application. The present in vivo study characterizes the degree and nature of inflammation caused by a novel class of self-assembling rosette nanotubes, which are biologically inspired, naturally water-soluble and free of metal content upon synthesis. Upon pulmonary administration of this material we examined responses at 24 h and 7d post-exposure. An acute inflammatory response is triggered at 50 and 25 μg doses by 24 h post-exposure but an inflammatory response is not triggered by a 5 μg dose. Lung inflammation observed at a 50 μg dose at 24 h was resolving by 7d. This work suggests that novel nanostructures with biological design may negate toxicity concerns for biomedical applications of nanotubes. This study also demonstrates that water-soluble rosette nanotube structures represent low pulmonary toxicity, likely due to their biologically inspired design, and their self-assembled architecture.Keywords: nanotoxicology, biocompatibility, nanomedicine, pulmonary drug delivery, lung inflammation

  10. Technology Reference Model (TRM) Reports: VA Category Framework Count Report

    Data.gov (United States)

    Department of Veterans Affairs — The One VA Enterprise Architecture (OneVA EA) is a comprehensive picture of the Department of Veterans Affairs' (VA) operations, capabilities and services and the...

  11. Bronchial arterial infusion versus bronchial combined pulmonary arterial infusion for pulmonary metastatic tumors

    International Nuclear Information System (INIS)

    Dong Sheng; Dong Weihua; Jia Ningyang; Zhang Dianbo; Xiao Xiangsheng

    2008-01-01

    Objective: To evaluate the pulmonary metastatic tumor response to different ways of transcatheter arterial infusion. Methods: Thirty-five patients with pulmonary metastatic tumors were randomized divided into two groups: 15 patients with 49 lesions treated with bronchial arterial infusion (BAI) and 20 patients with 65 lesions treated with bronchial arterial infusion (BM)combined with pulmonary arterial infusion (PAI). The therapeutic response was assessed by the WHO evaluation criteria. Results: The total effective rate(CR + PR) of BAI was 65.3% (32/49), PAI + BAI was 61.5%(40/65) showing no statistical difference. The median survival time of BAI was 9 mo, BAI + PAI was 11.5 mo, demonstrating no statistical significance. Conclusions: BAI should be the primary treatment for pulmonary metastatic tumor. (authors)

  12. Diagnostic value of multi-tumor markers protein biochip detection for primary pulmonary cancer

    International Nuclear Information System (INIS)

    Xu Fengpo; Wu Yiwei; Li Qingru; Fa Yihua

    2005-01-01

    To evaluate the diagnostic value of multi-tumor markers protein biochip detection for primary pulmonary cancer, 12 tumor markers including AFP, CEA, NSE, CA125, CA15-3, CA242, CA19-9, PSA, f-PSA, FER, β-HCG and HGH were measured by the protein biochip in the serum of 45 primary pulmonary cancer patients. Positive rate of tumor markers was FER (42.2%), CEA (35.6%), CA125 (24.4%), CA15-3 (17.8%), CA242 (13.3%), CA19-9 (11.1%), β-HCG(8.9%), HGH(6.7%), NSE(4.4%), AFP (0), f-PSA (0) and PSA (0), respectively. The rate of patients with one abnorma indicator was 57.8% except FER. The positive rate using multi-tumor markers protein biochip detection was significantly higher than that of single tumor marker detective method, and this detection can be used for the diagnosis of patients with primary pulmonary cancer. (authors)

  13. Patent ductus arteriosus with persistent pulmonary artery hypertension after transcatheter closure.

    Science.gov (United States)

    Feng, Jianqi; Kong, Xiangqing; Sheng, Yanhui; Yang, Rong

    2016-01-01

    To observe the change in pulmonary artery systolic pressure (PASP) of patients with persistent pulmonary arterial hypertension (PAH) after patent ductus arteriosus (PDA) occlusion. After occlusion of PDA in patients with PAH, some patients still tend to suffer from persistent PAH. A chest X-ray, an electrocardiogram, and an echocardiogram were performed on nine patients at 24 hours, 1 and 6 months, and 1 year serially. There was a significant fall ( P 0.05). During the follow up, there was a further fall in the PASP in five patients (No 1, 5, 6, 7, and 8). Four patients (No 2, 3, 4, and 8) showed the evidence of worsening PAH and were treated with sildenafil. Patient 2 died from acute right heart failure after a period of 11 months from the time of transcatheter closure, triggered by pulmonary infection. Some patients with borderline hemodynamic data with PDA and PAH can deteriorate or keep sustained PAH after PDA closure. The treatment of permanent closure to these patients must be cautious.

  14. Development of a continuous energy version of KENO V.a

    International Nuclear Information System (INIS)

    Dunn, M.E.; Bentley, C.L.; Goluoglu, S.; Paschal, L.S.; Dodds, H.L.

    1997-01-01

    KENO V.a is a multigroup Monte Carlo code that solves the Boltzmann transport equation and is used extensively in the nuclear criticality safety community to calculate the effective multiplication factor k eff of systems containing fissile material. Because of the smaller amount of disk storage and CPU time required in calculations, multigroup approaches have been preferred over continuous energy (point) approaches in the past to solve the transport equation. With the advent of high-performance computers, storage and CPU limitations are less restrictive, thereby making continuous energy methods viable for transport calculations. Moreover, continuous energy methods avoid many of the assumptions and approximations inherent in multigroup methods. Because a continuous energy version of KENO V.a does not exist, the objective of the work is to develop a new version of KENO V.a that utilizes continuous energy cross sections. Currently, a point cross-section library, which is based on a raw continuous energy cross-section library such as ENDF/B-V is not available for implementation in KENO V.a; however, point cross-section libraries are available for MCNP, another widely used Monte Carlo transport code. Since MCNP cross sections are based on ENDF data and are readily available, a new version of KENO V.a named PKENO V.a has been developed that performs the random walk using MCNP cross sections. To utilize point cross sections, extensive modifications have been made to KENO V.a. At this point in the research, testing of the code is underway. In particular, PKENO V.a, KENO V.a, and MCNP have been used to model nine critical experiments and one subcritical problem. The results obtained with PKENO V.a are in excellent agreement with MCNP, KENO V.a, and experiments

  15. A Preliminary Investigation of Wastewater Treatment Efficiency and Economic Cost of Subsurface Flow Oyster-Shell-Bedded Constructed Wetland Systems

    Directory of Open Access Journals (Sweden)

    Chia-Chuan Hsu

    2013-06-01

    Full Text Available We conducted a preliminary investigation of wastewater treatment efficiency and economic cost of the oyster-shell-bedded constructed wetlands (CWs compared to the conventional gravel-bedded CW based on field monitoring data of water quality and numerical modeling. Four study subsurface (SSF CWs were built to receive wastewater from Taipei, Taiwan. Among these sites, two are vertical wetlands, filled with bagged- (VA and scattered- (VB oyster shells, and the other two horizontal wetlands were filled with scattered-oyster shells (HA and gravels (HB. The BOD, NO3−, DO and SS treatment efficiency of VA and VB were higher than HA and HB. However, VA was determined as the best option of CW design due to its highest cost-effectiveness in term of BOD removal (only 6.56 US$/kg as compared to VB, HA and HB (10.88–25.01 US$/kg. The results confirmed that oyster shells were an effective adsorption medium in CWs. Hydraulic design and arrangement of oyster shells could be important in determining their treatment efficiency and cost-effectiveness. A dynamic model was developed to simulate substance transmissions in different treatment processes in the CWS using AQUASIM 2.1 based on the water quality data. Feasible ranges of biomedical parameters involved were determined for characterizing the importance of different biochemical treatment processes in SSF CWs. Future work will involve extending the experimental period to confirm the treatment efficiency of the oyster-shell-bedded CW systems in long-term operation and provide more field data for the simulated model instead of the literature values.

  16. Development of a parallelization method for KENO V.a

    International Nuclear Information System (INIS)

    Basoglu, B.; Bentley, C.; Dunn, M.

    1995-01-01

    The KENO V.a codes is a widely used Monte carlo codes that is part of the SCALE modular codes system for performing standardized computer analysis of nuclear systems for licensing evaluation. In the past few years, attempts have been made to speed up KENO V.a using new generation computers. In this paper we report on the initial development of a parallel version of KENO V.a for the Kendall Square Research supercomputer (KSRI) at ORNL. Investigations thus far have shown that the parallel code provides accurate results with significantly reduced computation times relative to the conventional KENO V.a code

  17. Pulmonary circulatory effects of norepinephrine in newborn infants with persistent pulmonary hypertension.

    Science.gov (United States)

    Tourneux, Pierre; Rakza, Thameur; Bouissou, Antoine; Krim, Gérard; Storme, Laurent

    2008-09-01

    To evaluate the respiratory and the pulmonary circulatory effects of norepinephrine in newborn infants with persistent pulmonary hypertension (PPHN)-induced cardiac dysfunction. Inclusion criteria were: 1) Newborn infants >35 weeks gestational age; 2) PPHN treated with inhaled nitric oxide; and 3) symptoms of circulatory failure despite adequate fluid resuscitation. Lung function and pulmonary hemodynamic variables assessed with Doppler echocardiography were recorded prospectively before and after starting norepinephrine. Eighteen newborns were included (gestational age: 37 +/- 3 weeks; birth weight: 2800 +/- 700 g). After starting norepinephrine, systemic pressure and left ventricular output increased respectively from 33 +/- 4 mm Hg to 49 +/- 4 mm Hg and from 172 +/- 79 mL/kg/min to 209+/-90 mL/kg/min (P ventilatory variables have not been changed, the post-ductal transcutaneous arterial oxygen saturation increased from 89% +/- 1% to 95% +/- 4%, whereas the oxygen need decreased from 51% +/- 24% to 41% +/- 20% (P newborn infants with PPHN through a decrease in pulmonary/systemic artery pressure ratio and improved cardiac performance.

  18. Radiographic findings in adult pulmonary tuberculosis

    International Nuclear Information System (INIS)

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

    1981-01-01

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

  19. Analysis of VaR on Stock Investing%股票投资的风险价值VaR分析

    Institute of Scientific and Technical Information of China (English)

    张江红; 唐泉

    2011-01-01

    VaR is a tool to measure financial risk,which is supported and recognized by the international financial community in recent years.For equity portfolios consisting of different market factors or different financial instruments,VaR can reliably evaluate the market risks.In the paper the basic principle and calculation of VaR is introduced,the company stock value at risk has been analyzed using normal method,which company has issued convertible bond and stock.Meanwhile the affect that the issuance of convertible bond to the underlying stock fluctuation has been taken into account in order to provide reference for the different types of investors.%VaR是近年来受到国际金融界广泛支持和认可的一种度量金融风险的工具.对于不同市场因子和不同金融工具的投资组合,VaR可以相对可靠地衡量其市场风险.本文介绍了VaR的基本原理和计算方法,并用正态分布对发行有可转债的上市公司股票的风险价值进行分析,考虑了可转债的发行对标的股票波动的影响,以期为资本市场不同类型的投资者在进行资本投资前估计风险提供参考.

  20. Tail dependence between oil and stocks of major oil-exporting countries using the CoVaR approach

    Directory of Open Access Journals (Sweden)

    Nader Trabelsi

    2017-12-01

    Full Text Available This paper investigates the negative tail risk dependence between oil shocks and stock indices (at aggregated and desegregated levels for Saudi Arabia (KSA, United Arab Emirates (UAE and Russia, over the period between 2007 and 2016. DCC-MGARCH approach and CoVaR measure are employed to assess the oil shock exposure. The results show that the tail dependence is significant and depends on the origin of the oil shocks, with intensity that varies across countries and sectors. Keywords: Oil price shocks, Oil-exporting countries, Conditional VaR, JEL Classification: C58, G11, Q4

  1. The D543N polymorphism of the SLC11A1/NRAMP1 gene is associated with treatment failure in male patients with pulmonary tuberculosis.

    Science.gov (United States)

    Salinas-Delgado, Yvain; Galaviz-Hernández, Carlos; Toral, René García; Ávila Rejón, Carmen A; Reyes-Lopez, Miguel A; Martínez, Antonio Rojas; Martínez-Aguilar, Gerardo; Sosa-Macías, Martha

    2015-09-01

    Polymorphisms in SLC11A1/NRAMP1 have shown an important association with susceptibility to tuberculosis and progression to active disease. However, whether there is an association of these polymorphisms with treatment failure is unknown. The aim of this study was to determine the association of SLC11A1 polymorphisms with treatment failure in Mexican subjects with pulmonary tuberculosis. Thirty-three subjects with treatment failure were paired by age and body mass index with 33 patients who successfully completed treatment and were considered cured. We assessed the polymorphisms of SLC11A1 in the regions of D543N and INT4 via polymerase chain reaction real-time TaqMan® single nucleotide polymorphism (SNP) genotyping. We found that D543N (G/A genotype) was associated with treatment failure in patients with pulmonary tuberculosis [odds ratio (OR) 11.61, 95% confidence interval (CI) 3.66-36.78]. When adjusted by gender, this association remained significant in males (OR 11.09, 95% CI 3.46-35.51). In our male population, the presence of the D543N polymorphism of SLC11A1 is a risk factor for treatment failure. This finding should be confirmed in other populations.

  2. 24-HOUR ARTERIAL STIFFNESS VALUES IN MEN WITH DIFFERENT PHENOTYPES OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE CONCURRENT WITH HYPERTENSION

    Directory of Open Access Journals (Sweden)

    N. A. Karoli

    2015-01-01

    Full Text Available Objective: to study the specific features of the daily arterial stiffness (AS profile in men with different phenotypes of chronic obstructive pulmonary disease (COPD concurrent with hypertension. Subjects and methods. The investigation enrolled 78 male patients with COPD and hypertension. The patients were divided according to COPD phenotypes into 2 groups: 1 COPD patients with emphysema; 2 those with bronchitis. The exclusion criteria were less than 40 years and more than 80 years of age; diabetes mellitus; coronary heart disease; vascular diseases; an exacerbation of chronic diseases; bronchial and pulmonary diseases of another etiology. The patients underwent 24-hour blood pressure and AS monitoring, external respiratory function testing: spirography with a short-acting β2-agonist test, a six-minute walk test at baseline and after a hemoglobin oxygen saturation test, and a CAT test. Results. The patients of both groups were observed to have a statistically significant increase in (dP/dtmax as compared to those of the control group (p < 0.05; p < 0.01 in both the daytime and nighttime. In these periods, the COPD patients with emphysema had a higher AIx than those with bronchitis (p < 0.001. There was a statistically significantly (p < 0.001 higher AIx in the nighttime than in the daytime in Groups 1 and 2 patients. Conclusion. The patients with different COPD phenotypes were noted to have impaired arterial elastic properties, circadian AS changes with predominantly nocturnal impaired vascular stiffness. Relationships were found between 24-hour AS values and clinicoanamnestic findings. 

  3. Volatile organic compounds and pulmonary function in the Third National Health and Nutrition Examination Survey, 1988-1994.

    Science.gov (United States)

    Elliott, Leslie; Longnecker, Matthew P; Kissling, Grace E; London, Stephanie J

    2006-08-01

    Volatile organic compounds (VOCs) are present in much higher concentrations indoors, where people spend most of their time, than outdoors and may have adverse health effects. VOCs have been associated with respiratory symptoms, but few studies address objective respiratory end points such as pulmonary function. Blood levels of VOCs may be more indicative of personal exposures than are air concentrations; no studies have addressed their relationship with respiratory outcomes. We examined whether concentrations of 11 VOCs that were commonly identified in blood from a sample of the U.S. population were associated with pulmonary function. We used data from 953 adult participants (20-59 years of age) in the Third National Health and Nutrition Examination Survey (1988-1994) who had VOC blood measures as well as pulmonary function measures. Linear regression models were used to evaluate the relationship between 11 VOCs and measures of pulmonary function. After adjustment for smoking, only 1,4-dichlorobenzene (1,4-DCB) was associated with reduced pulmonary function. Participants in the highest decile of 1,4-DCB concentration had decrements of -153 mL [95% confidence interval (CI) , -297 to -8] in forced expiratory volume in 1 sec and -346 mL/sec (95% CI, -667 to -24) in maximum mid-expiratory flow rate, compared with participants in the lowest decile. Exposure to 1,4-DCB, a VOC related to the use of air fresheners, toilet bowl deodorants, and mothballs, at levels found in the U.S. general population, may result in reduced pulmonary function. This common exposure may have long-term adverse effects on respiratory health.

  4. 24 CFR 970.11 - Procedures for the offer of sale to established eligible organizations.

    Science.gov (United States)

    2010-04-01

    ... capabilities; (6) A plan for financing the purchase of the property and a firm financial commitment as stated... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Procedures for the offer of sale to established eligible organizations. 970.11 Section 970.11 Housing and Urban Development Regulations Relating...

  5. The VA mission act: Funding to fail?

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2018-06-01

    Full Text Available No abstract available. Article truncated after 150 words. Yesterday on D-Day, the 74th anniversary of the invasion of Normandy, President Trump signed the VA Mission Act. The law directs the VA to combine a number of existing private-care programs, including the so-called Choice program, which was created in 2014 after veterans died waiting for appointments at the Phoenix VA (1. During the signing Trump touted the new law saying “there has never been anything like this in the history of the VA” and saying that veterans “can go right outside [the VA] to a private doctor”-but can they? Although the bill authorizes private care, it appropriates no money to pay for it. Although a bipartisan plan to fund the expansion is proposed in the House, the White House has been lobbying Republicans to vote the plan down (2. Instead Trump has been asking Congress to pay for veteran’s programs by cutting spending elsewhere (2. We in Arizona are …

  6. Comparison of rates of potentially inappropriate medication use according to the Zhan criteria for VA versus private sector medicare HMOs.

    Science.gov (United States)

    Barnett, Mitchell J; Perry, Paul J; Langstaff, Jodi D; Kaboli, Peter J

    2006-06-01

    Inappropriate prescribing in the elderly is common, but rates across different health care systems and the impact of formulary restrictions are not well described. To determine if rates of inappropriate medication use in the elderly differ between the Veterans Affairs (VA) health care system and the private sector Medicare health maintenance organization (HMO) patients. A cross-sectional study design compared administrative pharmacy claims from 10 distinct geographic regions in the United States in the VA health care system and 10 analogous regions for patients enrolled in Medicare HMOs. The cohorts included 123,633 VA and 157,517 Medicare HMO patients aged 65 years and older. Inappropriate medication use was identified using the Zhan modification of the Beers criteria, which categorizes 33 potentially inappropriate drugs into 3 major classifications: "always avoid," "rarely appropriate," and "some indications." Comparisons between the VA health care system and the private sector Medicare HMO were performed for overall differences and stratified by gender and age. The drug formulary status of the Zhan-criteria drugs was known for the VA health system but not for the Medicare HMO patients. Compared with private sector patients, VA patients were less likely to receive any inappropriate medication (21% vs. 29%, P private sector for males (21% vs. 24%, P private sector Medicare HMOs, elderly VA patients were less likely to receive medications defined by the Zhan criteria as potentially inappropriate. A restrictive formulary that excludes 12 of the 33 Zhan criteria drugs may be a factor in the reduction of undesired prescribing patterns in elderly populations.

  7. MR assessment of fetal pulmonary hypoplasia

    Energy Technology Data Exchange (ETDEWEB)

    Kuwashima, Shigeko; Kohno, Atsushi; Saiki, Natoru; Iimura, Fumitoshi; Kohno, Tatsuo; Hashimoto, Teisuke; Fujioka, Mutsuhisa [Dokkyo Univ. School of Medicine, Mibu, Tochigi (Japan)

    2000-08-01

    The purpose of this study is to evaluate pulmonary hypoplasia of the fetus using MRI. The subjects consisted of 36 fetuses (18 to 40 weeks' gestation). All fetuses or mothers had major anomalies diagnosed on fetal ultrasonography. MR imaging was performed with a 1.5-T magnet and HASTE (half-Fourier acquisition single-shot turbo spin-echo) sequence. MR images were evaluated with special attention to the intensity of the lung. A diagnosis of pulmonary hypoplasia was based on the clinical, surgical, and autopsy findings. All fetuses with normal pulmonary development showed high intensity in the lung, while all fetuses with pulmonary hypoplasia showed a low intensity in the lung, obscured pulmonary vessels and a small thorax. There was a close correlation between the lung intensity and pulmonary growth. MR assessment of lung intensity may facilitate the diagnosis of pulmonary hypoplasia, particularly after 26 weeks' gestation. Some of the normally developing lung showed a low intensity from 20 to 24 weeks of gestational age. The change to normal lung intensity may occur during this period. (author)

  8. Building capacity in VA to provide emergency gynecology services for women.

    Science.gov (United States)

    Cordasco, Kristina M; Huynh, Alexis K; Zephyrin, Laurie; Hamilton, Alison B; Lau-Herzberg, Amy E; Kessler, Chad S; Yano, Elizabeth M

    2015-04-01

    Visits to Veterans Administration (VA) emergency departments (EDs) are increasingly being made by women. A 2011 national inventory of VA emergency services for women revealed that many EDs have gaps in their resources and processes for gynecologic emergency care. To guide VA in addressing these gaps, we sought to understand factors acting as facilitators and/or barriers to improving VA ED capacity for, and quality of, emergency gynecology care. Semistructured interviews with VA emergency and women's health key informants. ED directors/providers (n=14), ED nurse managers (n=13), and Women Veteran Program Managers (n=13) in 13 VA facilities. Leadership, staff, space, demand, funding, policies, and community were noted as important factors influencing VA EDs building capacity and improving emergency gynecologic care for women Veterans. These factors are intertwined and cross multiple organizational levels so that each ED's capacity is a reflection not only of its own factors, but also those of its local medical center and non-VA community context as well as VA regional and national trends and policies. Policies and quality improvement initiatives aimed at building VA's emergency gynecologic services for women need to be multifactorial and aimed at multiple organizational levels. Policies need to be flexible to account for wide variations across EDs and their medical center and community contexts. Approaches that build and encourage local leadership engagement, such as evidence-based quality improvement methodology, are likely to be most effective.

  9. 78 FR 56271 - FY 2014-2020 Draft VA Strategic Plan

    Science.gov (United States)

    2013-09-12

    ... DEPARTMENT OF VETERANS AFFAIRS FY 2014-2020 Draft VA Strategic Plan AGENCY: Department of Veterans... Affairs (VA) is announcing the availability of the FY 2014-2020 Draft VA Strategic Plan (Strategic Plan... Act of 2010 (GPRAMA) (Pub. L. 111-352). The Strategic Plan provides the Department's long-term...

  10. High Prevalence of Pulmonary Hypertension Complicates the Care of Infants with Omphalocele.

    Science.gov (United States)

    Hutson, Shandee; Baerg, Joanne; Deming, Douglas; St Peter, Shawn D; Hopper, Andrew; Goff, Donna A

    2017-01-01

    Omphalocele is one of the most common abdominal wall defects. Many newborn infants born with omphalocele present with significant respiratory distress at birth, requiring mechanical ventilatory support, and have clinical evidence of pulmonary hypertension. Little information exists on the prevalence of and risk factors associated with pulmonary hypertension in this cohort of infants. To describe the prevalence of and risk factors associated with pulmonary hypertension among infants with omphalocele. This is a multicenter retrospective chart review of demographic data and clinical characteristics of infants with omphalocele admitted to the neonatal intensive care units of Loma Linda University Children's Hospital and Children's Mercy Hospital between 1994 and 2011. Echocardiogram images were reviewed for pulmonary hypertension, and statistical analyses were performed to identify risk factors associated with the presence of pulmonary hypertension. Pulmonary hypertension was diagnosed in 32/56 (57%) infants with omphalocele. Compared to infants without pulmonary hypertension, infants with pulmonary hypertension were more likely to have a liver-containing defect (16/32 [50%] vs. 5/24 [21%], p = 0.03), require intubation at birth (18/32 [56%] vs. 6/24 [17%], p = 0.03), and die during initial hospitalization (12/32 [38%] vs. 2/24 [8%], p = 0.01). The majority of infants with omphalocele have evidence of pulmonary hypertension which is associated with increased mortality. Echocardiograms to screen for pulmonary hypertension should be obtained at ≥2 days of life in infants with omphalocele, especially in those with liver within the omphalocele sac and/or in those infants who require intubation at birth to screen for pulmonary hypertension. © 2017 S. Karger AG, Basel.

  11. High-resolution CT findings in Streptococcus milleri pulmonary infection

    International Nuclear Information System (INIS)

    Okada, F.; Ono, A.; Ando, Y.; Nakayama, T.; Ishii, H.; Hiramatsu, K.; Sato, H.; Kira, A.; Otabe, M.; Mori, H.

    2013-01-01

    Aim: To assess pulmonary high-resolution computed tomography (CT) findings in patients with acute Streptococcus milleri pulmonary infection. Materials and methods: Sixty consecutive patients with acute S. milleri pneumonia who had undergone high-resolution CT chest examinations between January 2004 and March 2010 were retrospectively identified. Twenty-seven patients with concurrent infections were excluded. The final study group comprised 33 patients (25 men, 8 women; aged 20–88 years, mean 63.1 years) with S. milleri infection. The patients' clinical findings were assessed. Parenchymal abnormalities, enlarged lymph nodes, and pleural effusion were evaluated on high-resolution CT. Results: Underlying conditions included malignancy (n = 15), a smoking habit (n = 11), and diabetes mellitus (n = 8). CT images of all patients showed abnormal findings, including ground-glass opacity (n = 24), bronchial wall thickening (n = 23), consolidation (n = 17), and cavities (n = 7). Pleural effusion was found in 18 patients, and complex pleural effusions were found in seven patients. Conclusion: Pulmonary infection caused by S. milleri was observed mostly in male patients with underlying conditions such as malignancy or a smoking habit. The CT findings in patients with S. milleri consisted mainly of ground-glass opacity, bronchial wall thickening, pleural effusions, and cavities

  12. Disease activity of idiopathic pulmonary fibrosis -value of high resolution CT-

    International Nuclear Information System (INIS)

    Lee, Jin Seong; Im, Jung Gi; Han, Man Chung; Kim, Chu Wan; Suh, Jin Suk

    1991-01-01

    Idiopathic pulmonary fibrosis (IPF) has characteristic clinical and pathologic features. In patients with uniform intra-alveolar cellularity, the process is often referred to as desquamative interstitial pneumonia. When alveolar septal fibrosis predominate, the process is known as usual interstitial pneumonia. Recently most investigators believe that desquamative interstitial pneumonia is the early stage and usual interstitial pneumonia is the late stage of the same disease process. The lone-term survival and the best response to treatment with corticosteroids is found in patients with marked disease activity and little fibrosis. Since disease activity is reflected by interstitial and intraalveolar cellularity, activity of idiopathic pulmonary fibrosis might result in opacification of air spaces on CT scans. There was no significant difference in estimating the visual HRCT scores of active area between two observers (p>0.05). Activity score of HRCT scan correlated significantly with improvement of DLCO/VA after corticosteroids treatment

  13. Disease activity of idiopathic pulmonary fibrosis -value of high resolution CT-

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jin Seong; Im, Jung Gi; Han, Man Chung; Kim, Chu Wan; Suh, Jin Suk [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1991-01-15

    Idiopathic pulmonary fibrosis (IPF) has characteristic clinical and pathologic features. In patients with uniform intra-alveolar cellularity, the process is often referred to as desquamative interstitial pneumonia. When alveolar septal fibrosis predominate, the process is known as usual interstitial pneumonia. Recently most investigators believe that desquamative interstitial pneumonia is the early stage and usual interstitial pneumonia is the late stage of the same disease process. The lone-term survival and the best response to treatment with corticosteroids is found in patients with marked disease activity and little fibrosis. Since disease activity is reflected by interstitial and intraalveolar cellularity, activity of idiopathic pulmonary fibrosis might result in opacification of air spaces on CT scans. There was no significant difference in estimating the visual HRCT scores of active area between two observers (p>0.05). Activity score of HRCT scan correlated significantly with improvement of DLCO/VA after corticosteroids treatment.

  14. Endothelin receptor antagonist and airway dysfunction in pulmonary arterial hypertension

    Directory of Open Access Journals (Sweden)

    Borst Mathias M

    2009-12-01

    Full Text Available Abstract Background In idiopathic pulmonary arterial hypertension (IPAH, peripheral airway obstruction is frequent. This is partially attributed to the mediator dysbalance, particularly an excess of endothelin-1 (ET-1, to increased pulmonary vascular and airway tonus and to local inflammation. Bosentan (ET-1 receptor antagonist improves pulmonary hemodynamics, exercise limitation, and disease severity in IPAH. We hypothesized that bosentan might affect airway obstruction. Methods In 32 IPAH-patients (19 female, WHO functional class II (n = 10, III (n = 22; (data presented as mean ± standard deviation pulmonary vascular resistance (11 ± 5 Wood units, lung function, 6 minute walk test (6-MWT; 364 ± 363.7 (range 179.0-627.0 m, systolic pulmonary artery pressure, sPAP, 79 ± 19 mmHg, and NT-proBNP serum levels (1427 ± 2162.7 (range 59.3-10342.0 ng/L were measured at baseline, after 3 and 12 months of oral bosentan (125 mg twice per day. Results and Discussion At baseline, maximal expiratory flow at 50 and 25% vital capacity were reduced to 65 ± 25 and 45 ± 24% predicted. Total lung capacity was 95.6 ± 12.5% predicted and residual volume was 109 ± 21.4% predicted. During 3 and 12 months of treatment, 6-MWT increased by 32 ± 19 and 53 ± 69 m, respectively; p Conclusion This study gives first evidence in IPAH, that during long-term bosentan, improvement of hemodynamics, functional parameters or serum biomarker occur independently from persisting peripheral airway obstruction.

  15. Troubles continue for the Phoenix VA

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2014-10-01

    Full Text Available No abstract available. Article truncated after 150 words. According to the Joint Commission on the Accreditation of Healthcare Organizations (Joint Commission, JCAHO, an independent organization that reviews hospitals, the Phoenix VA does not comply with U.S. standards for safety, patient care and management (1. The hospital was at the epicenter of the national scandal over the quality of care being afforded to the nation's veterans where the now notorious practice of double-booking patient appointments was first exposed. The hospital's indifferent management provoked congressional investigations that uncovered still more system-wide abuses leading to the removal of the hospital director and the resignation of then VA secretary, Eric Shinseki. The hospital maintains its accreditation but with a follow-up survey in 1-6 months where it must show that it has successfully addressed the 13 identified problems (1. Inspectors who conducted the review in July found that VA employees were unable to report concerns "without retaliatory action from the hospital." Other alarming ...

  16. Outcomes of Percutaneous Closure of Patent Ductus Arteriosus Accompanied With Unilateral Absence of Pulmonary Artery.

    Science.gov (United States)

    Yang, Yankun; Zheng, Hong; Xu, Zhongying; Zhang, Gejun; Jin, Jinglin; Hu, Haibo; Tian, Tao; Zhou, Xianliang

    2017-04-01

    Limited data have reported the outcomes of percutaneous closure of patent ductus arteriosus (PDA) in patients with unilateral absence of pulmonary artery (UAPA). This study aimed to evaluate the symptomatology, diagnosis and therapy, especially the transcatheter closure of PDA in patients with PDA associated with UAPA. Patients diagnosed with PDA and UAPA were retrospectively enrolled from August 2010 through January 2016. Clinical data, treatment and follow-up information were evaluated. Thirteen patients (6 males and 7 females) were diagnosed with PDA associated with UAPA. Percutaneous closure was successfully conducted in 6 patients successfully. The median age was 7 years (7 months to 37 years). The mean diameter of the PDA and occluders were 4.7 ± 1.8mm (2-7mm) and 11.3 ± 3.9mm (6-14mm), respectively. The mean pulmonary artery pressure was 41.5 ± 13.5mmHg (25-62mmHg). The diameter of PDA has no relationship with the degree of pulmonary artery pressure (r = 0.239, P = 0.648). In 4 patients, systolic pulmonary arterial pressure decreased significantly after closure with 69.0 ± 10.7 versus 48.0 ± 11.3mmHg (P = 0.146), and also the mean pulmonary arterial pressure was 54.5 ± 5.7 mm Hg versus 30.5 ± 3.9mmHg (P = 0.04). In all, 1 patient had a trace residual shunt, which disappeared within 24 hours. In appropriate patients with PDA associated with UAPA, transcatheter closure of PDA has the potential to improve the pulmonary artery hypertension. Further follow-up is required to monitor the long-term outcomes. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  17. Postoperative management of pulmonary endarterectomy and outcome

    Directory of Open Access Journals (Sweden)

    Narayana Iyengar Ramakrishna

    2010-01-01

    Full Text Available Pulmonary artery thromboendarterectomy (PTE has been regarded as a promising, potentially curative surgical procedure. However, PTE is associated with specific postoperative complications, such as reperfusion pulmonary edema and right heart failure leading to a considerable mortality of 7-24%. Despite its limitations PTE is a better surgical alternative to lung transplantation which carries high morbidity and mortality. The aim of the study is to analyze the efficacy, safety, morbidity and survival associated in the postoperative period and quality of life after six months of PTE in Indian patients. Forty-one patients with surgically correctable chronic thromboembolic pulmonary hypertension underwent pulmonary endarterectomy. All patients were in New York Heart Association (NYHA Class II, III or IV. Preoperative mean pulmonary artery pressure was 40.98 ± 9.29 mmHg and mean pulmonary vascular resistance was 418.39 ± 95.88 dynes/sec/cm -5 . All patients were followed up to six months and a telephonic survey was conducted using a standard questionnaire. They were assessed and classified as per NYHA grading. There was a significant reduction in the mean pulmonary artery pressure (from 40.98 ± 9.29 mmHg to 24.13 ± 7.36 mmHg, P < 0.001 and pulmonary vascular resistance (from 418.39 ± 95.88 dynes/sec/cm -5 to 142.45 ± 36.27 dynes/sec/cm -5 , P < 0.001 with a concomitant increase in the cardiac index (from 1.99 ± 0.20 L/min/m 2 to 3.28 ± 0.56 L/min/m 2 , P < 0.001 during the postoperative period. The mortality rate in our study was 12.19% (five patients. Ninety per cent of the patients reported a significant improvement in the quality of life and exercise tolerance after surgery compared to the preoperative state. Pulmonary endarterectomy is an effective and potentially curative surgical treatment for patients with severe chronic thromboembolic pulmonary hypertension. The current techniques of operation make the procedure relatively safe and

  18. Follow-up of 5- to 11-year-old children treated for persistent pulmonary hypertension of the newborn

    DEFF Research Database (Denmark)

    Eriksen, Vibeke; Nielsen, Lars Holme; Klokker, Mads

    2009-01-01

    AIM: Determine the prevalence of sensorineural hearing loss (SNHL) and relate this to cumulative exposure to hypoxia, hypocapnia and hypotension. Describe chronic health problems among 5- to 11-year-old children treated for persistent pulmonary hypertension of the newborn (PPHN). METHODS: The index...... group consisted of 85 children and a reference group was matched for age, sex and municipality of current residence. Questionnaires were sent to the families. The families in the index group were asked to participate in an examination of their child's hearing. RESULTS: Seven children (11%) had SNHL...... therapy compared with 8% in the reference group (chi-square test, p = 0.028). In the index group five children had cerebral palsy and two had developmental delay. Nineteen percent in the index group and 5% in the reference group had remedial education (chi-square test, p = 0.008). CONCLUSION: Children...

  19. 38 CFR 26.7 - VA environmental decision making and documents.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false VA environmental decision making and documents. 26.7 Section 26.7 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) ENVIRONMENTAL EFFECTS OF THE DEPARTMENT OF VETERANS AFFAIRS (VA) ACTIONS § 26.7 VA environmental decision making and document...

  20. Engineering and biological characterization of VB6-845, an anti-EpCAM immunotoxin containing a T-cell epitope-depleted variant of the plant toxin bouganin.

    Science.gov (United States)

    Cizeau, Jeannick; Grenkow, Danielle M; Brown, Jennifer G; Entwistle, Joycelyn; MacDonald, Glen C

    2009-01-01

    The clinical development of immunotoxins in the treatment of solid tumors has been impeded in part, by the induction of an immune response directed primarily against the toxin moiety. Bouganin, a type I ribosome inactivating protein isolated from the leaf of Bougainvillea spectabilis Willd, was mutated to remove the T-cell epitopes while preserving the biological activity of the wild-type molecule. The T-cell epitope-depleted variant of bouganin (de-bouganin) was genetically linked to an anti-epithelial cell adhesion molecule (EpCAM) Fab moiety via a peptidic linker containing a furin proteolytic site to create the fusion construct VB6-845. To determine the optimal construct design for VB6-845, several dicistronic units where de-bouganin was genetically linked to either the N-terminal or C-terminal of either the heavy or light chain were engineered. Only the C-terminal variants expressed the full-length molecule. An in vitro assessment of the biological activity of VB6-845 showed that it bound and selectively killed EpCAM-positive cell lines with a greater potency than many commonly used chemotherapeutic agents. In vivo efficacy was demonstrated using an EpCAM-positive human tumor xenograft model in SCID mice with the majority of the mice treated being tumor free at the end of the study.

  1. Pregnancy complicated by superior vena cava thrombosis and pulmonary embolism in a patient with Behcet disease and the use of heparin for treatment

    International Nuclear Information System (INIS)

    Kale, A.; Akdeniz, N.A.; Akyildiz, L.; Kale, E.

    2006-01-01

    Batch disease is a multi systemic vasculitis of unknown origin. Vascular involvement has been considered to result from systemic vasculitis, occurs in 5-10% of these patients. We report a 34-year-old pregnant woman complicated by superior vena ca va thrombosis, and pulmonary embolism in a patient with Batch disease. (author)

  2. 38 CFR 74.27 - How will VA store information?

    Science.gov (United States)

    2010-07-01

    ... (CONTINUED) VETERANS SMALL BUSINESS REGULATIONS Records Management § 74.27 How will VA store information? VA... examination visits will be scanned onto portable media and fully secured in the Center for Veterans Enterprise...

  3. Pulmonary functions and sleep-related breathing disorders in lipid storage disease.

    Science.gov (United States)

    Bingöl, Züleyha; Tekce, Hacer Durmuş; Sağcan, Gülseren; Serdaroğlu, Piraye; Kıyan, Esen

    2018-03-01

    Pulmonary function abnormalities and sleep-related breathing disorders (SRBD) are frequent in subjects with several neuromuscular diseases but there is no data about lipid storage diseases (LSD). Therefore, we aimed to evaluate pulmonary functions and SRBD in adults with LSD. Pulmonary functions (forced expiratory volume (FEV 1 ), forced vital capacity (FVC), supine FVC, upright-supine FVC% change, maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), peak cough flow (PCF)), arterial blood gases, and polysomnographic data of all subjects were evaluated. Twenty-five subjects with LSD were evaluated [17 males, 8 females; age 34.9 ± 15 years; BMI 26.5 ± 3.4 kg/m 2 ]. MIP was - 72.2 ± 32.7 cmH 2 O ( 45 mmHg). REM sleep had decreased in all subjects (10.2% ± 6.1). Obstructive sleep apnea (OSA) was found in 80% of the subjects (n = 20; 9 mild, 9 moderate, 2 severe). For subjects with OSA, apnea-hypopnea index (AHI) was 20.8 ± 15.9/h, oxygen desaturation index (ODI) was 11.9 ± 15.4/h, AHI REM was 30.6 ± 19.7/h, AHI NREM was 19.7 ± 16.6/h, ODI REM was 27.2 ± 26.1/h, and ODI NREM was 11.4 ± 15/h. Five subjects (20%) diagnosed as REM-related OSA. Nocturnal mean SpO 2 was 94.9% ± 1.7, lowest SpO 2 was 73.3% ± 13.9, and time spent with SpO 2 < 90% was 2.4% ± 7.2. In subjects with LSD, pulmonary function impairment, daytime hypercapnia and hypoxemia, and OSA, especially REM-related OSA, are frequent. Therefore, pulmonary functions and polysomnography should be performed routinely.

  4. Medical Student Psychiatry Examination Performance at VA and Non-VA Clerkship Sites

    Science.gov (United States)

    Tucker, Phebe; von Schlageter, Margo Shultes; Park, EunMi; Rosenberg, Emily; Benjamin, Ashley B.; Nawar, Ola

    2009-01-01

    Objective: The authors examined the effects of medical student assignment to U.S. Department of Veterans Affairs (VA) Medical Center inpatient and outpatient psychiatry clerkship sites versus other university and community sites on the performance outcome measure of National Board of Medical Examiners (NBME) subject examination scores. Methods:…

  5. Abnormal pulmonary artery stiffness in pulmonary arterial hypertension: in vivo study with intravascular ultrasound.

    Directory of Open Access Journals (Sweden)

    Edmund M T Lau

    Full Text Available BACKGROUND: There is increasing recognition that pulmonary artery stiffness is an important determinant of right ventricular (RV afterload in pulmonary arterial hypertension (PAH. We used intravascular ultrasound (IVUS to evaluate the mechanical properties of the elastic pulmonary arteries (PA in subjects with PAH, and assessed the effects of PAH-specific therapy on indices of arterial stiffness. METHOD: Using IVUS and simultaneous right heart catheterisation, 20 pulmonary segments in 8 PAH subjects and 12 pulmonary segments in 8 controls were studied to determine their compliance, distensibility, elastic modulus and stiffness index β. PAH subjects underwent repeat IVUS examinations after 6-months of bosentan therapy. RESULTS: AT BASELINE, PAH SUBJECTS DEMONSTRATED GREATER STIFFNESS IN ALL MEASURED INDICES COMPARED TO CONTROLS: compliance (1.50±0.11×10(-2 mm(2/mmHg vs 4.49±0.43×10(-2 mm(2/mmHg, p<0.0001, distensibility (0.32±0.03%/mmHg vs 1.18±0.13%/mmHg, p<0.0001, elastic modulus (720±64 mmHg vs 198±19 mmHg, p<0.0001, and stiffness index β (15.0±1.4 vs 11.0±0.7, p = 0.046. Strong inverse exponential associations existed between mean pulmonary artery pressure and compliance (r(2 = 0.82, p<0.0001, and also between mean PAP and distensibility (r(2 = 0.79, p = 0.002. Bosentan therapy, for 6-months, was not associated with any significant changes in all indices of PA stiffness. CONCLUSION: Increased stiffness occurs in the proximal elastic PA in patients with PAH and contributes to the pathogenesis RV failure. Bosentan therapy may not be effective at improving PA stiffness.

  6. Accuracy of percutaneous lung biopsy for invasive pulmonary aspergillosis

    Energy Technology Data Exchange (ETDEWEB)

    Hoffer, F.A. [Dept. of Diagnostic Imaging, St. Jude Children' s Research Hospital, Memphis, TN (United States); Gow, K.; Davidoff, A. [Dept. of Surgery, St. Jude Children' s Research Hospital, Memphis, TN (United States); Flynn, P.M. [Dept. of Infectious Diseases, St. Jude Children' s Research Hospital, Memphis, TN (United States)

    2001-03-01

    Background. Invasive pulmonary aspergillosis is fulminant and often fatal in immunosuppressed patients. Percutaneous biopsy may select patients who could benefit from surgical resection. Objective. We sought to determine the accuracy of percutaneous biopsy for pediatric invasive pulmonary aspergillosis. Materials and methods. We retrospectively reviewed 28 imaging-guided percutaneous biopsies of the lungs of 24 children with suspected pulmonary aspergillosis. Twenty-two were being treated for malignancy and two for congenital immunodeficiency; 15 had received bone-marrow transplants. The accuracy of the percutaneous lung biopsy was determined by subsequent surgical resection, autopsy, or clinical course. Results. Histopathological studies showed ten biopsy specimens with septate hyphae, indicating a mold, and seven with Aspergillus flavus colonies in culture. The remaining 18 biopsies revealed no fungi. No patient had progressive aspergillosis after negative biopsy. Invasive pulmonary mold was detected by percutaneous biopsy with 100 % (10/10) sensitivity and 100 % (18/18) specificity. Percutaneous biopsy results influenced the surgical decision in 86 % (24 of 28) of the cases. Bleeding complicated the biopsy in 46 % (13/28) and hastened one death. Conclusion. Percutaneous biopsy of the lung is an accurate technique for the diagnosis of invasive pulmonary aspergillosis and correctly determines which immunosuppressed pediatric patients would benefit from therapeutic pulmonary resection. (orig.)

  7. Accuracy of percutaneous lung biopsy for invasive pulmonary aspergillosis

    International Nuclear Information System (INIS)

    Hoffer, F.A.; Gow, K.; Davidoff, A.; Flynn, P.M.

    2001-01-01

    Background. Invasive pulmonary aspergillosis is fulminant and often fatal in immunosuppressed patients. Percutaneous biopsy may select patients who could benefit from surgical resection. Objective. We sought to determine the accuracy of percutaneous biopsy for pediatric invasive pulmonary aspergillosis. Materials and methods. We retrospectively reviewed 28 imaging-guided percutaneous biopsies of the lungs of 24 children with suspected pulmonary aspergillosis. Twenty-two were being treated for malignancy and two for congenital immunodeficiency; 15 had received bone-marrow transplants. The accuracy of the percutaneous lung biopsy was determined by subsequent surgical resection, autopsy, or clinical course. Results. Histopathological studies showed ten biopsy specimens with septate hyphae, indicating a mold, and seven with Aspergillus flavus colonies in culture. The remaining 18 biopsies revealed no fungi. No patient had progressive aspergillosis after negative biopsy. Invasive pulmonary mold was detected by percutaneous biopsy with 100 % (10/10) sensitivity and 100 % (18/18) specificity. Percutaneous biopsy results influenced the surgical decision in 86 % (24 of 28) of the cases. Bleeding complicated the biopsy in 46 % (13/28) and hastened one death. Conclusion. Percutaneous biopsy of the lung is an accurate technique for the diagnosis of invasive pulmonary aspergillosis and correctly determines which immunosuppressed pediatric patients would benefit from therapeutic pulmonary resection. (orig.)

  8. Percutaneous balloon dilation of pulmonary stenosis

    International Nuclear Information System (INIS)

    Hua Yangde; Huang Ming; Li Jinkang; Qian Jinqing; Chen Xiuyu; Yang Siyuan

    2003-01-01

    Objective: Review our experience of balloon dilation of valvular pulmonary stenosis in 32 cases. Methods: Totally 32 cases of pulmonary stenosis admitted from 1995-2001 with age of 1.5-13 yrs mean 6.8. Diagnosis was made by clinical manifestations, EKG, ECHO and angiocardiography. Results: Before dilation, the mean systolic pressure of right ventricle was (93.5 ± 28.5) mmHg, after the procedure it reduced to (42 ± 9.0) mmHg. The pressure gradient between right ventricle and pulmonary artery before dilation was (76 ± 30) mmHg and become (24.5 ± 8.5) mmHg after dilation. The gradient pressure after dilation was less than 25 mmHg in 90.6% cases. A case of Noonan syndrome showed no response to balloon dilation and died during valvulectomy from accompanying left ventricular cardiomyopathy. Conclusions: Balloon dilation of valvular pulmonary stenosis is effective and safe. The selection of proper diameter of pulmonary valvular rings and sized of the balloon are the major factors

  9. Single-crystal growth of Group IVB and VB carbides by the floating-zone method

    International Nuclear Information System (INIS)

    Finch, C.B.; Chang, Y.K.; Abraham, M.M.

    1989-02-01

    The floating-zone method for the growth of Group IVB and VB carbides is described and reviewed. We have systematically investigated the technique and confirmed the growth of large single crystals of TiC/sub 0.95/, ZrC/sub 0.93/, ZrC/sub 0.98/, VC/sub 0.80/, NbC/sub 0.95/, TaC/sub 0.89/. Optimal growth conditions were in the 0.5-2.0 cm/h range under 8-12 atm helium. Good crystal growth results were achieved with hot-pressed starting rods of 90-95% density, using a ''double pancake'' induction coil and a 200-kHz/100- kW rf power supply. 36 refs., 5 figs., 3 tabs

  10. 50 CFR 635.21 - Gear operation and deployment restrictions.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Gear operation and deployment restrictions....21 Gear operation and deployment restrictions. Link to an amendment published at 75 FR 57701, Sept. 22, 2010. The green-stick gear authorization requirements under paragraphs (c)(2)(v)(A), (c)(2)(v)(B...

  11. 48 CFR 852.219-71 - VA mentor-protégé program.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false VA mentor-protégÃ....219-71 VA mentor-protégé program. As prescribed in 819.7115(a), insert the following clause: VA Mentor-Protégé Program (DEC 2009) (a) Large businesses are encouraged to participate in the VA Mentor-Protégé...

  12. What does Shulkin's firing mean for the VA?

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2018-03-01

    Full Text Available No abstract available. Article truncated at 150 words. David Shulkin MD, Secretary for Veterans Affairs (VA was finally fired by President Donald Trump ending long speculation (1. Trump nominated his personal physician, Ronny Jackson MD, to fill Shulkin’s post. The day after his firing, Shulkin criticized his firing in a NY Times op-ed claiming pro-privatization factions within the Trump administration led to his ouster (2. “They saw me as an obstacle to privatization who had to be removed,” Dr. Shulkin wrote. “That is because I am convinced that privatization is a political issue aimed at rewarding select people and companies with profits, even if it undermines care for veterans.” Former Secretary Shulkin’s tenure at the VA has had several controversies. First, as undersecretary of Veterans Healthcare and later as secretary money appropriated to the VA to obtain private care under the Veterans Access, Choice, and Accountability Acts of 2014 and the VA Choice and Quality Employment Act of …

  13. Effect of BSA Antigen Sensitization during the Acute Phase of Influenza A Viral Infection on CD11c+ Pulmonary Antigen Presenting Cells

    Directory of Open Access Journals (Sweden)

    Fumitaka Sato

    2009-01-01

    Conclusions: BSA antigen sensitization during the acute phase of influenza A viral infection enhanced IL-10 production from naive CD4+ T cell interaction with CD11c+ pulmonary APCs. The IL-10 secretion evoked Th2 responses in the lungs with downregulation of Th1 responses and was important for the eosinophil recruitment into the lungs after BSA antigen challenge.

  14. Volatile Organic Compounds and Pulmonary Function in the Third National Health and Nutrition Examination Survey, 1988–1994

    Science.gov (United States)

    Elliott, Leslie; Longnecker, Matthew P.; Kissling, Grace E.; London, Stephanie J.

    2006-01-01

    Background Volatile organic compounds (VOCs) are present in much higher concentrations indoors, where people spend most of their time, than outdoors and may have adverse health effects. VOCs have been associated with respiratory symptoms, but few studies address objective respiratory end points such as pulmonary function. Blood levels of VOCs may be more indicative of personal exposures than are air concentrations; no studies have addressed their relationship with respiratory outcomes. Objective We examined whether concentrations of 11 VOCs that were commonly identified in blood from a sample of the U.S. population were associated with pulmonary function. Methods We used data from 953 adult participants (20–59 years of age) in the Third National Health and Nutrition Examination Survey (1988–1994) who had VOC blood measures as well as pulmonary function measures. Linear regression models were used to evaluate the relationship between 11 VOCs and measures of pulmonary function. Results After adjustment for smoking, only 1,4-dichlorobenzene (1,4-DCB) was associated with reduced pulmonary function. Participants in the highest decile of 1,4-DCB concentration had decrements of −153 mL [95% confidence interval (CI), −297 to −8] in forced expiratory volume in 1 sec and −346 mL/sec (95% CI, −667 to −24) in maximum mid-expiratory flow rate, compared with participants in the lowest decile. Conclusions Exposure to 1,4-DCB, a VOC related to the use of air fresheners, toilet bowl deodorants, and mothballs, at levels found in the U.S. general population, may result in reduced pulmonary function. This common exposure may have long-term adverse effects on respiratory health. PMID:16882527

  15. Empirical analysis on future-cash arbitrage risk with portfolio VaR

    Science.gov (United States)

    Chen, Rongda; Li, Cong; Wang, Weijin; Wang, Ze

    2014-03-01

    This paper constructs the positive arbitrage position by alternating the spot index with Chinese Exchange Traded Fund (ETF) portfolio and estimating the arbitrage-free interval of futures with the latest trade data. Then, an improved Delta-normal method was used, which replaces the simple linear correlation coefficient with tail dependence correlation coefficient, to measure VaR (Value-at-risk) of the arbitrage position. Analysis of VaR implies that the risk of future-cash arbitrage is less than that of investing completely in either futures or spot market. Then according to the compositional VaR and the marginal VaR, we should increase the futures position and decrease the spot position appropriately to minimize the VaR, which can minimize risk subject to certain revenues.

  16. Patient deaths blamed on long waits at the Phoenix VA

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2014-04-01

    Full Text Available No abstract available. Article truncated at 150 words. This morning the lead article in the Arizona Republic was a report blaming as many as 40 deaths at the Phoenix VA on long waits (1. Yesterday, Rep. Jeff Miller, the chairman of the House Committee on Veterans Affairs, held a hearing titled “A Continued Assessment of Delays in VA Medical Care and Preventable Veteran Deaths.” “It appears as though there could be as many as 40 veterans whose deaths could be related to delays in care,” Miller announced to a stunned audience. The committee has spent months investigating patient-care scandals and allegations at VA facilities in Pittsburgh, Atlanta, Miami and other cities. said that dozens of VA hospital patients in Phoenix may have died while awaiting medical care. He went on to say that staff investigators have evidence that the Phoenix VA Health Care System keeps two sets of records to conceal prolonged waits that patients must endure for ...

  17. Onco-miR-24 regulates cell growth and apoptosis by targeting BCL2L11 in gastric cancer

    Directory of Open Access Journals (Sweden)

    Haiyang Zhang

    2016-01-01

    Full Text Available ABSTRACT Gastric cancer is one of the most common malignancies worldwide; however, the molecular mechanism in tumorigenesis still needs exploration. BCL2L11 belongs to the BCL-2 family, and acts as a central regulator of the intrinsic apoptotic cascade and mediates cell apoptosis. Although miRNAs have been reported to be involved in each stage of cancer development, the role of miR-24 in GC has not been reported yet. In the present study, miR-24 was found to be up-regulated while the expression of BCL2L11 was inhibited in tumor tissues of GC. Studies from both in vitro and in vivo shown that miR-24 regulates BCL2L11 expression by directly binding with 3′UTR of mRNA, thus promoting cell growth, migration while inhibiting cell apoptosis. Therefore, miR-24 is a novel onco-miRNA that can be potential drug targets for future clinical use.

  18. CT analysis of pulmonary Wegener's granulomatosis

    International Nuclear Information System (INIS)

    Liao Hualing; Chen Jianbo; Zhong Wenchen; Chen Jingdi

    2010-01-01

    Objective: To study the CT features and to improve the diagnostic accuracy of pulmonary Wegener's granulomatosis. Methods: 11 patients with histopathologically and clinically proven Wegener's granulomatosis were included in the study. Chest radiography was performed in all 11 patients and 8 patients underwent chest CT. Results: Lung abnormalities were noted in 10/11 patients including patchy lung opacities (n=3), multiple nodules (less than 3 cm in diameter, n=4), masses (more than 3cm in diameter, n=3), and cavitations (n=8). Multiple findings were observed in 4 patients. Conclusion: Imaging manifestations of pulmonary Wegener's granulomatosis were variable. Patchy lung opacities, nodules and cavitation were most common. Thin-walled cavity and ring-shaped cavity were characteristic. Pneumonia, abscess, tuberculosis and carcinoma should be included in the differential diagnosis. (authors)

  19. 77 FR 67063 - VA Directive 0005 on Scientific Integrity

    Science.gov (United States)

    2012-11-08

    ... in multiple areas, including data integrity, ethics, privacy, and human research protections, as well... replace the Association for the Accreditation of Human Research Protection Programs (AAHRPP) with Alion... human research protection programs. VA Response: VA is currently reviewing its accreditation...

  20. Pulmonary edema predictive scoring index (PEPSI), a new index to predict risk of reperfusion pulmonary edema and improvement of hemodynamics in percutaneous transluminal pulmonary angioplasty.

    Science.gov (United States)

    Inami, Takumi; Kataoka, Masaharu; Shimura, Nobuhiko; Ishiguro, Haruhisa; Yanagisawa, Ryoji; Taguchi, Hiroki; Fukuda, Keiichi; Yoshino, Hideaki; Satoh, Toru

    2013-07-01

    This study sought to identify useful predictors for hemodynamic improvement and risk of reperfusion pulmonary edema (RPE), a major complication of this procedure. Percutaneous transluminal pulmonary angioplasty (PTPA) has been reported to be effective for the treatment of chronic thromboembolic pulmonary hypertension (CTEPH). PTPA has not been widespread because RPE has not been well predicted. We included 140 consecutive procedures in 54 patients with CTEPH. The flow appearance of the target vessels was graded into 4 groups (Pulmonary Flow Grade), and we proposed PEPSI (Pulmonary Edema Predictive Scoring Index) = (sum total change of Pulmonary Flow Grade scores) × (baseline pulmonary vascular resistance). Correlations between occurrence of RPE and 11 variables, including hemodynamic parameters, number of target vessels, and PEPSI, were analyzed. Hemodynamic parameters significantly improved after median observation period of 6.4 months, and the sum total changes in Pulmonary Flow Grade scores were significantly correlated with the improvement in hemodynamics. Multivariate analysis revealed that PEPSI was the strongest factor correlated with the occurrence of RPE (p PEPSI to be a useful marker of the risk of RPE (cutoff value 35.4, negative predictive value 92.3%). Pulmonary Flow Grade score is useful in determining therapeutic efficacy, and PEPSI is highly supportive to reduce the risk of RPE after PTPA. Using these 2 indexes, PTPA could become a safe and common therapeutic strategy for CTEPH. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  1. 75 FR 9277 - Proposed Information Collection (VA National Rehabilitation Special Events, Event Registration...

    Science.gov (United States)

    2010-03-01

    ... Sports Clinic Application, VA Form 0924--233 hours. b. National Veterans Wheelchair Games Application, VA.... National Veterans TEE Tournament Application, VA Form 0927--133 hours. e. National Veterans Summer Sports... Form 0929--67 hours. OMB Control Number: 2900-New (VA Form 0924). Type of Review: Existing collection...

  2. VA National Bed Control System

    Data.gov (United States)

    Department of Veterans Affairs — The VA National Bed Control System records the levels of operating, unavailable and authorized beds at each VAMC, and it tracks requests for changes in these levels....

  3. The model of pulmonary embolism caused by autologous thrombus in rabbits

    Directory of Open Access Journals (Sweden)

    Yu-Jiao Ding

    2017-05-01

    Full Text Available Objective: To establish a model of pulmonary embolism in rabbits by using autologous thrombosis of rabbit ear vein, to study the method of establishing acute pulmonary embolism by using autologous thrombus and to explore the diagnostic value of oxygen partial pressure in acute pulmonary embolism. Methods: Twenty rabbits were randomly divided into normal group (n=5, 7 h group, 24h group, 1 week after model establishment Group. The arterial blood gas analysis was performed on the carotid arteries of rabbits at 7 h, 24 h and 1 W after modeling. Results: Normal group oxygen partial pressure (93.15 ± 2.26 mmHg, 7 h group oxygen partial pressure (81.98 ± 1.94 mmHg, 24 h group oxygen partial pressure (84.55 ± 2.18 mmHg, 1 W group oxygen partial pressure (92.66 ± 1.92 mmHg. Normal group oxygen partial pressure and 7 h group, 24 h group oxygen partial pressure, P value was less than 0.05 and less than 0.01, indicating that the difference was statistically significant. Normal group oxygen partial pressure and 1 week group oxygen partial pressure, P value greater than 0.05, indicating that the difference was not statistically significant. Conclusion: The oxygen partial pressure was reduced at 7 h after the establishment of the acute pulmonary embolism model and failed to return to normal within 24 h. After 1 week, the embolus began to dissolve, the respiratory and circulatory system was reestablished, and the oxygen partial pressure gradually Return to normal level. Indicating that there is a positive correlation between oxygen partial pressure and acute pulmonary embolism.

  4. VA Telemedicine: An Analysis of Cost and Time Savings.

    Science.gov (United States)

    Russo, Jack E; McCool, Ryan R; Davies, Louise

    2016-03-01

    The Veterans Affairs (VA) healthcare system provides beneficiary travel reimbursement ("travel pay") to qualifying patients for traveling to appointments. Travel pay is a large expense for the VA and hence the U.S. Government, projected to cost nearly $1 billion in 2015. Telemedicine in the VA system has the potential to save money by reducing patient travel and thus the amount of travel pay disbursed. In this study, we quantify this savings and also report trends in VA telemedicine volumes over time. All telemedicine visits based at the VA Hospital in White River Junction, VT between 2005 and 2013 were reviewed (5,695 visits). Travel distance and time saved as a result of telemedicine were calculated. Clinical volume in the mental health department, which has had the longest participation in telemedicine, was analyzed. Telemedicine resulted in an average travel savings of 145 miles and 142 min per visit. This led to an average travel payment savings of $18,555 per year. Telemedicine volume grew significantly over the study period such that by the final year the travel pay savings had increased to $63,804, or about 3.5% of the total travel pay disbursement for that year. The number of mental health telemedicine visits rose over the study period but remained small relative to the number of face-to-face visits. A higher proportion of telemedicine visits involved new patients. Telemedicine at the VA saves travel distance and time, although the reduction in travel payments remains modest at current telemedicine volumes.

  5. Evaluation of pulmonary gas distribution by the sup 133 Xe washout curve

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Masao; Katsuragawa, Shigehiko [Iwate Medical Univ., Morioka (Japan). School of Medicine (Japan)

    1989-10-01

    The pulmonary mixing index (PMI) and DeltaN{sup 2} derived from an N{sup 2} washout curve by the multiple-breath method, and the K{sub 1}/K{sub 4} ratio (K{sub 1}, K{sub 4} are the rate constant of washout obtained from the fast space and slow space, respectively) derived from regional {sup 133}Xe washout curves were evaluated in 12 healthy subjects and 22 subjects with pulmonary disease, who included 12 subjects with chronic obstructive pulmonary disease (COPD), 5 subjects with pulmonary fibrosis (PF) and 5 subjects with bronchial asthma (BA). The results were as follows: (1) PMI was 0.68{plus minus}0.31% (mean{plus minus}SD) in the PF group, 1.34{plus minus}0.40% in the BA group and 8.63{plus minus}5.01% in the COPD group. The DeltaN{sub 2} was 0.20{plus minus}0.11%, 0.64{plus minus}0.24% and 5.96{plus minus}4.21%, respectively. (2) The K{sub 1}/K{sub 4} ratio in the right lung was linearly correlated with that of the left lung (r=0.84, p<0.001). (3) The regional K{sub 1}/K{sub 4} ratio (mean{plus minus}SE) in healthy subjects was lowest in the basal region of the right lung. (4) The regional gas distribution score (RGDS) derived from the regional K{sub 1}/K{sub 4} ratios was 18.8{plus minus}0.9 (mean{plus minus}SE) in the healthy 12 subjects, 19.0{plus minus}1.2 in the PF group, 11.8{plus minus}1.8 in the BA group and 6.5{plus minus}0.6 in the COPD group. It was concluded that RGDS was more sensitive and useful parameter than PMI and DeltaN{sub 2} for detecting the disturbance of pulmonary gas distribution. (author).

  6. VA Dental Insurance Program--federalism. Direct final rule.

    Science.gov (United States)

    2013-10-22

    The Department of Veterans Affairs (VA) is taking direct final action to amend its regulations related to the VA Dental Insurance Program (VADIP), a pilot program to offer premium-based dental insurance to enrolled veterans and certain survivors and dependents of veterans. Specifically, this rule will add language to clarify the limited preemptive effect of certain criteria in the VADIP regulations.

  7. Exclusive double outlet right ventricle with atrioventricular concordance and pulmonary stenosis. Results of reconstructive surgery.

    Science.gov (United States)

    Busquet, J; Fontan, F; Choussat, A; Caianiello, G; Fernandez, G

    1988-01-01

    Double outlet right ventricle associated with atrioventricular concordance, pulmonary stenosis and situs solitus of the atria is a subset of double outlet right ventricle related through the surgical treatment. From 1974 to 1985, 14 patients, 5 males, 9 females (mean age 8.9 years, range 13 months-22 years) were operated upon. All patients had infundibular stenosis and normal or large pulmonary arteries. The apex of the heart was to the right in 2 patients, the right and left ventricles were superior and inferior in 2 patients and 1 patient had both anomalies. The ventricular septal defect was subaortic in 11 patients (aorto-mitral discontinuity in 5) and non-committed in 3 patients. Three patients had 2 ventricular septal defects. The aorta was anterior in 3 patients and to the right of the pulmonary artery in 11 patients. All patients, through a transventricular and transatrial approach, had a reconstructive surgery. In 3 patients, an aortic homograft valved conduit was used. One patient had the ventricular septal defect enlarged. There was one early death (7.1%) from high residual right ventricle pressure and no late death. One patient had a transient atrioventricular block. One patient was reoperated upon for a residual ventricular septal defect. All survivors had a good clinical result. Re-evaluation in 8 patients confirmed excellent haemodynamics: the right ventricle to pulmonary artery pressure gradient decreased from 80 mm Hg (range 60-95) preoperatively to 24 mm Hg (range 3-32) postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Comparing VA and private sector healthcare costs for end-stage renal disease.

    Science.gov (United States)

    Hynes, Denise M; Stroupe, Kevin T; Fischer, Michael J; Reda, Domenic J; Manning, Willard; Browning, Margaret M; Huo, Zhiping; Saban, Karen; Kaufman, James S

    2012-02-01

    Healthcare for end-stage renal disease (ESRD) is intensive, expensive, and provided in both the public and private sector. Using a societal perspective, we examined healthcare costs and health outcomes for Department of Veterans Affairs (VA) ESRD patients comparing those who received hemodialysis care at VA versus private sector facilities. Dialysis patients were recruited from 8 VA medical centers from 2001 through 2003 and followed for 12 months in a prospective cohort study. Patient demographics, clinical characteristics, quality of life, healthcare use, and cost data were collected. Healthcare data included utilization (VA), claims (Medicare), and patient self-report. Costs included VA calculated costs, Medicare dialysis facility reports and reimbursement rates, and patient self-report. Multivariable regression was used to compare costs between patients receiving dialysis at VA versus private sector facilities. The cohort comprised 334 patients: 170 patients in the VA dialysis group and 164 patients in the private sector group. The VA dialysis group had more comorbidities at baseline, outpatient and emergency visits, prescriptions, and longer hospital stays; they also had more conservative anemia management and lower baseline urea reduction ratio (67% vs. 72%; Pprivate sector dialysis group (Pprivate sector settings is critical in informing health policy options for patients with complex chronic illnesses such as ESRD.

  9. Psychiatric morbidity in patients of pulmonary tuberculosis-an observational study

    Directory of Open Access Journals (Sweden)

    Lalit Singh

    2015-01-01

    Full Text Available Background: A lot of stigma and misconceptions about pulmonary tuberculosis still persist, in spite of the advances in treatment. Thus, a mere diagnosis of pulmonary tuberculosis can be a psychological trauma to an individual. The situation has aggravated with the association of tuberculosis with HIV infection. Aim: To study the psychiatric morbidity due to the various psychological stresses faced by a patient of pulmonary tuberculosis. Materials and Methods: The study group consisted of 100 inpatients admitted to pulmonary ward with diagnosis of pulmonary tuberculosis. The control group consisted of 100 inpatients admitted to pulmonary ward with nontuberculous pulmonary diseases. Psychiatric history and mental status were recorded on a specially designed proforma and diagnosis of any psychiatric illness, if present, arrived at as per International Classification of Diseases (ICD-10. The psychiatric tests applied were beck's depression inventory (BDI and Taylor's Manifest Anxiety Scale (TMAS. Results: Of the patients of pulmonary tuberculosis, 24% could be given a diagnostic category, as per ICD-10, as compared to only 8% of the controls (P < 0.005. On BDI, 44% of patients of pulmonary tuberculosis showed depression as compared to 27% of the controls (P < 0.02. On TMAS, 38% of patients of pulmonary tuberculosis showed anxiety as compared to 24% of controls (P < 0.05. A greater incidence of depression (on BDI and anxiety (on TMAS was seen in those with longer duration of illness (P < 0.02 and in those with greater severity of illness (P < 0.02. Conclusion: In view of the high psychiatric morbidity associated with pulmonary tuberculosis, there is enough scope for psychiatric services to be made available to these patients. In addition, personnel involved in the treatment of these patients should be trained for early detection of psychiatric symptoms.

  10. Differential pulmonary and cardiac effects of pulmonary exposure to a panel of particulate matter-associated metals

    International Nuclear Information System (INIS)

    Wallenborn, J. Grace; Schladweiler, Mette J.; Richards, Judy H.; Kodavanti, Urmila P.

    2009-01-01

    Biological mechanisms underlying the association between particulate matter (PM) exposure and increased cardiovascular health effects are under investigation. Water-soluble metals reaching systemic circulation following pulmonary exposure are likely exerting a direct effect. However, it is unclear whether specific PM-associated metals may be driving this. We hypothesized that exposure to equimolar amounts of five individual PM-associated metals would cause differential pulmonary and cardiac effects. We exposed male WKY rats (14 weeks old) via a single intratracheal instillation (IT) to saline or 1 μmol/kg body weight of zinc, nickel, vanadium, copper, or iron in sulfate form. Responses were analyzed 4, 24, 48, or 96 h after exposure. Pulmonary effects were assessed by bronchoalveolar lavage fluid levels of total cells, macrophages, neutrophils, protein, albumin, and activities of lactate dehydrogenase, γ-glutamyl transferase, and n-acetyl glucosaminidase. Copper induced earlier pulmonary injury/inflammation, while zinc and nickel produced later effects. Vanadium or iron exposure induced minimal pulmonary injury/inflammation. Zinc, nickel, or copper increased serum cholesterol, red blood cells, and white blood cells at different time points. IT of nickel and copper increased expression of metallothionein-1 (MT-1) in the lung. Zinc, nickel, vanadium, and iron increased hepatic MT-1 expression. No significant changes in zinc transporter-1 (ZnT-1) expression were noted in the lung or liver; however, zinc increased cardiac ZnT-1 at 24 h, indicating a possible zinc-specific cardiac effect. Nickel exposure induced an increase in cardiac ferritin 96 h after IT. This data set demonstrating metal-specific cardiotoxicity is important in linking metal-enriched anthropogenic PM sources with adverse health effects.

  11. VA INFORMATION SYSTEMS: Computer Security Weaknesses Persist at the Veterans Health Administration

    National Research Council Canada - National Science Library

    2000-01-01

    .... To determine the status of computer security within VHA, we (1) evaluated information system general controls at the VA Maryland Health Cafe System, the New Mexico VA Health Care System, and the VA North Texas Health Care System and (2...

  12. Early pulmonary response is critical for extra-pulmonary carbon nanoparticle mediated effects: comparison of inhalation versus intra-arterial infusion exposures in mice.

    Science.gov (United States)

    Ganguly, Koustav; Ettehadieh, Dariusch; Upadhyay, Swapna; Takenaka, Shinji; Adler, Thure; Karg, Erwin; Krombach, Fritz; Kreyling, Wolfgang G; Schulz, Holger; Schmid, Otmar; Stoeger, Tobias

    2017-06-20

    The death toll associated with inhaled ambient particulate matter (PM) is attributed mainly to cardio-vascular rather than pulmonary effects. However, it is unclear whether the key event for cardiovascular impairment is particle translocation from lung to circulation (direct effect) or indirect effects due to pulmonary particle-cell interactions. In this work, we addressed this issue by exposing healthy mice via inhalation and intra-arterial infusion (IAI) to carbon nanoparticles (CNP) as surrogate for soot, a major constituent of (ultrafine) urban PM. Equivalent surface area CNP doses in the blood (30mm 2 per animal) were applied by IAI or inhalation (lung-deposited dose 10,000mm 2 ; accounting for 0.3% of lung-to-blood CNP translocation). Mice were analyzed for changes in hematology and molecular markers of endothelial/epithelial dysfunction, pro-inflammatory reactions, oxidative stress, and coagulation in lungs and extra-pulmonary organs after CNP inhalation (4 h and 24 h) and CNP infusion (4 h). For methodological reasons, we used two different CNP types (spark-discharge and Printex90), with very similar physicochemical properties [≥98 and ≥95% elemental carbon; 10 and 14 nm primary particle diameter; and 800 and 300 m 2 /g specific surface area] for inhalation and IAI respectively. Mild pulmonary inflammatory responses and significant systemic effects were observed following 4 h and 24 h CNP inhalation. Increased retention of activated leukocytes, secondary thrombocytosis, and pro-inflammatory responses in secondary organs were detected following 4 h and 24 h of CNP inhalation only. Interestingly, among the investigated extra-pulmonary tissues (i.e. aorta, heart, and liver); aorta revealed as the most susceptible extra-pulmonary target following inhalation exposure. Bypassing the lungs by IAI however did not induce any extra-pulmonary effects at 4 h as compared to inhalation. Our findings indicate that extra-pulmonary effects due to CNP

  13. Evaluation of clinical characteristics and prognosis of chronic pulmonary aspergillosis depending on the underlying lung diseases: Emphysema vs prior tuberculosis.

    Science.gov (United States)

    Koyama, Kazuya; Ohshima, Nobuharu; Suzuki, Junko; Kawashima, Masahiro; Okuda, Kenichi; Sato, Ryota; Suzukawa, Maho; Nagai, Hideaki; Matsui, Hirotoshi; Ohta, Ken

    2015-11-01

    There have been scarce data evaluating the differences of clinical characteristics and prognosis of chronic pulmonary aspergillosis (CPA) depending on underlying pulmonary diseases. We tried to clarify them in CPA patients who had pulmonary emphysema or previous pulmonary tuberculosis. We reviewed and evaluated CPA patients diagnosed between 2007 and 2013 with pulmonary emphysema (PE group; n = 29), with previous pulmonary tuberculosis (PT group; n = 47) and with combination of these 2 underlying conditions (CTE group; n = 24). In CT findings, fungus balls were rare in PE group (7% in PE group and 36% in PT group; p = 0.006). Compared with PT group, PE group patients exhibited more frequent preceding antibiotics administration (45% vs 11%; p = 0.002) and fever (52% vs 17%; p = 0.002), less frequent hemosputum (24% vs 57%; p = 0.008), and more frequent consolidations in imaging (79% vs 38%; p = 0.001) and respiratory failure (34% vs 13%; p = 0.020), possibly suggesting more acute clinical manifestations of CPA in emphysematous patients. Trend of the differences between PT and PE group was not changed when patients with fungal balls were excluded. Multivariate Cox regression analysis of risks for all-cause mortality revealed age (HR, 1.079; p = 0.002) and emphysema (HR, 2.45; p = 0.040) as risk factors. Assessment of underlying lung diseases is needed when we estimate prognosis and consider treatment of CPA patients. Particularly, emphysematous patients can be presented as refractory pneumonia and show poor prognosis. Copyright © 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  14. Computerized tomography and pulmonary diffusing capacity in highly trained athletes after performing a triathlon.

    Science.gov (United States)

    Caillaud, C; Serre-Cousiné, O; Anselme, F; Capdevilla, X; Préfaut, C

    1995-10-01

    We investigated the computerized tomographies (CTs) of the thorax and the pulmonary diffusing capacity for CO (DLCO) in eight male athletes before and after a triathlon. DLCO and alveolar volume (VA) were simultaneously measured during 9 s of breath holding. The transfer coefficient (KCO = DLCO/VA) was then calculated. CT scanning was performed during breath holding with the subjects in the supine position. Scanner analysis was done by 1) counting the linear and polygonal opacities (index of interstitial fluid accumulation) and 2) calculating the physical mean lung density and the mean slice mass. Results showed a significant reduction in DLCO (44.9 +/- 2.3 vs. 42.9 +/- 1.7 ml.min-1.mmHg-1; P triathlon and an increase in mean lung density (0.21 +/- 0.009 vs. 0.25 +/- 0.01 g/cm3; P long-distance race and showed a concomitant increase in CT lung density and in the number of opacities.

  15. Torsed pulmonary sequestration presenting as a painful chest mass

    International Nuclear Information System (INIS)

    Shah, Ricki; Carver, Terrence W.; Rivard, Douglas C.

    2010-01-01

    Pulmonary sequestration is a congenital abnormality that can be divided into intralobar or extralobar types. Both types are characterized by pulmonary tissue that does not communicate with the bronchial tree or pulmonary arteries and typically has its arterial supply arising from the descending aorta. We report a case of an 11-year-old girl with extralobar sequestration who presented with torsion causing abdominal pain and pleuritic chest pain. (orig.)

  16. Physicochemical properties of direct compression tablets with spray dried and ball milled solid dispersions of tadalafil in PVP-VA.

    Science.gov (United States)

    Wlodarski, K; Tajber, L; Sawicki, W

    2016-12-01

    The aim of this research was to develop immediate release tablets comprising solid dispersion (IRSDTs) of tadalafil (Td) in a vinylpyrrolidone and vinyl acetate block copolymer (PVP-VA), characterized by improved dissolution profiles. The solid dispersion of Td in PVP-VA (Td/PVP-VA) in a weight ratio of 1:1 (w/w) was prepared using two different processes i.e. spray drying and ball milling. While the former process has been well established in the formulation of IRSDTs the latter has not been exploited in these systems yet. Regardless of the preparation method, both Td/PVP-VA solid dispersions were amorphous as confirmed by PXRD, DSC and FTIR. However, different morphology of particles (SEM) resulted in differences in water apparent solubility and disk intrinsic dissolution rate (DIDR). Both solid dispersions and crystalline Td were successfully made into directly compressible tablets at three doses of Td, i.e. 2.5mg, 10mgand20mg, yielding nine different formulations (D 1 -D 9 ). Each of the lots met the requirements set by Ph.Eur. and was evaluated with respect to appearance, diameter, thickness, mass, hardness, friability, disintegration time and content of Td. IRSDTs performed as supersaturable formulations and had significantly improved water dissolution profiles in comparison with equivalent tablets containing crystalline Td and the marketed formulations. Tablets with both spray dried and ball milled Td/PVP-VA revealed the greatest improvement in dissolution depending on the investigated doses, i.e. 2.5mgand20mg, respectively. Also, dissolution of Td from Td/PVP-VA delivered in different forms occurred in the following order: powders>tablets>capsules. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. Evaluation of the angiographic findings in pulmonary atresia

    International Nuclear Information System (INIS)

    Choe, Kyu Ok; Sul, Jun Hee; Lee, Seung Kyu; Cho, Bum Koo; Hong, Pill Whoon

    1986-01-01

    We studied the angiographic findings in 65 patients with congenital pulmonary atresia, ages 4 days to 14 years (mean 3.3 yrs), from 1981 to 1986 at Severance Hospital Yonsei University. 1. 6 had pulmonary atresia with an intact interventricular septum, 38 had it with cardiac anomaly Renodynamically simulating TOF, and 21 associated with more complicated cardiac anomalies. 2. In the group with an intact ventricular septum, 5 showed confluent intrapericardial pulmonary artery, all segmental pulmonary arteries connected to intrapericardial artery. 3. In the group simulating TOF, aorta arose from RV with or without overriding in 35. In 27 patients with confluent intrapericardial pulmonary artery, 23 had more than 10 segmental pulmonary arteries connected to intrapericardial artery and 5 had severely hypoplastic hilar pulmonary arteries. In 11 with non confluent intrapericardial pulmonary artery, 4 had more than 10 segmental pulmonary arteries connected to central pulmonary artery and 9 had severely hypoplastic hilar pulmonary arteries. 4. In the group associated with more complicated cardiac anomaly, included 8 patients with atrioventricular discordance, 7 with univentricular heart and 6 with tricuspid atresia. In 17 patients with confluent intrapericardial artery, 16 had more than 10 segmental pulmonary arteries connected to intrapericardial artery, one showed severe hypoplasia of hilar pulmonary arteries. In another 4 with non confluence, no one showed more than 10 segmental arteries connected to intrapericardial or hilar pulmonary artery.

  18. ORF Sequence: NC_001146 [GENIUS II[Archive

    Lifescience Database Archive (English)

    Full Text Available inal member of the mitochondrial inner membrane electron transport chain; predominantly express...ed during aerobic growth while its isoform Vb (Cox5Bp) is expressed during anaerobic growth; Cox5ap ... NC_001146 gi|6324276 >gi|6324276|ref|NP_014346.1| Subunit Va of cytochrome c oxidase, which is the term

  19. ORF Sequence: NC_001141 [GENIUS II[Archive

    Lifescience Database Archive (English)

    Full Text Available inal member of the mitochondrial inner membrane electron transport chain; predominantly express...ed during anaerobic growth while its isoform Va (Cox5Ap) is expressed during aerobic growth; Cox5bp ... NC_001141 gi|6322080 >gi|6322080|ref|NP_012155.1| Subunit Vb of cytochrome c oxidase, which is the term

  20. Multiple approaches towards decolorization and reuse of a textile dye (VB-B) by a marine bacterium Shewanella decolorationis

    Digital Repository Service at National Institute of Oceanography (India)

    SatheeshBabu, S.; Mohandass, C.; VijayRaj, A.S.; Rajasabapathy, R.; Dhale, M.A.

    stream_size 41279 stream_content_type text/plain stream_name Water_Air_Soil_Pollut_224_1500a.pdf.txt stream_source_info Water_Air_Soil_Pollut_224_1500a.pdf.txt Content-Encoding UTF-8 Content-Type text/plain; charset=UTF-8...     1    Author version: Water Air Soil Pollut., vol.224(4); 2013; 1500 Multiple approaches towards decolorization and reuse of a textile dye (VB-B) by a marine bacterium Shewanella decolorationis S. Satheesh Babu, C.Mohandass*, A.S.Vijay Raj, R...

  1. Job satisfaction and burnout among VA and community mental health workers.

    Science.gov (United States)

    Salyers, Michelle P; Rollins, Angela L; Kelly, Yu-Fan; Lysaker, Paul H; Williams, Jane R

    2013-03-01

    Building on two independent studies, we compared burnout and job satisfaction of 66 VA staff and 86 community mental health center staff in the same city. VA staff reported significantly greater job satisfaction and accomplishment, less emotional exhaustion and lower likelihood of leaving their job. Sources of work satisfaction were similar (primarily working with clients, helping/witnessing change). VA staff reported fewer challenges with job-related aspects (e.g. flexibility, pay) but more challenges with administration. Community mental health administrators and policymakers may need to address job-related concerns (e.g. pay) whereas VA administrators may focus on reducing, and helping workers navigate, administrative policies.

  2. 48 CFR 852.219-9 - VA Small business subcontracting plan minimum requirements.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false VA Small business... Provisions and Clauses 852.219-9 VA Small business subcontracting plan minimum requirements. As prescribed in subpart 819.709, insert the following clause: VA Small Business Subcontracting Plan Minimum Requirements...

  3. Compliance of patients with chronic obstructive pulmonary disease to a pulmonary rehabilitation program

    Directory of Open Access Journals (Sweden)

    Janaina Schafer

    2012-04-01

    Full Text Available Background and Objectives: The lack of adherent and non-adherent to recommended treatment is a very common problem that interferes with the successful care and assistance to people with Chronic Obstructive Pulmonary Disease-COPD. This study compared the profi le of COPD patients that were adherent with non-adherent to a pulmonary rehabilitation program. Methods: was done an exploratory prospective observational study involving 24 patients with COPD Pulmonary Rehabilitation Program, divided into two groups according to full participation of the proposed treatment: Adhesive Group (GA = 18 subjects and non-adherent (GN = 06 subjects. The treatment occurred in 08 weeks, 3 times a week, lasting 1 hour and 30 minutes, assisted by a multidisciplinary team composed by physiotherapist, physical education professional, nutritionist, pharmacist, psychologist and pneumologist. Results: The GA did not differ from GN about the situation sociodemographic, anthropometric, cardiopulmonary exercise capacity and respiratory function. GN had more comorbidities when compared to GA and higher average amount of drugs used. All patients were characterized with reduced quality of life and correlation between cardiac function and quality of life was seen for both groups. Conclusion: Our results show that the advanced stage of disease and worsening of symptoms were determinants for the adherence of patients with COPD in the Pulmonary Rehabilitation Program. KEYWORDS: COPD. Pulmonary Rehabilition. Interdisciplinary Health Team.

  4. Pulmonary MRI at 3T: Non-enhanced pulmonary magnetic resonance Imaging Characterization Quotients for differentiation of infectious and malignant lesions

    Energy Technology Data Exchange (ETDEWEB)

    Nagel, Sebastian Niko, E-mail: sebastian.nagel@charite.de [Klinik und Hochschulambulanz für Radiologie, Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin (Germany); Kim, Damon, E-mail: damon.kim@charite.de [Klinik und Hochschulambulanz für Radiologie, Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin (Germany); Institut für Röntgendiagnostik, HELIOS Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125 Berlin (Germany); Penzkofer, Tobias, E-mail: tobias.penzkofer@charite.de [Klinik und Hochschulambulanz für Radiologie, Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin (Germany); Steffen, Ingo G., E-mail: ingo.steffen@charite.de [Klinik und Hochschulambulanz für Radiologie, Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin (Germany); Wyschkon, Sebastian, E-mail: sebastian.wyschkon@charite.de [Klinik und Hochschulambulanz für Radiologie, Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin (Germany); and others

    2017-04-15

    Objective: To investigate 3T pulmonary magnetic resonance imaging (MRI) for characterization of solid pulmonary lesions in immunocompromised patients and to differentiate infectious from malignant lesions. Materials and methods: Thirty-eight pulmonary lesions in 29 patients were evaluated. Seventeen patients were immunocompromised (11 infections and 6 lymphomas) and 12 served as controls (4 bacterial pneumonias, 8 solid tumors). Ten of the 15 infections were acute. Signal intensities (SI) were measured in the lesion, chest wall muscle, and subcutaneous fat. Scaled SIs as Non-enhanced Imaging Characterization Quotients ((SI{sub Lesion} − SI{sub Muscle})/(SI{sub Fat} − SI{sub Muscle})*100) were calculated from the T2-weighted images using the mean SI (T2-NICQ{sub mean}) or the 90th percentile of SI (T2-NICQ{sub 90th}) of the lesion. Simple quotients were calculated by dividing the SI of the lesion by the SI of chest wall muscle (e.g. T1-Q{sub mean}: SI{sub Lesion}/SI{sub Muscle}). Results: Infectious pulmonary lesions showed a higher T2-NICQ{sub mean} (40.1 [14.6–56.0] vs. 20.9 [2.4–30.1], p < 0.05) and T2-NICQ{sub 90th} (74.3 [43.8–91.6] vs. 38.5 [15.8–48.1], p < 0.01) than malignant lesions. T1-Q{sub mean} was higher in malignant lesions (0.85 [0.68–0.94] vs. 0.93 [0.87–1.09], p < 0.05). Considering infections only, T2-NICQ{sub 90th} was lower when anti-infectious treatment was administered >24 h prior to MRI (81.8 [71.8–97.6] vs. 41.4 [26.6–51.1], p < 0.01). Using Youden’s index (YI), the optimal cutoff to differentiate infectious from malignant lesions was 43.1 for T2-NICQ{sub mean} (YI = 0.42, 0.47 sensitivity, 0.95 specificity) and 55.5 for T2-NICQ{sub 90th} (YI = 0.61, 0.71 sensitivity, 0.91 specificity). Combining T2-NICQ{sub 90th} and T1-Q{sub mean} increased diagnostic performance (YI = 0.72, 0.77 sensitivity, 0.95 specificity). Conclusion: Considering each quotient alone, T2-NICQ{sub 90th} showed the best diagnostic performance and

  5. Identifying Homelessness among Veterans Using VA Administrative Data: Opportunities to Expand Detection Criteria.

    Directory of Open Access Journals (Sweden)

    Rachel Peterson

    Full Text Available Researchers at the U.S. Department of Veterans Affairs (VA have used administrative criteria to identify homelessness among U.S. Veterans. Our objective was to explore the use of these codes in VA health care facilities. We examined VA health records (2002-2012 of Veterans recently separated from the military and identified as homeless using VA conventional identification criteria (ICD-9-CM code V60.0, VA specific codes for homeless services, plus closely allied V60 codes indicating housing instability. Logistic regression analyses examined differences between Veterans who received these codes. Health care services and co-morbidities were analyzed in the 90 days post-identification of homelessness. VA conventional criteria identified 21,021 homeless Veterans from Operations Enduring Freedom, Iraqi Freedom, and New Dawn (rate 2.5%. Adding allied V60 codes increased that to 31,260 (rate 3.3%. While certain demographic differences were noted, Veterans identified as homeless using conventional or allied codes were similar with regards to utilization of homeless, mental health, and substance abuse services, as well as co-morbidities. Differences were noted in the pattern of usage of homelessness-related diagnostic codes in VA facilities nation-wide. Creating an official VA case definition for homelessness, which would include additional ICD-9-CM and other administrative codes for VA homeless services, would likely allow improved identification of homeless and at-risk Veterans. This also presents an opportunity for encouraging uniformity in applying these codes in VA facilities nationwide as well as in other large health care organizations.

  6. Identifying Homelessness among Veterans Using VA Administrative Data: Opportunities to Expand Detection Criteria

    Science.gov (United States)

    Peterson, Rachel; Gundlapalli, Adi V.; Metraux, Stephen; Carter, Marjorie E.; Palmer, Miland; Redd, Andrew; Samore, Matthew H.; Fargo, Jamison D.

    2015-01-01

    Researchers at the U.S. Department of Veterans Affairs (VA) have used administrative criteria to identify homelessness among U.S. Veterans. Our objective was to explore the use of these codes in VA health care facilities. We examined VA health records (2002-2012) of Veterans recently separated from the military and identified as homeless using VA conventional identification criteria (ICD-9-CM code V60.0, VA specific codes for homeless services), plus closely allied V60 codes indicating housing instability. Logistic regression analyses examined differences between Veterans who received these codes. Health care services and co-morbidities were analyzed in the 90 days post-identification of homelessness. VA conventional criteria identified 21,021 homeless Veterans from Operations Enduring Freedom, Iraqi Freedom, and New Dawn (rate 2.5%). Adding allied V60 codes increased that to 31,260 (rate 3.3%). While certain demographic differences were noted, Veterans identified as homeless using conventional or allied codes were similar with regards to utilization of homeless, mental health, and substance abuse services, as well as co-morbidities. Differences were noted in the pattern of usage of homelessness-related diagnostic codes in VA facilities nation-wide. Creating an official VA case definition for homelessness, which would include additional ICD-9-CM and other administrative codes for VA homeless services, would likely allow improved identification of homeless and at-risk Veterans. This also presents an opportunity for encouraging uniformity in applying these codes in VA facilities nationwide as well as in other large health care organizations. PMID:26172386

  7. A Role for Myosin Va in Human Cytomegalovirus Nuclear Egress.

    Science.gov (United States)

    Wilkie, Adrian R; Sharma, Mayuri; Pesola, Jean M; Ericsson, Maria; Fernandez, Rosio; Coen, Donald M

    2018-03-15

    Herpesviruses replicate and package their genomes into capsids in replication compartments within the nuclear interior. Capsids then move to the inner nuclear membrane for envelopment and release into the cytoplasm in a process called nuclear egress. We previously found that nuclear F-actin is induced upon infection with the betaherpesvirus human cytomegalovirus (HCMV) and is important for nuclear egress and capsid localization away from replication compartment-like inclusions toward the nuclear rim. Despite these and related findings, it has not been shown that any specific motor protein is involved in herpesvirus nuclear egress. In this study, we have investigated whether the host motor protein, myosin Va, could be fulfilling this role. Using immunofluorescence microscopy and coimmunoprecipitation, we observed associations between a nuclear population of myosin Va and the viral major capsid protein, with both concentrating at the periphery of replication compartments. Immunoelectron microscopy showed that nearly 40% of assembled nuclear capsids associate with myosin Va. We also found that myosin Va and major capsid protein colocalize with nuclear F-actin. Importantly, antagonism of myosin Va with RNA interference or a dominant negative mutant revealed that myosin Va is important for the efficient production of infectious virus, capsid accumulation in the cytoplasm, and capsid localization away from replication compartment-like inclusions toward the nuclear rim. Our results lead us to suggest a working model whereby human cytomegalovirus capsids associate with myosin Va for movement from replication compartments to the nuclear periphery during nuclear egress. IMPORTANCE Little is known regarding how newly assembled and packaged herpesvirus capsids move from the nuclear interior to the periphery during nuclear egress. While it has been proposed that an actomyosin-based mechanism facilitates intranuclear movement of alphaherpesvirus capsids, a functional role for

  8. An epidemiological study of paediatric pulmonary hypertension in Turkey.

    Science.gov (United States)

    Pektas, Ayhan; Pektas, Bilgehan M; Kula, Serdar

    2016-04-01

    The present study aims to evaluate the epidemiological characteristics of paediatric pulmonary hypertension within the entire Turkish population over a period of 5 years using the registry of the National Health Insurance System. All individuals aged pulmonary hypertension and secondary pulmonary hypertension were identified. The overall annual incidence of idiopathic pulmonary hypertension during childhood was 11.7 cases/million, whereas the overall annual incidence of secondary pulmonary hypertension during childhood was 9.5 cases/million. There was a gradual and significant increase in the annual incidence of idiopathic pulmonary hypertension and that of secondary pulmonary hypertension during the 5-year study period (p=0.001 for both). In the years 2012 and 2013, idiopathic pulmonary hypertension was significantly more frequent in children aged pulmonary hypertension, whereas the female to male ratio was 1.1:1 for secondary pulmonary hypertension during childhood. The incidence of paediatric pulmonary hypertension in Turkey is higher than those reported for the Western populations. Moreover, no female dominance could be observed. These discrepancies may be attributed to the differences in the study design, study cohort, timing of the study, and the definitions adopted for pulmonary hypertension classification.

  9. An academic-VA partnership: Student interprofessional teams integrated with VA PACT teams.

    Science.gov (United States)

    Swenty, Constance L; Schaar, Gina L; Butler, Ryan M

    2016-12-01

    Veterans are challenged with multiple unique healthcare issues related to their military service environment. Likewise, health care providers must understand the special concerns associated with military conflict and recognize how the veteran's care can be optimized by interprofessional care delivery. Little is taught didactically or clinically that supports nursing students in addressing the unique issues of the veteran or the student's need to work collaboratively with allied health team members to enhance the veteran's care. Because of limited exposure to the veteran's special conditions, nursing students who may seek a career with the veteran population often face challenges in rendering appropriate care. The VA offers an invaluable opportunity for health profession students to collaborate with VA interprofessional Patient Aligned Care Teams (PACT) ultimately optimizing veteran health outcomes. This academic partnership, that implements an interprofessional model, will prepare students to better embrace the veteran population. This article describes the immersion of health profession students in interprofessional collaborative practice (IPCP) using PACT team principles which ultimately promotes the students' ability to link theory content to patient care delivery. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Kollidon VA64, a membrane-resealing agent, reduces histopathology and improves functional outcome after controlled cortical impact in mice.

    Science.gov (United States)

    Mbye, Lamin H; Keles, Eyup; Tao, Luyang; Zhang, Jimmy; Chung, Joonyong; Larvie, Mykol; Koppula, Rajani; Lo, Eng H; Whalen, Michael J

    2012-03-01

    Loss of plasma membrane integrity is a feature of acute cellular injury/death in vitro and in vivo. Plasmalemma-resealing agents are protective in acute central nervous system injury models, but their ability to reseal cell membranes in vivo has not been reported. Using a mouse controlled cortical impact (CCI) model, we found that propidium iodide-positive (PI+) cells pulse labeled at 6, 24, or 48 hours maintained a degenerative phenotype and disappeared from the injured brain by 7 days, suggesting that plasmalemma permeability is a biomarker of fatal cellular injury after CCI. Intravenous or intracerebroventricular administration of Kollidon VA64, poloxamer P188, or polyethylene glycol 8000 resealed injured cell membranes in vivo (P<0.05 versus vehicle or poloxamer P407). Kollidon VA64 (1 mmol/L, 500 μL) administered intravenously to mice 1  hour after CCI significantly reduced acute cellular degeneration, chronic brain tissue damage, brain edema, blood-brain barrier damage, and postinjury motor deficits (all P<0.05 versus vehicle). However, VA64 did not rescue pulse-labeled PI+ cells from eventual demise. We conclude that PI permeability within 48 hours of CCI is a biomarker of eventual cell death/loss. Kollidon VA64 reduces secondary damage after CCI by mechanisms other than or in addition to resealing permeable cells.

  11. OneVA EA Vision and Strategy

    Data.gov (United States)

    Department of Veterans Affairs — The outcomes/goals supported by effective use of an EA are: Improved Service Delivery, Functional Integration, Resource Optimization and Authoritative Reference. VA...

  12. A correlative study of CT findings and pulmonary function in patients with pulmonary involvement during the active phase of rheumatoid arthritis

    International Nuclear Information System (INIS)

    Zhu Xiaolei; Xu Defu

    2006-01-01

    Objective: It is a correlative study of CT findings and pulmonary function in patients with pulmonary involvement during the active phase of rheumatoid arthritis. Methods: The CT images of 28 cases of pulmonary involvement during the active phase of rheumatoid arthritis were retrospectively analyzed. The pulmonary abnormalities revealed on CT images including distribution and extend of the lesions were quantitatively analyzed and scored. The correlation of CT scores with the results of pulmonary function tests was compared statistically. Results: Interlobular septa thickening was shown in 16 cases; ground-glass opacification was revealed in 14 cases; irregular lines were found in 11 cases; bronchiolectasis was noted in 7 cases; micro nodules were demonstrated in 4 cases; and honey combing alteration was visualized in 3 cases. The abnormality most frequent seen on CT images was reticular shadow and ground-glass opacification. CT visual score had a negative correlation with pulmonary function. Conclusion: CT visual score provides quantitative evaluation of the pulmonary involvement during the active phase of rheumatoid arthritis, and also indicates the pulmonary function and prognosis as well. (authors)

  13. [Pulmonary infections in patients with rheumatoid arthritis].

    Science.gov (United States)

    Takayanagi, Noboru; Tsuchiya, Yutaka; Tokunaga, Daidou; Miyahara, Yousuke; Yamaguchi, Shouzaburo; Saito, Hiroo; Ubukata, Mikio; Kurashima, Kazuyoshi; Yanagisawa, Tsutomu; Sugita, Yutaka

    2007-06-01

    We studied 149 rheumatoid arthritis (RA) patients (mean age 68.0 years; 68 men, 81 women) with pulmonary infections. The mean age at the onset of RA and the duration of RA was 57.2 +/- 15.2 years and 10.9 +/- 11.5 years, respectively. Pulmonary infections included nontuberculous mycobacteriosis in 59 patients (Mycobacterium avium complex infection, 50 cases : Mycobacterium kansasii infection, 4 cases; others, 5 cases), pneumonia in 46 patients, pulmonary tuberculosis in 28 patients, pulmonary aspergillosis in 12 patients, pulmonary cryptococcosis in 5 patients, Pneumocystis jiroveci pneumonia in 5 patients, lung abscess in 9 patients, exacerbation of bronchiectasis in 7 patients, and empyema in 4 patients. One hundred percent of patients with exacerbation of bronchiectasis, 91.7% of patients with pulmonary aspergillosis, 87% of patients with pneumonia, and 81.4% of patients with nontuberculous mycobacteriosis had underlying lung diseases. The pulmonary infections during therapy with steroids were pulmonary tuberculosis (78.6%), pneumonia (65.2%), and pulmonary aspergillosis (58.3%), while the pulmonary infections during methotrexate treatment were Pneumocystis jiroveci pneumonia (80%), pulmonary cryptococcosis (40%), and pulmonary tuberculosis (28.6%). Pulmonary infections in RA patients who were taking TNFalpha inhibitors included 1 patient each with nontuberculous mycobacteriosis, pneumonia, pulmonary tuberculosis, and Pneumocystis jiroveci pneumonia. Among the RA patients with lung abscess, malignancy was noted in 55.6%, and diabetes mellitus in 22.2%. Pseudomonas aeruginosa was the second-most-common cause of pneumonia and cause of all exacerbations of bronchiectasis. As well as immunosuppressive medications (steroids, methotrexate, TNFalpha inhibitors) and systemic comorbid diseases, underlying lung diseases could be one of the risk factor for pulmonary infections in patients with RA. The dominant risk factor for each pulmonary infection in patients with RA

  14. Flexural Stiffness of Myosin Va Subdomains as Measured from Tethered Particle Motion

    Science.gov (United States)

    Michalek, Arthur J.; Kennedy, Guy G.; Warshaw, David M.; Ali, M. Yusuf

    2015-01-01

    Myosin Va (MyoVa) is a processive molecular motor involved in intracellular cargo transport on the actin cytoskeleton. The motor's processivity and ability to navigate actin intersections are believed to be governed by the stiffness of various parts of the motor's structure. Specifically, changes in calcium may regulate motor processivity by altering the motor's lever arm stiffness and thus its interhead communication. In order to measure the flexural stiffness of MyoVa subdomains, we use tethered particle microscopy, which relates the Brownian motion of fluorescent quantum dots, which are attached to various single- and double-headed MyoVa constructs bound to actin in rigor, to the motor's flexural stiffness. Based on these measurements, the MyoVa lever arm and coiled-coil rod domain have comparable flexural stiffness (0.034 pN/nm). Upon addition of calcium, the lever arm stiffness is reduced 40% as a result of calmodulins potentially dissociating from the lever arm. In addition, the flexural stiffness of the full-length MyoVa construct is an order of magnitude less stiff than both a single lever arm and the coiled-coil rod. This suggests that the MyoVa lever arm-rod junction provides a flexible hinge that would allow the motor to maneuver cargo through the complex intracellular actin network. PMID:26770194

  15. VaRank: a simple and powerful tool for ranking genetic variants

    Directory of Open Access Journals (Sweden)

    Véronique Geoffroy

    2015-03-01

    Full Text Available Background. Most genetic disorders are caused by single nucleotide variations (SNVs or small insertion/deletions (indels. High throughput sequencing has broadened the catalogue of human variation, including common polymorphisms, rare variations or disease causing mutations. However, identifying one variation among hundreds or thousands of others is still a complex task for biologists, geneticists and clinicians.Results. We have developed VaRank, a command-line tool for the ranking of genetic variants detected by high-throughput sequencing. VaRank scores and prioritizes variants annotated either by Alamut Batch or SnpEff. A barcode allows users to quickly view the presence/absence of variants (with homozygote/heterozygote status in analyzed samples. VaRank supports the commonly used VCF input format for variants analysis thus allowing it to be easily integrated into NGS bioinformatics analysis pipelines. VaRank has been successfully applied to disease-gene identification as well as to molecular diagnostics setup for several hundred patients.Conclusions. VaRank is implemented in Tcl/Tk, a scripting language which is platform-independent but has been tested only on Unix environment. The source code is available under the GNU GPL, and together with sample data and detailed documentation can be downloaded from http://www.lbgi.fr/VaRank/.

  16. Home Health Care and Patterns of Subsequent VA and Medicare Health Care Utilization for Veterans

    Science.gov (United States)

    Van Houtven, Courtney Harold; Jeffreys, Amy S.; Coffman, Cynthia J.

    2008-01-01

    Purpose: The Veterans Affairs or VA health care system is in the process of significantly expanding home health care (HOC) nationwide. We describe VA HHC use in 2003 for all VA HHC users from 2002; we examine whether VA utilization across a broad spectrum of services differed for a sample of VA HHC users and their propensity-score-matched…

  17. ECG Markers of Hemodynamic Improvement in Patients with Pulmonary Hypertension

    Directory of Open Access Journals (Sweden)

    Marcin Waligóra

    2018-01-01

    Full Text Available Introduction. Several diagnostic tests have been recommended for risk assessment in pulmonary hypertension (PH, but the role of electrocardiography (ECG in monitoring of PH patients has not been yet established. Therefore the aim of the study was to evaluate which ECG patterns characteristic for pulmonary hypertension can predict hemodynamic improvement in patients treated with targeted therapies. Methods. Consecutive patients with pulmonary arterial hypertension (PAH or chronic thromboembolic pulmonary hypertension (CTEPH were eligible to be included if they had had performed two consecutive right heart catheterization (RHC procedures before and after starting of targeted therapies. Patients were followed up from June 2009 to July 2017. ECG patterns of right ventricular hypertrophy according to American College of Cardiology Foundation were assessed. Results. We enrolled 80 patients with PAH and 11 patients with inoperable CTEPH. The follow-up RHC was performed within 12.6±10.0 months after starting therapy. Based on median change of pulmonary vascular resistance, we divided our patients into two subgroups: with and without significant hemodynamic improvement. RV1, max⁡RV1,2 + max⁡SI,aVL-SV1, and PII improved along with the improvement of hemodynamic parameters including PVR. They predicted hemodynamic improvement with similarly good accuracy as shown in ROC analysis: RV1 (AUC: 0.75; 95% CI: 0.63–0.84, PII (AUC: 0.67, 95% CI: 0.56–0.77, and max⁡RV1,2+max⁡SI,aVL-SV1 (0.73; 95% CI: 0.63–0.82. In Cox regression only change in RV1 remained significant mortality predictor (HR: 1.12, 95% CI: 1.01–1.24. Conclusion. Electrocardiogram may be useful in predicting hemodynamic effects of targeted therapy in precapillary pulmonary hypertension. Decrease of RV1, max⁡RV1,2+max⁡SI,aVL-SV1, and PII corresponds with hemodynamic improvement after treatment. Of these changes a decrease of R wave amplitude in V1 is associated with better

  18. Identification of a region of frequent loss of heterozygosity at 11q24 in colorectal cancer.

    Science.gov (United States)

    Connolly, K C; Gabra, H; Millwater, C J; Taylor, K J; Rabiasz, G J; Watson, J E; Smyth, J F; Wyllie, A H; Jodrell, D I

    1999-06-15

    Loss of heterozygosity (LOH) at 11q23-qter occurs frequently in ovarian and other cancers, but for colorectal cancer, the evidence is conflicting. Seven polymorphic loci were analyzed between D11S897 and D11S969 in 50 colorectal tumors. Two distinct LOH regions were detected, suggesting possible sites for tumor-suppressor genes involved in colorectal neoplasia: a large centromeric region between D11S897 and D11S925, and a telomeric 4.9-Mb region between D11S912 and D11S969. There was no correlation with clinicopathological features. This analysis describes a region of LOH in the region 11q23.3-24.3 for the first time in colorectal cancer and provides complementary evidence for the ongoing effort to identify the gene(s) involved.

  19. Pulmonary Infection In Renal Transplant Recipients

    Directory of Open Access Journals (Sweden)

    Rassulineiad M

    2003-11-01

    Full Text Available Renal transplantation is ideal treatment of chronic renal failure. Pulmonary infection is a common and serious post transplant infection requiring hospitalization and is associated with high mortality. Increased susceptibility to infection is due to a decrease in the patients' immunological response caused by immunosuppression through drug administration, and by other influences."nMaterials and Methods: This study was case series and prospective, from July 2001 to July 2002 in Imam Khomeini hospital of Tehran."nResults: 164 renal transplant recipients were studied, 14 patients (8.5% had pulmonary infection, 11 of them (78.6% were female and 3 (21.4% were male. The mean age of them was 42.6 years. The patients were followed up for 9 to 12 months. All patients were on triple immunosuppressive regimens. The interval between transplantation and the appearance of pneumonia was 2 months to 10 years. The time of beginning infection in 3 cases (21.4% was between 1 to 6 months post transplantation, 11 cases (78.6% were occurred beyond 6 months after transplantation. In 7 cases (50%, pulmonary infection was occurred during first year after transplantation. None of the 14 patients developed pulmonary infection in first month after transplantation. BAL were used in 6 cases (42.8% of pulmonary infection, and organism were detected in 5 of them (83.3%. The most common clinical feature was fever. Six cases were due to mycobacterium tuberculosis (42.9%, this organism was the most common ethiology of pneumonia. In this study tuberculosis was seen in 3.6% of renal transplant recipients. One patient had pulmonary mucormycosis. All patients with pulmonary TB were cured, and other cases with unknown case, were cured with empirical treatment."nConclusion: Our finding indicate the invasive diagnostic procedures are required in order to earlier and reliable diagnosis and then better outcome of transplantation."n"n"n"n"n"n"n 

  20. Comparison of historically simulated VaR: Evidence from oil prices

    International Nuclear Information System (INIS)

    Costello, Alexandra; Asem, Ebenezer; Gardner, Eldon

    2008-01-01

    Cabedo and Moya [Cabedo, J.D., Moya, I., 2003. Estimating oil price 'Value at Risk' using the historical simulation approach. Energy Economics 25, 239-253] find that ARMA with historical simulation delivers VaR forecasts that are superior to those from GARCH. We compare the ARMA with historical simulation to the semi-parametric GARCH model proposed by Barone-Adesi et al. [Barone-Adesi, G., Giannopoulos, K., Vosper, L., 1999. VaR without correlations for portfolios of derivative securities. Journal of Futures Markets 19 (5), 583-602]. The results suggest that the semi-parametric GARCH model generates VaR forecasts that are superior to the VaR forecasts from the ARMA with historical simulation. This is due to the fact that GARCH captures volatility clustering. Our findings suggest that Cabedo and Moya's conclusion is mainly driven by the normal distributional assumption imposed on the future risk structure in the GARCH model. (author)

  1. Treatment Effect of Balloon Pulmonary Angioplasty in Chronic Thromboembolic Pulmonary Hypertension Quantified by Automatic Comparative Imaging in Computed Tomography Pulmonary Angiography.

    Science.gov (United States)

    Zhai, Zhiwei; Ota, Hideki; Staring, Marius; Stolk, Jan; Sugimura, Koichiro; Takase, Kei; Stoel, Berend C

    2018-05-01

    Balloon pulmonary angioplasty (BPA) in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) can have variable outcomes. To gain more insight into this variation, we designed a method for visualizing and quantifying changes in pulmonary perfusion by automatically comparing computed tomography (CT) pulmonary angiography before and after BPA treatment. We validated these quantifications of perfusion changes against hemodynamic changes measured with right-sided heart catheterization. We studied 14 consecutive CTEPH patients (12 women; age, 70.5 ± 24), who underwent CT pulmonary angiography and right-sided heart catheterization, before and after BPA. Posttreatment images were registered to pretreatment CT scans (using the Elastix toolbox) to obtain corresponding locations. Pulmonary vascular trees and their centerlines were detected using a graph cuts method and a distance transform method, respectively. Areas distal from vessels were defined as pulmonary parenchyma. Subsequently, the density changes within the vascular centerlines and parenchymal areas were calculated and corrected for inspiration level differences. For visualization, the densitometric changes were displayed in color-coded overlays. For quantification, the median and interquartile range of the density changes in the vascular and parenchymal areas (ΔVD and ΔPD) were calculated. The recorded changes in hemodynamic parameters, including changes in systolic, diastolic, and mean pulmonary artery pressure (ΔsPAP, ΔdPAP, and ΔmPAP, respectively) and vascular resistance (ΔPVR), were used as reference assessments of the treatment effect. Spearman correlation coefficients were employed to investigate the correlations between changes in perfusion and hemodynamic changes. Comparative imaging maps showed distinct patterns in perfusion changes among patients. Within pulmonary vessels, the interquartile range of ΔVD correlated significantly with ΔsPAP (R = -0.58, P = 0.03),

  2. 48 CFR 803.7000 - Display of the VA Hotline poster.

    Science.gov (United States)

    2010-10-01

    ... poster. 803.7000 Section 803.7000 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS... Improper Business Practices 803.7000 Display of the VA Hotline poster. (a) Under the circumstances described in paragraph (b) of this section, a contractor must display prominently a VA Hotline poster...

  3. Kohn Anomaly and Phase Stability in Group VB Transition Metals

    Directory of Open Access Journals (Sweden)

    Alexander Landa

    2018-03-01

    Full Text Available In the periodic table, only a few pure metals exhibit lattice or magnetic instabilities associated with Fermi surface nesting, the classical examples being α-U and Cr. Whereas α-U displays a strong Kohn anomaly in the phonon spectrum that ultimately leads to the formation of charge density waves (CDWs, Cr is known for its nesting-induced spin density waves (SDWs. Recently, it has become clear that a pronounced Kohn anomaly and the corresponding softening in the elastic constants is also the key factor that controls structural transformations and mechanical properties in compressed group VB metals—materials with relatively high superconducting critical temperatures. This article reviews the current understanding of the structural and mechanical behavior of these metals under pressure with an introduction to the concept of the Kohn anomaly and how it is related to the important concept of Peierls instability. We review both experimental and theoretical results showing different manifestations of the Kohn anomaly in the transverse acoustic phonon mode TA (ξ00 in V, Nb, and Ta. Specifically, in V the anomaly triggers a structural transition to a rhombohedral phase, whereas in Nb and Ta it leads to an anomalous reduction in yield strength.

  4. 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.

  5. A comparative study of pulmonary hypoperfusion secondary to cancerous invasion of central pulmonary artery in lung cancer with CT and DSA

    International Nuclear Information System (INIS)

    Guo Dajing; Miao Jingtao; Lu Wusheng; Bai Hongli

    2003-01-01

    Objective: To study CT features of pulmonary hypoperfusion in lung cancer with cancerous invasion of central pulmonary artery (CICPA) and the diagnostic value of CT. Methods: The pre-operative pulmonary DSA and contrast-enhanced spiral CT (including HRCT) findings in 20 cases of lung cancer with CICPA were carried out prospectively and comparatively. On DSA and CT, the distribution and quantitative variation of subpleural terminal pulmonary arterioles (pulmonary vessel signs), the filling degree of lung capillary, the post-contrast density changes of lung parenchyma, and the fluctuations of the time-density curve (pulmonary parenchymal signs) were blindly observed. The CT and DSA findings and their consistence were analyzed statistically. The diagnostic values of CT in secondary pulmonary hypoperfusion in lung cancer with CICPA were evaluated. Results: There were 30 lobar arteries with cancerous invasion among the 20 cases and 90% (27/30) of them presented pulmonary hypoperfusion on DSA. For diagnosing pulmonary hypoperfusion, CT had a sensitivity of 78%(21/27), a specificity of 100% (3/3), and an accuracy of 80%(24/30). There were no statistical correlation between pulmonary hypoperfusion and the degree of central pulmonary artery (CPA) stenosis (r s =0.40, P=0.073). Pulmonary vessel signs on CT had a good consistence with that on DSA (Kappa=0.69, P<0.001), while that of pulmonary parenchymal signs was lower (Kappa=0.37, P=0.011). Conclusion: Pulmonary hypoperfusion is one of the common findings in lung cancer with CICPA. CT is of great value in qualitative diagnosis on it, while for quantitative diagnosis, its value is limited to a certain degree

  6. Computed tomography characteristics of primary pulmonary lymphoepithelioma-like carcinoma in 41 patients

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Huali; Wu, Yaopan [Department of Radiology, State Key Laboratory of Oncology in South China/Sun Yat-sen University Cancer Center, Guangzhou, Guangdong (China); Lin, Yongbin [Department of Thoracic Surgery, State Key Laboratory of Oncology in South China/Sun Yat-sen University Cancer Center, Guangzhou, Guangdong (China); Cai, Qingqing [Department of Medical Oncology, State Key Laboratory of Oncology in South China/Sun Yat-sen University Cancer Center, Guangzhou, Guangdong (China); Ma, Guowei [Department of Thoracic Surgery, State Key Laboratory of Oncology in South China/Sun Yat-sen University Cancer Center, Guangzhou, Guangdong (China); Liang, Ying, E-mail: liangying@sysucc.org.cn [Department of Medical Oncology, State Key Laboratory of Oncology in South China/Sun Yat-sen University Cancer Center, Guangzhou, Guangdong (China)

    2013-08-15

    Purpose: To assess the computed tomography (CT) findings of primary pulmonary lymphoepithelioma-like carcinoma (LELC). Materials and methods: Clinical information and CT findings of 41 patients with pulmonary LELC were reviewed. CT images of 2 or 5 mm thickness were obtained with a pre-treatment CT and were jointly evaluated by two radiologists. Results: Thirty central tumors and 11 peripheral tumors with diameters ranging from 1.0 to 8.7 cm (mean, 4.1 ± 1.9 cm) were identified. Central tumors appeared to be larger than peripheral tumors (P = 0.017). Tumors occurred more frequently in right middle lobe (31.7%) and left lower lobe (29.3%). CT findings of patients with early stage were similar to those observed in patients with advanced stage except that lymphadenopathy was significantly more common in patients with advanced stage. CT findings of pulmonary LELC consisted of well defined border (63.4%), lobulation (78.0%), vascular or bronchial encasement (43.9%), obstructive pneumonia (41.5%), pleural effusion (12.2%) and calcification (4.9%). On contrast-enhanced CT scans, inhomogeneously enhanced tumors were significantly larger than homogeneously enhanced tumors (P < 0.001). Lymphadenopathy was seen in 28 patients, and lymph nodes with homogeneous enhancement were observed in 24/28 patients. Enlarged lymph nodes were more frequently occurred in peribronchial or hilar nodes (53.7%), subcrinal nodes (39.0%), right lower paratracheal nodes (31.7%) and right upper paratracheal nodes (22.0%). Conclusion: Pulmonary LELC usually appeared as a large, central, well defined and lobulated tumor with vascular or bronchial encasement and obstructive pneumonia. Calcification was rare in pulmonary LELC. Lymphadenopathy was common, usually with homogeneous enhancement.

  7. Supplementation with nanomolar concentrations of verbascoside during in vitro maturation improves embryo development by protecting the oocyte against oxidative stress: a large animal model study.

    Science.gov (United States)

    Martino, Nicola Antonio; Ariu, Federica; Bebbere, Daniela; Uranio, Manuel Filioli; Chirico, Adriana; Marzano, Giuseppina; Sardanelli, Anna Maria; Cardinali, Angela; Minervini, Fiorenza; Bogliolo, Luisa; Dell'Aquila, Maria Elena

    2016-10-01

    The effects of verbascoside (VB), added at nanomolar concentrations during in vitro maturation (IVM) of juvenile sheep oocytes, on in vitro embryo development and its mechanisms of action at the oocyte level were analyzed. Developmental rates, after IVM in the presence/absence of VB (1nM for 24h; 1nM for 2h; 10nM for 2h), were evaluated. The bioenergetic/oxidative status of oocytes matured after IVM in the presence/absence of 1nM VB for 24h was assessed by confocal analysis of mitochondria and reactive oxygen species (ROS), lipid peroxidation (LPO) assay, and quantitative PCR of bioenergy/redox-related genes. The addition of 1nM VB during 24h IVM significantly increased blastocyst formation and quality. Verbascoside reduced oocyte ROS and LPO and increased mitochondria/ROS colocalization while keeping mitochondria activity and gene expression unchanged. In conclusion, supplementation with nanomolar concentrations of VB during IVM, in the juvenile sheep model, promotes embryo development by protecting the oocyte against oxidative stress. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Bilateral multiple pulmonary artery aneurysms associated with cavitary pulmonary tuberculosis: a case report.

    Science.gov (United States)

    Pallangyo, Pedro; Lyimo, Frederick; Bhalia, Smita; Makungu, Hilda; Nyangasa, Bashir; Lwakatare, Flora; Suranyi, Pal; Janabi, Mohamed

    2017-07-19

    Pulmonary artery aneurysms constitute 50%) of cases, however, pulmonary artery aneurysm is a rare sequelae of pulmonary tuberculosis reported in about 5% of patients with chronic cavitary tuberculosis on autopsy. The natural history of this potentially fatal condition remains poorly understood and guidelines for optimal management are controversial. A 24-year-old man, a nursing student of African descent, was referred to us from an up-country regional hospital with a 4-week history of recurrent episodes of breathlessness, awareness of heartbeats and coughing blood 3 weeks after completing a 6-month course of anti-tuberculosis drugs. A physical examination revealed conjuctival and palmar pallor but there were no stigmata of connective tissue disorders, systemic vasculitides or congenital heart disease. An examination of the cardiovascular system revealed accentuated second heart sound (S 2 ) with early diastolic (grade 1/6) and holosystolic (grade 2/6) murmurs at the pulmonic and tricuspid areas respectively. Blood tests showed iron deficiency anemia, prolonged bleeding time, and mild hyponatremia. A chest radiograph revealed bilateral ovoid-shaped perihilar opacities while a computed tomography scan showed bilateral multiple pulmonary artery pseudoaneurysms with surrounding hematoma together with adjacent cystic changes, consolidations, and tree-in-bud appearance. Our patient refused to undergo surgery and died of aneurismal rupture after 9 days of hospitalization. The presence of intractable hemoptysis among patients with tuberculosis even after completion of anti-tuberculosis course should raise an index of suspicion for pulmonary artery aneurysm. Furthermore, despite of its rarity, early recognition and timely surgical intervention of pulmonary artery aneurysm is crucial to reducing morbidity and preventing the attributed mortality.

  9. ESTIMATING RISK ON THE CAPITAL MARKET WITH VaR METHOD

    Directory of Open Access Journals (Sweden)

    Sinisa Bogdan

    2015-06-01

    Full Text Available The two basic questions that every investor tries to answer before investment are questions about predicting return and risk. Risk and return are generally considered two positively correlated sizes, during the growth of risk it is expected increase of return to compensate the higher risk. The quantification of risk in the capital market represents the current topic since occurrence of securities. Together with estimated future returns it represents starting point of any investment. In this study it is described the history of the emergence of VaR methods, usefulness in assessing the risks of financial assets. Three main Value at Risk (VaR methodologies are decribed and explained in detail: historical method, parametric method and Monte Carlo method. After the theoretical review of VaR methods it is estimated risk of liquid stocks and portfolio from the Croatian capital market with historical and parametric VaR method, after which the results were compared and explained.

  10. Comparison of historically simulated VaR: Evidence from oil prices

    Energy Technology Data Exchange (ETDEWEB)

    Costello, Alexandra [Seminole Canada Energy, Calgary, AB (Canada); Asem, Ebenezer; Gardner, Eldon [Faculty of Management, University of Lethbridge, Lethbridge, AB (Canada)

    2008-09-15

    Cabedo and Moya [Cabedo, J.D., Moya, I., 2003. Estimating oil price 'Value at Risk' using the historical simulation approach. Energy Economics 25, 239-253] find that ARMA with historical simulation delivers VaR forecasts that are superior to those from GARCH. We compare the ARMA with historical simulation to the semi-parametric GARCH model proposed by Barone-Adesi et al. [Barone-Adesi, G., Giannopoulos, K., Vosper, L., 1999. VaR without correlations for portfolios of derivative securities. Journal of Futures Markets 19 (5), 583-602]. The results suggest that the semi-parametric GARCH model generates VaR forecasts that are superior to the VaR forecasts from the ARMA with historical simulation. This is due to the fact that GARCH captures volatility clustering. Our findings suggest that Cabedo and Moya's conclusion is mainly driven by the normal distributional assumption imposed on the future risk structure in the GARCH model. (author)

  11. Transcatheter Arterial Embolization With Spherical Embolic Agent for Pulmonary Metastases From Renal Cell Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Seki, Akihiko, E-mail: sekia@igtc.jp; Hori, Shinichi, E-mail: horishin@igtc.jp; Sueyoshi, Satoru, E-mail: sueyoshis@igtc.jp; Hori, Atsushi, E-mail: horiat@igtc.jp; Kono, Michihiko, E-mail: konom@igtc.jp; Murata, Shinichi, E-mail: muratas@igtc.jp; Maeda, Masahiko, E-mail: maedam@igtc.jp [Gate Tower Institute for Image Guided Therapy, Department of Radiology (Japan)

    2013-12-15

    Purpose: This retrospective study aimed to evaluate the safety and local efficacy of transcatheter arterial embolization (TAE) with superabsorbent polymer microspheres (SAP-MS) in patients with pulmonary metastases from renal cell carcinoma (RCC). Methods: Sixteen patients with unresectable pulmonary metastases from RCC refractory to standard therapy were enrolled to undergo TAE with the purpose of mass reduction and/or palliation. The prepared SAP-MS swell to approximately two times larger than their dry-state size (100-150 {mu}m [n = 14], 50-100 {mu}m [n = 2]). Forty-nine pulmonary nodules (lung n = 22, mediastinal lymph node n = 17, and hilar lymph node n = 10) were selected as target lesions for evaluation. Local tumor response was evaluated 3 months after TAE according to Response Evaluation Criteria in Solid Tumors (RECIST; version 1.1). The relationship between tumor enhancement ratio by CT during selective angiography and local tumor response was evaluated. Results: The number of TAE sessions per patient ranged from 1 to 5 (median 2.9). Embolized arteries at initial TAE were bronchial arteries in 14 patients (87.5 %) and nonbronchial systemic arteries in 11 patients (68.8 %). Nodule-based evaluation showed that 5 (10.2 %) nodules had complete response, 17 (34.7 %) had partial response, 15 (30.6 %) had stable disease, and 12 (24.5 %) had progressive disease. The response rate was significantly greater in 22 lesions that had a high tumor enhancement ratio than in 27 lesions that had a slight or moderate ratio (90.9 vs. 7.4 %, p = 0.01). Severe TAE-related adverse events did not occur. Conclusion: TAE with SAP-MS might be a well-tolerated and locally efficacious palliative option for patients with pulmonary metastases from RCC.

  12. VA Veterans Health Administration Access Data

    Data.gov (United States)

    Department of Veterans Affairs — At the Department of Veterans Affairs (VA), our most important mission is to provide the high quality health care and benefits Veterans have earned and deserve —...

  13. Evaluation of chronic pulmonary emphysema ultrafast computed tomography

    International Nuclear Information System (INIS)

    Tsuchida, Fumihiro; Yagyu, Hisanaga; Ohishi, Shuji; Nakamura, Hiroyuki; Matsuoka, Takeshi

    2003-01-01

    We compared pulmonary ventilation dynamics between 41 patients with pulmonary emphysema and 11 healthy subjects with normal pulmonary function using ultrafast computed tomography (CT). Regions of interest (ROIs) for multislice scanning were selected from the anatomical levels of the carina in the right upper lung field. Several identical slices were selected from the inspiratory and expiratory scans. The average CT values in the ROIs (AvROI) were obtained during the inspiratory phase (inAvROI) and the expiratory phase (exAvROI. The ratio of change from inAvROI to exAvROI ((I-E)/E ratio) was also used for image analysis. Furthermore, possible correlations between the CT image parameters and pulmonary function test parameters were examined. The results showed that the exAvROI and inAvROI values and (I-E)/E ratio were lower in the emphysema group than in the normal pulmonary function group. Among the image data parameters, the exAvROI value correlated most closely with pulmonary function parameters, in particular, with the pulmonary diffusing capacity. These findings suggest that image data parameters of ventilation dynamics may be useful for evaluating the severity of pulmonary emphysema. (author)

  14. Pulmonary complication associated with head and neck cancer surgery

    International Nuclear Information System (INIS)

    Manzoor, T.; Ahmed, Z.; Sheikh, N.A.; Khan, M.M.

    2007-01-01

    To evaluate the frequency of short-term pulmonary complications in the patients undergoing various head and neck cancer surgeries in our setup and to assess possible risk factors responsible for these complications. Seventy patients of age group 20 to 80 years, regardless of gender, treated surgically for head and neck cancers were enrolled. Main outcome measures included development of pulmonary complications following 15 days of oncological surgery. The complications studied were pneumothorax, bronchopneumonia, atelectasis, pulmonary embolism and cardiopulmonary arrest. A total of 24.28% patients suffered from postoperative pulmonary complications; 17.14% developed bronchopneumonia, 5.71% pulmonary embolism, and 1.42% went into cardiopulmonary arrest, none developed pneumothorax or pulmonary atelectasis. A significant correlation of postoperative bronchopneumonia was seen with heavy smoking and assisted ventilation. Pulmonary embolism was associated with extended assisted ventilation and prolonged surgery. Cardiopulmonary arrest was associated with comorbidity and assisted ventilation after surgery. The frequency of bronchopneumonia supersedes all of the postoperative pulmonary complications in head and neck oncological surgery. Patients at risk of developing postoperative complications are heavy smokers, diabetics, those undergoing prolonged surgery, tracheostomy, and extended assisted ventilation. (author)

  15. Semi-nonparametric VaR forecasts for hedge funds during the recent crisis

    Science.gov (United States)

    Del Brio, Esther B.; Mora-Valencia, Andrés; Perote, Javier

    2014-05-01

    The need to provide accurate value-at-risk (VaR) forecasting measures has triggered an important literature in econophysics. Although these accurate VaR models and methodologies are particularly demanded for hedge fund managers, there exist few articles specifically devoted to implement new techniques in hedge fund returns VaR forecasting. This article advances in these issues by comparing the performance of risk measures based on parametric distributions (the normal, Student’s t and skewed-t), semi-nonparametric (SNP) methodologies based on Gram-Charlier (GC) series and the extreme value theory (EVT) approach. Our results show that normal-, Student’s t- and Skewed t- based methodologies fail to forecast hedge fund VaR, whilst SNP and EVT approaches accurately success on it. We extend these results to the multivariate framework by providing an explicit formula for the GC copula and its density that encompasses the Gaussian copula and accounts for non-linear dependences. We show that the VaR obtained by the meta GC accurately captures portfolio risk and outperforms regulatory VaR estimates obtained through the meta Gaussian and Student’s t distributions.

  16. Research on Interval Forecast For Metal Futures Market′s VaR Based on Bootstrap%基于Bootstrap的金属期货市场风险VaR区间预测

    Institute of Scientific and Technical Information of China (English)

    沈盟; 王璐

    2016-01-01

    金属期货市场风险VaR的准确测度对防范期货交易风险及保持市场健康平稳运行有重要作用.传统的VaR测度方法主要以点预测为主,无法反映预测近似值的精确程度及范围. 因此,提出了一种基于Bootstrap的金属期货市场风险VaR区间预测方法,同时引入LR检验区间预测的有效性,最后利用我国铜和铝期货市场数据进行了VaR风险的区间预测. 结果表明,新的VaR区间预测方法能克服点预测的不足,准确有效地描述VaR的估计风险,同时置信区间上下限可用于风险的预警及控制.%The accurate measurement on metal futures market′s VaR is important to prevent the futures′transaction risk and maintain the market healthy and stable operation.The traditional methods measuring VaR focus on point forecast which can't re-flect the accuracy of the predictive value.A new method to measure the interval forecast for metal futures market's VaR based on bootstrap is put forward.LR test is used to test the effectiveness of interval forecast.Finally,we empirical study the interval fore-cast of copper and aluminum futures market's VaR in China.The results show that the new method can overcome the lack of point forecast,while the upper and lower confidence interval can be used for early warning and control financial risks.

  17. 38 CFR 2.4 - Delegation of authority to order paid advertising for use in recruitment.

    Science.gov (United States)

    2010-07-01

    ... Secretary and Associate Deputy Assistant Secretary for Human Resources Management, and to field facility... to order paid advertising for use in recruitment. 2.4 Section 2.4 Pensions, Bonuses, and Veterans... paid advertising for use in recruitment. Paid advertisements may be used in recruitment for VA...

  18. VA Personal Health Record Sample Data

    Data.gov (United States)

    Department of Veterans Affairs — My HealtheVet (www.myhealth.va.gov) is a Personal Health Record portal designed to improve the delivery of health care services to Veterans, to promote health and...

  19. The model of pulmonary embolism caused by autologous thrombus in rabbits

    OpenAIRE

    Yu-Jiao Ding; Yang Chen

    2017-01-01

    Objective: To establish a model of pulmonary embolism in rabbits by using autologous thrombosis of rabbit ear vein, to study the method of establishing acute pulmonary embolism by using autologous thrombus and to explore the diagnostic value of oxygen partial pressure in acute pulmonary embolism. Methods: Twenty rabbits were randomly divided into normal group (n=5), 7 h group, 24h group, 1 week after model establishment Group. The arterial blood gas analysis was performed on th...

  20. Computing Conditional VaR using Time-varying CopulasComputing Conditional VaR using Time-varying Copulas

    Directory of Open Access Journals (Sweden)

    Beatriz Vaz de Melo Mendes

    2005-12-01

    Full Text Available It is now widespread the use of Value-at-Risk (VaR as a canonical measure at risk. Most accurate VaR measures make use of some volatility model such as GARCH-type models. However, the pattern of volatility dynamic of a portfolio follows from the (univariate behavior of the risk assets, as well as from the type and strength of the associations among them. Moreover, the dependence structure among the components may change conditionally t past observations. Some papers have attempted to model this characteristic by assuming a multivariate GARCH model, or by considering the conditional correlation coefficient, or by incorporating some possibility for switches in regimes. In this paper we address this problem using time-varying copulas. Our modeling strategy allows for the margins to follow some FIGARCH type model while the copula dependence structure changes over time.

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

    International Nuclear Information System (INIS)

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

    2000-01-01

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

  2. Pulmonary dysfunction in obese early adolescents

    Directory of Open Access Journals (Sweden)

    Bambang Supriyatno

    2010-08-01

    Full Text Available Aim Obesity leads to various complications, including pulmonary dysfunction. Studies on pulmonary function of obese children are limited and the results are controversial. This study was aimed to determine proportion of pulmonary dysfunction on early adolescents with obesity and to evaluate correlation between obesity degree with pulmonary dysfunction degree.Methods A cross-sectional study was conducted at the Department of Child Health, Medical School, University of Indonesia, from November 2007 to December 2008. Subjects were 10 to 12 year-old adolescents with obesity. Subjects underwent pulmonary function test (PFT to assess FEV1/FVC, FEV1, FVC, V50, and V25.Results 110 subjects fulfilled study criteria, 83 (75.5% were male and 27 (24.5% were female with median BMI 26.7 (22.6-54.7 kg/m2; 92 subjects (83.6% were superobese. History of asthma and allergic rhinitis were found in 32 (29.1% and 46 (41.8% subjects, respectively. 64 (58.2% subjects had abnormal PFT results consisting of restrictive type in 28 (25.5% subjects, obstructive in 3 (2.7%, and combined type in 33 (30%. Mean FEV1, FVC, V50, and V25 values were below normal, while mean FEV1/FVC ratio was normal. There was no statistically significant correlation between BMI and PFT parameters. No significant correlation was found between degree of obesity and the severity of pulmonary dysfunction.Conclusions Pulmonary dysfunction occurs in 58.2% obese early adolescents. The most common abnormality was combined type (30%, followed by restrictive (25.5%, and obstructive type (2.7%. There was no correlation between BMI and pulmonary function test parameters. (Med J Indones 2010;19:179-84Key words: early adolescents, obesity, pulmonary function test

  3. Secretory proteins of the pulmonary extracellular lining

    International Nuclear Information System (INIS)

    Gupta, R.P.; Patton, S.E.; Eddy, M.; Smits, H.L.; Jetten, A.M.; Nettesheim, P.; Hook, G.E.R.

    1986-01-01

    The objective of this investigation was to identify proteins in the pulmonary extracellular lining (EL) that are secreted by cells of the pulmonary epithelium. Pulmonary lavage effluents from the lungs of rabbits were centrifuged to remove all cells and particulate materials. Serum proteins were removed by repeatedly passing concentrated lavage effluent fluid through an affinity column containing IgG fraction of goat anti-rabbit (whole serum) antiserum bound to Sepharose-4B. Nonserum proteins accounted for 21.3 +/- 10.3% of the total soluble proteins in pulmonary lavage effluents. Serum free lavage effluents (SFL) contained 25 identifiable proteins as determined by using SDS-PAGE under reducing conditions. Of these proteins approximately 73% was accounted for by a single protein with MW of 66 kd. The secretory nature of the proteins present in SFL was investigated by studying the incorporation of 35 S-methionine into proteins released by lung slices and trachea followed by SDS-PAGE and autoradiography. Many, but not all proteins present in SFL were identified as proteins secreted by pulmonary tissues. The major secretory proteins appeared to have MWs of 59, 53, 48, 43, 24, 14, and 6 kd under reducing conditions. These data demonstrate the presence of several proteins in the pulmonary extracellular lining that appear to be secreted by the pulmonary epithelium

  4. Determinants of exercise-induced pulmonary arterial hypertension in systemic sclerosis.

    Science.gov (United States)

    Voilliot, Damien; Magne, Julien; Dulgheru, Raluca; Kou, Seisyou; Henri, Christine; Laaraibi, Saloua; Sprynger, Muriel; Andre, Béatrice; Pierard, Luc A; Lancellotti, Patrizio

    2014-05-15

    Exercise-induced pulmonary arterial hypertension (EIPH) in systemic sclerosis (SSc) has already been observed but its determinants remain unclear. The aim of this study was to determine the incidence and the determinants of EIPH in SSc. We prospectively enrolled 63 patients with SSc (age 54±3years, 76% female) followed in CHU Sart-Tilman in Liège. All patients underwent graded semi-supine exercise echocardiography. Systolic pulmonary arterial pressure (sPAP) was derived from the peak velocity of the tricuspid regurgitation jet and adding the estimation of right atrial pressure, both at rest and during exercise. Resting pulmonary arterial hypertension (PH) was defined as sPAP > 35 mmHg and EIPH as sPAP > 50 mmHg during exercise. The following formulas were used: mean PAP (mPAP) = 0.61 × sPAP + 2, left atrial pressure (LAP)=1.9+1.24 × left ventricular (LV) E/e' and pulmonary vascular resistance (PVR)=(mPAP-LAP)/LV cardiac output (CO) and slope of mPAP-LVCO relationship=changes in mPAP/changes in LVCO. Resting PH was present in 3 patients (7%) and 21 patients developed EIPH (47%). Patients with EIPH had higher resting LAP (10.3 ± 2.2 versus 8.8 ± 2.3 mmHg; p = 0.03), resting PVR (2.6 ± 0.8 vs. 1.4 ± 1.1 Woods units; p=0.004), exercise LAP (13.3 ± 2.3 vs. 9 ± 1.7 mmHg; p exercise PVR (3.6 ± 0.7 vs. 2.1 ± 0.9 Woods units; p = 0.02) and slope of mPAP-LVCO (5.8 ± 2.4 vs. 2.9 ± 2.1 mmHg/L/min; p age and gender, exercise LAP (β=3.1 ± 0.8; p=0.001) and exercise PVR (β=7.9 ± 1.7; p=0.0001) were independent determinants of exercise sPAP. EIPH is frequent in SSc patients and is mainly related to both increased exercise LV filling pressure and exercise PVR. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. Nonmassive acute pulmonary embolism: evaluation of the impact of pulmonary arterial wall distensibility on the assessment of the CT obstruction score.

    Science.gov (United States)

    Bigot, Julien; Rémy-Jardin, Martine; Duhamel, Alain; Gorgos, Andréi-Bogdan; Faivre, Jean-Baptiste; Rémy, Jacques

    2010-02-01

    To evaluate the impact of pulmonary arterial wall distensibility on the assessment of a computed tomography (CT) score in patients with nonmassive pulmonary embolism (PE) (ie, Mastora score). The arterial wall distensibility of five central pulmonary arteries (pulmonary artery trunk, right and left main pulmonary arteries, right and left interlobar pulmonary arteries) was studied on ECG-gated CT angiographic studies of the chest in 15 patients with no pulmonary arterial hypertension (group 1; mean pulmonary artery pressure: 17.2 mm Hg) and 9 patients with nonmassive PE (group 2), using 2D reconstructions at every 10% of the R-R interval. The systolic and diastolic reconstruction time windows of the examined arteries were identical in the 2 groups, obtained at 20% and 80% of the R-R interval, respectively. No statistically significant difference was observed between the mean values of the pulmonary arterial wall distensibility between the 2 groups, varying between 20.5% and 24% in group 1 and between 23.3% and 25.9% in group 2. The coefficients of variation of the average arterial surfaces were found to vary between 4.30% and 6.50% in group 1 and 4.2% and 8.4% in group 2. Except the pulmonary artery trunk in group 2, all the intraclass correlation coefficients were around 0.8 or greater than 0.8, that is the cutoff for good homogeneity of measurements. The pulmonary arterial wall systolic-diastolic distensibility does not interfere with the assessment of a CT obstruction score in the setting of nonmassive PE.

  6. X-ray CT evaluation of pulmonary involvements of sarcoidosis

    International Nuclear Information System (INIS)

    Nishimura, Koichi; Izumi, Takateru; Kitaichi, Masanori

    1987-01-01

    We evaluated high resolution CT in 60 patients with histologically diagnosed pulmonary sarcoidosis and, also, studied the relationship between CT and findings in open lung biopsy specimens in 2 cases. The CT findings were as follows: (1) thickening of bronchial wall shadows (27 out of 60 cases, 45.0 %), (2) irregular enlargement of pulmonary vascular shadows (39 cases, 65.0 %), (3) small or large nodular shadows (24 cases, 40.0 %), (4) local volume loss (14 cases, 23.3 %), (5) slightly increased density of localized lung field areas (24 cases, 40.0 %), (6) pleural or subpleural involvement (27 cases, 45.0 %), (7) lymph node enlargement (59 cases, 98.3 %). X-ray CT in 7 patients revealed no evidence of lung field involvement in patients with histologicall confirmed epithelioid cell granuloma in transbronchial lung biopsy specimens. Lesions located within vessels or in the vascular wall, perivascular sheath or alveoli surrounding blood vessels might cause pulmonary vascular shadows to appear swollen on CT. In a comparative study, we found irregular dilatation of pulmonary vascular shadows corresponding to granulomas in the connective tissue sheath of blood vessels. Also, thickening of bronchial wall shadows corresponded to granulomas in and around the bronchial wall. From the point of histopathological view epithelioid cell granulomas in the bronchovascular sheath were most marked in sarcoidosis, and they apperaed on CT as an irregular enlargement of pulmonary vascular shadows and thickening of the bronchial wall. On the other hand, we reported that collapse of alveoli and fibrosis surrounding blood vessels could cause irregular enlargement of pulmonary vascular shadows on CT in idiopathic pulmonary fibrosis (IPF). Such shadows were seen on CT in both sarcoidosis and IPF but the mechanism of their appearance differed. (J.P.N.)

  7. Isolation and characterization of specific bacteriophage Va1 to Vibrio alginolyticus

    Directory of Open Access Journals (Sweden)

    Carla Fernández Espinel

    2017-04-01

    Full Text Available Vibrio alginolyticus is associated with diseases in aquaculture. The misuse of antibiotics has led to the search for alternatives in the treatment of bacterial diseases, among them the application of bacteriophages that infect and destroy bacteria selectively. In this way, a highly lytic V. alginolyticus bacteriophage, termed Va1, was isolated, with the aim to evaluate its physical chemical parameters. For this purpose, different temperature, pH, chloroform exposure and host range conditions were evaluated. The temperature stability of phage Va1 showed higher titers at 20 and 30 °C decreasing from 40 °C. With respect to pH, the highest titers for the bacteriophage were between 5 and 8, and chloroform exposure reduced viability of the Va1 phage by 25%. The one-step curve determined that the latency period and the burst size were 20 minutes and 192 PFU / infective center respectively. Under the transmission electron microscope, the Va1 phage showed an icosahedral head and a non-contractile tail, belonging to the Podoviridae family. In conclusion, Va1 phage presents potential characteristics for use in phage therapy.

  8. 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

  9. The Application of VaR Method to Risk Evaluation of Bank Loans%VaR方法在银行贷款风险评估中的应用

    Institute of Scientific and Technical Information of China (English)

    邹新月

    2005-01-01

    Value-at-Risk model developed recently is a mathemetical medol to measure and monitor market risk. The article focuses on discussing calculate procedure and calculate method about applying VaR means for the bank loan risk in evaluation, we make clear differentiate both the Bank for International Settlements draw credit risk reserve and VaR means calculate bank loan risk value, find VaR means in application practicality value and extensity perspective in our bank loan risk for evaluation

  10. Benefit of early discharge among patients with low-risk pulmonary embolism.

    Directory of Open Access Journals (Sweden)

    Li Wang

    Full Text Available Clinical guidelines recommend early discharge of patients with low-risk pulmonary embolism (LRPE. This study measured the overall impact of early discharge of LRPE patients on clinical outcomes and costs in the Veterans Health Administration population. Adult patients with ≥1 inpatient diagnosis for pulmonary embolism (PE (index date between 10/2011-06/2015, continuous enrollment for ≥12 months pre- and 3 months post-index date were included. PE risk stratification was performed using the simplified Pulmonary Embolism Stratification Index. Propensity score matching (PSM was used to compare 90-day adverse PE events (APEs [recurrent venous thromboembolism, major bleed and death], hospital-acquired complications (HACs, healthcare utilization, and costs among short (≤2 days versus long length of stay (LOS. Net clinical benefit was defined as 1 minus the combined rate of APE and HAC. Among 6,746 PE patients, 95.4% were men, 22.0% were African American, and 1,918 had LRPE. Among LRPE patients, only 688 had a short LOS. After 1:1 PSM, there were no differences in APE, but short LOS had fewer HAC (1.5% vs 13.3%, 95% CI: 3.77-19.94 and bacterial pneumonias (5.9% vs 11.7%, 95% CI: 1.24-3.23, resulting in better net clinical benefit (86.9% vs 78.3%, 95% CI: 0.84-0.96. Among long LOS patients, HACs (52 exceeded APEs (14 recurrent DVT, 5 bleeds. Short LOS incurred lower inpatient ($2,164 vs $5,100, 95% CI: $646.8-$5225.0 and total costs ($9,056 vs $12,544, 95% CI: $636.6-$6337.7. LRPE patients with short LOS had better net clinical outcomes at lower costs than matched LRPE patients with long LOS.

  11. Pulmonary infections after kidney transplantation: analysis of CT findings

    International Nuclear Information System (INIS)

    Xue Feng; Liu Shiyuan; Li Li; Gao Xin; Liu Kai; Li Huimin

    2009-01-01

    Objective: To review the CT findings in patients with pulmonary infection after kidney transplantation and to determine the characteristic features in different infections. Methods: The medical records were reviewed in 446 patients with pulmonary infection after kidney transplantation and 121 patients who had pulmonary thin-section CT were included in this study. The pattern and distribution of the pulmonary abnormalities were interpreted independently by two thoracic radiologists. Statistical analysis was performed using the χ 2 test and the Fisher's exact test. Results: (1) Time course: 65 (14.6%) patients initially had pulmonary infection in the first 30 days, 147 (32.9%) between 1 and 3 months, 91 (20.4%) between 3 and 6 months, 23 (5.2%) between 6 and 12 months, 120 (26.9%)after 12 months of transplantation. In the first month after procedure, bacterial infection (4/5,80.0%) was the most common infection, bacterial (34/41,82.9%), mixed (19/41,46.3%) and vires infections (11/41,26.8%) were seen commonly 1 to 6 months following transplant, the incidence of fungal (14/38, 36.8%) and mycobacterial (5/38,13.2%) infections was increased after 12 months of transplantation. (2)Pathogens: Bacterial (34,28%) and mixed infections (34,28%) were the most common, followed by fungus infection (9, 7%), TB(7,6%)and cytomegalovims (5,4%). (3)CT findings: Ground-glass attenuations (69,57.0%) was the most common findings of pneumonia, followed by reticular or linear opacities (68,56.2%), nodules (66,54.5%), pleural thickening (41,33.9%), consolidations (31,25.6%), tree-in-bud patterns (24, 19.8%), pleural effusion (22,18.2%), and bronchovascular bundle thickening (16,13.2%). Ground-glass attenuation was commonly seen in cytomegalovims pneumonia (4,80.0%), and nodule was commonly observed in bacterial infection (23,67.6%), tree-in-bud pattern was the most common finding in pulmonary tuberculosis(4, P=0.049). There were no statistically significant differences in the prevalence of

  12. VA OpenNotes: exploring the experiences of early patient adopters with access to clinical notes.

    Science.gov (United States)

    Nazi, Kim M; Turvey, Carolyn L; Klein, Dawn M; Hogan, Timothy P; Woods, Susan S

    2015-03-01

    To explore the experience of early patient adopters who accessed their clinical notes online using the Blue Button feature of the My HealtheVet portal. A web-based survey of VA patient portal users from June 22 to September 15, 2013. 33.5% of respondents knew that clinical notes could be viewed, and nearly one in four (23.5%) said that they had viewed their notes at least once. The majority of VA Notes users agreed that accessing their notes will help them to do a better job of taking medications as prescribed (80.1%) and be better prepared for clinic visits (88.6%). Nine out of 10 users agreed that use of visit notes will help them understand their conditions better (91.8%), and better remember the plan for their care (91.9%). In contrast, 87% disagreed that VA Notes will make them worry more, and 88.4% disagreed that access to VA Notes will be more confusing than helpful. Users who had either contacted their provider or healthcare team (11.9%) or planned to (13.5%) primarily wanted to learn more about a health issue, medication, or test results (53.7%). Initial assessment of the patient experience within the first 9 months of availability provides evidence that patients both value and benefit from online access to clinical notes. These findings are congruent with OpenNotes study findings on a broader scale. Additional outreach and education is needed to enhance patient awareness. Healthcare professionals should author notes keeping in mind the opportunity patient access presents for enhanced communication. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  13. Medical image of the week: septic pulmonary emboli misdiagnosed as metastatic disease

    Directory of Open Access Journals (Sweden)

    Dandachi D

    2014-07-01

    Full Text Available No abstract available. Article truncated at 150 words. A 54-year-old previously healthy man presented with acute onset of left-sided, sharp pleuritic chest pain and dry cough. He denied having fever, hemoptysis, shortness of breath, or unintentional weight loss. Review of system was positive for bright blood per rectum for the last year. He had a root canal procedure done 3 weeks prior to presentation. His is a 30 pack-year smoker, drinks alcohol occasionally, but denied any IV drug use. On admission, he was afebrile and hemodynamically stable. Clinical examination was positive for fecal occult blood test. CBC revealed WBC of 12,800/mm3 and his hemoglobin was11.9 g/dL. Thoracic CT scan with contrast was negative for pulmonary embolism, but showed multiple bilateral pulmonary nodules suspicious for malignancy (Figure 1. The left upper lobe showed a subpleural 2.4 x 1.5 cm rounded opacity and emphysematous changes. CT of the abdomen and pelvis showed folds in the stomach but was otherwise unremarkable...

  14. 78 FR 76412 - Agency Information Collection (VA National Rehabilitation Special Events, Event Registration...

    Science.gov (United States)

    2013-12-17

    ... INFORMATION: Titles: a. National Disabled Veterans Winter Sports Clinic Application, VA Form 0924a, c, d and..., c, e. j. Voluntary Service Application, VA Form 0927f. k. National Veterans Summer sports Clinic... Festival Event Application, VA0929a, b, c, d, e, f, g, h. Type of Review: Revision of an already approved...

  15. PERHITUNGAN VaR PORTOFOLIO SAHAM MENGGUNAKAN DATA HISTORIS DAN DATA SIMULASI MONTE CARLO

    Directory of Open Access Journals (Sweden)

    WAYAN ARTHINI

    2012-09-01

    Full Text Available Value at Risk (VaR is the maximum potential loss on a portfolio based on the probability at a certain time.  In this research, portfolio VaR values calculated from historical data and Monte Carlo simulation data. Historical data is processed so as to obtain stock returns, variance, correlation coefficient, and variance-covariance matrix, then the method of Markowitz sought proportion of each stock fund, and portfolio risk and return portfolio. The data was then simulated by Monte Carlo simulation, Exact Monte Carlo Simulation and Expected Monte Carlo Simulation. Exact Monte Carlo simulation have same returns and standard deviation  with historical data, while the Expected Monte Carlo Simulation satistic calculation similar to historical data. The results of this research is the portfolio VaR  with time horizon T=1, T=10, T=22 and the confidence level of 95 %, values obtained VaR between historical data and Monte Carlo simulation data with the method exact and expected. Value of VaR from both Monte Carlo simulation is greater than VaR historical data.

  16. Thoracoscopic-assisted pulmonary surgery for partial and complete lung lobectomy in dogs and cats: 11 cases (2008-2013).

    Science.gov (United States)

    Wormser, Chloe; Singhal, Sunil; Holt, David E; Runge, Jeffrey J

    2014-11-01

    To describe the use of thoracoscopic-assisted pulmonary surgery (TAPS) for partial and complete lung lobectomy in small animal patients and to evaluate short-term outcome. Retrospective case series. 11 client-owned dogs and cats. Procedures-Medical records of dogs and cats that underwent a partial or complete TAPS lung lobectomy were reviewed. All patients underwent general anesthesia and were positioned in lateral recumbency with the affected hemithorax uppermost. One-lung ventilation was not implemented in any patient. For initial exploration, a 5- to 10-mm incision was made for insertion of a 30° telescope approximately 5 to 7 rib spaces away from the site of the pulmonary lesion in the dorsal third of the thorax. All subsequent incision placements were case dependent and determined by the location of the lesion to be resected. Following lesion localization, a 2- to 7-cm minithoracotomy incision was made with direct thoracoscopic visualization without the use of rigid rib retractors. In 10 of 11 patients, a 360° wound retraction device was placed at the minithoracotomy site prior to exteriorization and resection of the affected lung. Lymph nodes were inspected intraoperatively, but biopsies were not performed; incisions were closed routinely, and a thoracostomy tube was placed in all patients. 3 cats and 8 dogs underwent successful partial (5) or complete (6) TAPS lung lobectomy over a 5-year period (2008 through 2013). Median surgery time was 92.7 minutes (range, 77 to 150 minutes). Thoracostomy tubes were removed a median of 22.3 hours after surgery (range, 18 to 36 hours). The median time to discharge was 3.1 days (range, 1 to 6 days). No intraoperative complications were encountered. All patients were discharged from the hospital, with 9 of 11 patients alive 6 months after surgery. Results of this study suggested that lung lobectomy by means of TAPS can be successfully performed in dogs and cats. When compared with total thoracoscopic surgery, TAPS may

  17. Poincare group, SU(3) and V-A in leptonic decay

    International Nuclear Information System (INIS)

    Boehm, A.

    1975-07-01

    From as few assumptions as possible about the relations between the Poincare group, the particle classifying SU(3) and V-A we derive properties of the K/sub l 3 / and K/sub L 2 / decays. From the assumed relation between SU(3) and the Poincare group and the first class condition it follows that the formfactor ratio Xi of K/sub l 3 / decay is Xi = --0.57, and that a value of Xi = 0 is in disagreement with very general and well accepted theoretical assumptions. Assuming universality of V-A, the Cabibbo suppression is derived from the relations between SU(3) and V-A as a consequence of the brokenness of SU(3). (U.S.)

  18. VA Health Care: VA Spends Millions on Post-Traumatic Stress Disorder Research and Incorporates Research Outcomes into Guidelines and Policy for Post-Traumatic Stress Disorder Services

    Science.gov (United States)

    2011-01-01

    post - traumatic stress disorder ( PTSD ) and...Veterans Affairs (VA) Intramural Post - Traumatic Stress Disorder ( PTSD ) Research Funding and VA’s Medical and Prosthetic Research Appropriation...Table 6: Department of Veterans Affairs (VA) Research Centers and Programs That Conduct or Support Post - Traumatic Stress Disorder ( PTSD ) Research

  19. The relationship between tumor markers and pulmonary embolism in lung cancer.

    Science.gov (United States)

    Xiong, Wei; Zhao, Yunfeng; Xu, Mei; Guo, Jian; Pudasaini, Bigyan; Wu, Xueling; Liu, Jinming

    2017-06-20

    Tumor markers (TMs) and D-Dimer are both hallmarks of severity and prognosis of lung cancer. Tumor markers could be related to pulmonary embolism (PE) in lung cancer. The number of abnormal tumor markers of lung cancer patients with pulmonary embolism (3.9 ± 1.1vs1.6 ± 0.6,P 0.005) was more than that in patients without pulmonary embolism. TMs panel (P trend tumor markers, TMs panel (OR5.98, P Tumor markers were compared between lung cancer patients complicated with pulmonary embolism and those without pulmonary embolism Then the correlation between each tumor marker as well as panel of combined TMs and D-Dimer as well as pulmonary embolism were analyzed for patients with pulmonary embolism. There is a relationship between tumor markers and pulmonary embolism in patients with lung cancer. The panel of combined tumor markers is a valuable diagnostic marker for pulmonary embolism in lung cancer.

  20. Employment status, employment functioning, and barriers to employment among VA primary care patients.

    Science.gov (United States)

    Zivin, Kara; Yosef, Matheos; Levine, Debra S; Abraham, Kristen M; Miller, Erin M; Henry, Jennifer; Nelson, C Beau; Pfeiffer, Paul N; Sripada, Rebecca K; Harrod, Molly; Valenstein, Marcia

    2016-03-15

    Prior research found lower employment rates among working-aged patients who use the VA than among non-Veterans or Veterans who do not use the VA, with the lowest reported employment rates among VA patients with mental disorders. This study assessed employment status, employment functioning, and barriers to employment among VA patients treated in primary care settings, and examined how depression and anxiety were associated with these outcomes. The sample included 287 VA patients treated in primary care in a large Midwestern VA Medical Center. Bivariate and multivariable analyses were conducted examining associations between socio-demographic and clinical predictors of six employment domains, including: employment status, job search self-efficacy, work performance, concerns about job loss among employed Veterans, and employment barriers and likelihood of job seeking among not employed Veterans. 54% of respondents were employed, 36% were not employed, and 10% were economically inactive. In adjusted analyses, participants with depression or anxiety (43%) were less likely to be employed, had lower job search self-efficacy, had lower levels of work performance, and reported more employment barriers. Depression and anxiety were not associated with perceived likelihood of job loss among employed or likelihood of job seeking among not employed. Single VA primary care clinic; cross-sectional study. Employment rates are low among working-aged VA primary care patients, particularly those with mental health conditions. Offering primary care interventions to patients that address mental health issues, job search self-efficacy, and work performance may be important in improving health, work, and economic outcomes. Published by Elsevier B.V.

  1. 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

  2. 78 FR 18425 - Proposed Information Collection VA Police Officer Pre-Employment Screening Checklist); Comment...

    Science.gov (United States)

    2013-03-26

    ... techniques or the use of other forms of information technology. Title: VA Police Officer Pre-Employment... Police Officer Pre-Employment Screening Checklist); Comment Request AGENCY: Office of Operations... approved collection. Abstract: VA personnel complete VA Form 0120 to document pre- employment history and...

  3. 76 FR 24570 - Proposed Information Collection (Application for VA Education Benefits) Activity; Comment Request

    Science.gov (United States)

    2011-05-02

    ... (Application for VA Education Benefits) Activity; Comment Request AGENCY: Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Benefits Administration (VBA... Under the Montgomery GI Bill, VA Form 22-1990E. c. Application for VA Education Benefits Under the...

  4. Validation of KENO V.a for the Portsmouth Gaseous Diffusion Plant

    International Nuclear Information System (INIS)

    Felsher, H.D.; Fentiman, A.W.; Tayloe, R.W.; D'Aquila, D.

    1992-01-01

    At the Portsmouth Gaseous Diffusion Plant, KENO V.a is used to make criticality calculations for complex configurations and a wide range of 235 U enrichments. It is essential that the calculated critical conditions either accurately reflect the true critical state or that the bias from the true critical conditions are well known. Accordingly, a study has been initiated to validate KENO V.a over the ranges of parameters expected to be used when modeling equipment and processes at Portsmouth. Preliminary results of that study are reported in this paper. The ultimate goal of this study is to identify a set of data from existing critical experiments that will exercise all KENO V.a parameters commonly used by Portsmouth's criticality safety personnel. A second goal is to identify a relatively small subset of those experiments that may be run frequently to ensure that KENO V.a provides consistent results

  5. HEMATOPOIETIC PROGENITOR CELL CONTENT OF VERTEBRAL BODY MARROW USED FOR COMBINED SOLID ORGAN AND BONE MARROW TRANSPLANTATION

    Science.gov (United States)

    Rybka, Witold B.; Fontes, Paulo A.; Rao, Abdul S.; Winkelstein, Alan; Ricordi, Camillo; Ball, Edward D.; Starzl, Thomas E.

    2010-01-01

    While cadaveric vertebral bodies (VB) have long been proposed as a suitable source of bone marrow (BM) for transplantation (BMT), they have rarely been used for this purpose. We have infused VB BM immediately following whole organ (WO) transplantation to augment donor cell chimerism. We quantified the hematopoietic progenitor cell (HPC) content of VB BM as well as BM obtained from the iliac crests (IC) of normal allogeneic donors (ALLO) and from patients with malignancy undergoing autologous marrow harvest (AUTO). Patients undergoing WOIBM transplantation also had AUTO BM harvested in the event that subsequent lymphohematopoietic reconstitution was required. Twenty-four VB BM, 24 IC BM-ALLO, 31 IC AUTO, and 24 IC WO-AUTO were harvested. VB BM was tested 12 to 72 hr after procurement and infused after completion ofWO grafting. IC BM was tested and then used or cryopreserved immediately. HPC were quantified by clonal assay measuring CFU-GM, BFU-E, and CFU-GEMM, and by flow cytometry for CD34+ progenitor cells. On an average, 9 VB were processed during each harvest, and despite an extended processing time the number of viable nucleated cells obtained was significantly higher than that from IC. Furthermore, by HPC content, VB BM was equivalent to IC BM, which is routinely used for BMT. We conclude that VB BM is a clinically valuable source of BM for allogeneic transplantation. PMID:7701582

  6. INFILTRATE PULMONARY TUBERCULOSIS, GASTRIC ULCER AND HIV INFECTION (COMORBIDITY AND MULTIMORBIDITY

    Directory of Open Access Journals (Sweden)

    E. S. Skvortsova

    2016-01-01

    Full Text Available Peptic ulcer is registered in 20,5% of those suffering from infiltrate pulmonary tuberculosis and in 19,5% of HIV patients at C2 stage, ill with infiltrate pulmonary tuberculosis and presenting complaints about dyspeptic disorders. The following is typical of multimorbidity of pulmonary tuberculosis, HIV infection and peptic ulcer: oligosymptomatic start of tuberculosis, asthenic syndrome dominating among clinical symptoms, manifestations of gastric and intestinal indigestion, weight loss (2-4 times more often compared to HIV negative patients, less expressed lung tissue destruction (2 time less compared to HIV negative patients. H. pylori is a causative agent of the peptic ulcer in 62,5% of patients with infiltrate pulmonary tuberculosis and in 58,7% of HIV infected patients at C2 stage, suffering from pulmonary tuberculosis. Comorbidity of H. pilori negative peptic ulcer and infiltrate pulmonary tuberculosis differs from comorbidity of H. pilori positive peptic ulcer and infiltrate pulmonary tuberculosis since the first has confidently true unfavorable forecast of the outcome.

  7. A novel method of fuzzy fault tree analysis combined with VB program to identify and assess the risk of coal dust explosions.

    Directory of Open Access Journals (Sweden)

    Hetang Wang

    Full Text Available Coal dust explosions (CDE are one of the main threats to the occupational safety of coal miners. Aiming to identify and assess the risk of CDE, this paper proposes a novel method of fuzzy fault tree analysis combined with the Visual Basic (VB program. In this methodology, various potential causes of the CDE are identified and a CDE fault tree is constructed. To overcome drawbacks from the lack of exact probability data for the basic events, fuzzy set theory is employed and the probability data of each basic event is treated as intuitionistic trapezoidal fuzzy numbers. In addition, a new approach for calculating the weighting of each expert is also introduced in this paper to reduce the error during the expert elicitation process. Specifically, an in-depth quantitative analysis of the fuzzy fault tree, such as the importance measure of the basic events and the cut sets, and the CDE occurrence probability is given to assess the explosion risk and acquire more details of the CDE. The VB program is applied to simplify the analysis process. A case study and analysis is provided to illustrate the effectiveness of this proposed method, and some suggestions are given to take preventive measures in advance and avoid CDE accidents.

  8. Geographic Distribution of VA Expenditures FY 2016

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  9. Geographic Distribution of VA Expenditures FY2010

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  10. Geographic Distribution of VA Expenditures FY2012

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  11. Geographic Distribution of VA Expenditures FY2004

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  12. Geographic Distribution of VA Expenditures FY1998

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  13. Geographic Distribution of VA Expenditures FY2009

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  14. Geographic Distribution of VA Expenditures FY2013

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  15. Geographic Distribution of VA Expenditures FY2002

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  16. Characterization of pulmonary protein profiles in response to zinc oxide nanoparticles in mice: a 24-hour and 28-day follow-up study

    Directory of Open Access Journals (Sweden)

    Pan CH

    2015-07-01

    Full Text Available Chih-Hong Pan,1,2,* Kai-Jen Chuang,3,4,* Jen-Kun Chen,5 Ta-Chih Hsiao,6 Ching-Huang Lai,2 Tim P Jones,7 Kelly A BéruBé,8 Gui-Bing Hong,9 Kin-Fai Ho,10,11 Hsiao-Chi Chuang12,13 1Institute of Occupational Safety and Health, Council of Labor Affairs, Executive Yuan, 2School of Public Health, National Defense Medical Center, 3School of Public Health, College of Public Health and Nutrition, 4Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, 5Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Miaoli, 6Graduate Institute of Environmental Engineering, National Central University, Taoyuan, Taiwan; 7School of Earth and Ocean Sciences, 8School of Biosciences, Cardiff University, Cardiff, Wales, UK; 9Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei, Taiwan; 10Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People’s Republic of China; 11Shenzhen Municipal Key Laboratory for Health Risk Analysis, Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, People’s Republic of China; 12School of Respiratory Therapy, College of Medicine, 13Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan *These authors contributed equally to this work Abstract: Although zinc oxide nanoparticles (ZnONPs are recognized to cause systemic disorders, little is known about the mechanisms that underlie the time-dependent differences that occur after exposure. The objective of this study was to investigate the mechanistic differences at 24 hours and 28 days after the exposure of BALB/c mice to ZnONPs via intratracheal instillation. An isobaric tag for the relative and absolute quantitation coupled with liquid chromatography/tandem mass spectrometry was used to identify the differential

  17. Continuous-energy version of KENO V.a for criticality safety applications

    International Nuclear Information System (INIS)

    Dunn, Michael E.; Greene, N. Maurice; Petrie, Lester M.

    2003-01-01

    KENO V.a is a multigroup Monte Carlo code that solves the Boltzmann transport equation and is used extensively in the criticality safety community to calculate the effective multiplication factor of systems with fissionable material. In this work, a continuous-energy or pointwise version of KENO V.a has been developed by first designing a new continuous-energy cross-section format and then by developing the appropriate Monte Carlo transport procedures to sample the new cross-section format. In order to generate pointwise cross sections for a test library, a series of cross-section processing modules were developed and used to process 50 ENDF/B-6 Release 7 nuclides for the test library. Once the cross-section processing procedures were in place, a continuous-energy version of KENO V.a was developed and tested by calculating 21 critical benchmark experiments. The point KENO-calculated results for the 21 benchmarks are in agreement with calculated results obtained with the multigroup version of KENO V.a using the 238-group ENDF/B-5 and 199-group ENDF/B-6 Release 3 libraries. Based on the calculated results with the prototypic cross-section library, a continuous-energy version of the KENO V.a code has been successfully developed and demonstrated for modeling systems with fissionable material. (author)

  18. CoVaCS: a consensus variant calling system.

    Science.gov (United States)

    Chiara, Matteo; Gioiosa, Silvia; Chillemi, Giovanni; D'Antonio, Mattia; Flati, Tiziano; Picardi, Ernesto; Zambelli, Federico; Horner, David Stephen; Pesole, Graziano; Castrignanò, Tiziana

    2018-02-05

    The advent and ongoing development of next generation sequencing technologies (NGS) has led to a rapid increase in the rate of human genome re-sequencing data, paving the way for personalized genomics and precision medicine. The body of genome resequencing data is progressively increasing underlining the need for accurate and time-effective bioinformatics systems for genotyping - a crucial prerequisite for identification of candidate causal mutations in diagnostic screens. Here we present CoVaCS, a fully automated, highly accurate system with a web based graphical interface for genotyping and variant annotation. Extensive tests on a gold standard benchmark data-set -the NA12878 Illumina platinum genome- confirm that call-sets based on our consensus strategy are completely in line with those attained by similar command line based approaches, and far more accurate than call-sets from any individual tool. Importantly our system exhibits better sensitivity and higher specificity than equivalent commercial software. CoVaCS offers optimized pipelines integrating state of the art tools for variant calling and annotation for whole genome sequencing (WGS), whole-exome sequencing (WES) and target-gene sequencing (TGS) data. The system is currently hosted at Cineca, and offers the speed of a HPC computing facility, a crucial consideration when large numbers of samples must be analysed. Importantly, all the analyses are performed automatically allowing high reproducibility of the results. As such, we believe that CoVaCS can be a valuable tool for the analysis of human genome resequencing studies. CoVaCS is available at: https://bioinformatics.cineca.it/covacs .

  19. Examination of Deposited Layers Composition on the Discharge Chamber Constructional Elements Tokamak T-11M after Two-Year Operation with Lithium Limiter

    International Nuclear Information System (INIS)

    Buzhinskij, O.; Barsuk, V.

    2006-01-01

    In this work the results of the research of internal structural elements state of the T11-M tokamak discharge chamber after two-year operation with lithium limiter are given [V.B. Lazarev, E.A. Azizov et al., Compatibility of the Lithium Capillary Limiter with Plasma in T-11M, 26 th EPS Conf. on Contr. Fusion Plasma Physics, ECA, vol. 231, pp. 845-848, 1999, V.A. Evtikhin, I.E. Lyublinski, A.V. Vertkov et al., Technology Aspects of Lithium Capillary pore Systems Application in Tokamak Device, SOFT-21 (Madrid), A-37, 2000]. The condition of molybdenic wall surface of the discharge chamber and internal steel surface of diagnostic ports has been investigated. X-ray microanalysis of deposited surface of the first wall has shown, that in deposited layer are contained in the main Mo and small amount Cu. In a composition of deposited layer on the ports surface, except the above-named elements, in a small amount is Fe. Because of the instrumental restrictions of this method of analysis, detection opportunity of lithium traces was missing. X-ray diffractometer analysis of deposited layer on the first wall surface has detected a mixture of several phases. The main phase is Li 2 CO 3 , one third from all deposited substance is Li 2 MoO 4 , there is also LiOH-HO phase. The deposited layer on diagnostic ports in the main consists of LiOH-H 2 O phase, there is also Li 2 CO 3 phase. The results of X-ray analysis of a dust probe from the B 4 C coated graphite limiter surface have not detected whatever extra phases, except a crystalline boron carbide phase. (author)

  20. Defining and targeting health disparities in chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Pleasants RA

    2016-10-01

    Full Text Available Roy A Pleasants,1–3 Isaretta L Riley,1–3 David M Mannino4 1Duke Asthma, Allergy, and Airways Center, 2Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University School of Medicine, 3Durham VA Medical Center, Durham, NC, 4Division of Pulmonary, Critical Care, and Sleep Medicine, Pulmonary Epidemiology Research Laboratory, University of Kentucky, Lexington, KY, USA Abstract: The global burden of chronic obstructive pulmonary disease (COPD continues to grow in part due to better outcomes in other major diseases and in part because a substantial portion of the worldwide population continues to be exposed to inhalant toxins. However, a disproportionate burden of COPD occurs in people of low socioeconomic status (SES due to differences in health behaviors, sociopolitical factors, and social and structural environmental exposures. Tobacco use, occupations with exposure to inhalant toxins, and indoor biomass fuel (BF exposure are more common in low SES populations. Not only does SES affect the risk of developing COPD and etiologies, it is also associated with worsened COPD health outcomes. Effective interventions in these people are needed to decrease these disparities. Efforts that may help lessen these health inequities in low SES include 1 better surveillance targeting diagnosed and undiagnosed COPD in disadvantaged people, 2 educating the public and those involved in health care provision about the disease, 3 improving access to cost-effective and affordable health care, and 4 markedly increasing the efforts to prevent disease through smoking cessation, minimizing use and exposure to BF, and decreasing occupational exposures. COPD is considered to be one the most preventable major causes of death from a chronic disease in the world; therefore, effective interventions could have a major impact on reducing the global burden of the disease, especially in socioeconomically disadvantaged populations. Keywords: health disparities

  1. Association between women veterans' experiences with VA outpatient health care and designation as a women's health provider in primary care clinics.

    Science.gov (United States)

    Bastian, Lori A; Trentalange, Mark; Murphy, Terrence E; Brandt, Cynthia; Bean-Mayberry, Bevanne; Maisel, Natalya C; Wright, Steven M; Gaetano, Vera S; Allore, Heather; Skanderson, Melissa; Reyes-Harvey, Evelyn; Yano, Elizabeth M; Rose, Danielle; Haskell, Sally

    2014-01-01

    Women veterans comprise a small percentage of Department of Veterans Affairs (VA) health care users. Prior research on women veterans' experiences with primary care has focused on VA site differences and not individual provider characteristics. In 2010, the VA established policy requiring the provision of comprehensive women's health care by designated women's health providers (DWHPs). Little is known about the quality of health care delivered by DWHPs and women veterans' experience with care from these providers. Secondary data were obtained from the VA Survey of Healthcare Experience of Patients (SHEP) using the Consumer Assessment of Healthcare Providers and Systems (CAHPS) patient-centered medical home (PCMH) survey from March 2012 through February 2013, a survey designed to measure patient experience with care and the DWHPs Assessment of Workforce Capacity that discerns between DWHPs versus non-DWHPs. Of the 28,994 surveys mailed to women veterans, 24,789 were seen by primary care providers and 8,151 women responded to the survey (response rate, 32%). A total of 3,147 providers were evaluated by the SHEP-CAHPS-PCMH survey (40%; n = 1,267 were DWHPs). In a multivariable model, patients seen by DWHPs (relative risk, 1.02; 95% CI, 1.01-1.04) reported higher overall experiences with care compared with patients seen by non-DWHPs. The main finding is that women veterans' overall experiences with outpatient health care are slightly better for those receiving care from DWHPs compared with those receiving care from non-DWHPs. Our findings have important policy implications for how to continue to improve women veterans' experiences. Our work provides support to increase access to DWHPs at VA primary care clinics. Published by Elsevier Inc.

  2. Analisis Risiko Investasi Saham Syariah Dengan Model Value AT Risk-Asymmetric Power Autoregressive Conditional Heterocedasticity (VaR-APARCH

    Directory of Open Access Journals (Sweden)

    Syarif Hidayatullah

    2017-04-01

    Full Text Available Penelitian ini membahas analisis risiko data runtun waktu dengan model Value at Risk- Asymmetric Power Autoregressive Conditional Heteroscedasticity (VaR-APARCHdalam pasar modal syariah. Metode yang digunakan dalam penelitian ini adalah penerapan kasus.Data yang digunakan adalah harga penutupan harian saham dalam Jakarta Islamic Index (JIIperiode 4 Maret 2013 sampai 8 April 2015.Model APARCH yang dipilih berdasarkan nilai Schwarz Criterion (SC.Langkah-langkah dalam penelitian ini adalah menguji kestasioneran data, mengidentifikasi model ARIMA,mengestimasi parameter model ARIMA, menguji diagnostik model ARIMA, mendeteksi ada tidaknya unsur ARCH atau unsur heteroskedastisitas, uji asimetris data saham, mengestimasi model APARCH, menguji diagnostik model APARCH, dan menghitung risiko dengan VaR-APARCH.Model terbaik yang dipilih adalah ARIMA ((3,0,0 dan APARCH (1,1. Model ini valid untuk menganalisis besar risiko investasi dalam jangka waktu 10 hari ke depan.

  3. Mannose-binding lectin deficiency and acute exacerbations of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Woodruff PG

    2012-11-01

    Full Text Available Richard K Albert,1 John Connett,2 Jeffrey L Curtis,3,4 Fernando J Martinez,3 MeiLan K Han,3 Stephen C Lazarus,5 Prescott G Woodruff51Medicine Service, Denver Health and Department of Medicine, University of Colorado Denver, Denver, CO, 2Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, 3Pulmonary and Critical Care Medicine, Department of Medicine, University of Michigan, Ann Arbor, MI, 4Pulmonary and Critical Care Medicine, VA Medical Center, Ann Arbor, MI, 5Pulmonary and Critical Care Medicine, Department of Medicine, and Cardiovascular Research Institute, University of California, San Francisco, CA, USABackground: Mannose-binding lectin is a collectin involved in host defense against infection. Whether mannose-binding lectin deficiency is associated with acute exacerbations of chronic obstructive pulmonary disease is debated.Methods: Participants in a study designed to determine if azithromycin taken daily for one year decreased acute exacerbations had serum mannose-binding lectin concentrations measured at the time of enrollment.Results: Samples were obtained from 1037 subjects (91% in the trial. The prevalence of mannose-binding lectin deficiency ranged from 0.5% to 52.2%, depending on how deficiency was defined. No differences in the prevalence of deficiency were observed with respect to any demographic variable assessed, and no differences were observed in time to first exacerbation, rate of exacerbations, or percentage of subjects requiring hospitalization for exacerbations in those with deficiency versus those without, regardless of how deficiency was defined.Conclusion: In a large sample of subjects with chronic obstructive pulmonary disease selected for having an increased risk of experiencing an acute exacerbation of chronic obstructive pulmonary disease, only 1.9% had mannose-binding lectin concentrations below the normal range and we found no association between mannose-binding lectin

  4. The dilatation of main pulmonary artery and right ventricle observed by enhanced chest computed tomography predict poor outcome in inoperable chronic thromboembolic pulmonary hypertension.

    Science.gov (United States)

    Ema, Ryogo; Sugiura, Toshihiko; Kawata, Naoko; Tanabe, Nobuhiro; Kasai, Hajime; Nishimura, Rintaro; Jujo, Takayuki; Shigeta, Ayako; Sakao, Seiichiro; Tatsumi, Koichiro

    2017-09-01

    Dilatation of the pulmonary artery and right ventricle on chest computed tomography images is often observed in patients with pulmonary hypertension. The clinical significance of these image findings has not been defined in chronic thromboembolic pulmonary hypertension. We investigated whether the pulmonary arterial and right ventricle dilatation was associated with poor outcome in chronic thromboembolic pulmonary hypertension. This was a retrospective cohort investigation in 60 subjects with inoperable chronic thromboembolic pulmonary hypertension diagnosed consecutively between 1997 and 2010 at Chiba University Hospital. Digital scout multi-detector chest computed tomography images were obtained. The main pulmonary arterial to ascending aortic diameter ratio and the right ventricular to left ventricular diameter ratio were calculated. Main pulmonary arterial to ascending aortic diameter ratio ranged from 0.85 to 1.84, and right ventricular to left ventricular diameter ratio ranged from 0.71 to 2.88. During the observation period of 1284.5days (range, 21-4550days), 13 patients required hospitalization due to worsening; 6 of them died. Kaplan-Meier analysis showed significant differences in hospitalization between the patients with main pulmonary arterial to ascending aortic diameter ratio of ≥1.1 and pulmonary hypertension. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  5. 76 FR 40453 - Agency Information Collection (Application for VA Education Benefits) Activity Under OMB Review

    Science.gov (United States)

    2011-07-08

    ... (Application for VA Education Benefits) Activity Under OMB Review AGENCY: Veterans Benefits Administration... Education Benefits, VA Form 22-1990. b. Application for Family Member to Use Transferred Benefits, VA Form 22-1990E. [[Page 40454

  6. Analysis of the impact of digital tomosynthesis on the radiological investigation of patients with suspected pulmonary lesions on chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    Quaia, Emilio; Baratella, Elisa; Cernic, Stefano; Lorusso, Arianna; Casagrande, Federica; Cioffi, Vincenzo; Cova, Maria Assunta [University of Trieste (Italy), Department of Radiology, Cattinara Hospital, Trieste (Italy)

    2012-09-15

    To assess the impact of digital tomosynthesis (DTS) on the radiological investigation of patients with suspected pulmonary lesions on chest radiography (CXR). Three hundred thirty-nine patients (200 male; age, 71.19 {+-} 11.9 years) with suspected pulmonary lesion(s) on CXR underwent DTS. Two readers prospectively analysed CXR and DTS images, and recorded their diagnostic confidence: 1 or 2 = definite or probable benign lesion or pseudolesion deserving no further diagnostic workup; 3 = indeterminate; 4 or 5 = probable or definite pulmonary lesion deserving further diagnostic workup by computed tomography (CT). Imaging follow-up by CT (n = 76 patients), CXR (n = 256) or histology (n = 7) was the reference standard. DTS resolved doubtful CXR findings in 256/339 (76 %) patients, while 83/339 (24 %) patients proceeded to CT. The mean interpretation time for DTS (mean {+-} SD, 220 {+-} 40 s) was higher (P < 0.05; Wilcoxon test) than for CXR (110 {+-} 30 s), but lower than CT (600 {+-} 150 s). Mean effective dose was 0.06 mSv (range 0.03-0.1 mSv) for CXR, 0.107 mSv (range 0.094-0.12 mSv) for DTS, and 3 mSv (range 2-4 mSv) for CT. DTS avoided the need for CT in about three-quarters of patients with a slight increase in the interpretation time and effective dose compared to CXR. (orig.)

  7. The chest X-ray in pulmonary capillary haemorrhage: correlation with carbon monoxide uptake

    International Nuclear Information System (INIS)

    Bowley, N.B.; Hughes, J.M.B.; Steiner, R.E.

    1979-01-01

    Serial changes in carbon monoxide uptake (Ksub(CO) or Dsub(L)CO/VA) were used to monitor episodes of pulmonary capillary haemorrhage in Goodpasture's syndrome (13 cases), immune complex nephritis (three cases) and idiopathic haemosiderosis (one case). Air-space shadowing on the chest X-ray (on a scoring system 0 to 12) was assessed in the light of the changes of Ksub(CO). In 14 out of 27 episodes of bleeding, the rise and fall of Ksub(CO) was matched in time by the appearance and disappearance of air-space shadowing on the chest X-ray. In six episodes the chest X-ray remained normal despite a rise of Ksub(CO). In two cases air-space shadowing appeared up to 48 h after the rise of Ksub(CO). On five occasions chest X-ray abnormalities preceded the rise of Ksub(CO) but chest infection or fluid overload accounted for three of these. In cases with suspected pulmonary capillary haemorrhage, measurements of carbon monoxide uptake will provide additional information and will assist in the interpretation of the chest X-ray. (author)

  8. Pulmonary malaria: high-resolution computed tomography findings - a case report

    International Nuclear Information System (INIS)

    Rodrigues, Rosana; Souza, Daniel Andrade Tinoco de; Marchiori, Edson

    2004-01-01

    We report the case of a 38-year-old man with pulmonary malaria. High-resolution computed tomography showed thickening of the peribronchovascular interstitium and interlobular septa, areas of consolidation and ground glass attenuation and bilateral pleural effusion suggesting pulmonary edema. The patient recovered well after receiving specific treatment and was discharged after 11 days of hospitalization. (author)

  9. [Clinical and radiological features of pulmonary tuberculosis manifested as interstitial lung diseases.].

    Science.gov (United States)

    Shi, Ju-Hong; Feng, Rui-E; Tian, Xin-Lun; Xu, Wen-Bing; Xu, Zuo-Jun; Liu, Hong-Rui; Zhu, Yuan-Jue

    2009-12-01

    The purpose of this paper was to investigate the clinical and radiological features of pulmonary tuberculosis presenting as interstitial lung diseases (ILD). We analyzed the data of cases suspected of diffuse parenchyma lung diseases at this hospital between October 2003 and October 2007. The diagnosis of active pulmonary tuberculosis was based on epithelioid granuloma or positive acid-fast bacilli in lung biopsy and changes on serial radiographs obtained during treatment. The data of a series of 230 consecutive patients with suspected ILD were retrospectively analyzed. The diagnosis was confirmed by lung biopsy. Twelve patients were confirmed to have pulmonary tuberculosis. There were 5 males and 7 females with a mean age of 38 +/- 11 years (range, 17 - 68). The median course of disease in these patients was 3 months (range, 0.5 - 18 months). Patients with pulmonary tuberculosis presented with fever (11/12), cough (9/12), weight loss (7/12), dyspnea (7/12), lymphadenopathy (4/12), and splenohepatomegaly (2/12). On chest CT scan, ground-glass attenuation was identified in 4, bilateral patchy infiltration in 5, tree-in-bud appearance 1, and centrilobular lesions in 2 of the 12 patients. During the follow-up period (median, 9 month, range from 3 to 12 month), 11 patients improved, but 1 died of diabetic ketoacidosis. The diagnosis of pulmonary tuberculosis should be considered in suspected ILD patients presenting with fever, splenohepatomegaly and lymphadenopathy.

  10. Korteweg-deVries-Burgers (KdVB) equation in a five component cometary plasma with kappa described electrons and ions

    Science.gov (United States)

    Michael, Manesh; Willington, Neethu T.; Jayakumar, Neethu; Sebastian, Sijo; Sreekala, G.; Venugopal, Chandu

    2016-12-01

    We investigate the existence of ion-acoustic shock waves in a five component cometary plasma consisting of positively and negatively charged oxygen ions, kappa described hydrogen ions, hot solar electrons, and slightly colder cometary electrons. The KdVB equation has been derived for the system, and its solution plotted for different kappa values, oxygen ion densities, as well as the temperature ratios for the ions. It is found that the amplitude of the shock wave decreases with increasing kappa values. The strength of the shock profile decreases with increasing temperatures of the positively charged oxygen ions and densities of negatively charged oxygen ions.

  11. Graphical linking of MO multicenter bond index and VB structures. II-5-c rings and 6-c heterocyclic rings

    International Nuclear Information System (INIS)

    Bollini, Carlos Guido; Giambiagi, Mario; Giambiagi, Myriam Segre de; Figueiredo, Aloysio Paiva de

    2001-02-01

    Through the graphical method proposed it is possible to set a link between an MO multicenter bond index and VB structures. The value of the index depends on the order of the atoms involved if they are more than three. For 5-c rings three basic structures are required; the eventually different values are 12. Unlike the 6-c case it may happen that different pairs of basic structures are used to build the same polygon. For the 6-c rings including heteroatoms the original degeneracy of benzene splits leading eventually to 60 different I ring values. (author)

  12. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-03-15

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

  14. Sequence Classification: 893123 [

    Lifescience Database Archive (English)

    Full Text Available inal member of the mitochondrial inner membrane electron transport chain; predominantly express...ed during aerobic growth while its isoform Vb (Cox5Bp) is expressed during anaerobic growth; Cox5ap || http://www.ncbi.nlm.nih.gov/protein/6324276 ... ...TMB TMH TMB TMB TMB TMB >gi|6324276|ref|NP_014346.1| Subunit Va of cytochrome c oxidase, which is the term

  15. MODEL NON LINIER GARCH (NGARCH UNTUK MENGESTIMASI NILAI VALUE at RISK (VaR PADA IHSG

    Directory of Open Access Journals (Sweden)

    I KOMANG TRY BAYU MAHENDRA

    2015-06-01

    Full Text Available In investment, risk measurement is important. One of risk measure is Value at Risk (VaR. There are many methods that can be used to estimate risk based on VaR framework. One of them Non Linier GARCH (NGARCH model. In this research, determination of VaR used NGARCH model. NGARCH model allowed for asymetric behaviour in the volatility such that “good news” or positive return and “bad news” or negative return. Based on calculations of VaR, the higher of the confidence level and the longer the investment period, the risk was greater. Determination of VaR using NGARCH model was less than GARCH model.

  16. Vectorization of the KENO V.a criticality safety code

    International Nuclear Information System (INIS)

    Hollenbach, D.F.; Dodds, H.L.; Petrie, L.M.

    1991-01-01

    The development of the vector processor, which is used in the current generation of supercomputers and is beginning to be used in workstations, provides the potential for dramatic speed-up for codes that are able to process data as vectors. Unfortunately, the stochastic nature of Monte Carlo codes prevents the old scalar version of these codes from taking advantage of the vector processors. New Monte Carlo algorithms that process all the histories undergoing the same event as a batch are required. Recently, new vectorized Monte Carlo codes have been developed that show significant speed-ups when compared to the scalar version of themselves or equivalent codes. This paper discusses the vectorization of an already existing and widely used criticality safety code, KENO V.a All the changes made to KENO V.a are transparent to the user making it possible to upgrade from the standard scalar version of KENO V.a to the vectorized version without learning a new code

  17. Impact of Major Pulmonary Resections on Right Ventricular Function: Early Postoperative Changes.

    Science.gov (United States)

    Elrakhawy, Hany M; Alassal, Mohamed A; Shaalan, Ayman M; Awad, Ahmed A; Sayed, Sameh; Saffan, Mohammad M

    2018-01-15

    Right ventricular (RV) dysfunction after pulmonary resection in the early postoperative period is documented by reduced RV ejection fraction and increased RV end-diastolic volume index. Supraventricular arrhythmia, particularly atrial fibrillation, is common after pulmonary resection. RV assessment can be done by non-invasive methods and/or invasive approaches such as right cardiac catheterization. Incorporation of a rapid response thermistor to pulmonary artery catheter permits continuous measurements of cardiac output, right ventricular ejection fraction, and right ventricular end-diastolic volume. It can also be used for right atrial and right ventricular pacing, and for measuring right-sided pressures, including pulmonary capillary wedge pressure. This study included 178 patients who underwent major pulmonary resections, 36 who underwent pneumonectomy assigned as group (I) and 142 who underwent lobectomy assigned as group (II). The study was conducted at the cardiothoracic surgery department of Benha University hospital in Egypt; patients enrolled were operated on from February 2012 to February 2016. A rapid response thermistor pulmonary artery catheter was inserted via the right internal jugular vein. Preoperatively the following was recorded: central venous pressure, mean pulmonary artery pressure, pulmonary capillary wedge pressure, cardiac output, right ventricular ejection fraction and volumes. The same parameters were collected in fixed time intervals after 3 hours, 6 hours, 12 hours, 24 hours, and 48 hours postoperatively. For group (I): There were no statistically significant changes between the preoperative and postoperative records in the central venous pressure and mean arterial pressure; there were no statistically significant changes in the preoperative and 12, 24, and 48 hour postoperative records for cardiac index; 3 and 6 hours postoperative showed significant changes. There were statistically significant changes between the preoperative and

  18. Pulmonary arterial hypertension in children: diagnosis using ratio of main pulmonary artery to ascending aorta diameter as determined by multi-detector computed tomography.

    Science.gov (United States)

    Caro-Domínguez, Pablo; Compton, Gregory; Humpl, Tilman; Manson, David E

    2016-09-01

    The ratio of the transverse diameter of the main pulmonary artery (MPA) to ascending aorta as determined at multi-detector CT is a tool that can be used to assess the pulmonary arterial size in cases of pulmonary arterial hypertension in children. To establish a ratio of MPA to ascending aorta diameter using multi-detector CT imaging suggestive of pulmonary arterial hypertension in children. We hypothesize that a defined ratio of MPA to ascending aorta is identifiable on multi-detector CT and that higher ratios can be used to reliably diagnose the presence of pulmonary arterial hypertension in children. We calculated the multi-detector CT ratio of MPA to ascending aorta diameter in 44 children with documented pulmonary arterial hypertension by right heart catheterization and in 44 age- and gender-matched control children with no predisposing factors for pulmonary arterial hypertension. We compared this multi-detector-CT-determined ratio with the MPA pressure in the study group, as well as with the ratio of MPA to ascending aorta in the control group. A threshold ratio value was calculated to accurately identify children with pulmonary arterial hypertension. Children with documented primary pulmonary arterial hypertension have a significantly higher ratio of MPA to ascending aorta (1.46) than children without pulmonary arterial hypertension (1.11). A ratio of 1.3 carries a positive likelihood of 34 and a positive predictive value of 97% for the diagnosis of pulmonary arterial hypertension. The pulmonary arteries were larger in children with pulmonary arterial hypertension than in a control group of normal children. A CT-measured ratio of MPA to ascending aorta of 1.3 should raise the suspicion of pulmonary arterial hypertension in children.

  19. METABOLIC DISORDERS AND PULMONARY EMBOLISM

    Directory of Open Access Journals (Sweden)

    O. Ya. Vasiltseva

    2015-01-01

    patients (40%. In the group body mass index (BMI was (29.24 ± 7.87 kg/m2 . Obesity diagnosed in 157patients (20.9%. It occurs in24.7% of cases for women andin 15.2% of cases for men. If a patient had obesity grade 3 was found to increase the risk of a massive thromboembolism in 3.27 times (OR = 3.27; 95% confidence interval [1.60–6.69]; p = 0.001 and an increase in the risk of fatal thromboembolism 3.56 times(OR = 3.56; 95% CI [1.73–7.43]; p = 0.001. It does not detect the influence of obesity 1 and 2 degrees on the development of a massive pulmonary embolism, or PE, which would cause the patient's death. Significant effect of type 2 diabetes was found on the development of the heavy flow of fatal pulmonary embolism. 

  20. 76 FR 79067 - Payment or Reimbursement for Emergency Treatment Furnished by Non-VA Providers in Non-VA...

    Science.gov (United States)

    2011-12-21

    ... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900-AN49 Payment or Reimbursement for Emergency..., authorize the Secretary of Veterans Affairs to reimburse eligible veterans for costs related to non-VA.... Specifically, section 1725 authorizes reimbursement for emergency treatment for eligible veterans with...

  1. Pulmonary function tests correlated with thoracic volumes in adolescent idiopathic scoliosis.

    Science.gov (United States)

    Ledonio, Charles Gerald T; Rosenstein, Benjamin E; Johnston, Charles E; Regelmann, Warren E; Nuckley, David J; Polly, David W

    2017-01-01

    Scoliosis deformity has been linked with deleterious changes in the thoracic cavity that affect pulmonary function. The causal relationship between spinal deformity and pulmonary function has yet to be fully defined. It has been hypothesized that deformity correction improves pulmonary function by restoring both respiratory muscle efficiency and increasing the space available to the lungs. This research aims to correlate pulmonary function and thoracic volume before and after scoliosis correction. Retrospective correlational analysis between thoracic volume modeling from plain x-rays and pulmonary function tests was conducted. Adolescent idiopathic scoliosis patients enrolled in a multicenter database were sorted by pre-operative Total Lung Capacities (TLC) % predicted values from their Pulmonary Function Tests (PFT). Ten patients with the best and ten patients with the worst TLC values were included. Modeled thoracic volume and TLC values were compared before and 2 years after surgery. Scoliosis correction resulted in an increase in the thoracic volume for patients with the worst initial TLCs (11.7%) and those with the best initial TLCs (12.5%). The adolescents with the most severe pulmonary restriction prior to surgery strongly correlated with post-operative change in total lung capacity and thoracic volume (r 2  = 0.839; p volume in this group was 373.1 cm 3 (11.7%) which correlated with a 21.2% improvement in TLC. Scoliosis correction in adolescents was found to increase thoracic volume and is strongly correlated with improved TLC in cases with severe restrictive pulmonary function, but no correlation was found in cases with normal pulmonary function. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:175-182, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  2. Methods for estimating and comparing VA outpatient drug benefits with the private sector.

    Science.gov (United States)

    Render, Marta L; Nowak, John; Hammond, Emmett K; Roselle, Gary

    2003-06-01

    To estimate and compare Veterans Health Administration (VA) expenditures for outpatient pharmaceuticals for veterans at six VA facilities with hypothetical private sector costs. Using the VA Pharmacy Benefits Management Strategic Health Care Group (PBM) database, we extracted data for all dispensed outpatient prescriptions from the six study sites over federal fiscal year 1999. After extensive data validation, we converted prescriptions to the same units and merged relevant VA pricing information by National Drug Code to Redbook listed average wholesale price and the Medicaid maximal allowable charge, where available. We added total VA drug expenditures to personnel cost from the pharmacy portion of that medical center's cost distribution report. Hypothetical private sector payments were $200.8 million compared with an aggregate VA budget of $118.8 million. Using National Drug Code numbers, 97% of all items dispensed from the six facilities were matched to private sector price data. Nonmatched pharmaceuticals were largely generic over-the-counter pain relievers and commodities like alcohol swabs. The most commonly prescribed medications reflect the diseases and complaints of an older male population: pain, cardiovascular problems, diabetes, and depression or other psychiatric disorders. Use of the VA PBM database permits researchers to merge expenditure and prescription data to patient diagnoses and sentinel events. A critical element in its use is creating similar units among the systems. Such data sets permit a deeper view of the variability in drug expenditures, an important sector of health care whose inflation has been disproportionate to that of the economy and even health care.

  3. Malaria epidemiology in the Pakaanóva (Wari') Indians, Brazilian Amazon.

    Science.gov (United States)

    Sá, D Ribeiro; Souza-Santos, R; Escobar, A L; Coimbra, C E A

    2005-04-01

    This paper reports the results of a longitudinal study of malaria incidence (1998-2002) among the Pakaanóva (Wari') Indians, Brazilian southwest Amazon region, based on data routinely gathered by Brazilian National Health Foundation outposts network in conjunction with the Indian health service. Malaria is present yearlong in the Pakaanóva. Statistically significant differences between seasons or months were not noticed. A total of 1933 cases of malaria were diagnosed in the Pakaanóva during this period. The P. vivax / P. falciparum ratio was 3.4. P. vivax accounted for 76.5% of the cases. Infections with P. malariae were not recorded. Incidence rates did not differ by sex. Most malaria cases were reported in children < 10 years old (45%). About one fourth of all cases were diagnosed on women 10-40 years old. An entomological survey carried out at two Pakaanóva villages yielded a total of 3.232 specimens of anophelines. Anopheles darlingi predominated (94.4%). Most specimens were captured outdoors and peak activity hours were noted at early evening and just before sunrise. It was observed that Pakaanóva cultural practices may facilitate outdoor exposure of individuals of both sexes and all age groups during peak hours of mosquito activities (e.g., coming to the river early in the morning for bathing or to draw water, fishing, engaging in hunting camps, etc). In a context in which anophelines are ubiquitous and predominantly exophilic, and humans of both sexes and all ages are prone to outdoor activities during peak mosquito activity hours, malaria is likely to remain endemic in the Pakaanóva, thus requiring the development of alternative control strategies that are culturally and ecologically sensitive.

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

    Science.gov (United States)

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

    2016-01-01

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

  5. Heart disease in patients with pulmonary embolism.

    Science.gov (United States)

    Pesavento, Raffaele; Piovella, Chiara; Prandoni, Paolo

    2010-09-01

    Several heart diseases are promoters of left-side cardiac thrombosis and could lead to arterial embolism. The same mechanism may be responsible for right-side cardiac thrombosis and therefore be a direct source of pulmonary embolism. Yasuoka et al. showed a higher incidence of perfusion defects in lung scan in patients with spontaneous echocontrast in the right atrium than in those without it (40% and 7% respectively; P=0.006). We recently assessed the prevalence of heart diseases in 11.236 consecutive patients older than 60 years discharged from Venetian hospitals with a diagnosis of pulmonary embolism. We observed a higher prevalence of all-cause heart diseases (odds ratio 1.26; 95% confidence interval, 1.13-1.40) in patients with a diagnosis of pulmonary embolism alone (secondary or unprovoked) compared with those discharged with a diagnosis of pulmonary embolism associated with deep vein thrombosis, generating the hypothesis that some specific heart diseases in older patients could themselves be a possible source of pulmonary emboli. Further prospective studies are required to confirm these findings, which have the potential to open new horizons for the interpretation and management of venous thromboembolic disease.

  6. 24 CFR 3500.11 - Mailing.

    Science.gov (United States)

    2010-04-01

    ... REAL ESTATE SETTLEMENT PROCEDURES ACT § 3500.11 Mailing. The provisions of this part requiring or... obtained by the lender or settlement agent, except that a revised address shall be used where the lender or settlement agent has been expressly informed in writing of a change in address. ...

  7. The Burr X Pareto Distribution: Properties, Applications and VaR Estimation

    Directory of Open Access Journals (Sweden)

    Mustafa Ç. Korkmaz

    2017-12-01

    Full Text Available In this paper, a new three-parameter Pareto distribution is introduced and studied. We discuss various mathematical and statistical properties of the new model. Some estimation methods of the model parameters are performed. Moreover, the peaks-over-threshold method is used to estimate Value-at-Risk (VaR by means of the proposed distribution. We compare the distribution with a few other models to show its versatility in modelling data with heavy tails. VaR estimation with the Burr X Pareto distribution is presented using time series data, and the new model could be considered as an alternative VaR model against the generalized Pareto model for financial institutions.

  8. Right Heart End-Systolic Remodeling Index Strongly Predicts Outcomes in Pulmonary Arterial Hypertension: Comparison With Validated Models.

    Science.gov (United States)

    Amsallem, Myriam; Sweatt, Andrew J; Aymami, Marie C; Kuznetsova, Tatiana; Selej, Mona; Lu, HongQuan; Mercier, Olaf; Fadel, Elie; Schnittger, Ingela; McConnell, Michael V; Rabinovitch, Marlene; Zamanian, Roham T; Haddad, Francois

    2017-06-01

    Right ventricular (RV) end-systolic dimensions provide information on both size and function. We investigated whether an internally scaled index of end-systolic dimension is incremental to well-validated prognostic scores in pulmonary arterial hypertension. From 2005 to 2014, 228 patients with pulmonary arterial hypertension were prospectively enrolled. RV end-systolic remodeling index (RVESRI) was defined by lateral length divided by septal height. The incremental values of RV free wall longitudinal strain and RVESRI to risk scores were determined. Mean age was 49±14 years, 78% were female, 33% had connective tissue disease, 52% were in New York Heart Association class ≥III, and mean pulmonary vascular resistance was 11.2±6.4 WU. RVESRI and right atrial area were strongly connected to the other right heart metrics. Three zones of adaptation (adapted, maladapted, and severely maladapted) were identified based on the RVESRI to RV systolic pressure relationship. During a mean follow-up of 3.9±2.4 years, the primary end point of death, transplant, or admission for heart failure was reached in 88 patients. RVESRI was incremental to risk prediction scores in pulmonary arterial hypertension, including the Registry to Evaluate Early and Long-Term PAH Disease Management score, the Pulmonary Hypertension Connection equation, and the Mayo Clinic model. Using multivariable analysis, New York Heart Association class III/IV, RVESRI, and log NT-proBNP (N-Terminal Pro-B-Type Natriuretic Peptide) were retained (χ 2 , 62.2; P right heart metrics, RVESRI demonstrated the best test-retest characteristics. RVESRI is a simple reproducible prognostic marker in patients with pulmonary arterial hypertension. © 2017 American Heart Association, Inc.

  9. Benchmark calculations by KENO-Va using the JEF 2.2 library

    Energy Technology Data Exchange (ETDEWEB)

    Markova, L.

    1994-12-01

    This work has to be a contribution to the validation of the JEF2.2 neutron cross-section libarary, following the earlier published benchmark calculations having been performed to validate the previous version JEF1.1 of the libarary. Several simple calculational problems and one experimental problem were chosen for a criticality calculations. In addition also a realistic hexagonal arrangement of the VVER-440 fuel assemblies in a spent fuel cask were analyzed in a partly cylindrized model. All criticality calculations, carried out by the KENO-Va code using the JEF2.2 neutron cross-section library in 172 energy groups, resulted in multiplication factors (k{sub eff}) which were tabulated and compared with the results of other available calculations of the same problems. (orig.).

  10. 75 FR 33216 - Payment or Reimbursement for Emergency Treatment Furnished by Non-VA Providers in Non-VA...

    Science.gov (United States)

    2010-06-11

    ... health care services for veterans).'' Proposed Sec. 17.121(a) would establish the clinical decision maker... practice to utilize the services of health care professionals, such as nurses, for purposes of clinical review. For this reason, establishing the clinical decision maker as a ``designated VA clinician'' would...

  11. Pharmacology of milrinone in neonates with persistent pulmonary hypertension of the newborn and suboptimal response to inhaled nitric oxide.

    Science.gov (United States)

    McNamara, Patrick J; Shivananda, Sandesh P; Sahni, Mohit; Freeman, David; Taddio, Anna

    2013-01-01

    Persistent pulmonary hypertension of the newborn is a common problem with significant morbidity and mortality. Inhaled nitric oxide is the standard care, but up to 40% of neonates are nonresponders. Milrinone is a phosphodiesterase III inhibitor which increases the bioavailability of cyclic adenosine monophosphate and has been shown to improve pulmonary hemodynamics in animal experimental models. The primary objective was to investigate the pharmacological profile of milrinone in persistent pulmonary hypertension of the newborn. Secondary objectives were to delineate short-term outcomes and safety profile. An open label study of milrinone in neonates with persistent pulmonary hypertension of the newborn was conducted. Patients received an intravenous loading dose of milrinone (50 μg/kg) over 60 mins followed by a maintenance infusion (0.33-0.99 μg/kg/min) for 24-72 hrs. Physiologic indices of cardiorespiratory stability and details of cointerventions were recorded. Serial blood milrinone levels were collected after the bolus, following initiation of the maintenance infusion to determine steady state levels, and following discontinuation of the drug to determine clearance. Echocardiography was performed before and after (1, 12 hrs) milrinone initiation. Milrinone. Eleven neonates with a diagnosis of persistent pulmonary hypertension of the newborn who met eligibility criteria were studied. The median (SD) gestational age and weight at birth were 39.2 ± 1.3 wks and 3481 ± 603 g. The mean (± sd) half-life, total body clearance, volume of distribution, and steady state concentration of milrinone were 4.1 ± 1.1 hrs, 0.11 ± 0.01 L/kg/hr, 0.56 ± 0.19 L/kg, and 290.9 ± 77.7 ng/mL. The initiation of milrinone led to an improvement in PaO2 (p = 0.002) and a sustained reduction in FIO2 (p milrinone treatment. The pharmacokinetics of milrinone in persistent pulmonary hypertension of the newborn is consistent with published data. The administration of intravenous

  12. Lymphocyte aggregates persist and accumulate in the lungs of patients with idiopathic pulmonary fibrosis

    Directory of Open Access Journals (Sweden)

    Todd NW

    2013-03-01

    Full Text Available Nevins W Todd,1,2 Rachel G Scheraga,1,3 Jeffrey R Galvin,1,4 Aldo T Iacono,1 E James Britt,1 Irina G Luzina,1,2 Allen P Burke,5,* Sergei P Atamas1,2,* 1Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; 2Baltimore VA Medical Center, Baltimore, MD, USA; 3Critical Care Medicine Department, National Institutes of Health, Bethesda, MD, USA; 4Department of Diagnostic Radiology, University of Maryland School of Medicine, Baltimore, MD, USA; 5Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, USA *These authors contributed equally to this work Background: Idiopathic pulmonary fibrosis (IPF is a fatal lung disease with no known effective therapy. It is often assumed, but has not been objectively evaluated, that pulmonary inflammation subsides as IPF progresses. The goal of this work was to assess changes in the degree of inflammatory cell infiltration, particularly lymphocytic infiltration, over the duration of illness in IPF. Methods: Sixteen patients with confirmed IPF were identified in patients whom surgical lung biopsy (SLB was performed in early disease, and in patients whom lung transplantation was subsequently performed in end stage disease. A numerical scoring system was used to histologically quantify the amount of fibrosis, honeycomb change, fibroblastic foci, and lymphocyte aggregates in each SLB and lung explant tissue sample. Analyses of quantitative scores were performed by comparing paired, matched samples of SLB to lung explant tissue. Results: Median time [1st, 3rd quartiles] from SLB to lung transplantation was 24 [15, 29] months. Histologic fibrosis and honeycomb change were more pronounced in the explant samples compared with SLB (P < 0.001 and P < 0.01, respectively, and most notably, higher numbers of lymphocyte aggregates were observed in the explant samples compared to SLB (P = 0.013. Immunohistochemical analyses revealed abundant CD3+ (T lymphocyte and CD20+ (B

  13. Pulmonary leukemic involvement: high-resolution computed tomography evaluation

    International Nuclear Information System (INIS)

    Oliveira, Ana Paola de; Marchiori, Edson; Souza Junior, Arthur Soares

    2004-01-01

    Objective: To evaluate the role of high-resolution computed tomography (HRCT) in patients with leukemia and pulmonary symptoms, to establish the main patterns and to correlate them with the etiology. Materials and Methods: This is a retrospective study of the HRCT of 15 patients with leukemia and pulmonary symptoms. The examinations were performed using a spatial high-resolution protocol and were analyzed by two independent radiologists. Results: The main HRCT patterns found were ground-glass opacity (n=11), consolidation (n=9), airspace nodules (n=3), septal thickening (n=3), tree-in-bud pattern (n=3), and pleural effusion (n=3). Pulmonary infection was the most common finding seen in 12 patients: bacterial pneumonia (n=6), fungal infection (n = 4), pulmonary tuberculosis (n=1) and viral infection (n=1). Leukemic pleural infiltration (n=1), lymphoma (n=1) and pulmonary hemorrhage (n=1) were detected in the other three patients. Conclusion: HRCT is an important tool that may suggest the cause of lung involvement, its extension and in some cases to guide invasive procedures in patients with leukemia. (author)

  14. Quality of CT pulmonary angiography for suspected pulmonary embolus in pregnancy

    International Nuclear Information System (INIS)

    U-King-Im, Jean Marie; Freeman, Susan J.; Boylan, Teresa; Cheow, Heok K.

    2008-01-01

    The main objective of this study was to assess the quality of CT pulmonary angiography (CTPA) for suspected pulmonary embolus (PE) in the pregnant population. We retrospectively identified 40 consecutive pregnant patients who underwent CTPA from January 2005 to December 2006. Forty consecutive age-matched non-pregnant women were used as a control group. Studies were subjectively graded according to overall image quality by two readers in consensus, in randomised and blinded manner. Moreover, contrast enhancement of pulmonary arteries was subjectively and objectively evaluated. The proportion of sub-optimal studies was more than three times higher in the pregnant group (27.5%, n = 11) compared with the non-pregnant group (7.5%, n = 3; p = 0.015). Mean contrast enhancement was consistently higher in the non-pregnant group compared with pregnant group, both subjectively and objectively. The percentage of inadequately opacified vascular segments was more than two times higher in the pregnant group (28.7%, n = 264) than in the non-pregnant group (13.3%, n 122; p = 0.0001). The incidence of sub-optimal CTPA studies is higher in pregnancy when compared with an age-matched non-pregnant control group. In addition to radiation issues, this should also be considered when implementing diagnostic strategies for suspected PE in pregnancy. (orig.)

  15. Radiosensitivity of pulmonary alveolar macrophages in rats exposed to local X-irradiation

    International Nuclear Information System (INIS)

    Gong Yifen; Fei Lihua; Wu Dechang

    1987-01-01

    The radiosensitivity of pulmonary alveolar macrophages (PAMs) in rats exposed to local thoracic X-irradiatoin was studied. The percentages of mitotic and labeling cells were used as biological endpoints. The parameters of radiosensitivity of PAMs obtained on the second day after local exposure are as follows: D 0 = 0.68 Gy, Dq = 0.06 Gy, n = 1.1 for mitotic cells and D 0 = 1.04 Gy, Dq = 0.12 Gy, n = 1.12 for labeling cells. The parameters of radiosensitivity of PAMs in bronchical lavage obtained immediately after X-irradiation are: D 0 = 3.56 Gy, Dq = 0.77 Gy, n = 1.24 for labeling cells and D 0 = 3.69 Gy, Dq = 0.35 Gy, n = 1.1 for mitotic cells. The comparison of thses results indicates that the radiation effect on PAMs obtained immediately after X-irradiation is less severe than that of PAMs obtained 2 days later. It might be caused by the delay of cell cycle within 2 days after X-irradiation

  16. Pulmonary tuberculosis in patients with idiopathic pulmonary fibrosis

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-11-01

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

  17. 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

  18. Anterior pituitary failure (panhypopituitarism) with balanced chromosome translocation 46,XY,t(11;22)(q24;q13).

    Science.gov (United States)

    Yang, C Y; Chou, C W; Chen, S Y; Cheng, H M

    2001-04-01

    Hypopituitarism is the clinical syndrome that results from failure of the anterior pituitary gland to produce its hormones. Hypopituitarism can result from: (1) intrinsic or primary pituitary disease; (2) intrinsic hypothalamic or secondary pituitary disease; or (3) extrinsic extrasellar or parasellar disease. The etiologies of primary hypopituitarism are miscellaneous. The dominant clinical picture of hypopituitarism in the adult is that of hypogonadism. Reports have associated hypopituitarism with anti-pituitary-antibodies, hereditary syndrome and chromosome defects, but hypopituitarism has rarely been associated with balanced chromosome translocation (11;22)(q24;q13). Here, we describe a case of anterior pituitary failure with balanced chromosome translocation. A 19-year-old Chinese teenager presented with failure of pubertal development and sexual infantilism. On examination, the patient had the classic appearance of hypogonadism. Endocrine studies and three combined pituitary function tests revealed panhypopituitarism. A chromosomal study revealed 46,XY,t(11;22)(q24;q13), a balanced translocation between 11q24 and 22q13. Chest films showed delayed fusion of bilateral humeral head epiphyses and bilateral acromions. Scrotal sonography revealed testes were small bilaterally. Magnetic resonance imaging (MRI) of the sella revealed pituitary dwarfism. The patient received 19 months replacement therapy, including steroids (prednisolone 5 mg each day), L-thyroxine (Eltroxin 100 ug each day), and testosterone enanthate 250 mg every two weeks. His height increased 4 cm with secondary sexual characteristics developed, and muscle power increased.

  19. Areas of normal pulmonary parenchyma on HRCT exhibit increased FDG PET signal in IPF patients

    Energy Technology Data Exchange (ETDEWEB)

    Win, Thida [Lister Hospital, Respiratory Medicine, Stevenage (United Kingdom); Thomas, Benjamin A.; Lambrou, Tryphon; Hutton, Brian F.; Endozo, Raymondo; Shortman, Robert I.; Afaq, Asim; Ell, Peter J.; Groves, Ashley M. [University College London, Institute of Nuclear Medicine, University College Hospital, London (United Kingdom); Screaton, Nicholas J. [Papworth Hospital, Radiology Department, Papworth Everard (United Kingdom); Porter, Joanna C. [University College London, Centre for Respiratory Diseases, University College Hospital, London (United Kingdom); Maher, Toby M. [Royal Brompton Hospital, Interstitial Lung Disease Unit, London (United Kingdom); Lukey, Pauline [GSK, Fibrosis DPU, Research and Development, Stevenage (United Kingdom)

    2014-02-15

    Patients with idiopathic pulmonary fibrosis (IPF) show increased PET signal at sites of morphological abnormality on high-resolution computed tomography (HRCT). The purpose of this investigation was to investigate the PET signal at sites of normal-appearing lung on HRCT in IPF. Consecutive IPF patients (22 men, 3 women) were prospectively recruited. The patients underwent {sup 18}F-FDG PET/HRCT. The pulmonary imaging findings in the IPF patients were compared to the findings in a control population. Pulmonary uptake of {sup 18}F-FDG (mean SUV) was quantified at sites of morphologically normal parenchyma on HRCT. SUVs were also corrected for tissue fraction (TF). The mean SUV in IPF patients was compared with that in 25 controls (patients with lymphoma in remission or suspected paraneoplastic syndrome with normal PET/CT appearances). The pulmonary SUV (mean ± SD) uncorrected for TF in the controls was 0.48 ± 0.14 and 0.78 ± 0.24 taken from normal lung regions in IPF patients (p < 0.001). The TF-corrected mean SUV in the controls was 2.24 ± 0.29 and 3.24 ± 0.84 in IPF patients (p < 0.001). IPF patients have increased pulmonary uptake of {sup 18}F-FDG on PET in areas of lung with a normal morphological appearance on HRCT. This may have implications for determining disease mechanisms and treatment monitoring. (orig.)

  20. Balloon catheter dilatation for mitral stenosis and severe pulmonary hypertension

    International Nuclear Information System (INIS)

    Wang Manhong

    2002-01-01

    Objective: To determine the safety and efficacy of percutaneous balloon mitral valvuloplasty (PBMV) for patients with mitral stenosis and severe pulmonary hypertension, and to assess the changes in pulmonary systolic pressure during follow-up. Methods: Forty-two patients with rheumatic mitral stenosis and severe pulmonary hypertension (pulmonary systolic pressure > 75 mmHg) underwent PBMV using standard Inoue technique, and the changes in clinical functional status and echo Doppler pulmonary systolic pressure during follow-up were assessed. Results: PBMV was successful in 39 patients. Immediately after the procedure, mitral valve area increased from (0.83 +- 0.12) cm 2 to (1.75 +- 0.11) cm 2 , pulmonary systolic pressure decreased from (85 +- 7) mmHg to (61 +- 13) mmHg (all P < 0.001). Severe mitral regurgitation occurred in 3 patients, one of whom underwent mitral valve replacement. During follow-up (average 6 months), in 39 patients with successful PBMV, the clinical functional status was improved and pulmonary systolic pressure was further decreased despite unchanged mitral valve area. Conclusions: PBMV was safe and effective for patients with mitral stenosis and severe pulmonary hypertension. Clinical functional status was improved and pulmonary systolic pressure was continuously decreased during the short-term follow-up

  1. Load Adaptability in Patients With Pulmonary Arterial Hypertension.

    Science.gov (United States)

    Amsallem, Myriam; Boulate, David; Aymami, Marie; Guihaire, Julien; Selej, Mona; Huo, Jennie; Denault, Andre Y; McConnell, Michael V; Schnittger, Ingela; Fadel, Elie; Mercier, Olaf; Zamanian, Roham T; Haddad, Francois

    2017-09-01

    Right ventricular (RV) adaptation to pressure overload is a major prognostic factor in patients with pulmonary arterial hypertension (PAH). The objectives were first to define the relation between RV adaptation and load using allometric modeling, then to compare the prognostic value of different indices of load adaptability in PAH. Both a derivation (n = 85) and a validation cohort (n = 200) were included. Load adaptability was assessed using 3 approaches: (1) surrogates of ventriculo-arterial coupling (e.g., RV area change/end-systolic area), (2) simple ratio of function and load (e.g., tricuspid annular plane systolic excursion/right ventricular systolic pressure), and (3) indices assessing the proportionality of adaptation using allometric pressure-function or size modeling. Proportional hazard modeling was used to compare the hazard ratio for the outcome of death or lung transplantation. The mean age of the derivation cohort was 44 ± 11 years, with 80% female and 74% in New York Heart Association class III or IV. Mean pulmonary vascular resistance index (PVRI) was 24 ± 11 with a wide distribution (1.6 to 57.5 WU/m 2 ). Allometric relations were observed between PVRI and RV fractional area change (R 2  = 0.53, p adaptation. In right heart parameters, RVESAI was the strongest predictor of outcomes (hazard ratio per SD = 1.93, 95% confidence interval 1.37 to 2.75, p adaptability indices provided stronger discrimination of outcome than simple RV adaptation metrics in either the derivation or the validation cohort. In conclusion, allometric modeling enables quantification of the proportionality of RV load adaptation but offers small incremental prognostic value to RV end-systolic dimension in PAH. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Testing popular VaR models in EU new member and candidate states

    Directory of Open Access Journals (Sweden)

    Saša Žiković

    2007-12-01

    Full Text Available The impact of allowing banks to calculate their capital requirement based on their internal VaR models, and the impact of regulation changes on banks in transitional countries has not been well studied. This paper examines whether VaR models that are created and suited for developed markets apply to the volatile stock markets of EU new member and candidate states (Bulgaria, Romania, Croatia and Turkey. Nine popular VaR models are tested on five stock indexes from EU new member and candidate states. Backtesting results show that VaR models commonly used in developed stock markets are not well suited for measuring market risk in these markets. Presented findings bear very important implications that have to be addressed by regulators and risk practitioners operating in EU new member andcandidate states. Risk managers have to start thinking outside the frames set by their parent companies or else investors present in these markets may find themselves in serious trouble, dealing with losses that they have not been expecting. National regulators have to take into consideration that simplistic VaR models that are widely used in some developed countries are not well suited for these illiquid and developing stock markets.

  3. Pulmonary complications after abdominal surgery in patients with mild-to-moderate chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Kim TH

    2016-11-01

    Full Text Available Tae Hoon Kim, Jae Seung Lee, Sei Won Lee, Yeon-Mok Oh Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Abstract: Postoperative pulmonary complications (PPCs are one of the most important causes of postoperative morbidity and mortality after abdominal surgery. Although chronic obstructive pulmonary disease (COPD has been considered a risk factor for PPCs, it remains unclear whether mild-to-moderate COPD is a risk factor. This retrospective cohort study included 387 subjects who underwent abdominal surgery with general anesthesia in a tertiary referral hospital. PPCs included pneumonia, pulmonary edema, pulmonary thromboembolism, atelectasis, and acute exacerbation of COPD. Among the 387 subjects, PPCs developed in 14 (12.0% of 117 patients with mild-to-moderate COPD and in 13 (15.1% of 86 control patients. Multiple logistic regression analysis revealed that mild-to-moderate COPD was not a significant risk factor for PPCs (odds ratio [OR] =0.79; 95% confidence interval [CI] =0.31–2.03; P=0.628. However, previous hospitalization for respiratory problems (OR =4.20; 95% CI =1.52–11.59, emergency surgery (OR =3.93; 95% CI =1.75–8.82, increased amount of red blood cell (RBC transfusion (OR =1.09; 95% CI =1.05–1.14 for one pack increase of RBC transfusion, and laparoscopic surgery (OR =0.41; 95% CI =0.18–0.93 were independent predictors of PPCs. These findings suggested that mild-to-moderate COPD may not be a significant risk factor for PPCs after abdominal surgery.Keywords: postoperative pulmonary complications, spirometry, risk factor, abdominal surgery, postoperative complications, postoperative care

  4. 76 FR 71920 - Payment for Home Health Services and Hospice Care by Non-VA Providers

    Science.gov (United States)

    2011-11-21

    ... concerning the billing methodology for non-VA providers of home health services and hospice care. The proposed rulemaking would include home health services and hospice care under the VA regulation governing... to ``RIN 2900-AN98--Payment for home health and services and hospice care by non-VA providers...

  5. Pulmonary arterial hypertension in children: diagnosis using ratio of main pulmonary artery to ascending aorta diameter as determined by multi-detector computed tomography

    International Nuclear Information System (INIS)

    Caro-Dominguez, Pablo; Manson, David E.; Compton, Gregory; Humpl, Tilman

    2016-01-01

    The ratio of the transverse diameter of the main pulmonary artery (MPA) to ascending aorta as determined at multi-detector CT is a tool that can be used to assess the pulmonary arterial size in cases of pulmonary arterial hypertension in children. To establish a ratio of MPA to ascending aorta diameter using multi-detector CT imaging suggestive of pulmonary arterial hypertension in children. We hypothesize that a defined ratio of MPA to ascending aorta is identifiable on multi-detector CT and that higher ratios can be used to reliably diagnose the presence of pulmonary arterial hypertension in children. We calculated the multi-detector CT ratio of MPA to ascending aorta diameter in 44 children with documented pulmonary arterial hypertension by right heart catheterization and in 44 age- and gender-matched control children with no predisposing factors for pulmonary arterial hypertension. We compared this multi-detector-CT-determined ratio with the MPA pressure in the study group, as well as with the ratio of MPA to ascending aorta in the control group. A threshold ratio value was calculated to accurately identify children with pulmonary arterial hypertension. Children with documented primary pulmonary arterial hypertension have a significantly higher ratio of MPA to ascending aorta (1.46) than children without pulmonary arterial hypertension (1.11). A ratio of 1.3 carries a positive likelihood of 34 and a positive predictive value of 97% for the diagnosis of pulmonary arterial hypertension. The pulmonary arteries were larger in children with pulmonary arterial hypertension than in a control group of normal children. A CT-measured ratio of MPA to ascending aorta of 1.3 should raise the suspicion of pulmonary arterial hypertension in children. (orig.)

  6. Pulmonary arterial hypertension in children: diagnosis using ratio of main pulmonary artery to ascending aorta diameter as determined by multi-detector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Caro-Dominguez, Pablo; Manson, David E. [University of Toronto, Department of Diagnostic Imaging, The Hospital for Sick Children, Department of Medical Imaging, Toronto, ON (Canada); Compton, Gregory [University of Toronto, Department of Diagnostic Imaging, The Hospital for Sick Children, Department of Medical Imaging, Toronto, ON (Canada); Epworth Hospital, Epworth Medical Imaging, Richmond, VIC (Australia); Humpl, Tilman [University of Toronto, Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON (Canada)

    2016-09-15

    The ratio of the transverse diameter of the main pulmonary artery (MPA) to ascending aorta as determined at multi-detector CT is a tool that can be used to assess the pulmonary arterial size in cases of pulmonary arterial hypertension in children. To establish a ratio of MPA to ascending aorta diameter using multi-detector CT imaging suggestive of pulmonary arterial hypertension in children. We hypothesize that a defined ratio of MPA to ascending aorta is identifiable on multi-detector CT and that higher ratios can be used to reliably diagnose the presence of pulmonary arterial hypertension in children. We calculated the multi-detector CT ratio of MPA to ascending aorta diameter in 44 children with documented pulmonary arterial hypertension by right heart catheterization and in 44 age- and gender-matched control children with no predisposing factors for pulmonary arterial hypertension. We compared this multi-detector-CT-determined ratio with the MPA pressure in the study group, as well as with the ratio of MPA to ascending aorta in the control group. A threshold ratio value was calculated to accurately identify children with pulmonary arterial hypertension. Children with documented primary pulmonary arterial hypertension have a significantly higher ratio of MPA to ascending aorta (1.46) than children without pulmonary arterial hypertension (1.11). A ratio of 1.3 carries a positive likelihood of 34 and a positive predictive value of 97% for the diagnosis of pulmonary arterial hypertension. The pulmonary arteries were larger in children with pulmonary arterial hypertension than in a control group of normal children. A CT-measured ratio of MPA to ascending aorta of 1.3 should raise the suspicion of pulmonary arterial hypertension in children. (orig.)

  7. Evaluation of peripheral pulmonary perfusion decrease of 99m-Tc MAA scintigraphy using SPECT/CT

    International Nuclear Information System (INIS)

    Yoneyama, Tatsuya; Kamisaki, Yuichi; Kameda, Keisuke; Seto, Hikaru

    2012-01-01

    We often experienced non-segmented peripheral patchy decrease (NSPPD) in 99m Tc-macro-aggregated albumin (MAA) pulmonary perfusion scan using single photon emission computed tomography (SPECT)/CT. Seventy cases were evaluated by 99m Tc-MAA SPECT/CT. NSPPD was seen in 22 cases (31.4%), of which 17 were assessed for pulmonary hypertension. Pulmonary hypertension was diagnosed in 11 cases, which consisted of 3 chronic thromboembolic pulmonary hypertension, 2 idiopathic pulmonary arterial hypertension, 2 systemic lupus eryhthematosus and 4 left ventricular heart disease. We suggest that NSPPD may indicate the early stage of pulmonary hypertension (PH). (author)

  8. Age-related incidence of pulmonary embolism and additional pathologic findings detected by computed tomography pulmonary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Groth, M., E-mail: groth.michael@googlemail.com [Center for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg (Germany); Henes, F.O., E-mail: f.henes@uke.uni-hamburg.de [Center for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg (Germany); Mayer, U., E-mail: mayer@uke.uni-hamburg.de [Emergency Department, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg (Germany); Regier, M., E-mail: m.regier@uke.uni-hamburg.de [Center for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg (Germany); Adam, G., E-mail: g.adam@uke.uni-hamburg.de [Center for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg (Germany); Begemann, P.G.C., E-mail: p.begemann@me.com [Center for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg (Germany)

    2012-08-15

    Objective: To compare the incidence of pulmonary embolism (PE) and additional pathologic findings (APF) detected by computed tomography pulmonary angiography (CTPA) according to different age-groups. Materials and methods: 1353 consecutive CTPA cases for suspected PE were retrospectively reviewed. Patients were divided into seven age groups: {<=}29, 30-39, 40-49, 50-59, 60-69, 70-79 and {>=}80 years. Differences between the groups were tested using Fisher's exact or chi-square test. A p-value < 0.0024 indicated statistical significance when Bonferroni correction was used. Results: Incidence rates of PE ranged from 11.4% to 25.4% in different age groups. The three main APF were pleural effusion, pneumonia and pulmonary nodules. No significant difference was found between the incidences of PE in different age groups. Furthermore, APF in different age groups revealed no significant differences (all p-values > 0.0024). Conclusion: The incidences of PE and APF detected by CTPA reveal no significant differences between various age groups.

  9. Mycobacterium avium complex pulmonary disease: characteristics and treatment in an Irish patient cohort.

    LENUS (Irish Health Repository)

    Judge, EP

    2016-04-01

    The prevalence of Mycobacterium avium complex (MAC) pulmonary disease is increasing globally. However, reliable national and international data relating to its epidemiology and management is lacking. During the period 2003-2014, MAC was isolated from the pulmonary samples of 75 patients at the Irish Mycobacteria Reference Laboratory (IMRL). Most patients (42, 56%) had underlying pulmonary disease, and 37 (49%) had clinical\\/radiographic characteristics consistent with MAC pulmonary disease. However, only 18 patients (24%) fulfilled internationally accepted criteria for diagnosis\\/treatment of this disease. Treatment was started in 13 (72%) of these cases, which is similar to internationally published treatment rates. The diagnosis of significant MAC pulmonary disease can be difficult, and treatment is not always warranted even when diagnostic criteria are met.

  10. 24 CFR 202.11 - Title I.

    Science.gov (United States)

    2010-04-01

    ... in 24 CFR 25.5. Civil money penalties may be imposed against Title I lenders and mortgagees pursuant... unacceptable risk to the Department; or (iv) Transfer of a Title I loan to a party that does not have a valid...

  11. 46 CFR 7.55 - Cape Henry, VA to Cape Fear, NC.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Cape Henry, VA to Cape Fear, NC. 7.55 Section 7.55 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC BOUNDARY LINES Atlantic Coast § 7.55 Cape Henry, VA to Cape Fear, NC. (a) A line drawn from Rudee Inlet Jetty Light “2” to...

  12. 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.

  13. Can reported VaR be used as an indicator of the volatility of share prices? Evidence from UK banks.

    OpenAIRE

    Ou, Shian Kao

    2006-01-01

    Value at Risk (VaR) is used as an indicator to measure the risks contained in a firm. With the uprising development of VaR theory and computational techniques, the VaR is nowadays adopted by banks and reported in annual reports. Since the method to calculate VaR is questioned, and the reported VaR can not be thoroughly audited, this paper attempts to find the relationship between the reported VaR and the volatility of share price for UK listed banks. This paper reviews literature about VaR an...

  14. Graphical linking of MO multicenter bond index and VB structures. II-5-c rings and 6-c heterocyclic rings

    CERN Document Server

    Bollini, C G; Giambiagi, M

    2001-01-01

    Through the graphical method proposed it is possible to set a link between an MO multicenter bond index and VB structures. The value of the index depends on the order of the atoms involved if they are more than three. For 5-c rings three basic structures are required; the eventually different values are 12. Unlike the 6-c case it may happen that different pairs of basic structures are used to build the same polygon. For the 6-c rings including heteroatoms the original degeneracy of benzene splits leading eventually to 60 different I sub r sub i sub n sub g values.

  15. VA's National PTSD Brain Bank: a National Resource for Research.

    Science.gov (United States)

    Friedman, Matthew J; Huber, Bertrand R; Brady, Christopher B; Ursano, Robert J; Benedek, David M; Kowall, Neil W; McKee, Ann C

    2017-08-25

    The National PTSD Brain Bank (NPBB) is a brain tissue biorepository established to support research on the causes, progression, and treatment of PTSD. It is a six-part consortium led by VA's National Center for PTSD with participating sites at VA medical centers in Boston, MA; Durham, NC; Miami, FL; West Haven, CT; and White River Junction, VT along with the Uniformed Services University of Health Sciences. It is also well integrated with VA's Boston-based brain banks that focus on Alzheimer's disease, ALS, chronic traumatic encephalopathy, and other neurological disorders. This article describes the organization and operations of NPBB with specific attention to: tissue acquisition, tissue processing, diagnostic assessment, maintenance of a confidential data biorepository, adherence to ethical standards, governance, accomplishments to date, and future challenges. Established in 2014, NPBB has already acquired and distributed brain tissue to support research on how PTSD affects brain structure and function.

  16. Coexisting bronchogenic carcinoma and pulmonary tuberculosis in the same lobe: radiologic findings and clinical significance

    International Nuclear Information System (INIS)

    Kim, Young Il; Goo, Jin Mo; Im, Jung Gi; Kim, Hyae Young; Song, Jae Woo

    2001-01-01

    Bronchogenic carcinoma can mimic or be masked by pulmonary tuberculosis (TB), and the aim of this study was to describe the radiologic findings and clinical significance of bronchogenic carcinoma and pulmonary TB which coexist in the same lobe. The findings of 51 patients (48 males and three females, aged 48-79 years) in whom pulmonary TB and bronchogenic carcinoma coexisted in the same lobe were analyzed. The morphologic characteristics of a tumor, such as its diameter and margin, the presence of calcification or cavitation, and mediastinal lymphadenopathy, as seen at CT, were retrospectively assessed, and the clinical stage of the lung cancer was also determined. Using the serial chest radiographs available for 21 patients, the possible causes of delay in the diagnosis of lung cancer were analyzed. Lung cancers with coexisting pulmonary TB were located predominantly in the upper lobes (82.4%). The mean diameter of the mass was 5.3 cm, and most tumors (n=42, 82.4%) had a lobulated border. Calcification within the tumor was seen in 20 patients (39.2%), and cavitation in five (9.8%). Forty-two (82.4%) had mediastinal lymphadenopathy, and more than half the tumors (60.8%) were at an advanced stage [IIIB (n=11) or IV (n=20)]. The average delay in diagnosing lung cancer was 11.7 (range, 1-24) months, and the causes of this were failure to observe new nodules masked by coexisting stable TB lesions (n=8), misinterpretation of new lesions as aggravation of TB (n=5), misinterpretation of lung cancer as tuberculoma at initial radiography (n=4), masking of the nodule by an active TB lesion (n=3), and subtleness of the lesion (n=1). Most cancers concurrent with TB are large, lobulated masses with mediastinal lymphadenopathy, indicating that the morphologic characteristics of lung cancer with coexisting pulmonary TB are similar to those of lung cancer without TB. The diagnosis of lung cancer is delayed mainly because of masking by a tuberculous lesion, and this suggests that

  17. Transcatheter closure of patent ductus arteriosus with severe pulmonary arterial hypertension in adults

    International Nuclear Information System (INIS)

    Zhao Shihua; Yan Chaowu; Jiang Shiliang; Xu Zhongying; Huang Lianjun; Ling Jian; Zheng Hong; Wang Cheng; Hu Haibo; Wu Wenhui; Li Shiguo; Dai Ruping

    2006-01-01

    Objective: To evaluate the effect of self-expandable occluder on closure of patent ductus arteriosus (PDA) with severe pulmonary arterial hypertension (PH) in adults. Methods: Twenty-eight adult patients underwent transcatheter closure of PDA at a mean age of (31.3±11.6) years [(18-58) years]. Either Amplatzer duct occluder or domestic device was used in the present study. X-ray, EKG and UCG were repeated in one day, one month, three months, and six months. Results: Twenty of the 28 patients had successful occlusion, and the other 8 patients were given up. In the successful group, the narrowest diameter of PDA was (10.4±2.7) mm [(6-16) mm], the diameter of selected occluder was (15.6±3.2)mm [(10-20) mm] at the end of pulmonary artery. Systemic artery oxygen saturation (SAsat) before and after oxygen inhalation was (93.5±1.8)%, (98.2±1.8)%, respectively (P<0.01). Systolic pulmonary arterial pressure decreased significantly after trial occlusion from (95.5± 24.l) mm Hg to (56.3±18.3) mm Hg (P<0.01); Mean pulmonary arterial pressures decreased significantly from (70.8±18.2) mm Hg to (41.0±13.8 )mm Hg (P<0. 01), too. Six months later UCG showed that the dimensions of left atrium, left ventricle and pulmonary artery attenuated significantly with one exception; X rays showed decreased pulmonary vascularity or cardiac size as well [cardio-thoracic ratio: (59.2±6.6)% vs (54.2±3.3)%, P<0.01]. In given up group, four patients were defined as Eisenmenger syndromes with differential cyanosis. They presented with elevated systolic pulmonary arterial pressure [(110.3±13.9) mm Hg vs (139.5±20.0)mm Hg, P<0.01], or decreased systolic aortic pressure[(116.0±20.2)mm Hg vs (106.3±16.9) mm Hg, P<0.05]after occlusion. The others included two cases with large residual shunt, and two cases with worsening of symptoms. Conclusions: Transcatheter closure of PDA with reversible severe PH is feasible, effective and safe in adults. (authors)

  18. Transcatheter closure of patent ductus arteriosus with severe pulmonary arterial hypertension in adults

    Energy Technology Data Exchange (ETDEWEB)

    Shihua, Zhao; Chaowu, Yan; Shiliang, Jiang; Zhongying, Xu; Lianjun, Huang; Jian, Ling; Hong, Zheng; Cheng, Wang; Haibo, Hu; Wenhui, Wu; Shiguo, Li; Ruping, Dai [Department of Radiology, Cardiovascular Inst. and Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing Union Medical College, Beijing (China)

    2006-11-15

    Objective: To evaluate the effect of self-expandable occluder on closure of patent ductus arteriosus (PDA) with severe pulmonary arterial hypertension (PH) in adults. Methods: Twenty-eight adult patients underwent transcatheter closure of PDA at a mean age of (31.3{+-}11.6) years [(18-58) years]. Either Amplatzer duct occluder or domestic device was used in the present study. X-ray, EKG and UCG were repeated in one day, one month, three months, and six months. Results: Twenty of the 28 patients had successful occlusion, and the other 8 patients were given up. In the successful group, the narrowest diameter of PDA was (10.4{+-}2.7) mm [(6-16) mm], the diameter of selected occluder was (15.6{+-}3.2)mm [(10-20) mm] at the end of pulmonary artery. Systemic artery oxygen saturation (SAsat) before and after oxygen inhalation was (93.5{+-}1.8)%, (98.2{+-}1.8)%, respectively (P<0.01). Systolic pulmonary arterial pressure decreased significantly after trial occlusion from (95.5{+-} 24.l) mm Hg to (56.3{+-}18.3) mm Hg (P<0.01); Mean pulmonary arterial pressures decreased significantly from (70.8{+-}18.2) mm Hg to (41.0{+-}13.8 )mm Hg (P<0. 01), too. Six months later UCG showed that the dimensions of left atrium, left ventricle and pulmonary artery attenuated significantly with one exception; X rays showed decreased pulmonary vascularity or cardiac size as well [cardio-thoracic ratio: (59.2{+-}6.6)% vs (54.2{+-}3.3)%, P<0.01]. In given up group, four patients were defined as Eisenmenger syndromes with differential cyanosis. They presented with elevated systolic pulmonary arterial pressure [(110.3{+-}13.9) mm Hg vs (139.5{+-}20.0)mm Hg, P<0.01], or decreased systolic aortic pressure[(116.0{+-}20.2)mm Hg vs (106.3{+-}16.9) mm Hg, P<0.05]after occlusion. The others included two cases with large residual shunt, and two cases with worsening of symptoms. Conclusions: Transcatheter closure of PDA with reversible severe PH is feasible, effective and safe in adults. (authors)

  19. Pulmonary extraction of serotonin and propranolol in patients with adult respiratory distress syndrome

    International Nuclear Information System (INIS)

    Morel, D.R.; Dargent, F.; Bachmann, M.; Suter, P.M.; Junod, A.F.

    1985-01-01

    Because injury to the pulmonary vascular endothelium is associated with the development of the adult respiratory distress syndrome (ARDS), the authors assessed the metabolic function of pulmonary endothelial cells by the measurements of the first-pass pulmonary extraction of [ 14 C]serotonin and [ 3 H]propranolol in 15 patients with ARDS and 15 patients at risk for developing ARDS. Serotonin extraction ratio was lower in patients with ARDS (0.85 +/- 0.10, mean +/- SD) than in patients at risk (0.91 +/- 0.04) (p less than 0.025), and both values were significantly reduced (p less than 0.005) when compared with a control group value (0.97 +/- 0.01). The decrease in serotonin extraction was correlated with the severity of ARDS (r = -0.67) (p less than 0.001) and with pulmonary function changes over time. Propranolol extraction ratio was decreased in patients at risk (0.66 +/- 0.11) (p less than 0.005) but not in patients with ARDS (0.75 +/- 0.11), when compared with those in the control group (0.81 +/- 0.03). Low values in patients at risk were restored to normal by continuous positive airway pressure breathing. The authors conclude that pulmonary extraction of serotonin, an index of pulmonary endothelial cell function, correlates with the severity of ARDS

  20. Feasibility and acceptability of interventions to delay gun access in VA mental health settings.

    Science.gov (United States)

    Walters, Heather; Kulkarni, Madhur; Forman, Jane; Roeder, Kathryn; Travis, Jamie; Valenstein, Marcia

    2012-01-01

    The majority of VA patient suicides are completed with firearms. Interventions that delay patients' gun access during high-risk periods may reduce suicide, but may not be acceptable to VA stakeholders or may be challenging to implement. Using qualitative methods, stakeholders' perceptions about gun safety and interventions to delay gun access during high-risk periods were explored. Ten focus groups and four individual interviews were conducted with key stakeholders, including VA mental health patients, mental health clinicians, family members and VA facility leaders (N=60). Transcripts were consensus-coded by two independent coders, and structured summaries were developed and reviewed using a consensus process. All stakeholder groups indicated that VA health system providers had a role in increasing patient safety and emphasized the need for providers to address gun access with their at-risk patients. However, VA mental health patients and clinicians reported limited discussion regarding gun access in VA mental health settings during routine care. Most, although not all, patients and clinicians indicated that routine screening for gun access was acceptable, with several noting that it was more acceptable for mental health patients. Most participants suggested that family and friends be involved in reducing gun access, but expressed concerns about potential family member safety. Participants generally found distribution of trigger locks acceptable, but were skeptical about its effectiveness. Involving Veteran Service Organizations or other individuals in temporarily holding guns during high-risk periods was acceptable to many participants but only with numerous caveats. Patients, clinicians and family members consider the VA health system to have a legitimate role in addressing gun safety. Several measures to delay gun access during high-risk periods for suicide were seen as acceptable and feasible if implemented thoughtfully. Published by Elsevier Inc.

  1. Magnetic resonance imaging of anomalous pulmonary venous connections

    International Nuclear Information System (INIS)

    Choe, Yeon Hyeon; Lee, Heung Jae; Kim, Hak Soo; Ko, Jae Kon; Kim, Ji Eun; Han, Jae Jin

    1994-01-01

    We evaluated the capability of MR in the diagnosis of anomalous pulmonary venous connection (APVC). The patient group consisted of 11 total APVC and 8 partial APVC diagnosed with MR. Echocardiography was performed in all cases, cardiac angiography in 12 cases and operation in 12 cases. We compared MR findings with those of operation, echocardiography and cardiac angiography. In surgically proven 12 cases, diagnostic accuracy of preoperative MR, echocardiography and cardiac angiography was 100%, 67%, and 63%, respectively. In the remaining cases, MR findings well correlated with those of echocardiography or cardiac angiography. Stenosis of common pulmonary vein or superior vena cava was identified in 4 cases. In one patient, MR duplicated associated cortriatriatum clearly. MR is an effective modally in depicting anomalous pulmonary venous connections

  2. Role of oxidative stress in thuringiensin-induced pulmonary toxicity

    International Nuclear Information System (INIS)

    Tsai, S.-F.; Yang Chi; Liu, B.-L.; Hwang, J.-S.; Ho, S.-P.

    2006-01-01

    To understand the effect of thuringiensin on the lungs tissues, male Sprague-Dawley rats were administrated with thuringiensin by intratracheal instillation at doses 0.8, 1.6 and 3.2 mg/kg of body weight, respectively. The rats were sacrificed 4 h after treatment, and lungs were isolated and examined. Subsequently, an effective dose of 1.6 mg/kg was selected for the time course study (4, 8, 12, and 24 h). Intratracheal instillation of thuringiensin resulted in lung damage, as evidenced by increase in lung weight and decrease in alkaline phosphatase (10-54%), an enzyme localized primarily in pulmonary alveolar type II epithelial cells. Furthermore, the administration of thuringiensin caused increases in lipid peroxidation (21-105%), the indices of lung injury. In addition, the superoxide dismutase (SOD) and glutathione (GSH) activities of lung tissue extracts were measured to evaluate the effect of thuringiensin on antioxidant defense system. The SOD activity and GSH content in lung showed significant decreases in a dose-related manner with 11-21% and 15-37%, respectively. Those were further supported by the release of proinflammatory cytokines, as indicated by increases in IL-1β (229-1017%) and TNF-α (234%) levels. Therefore, the results demonstrated that changes in the pulmonary oxidative-antioxidative status might play an important role in the thuringiensin-induced lung injury

  3. 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.

  4. Easy handling of tectonic data: the programs TectonicVB for Mac and TectonicsFP for Windows™

    Science.gov (United States)

    Ortner, Hugo; Reiter, Franz; Acs, Peter

    2002-12-01

    TectonicVB for Macintosh and TectonicsFP for Windows TM operating systems are two menu-driven computer programs which allow the shared use of data on these environments. The programs can produce stereographic plots of orientation data (great circles, poles, lineations). Frequently used statistical procedures like calculation of eigenvalues and eigenvectors, calculation of mean vector with concentration parameters and confidence cone can be easily performed. Fault data can be plotted in stereographic projection (Angelier and Hoeppener plots). Sorting of datasets into homogeneous subsets and rotation of tectonic data can be performed in interactive two-diagram windows. The paleostress tensor can be calculated from fault data sets using graphical (calculation of kinematic axes and right dihedra method) or mathematical methods (direct inversion or numerical dynamical analysis). The calculations can be checked in dimensionless Mohr diagrams and fluctuation histograms.

  5. EXERCISE-INDUCED PULMONARY HEMORRHAGE AFTER RUNNING A MARATHON

    Science.gov (United States)

    We report on a healthy 26-year-old male who had an exercise-induced pulmonary hemorrhage (EIPH) within 24 hours of running a marathon. There were no symptoms, abnormalities on exam, or radiographic infiltrates. He routinely participated in bronchoscopy research and the EIPH was e...

  6. 46 CFR 7.45 - Cape Henlopen, DE to Cape Charles, VA.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Cape Henlopen, DE to Cape Charles, VA. 7.45 Section 7.45... Atlantic Coast § 7.45 Cape Henlopen, DE to Cape Charles, VA. (a) A line drawn from the easternmost extremity of Indian River Inlet North Jetty to latitude 38°36.5′ N. longitude 75°02.8′ W. (Indian River...

  7. VA Enterprise Design Patterns - 5.1 (Mobility) Mobile

    Data.gov (United States)

    Department of Veterans Affairs — First of a set of guidance documents that establish the architectural foundation for mobile computing in the VA. This document outlines the enterprise capabilities...

  8. VA Enterprise Design Patters - 2.5 (Enterprise Architecture)

    Data.gov (United States)

    Department of Veterans Affairs — Enterprise architectural guidelines and constraints that provide references to the use of enterprise capabilities that will enable the VA to access and exchange data...

  9. Computed tomographic pulmonary angiography in the assessment of severity of chronic thromboembolic pulmonary hypertension and right ventricular dysfunction

    International Nuclear Information System (INIS)

    Liu Min; Ma Zhanhong; Guo Xiaojuan; Zhang Hongxia; Yang Yuanhua; WangChen

    2011-01-01

    /LVd: beta = 11.812, P = 0.000; RVAWT: beta = 2.426, P = 0.000; MPAd: beta = 0.677, P = 0.003). Conclusion: Computed tomographic pulmonary angiography is a valuable tool to evaluate hemodynamics, right ventricular function of CTEPH, but neither Qanadli Index nor Mastora Index can reflect pulmonary arterial obstruction in CTEPH accurately.

  10. Solitary pulmonary metastases in high-risk melanoma patients: a prospective comparison of conventional and computed tomography

    International Nuclear Information System (INIS)

    Heaston, D.K.; Putman, C.E.; Rodan, B.A.; Nicholson, E.; Ravin, C.E.; Korobkin, M.; Chen, J.T.; Seigler, H.F.

    1983-01-01

    A prospective comparison of chest radiography, conventional tomography, and computed tomography (CT) in the detection or confirmation of solitary pulmonary nodules was made in 42 patients with high propensity for pulmonary metastases due to advanced local (Clark level IV or V) or regional malignant melanoma. Unequivocal nodules were revealed by chest radiography in 11 patients, conventional tomograhy in 16, and computed tomography in 20 patients. Both plain films and tomography in three of these 20 were normal, but follow-up verified pulmonary metastases. Computed tomography detected more pulmonary nodules than conventional tomography in 11 patients in addition to identifying lesions in extrapulmonary sites. Therefore, chest CT is recommended before institution of immunotherapy or surgical removal of a solitary pulmonary melanoma metastasis. Once chemotherapy had been instituted for bulky regional or cutaneous involvement, however, the findings of either conventional or computed tomography were comparable in this study

  11. CT findings in primary pulmonary lymphomas

    International Nuclear Information System (INIS)

    Cardinale, Luciano; Allasia, Marco; Cataldi, Aldo; Ferraris, Fabrizio; Fava, Cesare; Parvis, Guido

    2005-01-01

    Purpose. To describe the CT findings of pathologically confirmed primary pulmonary lymphomas. Materials and methods. The CT examinations of 11 patients with pathologically proven primary pulmonary lymphoma (9 BALT lymphomas and 2 non-BALT lymphomas) were retrospectively reviewed by three radiologists. Evaluated findings included morphology (consolidation, mass, nodule), number and distribution of lesions. Other CT findings such as air bronchogram, lymphadenopathy atelectasis and pleural effusion were also assessed. Results. Pulmonary lesions were depicted as air-space consolidation (pneumonia-like) in 5 patients (45%), tumour-like rounded opacity in 4 (36%), and nodules in 4 (36%). Multiple and bilateral long lesions were seen in 3 patients (27%). Air bronchogram was present in 7 patients (63%), lymphadenopathy in 3 (27%), atelectasis in 4 (36%) and pleural effusion in only 1 (9%). Conclusions. Our results agree with previous studies regarding lesion patterns and their relative frequency. A smaller number of nodules and of multiple lesions were found compared with some previous studies. The most frequent pattern was airspace consolidation [it

  12. CT diagnosis of primary lung cancer coexisting with pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Kim, Sun Joo; Kim, Young Sook; Oh, Jae Hee; Kim, Eun Kyoung; Kim, Young Chul

    1992-01-01

    When bronchogenic carcinoma is coexisting with pulmonary tuberculosis, it is difficult to differentiate bronchogenic carcinoma from pulmonary tuberculosis radiographically. Thus, the object of this study is to define differential diagnosis of bronchogenic carcinoma by computed tomography. We analyzed CT scans of 27 patients with radiologic findings of pulmonary tuberculosis and mass of which twelve cases were pulmonary tuberculosis and fifteen cases were primary lung cancer. The location of parenchymal infiltration and the mass was the same in 60%(9/15) of the primary lung cancer in cases and 83%(10/12) of the pulmonary tuberculosis cases. The common location of the mass was the both upper lobes in 92%(11/12) of the pulmonary tuberculosis cases and 53%(8/15) of the primary lung cancer cases. The common locations of the mediastinal lymphadenopathy were 4R, 2R of the pulmonary tuberculosis cases and 4R, 10R of the primary lung cancer cases. In the feature of post enhanced lymph nodes, homogenous increased density was more frequent in primary lung cancer. Measurements of the maximum thickness part of the cavity wall was not a reliable indication of malignancy

  13. Clinical validity of a normal pulmonary angiogram in patients with suspected pulmonary embolism - A critical review

    International Nuclear Information System (INIS)

    Beek, Edwin J.R. van; Brouwers, Elise M.J.; Song Bin; Stein, Paul D.; Oudkerk, Matthijs

    2001-01-01

    AIM: To determine the validity of a normal pulmonary angiogram in the exclusion of pulmonary embolism (PE), based on the safety of withholding anticoagulant therapy in patients with a normal pulmonary angiogram. MATERIALS AND METHODS: A review of English reports published between 1965 and April 1999 was carried out. Eligible articles described prospective studies in patients with suspected PE and a normal pulmonary angiogram, who remained untreated and were followed-up for a minimum of 3 months. Articles were evaluated by two authors, using pre-defined criteria for strength of design. End points consisted of fatal and non-fatal recurrent thromboembolic events. A sensitivity analysis was performed, by removing one study at a time from the overall results and by comparing pre- and post-1990 publications. RESULTS: Among 1050 patients in eight articles included in the analysis, recurrent thromboembolic events were described in 18 patients (1.7% 95% CI: 1.0-2.7%). These were fatal in three patients (0.3% 95% CI: 0.02-0.7%). The recurrence rate of PE decreased from 2.9% (95% CI: 1.4-6.8%) before 1990 to 1.1% (95% CI: 0.5-2.2%) after 1990. CONCLUSION: It would appear that the ability to exclude PE by angiography has improved over the years, as indicated by recurrence rate of PE. The low recurrence rate of PE supports the validity of a normal pulmonary angiogram for the exclusion of PE. Beek, E.J.R. van et al. (2001)

  14. 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.

  15. Pulmonary disposition and pharmacokinetics of minocycline in adult horses.

    Science.gov (United States)

    Echeverria, Kate O; Lascola, Kara M; Giguère, Steeve; Foreman, Jonathan H; Austin, Scott A

    2017-11-01

    OBJECTIVE To determine pharmacokinetics and pulmonary disposition of minocycline in horses after IV and intragastric administration. ANIMALS 7 healthy adult horses. PROCEDURES For experiment 1 of the study, minocycline was administered IV (2.2 mg/kg) or intragastrically (4 mg/kg) to 6 horses by use of a randomized crossover design. Plasma samples were obtained before and 16 times within 36 hours after minocycline administration. Bronchoalveolar lavage (BAL) was performed 4 times within 24 hours after minocycline administration for collection of pulmonary epithelial lining fluid (PELF) and BAL cells. For experiment 2, minocycline was administered intragastrically (4 mg/kg, q 12 h, for 5 doses) to 6 horses. Plasma samples were obtained before and 20 times within 96 hours after minocycline administration. A BAL was performed 6 times within 72 hours after minocycline administration for collection of PELF samples and BAL cells. RESULTS Mean bioavailability of minocycline was 48% (range, 35% to 75%). At steady state, mean ± SD maximum concentration (Cmax) of minocycline in plasma was 2.3 ± 1.3 μg/mL, and terminal half-life was 11.8 ± 0.5 hours. Median time to Cmax (Tmax) was 1.3 hours (interquartile range [IQR], 1.0 to 1.5 hours). The Cmax and Tmax of minocycline in the PELF were 10.5 ± 12.8 μg/mL and 9.0 hours (IQR, 5.5 to 12.0 hours), respectively. The Cmax and Tmax for BAL cells were 0.24 ± 0.1 μg/mL and 6.0 hours (IQR, 0 to 6.0 hours), respectively. CONCLUSIONS AND CLINICAL RELEVANCE Minocycline was distributed into the PELF and BAL cells of adult horses.

  16. 38 CFR 74.26 - What types of business information will VA collect?

    Science.gov (United States)

    2010-07-01

    ... VETERANS AFFAIRS (CONTINUED) VETERANS SMALL BUSINESS REGULATIONS Records Management § 74.26 What types of business information will VA collect? VA will examine a variety of business records. See § 74.12, “What is... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false What types of business...

  17. 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

  18. 2017-11-24T17:45:52Z https://www.ajol.info/index.php/all/oai oai:ojs ...

    African Journals Online (AJOL)

    article/21769 2017-11-24T17:45:52Z qm:ART On rings generating supernilpotent and special atoms France-Jackson, H; Nelson Mandela Metropolitan University, Department of Mathematics and Applied Mathematics, Summerstrand Campus ...

  19. CHANGES IN THE PARAMETERS OF 24-HOUR BLOOD PRESSURE MONITORING AND ARTERIAL STIFFNESS IN PATIENTS WITH HYPERTENSION AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE TREATED WITH VALSARTAN

    Directory of Open Access Journals (Sweden)

    N. A. Karoli

    2015-09-01

    Full Text Available Aim. To study changes in the parameters of the 24-hour blood pressure (BP monitoring and arterial stiffness (AS in patients with arterial hypertension (HT and chronic obstructive pulmonary disease (COPD treated with angiotensin II receptors blocker, valsartan.Material and methods. Men with HT and COPD (n=23, who have been receiving valsartan with starting dose 80 mg/day for 6 months as antihypertensive therapy were included into the study. If target BP was not achieved, correction of the valsartan dose was carried out with the hydrochlorothiazide addition when needed. Clinical examination, 24-hour BP and AS monitoring using BPLab MnSDP-2 monitor ("Petr TELEGIN",Russia, clinical evaluation of COPD were performed.Results. Abnormal circadian BP profile and the elastic properties of arteries were diagnosed in the majority of hypertensive patients with COPD. Valsartan therapy allowed to achieve target BP levels in 100% of patients, normalization of circadian BP profile in 56.5%, improvement in AS parameters: a significant increase in PTT2 (from 89.6±14.3 to 94.4±18.4 ms, reduction of (dP/dtmax (from 566.6±117.9 to 518.8±146.2 mmHg/s, AIx (from -4.0±15.2 to -11.6±20.8 % as compared to the baseline. Circadian changes in daily parameters of AS in studied patients with the most obvious night-time abnormalities of the elastic properties of arteries were detected. Valsartan intake led to Alx reduction at night-time.Conclusion. Valsartan-based therapy in hypertensive patients with concomitant COPD demonstrated a high antihypertensive efficacy and favorable changes in the elastic properties of the vascular wall that confirm its organoprotective effect.

  20. CHANGES IN THE PARAMETERS OF 24-HOUR BLOOD PRESSURE MONITORING AND ARTERIAL STIFFNESS IN PATIENTS WITH HYPERTENSION AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE TREATED WITH VALSARTAN

    Directory of Open Access Journals (Sweden)

    N. A. Karoli

    2014-01-01

    Full Text Available Aim. To study changes in the parameters of the 24-hour blood pressure (BP monitoring and arterial stiffness (AS in patients with arterial hypertension (HT and chronic obstructive pulmonary disease (COPD treated with angiotensin II receptors blocker, valsartan.Material and methods. Men with HT and COPD (n=23, who have been receiving valsartan with starting dose 80 mg/day for 6 months as antihypertensive therapy were included into the study. If target BP was not achieved, correction of the valsartan dose was carried out with the hydrochlorothiazide addition when needed. Clinical examination, 24-hour BP and AS monitoring using BPLab MnSDP-2 monitor ("Petr TELEGIN",Russia, clinical evaluation of COPD were performed.Results. Abnormal circadian BP profile and the elastic properties of arteries were diagnosed in the majority of hypertensive patients with COPD. Valsartan therapy allowed to achieve target BP levels in 100% of patients, normalization of circadian BP profile in 56.5%, improvement in AS parameters: a significant increase in PTT2 (from 89.6±14.3 to 94.4±18.4 ms, reduction of (dP/dtmax (from 566.6±117.9 to 518.8±146.2 mmHg/s, AIx (from -4.0±15.2 to -11.6±20.8 % as compared to the baseline. Circadian changes in daily parameters of AS in studied patients with the most obvious night-time abnormalities of the elastic properties of arteries were detected. Valsartan intake led to Alx reduction at night-time.Conclusion. Valsartan-based therapy in hypertensive patients with concomitant COPD demonstrated a high antihypertensive efficacy and favorable changes in the elastic properties of the vascular wall that confirm its organoprotective effect.

  1. [Clinical efficacy of high-frequency oscillatory ventilation combined with pulmonary surfactant in treatment of neonatal pulmonary hemorrhage].

    Science.gov (United States)

    Lin, Xin-Zhu; Lai, Ji-Dong; Lv, Mei; Zhu, Yao; Wang, Lian; Chen, Chao

    2015-04-01

    To explore the clinical efficacy of high-frequency oscillatory ventilation (HFOV) combined with pulmonary surfactant (PS) in the treatment of neonatal pulmonary hemorrhage (NPH). A total of 122 neonates diagnosed with NPH between January 2010 and June 2014 were enrolled. After being stratified by gestational age, the neonates were randomly divided into treatment (HFOV+PS) and control (HFOV alone) groups (n=61 each). Both groups were treated with HFOV after the onset of NPH. After 2-4 hours of HFOV treatment, the treatment group received PS via intratracheal injections, followed by continuous use of HFOV. Dynamic changes in the blood gas, oxygenation index (OI), and PaO2/FiO2 (P/F) values of the neonates were determined before HFOV treatment and after 6, 12, and 24 hours of HFOV treatment. The time to hemostasis, duration of ventilation, incidence of complications, and cure rate were compared between groups. After 6, 12, and 24 hours of HFOV treatment, the treatment group had significantly improved PaO2, PaCO2, O/I, and P/F values compared with the control group (P0.05). HFOV combined with PS is an effective treatment to improve oxygenation, shorten the time to hemostasis and the duration of ventilation, and reduce the incidence of complications in neonates with NPH. However, the dual therapy is unable to reduce the mortality of neonates compared with HFOV monotherapy.

  2. Evaluation of Tl-201 lung uptake and impairment of pulmonary perfusion on scintigraphies in pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Fujii, Tadashige; Tanaka, Masao; Koizumi, Tomonori; Kubo, Keishi

    2000-01-01

    Tl-201 lung uptake in 74 patients (85 lesions) and pulmonary perfusion in 105 patients were studied to evaluate clinical usefulness of Tl-201 lung uptake and perfusion lung scintigraphy in pulmonary tuberculosis, using a scintillation camera with a mini-computer system. As indices of Tl-201 lung uptake, lung (lesion) to upper mediastinum uptake ratio (L/M) and visual grading were used. L/M in pulmonary tuberculosis was 1.96±0.66, which was significantly larger than 1.04±0.24 in healthy controls and lower than that in heart diseases with left heart failure and idiopathic interstitial pneumonia, and showed no significant differences with that in acute pneumonia, pyothorax, primary lung cancer and malignant mediastinal tumor. L/M in pulmonary tuberculosis did not correlate with CRP, erythrocyte sedimentation rate, Gaffky number of sputum and body temperature. It correlated with the type of pulmonary tuberculosis according to the Gakken Classification reflecting the disease activity. It was larger in the exudative type, caseo-infiltrative one, disseminated one, one with cavity in infiltrative lesion than the fibro-caseous one. On perfusion lung scintigram, impairment of pulmonary perfusion larger than area of the entire unilateral lung was observed in 68 cases (64.8%). Area of hypoperfused lung field, which correlated with % vital capacity (r=0.60, p=0.0002) and PaO 2 (r=0.39,p=0.0024), was significantly larger in patients with silicosis and those with bilateral pleural involvements such as pleural callosity than in those with type III according to the Gakkai Classification. Most of the patients showed decreased pulmonary perfusion and Tl-201 accumulation of which grade reflects the disease activity in active tuberculous lesion. Patients with miliary tuberculosis and those with silicotuberculosis showed diffuse Tl-201 accumulation in the both lungs. Tl-201 lung scintigraphy seems to be useful for visualizing active tuberculous lesions, particularly the ones that

  3. Interferon-gamma response to the treatment of active pulmonary and extra-pulmonary tuberculosis.

    Science.gov (United States)

    Liang, L; Shi, R; Liu, X; Yuan, X; Zheng, S; Zhang, G; Wang, W; Wang, J; England, K; Via, L E; Cai, Y; Goldfeder, L C; Dodd, L E; Barry, C E; Chen, R Y

    2017-10-01

    Interferon-gamma (IFN-γ) release assays (IGRAs) are used to diagnose tuberculosis (TB) but not to measure treatment response. To measure IFN-γ response to active anti-tuberculosis treatment. Patients from the Henan Provincial Chest Hospital, Henan, China, with TB symptoms and/or signs were enrolled into this prospective, observational cohort study and followed for 6 months of treatment, with blood and sputum samples collected at 0, 2, 4, 6, 8, 16 and 24 weeks. The QuantiFERON® TB-Gold assay was run on collected blood samples. Participants received a follow-up telephone call at 24 months to determine relapse status. Of the 152 TB patients enrolled, 135 were eligible for this analysis: 118 pulmonary (PTB) and 17 extra-pulmonary TB (EPTB) patients. IFN-γ levels declined significantly over time among all patients (P = 0.002), with this decline driven by PTB patients (P = 0.001), largely during the initial 8 weeks of treatment (P = 0.019). IFN-γ levels did not change among EPTB patients over time or against baseline culture or drug resistance status. After 6 months of effective anti-tuberculosis treatment, IFN-γ levels decreased significantly in PTB patients, largely over the initial 8 weeks of treatment. IFN-γ concentrations may offer some value for monitoring anti-tuberculosis treatment response among PTB patients.

  4. 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...

  5. Morphologic characteristics of central pulmonary thromboemboli predict haemodynamic response in massive pulmonary embolism.

    Science.gov (United States)

    Podbregar, Matej; Voga, Gorazd; Krivec, Bojan

    2004-08-01

    On hospital admission, the morphology of the central pulmonary artery thromboemboli is an independent predictor of 30-day mortality in patients with massive pulmonary embolism (MPE). This may be due to the differential susceptibility of thromboemboli to thrombolysis. The aim of this study was to assess haemodynamic response to treatment in patients with MPE and morphologically different thromboemboli. Prospective observational study. An 11-bed closed medical ICU at a 860-bed community general hospital. Twelve consecutive patients with shock or hypotension due to MPE and central pulmonary thromboemboli detected by transesophageal echocardiography who were treated with thrombolysis between January 2000 through April 2002. Patients were divided into two groups according to the characteristics of detected central pulmonary thromboemboli: group 1, thrombi with one or more long, mobile parts; and group 2, immobile thrombi. Urokinase infusion was terminated when mixed venous oxygen saturation was stabilized above 60% for 15 min. At 2 h, the total pulmonary vascular resistance index was reduced more in group 1 than group 2 [from 27+/-12 mmHg/(l.min.m(2)) to 14+/-6 mmHg/(l.min.m(2)) (-52%) vs 27+/-8 mmHg/(l.min.m(2)) to 23+/-10 mmHg/(l.min.m(2)) (-15%), respectively, P=0.04]. In group 1 thrombolysis was terminated earlier than group 2 (89+/-40 min vs 210+/-62 min, respectively, P= 0.0024). The cumulative dose of urokinase used in group 1 was lower than group 2 (1.7+/-0.3 M i.u. vs 2.7+/-0.5 M i.u., respectively, P= 0.023). Haemodynamic stabilization is achieved faster in patients with mobile central thromboemboli detected by transesophageal echocardiography during MPE.

  6. 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

  7. Energy efficiency and pulmonary artery flow after balloon pulmonary angioplasty for inoperable, chronic thromboembolic pulmonary hypertension: Analysis by phase-contrast MRI

    Energy Technology Data Exchange (ETDEWEB)

    Nagao, Michinobu, E-mail: nagao.michinobu@twmu.ac.jp [Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women’s Medical University, Tokyo (Japan); Yamasaki, Yuzo [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Abe, Kohtaro; Hosokawa, Kazuya [Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Kawanami, Satoshi [Department of Molecular Imaging & Diagnosis, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Kamitani, Takeshi; Yamanouchi, Torahiko [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Yabuuchi, Hidetake [Department of Medical Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Fukushima, Kenji [Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women’s Medical University, Tokyo (Japan); Honda, Hiroshi [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan)

    2017-02-15

    Purpose: The aims of this study were to propose a new quantitative method for pulmonary artery (PA) flow energetics using phase-contrast magnetic resonance imaging (PC-MRI), and to investigate how balloon pulmonary angioplasty (BPA) impacts energetics in chronic thromboembolic pulmonary hypertension (CTEPH). Materials and methods: PC-MRI at 3-Teslar and with a flow sensitive gradient echo was used to examine energetics prior to and following BPA for 24 CTEPH patients. Stroke volume (m; ml) and mean velocity (V; mm/s) for the main pulmonary artery (PA), right PA, and left PA were calculated from a time-flow curve derived from PC-MRI. Based on the Bernoulli principle, PA energy was identified as 1/2 mV{sup 2} (μj/kg), and energy loss was defined as the following equation “energy loss = main PA energy − (rt. PA energy + lt. PA energy)”. Results: Right PA energy was significantly greater post-BPA than pre-BPA (61 ± 55 vs. 32 ± 40 μj/kg). There was no difference in main PA and left PA energies. Energy loss was significantly decreased post-BPA (18 ± 97 μj/kg) than pre-BPA (79 ± 125 μj/kg). An optimal cutoff of left PA energy of 45 μj/kg pre-BPA can be used to predict patients with mPAP ≥ 30 mmHg after BPA, with an area under the curve of 0.91, 78% sensitivity, and 92% specificity. Conclusion: Analysis of PA energetics using phase-contrast MRI demonstrates that BPA improves energy loss in CTEPH. In addition, BPA responses can be predicted by PA energy status pre-treatment.

  8. Pulmonary vein dimensions and variation of branching pattern in patients with paroxysmal atrial fibrillation using magnetic resonance angiography

    International Nuclear Information System (INIS)

    Takase, Bonpei; Nagata, Masayoshi; Matsui, Takemi

    2004-01-01

    Pulmonary veins are the most frequent origin of focal and paroxysmal atrial fibrillation. Although radiofrequency ablation has been attempted for the treatment of focal and paroxysmal atrial fibrillation, the anatomy of the pulmonary vein is still not fully understood. To investigate the dimensions and anatomical variation of the pulmonary vein in patients with paroxysmal atrial fibrillation, we performed breath-hold gadolinium enhanced magnetic resonance (MR) angiography using a 1.5 T cardiac MR imager (GE CV/i) in 32 patients with paroxysmal atrial fibrillation (61±8 years old), 11 patients with chronic atrial fibrillation (64±9 years old), and 26 patients with normal sinus rhythm (55±15 years old). Three-dimensional images of the pulmonary veins were thus obtained, and the diameters of the most proximal portion of the left or right superior pulmonary vein and left or right inferior pulmonary vein were measured. Pulmonary vein branching variations were determined by a visual qualitative analysis by two separate readers' agreements, who were blinded to any clinical information. We focused on the existence of a complex-branching pattern draining into the orifice of four pulmonary veins. Patients with either paroxysmal atrial fibrillation or chronic atrial fibrillation showed larger superior pulmonary veins than those with normal sinus rhythm (mean±SD; in the left superior pulmonary vein, 20±3 mm 23±3 mm vs 16±3 mm, P<0.05; in right superior pulmonary vein, 19±4 mm, 19±2 mm vs 16±2 mm, P<0.05). Complex-branching pattern was frequently observed in inferior pulmonary veins in patients with either paroxysmal atrial fibrillation or chronic atrial fibrillation; 25/32 patients with paroxysmal atrial fibrillation, 11/11 patients with chronic atrial fibrillation, compared to 7/26 patients with normal sinus rhythm. Complex-branching patterns were not observed in superior pulmonary veins in any patients in this cohort. In patients with paroxysmal atrial fibrillation

  9. Are all pulmonary hypoplasias the same? A comparison of pulmonary outcomes in neonates with congenital diaphragmatic hernia, omphalocele and congenital lung malformation.

    Science.gov (United States)

    Akinkuotu, Adesola C; Sheikh, Fariha; Cass, Darrell L; Zamora, Irving J; Lee, Timothy C; Cassady, Christopher I; Mehollin-Ray, Amy R; Williams, Jennifer L; Ruano, Rodrigo; Welty, Stephen E; Olutoye, Oluyinka O

    2015-01-01

    Patients with congenital diaphragmatic hernias (CDH), omphaloceles, and congenital lung malformations (CLM) may have pulmonary hypoplasia and experience respiratory insufficiency. We hypothesize that given equivalent lung volumes, the degree of respiratory insufficiency will be comparable regardless of the etiology. Records of all fetuses with CDH, omphalocele, and CLM between January 2000 and June 2013 were reviewed. MRI-based observed-to-expected total fetal lung volumes (O/E-TFLV) were calculated. An analysis of outcomes in patients with O/E-TFLV between 40% and 60%, the most inclusive range, was performed. 285 patients were evaluated (161, CDH; 24, omphalocele; 100, CLM). Fetuses with CDH had the smallest mean O/E-TFLV. CDH patients were intubated for longer and had a higher incidence of pulmonary hypertension. Fifty-six patients with the three diagnoses had an O/E-TFLV of 40%-60%. The need for ECMO, supplemental oxygen at 30days of life, and 6-month mortality were similar among groups. CDH patients had a significantly longer duration of intubation and higher incidence of pulmonary hypertension than the other two diagnoses. Given equivalent lung volumes (40%-60% of expected), CDH patients require more pulmonary support initially than omphalocele and CLM patients. In addition to lung volumes, disease-specific factors, such as pulmonary hypertension in CDH, also contribute to pulmonary morbidity and overall outcome. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. 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)

  11. The influence of bisphosphonates on human osteoblast migration and integrin aVb3/tenascin C gene expression in vitro

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    Said Yekta Sareh

    2011-02-01

    Full Text Available Abstract Background Bisphosphonates are therapeutics of bone diseases, such as Paget's disease, multiple myeloma or osteoclastic metastases. As a severe side effect the bisphosphonate induced osteonecrosis of the jaw (BONJ often requires surgical treatment and is accompanied with a disturbed wound healing. Therefore, the influence on adhesion and migration of human osteoblasts (hOB after bisphosphonate therapy has been investigated by morphologic as well as gene expression methods. Methods By a scratch wound experiment, which measures the reduction of defined cell layer gap, the morphology and migration ability of hOB was evaluated. A test group of hOB, which was stimulated by zoledronate 5 × 10-5M, and a control group of unstimulated hOB were applied. Furthermore the gene expression of integrin aVb3 and tenascin C was quantified by Real-Time rtPCR at 5data points over an experimental period of 14 days. The bisphosphonates zoledronate, ibandronate and clodronate have been compared with an unstimulated hOB control. Results After initially identical migration and adhesion characteristics, zoledronate inhibited hOB migration after 50 h of stimulation. The integrinavb3 and tenascin C gene expression was effected by bisphosphonates in a cell line dependent manner with decreased, respectively inconsistent gene expression levels over time. The non-nitrogen containing bisphosphonates clodronate led to decreased gene expression levels. Conclusion Bisphosphonates seem to inhibit hOB adhesion and migration. The integrin aVb3 and tenascin C gene expression seem to be dependent on the cell line. BONJ could be enhanced by an inhibition of osteoblast adhesion and migration. The gene expression results, however, suggest a cell line dependent effect of bisphosphonates, which could explain the interindividual differences of BONJ incidences.

  12. 18F-Fluorodeoxyglucose positron emission tomography pulmonary imaging in idiopathic pulmonary fibrosis is reproducible: implications for future clinical trials

    International Nuclear Information System (INIS)

    Win, Thida; Lambrou, Tryphon; Hutton, Brian F.; Kayani, Irfan; Endozo, Raymondo; Shortman, Robert I.; Groves, Ashley M.; Screaton, Nicholas J.; Porter, Joanna C.; Maher, Toby M.; Lukey, Pauline

    2012-01-01

    Noninvasive markers of disease activity in patients with idiopathic pulmonary fibrosis (IPF) are lacking. We performed this study to investigate the reproducibility of pulmonary 18 F-FDG PET/CT in patients with IPF. The study group comprised 13 patients (11 men, 2 women; mean age 71.1 ± 9.9 years) with IPF recruited for two thoracic 18 F-FDG PET/CT studies performed within 2 weeks of each other. All patients were diagnosed with IPF in consensus at multidisciplinary meetings as a result of typical clinical, high-resolution CT and pulmonary function test features. Three methods for evaluating pulmonary 18 F-FDG uptake were used. The maximal 18 F-FDG pulmonary uptake (SUVmax) in the lungs was determined using manual region-of-interest placement. An 18 F-FDG uptake intensity histogram was automatically constructed from segmented lungs to evaluate the distribution of SUVs. Finally, mean SUV was determined for volumes-of-interest in pulmonary regions with interstitial lung changes identified on CT scans. Processing included correction for tissue fraction effects. Bland-Altman analysis was performed and interclass correlation coefficients (ICC) were determined to assess the reproducibility between the first and second PET scans, as well as the level of intraobserver and interobserver agreement. The mean time between the two scans was 6.3 ± 4.3 days. The interscan ICCs for pulmonary SUVmax analysis and mean SUV corrected for tissue fraction effects were 0.90 and 0.91, respectively. Intensity histograms were different in only 1 of the 13 paired studies. Intraobserver agreement was also excellent (0.80 and 0.85, respectively). Some bias was observed between observers, suggesting that serial studies would benefit from analysis by the same observer. This study demonstrated that there is excellent short-term reproducibility in pulmonary 18 F-FDG uptake in patients with IPF. (orig.)

  13. Interaction of blood coagulation factor Va with phospholipid vesicles examined by using lipophilic photoreagents

    International Nuclear Information System (INIS)

    Krieg, U.C.; Isaacs, B.S.; Yemul, S.S.; Esmon, C.T.; Bayley, H.; Johnson, A.E.

    1987-01-01

    Two different lipophilic photoreagents, [ 3 H]adamantane diazirine and 3-(trifluoromethyl)-3-(m-[ 125 I]iodophenyl)diazirine (TID), have been utilized to examine the interactions of blood coagulation factor Va with calcium, prothrombin, factor Xa, and, in particular, phospholipid vesicles. With each of these structurally dissimilar reagents, the extent of photolabeling of factor Va was greater when the protein was bound to a membrane surface than when it was free in solution. Specifically, the covalent photoreaction with Vl, the smaller subunit of factor Va, was 2-fold higher in the presence of phosphatidylcholine/phosphatidylserine (PC/PS, 3:1) vesicles, to which factor Va binds, than in the presence of 100% PC vesicles, to which the protein does not bind. However, the magnitude of the PC/PS-dependent photolabeling was much less than has been observed previously with integral membrane proteins. It therefore appears that the binding of factor Va to the membrane surface exposes Vl to the lipid core of the bilayer, but that only a small portion of the Vl polypeptide is exposed to, or embedded in, the bilayer core. Addition of either prothrombin or active-site-blocked factor Xa to PC/PS-bound factor Va had little effect on the photolabeling of Vl with TID, but reduced substantially the covalent labeling of Vh, the larger subunit of factor Va. This indicates that prothrombin and factor Xa each cover nonpolar surfaces on Vh when the macromolecules associate on the PC/PS surface. It therefore seems likely that the formation of the prothrombinase complex involves a direct interaction between Vh and factor Xa and between Vh and prothrombin.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. Electroencephalogram (EEG spectral features discriminate between Alzheimer’s (AD and Vascular dementia (VaD

    Directory of Open Access Journals (Sweden)

    Emanuel eNeto

    2015-02-01

    Full Text Available Alzheimer’s disease (AD and vascular dementia (VaD present with similar clinical symptoms of cognitive decline, but the underlying pathophysiological mechanisms differ. To determine whether clinical electroencephalography (EEG can provide information relevant to discriminate between these diagnoses, we used quantitative EEG analysis to compare the spectra between non-medicated patients with AD (n=77 and VaD (n=77 and healthy elderly normal controls (NC (n=77. We use curve-fitting with a combination of a power loss and Gaussian function to model the averaged resting-state spectra of each EEG channel extracting six parameters. We assessed the performance of our model and tested the extracted parameters for group differentiation. We performed regression analysis in a MANCOVA with group, age, gender, and number of epochs as predictors and further explored the topographical group differences with pair-wise contrasts. Significant topographical differences between the groups were found in several of the extracted features. Both AD and VaD groups showed increased delta power when compared to NC, whereas the AD patients showed a decrease in alpha power for occipital and temporal regions when compared with NC. The VaD patients had higher alpha power than NC and AD. The AD and VaD groups showed slowing of the alpha rhythm. Variability of the alpha frequency was wider for both AD and VaD groups. There was a general decrease in beta power for both AD and VaD. The proposed model is a useful to parameterize spectra which allowed extracting relevant clinical EEG key features that move towards simple and interpretable diagnostic criteria.

  15. LIFE JOURNEY: MEDICAL AND SCIENTIFIC WORK OF PROFESSOR V.A. SOKOLOV

    Directory of Open Access Journals (Sweden)

    P. A. Ivanov

    2017-01-01

    Full Text Available The article is dedicated to doctor of medicine, professor V.A. Sokolov. In 2017 he celebrates his eightieth birthday. Professor V.A. .Sokolov is one of the founders of polytrauma treatment in USSR and Russia. For a long time he had been heading polytrauma department at the N.V. Sklifosovsky Research Institute for Emergency Medicine. Due to his work, algorithms of life sustaining and recovery of serious patients were developed. Professor V.A. Sokolov is the author of 6 monographies and about 300 periodical papers. Besides, he is the holder of 32 patents. Some of his inventions were popularized and manufactured. He had been leading active scientific work, which resulted in 6 doctoral dissertations and 15 candidate theses. The staff of N.V. Sklifosovsky Research Institute for Emergency Medicine congratulates on the anniversary.

  16. 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)

  17. Estimating right ventricular stroke work and the pulsatile work fraction in pulmonary hypertension.

    Science.gov (United States)

    Chemla, Denis; Castelain, Vincent; Zhu, Kaixian; Papelier, Yves; Creuzé, Nicolas; Hoette, Susana; Parent, Florence; Simonneau, Gérald; Humbert, Marc; Herve, Philippe

    2013-05-01

    The mean pulmonary artery pressure (mPAP) replaces mean systolic ejection pressure (msePAP) in the classic formula of right ventricular stroke work (RVSW) = (mPAP - RAP) × stroke volume, where RAP is mean right atrial pressure. Only the steady work is thus taken into account, not the pulsatile work, whereas pulmonary circulation is highly pulsatile. Our retrospective, high-fidelity pressure study tested the hypothesis that msePAP was proportional to mPAP, and looked at the implications for RVSW. Eleven patients with severe, precapillary pulmonary hypertension (PH) (six patients with idiopathic pulmonary arterial hypertension and five with chronic thromboembolic PH; mPAP = 57 ± 10 mm Hg) were studied at rest and during mild to moderate exercise. Eight non-PH control subjects were also studied at rest (mPAP = 16 ± 2 mm Hg). The msePAP was averaged from end diastole to dicrotic notch. In the full data set (53 pressure-flow points), mPAP ranged from 14 to 99.5 mm Hg, cardiac output from 2.38 to 11.1 L/min, and heart rate from 53 to 163 beats/min. There was a linear relationship between msePAP and mPAP (r² = 0.99). The msePAP matched 1.25 mPAP (bias, -0.5 ± 2.6 mm Hg). Results were similar in the resting non-PH group and in resting and the exercising PH group. This implies that the classic formula markedly underestimates RVSW and that the pulsatile work may be a variable 20% to 55% fraction of RVSW, depending on RAP and mPAP. At rest, RVSW in patients with PH was twice as high as that of the non-PH group (P work fraction was similar between the two groups (26 ± 4% vs 24 ± 1%) because of the counterbalancing effects of high RAP (11 ± 5 mm Hg vs 4 ± 2 mm Hg), which increases the fraction, and high mPAP, which decreases the fraction. Our study favored the use of an improved formula that takes into account the variable pulsatile work fraction: RVSW = (1.25 mPAP - RAP) × stroke volume. Increased RAP and increased mPAP have opposite effects on the pulsatile work

  18. Pulmonary hypertenstion ad leading factor in patients undergoing dialysis

    International Nuclear Information System (INIS)

    Rehman, I.U.; Sumera, A.; Idrees, M.K.; Tanweer, A.

    2014-01-01

    Objective: To determine the frequency and leading factors of pulmonary hypertension among chronic hemodialysis patients. Study Design: Case series. Place and Duration of Study: Hemodialysis Unit, Department of Nephrology, Sindh Institute of Urology and Transplantation, Karachi, from September 2011 to March 2012. Methodology: Patients of either gender aged between 16 to 60 years of age undergoing hemodialysis for at least 3 months not having pre-existing valvular heart disease, chronic lung disease or connective tissue disorder were included. Pulmonary hypertension was prospectively estimated by Doppler echocardiogram on patients undergoing dialysis. Pulmonary artery pressure was calculated on the post-dialysis day and leading factors were compared between patients with and without pulmonary hypertension. Results: A total of 178 patients were included in study with male to female ratio120/58 (2.06:1). The mean age was 33.84 +- 11.9 years. The mean duration of hemodialysis was 23.85 +- 22.48 months. Pulmonary hypertension was found in 76 (42.7%) patients. Out of the studied factors, low serum albumin ( 3.4 mg/dl, p = 0.01) was found to be statistically significant in patients with pulmonary hypertension. Conclusion: Pulmonary hypertension was frequently present in dialysis population (42.7%). This subset of patients had significantly lower albumin levels in serum. More research is needed in its pathogenesis to arrest its course. (author)

  19. Pulmonary venous flow index as a predictor of pulmonary vascular resistance variability in congenital heart disease with increased pulmonary flow: a comparative study before and after oxygen inhalation.

    Science.gov (United States)

    Rivera, Ivan Romero; Mendonça, Maria Alayde; Andrade, José Lázaro; Moises, Valdir; Campos, Orlando; Silva, Célia Camelo; Carvalho, Antonio Carlos

    2013-09-01

    There is no definitive and reliable echocardiographic method for estimating the pulmonary vascular resistance (PVR) to differentiate persistent vascular disease from dynamic pulmonary hypertension. The aim of this study was to analyze the relationship between the pulmonary venous blood flow velocity-time integral (VTIpv) and PVR. Eighteen patients (10 females; 4 months to 22 years of age) with congenital heart disease and left to right shunt were studied. They underwent complete cardiac catheterization, including measurements of the PVR and Qp:Qs ratio, before and after 100% oxygen inhalation. Simultaneous left inferior pulmonary venous flow VTIpv was obtained by Doppler echocardiography. The PVR decreased significantly from 5.0 ± 2.6 W to 2.8 ± 2.2 W (P = 0.0001) with a significant increase in the Qp:Qs ratio, from 3.2 ± 1.4 to 4.9 ± 2.4 (P = 0.0008), and the VTIpv increased significantly from 22.6 ± 4.7 cm to 28.1 ± 6.2 cm (P = 0.0002) after 100% oxygen inhalation. VTIpv correlated well with the PVR and Qp:Qs ratio (r = -0.74 and 0.72, respectively). Diagnostic indexes indicated a sensitivity of 86%, specificity of 75%, accuracy of 83%, a positive predictive value of 92% and a negative predictive value of 60%. The VTIpv correlated well with the PVR. The measurement of this index before and after oxygen inhalation may become a useful noninvasive test for differentiating persistent vascular disease from dynamic and flow-related pulmonary hypertension. © 2013, Wiley Periodicals, Inc.

  20. 75 FR 25321 - Agency Information Collection (VA National Rehabilitation Special Events, Event Registration...

    Science.gov (United States)

    2010-05-07

    ... Winter Sports Clinic Application, VA Form 0924a series. b. National Veterans Wheelchair Games Application.... National Veterans TEE Tournament Application, VA Form 0927a series. e. National Veterans Summer Sports... Form 0929a series. Type of Review: Existing collection in use without an OMB control number. Abstract...

  1. CT manifestations of pulmonary Langerhans cell histiocytosis

    International Nuclear Information System (INIS)

    Qiang Jun; Yu Wei; Gao Wanqin; Song Haiqiao; Ma Yingjian

    2010-01-01

    Objective: To analyzes the CT manifestations of pulmonary Langerhans cell histiocytosis (PLCH). Methods: CT features of 11 patients with PLCH proved pathologically were analyzed retrospectively. Results: The main findings in 11 PLCHs were cysts and nodules. Two cases only had cysts, and 1 only had nodules, which most had cavitations. The other 8 cases showed cysts and nodules with 4 cases mainly manifested with cysts and nine mainly manifested with nodules. Two cases had pulmonary interstitial changes. One case only had cysts in the left upper lung field and 10 cases had lesions not only in the upper and middle but in the lower lung field, which 2 cases had more lesions in the lower and costo-phrenic angle field and 8 cases had less lesions in the costo-phrenic angle field. Three of these 8 cases had more lesions in the superior lobe and apical segment of lower lobe. Conclusion: CT manifestations of PLCH are helpful for the early diagnosis. (authors)

  2. Late onset postoperative pulmonary fistula following a pulmonary segmentectomy using electrocautery or a harmonic scalpel.

    Science.gov (United States)

    Takagi, Keigo; Hata, Yoshinobu; Sasamoto, Shuichi; Tamaki, Kazuyoshi; Fukumori, Kazuhiko; Otsuka, Hajime; Hasegawa, Chiyoko; Shibuya, Kazutoshi

    2010-08-01

    The purpose of this study is to retrospectively examine the postoperative pulmonary fistula as a complication after the use of either electrocautery or a harmonic scalpel without stapling devices. The subjects of this study consisted of 28 patients who received a segmentectomy for a pulmonary malignant tumor, 25 cases of lung cancer and 3 of metastatic lung tumor. The electrocautery was used in 17 patients (EC group) and the harmonic scalpel in 11 (HS group). The levels of postoperative air leakage and postoperative complications were examined among the two groups retrospectively. The histological findings of the cut surface of the segmentectomy by electrocautery and harmonic scalpel were also examined. Hemostasis and air leakage both were well controlled during the operation, and the postoperative drainage period was short. No major postoperative complications occurred, and all patients began walking in the early postoperative days. However, 1 to 3 postoperative months after discharge, 8 patients showed late onset of a pulmonary fistula, 3 of the 17 (18%) in the EC group and 5 of the 11 (45%) in the HS group. The histological findings of the cut surface of the segmentectomy showed that most of the layer of coagulation necrosis by the harmonic scalpel measured 2 mm thick, and it was denser than that cut from electrocautery. The lumen of the bronchus markedly decreased in size, but it remained, as it also did under the effects of electrocautery. In the months following the operation, the incidence of the late onset of a pulmonary fistula was higher when the harmonic scalpel was used. It was believed that the small bronchial stump could not tolerate the airway pressure because the thick coagulation necrosis delayed healing of the postoperative wound. It was necessary to ligate the stump of a small bronchus, even though the stump had been temporally closed by coagulation necrosis with the electrocautery or harmonic scalpel during the operation.

  3. V.A. Gorodtsov and Kazan: tour 1920

    Directory of Open Access Journals (Sweden)

    Kuzminykh Sergey V.

    2014-12-01

    Full Text Available A fragment of an archival document is published, that is connected to the September 8-12, 1920, stay in Kazan of V.A. Gorodtsov, who headed the Archaeological Subdepartment with the Museum Department of the RSFSR People’s Commissariat for Education, in the framework of his inspecting tour around the towns of the Volga and Urals region. The document is a diary, and its entries reflect information about the tour and its results that had not been exhaustively reflected in official documentation. It narrates about meetings, polemic exchanges, Gorodtsov’s addresses to scientists and the public, his impressions of the archaeological investigations in the regions, and the state of the museums and collections. V.A. Gorodtsov’s encounters and personal contacts with B.F. Adler, N.F. Katanov, M.G. Hudyakov and other researchers had played a positive role in archaeology development in the Volga-Kama region during the hardest times after the revolution.

  4. Evaluation of commissural malalignment of aortic-pulmonary sinus using cardiac CT for arterial switch operation: comparison with transthoracic echocardiography

    International Nuclear Information System (INIS)

    Bang, Ji Hyun; Park, Jeong-Jun; Goo, Hyun Woo

    2017-01-01

    There are limited data regarding the influence of commissural malalignment of the aortic-pulmonary sinus on the arterial switch operation. To compare diagnostic accuracy between cardiac CT and echocardiography for evaluating commissural malalignment of aortic-pulmonary sinus in children with complete transposition of the great arteries and to seek potential clinical implication of commissural malalignment on the arterial switch operation. In 37 patients (35 boys; median age: 8 days, range: 3-80 days) with complete transposition of the great arteries who had tricuspid semilunar valves and underwent an arterial switch operation, the degree of the commissural rotation of the aortic-pulmonary sinus was assessed on cardiac CT (n=37) and echocardiography (n=35). With surgical finding as a reference, cardiac CT was compared with echocardiography in identifying commissural malalignment in 35 patients. The influence of the height difference between the semilunar valves measured by cardiac CT on the identification of commissural malalignment with cardiac CT and echocardiography was evaluated. The impact of commissural malalignment on coronary transfer techniques was evaluated. In operative findings, the commissures of the semilunar valves were aligned in 24 patients and malaligned in 13. With surgical findings as a reference, cardiac CT showed higher, but not statistically significant (P>0.05), sensitivity (91.7% vs. 75.0%), specificity (87.0% vs. 78.3%) and accuracy (88.6% vs. 77.1%) for the diagnosis of the malalignment than echocardiography. The measured height difference between the semilunar valves did not affect the identification of the malalignment with cardiac CT and echocardiography. The surgical malalignment group showed a higher requirement of modified coronary transfer techniques than the surgical aligned group (11/13 vs. 11/24, P=0.03). Cardiac CT and echocardiography appear useful for evaluating commissural malalignment of the semilunar valves in patients with

  5. Evaluation of commissural malalignment of aortic-pulmonary sinus using cardiac CT for arterial switch operation: comparison with transthoracic echocardiography

    Energy Technology Data Exchange (ETDEWEB)

    Bang, Ji Hyun; Park, Jeong-Jun [Asan Medical Center, University of Ulsan College of Medicine, Divisions of Pediatric Cardiac Surgery, Seoul (Korea, Republic of); Goo, Hyun Woo [Asan Medical Center, University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Seoul (Korea, Republic of)

    2017-05-15

    There are limited data regarding the influence of commissural malalignment of the aortic-pulmonary sinus on the arterial switch operation. To compare diagnostic accuracy between cardiac CT and echocardiography for evaluating commissural malalignment of aortic-pulmonary sinus in children with complete transposition of the great arteries and to seek potential clinical implication of commissural malalignment on the arterial switch operation. In 37 patients (35 boys; median age: 8 days, range: 3-80 days) with complete transposition of the great arteries who had tricuspid semilunar valves and underwent an arterial switch operation, the degree of the commissural rotation of the aortic-pulmonary sinus was assessed on cardiac CT (n=37) and echocardiography (n=35). With surgical finding as a reference, cardiac CT was compared with echocardiography in identifying commissural malalignment in 35 patients. The influence of the height difference between the semilunar valves measured by cardiac CT on the identification of commissural malalignment with cardiac CT and echocardiography was evaluated. The impact of commissural malalignment on coronary transfer techniques was evaluated. In operative findings, the commissures of the semilunar valves were aligned in 24 patients and malaligned in 13. With surgical findings as a reference, cardiac CT showed higher, but not statistically significant (P>0.05), sensitivity (91.7% vs. 75.0%), specificity (87.0% vs. 78.3%) and accuracy (88.6% vs. 77.1%) for the diagnosis of the malalignment than echocardiography. The measured height difference between the semilunar valves did not affect the identification of the malalignment with cardiac CT and echocardiography. The surgical malalignment group showed a higher requirement of modified coronary transfer techniques than the surgical aligned group (11/13 vs. 11/24, P=0.03). Cardiac CT and echocardiography appear useful for evaluating commissural malalignment of the semilunar valves in patients with

  6. Surgical treatment in non-small cell lung cancer with pulmonary oligometastasis.

    Science.gov (United States)

    He, Jinyuan; Li, Yun; An, Jun; Hu, Liu; Zhang, Junhang

    2017-02-02

    Previous studies have demonstrated survival benefits for local treatment in solitary metastatic non-small cell lung cancer (NSCLC).This study aimed to investigate the effect of local surgery for NSCLC with pulmonary oligometastasis. This study included 21 patients of NSCLC with pulmonary oligometastasis between January 2003 and December 2013, which were divided into two groups, group A (11 cases) for local surgery and group B (10 cases) for systematic chemotherapy, compared the median survival time (MST) and 5-year survival rate between the two groups, and analyzed the impact of the pathological types, the TNM and pN stage of primary tumor, the site, and the mode and number of oligometastatic nodule on group A. The MST of group A and B were 37 and 11.6 months respectively, 5-year survival rates were 18.2 and 9.1% respectively (p  0.05). Local surgery significantly prolonged the overall survival time and 5-year survival rate of primary NSCLC with pulmonary oligometastasis.

  7. Expression of PDGF-beta receptor in broilers with pulmonary hypertension induced by cold temperature and its association with pulmonary vascular remodeling.

    Science.gov (United States)

    Li, Jin-Chun; Pan, Jia-Qiang; Huang, Guo-Qing; Tan, Xun; Sun, Wei-Dong; Liu, Yan-Juan; Wang, Xiao-Long

    2010-02-01

    The purpose of the present study was to characterize the relationship between platelet-derived growth factor beta receptor (PDGF-beta receptor) expression and pulmonary vascular remodeling found in broilers subjected to cold temperature beginning at 14 days of age. One hundred and sixty-one-day-old mixed-sex Avian-2000 commercial broilers were randomly divided into a normal temperature group (control) and a cold temperature group (cold). All the birds were brooded in normal temperature up to day 14, with the lighting schedule at 24 h per day. Starting at day 14, birds in the cold group were moved to a pen in the cold house and subjected to low temperature, while birds in the control group were still brooded at normal temperature. On days 14, 23, 30, 37 and 44, the right/total ventricle weight ratio (RV/TV), packed cell volume (PCV), the vessel wall area to vessel total area ratio (WA/TA), mean media thickness in pulmonary arterioles (mMTPA) and the expression of PDGF-beta receptor in pulmonary arterioles were measured, respectively. Cumulative pulmonary hypertension syndrome (PHS) morbidity was recorded in each group. Cool ambient temperature increased PHS morbidity of broilers. The values of WA/TA and mMTPA were also increased significantly compared with control group. PCV values in the cold temperature group were elevated from days 30 to 44, and RV/TV ratios were increased on days 37 and 44. Cold exposure enhanced PDGF-beta receptor expression in pulmonary arterioles, and the PDGF-beta receptor expression was significantly correlated with pulmonary vascular remodeling that was dedicated by increased WA/TA and mMTPA. The results indicated that PDGF-beta and its receptor were involved in the underlying mechanisms of pulmonary vascular remodeling in pulmonary hypertensive broilers. Copyright 2009 Elsevier Ltd. All rights reserved.

  8. The Shock and Vibration Digest, Volume 17, Number 10

    Science.gov (United States)

    1985-10-01

    Venkayya, V.B. and Tischler, V.A., 49. Calico , R.A., Jr. and Tnyfault, D.V., "Frequency Control and the Effect on the "Decoupled Large Space Structure...Hurwitz presented. The threshold concept is de- Numerical Structural Mechanics scribed, as are receiver operating charac- Branch (Code 1844 ) teristic...Part Vibration and Dynamics of Off Road Vehi- 2 - Realistic Complex Elements des M. Apetaur I.A. Craighead, P.R. Brown Prague Univ. of Tech

  9. Vađenje podrtina i potonulih stvari u svjetlu novele Pomorskog zakonika iz 2013. godine

    Directory of Open Access Journals (Sweden)

    Vesna Skorupan Wolff

    2017-11-01

    Full Text Available Materiju vađenja podrtina i potonulih stvari uređuju odredbe upravnopravne prirode koje reguliraju odnose između vlasnika podrtine ili potonule stvari, odnosno ovlaštene osobe i upravnih tijela, a kojima se uređuju razni pravni aspekti postupka vađenja. Pravo vaditi podrtinu ili potonulu stvar primarno ima njezin vlasnik odnosno ovlaštena osoba. Zakon vlasnicima podrtina i potonulih stvari, odnosno ovlaštenim osobama, ostavlja primjeren rok u kojem mogu pokrenuti upravni postupak za dobivanje dozvole za vađenje podrtine ili potonule stvari. Na taj način jamči se nepovredivost vlasništva i utvrđuje načelo prema kojem činjenica da je stvar potonula ili se nasukala ne utječe izravno na vlasnička prava njezina dotadašnjeg vlasnika. Međutim, ako vlasnik, odnosno ovlaštena osoba ne zatraži odobrenje za vađenje podrtine ili potonule stvari, ili kad bez opravdanog razloga prekine ili napusti započeto vađenje kao i u slučaju ako je ovlaštena osoba nepoznata, PZ nudi pravni okvir i omogućuje da vađenje podrtine ili potonule stvari poduzme pošteni nalaznik ili lučka kapetanija. U okviru instituta vađenja podrtina i potonulih stvari uvodi se posebno pravno uređenje za nalaz stvari u moru te se precizno normiraju svi segmenti postupka vađenja kada ga poduzima pošteni nalaznik ili lučka kapetanija. Uređuju se i sva relevantna pitanja u svezi postupanja s izvađenim stvarima kao što su njihovo čuvanje te u propisanim slučajevima mogućnost prodaje na javnoj dražbi. PZ-om se precizno uređuju obvezni odnosi koji nastaju između vlasnika, odnosno ovlaštene osobe i poštenog nalaznika te vlasnika, odnosno ovlaštene osobe i lučke kapetanije, ovisno o tome tko je poduzeo vađenje, a koji se odnose na plaćanje naknade za vađenje, čuvanje, nalazninu i druge tražbine koje zakon priznaje poštenim nalaznicima i lučkim kapetanijama. U okviru toga, uređuje se i posebno stvarnopravno uređenje za stjecanje prava vlasni

  10. 2018-02-23T11:03:24Z https://www.ajol.info/index.php/all/oai oai:ojs ...

    African Journals Online (AJOL)

    article/90336 2018-02-23T11:03:24Z njtr:ART Design and construction of a microcontroller based single axis solar tracker Zubair, S Suleiman, A Abdulazzez, HT Salihu, BA Solar, Tracking, Microcontroller, photocells, drivers, single axis. Solar ...

  11. VA Dental Insurance Program--federalism. Direct final rule; confirmation of effective date.

    Science.gov (United States)

    2014-03-20

    The Department of Veterans Affairs (VA) published a direct final rule in the Federal Register on October 22, 2013, amending its regulations related to the VA Dental Insurance Program (VADIP), a pilot program to offer premium-based dental insurance to enrolled veterans and certain survivors and dependents of veterans. Specifically, this rule adds language to clarify the limited preemptive effect of certain criteria in the VADIP regulations. VA received no comments concerning this rule or its companion substantially identical proposed rule published in the Federal Register on October 23, 2013. This document confirms that the direct final rule became effective on December 23, 2013. In a companion document in this issue of the Federal Register, we are withdrawing as unnecessary the proposed rule.

  12. 38 CFR 1.9 - Description, use, and display of VA seal and flag.

    Science.gov (United States)

    2010-07-01

    ... stars represent the five branches of military service. The crossed flags represent our nation's history... employees. (D) Official VA signs. (E) Official publications or graphics issued by and attributed to VA, or...) Souvenir or novelty items. (iii) Toys or commercial gifts or premiums. (iv) Letterhead design, except on...

  13. Differentiation of pulmonary embolism from high altitude pulmonary edema

    International Nuclear Information System (INIS)

    Khan, D.A.; Hashim, R.; Mirza, T.M.; Matloob-ur-Rehman, M.

    2003-01-01

    Objective: To differentiate the high altitude pulmonary edema (HAPE) from pulmonary embolism (PE) by clinical probability model of PE, lactate dehydrogenase (LDH), aspartate transaminase (AST) and D-dimer assays at high altitude. Subjects and Methods: Consecutive 40 patients evacuated from height > 3000 meters with symptoms of PE or HAPE were included. Clinical pretest probabilities scores of PE, Minutex D-dimer assay (Biopool international) and cardiac enzymes estimation by IFCC approved methods, were used for diagnosis. Mann-Whitney U test was applied by using SPSS and level of significance was taken at (p 500 ng/ml. Plasma D-dimer of 500 ng/ml was considered as cut-off value; 6(66.7%) patients of PE could be diagnosed and 30 (96.7%) cases of HAPE excluded indicating very good negative predictive value. Serum LDH, AST and CK were raised above the reference ranges in 8 (89%), 7 (78%) and 3 (33%) patients of PE as compared to 11 (35%), 6 (19%) and 9 (29%) of HAPE respectively. Conclusion: Clinical assessment in combination with D-dimer assay, LDH and AST can be used for timely differentiation of PE from HAPE at high altitude where diagnostic imaging procedures are not available. (author)

  14. Pulmonary spheral tuberculosis: features and clinical significance of spiral dynamic CT

    International Nuclear Information System (INIS)

    Xie Ruming; Ma Daqing; Li Tieyi; Chen Yi; Lu Fudong; Zhou Xinhua

    2001-01-01

    Objective: To assess the features and clinical significance of spiral dynamic CT in patients with pulmonary spheral tuberculosis. Methods: The 54 foci in 42 patients with pulmonary spheral tuberculosis were studied. Thin-sections at 2 mm thickness and 2 mm interval through the nodular center were obtained before and after administration of contrast material. Results: In 54 pulmonary spheral tuberculosis, maximum enhanced CT value in 51 (94.4%, 51/54) foci was less than 20 HU, and more than 20 HU in the other 3(5.6%, 3/54) foci. 27(50.0%, 27/54) foci showed no any enhancement, 24, (44%, 24/54) foci showed capsular enhancement, 1(1.9%, 1/54) focus showed peripheral enhancement and 2(3.7%, 2/54) foci showed extensive enhancement. The accuracy of the correct diagnosis was 25.9% in terms of plain CT and 94.4% in terms of enhanced CT scanning. The difference was significant (x 2 = 50.1, P < 0.05). The curative effect of extensive enhanced foci and peripheral enhanced foci was optimal, capsular enhanced foci was second, and non-enhanced foci was barely satisfactory. Conclusion: Spiral dynamic CT technique may improve the accuracy of diagnosing pulmonary spheral tuberculosis. No enhancement and/or capsular enhancement were suggestive of tuberculosis. The enhancing character of foci might contribute to assess the curative effect of anti-tuberculosis

  15. 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 ...

  16. Pulmonary tissue volume, cardiac output, and diffusing capacity in sustained microgravity

    Science.gov (United States)

    Verbanck, S.; Larsson, H.; Linnarsson, D.; Prisk, G. K.; West, J. B.; Paiva, M.

    1997-01-01

    In microgravity (microG) humans have marked changes in body fluids, with a combination of an overall fluid loss and a redistribution of fluids in the cranial direction. We investigated whether interstitial pulmonary edema develops as a result of a headward fluid shift or whether pulmonary tissue fluid volume is reduced as a result of the overall loss of body fluid. We measured pulmonary tissue volume (Vti), capillary blood flow, and diffusing capacity in four subjects before, during, and after 10 days of exposure to microG during spaceflight. Measurements were made by rebreathing a gas mixture containing small amounts of acetylene, carbon monoxide, and argon. Measurements made early in flight in two subjects showed no change in Vti despite large increases in stroke volume (40%) and diffusing capacity (13%) consistent with increased pulmonary capillary blood volume. Late in-flight measurements in four subjects showed a 25% reduction in Vti compared with preflight controls (P volume, to the extent that it was no longer significantly different from preflight control. Diffusing capacity remained elevated (11%; P pulmonary perfusion and pulmonary capillary blood volume, interstitial pulmonary edema does not result from exposure to microG.

  17. 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.

  18. Acute pulmonary edema after near strangulation

    International Nuclear Information System (INIS)

    Shumaker, D.; Kottamasu, S.; Preston, G.; Treloar, D.

    1988-01-01

    We report a case of acute, noncardiogenic pulmonary edema in an 11 year old boy who suffered strangulation during an altercation. The clinical presentation was characterized by moderate respiratory distress and hemoptysis. Both the radiographic and clinical findings resolved during the three day admission which followed. A review of the literature is presented, and possible pathogenesis is discussed. (orig.)

  19. Changes in perfusion scintigraphy in the first days of heparin therapy in patients with acute pulmonary embolism

    NARCIS (Netherlands)

    de Groot, M. R.; Oostdijk, A. H.; Engelage, A. H.; van Marwijk Kooy, M.; Büller, H. R.

    2000-01-01

    Patients with suspected pulmonary embolism often receive heparin therapy for hours to days before ventilation/perfusion scintigraphy is completed. We assessed to what extent the lung scan classification and pulmonary vascular perfusion changed over a period of 2-4 days of full anticoagulant therapy.

  20. Noncardiogenic Pulmonary Edema after Amlodipine Overdose without Refractory Hypotension and Bradycardia

    Directory of Open Access Journals (Sweden)

    M. Hedaiaty

    2015-01-01

    Full Text Available Amlodipine overdose can be life-threatening when manifesting as noncardiogenic pulmonary edema. Treatment remains challenging. We describe a case of noncardiogenic pulmonary edema without refractory hypotension and bradycardia after ingestion of 500 milligram amlodipine with suicidal intent. Mechanical ventilation, dexamethasone, atrovent HFA (ipratropium, pulmicort inhalation, and antibiotic therapy were used for the management. Length of hospital stay was 11 days. The patient was discharged with full recovery.

  1. 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 ...

  2. On Setting Day-Ahead Equity Trading Risk Limits: VaR Prediction at Market Close or Open?

    Directory of Open Access Journals (Sweden)

    Ana-Maria Fuertes

    2016-09-01

    Full Text Available This paper investigates the information content of the ex post overnight return for one-day-ahead equity Value-at-Risk (VaR forecasting. To do so, we deploy a univariate VaR modeling approach that constructs the forecast at market open and, accordingly, exploits the available overnight close-to-open price variation. The benchmark is the bivariate VaR modeling approach proposed by Ahoniemi et al. that constructs the forecast at the market close instead and, accordingly, it models separately the daytime and overnight return processes and their covariance. For a small cap portfolio, the bivariate VaR approach affords superior predictive ability than the ex post overnight VaR approach whereas for a large cap portfolio the results are reversed. The contrast indicates that price discovery at the market open is less efficient for small capitalization, thinly traded stocks.

  3. {sup 18}F-Fluorodeoxyglucose positron emission tomography pulmonary imaging in idiopathic pulmonary fibrosis is reproducible: implications for future clinical trials

    Energy Technology Data Exchange (ETDEWEB)

    Win, Thida [Lister Hospital, Respiratory Medicine, Stevenage (United Kingdom); Lambrou, Tryphon; Hutton, Brian F.; Kayani, Irfan; Endozo, Raymondo; Shortman, Robert I.; Groves, Ashley M. [UCL/UCH, Institute of Nuclear Medicine, London (United Kingdom); Screaton, Nicholas J. [Papworth Hospital, Radiology Department, Cambridge (United Kingdom); Porter, Joanna C. [UCL/UCH, Centre for Respiratory Diseases, London (United Kingdom); Maher, Toby M. [Royal Brompton Hospital, Interstitial Lung Disease Unit, London (United Kingdom); Lukey, Pauline [GSK, Fibrosis DPU, Research and Development, Stevenage (United Kingdom)

    2012-03-15

    Noninvasive markers of disease activity in patients with idiopathic pulmonary fibrosis (IPF) are lacking. We performed this study to investigate the reproducibility of pulmonary {sup 18}F-FDG PET/CT in patients with IPF. The study group comprised 13 patients (11 men, 2 women; mean age 71.1 {+-} 9.9 years) with IPF recruited for two thoracic {sup 18}F-FDG PET/CT studies performed within 2 weeks of each other. All patients were diagnosed with IPF in consensus at multidisciplinary meetings as a result of typical clinical, high-resolution CT and pulmonary function test features. Three methods for evaluating pulmonary {sup 18}F-FDG uptake were used. The maximal {sup 18}F-FDG pulmonary uptake (SUVmax) in the lungs was determined using manual region-of-interest placement. An {sup 18}F-FDG uptake intensity histogram was automatically constructed from segmented lungs to evaluate the distribution of SUVs. Finally, mean SUV was determined for volumes-of-interest in pulmonary regions with interstitial lung changes identified on CT scans. Processing included correction for tissue fraction effects. Bland-Altman analysis was performed and interclass correlation coefficients (ICC) were determined to assess the reproducibility between the first and second PET scans, as well as the level of intraobserver and interobserver agreement. The mean time between the two scans was 6.3 {+-} 4.3 days. The interscan ICCs for pulmonary SUVmax analysis and mean SUV corrected for tissue fraction effects were 0.90 and 0.91, respectively. Intensity histograms were different in only 1 of the 13 paired studies. Intraobserver agreement was also excellent (0.80 and 0.85, respectively). Some bias was observed between observers, suggesting that serial studies would benefit from analysis by the same observer. This study demonstrated that there is excellent short-term reproducibility in pulmonary {sup 18}F-FDG uptake in patients with IPF. (orig.)

  4. Risk Stratification by 24-Hour Ambulatory Blood Pressure and Estimated Glomerular Filtration Rate in 5322 Subjects From 11 Populations

    DEFF Research Database (Denmark)

    Boggia, José; Thijs, Lutgarde; Li, Yan

    2013-01-01

    subjects (median age, 51.8 years; 43.1% women) randomly recruited from 11 populations, who had baseline measurements of 24-hour ambulatory blood pressure (ABP(24)) and eGFR. We computed hazard ratios using multivariable-adjusted Cox regression. Median follow-up was 9.3 years. In fully adjusted models......, which included both ABP(24) and eGFR, ABP(24) predicted (P≤0.008) both total (513 deaths) and cardiovascular (206) mortality; eGFR only predicted cardiovascular mortality (P=0.012). Furthermore, ABP(24) predicted (P≤0.0056) fatal combined with nonfatal events as a result of all cardiovascular causes...... (555 events), cardiac disease (335 events), or stroke (218 events), whereas eGFR only predicted the composite cardiovascular end point and stroke (P≤0.035). The interaction terms between ABP(24) and eGFR were all nonsignificant (P≥0.082). For cardiovascular mortality, the composite cardiovascular end...

  5. [POL-PAVTI--Polish report on transcatheter pulmonary artery valve implantation of Melody-Medtronic prosthesis in the first 14 patients in Poland].

    Science.gov (United States)

    Ruzyłło, Witold; Demkow, Marcin; Włodarska, Elzbieta K; Kowalski, Mirosław; Spiewak, Mateusz; Siudalska, Hanna; Wolski, Piotr; Miśko, Jolanta; Hoffman, Piotr; Kusa, Jacek; Szkutnik, Małgorzata; Białkowski, Jacek; Fiszer, Roland; Urbańska, Ewa; Sondergaard, Lars

    2009-10-01

    To assess the early results of the pulmonary artery valve transcatheter implantation (PAVTI) in pts included into POL-PAVTI registry. Detailed medical and economic analyses were performed. Pulmonary artery valve implantation was performed in 14 pts (9 men), aged 16-31 (mean 24.6 +/- 4.8) years, with pulmonary homograft dysfunction after total repair of tetralogy of Fallot (4 pts), pulmonary atresia (2 pts), pulmonary stenosis (1 pt), common arterial trunk type I (1 pt), Ross procedure (3 pts) and TGA - Rastelli operation (3 pts). Eleven pts underwent in the past 2-5 surgical or/and catheter interventions. Indication for PAVTI was based on clinical evaluation and echocardiographic studies. Assessment of morphological and functional features of the right ventricle (RV) and homograft with the use of cardiac magnetic resonance (CMR) was performed in 10 cases. Pulmonary stenosis (max. pulmonary gradient 32-119, mean 72 +/- 28 mmHg) was observed in 13 pts and/or significant pulmonary regurgitation in 10 pts. The procedure was performed in general anesthesia. The deployment of a valved stent in the pulmonary valve position was preceded by a metal stent implantation. Results were evaluated by echocardiography two days after the procedure and one month later. Four patients were evaluated 6 months after procedure. Time of the procedure varied 60-190 (mean 127 +/- 35) min, time of fluoroscopy ranged 12-31 (mean 21 +/- 11) min. PAVTI was successfully performed in all pts without serious complications. Patients were discharged from the hospital 48-293 (mean 120 +/- 71) h after procedure. Significant reduction of pulmonary gradient after the procedure assessed by echocardiography was observed on the second day (20-60, mean 38 +/- 12 mmHg, p < 0.0001) and one month (19-52, mean 34 +/- 9 mmHg, p < 0.0001). Mild pulmonary regurgitation was observed in 2 pts. In 5 pts evaluated 6 months after procedure haemodynamic parameters were unchanged; no late complications were observed

  6. Home-based pulmonary rehabilitation improves clinical features and systemic inflammation in chronic obstructive pulmonary disease patients

    Directory of Open Access Journals (Sweden)

    Nascimento ESP

    2015-03-01

    Full Text Available Eloisa Sanches Pereira do Nascimento,1 Luciana Maria Malosá Sampaio,1 Fabiana Sobral Peixoto-Souza,1 Fernanda Dultra Dias,1 Evelim Leal Freitas Dantas Gomes,1 Flavia Regina Greiffo,2 Ana Paula Ligeiro de Oliveira,2 Roberto Stirbulov,3 Rodolfo Paula Vieira,2 Dirceu Costa11Laboratory of Functional Respiratory Evaluation (LARESP, 2Laboratory of Pulmonary and Exercise Immunology (LABPEI, Nove de Julho University (UNINOVE, São Paulo, SP, Brazil; 3Department of Pneumology, Santa Casa University Hospital, São Paulo, SP, BrazilAbstract: Chronic obstructive pulmonary disease (COPD is a respiratory disease characterized by chronic airflow limitation that leads beyond the pulmonary changes to important systemic effects. COPD is characterized by pulmonary and systemic inflammation. However, increases in the levels of inflammatory cytokines in plasma are found even when the disease is stable. Pulmonary rehabilitation improves physical exercise capacity and quality of life and decreases dyspnea. The aim of this study was to evaluate whether a home-based pulmonary rehabilitation (HBPR program improves exercise tolerance in COPD patients, as well as health-related quality of life and systemic inflammation. This prospective study was conducted at the Laboratory of Functional Respiratory Evaluation, Nove de Julho University, São Paulo, Brazil. After anamnesis, patients were subjected to evaluations of health-related quality of life and dyspnea, spirometry, respiratory muscle strength, upper limbs incremental test, incremental shuttle walk test, and blood test for quantification of systemic inflammatory markers (interleukin [IL]-6 and IL-8. At the end of the evaluations, patients received a booklet containing the physical exercises to be performed at home, three times per week for 8 consecutive weeks. Around 25 patients were enrolled, and 14 completed the pre- and post-HBPR ratings. There was a significant increase in the walked distance and the maximal

  7. Mediastinal and extrapleural fat hypertrophy in idiopathic pulmonary fibrosis on high-resolution CT: comparison with normal individuals

    International Nuclear Information System (INIS)

    Son, Kyu Ri; Lee, Hyun Ju; Lim, Kun Young; Lee, Chang Hyun; Goo, Jin Mo; Im, Jung Gi

    2004-01-01

    We wished to compare the amount of mediastinal and extrapleural fat on high resolution CT for patients with idiopathic pulmonary fibrosis (IPF) with that of normal individuals, and we wished to evaluate the correlation between the amount of fat and the degree of pulmonary fibrosis. We selected a group of 25 patients with radiologically and clinically diagnosed IPF and we also selected another group of 25 age and gender-matched patients having no abnormalities on pulmonary function testing as well as HRCT as controls from our radiologic database search (mean age: 59 years, M:F= 11:14). We measured the area of mediastinal and extrapleural fat at the levels of the aortic arch and at the origin of the right pulmonary artery and right inferior pulmonary vein on three sections of HRCT by using software (Rapidia; 3DMED, Seoul, Korea). The total amount of fat was calculated by summing up the areas of the mediastinal and extrapleural fat, which is corrected by the body mass index; we also evaluated statistical differences between the two groups. At same sections of CT, the ratio (%) of the honeycombing area to the total areas of the lung was calculated. We evaluated the relationship between the amount of extrapleural or mediastinal fat with the ratio (%) of the honeycombing area. The total amount of fat in patients with IPF and normal individuals were 67.24±19.03 cm 2 and 32.55±11.91 cm 2 , respectively. The fat amount corrected by body mass index was 280.48±74.43 mm 2 /kg/m 2 in the IPF patients and 137.06±41.76 mm 2 /kg/m 2 in normal individuals. The differences between two groups for the total amount of fat and fat amount, as corrected for by the body mass index, were statistically significant (p<0.0001). The ratio (%) of the honeycombing area and the total amount of fat showed a moderate correlation (rho= 0.43, p=0.032). Patients with IPF have a larger amount of mediastinal and extrapleural fat than normal individuals. The hypertrophy of mediastinal and extrapleural

  8. Mediastinal and extrapleural fat hypertrophy in idiopathic pulmonary fibrosis on high-resolution CT: comparison with normal individuals

    Energy Technology Data Exchange (ETDEWEB)

    Son, Kyu Ri; Lee, Hyun Ju; Lim, Kun Young; Lee, Chang Hyun; Goo, Jin Mo; Im, Jung Gi [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2004-12-01

    We wished to compare the amount of mediastinal and extrapleural fat on high resolution CT for patients with idiopathic pulmonary fibrosis (IPF) with that of normal individuals, and we wished to evaluate the correlation between the amount of fat and the degree of pulmonary fibrosis. We selected a group of 25 patients with radiologically and clinically diagnosed IPF and we also selected another group of 25 age and gender-matched patients having no abnormalities on pulmonary function testing as well as HRCT as controls from our radiologic database search (mean age: 59 years, M:F= 11:14). We measured the area of mediastinal and extrapleural fat at the levels of the aortic arch and at the origin of the right pulmonary artery and right inferior pulmonary vein on three sections of HRCT by using software (Rapidia; 3DMED, Seoul, Korea). The total amount of fat was calculated by summing up the areas of the mediastinal and extrapleural fat, which is corrected by the body mass index; we also evaluated statistical differences between the two groups. At same sections of CT, the ratio (%) of the honeycombing area to the total areas of the lung was calculated. We evaluated the relationship between the amount of extrapleural or mediastinal fat with the ratio (%) of the honeycombing area. The total amount of fat in patients with IPF and normal individuals were 67.24{+-}19.03 cm{sup 2} and 32.55{+-}11.91 cm{sup 2}, respectively. The fat amount corrected by body mass index was 280.48{+-}74.43 mm{sup 2}/kg/m{sup 2} in the IPF patients and 137.06{+-}41.76 mm{sup 2}/kg/m{sup 2} in normal individuals. The differences between two groups for the total amount of fat and fat amount, as corrected for by the body mass index, were statistically significant (p<0.0001). The ratio (%) of the honeycombing area and the total amount of fat showed a moderate correlation (rho= 0.43, p=0.032). Patients with IPF have a larger amount of mediastinal and extrapleural fat than normal individuals. The

  9. A Small Fullerene (C{sub 24}) may be the Carrier of the 11.2 μ m Unidentified Infrared Band

    Energy Technology Data Exchange (ETDEWEB)

    Bernstein, L. S.; Shroll, R. M. [Spectral Sciences, Inc., 4 Fourth Ave., Burlington, MA 01803 (United States); Lynch, D. K. [Thule Scientific, P.O. Box 953, Topanga, CA 90290 (United States); Clark, F. O., E-mail: larry@spectral.com, E-mail: rshroll@spectral.com, E-mail: dave@caltech.edu, E-mail: frank.clark@gmail.com [Wopeco Research, 125 South Great Road, Lincoln, MA 01773 (United States)

    2017-02-20

    We analyze the spectrum of the 11.2 μ m unidentified infrared band (UIR) from NGC 7027 and identify a small fullerene (C{sub 24}) as a plausible carrier. The blurring effects of lifetime and vibrational anharmonicity broadening obscure the narrower, intrinsic spectral profiles of the UIR band carriers. We use a spectral deconvolution algorithm to remove the blurring, in order to retrieve the intrinsic profile of the UIR band. The shape of the intrinsic profile—a sharp blue peak and an extended red tail—suggests that the UIR band originates from a molecular vibration–rotation band with a blue band head. The fractional area of the band-head feature indicates a spheroidal molecule, implying a nonpolar molecule and precluding rotational emission. Its rotational temperature should be well approximated by that measured for nonpolar molecular hydrogen, ∼825 K for NGC 7027. Using this temperature, and the inferred spherical symmetry, we perform a spectral fit to the intrinsic profile, which results in a rotational constant implying C{sub 24} as the carrier. We show that the spectroscopic parameters derived for NGC 7027 are consistent with the 11.2 μ m UIR bands observed for other objects. We present density functional theory (DFT) calculations for the frequencies and infrared intensities of C{sub 24}. The DFT results are used to predict a spectral energy distribution (SED) originating from absorption of a 5 eV photon, and characterized by an effective vibrational temperature of 930 K. The C{sub 24} SED is consistent with the entire UIR spectrum and is the dominant contributor to the 11.2 and 12.7 μ m bands.

  10. 77 FR 21158 - VA Directive 0005 on Scientific Integrity: Availability for Review and Comment

    Science.gov (United States)

    2012-04-09

    ... Draft VA Directive 0005 on Scientific Integrity: [square] Fosters a culture of transparency, integrity, and ethical behavior in the development and application of scientific and technological findings in VA... information from inappropriate political or commercial influence; [square] Ensures that selection and...

  11. 48 CFR 853.236-70 - VA Form 10-6298, Architect-Engineer Fee Proposal.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false VA Form 10-6298, Architect-Engineer Fee Proposal. 853.236-70 Section 853.236-70 Federal Acquisition Regulations System DEPARTMENT OF...-Engineer Fee Proposal. VA Form 10-6298, Architect-Engineer Fee Proposal, shall be used as prescribed in 836...

  12. Clinical efficacy and safety of ICS/LABA in patients with combined idiopathic pulmonary fibrosis and emphysema.

    Science.gov (United States)

    Dong, Fushi; Zhang, Yimei; Chi, Fangzhou; Song, Qi; Zhang, Lijuan; Wang, Yupeng; Che, Chunli

    2015-01-01

    The study aim was to explore the clinical efficacy and safety of inhaled corticosteroids (ICS)/long-acting beta2-agonists (LABA) in combined with idiopathic pulmonary fibrosis and emphysema. 45 patients with combined idiopathic pulmonary fibrosis and emphysema (CPFE) who were treated with ICS/LABA (Group A), 24 patients with CPFE who were treated without ICS/LABA (Group B) and 35 patients with idiopathic pulmonary fibrosis (IPF) (Group C) were enrolled into this study. Then, clinical efficacy and safety of ICS/LABA was analyzed through lung function scores and lung high-resolution computed tomography (HRCT) scans. Compared with baseline levels, the FEV1%, FVC% and DLCO% levels were increased 11.2%, 13.53% and 12.8% respectively in group A, but declined 14.21%, 16.8% and 21.25% respectively in group B, meanwhile, lung HRCT score was declined 9.31 in group A but increased 14.87 in group B, and there was significant difference between group A and group B (P0.05). The incidence of adverse reaction was higher in group A than that in group B during this study, but there was no significant difference (P>0.05). ICS/LABA therapy could improve lung function condition in patients with CPFE and declined acute out-break frequency and severity of diseases during acute episode period.

  13. The chemokines CCL11, CCL20, CCL21, and CCL24 are preferentially expressed in polarized human secondary lymphoid follicles.

    Science.gov (United States)

    Buri, Caroline; Gutersohn, Andreas; Hauser, Chantal; Kappeler, Andreas; Mueller, Christoph

    2004-10-01

    Chemokines regulate cellular trafficking to and from lymphoid follicles. Here, the distribution pattern of four CCL chemokines is defined by in situ hybridization in human lymphoid follicles from tonsils and lymph nodes (LNs) of newborns and adults. Cells expressing CCL11 (eotaxin) and CCL20 (Exodus) were preferentially located within follicles, while cells expressing CCL21 (secondary lymphoid-tissue chemokine) and CCL24 (eotaxin-2) mRNA were almost exclusively found in the perifollicular areas. Hence, the two CCR3-binding chemokines, CCL11 and CCL24, showed a mutually exclusive expression pattern in the intra- and extra-follicular areas, respectively. Chemokine gene expression paralleled follicular maturation: in tonsils, where approximately 80% of follicles are polarized, CCL11 and CCL20 mRNA-positive cells were detected more frequently than in lymph nodes from adults, where about half of follicles are non-polarized. No intrafollicular chemokine expression was detectable in the primary follicles from newborns. Extrafollicular cells expressing CCL21 and CCL24 were again more frequent in tonsils than in LNs from adults. The observed preferential presence of cells expressing CC chemokines in polarized human lymphoid follicles indicates that chemokines are not only instrumental in the induction of follicle formation, but may also be involved in their further differentiation.

  14. Balloon Pulmonary Angioplasty in Chronic Thromboembolic Pulmonary Hypertension: New Horizons in the Interventional Management of Pulmonary Embolism.

    Science.gov (United States)

    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.

  15. 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

  16. Kritika važećeg i prijedlog novog pravnog uređenja vađenja i uklanjanja podrtina i potonulih stvari

    Directory of Open Access Journals (Sweden)

    Vesna Skorupan Wolff

    2012-12-01

    Full Text Available Glavni cilj rada je ponuditi i prikazati rješenja koja predstavljaju prijedlog novog pravnog uređenja instituta vađenja i uklanjanja podrtina i potonulih stvari. Prije toga, autorice u radu prikazuju genezu pravnih izvora u povijesti i ranijem domaćem zakonodavstvu te proučavaju sva relevantna pitanja i sve odredbe važećeg Pomorskog zakonika (u nastavku PZ o ovoj materiji. Analizira se značenje i uporaba pojedinih izraza, sistematizacija zakonske građe unutar strukture zakona te sadržaj i domašaj pojedinih odredbi. Autorice preispituju razinu usklađenosti pozitivnog PZ-a sa suvremenom međunarodnom regulativom u ovom području. Ukazuje se na važne probleme koji mogu nastati zbog manjkavosti odredbi pozitivnog PZ-a i nepostojanja sustavne regulacije svih relevantnih pitanja koja se mogu pojaviti u praksi. U okviru istraživanja provodi se i poredbena analiza ovih instituta u drugim nacionalnim zakonodavstvima. Predložena zakonska rješenja odlikuju se cjelovitošću i sustavnošću u normiranju svih relevantnih pitanja. Uređivanje ovih instituta specijalnim odredbama pružit će viši stupanj pravne sigurnosti te viši stupanj sigurnosti plovidbe Jadranom, zaštite okoliša, njegovih prirodnih bogatstava i drugih povezanih interesa.

  17. Pulmonary Arteriovenous Fistula: Clinical and Histologic Spectrum of Four Cases

    Directory of Open Access Journals (Sweden)

    Soomin Ahn

    2016-09-01

    Full Text Available Pulmonary arteriovenous fistula (PAVF is abnormally dilated vessels that provide a right-to-left shunt between pulmonary artery and pulmonary vein and is clinically divided into simple and complex type. Here, we report four cases of surgically resected sporadic PAVFs presenting various clinical and histologic spectrums. Cases 1 (a 57-old-female and 2 (a 54-old-female presented as incidentally identified single aneurysmal fistulas and the lesions were surgically removed without complication. On the other hand, case 3 (an 11-old-male showed diffuse dilated vascular sacs involving both lungs and caused severe hemodynamic and pulmonary dysfunction. Embolization and surgical resection of the main lesion failed to relieve the symptoms. Case 4 (a 36-old-male had a localized multiloculated cyst clinically mimicking congenital cystic adenomatoid malformation. Microscopically, the lesion consisted of dilated thick vessels, consistent with the diagnosis of fistulous arteriovenous malformation/hemangioma.

  18. 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

  19. Forecasting VaR and ES of stock index portfolio: A Vine copula method

    Science.gov (United States)

    Zhang, Bangzheng; Wei, Yu; Yu, Jiang; Lai, Xiaodong; Peng, Zhenfeng

    2014-12-01

    Risk measurement has both theoretical and practical significance in risk management. Using daily sample of 10 international stock indices, firstly this paper models the internal structures among different stock markets with C-Vine, D-Vine and R-Vine copula models. Secondly, the Value-at-Risk (VaR) and Expected Shortfall (ES) of the international stock markets portfolio are forecasted using Monte Carlo method based on the estimated dependence of different Vine copulas. Finally, the accuracy of VaR and ES measurements obtained from different statistical models are evaluated by UC, IND, CC and Posterior analysis. The empirical results show that the VaR forecasts at the quantile levels of 0.9, 0.95, 0.975 and 0.99 with three kinds of Vine copula models are sufficiently accurate. Several traditional methods, such as historical simulation, mean-variance and DCC-GARCH models, fail to pass the CC backtesting. The Vine copula methods can accurately forecast the ES of the portfolio on the base of VaR measurement, and D-Vine copula model is superior to other Vine copulas.

  20. 30 CFR 57.22218 - Seals and stoppings (III, V-A, and V-B mines).

    Science.gov (United States)

    2010-07-01

    ... combustible materials or foam-type blocks shall be coated with at least one inch of construction plaster containing perlite and gypsum; at least one inch of expanded vermiculite, Portland cement and limestone; or other coatings with equivalent fire resistance. Stoppings constructed to phenolic foam blocks at least...

  1. Solitary pulmonary nodule by pulmonary hematoma under warfarin therapy

    International Nuclear Information System (INIS)

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

    1983-01-01

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

  2. Solitary pulmonary nodule by pulmonary hematoma under warfarin therapy

    Energy Technology Data Exchange (ETDEWEB)

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

    1983-06-01

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

  3. Study of pathophysiology of pulmonary circulation in polycythemia using scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Fujii, Tadashige; Tanaka, Masao; Takeda, Tadashi; Kawashima, Akira; Kubo, Keiji; Kobayashi, Toshio; Handa, Kenjiro; Yoshimura, Kazuhiko (Shinshu Univ., Matsumoto, Nagano (Japan). Faculty of Medicine)

    1993-09-01

    In order to evaluate the pathophysiology of pulmonary circulation in polycythemia, Tl-201 myocardial scintigraphy and perfusion lung scintigraphy with 99m-Tc-MAA were performed in 19 cases of polycythemia including polycythemia rubra vera and in 11 cases of secondary polycythemia due to pulmonary diseases. Tl-201 lung uptake, right ventricular visualization and pulmonary perfusion impairment were studied. In the 19 cases, Tl-201 lung uptake was observed in all cases and 54.5% of them showed moderate lung uptake. The grade of right ventricular visualization was moderate in one case and slight in 16 cases; right ventricular hypertrophy was shown in 89.5% of all cases by Tl-201 scintigraphy, only one of which showed right ventricular hypertrophy on electrocardiography. Abnormalities of lung perfusion consisted of scattered small areas of hypoperfusion in 36.8%, peripheral hypoperfusion in 78.9% and uneven distribution of pulmonary perfusion in 94.7%. The degree of hypoperfusion was slightly related to decrease in FEV 1.0%, V25 and PaO[sub 2] and increase in circulating blood volume and peripheral red blood cell counts. Abnormalities of pulmonary function consisted of increased RV/TLC in 50.0%, increased CV/VC in 35.7% and decreased V25 in 36.8%. Arterial blood gases showed hypoxemia in 57.1%, the degree of which was slightly related to increase in RV/TLC and CV/VC and decrease in V25. Cases of secondary polycythemia due to pulmonary diseases showed more marked right ventricular visualization, pulmonary perfusion impairment and abnormalities of various kinds of pulmonary function than polycythemia rubra vera cases. It seems to be important to evaluate the pathophysiology of pulmonary circulation in polycythemia rubra vera as well as secondary polycythemia due to cardio-pulmonary diseases, because pulmonary perfusion impairment and moderate right ventricular visualization are observed frequently in polycythemia rubra vera. (author).

  4. Study of pathophysiology of pulmonary circulation in polycythemia using scintigraphy

    International Nuclear Information System (INIS)

    Fujii, Tadashige; Tanaka, Masao; Takeda, Tadashi; Kawashima, Akira; Kubo, Keiji; Kobayashi, Toshio; Handa, Kenjiro; Yoshimura, Kazuhiko

    1993-01-01

    In order to evaluate the pathophysiology of pulmonary circulation in polycythemia, Tl-201 myocardial scintigraphy and perfusion lung scintigraphy with 99m-Tc-MAA were performed in 19 cases of polycythemia including polycythemia rubra vera and in 11 cases of secondary polycythemia due to pulmonary diseases. Tl-201 lung uptake, right ventricular visualization and pulmonary perfusion impairment were studied. In the 19 cases, Tl-201 lung uptake was observed in all cases and 54.5% of them showed moderate lung uptake. The grade of right ventricular visualization was moderate in one case and slight in 16 cases; right ventricular hypertrophy was shown in 89.5% of all cases by Tl-201 scintigraphy, only one of which showed right ventricular hypertrophy on electrocardiography. Abnormalities of lung perfusion consisted of scattered small areas of hypoperfusion in 36.8%, peripheral hypoperfusion in 78.9% and uneven distribution of pulmonary perfusion in 94.7%. The degree of hypoperfusion was slightly related to decrease in FEV 1.0%, V25 and PaO 2 and increase in circulating blood volume and peripheral red blood cell counts. Abnormalities of pulmonary function consisted of increased RV/TLC in 50.0%, increased CV/VC in 35.7% and decreased V25 in 36.8%. Arterial blood gases showed hypoxemia in 57.1%, the degree of which was slightly related to increase in RV/TLC and CV/VC and decrease in V25. Cases of secondary polycythemia due to pulmonary diseases showed more marked right ventricular visualization, pulmonary perfusion impairment and abnormalities of various kinds of pulmonary function than polycythemia rubra vera cases. It seems to be important to evaluate the pathophysiology of pulmonary circulation in polycythemia rubra vera as well as secondary polycythemia due to cardio-pulmonary diseases, because pulmonary perfusion impairment and moderate right ventricular visualization are observed frequently in polycythemia rubra vera. (author)

  5. Initial CT manifestations of invasive pulmonary aspergillosis in 45 non-HIV immunocompromised patients: association with patient outcome?

    International Nuclear Information System (INIS)

    Horger, Marius; Hebart, Holger; Einsele, Hermann; Lengerke, Claudia; Claussen, C.D.; Vonthein, Reinhard; Pfannenberg, Christina

    2005-01-01

    Purpose: To assess early high-resolution computer tomographic (CT) signs of invasive pulmonary aspergillosis (IPA) in non-HIV immunosuppressed patients and their potential association with patient's outcome, including frequency and severity of pulmonary hemorrhage, taking also in consideration the impact of other known risk factors contributory to IPA. Material and methods: A retrospective review of serial CT scans was performed in 45 immunocompromised patients with a total of 46 episodes of invasive pulmonary aspergillosis. All patients underwent CT beginning with the day they showed clinical or laboratory signs of infection. Serial follow-up CT included more than two, up to 12 CT examinations. Patient's outcome was judged by clinical and radiological follow-up and classified as survival, death by IPA, or death unrelated to IPA. The influence of patient's age, underlying disease, hematopoietic stem cell transplantation, neutropenia, graft versus host disease, and antifungal therapy onset was also statistically considered. Results: Three main CT findings were identified: small nodules (<1 cm) 43% (20/46), large nodules 21% (10/46) and consolidations, either in patchy ± segmental 26% (12/46), or peribronchial distribution ± tree in bud 9% (4/46). In 11 patients (24%) we found a combination of two or more of these signs: 9 (19%) patients presented concurrent small nodules accompanied by reticulation, tree in bud or peribronchial infiltrates, while 2 (4%) patients showed large pulmonary nodules accompanied by large consolidations. An accompanying 'halo' sign was observed in 38 patients (82%). Crescent sign followed by cavitation was encountered in 29 patients (63%). Two patients succumbed to massive pulmonary bleeding caused by IPA. Twenty-one patients (15/46) deceased in this series, 12 of them succumbed to IPA, 1 died from cerebral invasive aspergillosis, while in 9 patients the cause of death was not primarily IPA. Manifest pulmonary hemorrhage occurred in 19% (9

  6. 38 CFR 3.2130 - Will VA accept a signature by mark or thumbprint?

    Science.gov (United States)

    2010-07-01

    ... signature by mark or thumbprint? 3.2130 Section 3.2130 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF... of This Title General § 3.2130 Will VA accept a signature by mark or thumbprint? VA will accept signatures by mark or thumbprint if: (a) They are witnessed by two people who sign their names and give their...

  7. Enhanced dissolution rate of dronedarone hydrochloride via preparation of solid dispersion using vinylpyrrolidone-vinyl acetate copolymer (Kollidone® VA 64)

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Hyuck Jun; Kang, Myung Joo [College of Pharmacy, Dankook University, Cheonan (Korea, Republic of); Han, Sang Duk [Dong-A ST Rese arch Institute, Pharmaceutical Product Research Laboratories, Yongin (Korea, Republic of)

    2015-09-15

    Solid dispersion (SD) systems have been widely used to increase the dissolution rate and oral absorption of poorly water-soluble compounds. In order to enhance the dissolution rate of dronedarone hydrochloride (DRN), a recent antiarrhythmic agent, SDs of DRN were formulated using conventional solvent evaporation method with amorphous polymers including hydroxypropyl methyl cellulose (HPMC), poly(vinyl pyrrolidone) (PVP), and vinylpyrrolidone-vinyl acetate copolymer (VA64). The prepared SDs were characterized in terms of drug crystallinity, morphology, and in vitro dissolution profile in aqueous medium. The physical characterization using differential scanning calorimetry and X-ray powder diffraction revealed that the active compound was molecularly dispersed in all polymeric carriers tested, in a stable amorphous form in drug to polymer ratios ranging from 1:0.5 to 1:2. The dissolution rates of DRN in all SDs were much higher than those from the corresponding physical mixture and drug powder alone. In particular, the greatest dissolution enhancement was obtained from the VA64-based SD in a drug to polymer weight ratio of 1:1, achieving almost complete drug release after 120 min at pH 1.2. Thus, VA64-based SD with higher drug dissolution rate along with a simple preparation process is suggested as an alternative for the oral formulation of the benzofuran derivative.

  8. MR imaging of the pulmonary vasculature: Cine and high-resolution techniques

    International Nuclear Information System (INIS)

    Gefter, W.B.; Hatabu, H.; Kressel, H.Y.; Axel, L.; Lenkinski, R.E.; Schiebler, M.L.; Dougherty, L.; Douglas, P.S.; Reichek, N.

    1987-01-01

    Pulmonary vessels were evaluated on 43 cine examinations (12 normals, 31 with cardiopulmonary diseases) at 1.5 T (General Electric). Arteries and veins could be differentiated by characteristic intensity fluctuations in 90%. Abnormal patterns were observed with elevated left atrial pressure, pulmonary hypertension, pulmonic stenosis, and mitral regurgitation. A small arteriovenous malformation was identified. Approaches to high-resolution imaging included surface coils, 24-cm field of view, and 256 x 256 matrix. Spin-echo (SE) sequences gated in systole or diastole, and GRASS with and without breath-holding were evaluated. Surface-coil SE diastolic images (4 NEX) visualized sixth- and seventh-generation vessels. Breath-hold GRASS showed fifth- and sixth-generation vessels without respiratory artifact. These are promising techniques for displaying the pulmonary circulation

  9. Improving early diagnosis of pulmonary infections in patients with febrile neutropenia using low-dose chest computed tomography.

    Directory of Open Access Journals (Sweden)

    M G Gerritsen

    Full Text Available We performed a prospective study in patients with chemotherapy induced febrile neutropenia to investigate the diagnostic value of low-dose computed tomography compared to standard chest radiography. The aim was to compare both modalities for detection of pulmonary infections and to explore performance of low-dose computed tomography for early detection of invasive fungal disease. The low-dose computed tomography remained blinded during the study. A consensus diagnosis of the fever episode made by an expert panel was used as reference standard. We included 67 consecutive patients on the first day of febrile neutropenia. According to the consensus diagnosis 11 patients (16.4% had pulmonary infections. Sensitivity, specificity, positive predictive value and negative predictive value were 36%, 93%, 50% and 88% for radiography, and 73%, 91%, 62% and 94% for low-dose computed tomography, respectively. An uncorrected McNemar showed no statistical difference (p = 0.197. Mean radiation dose for low-dose computed tomography was 0.24 mSv. Four out of 5 included patients diagnosed with invasive fungal disease had radiographic abnormalities suspect for invasive fungal disease on the low-dose computed tomography scan made on day 1 of fever, compared to none of the chest radiographs. We conclude that chest radiography has little value in the initial assessment of febrile neutropenia on day 1 for detection of pulmonary abnormalities. Low-dose computed tomography improves detection of pulmonary infiltrates and seems capable of detecting invasive fungal disease at a very early stage with a low radiation dose.

  10. Improving early diagnosis of pulmonary infections in patients with febrile neutropenia using low-dose chest computed tomography.

    Science.gov (United States)

    Gerritsen, M G; Willemink, M J; Pompe, E; van der Bruggen, T; van Rhenen, A; Lammers, J W J; Wessels, F; Sprengers, R W; de Jong, P A; Minnema, M C

    2017-01-01

    We performed a prospective study in patients with chemotherapy induced febrile neutropenia to investigate the diagnostic value of low-dose computed tomography compared to standard chest radiography. The aim was to compare both modalities for detection of pulmonary infections and to explore performance of low-dose computed tomography for early detection of invasive fungal disease. The low-dose computed tomography remained blinded during the study. A consensus diagnosis of the fever episode made by an expert panel was used as reference standard. We included 67 consecutive patients on the first day of febrile neutropenia. According to the consensus diagnosis 11 patients (16.4%) had pulmonary infections. Sensitivity, specificity, positive predictive value and negative predictive value were 36%, 93%, 50% and 88% for radiography, and 73%, 91%, 62% and 94% for low-dose computed tomography, respectively. An uncorrected McNemar showed no statistical difference (p = 0.197). Mean radiation dose for low-dose computed tomography was 0.24 mSv. Four out of 5 included patients diagnosed with invasive fungal disease had radiographic abnormalities suspect for invasive fungal disease on the low-dose computed tomography scan made on day 1 of fever, compared to none of the chest radiographs. We conclude that chest radiography has little value in the initial assessment of febrile neutropenia on day 1 for detection of pulmonary abnormalities. Low-dose computed tomography improves detection of pulmonary infiltrates and seems capable of detecting invasive fungal disease at a very early stage with a low radiation dose.

  11. Introduction to Pulmonary Fibrosis

    Science.gov (United States)

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

  12. [Effect of a simulation-based education on cardio-pulmonary emergency care knowledge, clinical performance ability and problem solving process in new nurses].

    Science.gov (United States)

    Kim, Yun Hee; Jang, Keum Seong

    2011-04-01

    This study was conducted to examine the effects of simulation-based education regarding care in a cardio-pulmonary emergency care as related to knowledge, clinical performance ability, and problem solving process in new nurses. An equivalent control group pre-post test experimental design was used. Fifty new nurses were recruited, 26 nurses for the experimental group and 24 nurses for the control group. The simulation-based cardio-pulmonary emergency care education included lecture, skill training, team-based practice, and debriefing, and it was implemented with the experimental group for a week in May, 2009. Data were analyzed using frequency, ratio, chi-square, Fisher's exact probability and t-test with the SPSS program. The experimental group who had the simulation-based education showed significantly higher know-ledge (t=5.76, pproblem solving process was not included (t=1.11, p=.138). The results indicate that a simulation-based education is an effective teaching method to improve knowledge and clinical performance ability in new nurses learning cardio-pulmonary emergency care. Further study is needed to identify the effect of a simulation-based team discussion on cognitive outcome of clinical nurses such as problem solving skills.

  13. Measurement of pulmonary vascular resistance of Fontan candidates with pulmonary arterial distortion by means of pulmonary perfusion imaging

    International Nuclear Information System (INIS)

    Park, In-Sam; Mizukami, Ayumi; Tomimatsu, Hirofumi; Kondou, Chisato; Nakanishi, Toshio; Nakazawa, Makoto; Momma, Kazuo

    1998-01-01

    We measured the distribution of blood flow to the right (R) and left lung (L) by means of pulmonary perfusion imaging and calculated pulmonary vascular resistance (Rp) in 13 patients, whose right and left pulmonary artery pressures were different by 2 to 9 mmHg due to pulmonary arterial distortion (5 interruption, 8 stenosis). The right lung/left lung blood flow ratio was determined and from the ratio and the total pulmonary blood flow, which was determined using the Fick's principle, the absolute values of right and left pulmonary blood flow were calculated. Using the right and left pulmonary blood flow and the right and left pulmonary arterial pressures, right and left pulmonary vascular resistance were calculated, separately. Vascular resistance of the whole lung (Rp) was then calculated using the following equation. 1/(Rp of total lung)=1/(Rp of right lung)+1/(Rp of left lung). Rp calculated from this equation was 1.8+/-0.8 U·m 2 and all values were less than 3 U·m 2 (range 0.3-2.8). Rp estimated from the conventional method using the total pulmonary blood flow and pulmonary arterial pressures, without using the right/left blood flow ratio, ranging from 0.4 to 3.8 U·m 2 and 5 of 13 patients showed Rp>3 U·m 2 . All patients underwent Fontan operation successfully. These data indicated that this method is useful to estimate Rp and to determine the indication of Fontan operation in patients with pulmonary arterial distortions. (author)

  14. 78 FR 62441 - VA Dental Insurance Program-Federalism

    Science.gov (United States)

    2013-10-22

    ...--Federalism AGENCY: Department of Veterans Affairs. ACTION: Direct final rule. SUMMARY: The Department of... that they are submitted in response to ``RIN 2900-AO85-VA Dental Insurance Program-- Federalism... add preemption language in accordance with the discussion above. Executive Order 13132, Federalism...

  15. Pulmonary Fibrosis Foundation

    Science.gov (United States)

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

  16. A Stochastic Dominance Approach to the Basel III Dilemma: Expected Shortfall or VaR?

    NARCIS (Netherlands)

    C-L. Chang (Chia-Lin); J.A. Jiménez-Martín (Juan-Ángel); E. Maasoumi (Esfandiar); M.J. McAleer (Michael); T. Pérez-Amaral (Teodosio)

    2015-01-01

    markdownabstract__Abstract__ The Basel Committee on Banking Supervision (BCBS) (2013) recently proposed shifting the quantitative risk metrics system from Value-at-Risk (VaR) to Expected Shortfall (ES). The BCBS (2013) noted that “a number of weaknesses have been identified with using VaR for

  17. Impact of Balloon Pulmonary Angioplasty on Hemodynamics and Clinical Outcomes in Patients with Chronic Thromboembolic Pulmonary Hypertension: the Initial Korean Experience.

    Science.gov (United States)

    Kwon, Woochan; Yang, Jeong Hoon; Park, Taek Kyu; Chang, Sung A; Jung, Dong Seop; Cho, Young Seok; Kim, Sung Mok; Kim, Tae Jung; Park, Hye Yoon; Choi, Seung Hyuk; Kim, Duk Kyung

    2018-01-22

    The treatment of choice for chronic thromboembolic pulmonary hypertension (CTEPH) is pulmonary endarterectomy (PEA). However, not all patients are eligible for PEA, and some patients experience recurrence of pulmonary hypertension even after PEA. Patients who underwent balloon pulmonary angioplasty (BPA) between December 2015 and April 2017 were enrolled from the Samsung Medical Center CTEPH registry. Enrolled patients underwent right heart catheterization, echocardiography, and 6-minute walk distance (6MWD) at baseline, 4 and 24 weeks after their first BPA session. We compared clinical and hemodynamic parameters at the baseline and last BPA session. Fifty-two BPA sessions were performed in 15 patients, six of whom had a history of PEA. BPA resulted in improvements in World Health Organization (WHO) functional class (2.9 ± 0.8 to 1.7 ± 0.6, P = 0.002), 6MWD (387.0 ± 86.4 to 453.4 ± 64.8 m, P = 0.01), tricuspid annular plane systolic excursion (14.1 ± 3.6 to 15.6 ± 4.3 mm, P = 0.03) and hemodynamics, including a decline in mean pulmonary artery pressure (41.1 ± 13.1 to 32.1 ± 9.5 mmHg, P < 0.001) and in pulmonary vascular resistance (607.4 ± 452.3 to 406.7 ± 265.4 dyne.sec.cm⁻⁵, P = 0.01) but not in cardiac index (2.94 ± 0.79 to 2.96 ± 0.93 L/min/m², P = 0.92). Six cases of complications were recorded, including two cases of reperfusion injury. BPA might be a safe and effective treatment strategy for both inoperable CTEPH patients and patients with residual pulmonary hypertension after PEA. © 2018 The Korean Academy of Medical Sciences.

  18. VaR: Exchange Rate Risk and Jump Risk

    Directory of Open Access Journals (Sweden)

    Fen-Ying Chen

    2010-01-01

    Full Text Available Incorporating the Poisson jumps and exchange rate risk, this paper provides an analytical VaR to manage market risk of international portfolios over the subprime mortgage crisis. There are some properties in the model. First, different from past studies in portfolios valued only in one currency, this model considers portfolios not only with jumps but also with exchange rate risk, that is vital for investors in highly integrated global financial markets. Second, in general, the analytical VaR solution is more accurate than historical simulations in terms of backtesting and Christoffersen's independence test (1998 for small portfolios and large portfolios. In other words, the proposed model is reliable not only for a portfolio on specific stocks but also for a large portfolio. Third, the model can be regarded as the extension of that of Kupiec (1999 and Chen and Liao (2009.

  19. Idiopathic pulmonary fibrosis with coexisting emphysema : high-resolution CT and clinical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Eun Young; Kim, Kyeong Ah; Oh, Yu Whan; Shim, Jae Jeong; Kang, Kyung Ho [Korea Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-05-01

    To correlate high-resolution CT (HRCT) findings with smoking history and pulmonary function test (PFT) in patients with idiopathic pulmonary fibrosis (IPF) with or without coexisting emphsema. The study included 24 patients who had undergone HRCT and in whom IPF had been confirmed pathologically (n=7) and clinically (n=17). The patients included 19 men and 5 women aged between from 44 and 78(mean 59) years. HRCT findings were reviewed by two radiologists and assessed for the presence and extent of emphysema (CT emphysema score;CES) and honeycombing (CT honeycombing score;CHS). CES and CHS were retrospectively correlated with smoking status and pulmonary function test. Evidence of emphysema was seen on HRCT in 20 fo 24 patients with IPF (83%). CES was 14.3 and CHS was 18.1 in smokers with IPF, as compared with 1.8 and 6.7 in nonsmokers (p<0.01). Pulmonary function tests showed lower percent predicted FEVI (69.3%), FVC (64.7%), TLC (73.7%), and RV (77.3%), a lower percent predicted diffusing capacity of carbon monoxide (58.2%), and normal FEVI/FVC (99.1%). The pulmonary function test in smokers showed higher TLC and RV than in nonsmokers. Eight of nine patients whose CES was higher than their CHS, an seen on HRCT, were smokers and had a smoking history of 33.1 pack-years. Seven of 15 whose CHS was higher than their CES were smokers and had a smoking history of 16.8 pack-years. In patients with a higher CES than CHS pulmonary function test results showed normal TLC(85%) and RV(100.7%); this contrasted with decreased TLC(72%) and RV (68%) in patients whose CHS was higher than their CES. Emphysema is a frequently associated finding in patients with IPF, as seen on HRCT, and emphysema is more frequent and extensive in smokers with IPF than non-smokers. HRCT is useful for detecting emphysema in patients with IPF, and the extent of emphysema on HRCT correlates with the results of the pulmonary function test and smoking status.

  20. Idiopathic pulmonary fibrosis with coexisting emphysema : high-resolution CT and clinical correlation

    International Nuclear Information System (INIS)

    Kang, Eun Young; Kim, Kyeong Ah; Oh, Yu Whan; Shim, Jae Jeong; Kang, Kyung Ho

    1997-01-01

    To correlate high-resolution CT (HRCT) findings with smoking history and pulmonary function test (PFT) in patients with idiopathic pulmonary fibrosis (IPF) with or without coexisting emphsema. The study included 24 patients who had undergone HRCT and in whom IPF had been confirmed pathologically (n=7) and clinically (n=17). The patients included 19 men and 5 women aged between from 44 and 78(mean 59) years. HRCT findings were reviewed by two radiologists and assessed for the presence and extent of emphysema (CT emphysema score;CES) and honeycombing (CT honeycombing score;CHS). CES and CHS were retrospectively correlated with smoking status and pulmonary function test. Evidence of emphysema was seen on HRCT in 20 fo 24 patients with IPF (83%). CES was 14.3 and CHS was 18.1 in smokers with IPF, as compared with 1.8 and 6.7 in nonsmokers (p<0.01). Pulmonary function tests showed lower percent predicted FEVI (69.3%), FVC (64.7%), TLC (73.7%), and RV (77.3%), a lower percent predicted diffusing capacity of carbon monoxide (58.2%), and normal FEVI/FVC (99.1%). The pulmonary function test in smokers showed higher TLC and RV than in nonsmokers. Eight of nine patients whose CES was higher than their CHS, an seen on HRCT, were smokers and had a smoking history of 33.1 pack-years. Seven of 15 whose CHS was higher than their CES were smokers and had a smoking history of 16.8 pack-years. In patients with a higher CES than CHS pulmonary function test results showed normal TLC(85%) and RV(100.7%); this contrasted with decreased TLC(72%) and RV (68%) in patients whose CHS was higher than their CES. Emphysema is a frequently associated finding in patients with IPF, as seen on HRCT, and emphysema is more frequent and extensive in smokers with IPF than non-smokers. HRCT is useful for detecting emphysema in patients with IPF, and the extent of emphysema on HRCT correlates with the results of the pulmonary function test and smoking status

  1. The process of implementing a rural VA wound care program for diabetic foot ulcer patients.

    Science.gov (United States)

    Reiber, Gayle E; Raugi, Gregory J; Rowberg, Donald

    2007-10-01

    Delivering and documenting evidence-based treatment to all Department of Veterans Affairs (VA) foot ulcer patients has wide appeal. However, primary and secondary care medical centers where 52% of these patients receive care are at a disadvantage given the frequent absence of trained specialists to manage diabetic foot ulcers. A retrospective review of diabetic foot ulcer patient records and a provider survey were conducted to document the foot ulcer problem and to assess practitioner needs. Results showed of the 125 persons with foot ulcers identified through administrative data, only, 21% of diabetic foot patients were correctly coded. Chronic Care and Microsystem models were used to prepare a tailored intervention in a VA primary care medical center. The site Principal Investigators, a multidisciplinary site wound care team, and study investigators jointly implemented a diabetic foot ulcer program. Intervention components include wound care team education and training, standardized good wound care practices based on strong scientific evidence, and a wound care template embedded in the electronic medical record to facilitate data collection, clinical decision making, patient ordering, and coding. A strategy for delivering offloading pressure devices, regular case management support, and 24/7 emergency assistance also was developed. It took 9 months to implement the model. Patients were enrolled and followed for 1 year. Process and outcome evaluations are on-going.

  2. Pulmonary agenesis

    OpenAIRE

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

    2009-01-01

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

  3. SlaVaComp Fonts Converter

    Directory of Open Access Journals (Sweden)

    Simon Skilevic

    2013-12-01

    Full Text Available This paper presents a fonts converter that was developed as a part of the Freiburg project on historical corpus linguistics. The tool named SlaVaComp-Konvertierer converts Church Slavonic texts digitized with non-Unicode fonts into the Unicode format without any loss of information contained in the original file and without damage to the original formatting. It is suitable for the conversion of all idiosyncratic fonts—not only Church Slavonic—and therefore can be used not only in Palaeoslavistic, but also in all historical and philological studies.

  4. The Analysis of The Starting Pattern in Nezami’s Khosrow va Shirin, Leili va Majnoun and Haft Peykar

    Directory of Open Access Journals (Sweden)

    Tayebe Ja’fari

    2016-05-01

    Full Text Available AbstractAccording to what Nezami states in his versified story Khosro va Shirin, King Hormoz is a fair and peasant-supporter monarch and everything is alright in his time. The only matter which bothers the King’s mind and feelings is the sadness of having no child. But this piteous sadness is removed after vowing, sacrificing and being born a boy as a result. This boy is totally different from his age children because of his unique characteristics.    Leili va Majnoon’s starting pattern can be Khosro va Shirin’s starting pattern simply by having some changes in characters. In this poem, the memoir related to the chieftain of Amer, who was one of the Arab grandees and has a settled land, is expressed. He is an artist who has a significant reputation in hospitality and being mendicant-adherent, but the sadness of having no child makes him like King Hormoz, so he decides to vow and sacrifice and asks God to give him a child.   Based on an archetypal approach, the boy who has been requested by prayer in Khosrow va Shirin, Leili va Majnoon, and other myths is an archetypal item that these literary works’ starting patterns are the expression of common conditions before, during, and after his birth. He is the heavenly child who has been born to make a great upheaval.   Based on an archetypal approach, the heavenly child can be considered as the best form of emanation of the potential aspect of Ego in dreams and myths in which the king, as the actual aspect of this archetype, wishes this child’s birth; to reach his perfect ideal. With this paraphastic approach, Khosrow Parviz and King Hormoz are respectively the potential and the actual aspect of Ego. Hormoz is the actual part that is almost perfect. He is an ideal, fair and peasant-supporter king. But this perfect person is only some parts of his talent who has reached the actuality and can be manifest. This potential aspect is the child whom the king is

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

    Directory of Open Access Journals (Sweden)

    Chuanchen Zhang

    2016-01-01

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

  6. ON THE DETECTABILITY OF A PREDICTED MESOLENSING EVENT ASSOCIATED WITH THE HIGH PROPER MOTION STAR VB 10

    International Nuclear Information System (INIS)

    Lépine, Sébastien; DiStefano, Rosanne

    2012-01-01

    Extrapolation of the astrometric motion of the nearby low-mass star VB 10 indicates that sometime in late 2011 December or during the first 2-3 months of 2012, the star will make a close approach to a background point source. Based on astrometric uncertainties, we estimate a 1 in 2 chance that the distance of closest approach ρ min will be less than 100 mas, a 1 in 5 chance that ρ min min J planet on a moderately wide (≈0.18 AU–0.84 AU) orbit, there is a chance (1% to more than 10%, depending on the distance of closest approach and orbital period and inclination) that a passage of the planet closer to the background source will result in a secondary event of higher magnification. The detection of secondary events could be made possible with a several-times-per-night multi-site monitoring campaign.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1967-09-15

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

  8. Chronic obstructive pulmonary disease in patients admitted with heart failure

    DEFF Research Database (Denmark)

    Iversen, K K; Kjaergaard, J; Akkan, D

    2008-01-01

    OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is an important differential diagnosis in patients with heart failure (HF). The primary aims were to determine the prevalence of COPD and to test the accuracy of self-reported COPD in patients admitted with HF. Secondary aims were to study...... valve. CONCLUSION: Chronic obstructive pulmonary disease is frequent in patients admitted with HF and self-reported COPD only identifies a minority. The prevalence of COPD was high in both patients with systolic and nonsystolic HF....... a possible relationship between right and left ventricular function and pulmonary function. DESIGN: Prospective substudy. SETTING: Systematic screening at 11 centres. SUBJECTS: Consecutive patients (n = 532) admitted with HF requiring medical treatment with diuretics and an episode with symptoms...

  9. Validation of KENO V.a: Comparison with critical experiments

    International Nuclear Information System (INIS)

    Jordan, W.C.; Landers, N.F.; Petrie, L.M.

    1986-12-01

    Section 1 of this report documents the validation of KENO V.a against 258 critical experiments. Experiments considered were primarily high or low enriched uranium systems. The results indicate that the KENO V.a Monte Carlo Criticality Program accurately calculates a broad range of critical experiments. A substantial number of the calculations showed a positive or negative bias in excess of 1 1/2% in k-effective (k/sub eff/). Classes of criticals which show a bias include 3% enriched green blocks, highly enriched uranyl fluoride slab arrays, and highly enriched uranyl nitrate arrays. If these biases are properly taken into account, the KENO V.a code can be used with confidence for the design and criticality safety analysis of uranium-containing systems. Sections 2 of this report documents the results of investigation into the cause of the bias observed in Sect. 1. The results of this study indicate that the bias seen in Sect. 1 is caused by code bias, cross-section bias, reporting bias, and modeling bias. There is evidence that many of the experiments used in this validation and in previous validations are not adequately documented. The uncertainty in the experimental parameters overshadows bias caused by the code and cross sections and prohibits code validation to better than about 1% in k/sub eff/. 48 refs., 19 figs., 19 tabs

  10. Retrograde pulmonary arteriography

    International Nuclear Information System (INIS)

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

    1984-01-01

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

  11. 78 FR 63143 - VA Dental Insurance Program-Federalism

    Science.gov (United States)

    2013-10-23

    ...--Federalism AGENCY: Department of Veterans Affairs. ACTION: Proposed rule. SUMMARY: The Department of Veterans... that they are submitted in response to ``RIN 2900-AO86-VA Dental Insurance Program-- Federalism... Order 13132, Federalism Section 6(c) of Executive Order 13132 (entitled ``Federalism'') requires an...

  12. VA Library Service--Today's look at Tomorrow's Library.

    Science.gov (United States)

    Veterans Administration, Washington, DC.

    The Conference Poceedings are divided into three broad topics: systems planning, audiovisuals in biomedical communication, and automation and networking. Speakers from within the Veterans Administration (VA), from the National Medical Audiovisual Center, and the Lister Hill National Center for Biomedical Communications, National Library of…

  13. Polymorphisms of SP110 are associated with both pulmonary and extra-pulmonary tuberculosis among the Vietnamese.

    Directory of Open Access Journals (Sweden)

    Gregory J Fox

    Full Text Available Tuberculosis (TB is an infectious disease that remains a major cause of morbidity and mortality worldwide, yet the reasons why only 10% of people infected with Mycobacterium tuberculosis go on to develop clinical disease are poorly understood. Genetically determined variation in the host immune response is one factor influencing the response to M. tuberculosis. SP110 is an interferon-responsive nuclear body protein with critical roles in cell cycling, apoptosis and immunity to infection. However association studies of the gene with clinical TB in different populations have produced conflicting results.To examine the importance of the SP110 gene in immunity to TB in the Vietnamese we conducted a case-control genetic association study of 24 SP110 variants, in 663 patients with microbiologically proven TB and 566 unaffected control subjects from three tertiary hospitals in northern Vietnam.Five SNPs within SP110 were associated with all forms of TB, including four SNPs at the C terminus (rs10208770, rs10498244, rs16826860, rs11678451 under a dominant model and one SNP under a recessive model, rs7601176. Two of these SNPs were associated with pulmonary TB (rs10208770 and rs16826860 and one with extra-pulmonary TB (rs10498244.SP110 variants were associated with increased susceptibility to both pulmonary and extra-pulmonary TB in the Vietnamese. Genetic variants in SP110 may influence macrophage signaling responses and apoptosis during M. tuberculosis infection, however further research is required to establish the mechanism by which SP110 influences immunity to tuberculosis infection.

  14. Polymorphisms of SP110 are associated with both pulmonary and extra-pulmonary tuberculosis among the Vietnamese.

    Science.gov (United States)

    Fox, Gregory J; Sy, Dinh Ngoc; Nhung, Nguyen Viet; Yu, Bing; Ellis, Magda K; Van Hung, Nguyen; Cuong, Nguyen Kim; Thi Lien, Luu; Marks, Guy B; Saunders, Bernadette M; Britton, Warwick J

    2014-01-01

    Tuberculosis (TB) is an infectious disease that remains a major cause of morbidity and mortality worldwide, yet the reasons why only 10% of people infected with Mycobacterium tuberculosis go on to develop clinical disease are poorly understood. Genetically determined variation in the host immune response is one factor influencing the response to M. tuberculosis. SP110 is an interferon-responsive nuclear body protein with critical roles in cell cycling, apoptosis and immunity to infection. However association studies of the gene with clinical TB in different populations have produced conflicting results. To examine the importance of the SP110 gene in immunity to TB in the Vietnamese we conducted a case-control genetic association study of 24 SP110 variants, in 663 patients with microbiologically proven TB and 566 unaffected control subjects from three tertiary hospitals in northern Vietnam. Five SNPs within SP110 were associated with all forms of TB, including four SNPs at the C terminus (rs10208770, rs10498244, rs16826860, rs11678451) under a dominant model and one SNP under a recessive model, rs7601176. Two of these SNPs were associated with pulmonary TB (rs10208770 and rs16826860) and one with extra-pulmonary TB (rs10498244). SP110 variants were associated with increased susceptibility to both pulmonary and extra-pulmonary TB in the Vietnamese. Genetic variants in SP110 may influence macrophage signaling responses and apoptosis during M. tuberculosis infection, however further research is required to establish the mechanism by which SP110 influences immunity to tuberculosis infection.

  15. Polymorphisms of SP110 Are Associated with both Pulmonary and Extra-Pulmonary Tuberculosis among the Vietnamese

    Science.gov (United States)

    Fox, Gregory J.; Sy, Dinh Ngoc; Nhung, Nguyen Viet; Yu, Bing; Ellis, Magda K.; Van Hung, Nguyen; Cuong, Nguyen Kim; Thi Lien, Luu; Marks, Guy B.; Saunders, Bernadette M.; Britton, Warwick J.

    2014-01-01

    Background Tuberculosis (TB) is an infectious disease that remains a major cause of morbidity and mortality worldwide, yet the reasons why only 10% of people infected with Mycobacterium tuberculosis go on to develop clinical disease are poorly understood. Genetically determined variation in the host immune response is one factor influencing the response to M. tuberculosis. SP110 is an interferon-responsive nuclear body protein with critical roles in cell cycling, apoptosis and immunity to infection. However association studies of the gene with clinical TB in different populations have produced conflicting results. Methods To examine the importance of the SP110 gene in immunity to TB in the Vietnamese we conducted a case-control genetic association study of 24 SP110 variants, in 663 patients with microbiologically proven TB and 566 unaffected control subjects from three tertiary hospitals in northern Vietnam. Results Five SNPs within SP110 were associated with all forms of TB, including four SNPs at the C terminus (rs10208770, rs10498244, rs16826860, rs11678451) under a dominant model and one SNP under a recessive model, rs7601176. Two of these SNPs were associated with pulmonary TB (rs10208770 and rs16826860) and one with extra-pulmonary TB (rs10498244). Conclusion SP110 variants were associated with increased susceptibility to both pulmonary and extra-pulmonary TB in the Vietnamese. Genetic variants in SP110 may influence macrophage signaling responses and apoptosis during M. tuberculosis infection, however further research is required to establish the mechanism by which SP110 influences immunity to tuberculosis infection. PMID:25006821

  16. Lung cancer in patients with idiopathic pulmonary fibrosis: frequency and CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hak Jong; Im, Jung Gi; Ahn, Joong Mo; Yeon, Kyung Mo [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

    1994-12-15

    The incidence of lung cancer in patients with idiopathic pulmonary fibrosis(lPF) is higher than that of general population. To evaluate the frequency and CT findings of lung cancer associated with idiopathic pulmonary fibrosis, we analyzed 19 patients with lung cancer associated with idiopathic pulmonary fibrosis. We analyzed retrospectively 19 patients with histologically confirmed lung cancer out of 208 patients diagnosed as IPF either by CT and clinical findings(n=188) or histologically(n=20). All 19 patients were male, aged 40-85 years (mean 66 years). Scanning techniques were conventional CT in 12 patients, HRCT in 1 patient and both conventional CT and HRCT in 6 patients. We analyzed the CT patterns of lung cancer and IPF, locations of the tumor and histologic types of lung cancer. The incidence of lung cancer in patients with idiopathic pulmonary fibrosis was 9.1%(19/208). In 11 of 19 patients, CT findings of lung cancer were ill-defined consolidation-like mass. Lung cancer was located mainly in lower lobes(right lower lobe; 10/19, left lower lobe; 5/19) and at the periphery(12/19). Histologically, squamous cell carcinoma was the most common cell type (11/19). The incidence of lung cancer in patients with idiopathic pulmonary fibrosis was much higher than that of general population. Typical CT findings of lung cancer were predominantly ill-defined consolidation like mass at the peripheral lung portion which is the location where the most advanced fibrosis occur.

  17. Lung cancer in patients with idiopathic pulmonary fibrosis: frequency and CT findings

    International Nuclear Information System (INIS)

    Lee, Hak Jong; Im, Jung Gi; Ahn, Joong Mo; Yeon, Kyung Mo

    1994-01-01

    The incidence of lung cancer in patients with idiopathic pulmonary fibrosis(lPF) is higher than that of general population. To evaluate the frequency and CT findings of lung cancer associated with idiopathic pulmonary fibrosis, we analyzed 19 patients with lung cancer associated with idiopathic pulmonary fibrosis. We analyzed retrospectively 19 patients with histologically confirmed lung cancer out of 208 patients diagnosed as IPF either by CT and clinical findings(n=188) or histologically(n=20). All 19 patients were male, aged 40-85 years (mean 66 years). Scanning techniques were conventional CT in 12 patients, HRCT in 1 patient and both conventional CT and HRCT in 6 patients. We analyzed the CT patterns of lung cancer and IPF, locations of the tumor and histologic types of lung cancer. The incidence of lung cancer in patients with idiopathic pulmonary fibrosis was 9.1%(19/208). In 11 of 19 patients, CT findings of lung cancer were ill-defined consolidation-like mass. Lung cancer was located mainly in lower lobes(right lower lobe; 10/19, left lower lobe; 5/19) and at the periphery(12/19). Histologically, squamous cell carcinoma was the most common cell type (11/19). The incidence of lung cancer in patients with idiopathic pulmonary fibrosis was much higher than that of general population. Typical CT findings of lung cancer were predominantly ill-defined consolidation like mass at the peripheral lung portion which is the location where the most advanced fibrosis occur

  18. Timing of surgical site infection and pulmonary complications after laparotomy

    DEFF Research Database (Denmark)

    Gundel, Ossian; Gundersen, Sofie Kirchhoff; Dahl, Rikke Maria

    2018-01-01

    BACKGROUND: Surgical site infection (SSI) and other postoperative complications are associated with high costs, morbidity, secondary surgery, and mortality. Many studies have identified factors that may prevent SSI and pulmonary complications, but it is important to know when they in fact occur....... The aim of this study was to investigate the diagnostic timing of surgical site infections and pulmonary complications after laparotomy. MATERIAL AND METHODS: This is a secondary analysis of the PROXI trial which was a randomized clinical trial conducted in 1400 patients undergoing elective or emergent...... laparotomy. Patients were randomly allocated to either 80% or 30% perioperative inspiratory oxygen fraction. RESULTS: SSI or pulmonary complications were diagnosed in 24.2% (95% CI: 22.0%-26.5%) of the patients at a median of 9 days [IQR: 5-15] after surgery. Most common was surgical site infection (19...

  19. The prevalence of pulmonary tuberculosis in Jeonbug Province

    International Nuclear Information System (INIS)

    Rhee, S. J.; Moon, M. C.; Song, H. Y.; Choi, K. C.

    1981-01-01

    A photofluorographic mass survey of P-A chest had been done to the 13136 residents (male 6264, female 6872) in Jeonbug province, Korea for about 2 years from May 5, to Dec.19, 1978 and from Mar. 5, to Dec. 22, 1979. The results are as follows: 1. The prevalence rate of all active pulmonary tuberculosis is 5.3%. 2. The prevalence rate of male(8.8%) is 4.2 times higher than that of female (2.1%). 3. The prevalence rates of all old age groups above fifty years are higher than that of remainder under fifty years of age. Of these, 61-70 years old age group is highest in prevalence rate. 4. According to extent of active pulmonary tuberculosis, 77.5% is minimal, 15.4% is moderately advanced, and 7.1% is far advanced. Inactive pulmonary tuberculosis are 39 cases (0.3% to objective population). 5. In the incidence of the involved side, right side is about 2 times higher than the left, and involvement of both sides is increased in moderately and far advance pulmonary tuberculosis. In all pulmonary tuberculosis, one or both upper lung fields are most commonly involved. The incidences of cavity in moderately and far advanced pulmonary tuberculosis show no significant difference. 6. The incidences of other intrathoracic lesions are as follows: suspected hypertensive heart disease 2.4%, dextrocardia with situs inversus 0.04%, pleural calcification 0.4%, pleural thickening 0.2%, pleural effusion 0.1%, pneumonia 0.02%, bronchiectasis 0.1%, lung abscess 0.02%, C.O.P.D. 0.2%, suspected lung tumor 0.06%, pneumothorax 0.0076%, and suspected mediastinal tumor 0.02%

  20. 77 FR 60746 - Proposed Information Collection (VA/DOD Joint Disability Evaluation Board Claim) Activity...

    Science.gov (United States)

    2012-10-04

    ... burden of the collection of information on respondents, including through the use of automated collection techniques or the use of other forms of information technology. Title: VA/DOD Joint Disability Evaluation... War on Terror Heroes, VA and the Department of Defense (DOD) have agreed to develop a joint process in...

  1. The impact of the Department of Veterans Affairs Health Care Personnel Enhancement Act of 2004 on VA physicians' salaries and retention.

    Science.gov (United States)

    Weeks, William B; Wallace, Tanner A; Wallace, Amy E

    2009-01-01

    To determine whether the Department of Veterans Affairs Health Care Personnel Enhancement Act (the Act), which was designed to achieve VA physician salary parity with American Academy of Medical Colleges (AAMC) Associate Professors and enacted in 2006, had achieved its goal. Using VA human resources datasets and data from the AAMC, we calculated mean VA physician salaries, with 95 percent confidence intervals, for 15 different medical specialties. For each specialty, we compared VA salaries to the median, 25th, and 75th percentile of AAMC Associate Professors' incomes. The Act's passage resulted in a $20,000 annual increase in VA physicians' salaries. VA primary care physicians, medical subspecialists, and psychiatrists had salaries that were comparable to their AAMC counterparts prior to and after enactment of the Act. However, VA surgical specialists', anesthesiologists', and radiologists' salaries lagged their AAMC counterparts both before and after the Act's enactment. Income increases were negatively correlated with full-time workforce changes. VA does not appear to provide comparable salaries for physicians necessary for surgical care. In certain cases, VA should consider outsourcing surgical services.

  2. Detection of pulmonary aspiration in children with gastroesophageal reflux

    International Nuclear Information System (INIS)

    Orellana, P.; Olea, E.; Pino, C.; Rossel, M.; Ceresa, S.; Gonzalez, P.; Otarola, S.; Astudillo, S.

    1985-01-01

    The presence of pulmonary aspiration (PA) should be suspected in two groups of patients; those with symptoms of gastroesophageal reflux (GER) and pulmonary disease and patient's with pulmonary symptoms without signs of GER in whom other etiologies of pulmonary disease have been excluded. To determine if PA could be diagnosed in children using radionuclides 114 patients aged 3-12 months drank 500 μCi of Tc-99m sulfur colloid mixed with infant formula and an additional 1.5 mCi was administered in the evening. All medicine was suspended 24 hours before. Images of the chest in supine position (ant, post views) were acquired on computer in 32 x 32 (byte mode) during 5 min each view at 2 and 18 hours. No outside pressure was applied. None of the patients with digestive symptomatology alone had positive exam. Of 88 patients with bronchopulmonary symptomatology 35 had abnormal examination 35% with moderate symptom were (Abn) and 55% with severe disease were abnormal. The radionuclide method appears to be the ideal study in patients where PA is suspected. The positivity of the method depends on the group of patients selected. The sensitivity is highest in patients with marked symptomatology

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

    Directory of Open Access Journals (Sweden)

    Sanapareddy Nina

    2010-02-01

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

  4. Relationship between signal intensity of blood flow in the pulmonary artery obtained by magnetic resonance imaging and results of right cardiac catheterization in patients with pulmonary disease

    Energy Technology Data Exchange (ETDEWEB)

    Yuguchi, Yasutoshi; Nagao, Keiichi; Kouno, Norihiro; Tanabe, Nobuhiro; Okita, Shinya; Tojima, Hirokazu; Okada, Osamu; Kuriyama, Takayuki [Chiba Univ. (Japan). School of Medicine; Yamaguchi, Tetsuo

    1992-08-01

    Electrocardiogram-gated spin-echo magnetic resonance (MR) images of the chest were obtained in five normal controls and 35 patients with pulmonary disease (11 chronic obstructive pulmonary disease, 6 pulmonary thromboembolism, 5 primary pulmonary hypertension, 4 interstitial pulmonary disease, 4 pulmonary hypertension with disturbance of portal circulation, and 5 other diseases) who underwent right cardiac catheterization. In transverse images at the level of the right main pulmonary artery (rPA) and sagittal images at the level through the midsternal line and the spinal cord, the signal intensity of blood flow in the rPA was quantitatively evaluated, and the correlations with the MR signal intensity of intravascular flow and the parameters of hemodynamics were studied. In diastole MR images of both normal controls and patients mostly showed a significant signal and visible flow images. In systolic MR images, the mean values of hemodynamic parameters (mean pulmonary arterial pressure (mPAP), pulmonary arteriolar resistance (PAR), and cardiac index (CI)) were abnormal in patients with significant signal intensity of flow compared with those in patients without sufficient MR signal. The signal intensity was not correlated with mPAP; however, it significantly increased as PAR increased, and it increased as CI decreased both in diastole and in systole. Especially in systole, there was good correlation between the signal intensity in transverse MR images and CI and between signal intensity in sagittal MR images and PAR . These results suggest that the signal intensity of blood flow in the rPA on MR images can be used as an index of the severity of right heart failure associated with pulmonary disease. MR imaging is a useful modality to evaluate pulmonary circulation disturbance because of its ability to assess blood flow in the pulmonary artery noninvasively without interference from other structures such as bone and normal lung. (J.P.N.).

  5. Vaccenic acid and trans fatty acid isomers from partially hydrogenated oil both adversely affect LDL cholesterol: a double-blind, randomized controlled trial.

    Science.gov (United States)

    Gebauer, Sarah K; Destaillats, Frédéric; Dionisi, Fabiola; Krauss, Ronald M; Baer, David J

    2015-12-01

    Adverse effects of industrially produced trans fatty acids (iTFAs) on the risk of coronary artery disease are well documented in the scientific literature; however, effects of naturally occurring trans fatty acids (TFAs) from ruminant animals (rTFA), such as vaccenic acid (VA) and cis-9,trans-11 conjugated linoleic acid (c9,t11-CLA), are less clear. Although animal and cell studies suggest that VA and c9,t11-CLA may be hypocholesterolemic and antiatherogenic, epidemiologic data comparing rTFAs and iTFAs are inconsistent, and human intervention studies have been limited, underpowered, and not well controlled. We determined the effects of VA, c9,t11-CLA, and iTFA, in the context of highly controlled diets (24 d each), on lipoprotein risk factors compared with a control diet. We conducted a double-blind, randomized, crossover feeding trial in 106 healthy adults [mean ± SD age: 47 ± 10.8 y; body mass index (in kg/m(2)): 28.5 ± 4.0; low-density lipoprotein (LDL) cholesterol: 3.24 ± 0.63 mmol/L]. Diets were designed to have stearic acid replaced with the following TFA isomers (percentage of energy): 0.1% mixed isomers of TFA (control), ∼3% VA, ∼3% iTFA, or 1% c9,t11-CLA. Total dietary fat (34% of energy) and other macronutrients were matched. Total cholesterol (TC), LDL cholesterol, triacylglycerol, lipoprotein(a), and apolipoprotein B were higher after VA than after iTFA; high-density lipoprotein (HDL) cholesterol and apolipoprotein AI also were higher after VA. Compared with control, VA and iTFA both increased TC, LDL cholesterol, ratio of TC to HDL cholesterol, and apolipoprotein B (2-6% change; P cholesterol, apolipoprotein AI, apolipoprotein B, and lipoprotein(a) (2-6% change; P < 0.05), whereas iTFA did not. c9,t11-CLA lowered triacylglycerol (P ≤ 0.01) and had no effect on other lipoprotein risk factors. With respect to risk of cardiovascular disease, these results are consistent with current nutrition labeling guidelines, with the requirement of VA, but

  6. 78 FR 77204 - Proposed Information Collection (VA National Veterans Sports Programs and Special Event Surveys...

    Science.gov (United States)

    2013-12-20

    ... AGENCY: Office of Public & Intergovernmental Affairs, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Office of Public Affairs (OPA), Department of Veterans Affairs (VA), is announcing an... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-NEW] Proposed Information Collection (VA...

  7. Study of regional pulmonary gas exchange using radiotracers

    International Nuclear Information System (INIS)

    Hichwa, R.D.

    1981-01-01

    Respiration involves the exchange of gases between the environment and the blood across the alveolar membrane. Four processes characterize the dynamics of gas exchange: ventilation, diffusion, perfusion and chemical binding with hemoglobin. A study was undertaken to investigate each of these processes, utilizing accelerator production and high yield synthesis of four gaseous radiotracers (/sup 81m/Kr, Ch 3 18 F, 11 CO, 15 O 2 ). Conventional gamma camera images and ancillary physiological data were acquired. Mathematical models were developed to predict the tracer clearance from the lungs during a breath hold and during washout post breath hold. Images of the insoluble /sup 81m/Kr synchronized with the tidal breathing maneuver depict regional ventilation. Tracer bolus inhalation, relative compliance and regional phase information are obtained from krypton dCynamic studies. More soluble CH 3 18 F is used to determine regional pulmonary perfusion during a breath hold. Respiratory clearance of seven, inert, positron-emitting radiotracers define the tracer volume of distribution. The tight-binding of 11 CO to hemoglobin permits the regional measurement of carbon monoxide pulmonary diffusion capacity. A relative CO blood:gas partition coefficient is calculated from the washout of no-carrier-added levels of 11 CO and verified by in vitro radiometric measurements. Regional oxygen pulmonary diffusion capacity determined from 15 O 2 clearance during a breath hold reveals results similar to those obtained with CO. All experimental data are in good agreement with the predictions of a two-compartment open model. A more advanced oxygen model is presented that incorporates radioactive oxygen exchange with stable oxygen on the hemoglobin molecule and metabolic removal of the tracer at the tissues

  8. Towards the PET radiotracer for p75 neurotrophin receptor: [(11)C]LM11A-24 shows biological activity in vitro, but unfavorable ex vivo and in vivo profile.

    Science.gov (United States)

    Gibon, Julien; Kang, Min Su; Aliaga, Arturo; Sharif, Behrang; Rosa-Neto, Pedro; Séguéla, Philippe; Barker, Philip A; Kostikov, Alexey

    2016-10-01

    Mature neurotrophins as well as their pro forms are critically involved in the regulation of neuronal functions. They are signaling through three distinct types of receptors: tropomyosin receptor kinase family (TrkA/B/C), p75 neurotrophin receptor (p75(NTR)) and sortilin. Aberrant expression of p75(NTR) in the CNS is implicated in a variety of neurodegenerative diseases, including Alzheimer's disease. The goal of this work was to evaluate one of the very few reported p75(NTR) small molecule ligands as a lead compound for development of novel PET radiotracers for in vivo p75(NTR) imaging. Here we report that previously described ligand LM11A-24 shows significant inhibition of carbachol-induced persistent firing (PF) of entorhinal cortex (EC) pyramidal neurons in wild-type mice via selective interaction with p75(NTR). Based on this electrophysiological assay, the compound has very high potency with an EC50<10nM. We optimized the radiosynthesis of [(11)C]LM11A-24 as the first attempt to develop PET radioligand for in vivo imaging of p75(NTR). Despite some weak interaction with CNS tissues, the radiolabeled compound showed unfavorable in vivo profile presumably due to high hydrophilicity. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Clinical significance of pulmonary nodules detected on abdominal CT in pediatric patients

    International Nuclear Information System (INIS)

    Breen, Micheal; Lee, Edward Y.; Zurakowski, David

    2015-01-01

    The clinical significance of a pulmonary nodule that is detected incidentally on CT studies in children is unknown. In addition, there is limited information regarding the management of incidentally detected pulmonary nodules discovered on abdominal CT studies in children. The purpose of this study was to investigate the clinical significance of incidental pulmonary nodules detected on abdominal CT studies in children. This was a retrospective study performed following institutional review board approval. Abdominal CT reports in patients younger than 18 years of age from July 2004 to June 2011 were reviewed for the terms ''nodule,'' ''nodular'' or ''mass'' in reference to the lung bases. The study population included those pediatric patients in whom pulmonary nodules were initially detected on abdominal CT studies. The largest pulmonary nodules detected on CT studies were evaluated for their features (size, shape, margin, attenuation, location, and presence of calcification and cavitation). Follow-up CT studies and clinical records were reviewed for demographic information, history of underlying malignancies and the clinical outcome of the incidental pulmonary nodules. Comparison of malignant versus benign pulmonary nodules was performed with respect to the size of the nodule, imaging features on CT, and patient history of malignancy using the Student's t-test and Fisher exact test. Youden J-index in receiver operating characteristic (ROC) analysis was used to determine the optimal cut-off size for suggesting a high risk of malignancy of incidentally detected pulmonary nodules. Pulmonary nodules meeting inclusion criteria were detected in 62 (1.2%) of 5,234 patients. The mean age of patients with nodules was 11.2 years (range: 5 months-18 years). Thirty-one patients (50%) had follow-up CT studies and two of these patients (6%) were subsequently found to have malignant pulmonary nodules. Both of these

  10. Clinical significance of pulmonary nodules detected on abdominal CT in pediatric patients

    Energy Technology Data Exchange (ETDEWEB)

    Breen, Micheal; Lee, Edward Y. [Boston Children' s Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Zurakowski, David [Boston Children' s Hospital and Harvard Medical School, Departments of Anesthesiology and Surgery, Boston, MA (United States)

    2015-11-15

    The clinical significance of a pulmonary nodule that is detected incidentally on CT studies in children is unknown. In addition, there is limited information regarding the management of incidentally detected pulmonary nodules discovered on abdominal CT studies in children. The purpose of this study was to investigate the clinical significance of incidental pulmonary nodules detected on abdominal CT studies in children. This was a retrospective study performed following institutional review board approval. Abdominal CT reports in patients younger than 18 years of age from July 2004 to June 2011 were reviewed for the terms ''nodule,'' ''nodular'' or ''mass'' in reference to the lung bases. The study population included those pediatric patients in whom pulmonary nodules were initially detected on abdominal CT studies. The largest pulmonary nodules detected on CT studies were evaluated for their features (size, shape, margin, attenuation, location, and presence of calcification and cavitation). Follow-up CT studies and clinical records were reviewed for demographic information, history of underlying malignancies and the clinical outcome of the incidental pulmonary nodules. Comparison of malignant versus benign pulmonary nodules was performed with respect to the size of the nodule, imaging features on CT, and patient history of malignancy using the Student's t-test and Fisher exact test. Youden J-index in receiver operating characteristic (ROC) analysis was used to determine the optimal cut-off size for suggesting a high risk of malignancy of incidentally detected pulmonary nodules. Pulmonary nodules meeting inclusion criteria were detected in 62 (1.2%) of 5,234 patients. The mean age of patients with nodules was 11.2 years (range: 5 months-18 years). Thirty-one patients (50%) had follow-up CT studies and two of these patients (6%) were subsequently found to have malignant pulmonary nodules. Both of these

  11. Access to mental health care among women Veterans: is VA meeting women's needs?

    Science.gov (United States)

    Kimerling, Rachel; Pavao, Joanne; Greene, Liberty; Karpenko, Julie; Rodriguez, Allison; Saweikis, Meghan; Washington, Donna L

    2015-04-01

    Patient-centered access to mental health describes the fit between patient needs and resources of the system. To date, little data are available to guide implementation of services to women veterans, an underrepresented minority within Department of Veteran Affairs (VA) health care. The current study examines access to mental health care among women veterans, and identifies gender-related indicators of perceived access to mental health care. A population-based sample of 6287 women veterans using VA primary care services participated in a survey of past year perceived need for mental health care, mental health utilization, and gender-related mental health care experiences. Subjective rating of how well mental health care met their needs was used as an indicator of perceived access. Half of all women reported perceived mental health need; 84.3% of those women received care. Nearly all mental health users (90.9%) used VA services, although only about half (48.8%) reported that their mental health care met their needs completely or very well. Gender related experiences (availability of female providers, women-only treatment settings, women-only treatment groups, and gender-related comfort) were each associated with 2-fold increased odds of perceived access, and associations remained after adjusting for ease of getting care. Women VA users demonstrate very good objective access to mental health services. Desire for, and access to specialized mental health services for women varies across the population and are important aspects of shared decision making in referral and treatment planning for women using VA primary care.

  12. [Pulmonary function in patients with infiltrative pulmonary tuberculosis].

    Science.gov (United States)

    Nefedov, V B; Popova, L A; Shergina, E A

    2007-01-01

    Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/VC%, PEF, MEF25, MEF50, MEF75, TLC, TGV, pulmonary residual volume (PRV), R(aw), R(in),, R(ex), DLCO-SB, DLCO-SS, PaO2, and PaCO2 were determined in 103 patients with infiltrative pulmonary tuberculosis. Pulmonary dysfunction was detected in 83.5% of the patients. Changes were found in lung volumes and capacities in 63.1%, impaired bronchial patency and pulmonary gas exchange dysfunction were in 60.2 and 41.7%, respectively. The changes in pulmonary volumes and capacities appeared as increased PRV, decreased VC and FVC, and decreased and increased TGV and TLC; impaired bronchial patency presented as decreased PEF, MEF25, MEF50, MEF75, FEV1/VC% and increased R(aw) R(in), and R(ex); pulmonary gas exchange dysfunction manifested itself as reduced DLCO-SB, DLCO-SS, and PaO2 and decreased and increased PaCO2. The magnitude of the observed functional changes was generally slight. Significant disorders were observed rarely and very pronounced ones were exceptional.

  13. [Pulmonary function in patients with disseminated pulmonary tuberculosis].

    Science.gov (United States)

    Nefedov, V B; Shergina, E A; Popova, L A

    2007-01-01

    Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/VC%, PEF, MEF25%, MEF50%, MEF75%, TLS, TGV, pulmonary residual volume (PRV), Raw, Rin, Rex, DLCO-SB, DLCO-SS, PaO2, and PaCO2 were determined in 29 patients with disseminated pulmonary tuberculosis. Pulmonary dysfunction was detected in 93.1% of the patients. Changes were found in lung volumes and capacities in 65.5%, impaired bronchial patency and pulmonary gas exchange dysfunction were in 79.3 and 37.9%, respectively. The changes in pulmonary volumes and capacities appeared as increased PRV, decreased VC, FVC, and TLS, decreased and increased TGV; impaired bronchial patency presented as decreased PEF, MEF25%, MEF50%, MEF75%, and FEV1/VC% and increased Raw, Rin, and Rex; pulmonary gas exchange dysfunction manifested itself as reduced DLCO-SS and PaO2 and decreased and increased PaCO2. The observed functional changes varied from slight to significant and pronounced with a preponderance of small disorders, a lower detection rate of significant disorders, and rare detection of very pronounced ones.

  14. 76 FR 38302 - Safety Zone; Cape Charles Fireworks, Cape Charles Harbor, Cape Charles, VA

    Science.gov (United States)

    2011-06-30

    ... the Town of Cape Charles will sponsor a fireworks display on the shoreline of the navigable waters of...-AA00 Safety Zone; Cape Charles Fireworks, Cape Charles Harbor, Cape Charles, VA AGENCY: Coast Guard... navigable waters of Cape Charles City Harbor in Cape Charles, VA in support of the Fourth of July Fireworks...

  15. 76 FR 27970 - Safety Zone; Cape Charles Fireworks, Cape Charles Harbor, Cape Charles, VA.

    Science.gov (United States)

    2011-05-13

    ... Charles will sponsor a fireworks display on the shoreline of the navigable waters of Cape Charles City...[deg]01'30'' W (NAD 1983). This safety zone will be established in the vicinity of Cape Charles, VA...-AA00 Safety Zone; Cape Charles Fireworks, Cape Charles Harbor, Cape Charles, VA. AGENCY: Coast Guard...

  16. Associations between thoracic radiographic changes and severity of pulmonary arterial hypertension diagnosed in 60 dogs via Doppler echocardiography: A retrospective study.

    Science.gov (United States)

    Adams, Dustin S; Marolf, Angela J; Valdés-Martínez, Alejandro; Randall, Elissa K; Bachand, Annette M

    2017-07-01

    Doppler echocardiography is a noninvasive method for estimating and grading pulmonary arterial hypertension. No current literature associates significance of radiographic findings with severity of pulmonary arterial hypertension. We hypothesized that the number and conspicuity of radiographic findings suggestive of pulmonary arterial hypertension would be greater based on the severity of pulmonary arterial hypertension. Dogs with pulmonary arterial hypertension and normal control dogs were included in this retrospective, case control study. Three radiologists blinded to echocardiographic results scored thoracic radiographs for right ventricular and main pulmonary artery enlargement and pulmonary lobar artery enlargement, tortuosity, and blunting by multiple methods. Presence or absence of each finding was scored in an additive fashion and averaged for each grade of pulmonary arterial hypertension severity. Seventy-one dogs (60 dogs with pulmonary arterial hypertension and 11 control dogs) of which some had multiple studies were included: 20 mild, 21 moderate, 25 severe, and 11 absent pulmonary arterial hypertension. The following radiographic findings were significantly associated with increasing pulmonary arterial hypertension severity: right ventricular enlargement by "reverse D" and "3/5-2/5 cardiac ratio" methods, main pulmonary artery enlargement, and caudal lobar artery enlargement by the "3rd rib" method. Mean scores for severe pulmonary arterial hypertension and normal dogs were significantly different (P-value < 0.0001). Mean scores between different pulmonary arterial hypertension grades increased with severity but were not statistically significant. Individually and in combination, radiographic findings performed poorly in differentiating severity of pulmonary arterial hypertension. Findings indicated that thoracic radiographs should be utilized in conjunction with Doppler echocardiography in a complete diagnostic work-up for dogs with suspected

  17. Mycobacterial and nonbacterial pulmonary complications in hospitalized patients with human immunodeficiency virus infection: A prospective, cohort study

    Directory of Open Access Journals (Sweden)

    Afessa Bekele

    2001-09-01

    Full Text Available Abstract Background A prospective observational study was done to describe nonbacterial pulmonary complications in hospitalized patients with human immunodeficiency virus (HIV infection. Methods The study included 1,225 consecutive hospital admissions of 599 HIV-infected patients treated from April 1995 through March 1998. Data included demographics, risk factors for HIV infection, Acute Physiology and Chronic Health Evaluation (APACHE II score, pulmonary complications, CD4+ lymphocyte count, hospital stay and case-fatality rate. Results Patient age (mean ± SD was 38.2 ± 8.9 years, 62% were men, and 84% were African American. The median APACHE II score was 14, and median CD4+ lymphocyte count was 60/μL. Pulmonary complications were Pneumocystis carinii pneumonia (85 in 78 patients, Mycobacterium avium complex (51 in 38, Mycobacterium tuberculosis (40 in 35, Mycobacterium gordonae (11 in 11, Mycobacterium kansasii (10 in 9, Cytomegalovirus (10 in 10, Nocardia asteroides (3 in 3, fungus ball (2 in 2, respiratory syncytial virus (1, herpes simplex virus (1, Histoplasma capsulatum (1, lymphoma (3 in 3, bronchogenic carcinoma (2 in 2, and Kaposi sarcoma (1. The case-fatality rate of patients was 11% with Pneumocystis carinii pneumonia; 5%, Mycobacterium tuberculosis; 6%, Mycobacterium avium complex; and 7%, noninfectious pulmonary complications. Conclusion Most pulmonary complications in hospitalized patients with HIV are from Pneumocystis and mycobacterial infection.

  18. Evaluation of recently validated non- invasive formula using basic lung functions as new screening tool for pulmonary hypertension in idiopathic pulmonary fibrosis patients

    International Nuclear Information System (INIS)

    Ghanem, Maha K; Makhlouf, Hoda A; Agmy, Gamal R; Imam, Hisham M K; Fouad, Doaa A

    2009-01-01

    A prediction formula for mean pulmonary artery pressure (MPAP) using standard lung function measurement has been recently validated to screen for pulmonary hypertension (PH) in idiopathic pulmonary fibrosis (IPF) patients. To test the usefulness of this formula as a new non invasive screening tool for PH in IPF patients. Also, to study its correlation with patients' clinical data, pulmonary function tests, arterial blood gases (ABGs) and other commonly used screening methods for PH including electrocardiogram (ECG), chest X ray (CXR), trans-thoracic echocardiography (TTE) and computerized tomography pulmonary angiography (CTPA). Cross-sectional study of 37 IPF patients from tertiary hospital. The accuracy of MPAP estimation was assessed by examining the correlation between the predicted MPAP using the formula and PH diagnosed by other screening tools and patients' clinical signs of PH. There was no statistically significant difference in the prediction of PH using cut off point of 21 or 25 mm Hg (p0 = 0.24). The formula-predicted MPAP greater than 25 mm Hg strongly correlated in the expected direction with O2 saturation (r = - 0.95, P 0.05). The prediction formula for MPAP using standard lung function measurements is a simple non invasive tool that can be used as TTE to screen for PH in IPF patients and select those who need right heart catheterization. (author)

  19. Tirkistelijöiden historiaa: Lectio Praecursoria 7.11.2014

    Directory of Open Access Journals (Sweden)

    Juuso Marttila

    2015-06-01

    Full Text Available FM Juuso Marttilan taloushistorian väitöskirja Työ teollistumisen ja arjen rajapintana. Strömforsin ja Ramnäsin rautaruukkiyhteisöt 1880–1950 tarkastettiin 7.11.2014 Jyväskylän yliopistossa. Vastaväittäjänä toimi professori Pertti Haapala Tampereen yliopistosta ja kustoksena professori Jari Ojala Jyväskylän yliopistosta.

  20. Potential application of immobilized streptokinase extracted from Streptococcus equinus VIT_VB2.

    Science.gov (United States)

    Vaishnavi, B; Subathra Devi, C

    2017-11-26

    Streptokinase purified from Streptococcus equinus VIT_VB2 isolated from bovine milk sample was immobilized in various solid supports namely entrapment in agarose gel, calcium alginate beads and gelatin gel by cross-linking with formaldehyde. Immobilization of streptokinase in calcium alginate beads showed maximum efficiency (81.8 ± 1.06%) when compared with entrapment with agarose gel (55.6 ± 2.17%) and cross-linked gelatin formaldehyde gel (71.0 ± 1.54%). The purified SK activity was expressed maximum in calcium alginate (1%) and gelatin gel (0.25%) with 1292.68 ± 1.33 and 1121.9 ± 1.2 U mL -1 , respectively. Similarly, SK entrapped in gelatin gel and calcium alginate showed maximum in vitro blood clot lysis activity with 77.67 ± 2.64% and 76.16 ± 2.72%, respectively. The immobilized SK in gelatin gel showed complete clot lysis within 15 min; hence, this application of the study could be used in the treatment of superficial thrombophlebitis, phlebitis, and venous thrombosis. These beads were used for three repeated cycles to check the conversion of substrates into their products, and we concluded that SK can be immobilized in the suitable matrices. Therefore, this helps in the drug-delivery strategies in highly efficient way, moreover, economically competent process in the pharmaceutics.