WorldWideScience

Sample records for radionuclide regurgitant index

  1. Inversion of the radionuclide regurgitant index in right-sided valvular regurgitation

    Novack, H.; Machac, J.; Horowitz, S.F.

    1985-11-01

    Estimation of left-sided valvular insufficiency has been obtained using the ratio of left- to right-ventricular stroke counts, i.e., the regurgitant index. The present study was designed to evaluate the usefulness of the regurgitant index in identifying patients with isolated right-sided valvular insufficiency. We identified 12 patients with tricuspid or pulmonic regurgitation by at least two of the following criteria: (1) pulsatile liver, (2) positive Carvallo's sign, and (3) pulsatile jugular-venous distension. In 9 of the 12 patients, the right-sided insufficiency was confirmed by catheterization or contrast echocardiography and flow-directed pulsed-echo Doppler. The regurgitant index in patients with right-sided insufficiency was 0.59 +- 0.23. This was significantly different from patients with left-sided insufficiency (3.09 +- 0.8) and from control subjects (1.49 +- 0.32). In 11 of the 12 patients with right-sided regurgitant lesions, the regurgitant index was less than 1.0. The hepatic expansion fraction, a possible correlate of an expansile liver, has previously been found to be both sensitive and specific for the detection of patients with right-sided regurgitation. We calculated the hepatic expansion fraction in 6 patients with tricuspid regurgitation (including 3 with pulsatile livers) and 5 controls using the method of Handler et al.. In the present study, the hepatic expansion fraction in tricuspid-insufficiency patients was 4.3% as compared to 4.1% in normals (P=NS). In summary, this study suggests that the regurgitant index may be a sensitive tool for the diagnosis of right-sided regurgitant lesions, while the hepatic expansion fraction does not appear to be useful for identifying tricuspid insufficiency.

  2. Inversion of the radionuclide regurgitant index in right-sided valvular regurgitation

    Novack, H.; Machac, J.; Horowitz, S.F.; Mount Sinai Medical Center, New York

    1985-01-01

    Estimation of left-sided valvular insufficiency has been obtained using the ratio of left- to right-ventricular stroke counts, i.e., the regurgitant index. The present study was designed to evaluate the usefulness of the regurgitant index in identifying patients with isolated right-sided valvular insufficiency. We identified 12 patients with tricuspid or pulmonic regurgitation by at least two of the following criteria: (1) pulsatile liver, (2) positive Carvallo's sign, and (3) pulsatile jugular-venous distension. In 9 of the 12 patients, the right-sided insufficiency was confirmed by catheterization or contrast echocardiography and flow-directed pulsed-echo Doppler. The regurgitant index in patients with right-sided insufficiency was 0.59+-0.23. This was significantly different from patients with left-sided insufficiency (3.09+-0.8; P<0.001) and from control subjects (1.49+-0.32; P<0.001). In 11 of the 12 patients with right-sided regurgitant lesions, the regurgitant index was less than 1.0. The hepatic expansion fraction, a possible correlate of an expansile liver, has previously been found to be both sensitive and specific for the detection of patients with right-sided regurgitation. We calculated the hepatic expansion fraction in 6 patients with tricuspid regurgitation (including 3 with pulsatile livers) and 5 controls using the method of Handler et al.. In the present study, the hepatic expansion fraction in tricuspid-insufficiency patients was 4.3% as compared to 4.1% in normals (P=NS). In summary, this study suggests that the regurgitant index may be a sensitive tool for the diagnosis of right-sided regurgitant lesions, while the hepatic expansion fraction does not appear to be useful for identifying tricuspid insufficiency. (orig.)

  3. Quantitative assessment of valvular regurgitation using radionuclide ventriculography

    Shi Rongfang

    1992-01-01

    Radionuclide ventriculography has been used to assess quantitatively the extent of mitral and aortic regurgitation in 70 patients and compared to echocardiography and the finding of surgery. Two radionuclide parameters were measured: regurgitant index (RI) = left ventricular stroke counts/right ventricular stroke counts; and regurgitant fraction (RF) = left ventricular stroke counts-right ventricular stroke counts/left ventricular stroke counts. In 28 patients without valvular heart disease, the RI was 1.10 ± 0.15 and Rf was 10.3 ± 15.0%, respectively. However, in patients with valvular regurgitation, the RI and RF were 3.41 ± 1.73 and 61.1 ± 21.2%, respectively. A good correlation was found between the results obtained by radionuclide techniques and the findings of surgery and doppler studies. The level of concordance between RI and surgical findings was 91.7%. Follow up studies in 10 patients after valvular replacement surgery showed the RI and RF return to normal. These data suggested that radionuclide ventriculography is very useful for quantitative assessment of valvular regurgitation

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

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

    1986-01-01

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

  5. Quantitation of aortic and mitral regurgitation in the pediatric population: evaluation by radionuclide angiocardiography

    Hurwitz, R.A.; Treves, S.; Freed, M.; Girod, D.A.; Caldwell, R.L.

    1983-01-01

    The ability to quantitate aortic (AR) or mitral regurgitation (MR), or both, by radionuclide angiocardiography was evaluated in children and young adults at rest and during isometric exercise. Regurgitation was estimated by determining the ratio of left ventricular stroke volume to right ventricular stroke volume obtained during equilibrium ventriculography. The radionuclide measurement was compared with results of cineangiography, with good correlation between both studies in 47 of 48 patients. Radionuclide stroke volume ratio was used to classify severity: the group with equivocal regurgitation differed from the group with mild regurgitation (p less than 0.02); patients with mild regurgitation differed from those with moderate regurgitation (p less than 0.001); and those with moderate regurgitation differed from those with severe regurgitation (p less than 0.01). The stroke volume ratio was responsive to isometric exercise, remaining constant or increasing in 16 of 18 patients. After surgery to correct regurgitation, the stroke volume ratio significantly decreased from preoperative measurements in all 7 patients evaluated. Results from the present study demonstrate that a stroke volume ratio greater than 2.0 is compatible with moderately severe regurgitation and that a ratio greater than 3.0 suggests the presence of severe regurgitation. Thus, radionuclide angiocardiography should be useful for noninvasive quantitation of AR or MR, or both, helping define the course of young patients with left-side valvular regurgitation

  6. Jet length/velocity ratio: a new index for echocardiographic evaluation of chronic aortic regurgitation.

    Güvenç, Tolga Sinan; Karaçimen, Denizhan; Erer, Hatice Betül; İlhan, Erkan; Sayar, Nurten; Karakuş, Gültekin; Çekirdekçi, Elif; Eren, Mehmet

    2015-01-01

    Management of aortic regurgitation depends on the assessment for severity. Echocardiography remains as the most widely available tool for evaluation of aortic regurgitation. In this manuscript, we describe a novel parameter, jet length/velocity ratio, for the diagnosis of severe aortic regurgitation. A total of 30 patients with aortic regurgitation were included to this study. Severity of aortic regurgitation was assessed with an aortic regurgitation index incorporating five echocardiographic parameters. Jet length/velocity ratio is calculated as the ratio of maximum jet penetrance to mean velocity of regurgitant flow. Jet length/velocity ratio was significantly higher in patients with severe aortic regurgitation (2.03 ± 0.53) compared to patients with less than severe aortic regurgitation (1.24 ± 0.32, P < 0.001). Correlation of jet length/velocity ratio with aortic regurgitation index was very good (r(2) = 0.86) and correlation coefficient was higher for jet length/velocity ratio compared to vena contracta, jet width/LVOT ratio and pressure half time. For a cutoff value of 1.61, jet length/velocity ratio had a sensitivity of 92% and specificity of 88%, with an AUC value of 0.955. Jet length/velocity ratio is a novel parameter that can be used to assess severity of chronic aortic regurgitation. Main limitation for usage of this novel parameter is jet impringement to left ventricular wall. © 2014, Wiley Periodicals, Inc.

  7. Radionuclide angiographic evaluation of left ventricular performance at rest and during exercise in patients with aortic regurgitation

    Iskandrian, A.S.; Heo, J.

    1986-01-01

    Radionuclide angiographic evaluation of LV performance at rest and during exercise in patients with AR have shown that an abnormal EF response to exercise may be observed in asymptomatic patients with normal resting LV function. The EF response to exercise has been correlated with a number of clinical and exercise measurements; important among these are the slope of the systolic pressure-to-end-systolic volume, end-systolic volume, cardiac index, pulmonary capillary wedge pressure, and wall stress. The changes in the regurgitant fraction, EF, and LV volume have shown considerable individual variability; they have also allowed a better understanding of the circulatory responses during exercise. Radionuclide angiography provides a reliable and reproducible method of measuring the rest LVEF that is important in the timing and the outcome of valve replacement. The value of the EF response to exercise in patient management is not yet clear; it is possible that other radionuclide-derived measurements at rest or during exercise, such as the systolic pressure-to-end-systolic volume relationship, and the end-systolic volume may provide complementary information to that provided by the EF

  8. Validation of rest and exercise radionuclide angiography in patients with aortic regurgitation

    Gosiewska-Marcinkowska, E.; Rawczynska-Englert, I.; Szumilak, B.; Konieczna, S.; Rozycka-Chrzanowska, B.

    1992-01-01

    The aim of the study was to evaluate the significance of rest and stress test using radionuclide angiography (RA) in assessment of left ventricular (LV) function in the patients with aortic regurgitation (AR). In 32 patients we analyzed pre and 12 months after aortic valve replacement (AVR) the clinical data (including LV cavity dimension, LV hypertrophy, relative heart volume - RHV, the value of diastolic pressure) and the RA at rest and during supine stress test. We compared the clinical data with eject fraction (EF) and rest (EFr), at exercise (EFex) and ΔEF=EFex-EFr. Results show good correlation between clinical data and EF. Conclusions: 1) exercise RA is an useful method of estimation of LV function and after AVR; 2) early evaluation of the reserve of the LV allows to establish the appropriate time for AVR even before the signs of insufficiency of the LV are revealed. (author). 8 refs, 2 tabs

  9. Evaluation of aortic and mitral valve regurgitation by radionuclide ventriculography: comparison with the method of Sandler and Dodge

    Kress, P.; Geffers, H.; Stauch, M.; Nechwatal, W.; Sigel, H.; Bitter, F.; Adam, W.E.

    1981-01-01

    The present investigation was undertaken to introduce a quantitative scintigraphic method for evaluation of regurgitation and to compare it with the generally accepted quantitative method of Sandler and Dodge. Radionuclide ventriculography was carried out after injection of 20 mCi 99mtechnetium-labeled red blood cells. Time-activity curves were obtained from the left and right ventricular regions. The ratio of end-diastolic-end-systolic count-rate differences for the left and right ventricles was calculated. The ratio (A) was compared with a hemodynamic ratio determined after the method of Sandler and Dodge with the stroke volume of the left ventricle measured angiographically, and the stroke volume of the right ventricle measured by thermodilution. In 33 patients with aortic and mitral valve regurgitation researchers found a correlation of r . 0.75. Due to a broad range of normal values of the sensitivity of the scintigraphic method is low. The specificity seems to be high, however, since in 64 patients with all types of heart diseases there were no false positive results. Comparing the described scintigraphic method with other modern or generally accepted methods, the principal advantages are noninvasiveness, good practicability, and the fact that important additional information about the functional state of the heart is gained. This is important in follow-up studies in patients with chronic valvular incompetence. It seems that this method will become a valuable supplement to heart catheterization in the diagnosis of valvular heart disease and may partially replace invasive methods for measuring the regurgitation fraction.

  10. Evaluation of aortic and mitral valve regurgitation by radionuclide ventriculography: comparison with the method of Sandler and Dodge

    Kress, P.; Geffers, H.; Stauch, M.; Nechwatal, W.; Sigel, H.; Bitter, F.; Adam, W.E.

    1981-01-01

    The present investigation was undertaken to introduce a quantitative scintigraphic method for evaluation of regurgitation and to compare it with the generally accepted quantitative method of Sandler and Dodge. Radionuclide ventriculography was carried out after injection of 20 mCi 99mtechnetium-labeled red blood cells. Time-activity curves were obtained from the left and right ventricular regions. The ratio of end-diastolic-end-systolic count-rate differences for the left and right ventricles was calculated. The ratio (A) was compared with a hemodynamic ratio determined after the method of Sandler and Dodge with the stroke volume of the left ventricle measured angiographically, and the stroke volume of the right ventricle measured by thermodilution. In 33 patients with aortic and mitral valve regurgitation researchers found a correlation of r . 0.75. Due to a broad range of normal values of the sensitivity of the scintigraphic method is low. The specificity seems to be high, however, since in 64 patients with all types of heart diseases there were no false positive results. Comparing the described scintigraphic method with other modern or generally accepted methods, the principal advantages are noninvasiveness, good practicability, and the fact that important additional information about the functional state of the heart is gained. This is important in follow-up studies in patients with chronic valvular incompetence. It seems that this method will become a valuable supplement to heart catheterization in the diagnosis of valvular heart disease and may partially replace invasive methods for measuring the regurgitation fraction

  11. De Vega Annuloplasty for Functional Tricupsid Regurgitation: Concept of Tricuspid Valve Orifice Index to Optimize Tricuspid Valve Annular Reduction

    Hwang, Ho Young; Chang, Hyoung Woo; Jeong, Dong Seop

    2013-01-01

    We evaluated long-term results of De Vega annuloplasty measured by cylindrical sizers for functional tricuspid regurgitation (FTR) and analyzed the impact of measured annular size on the late recurrence of tricuspid valve regurgitation. Between 2001 and 2011, 177 patients (57.9±10.5 yr) underwent De Vega annuloplasty for FTR. Three cylindrical sizers (actual diameters of 29.5, 31.5, and 33.5 mm) were used to reproducibly reduce the tricuspid annulus. Long-term outcomes were evaluated and risk factor analyses for the recurrence of FTR ≥3+ were performed. Measured annular diameter indexed by patient's body surface area was included in the analyses as a possible risk factor. Operative mortality occurred in 8 patients (4.5%). Ten-year overall and cardiac death-free survivals were 80.5% and 90.8%, respectively. Five and 10-yr freedom rates from recurrent FTR were 96.5% and 93.1%, respectively. Cox proportional hazard model revealed that higher indexed annular size was the only risk factor for the recurrence of FTR (P=0.006). A minimal P value approach demonstrated that indexed annular diameter of 22.5 mm/m2 was a cut-off value predicting the recurrence of FTR. De Vega annuloplasty for FTR results in low rates of recurrent FTR in the long-term. Tricuspid annulus should be reduced appropriately considering patients' body size to prevent recurrent FTR. PMID:24339705

  12. Tricuspid regurgitation

    ... and dentist if you have a history of heart valve disease or congenital heart disease before treatment. Some people ... Regurgitation Tricuspid Regurgitation Ebstein's anomaly References Carabello BA. Valvular heart disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil ...

  13. Pixel-wise derivation of pulmonary regurgitation index could influence clinical decision: A phase-contrast MR imaging study on patients with repaired tetralogy of Fallot.

    Wu, Pei-Hsin; Chung, Hsiao-Wen; Wu, Ming-Ting; Ko, Cheng-Wen

    2017-08-01

    Regurgitant fraction (RF) measured from 2D phase-contrast MRI has been used as a standard to quantitate the degree of pulmonary regurgitation and serves as a determinant indicator of prognosis for tetralogy of Fallot after surgical repair. This study demonstrated the potential underestimate of RF using the conventional definition and its impact on clinical decision when backward flow occurred during systolic periods. Quantitative flow parameters, including forward flow volume (FFV), backward flow volume (BFV), and RF were estimated by two approaches: One derived from conventional ROI-averaged curve (bulk quantity) and the other in a pixel-wise manner to spatially reflect inhomogeneous flow profile (pixel-wise quantity). Eccentricity at systolic peak (Ecc sys ) was adopted as an index reflecting spatial flow inhomogeneity. Flow parameters derived from ROI-averaged curves on main pulmonary artery were significantly smaller than that of pixel-wise measurement (P 0.3 appears greater compared to the group with Ecc sys < 0.3. Thirteen out of 68 RF values (19%) were underrated while using bulk analysis. The spatial-related flow parameters showed more consistency with the qualitative flow profile pattern for pulmonary arteries, and could be a decisive complement for diagnostic classification. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Radionuclide hepatic perfusion index and ultrasonography: Assessment of portal hypertension in clinical practice

    Seidlova, V.; Hobza, J.; Pumprla, J.; Charouzek, J.

    1989-01-01

    The application is described of radionuclide angiography with hepatic perfusion index (HPI) determination in diagnosis of portal blood flow as an indicator of portal hypertension. 99m Tc and 113 In were used as tracers. Over forty patients suffering from chronic hepatitis or liver cirrhosis were included in the study. Ultrasound was used as a preliminary rapid diagnosis of portal hypertension. Radionuclide angiography combined with the HPI technique was confirmed to be a beneficial noninvasive method offering reproducible quantitative information on portal flow well correlating with the degree of portal hypertension, while the combination of ultrasound examination with radionuclide HPI determination appears to greatly enrich the diagnostic potential in hepatology. (L.O.). 4 figs., 11 refs

  15. Left ventricular function in chronic aortic regurgitation

    Iskandrian, A.S.; Hakki, A.H.; Manno, B.; Amenta, A.; Kane, S.A.

    1983-01-01

    Left ventricular performance was determined in 42 patients with moderate or severe aortic regurgitation during upright exercise by measuring left ventricular ejection fraction and volume with radionuclide ventriculography. Classification of the patients according to exercise tolerance showed that patients with normal exercise tolerance (greater than or equal to 7.0 minutes) had a significantly higher ejection fraction at rest (probability [p] . 0.02) and during exercise (p . 0.0002), higher cardiac index at exercise (p . 0.0008) and lower exercise end-systolic volume (p . 0.01) than did patients with limited exercise tolerance. Similar significant differences were noted in younger patients compared with older patients in ejection fraction at rest and exercise (both p . 0.001) and cardiac index at rest (p . 0.03) and exercise (p . 0.0005). The end-diastolic volume decreased during exercise in 60% of the patients. The patients with a decrease in volume were significantly younger and had better exercise tolerance and a larger end-diastolic volume at rest than did patients who showed an increase in volume. The mean corrected left ventricular end-diastolic radius/wall thickness ratio was significantly greater in patients with abnormal than in those with normal exercise reserve (mean +/- standard deviation 476 +/- 146 versus 377 +/- 92 mm Hg, p less than 0.05). Thus, in patients with chronic aortic regurgitation: 1) left ventricular systolic function during exercise was related to age, exercise tolerance and corrected left ventricular end-diastolic radius/wall thickness ratio, and 2) the end-diastolic volume decreased during exercise, especially in younger patients and patients with normal exercise tolerance or a large volume at rest

  16. Left atrial volume index as a predictor for persistent left ventricular dysfunction after aortic valve surgery in patients with chronic aortic regurgitation: the role of early postoperative echocardiography.

    Cho, In-Jeong; Chang, Hyuk-Jae; Hong, Geu-Ru; Heo, Ran; Sung, Ji Min; Lee, Sang-Eun; Chang, Byung-Chul; Shim, Chi Young; Ha, Jong-Won; Chung, Namsik

    2015-06-01

    This study aimed to explore whether echocardiographic measurements during the early postoperative period can predict persistent left ventricular systolic dysfunction (LVSD) after aortic valve surgery in patients with chronic aortic regurgitation (AR). We prospectively recruited 54 patients (59 ± 12 years) with isolated chronic severe AR who subsequently underwent aortic valve surgery. Standard transthoracic echocardiography was performed before the operation, during the early postoperative period (≤2 weeks), and then 1 year after the surgery. Twelve patients with preoperative LVSD demonstrated LVSD at early after the surgery. Of the 42 patients without LVSD at preoperative echocardiography, 15 patients (36%) developed early postoperative LVSD after surgical correction. All 27 patients without LVSD at early postoperative echocardiography maintained LV function at 1 year after surgery. In the other 27 patients with postoperative LVSD, 17 patients recovered from LVSD and 10 patients did not at 1 year after surgery. Multiple logistic analysis demonstrated that postoperative left atrial volume index (LAVI) was the only independent predictor for persistent LVSD at 1 year after surgery in patients with postoperative LVSD (OR 1.180, 95% CI, 1.003-1.390, P = 0.046). The optimal LAVI cutoff value (>34.9 mL/m(2) ) had a sensitivity of 80% and a specificity of 88% for the prediction of persistent LVSD. Prevalence of early postoperative LVSD was relatively high, even in the patients without LVSD at preoperative echocardiography. Postoperative LAVI could be useful to predict persistent LVSD after aortic valve surgery in patients with early postoperative LVSD. © 2014, Wiley Periodicals, Inc.

  17. Reduction of regurgitation in aortic insufficiency by inhibition of the renin/angiotensin conversion enzyme

    Reske, S.N.; Heck, I.; Mattern, H.

    1984-10-01

    The effect of captopril-mediated afterload reduction on regurgitation was investigated in 10 patients with aortic insufficiency. Regurgitation was quantitated by the regurgitation fraction and the relation of regurgitant volume to end-diastolic volume, which were derived from gated radionuclide ventriculography. 19 patients with coronary artery disease and no evidence of valvular heart disease served as controls. In patients with coronary artery disease no significant reguration was found. In patients with aortic regurgitation the blood concentration of angiotensin I increased whereas that of angiotensin II decreased significantly after captopril-medication; thus, the conversion of angiotensin I to II was reduced to about 50% of the control value. Whereas blood pressure and heart rate did not change significantly, the regurgitation fraction and the normalized regurgitant volume were significantly reduced. The ejection fraction remained essentially unchanged. These findings suggest a favorable influence of captopril-induced afterload reduction on hemodynamics in aortic regurgitation.

  18. Effects of upright and supine position on cardiac rest and exercise response in aortic regurgitation.

    Shen, W F; Roubin, G S; Fletcher, P J; Choong, C Y; Hutton, B F; Harris, P J; Kelly, D T

    1985-02-01

    The effects of upright and supine position on cardiac response to exercise were assessed by radionuclide ventriculography in 15 patients with moderate to severe aortic regurgitation (AR) and in 10 control subjects. In patients with AR, heart rate was higher during upright exercise, but systolic and diastolic blood pressure and left ventricular (LV) output were similar during both forms of exercise. LV stroke volume and end-diastolic volume were not altered during supine exercise. LV end-systolic volume increased and ejection fraction decreased during supine exercise, but both were unchanged during upright exercise. Of 15 patients, 5 in the upright and 12 in the supine position had an abnormal LV ejection fraction response to exercise (p less than 0.01). Right ventricular ejection fraction increased and regurgitant index decreased with both forms of exercise and was not significantly different between the 2 positions. Thus, posture is important in determining LV response to exercise in patients with moderate to severe AR.

  19. Problem: Mitral Valve Regurgitation

    ... each time the left ventricle contracts. Watch an animation of mitral valve regurgitation A leaking mitral valve ... Not Alone Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Heart Attack Symptoms ...

  20. Problem: Heart Valve Regurgitation

    ... should be completely closed For example: Watch an animation of mitral valve regurgitation A leaking mitral valve ... Not Alone Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Heart Attack Symptoms ...

  1. Radionuclide determination of right and left ventricular stroke volumes

    Shen, Wei Feng; Roubin, G S; Choong, C Y.P.; Harris, P J; Flether, P J; Kelly, D T; Uren, R F; Hutton, B F

    1985-03-01

    The relationship between radionuclide and thermodilution measurement of stroke volumes (SV) was investigated in 30 patients without valvular regurgitation or intracardiac shunt (group A) at rest and during exercise. Both attenuated radionuclide right ventricular (RV) and left ventricular (LV) SV measurements correlated well with the SV determined by the thermodilution method (r = 0.87 and r = 0.93, all P < 0.001). The reliability of the radionuclide method to estimate SV was evaluated prospectively in two additional groups of patients. In 11 patients without valvular regurgitation or intracardiac shunt (group B) the radionuclide RVSV and LVSV closely approximated to thermodilution SV at rest and during exercise. In 15 patients with aortic regurgitation (group C) the radionuclide stroke volume ratio correlated well with the angiographic regurgitant fraction. Thus, both RVSV and LVSV and the severity of aortic regurgitation can be reliably measured with gated radionuclide ventriculography.

  2. Management of tricuspid regurgitation

    Taramasso, Maurizio; Lapenna, Elisabetta; Alfieri, Ottavio

    2014-01-01

    Secondary tricuspid regurgitation is the most frequent type of tricuspid insufficiency in western countries. Its surgical treatment is still an object of debate both in terms of timing and surgical techniques. Until recently, the avoidance of surgery for tricuspid repair was commonly accepted in patients with less than severe secondary tricuspid regurgitation undergoing left-sided valve surgery. More recently, compelling evidence in favour of a more aggressive surgical approach in this setting has emerged. The surgical technique should be tailored to the stage of disease. Ring annuloplasty is more durable than suture annuloplasty and represents the method of choice in the presence of isolated annular dilatation. In patients in whom the dilatation of the tricuspid annulus is combined with significant leaflet tethering, annuloplasty alone is unlikely to be durable and additional procedures have been proposed in order to achieve a more durable repair. In this review, pathophysiology, surgical indications, techniques of repair and outcomes of secondary tricuspid regurgitation will be discussed. We will also focus on the challenging issue of significant tricuspid regurgitation occurring late after left-sided valve surgery. Finally, the current and future role of percutaneous tricuspid valve technologies will be briefly described. PMID:25184048

  3. Exercise testing in asymptomatic or minimally symptomatic aortic regurgitation: relationship of left ventricular ejection fraction to left ventricular filling pressure during exercise

    Boucher, C.A.; Wilson, R.A.; Kanarek, D.J.; Hutter, A.M. Jr.; Okada, R.D.; Liberthson, R.R.; Strauss, H.W.; Pohost, G.M.

    1983-01-01

    Exercise radionuclide angiography is being used to evaluate left ventricular function in patients with aortic regurgitation. Ejection fraction is the most common variable analyzed. To better understand the rest and exercise ejection fraction in this setting, 20 patients with asymptomatic or minimally symptomatic severe aortic regurgitation were studied. All underwent simultaneous supine exercise radionuclide angiography and pulmonary gas exchange measurement and underwent rest and exercise measurement of pulmonary artery wedge pressure (PAWP) during cardiac catheterization. Eight patients had a peak exercise PAWP less than 15 mm Hg (group 1) and 12 had a peak exercise PAWP greater than or equal to 15 mm Hg (group 2). Group 1 patients were younger and more were in New York Heart Association class I. The two groups had similar cardiothoracic ratios, changes in ejection fractions with exercise, and rest and exercise regurgitant indexes. Using multiple regression analysis, the best correlate of the exercise PAWP was peak oxygen uptake (r . -0.78, p less than 0.01). No other measurement added significantly to the regression. When peak oxygen uptake was excluded, rest and exercise ejection fraction also correlated significantly (r . -0.62 and r . -0.60, respectively, p less than 0.01). Patients with asymptomatic or minimally symptomatic severe aortic regurgitation have a wide spectrum of cardiac performance in terms of the PAWP during exercise. The absolute rest and exercise ejection fraction and the level of exercise achieved are noninvasive variables that correlate with exercise PAWP in aortic regurgitation, but the change in ejection fraction with exercise by itself is not

  4. Mitral regurgitation: anatomy is destiny.

    Athanasuleas, Constantine L; Stanley, Alfred W H; Buckberg, Gerald D

    2018-04-26

    Mitral regurgitation (MR) occurs when any of the valve and ventricular mitral apparatus components are disturbed. As MR progresses, left ventricular remodelling occurs, ultimately causing heart failure when the enlarging left ventricle (LV) loses its conical shape and becomes globular. Heart failure and lethal ventricular arrhythmias may develop if the left ventricular end-systolic volume index exceeds 55 ml/m2. These adverse changes persist despite satisfactory correction of the annular component of MR. Our goal was to describe this process and summarize evolving interventions that reduce the volume of the left ventricle and rebuild its elliptical shape. This 'valve/ventricle' approach addresses the spherical ventricular culprit and offsets the limits of treating MR by correcting only its annular component.

  5. Regional ejection fraction: a quantitative radionuclide index of regional left ventricular performance

    Maddox, D.E.; Wynne, J.; Uren, R.; Parker, J.A.; Idoine, J.; Siegel, L.C.; Neill, J.M.; Cohn, P.F.; Holman, B.L.

    1979-01-01

    Left ventricular regional ejection fractions were derived from background-corrected, time-activity curves in 43 patients assessed by both gated equilibrium radionuclide angiocardiography and left ventricular contrast angiography. From a single, modified left anterior oblique projection, the regional change in background corrected counts was determined in each of three anatomic regions. The normal range for regional radionuclide ejection fraction was determined in 10 patients with normal contrast ventriculograms and without obstructive coronary artery disease at coronary arteriography. Regional ejection fraction was compared with percent segmental axis shortening and extent of akinetic segments in corresponding regions of the contrast ventriculogram. Radionuclide and roentgenographic methods were in agreement as to the presence or absence of abnormal wall motion in 83 of 99 left ventricular regions (84%) in 33 patients evaluated prospectively. Comparison of regional ejection fraction demonstrated significant differences between regions with roentgenographically determined normokinesis hypokinesis, and akinesis. We conclude that the left ventricular regional ejection fraction provides a reliable quantitative assessment of regional left ventricular performance

  6. Correlation of heart rate and radionuclide index of left ventricular contraction and relaxation

    Adachi, Haruhiko; Sugihara, Hiroki; Nakagawa, Hiroaki; Inagaki, Suetsugu; Kubota, Yasushi; Nakagawa, Masao

    1990-01-01

    Since the cardiac function indices derived from radionuclide ventriculography (RNV) are considered to depend on the heart rate, we studied the relationship between systolic or diastolic indices and heart rates in patients with normal RNV and devised a method of correcting these indices according to the heart rate. For the systolic indices, the heart rate showed significant correlation with ET (r=-0.640), PER (r=0.791) and TPE (r=-0.401) but not with EF, 1/3 EF, MNSER or 1/3 MNSER. For the diastolic indices, the heart rate correlated well with FT (r=-0.938), RFT (r=-0.736), SFT (r=-0.803), 1/3 FF (r=-0.758), PFR (r=0.759), 1/3 PFR (r=0.742) and TPF (r=-0.389) but not with AFT, 1/3 MNDFR or AFF. These results indicate that many systolic and diastolic indices derived from RNV are affected by the heart rate, So when cardiac function is evaluated with the use of radionuclide indices, those which are independent of the heart rate should be used, or they should be corrected for the heart rate. As a method of correction, we proposed a rotating method obtained by manipulation of the regression equation of heart rates and indices. This new method is certain and easier to use when the correcting equations are set into a computer program. (author)

  7. Mitral regurgitation: challenges and solutions

    Ejiofor JI

    2016-05-01

    Full Text Available Julius I Ejiofor, Lawrence Cohn,† Tsuyoshi Kaneko Division of Cardiac Surgery, Brigham and Women’s Hospital, Boston, MA, USA †Lawrence Cohn passed away on January 9, 2016 Abstract: Since the first mitral valvuloplasty in 1923, the technique of mitral valvuloplasty has matured over the years and now has become the first-line treatment, especially in patients with myxomatous mitral regurgitation (MR. We have highlighted some of the major problems that are encountered with the various etiologies of MR. We believe that repair is always the optimal surgical procedure for any of the above etiologies if it is consistent with a long-term result. However, replacement has shown to be a safer procedure in some instances such as severe functional MR or destructive endocarditis. Keywords: mitral regurgitation, mitral valvuloplasty, systolic anterior motion, functional mitral regurgitation, rheumatic valve disease

  8. Intermittent mechanical and clinical intravalvar regurgitation aortic ...

    Mechanical prosthetic valve regurgitation may be either peri- prosthetic or intraprosthetic. The la"er is usually mild, occur- ring in the majority of normally functioning valves and is due to the 'regurgitant flow' closing the valve. An unusual case is reported of intermi"ent intraprosthetic regurgitation through a normally ...

  9. Concentration levels of alpha emitting radionuclides in natural waters. Implications in the use of various radionuclides of reference for the determination of total alpha activity index

    Corbacho, J. A.; Baeza, A.; Guillen, J.; Valles, I.; Serrano, I.; Camacho, A.; Montana, M.

    2013-01-01

    The present study was carried out a statistical evaluation of the natural radioactive contents of a large number of water samples collected at different points of the Spanish geography, in order to meet its controlling radioactive composition and assessing the implications of total alpha activity index can have in this type of samples. (Author)

  10. Comparison of vasodilator drug prazosin with digoxin in aortic regurgitation.

    Hockings, B E; Cope, G D; Clarke, G M; Taylor, R R

    1980-01-01

    Intravenous administration of the vasodilator sodium nitroprusside has beneficial haemodynamic effects in subjects with severe aortic regurgitation while acute digitalisation can produce unwanted effects associated with an increase in systemic vascular resistance. This study compares the haemodynamic effects of the vasodilator prazosin and digoxin in eight patients with isolated severe aortic regurgitation. Prazosin 5 mg orally resulted in a 12 +/- 3 (SE) per cent increase in cardiac index (thermodilution), maintained over four to six hours, while digoxin 0.75 mg intravenously did not change the cardiac index. Prazosin reduced mean arterial pressure by 9 +/- 3 mmHg and systemic vascular resistance by 18 +/- 4 per cent while digoxin resulted in a 6 +/- 2 per cent increase in the latter. Mean pulmonary capillary wedge pressure fell 3 mmHg with prazosin. In this group of patients with severe aortic regurgitation but without severe cardiac failure, the changes with either drug, studied in doses conventionally used, were small but those with prazosin were directionally more desirable than those resulting from digoxin. PMID:7378215

  11. Echocardiographic evaluation of mitral geometry in functional mitral regurgitation

    Maleki Majid

    2008-10-01

    Full Text Available Abstract Objectives We sought to evaluate the geometric changes of the mitral leaflets, local and global LV remodeling in patients with left ventricular dysfunction and varying degrees of Functional mitral regurgitation (FMR. Background Functional mitral regurgitation (FMR occurs as a consequence of systolic left ventricular (LV dysfunction caused by ischemic or nonischemic cardiomyopathy. Mitral valve repair in ischemic MR is one of the most controversial topic in surgery and proper repairing requires an understanding of its mechanisms, as the exact mechanism of FMR are not well defined. Methods 136 consecutive patients mean age of 55 with systolic LV dysfunction and FMR underwent complete echocardiography and after assessing MR severity, LV volumes, Ejection Fraction, LV sphericity index, C-Septal distance, Mitral valve annulus, Interpapillary distance, Tenting distance and Tenting area were obtained. Results There was significant association between MR severity and echocardiogarphic indices (all p values Mitral annular dimensions and area, C-septal distance and sphericity index, although greater in patients with severe regurgitation, did not significantly contribute to FMR severity. Conclusion Degree of LV enlargement and dysfunction were not primary determinants of FMR severity, therefore local LV remodeling and mitral valve apparatus deformation are the strongest predictors of functional MR severity.

  12. Surgical treatment of functional mitral regurgitation

    Braun, Jerry

    2012-01-01

    In this thesis the surgical options for treatment of functional mitral regurgitation (MR) are described. In functional MR, the mitral valve has a normal anatomy, which distinguishes this type of insufficiency from organic MR. Regurgitation in functional MR is related to an abnormal geometry of the

  13. Regurgitative food transfer among wild wolves

    L. David Mech; Paul C. Wolf; Jane M. Packard

    1999-01-01

    Few studies of monogamous canids have addressed regurgitation in the context of extended parental care and alloparental care within family groups. We studied food transfer by regurgitation in a pack of wolves on Ellesmere Island, North West Territories, Canada, during 6 summers from 1988 through 1996. All adult wolves, including yearlings and a post-reproductive female...

  14. Quantification of aortic regurgitation by magnetic resonance velocity mapping

    Søndergaard, Lise; Lindvig, K; Hildebrandt, P

    1993-01-01

    The use of magnetic resonance (MR) velocity mapping in the quantification of aortic valvular blood flow was examined in 10 patients with angiographically verified aortic regurgitation. MR velocity mapping succeeded in identifying and quantifying the regurgitation in all patients, and the regurgit......The use of magnetic resonance (MR) velocity mapping in the quantification of aortic valvular blood flow was examined in 10 patients with angiographically verified aortic regurgitation. MR velocity mapping succeeded in identifying and quantifying the regurgitation in all patients...

  15. Characterization of Chronic Aortic and Mitral Regurgitation Undergoing Valve Surgery Using Cardiovascular Magnetic Resonance.

    Polte, Christian L; Gao, Sinsia A; Johnsson, Åse A; Lagerstrand, Kerstin M; Bech-Hanssen, Odd

    2017-06-15

    Grading of chronic aortic regurgitation (AR) and mitral regurgitation (MR) by cardiovascular magnetic resonance (CMR) is currently based on thresholds, which are neither modality nor quantification method specific. Accordingly, this study sought to identify CMR-specific and quantification method-specific thresholds for regurgitant volumes (RVols), RVol indexes, and regurgitant fractions (RFs), which denote severe chronic AR or MR with an indication for surgery. The study comprised patients with moderate and severe chronic AR (n = 38) and MR (n = 40). Echocardiography and CMR was performed at baseline and in all operated AR/MR patients (n = 23/25) 10 ± 1 months after surgery. CMR quantification of AR: direct (aortic flow) and indirect method (left ventricular stroke volume [LVSV] - pulmonary stroke volume [PuSV]); MR: 2 indirect methods (LVSV - aortic forward flow [AoFF]; mitral inflow [MiIF] - AoFF). All operated patients had severe regurgitation and benefited from surgery, indicated by a significant postsurgical reduction in end-diastolic volume index and improvement or relief of symptoms. The discriminatory ability between moderate and severe AR was strong for RVol >40 ml, RVol index >20 ml/m 2 , and RF >30% (direct method) and RVol >62 ml, RVol index >31 ml/m 2 , and RF >36% (LVSV-PuSV) with a negative likelihood ratio ≤ 0.2. In MR, the discriminatory ability was very strong for RVol >64 ml, RVol index >32 ml/m 2 , and RF >41% (LVSV-AoFF) and RVol >40 ml, RVol index >20 ml/m 2 , and RF >30% (MiIF-AoFF) with a negative likelihood ratio surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Radionuclide stroke count ratios for assessment of right and left ventricular volume overload in children

    Parrish, M.D.; Graham, T.P. Jr.; Born, M.L.; Jones, J.P.; Boucek, R.J. Jr.; Artman, M.; Partain, C.L.

    1983-01-01

    The ratio of left ventricular to right ventricular stroke counts measured by radionuclide angiography has been used in adults to estimate the severity of left-sided valvular regurgitation. The validation of this technique in children for assessment of right and left ventricular volume overload is reported herein. Radionuclide stroke count ratios in 60 children aged 0.5 to 19 years (mean 11) were determined. Based on their diagnoses, the patients were divided into 3 groups: (1) normal--40 patients with no shunts or valvular regurgitation, (2) left ventricular volume overload--13 patients with mitral or aortic regurgitation, or both, and (3) right ventricular volume overload--7 patients, 2 with severe tricuspid regurgitation, 3 with atrial septal defects, and 2 with total anomalous pulmonary venous drainage. The radionuclide stroke count ratio clearly differentiated these groups (p less than 0.05): normal patients had a stroke count ratio of 1.04 +/- 0.17 (mean +/- 1 standard deviation), the left ventricular volume overload group had a stroke count ratio of 2.43 +/- 0.86, and the right ventricular volume overload group had a stroke count ratio of 0.44 +/- 0.17. In 22 of our 60 patients, radionuclide stroke count ratios were compared with cineangiographic stroke volume ratios, resulting in a correlation coefficient of 0.88. It is concluded that radionuclide ventriculography is an excellent tool for qualitative and quantitative assessment of valvular regurgitation in children

  17. Radionuclide trap

    McGuire, J.C.

    1978-01-01

    The deposition of radionuclides manganese-54, cobalt-58 and cobalt-60 from liquid sodium coolant is controlled by providing surfaces of nickel or high nickel alloys to extract the radionuclides from the liquid sodium, and by providing surfaces of tungsten, molybdenum or tantalum to prevent or retard radionuclide deposition

  18. Color Doppler Echocardiographic Assessment of Valvular Regurgitation in Normal Infants

    Shu-Ting Lee

    2010-01-01

    Conclusion: The prevalence of inaudible valvular regurgitation is high in infants with structurally normal hearts. Multiple-valve involvement with regurgitation is not uncommon. Mild severity and low velocity on color Doppler, and the structural information provided by 2D imaging strongly suggest that these regurgitant flows are physiologically normal in infancy.

  19. Evaluation of effective regurgitant orifice area of mitral valvular regurgitation by multislice cardiac computed tomography

    Vural, M.; Ucar, O.; Celebi, O.O.; Cicekcioglu, H.; Durmaz, H.A.; Selvi, N.A.; Koparal, S.; Aydogdu, S.

    2010-01-01

    The purpose of our study was to assess the diagnostic accuracy of multislice computed tomography (MSCT) for the identification and quantification of mitral valve regurgitation in comparison with transthoracic echocardiography (TTE). Twenty-six patients (15 females, 11 males with a mean age of 44.6±14.1 years) who were in follow-up with the diagnosis of mitral regurgitation and those who were referred for MSCT were enrolled. MSCT results were compared with TTE measurements. The mean effective mitral regurgitant orifice area at MSCT was 23.1±13.0 mm 2 and at echocardiography was 24.4±16.0mm 2 . Bland-Altman analysis showed good agreement between the two imaging methods. MSCT provides reliable and good results for the evaluation of mitral regurgitation. (author)

  20. Valve repair for traumatic tricuspid regurgitation.

    Maisano, F; Lorusso, R; Sandrelli, L; Torracca, L; Coletti, G; La Canna, G; Alfieri, O

    1996-01-01

    The review of six cases of valve repair for traumatic tricuspid regurgitation in our institution and 74 in the literature in order to assess effective methods of treating this lesion. Tricuspid valve regurgitation is a rare complication of blunt chest trauma. Optimal treatment for this condition is still controversial ranging from long-term medical therapy to early surgical correction. We followed the cases of six consecutive patients with post-traumatic tricuspid incompetence who were successfully treated with reparative techniques. All patients were male and their ages ranged from 18 years to 42 years. Valve regurgitation was always secondary to blunt chest trauma due to motor vehicle accident. The mechanism of valve insufficiency was invariably anterior leaflet prolapse due to chordal or papillary muscle rupture associated with annular dilatation. Surgical procedures included Carpentier ring implant (5 patients), Bex posterior annuloplasty (1 patient), implant of artificial chordae (4 patients), papillary muscle reinsertion (2 patients), commissuroplasty (1 patient) and "artificial double orifice" technique (1 patient). Tricuspid insufficiency improved in all patients after the correction. No complications were recorded and all patients were asymptomatic at the follow-up. Since post-traumatic tricuspid regurgitation is effectively correctable with reparative techniques, early operation is recommended to relieve symptoms and to prevent right ventricular dysfunction.

  1. Radionuclide toxicity

    Galle, P.

    1982-01-01

    The aim of this symposium was to review the radionuclide toxicity problems. Five topics were discussed: (1) natural and artificial radionuclides (origin, presence or emission in the environment, human irradiation); (2) environmental behaviour of radionuclides and transfer to man; (3) metabolism and toxicity of radionuclides (radioiodine, strontium, rare gas released from nuclear power plants, ruthenium-activation metals, rare earths, tritium, carbon 14, plutonium, americium, curium and einsteinium, neptunium, californium, uranium) cancerogenous effects of radon 222 and of its danghter products; (4) comparison of the hazards of various types of energy; (5) human epidemiology of radionuclide toxicity (bone cancer induction by radium, lung cancer induction by radon daughter products, liver cancer and leukaemia following the use of Thorotrast, thyroid cancer; other site of cancer induction by radionuclides) [fr

  2. Indexed

    Hagy, Jessica

    2008-01-01

    Jessica Hagy is a different kind of thinker. She has an astonishing talent for visualizing relationships, capturing in pictures what is difficult for most of us to express in words. At indexed.blogspot.com, she posts charts, graphs, and Venn diagrams drawn on index cards that reveal in a simple and intuitive way the large and small truths of modern life. Praised throughout the blogosphere as “brilliant,” “incredibly creative,” and “comic genius,” Jessica turns her incisive, deadpan sense of humor on everything from office politics to relationships to religion. With new material along with some of Jessica’s greatest hits, this utterly unique book will thrill readers who demand humor that makes them both laugh and think.

  3. Radionuclide cisternography

    Song, H.H.

    1980-01-01

    The purpose of this thesis is to show that radionuclide cisternography makes an essential contribution to the investigation of cerebrospinal fluid (CSF) dynamics, especially for the investigation of hydrocephalus. The technical details of radionuclide cisternography are discussed, followed by a description of the normal and abnormal radionuclide cisternograms. The dynamics of CFS by means of radionuclide cisternography were examined in 188 patients in whom some kind of hydrocephalus was suspected. This study included findings of anomalies associated with hydrocephalus in a number of cases, such as nasal liquorrhea, hygromas, leptomeningeal or porencephalic cysts. The investigation substantiates the value of radionuclide cisternography in the diagnosis of disturbances of CSF flow. The retrograde flow of radiopharmaceutical into the ventricular system (ventricular reflux) is an abnormal phenomenon indicating the presence of communicating hydrocephalus. (Auth.)

  4. Diffuse Alveolar Hemorrhage due to Acute Mitral Valve Regurgitation

    Creticus P. Marak

    2013-01-01

    Full Text Available Diffuse alveolar hemorrhage (DAH can be caused by several etiologies including vasculitis, drug exposure, anticoagulants, infections, mitral valve stenosis, and regurgitation. Chronic mitral valve regurgitation (MR has been well documented as an etiological factor for DAH, but there have been only a few cases which have reported acute mitral valve regurgitation as an etiology of DAH. Acute mitral valve regurgitation can be a life-threatening condition and often requires urgent intervention. In rare cases, acute mitral regurgitation may result in a regurgitant jet which is directed towards the right upper pulmonary vein and may specifically cause right-sided pulmonary edema and right-sided DAH. Surgical repair of the mitral valve results in rapid resolution of DAH. Acute MR should be considered as a possible etiology in patients presenting with unilateral pulmonary edema, hemoptysis, and DAH.

  5. Radionuclide carrier

    Hartman, F.A.; Kretschmar, H.C.; Tofe, A.J.

    1978-01-01

    A physiologically acceptable particulate radionuclide carrier is described. It comprises a modified anionic starch derivative with 0.1% to 1.5% by weight of a reducing agent and 1 to 20% by weight of anionic substituents

  6. Gastroesophageal Reflux: Regurgitation in the Infant Population.

    Ferguson, Teresa D

    2018-03-01

    Gastroesophageal reflux (GER) is common in infancy and mainly treated through nonpharmacological interventions. Knowing the early warning signs of GER is important for nursing assessment. Untreated GER can become acute when an infant fails to gain weight and has recurrent, forceful vomiting. Further investigation of gastroesophageal reflux disease (GERD) is indicated when failure to gain weight, irritability, swallowing difficulties, regurgitation, and respiratory complications occur and should trigger referral to pediatric specialists. This article will share information about uncomplicated GER, GERD, and symptoms of these diagnoses, common screening tests, and treatment options. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Factors influencing the variations of ejection fraction during exercise in chronic aortic regurgitation

    Bassand, J.P.; Faivre, R.; Berthout, P.; Maurat, J.P.; Cardot, J.C.; Verdenet, J.; Bidet, R.

    1987-01-01

    The influence of left ventricular volume variations and regurgitant fraction variations upon left ventricular ejection fraction during exercise was examined using equilibrium radionuclide angiography in patients suffering from aortic regurgitation. Ejection fraction (EF), regurgitant fraction (RF), end diastolic volume (EDV) and end systolic volume (ESV) variations from rest to peak exercise were determined in 44 patients suffering from chronic aortic regurgitation (AR) and in 8 healthy volunteers (C). In C, EF increased (+0.10±0.03, P<0.01) and ESV decreased significantly (-23%±12%, P<0.01), RF and EDV did not vary significantly. In AR patients, EF, EDV and ESV did not vary significantly because of important scattering of individual values. Changes in EF and ESV were inversely correlated (r=-0.79, P<0.01) and RF decreased significantly (-0.12±0.10, P<0.01). Volumes and EF changes during exercise occurred in three different ways. In a 1st subgroup of 7 patients, EF increased (+0.09±0.03, P<0.05) in conjunction with a reduction of ESV (-24%±12%, P<0.05) without a significant change in EDV. In a 2nd group of 22 patients, EF decreased (-0.04±0.07, P<0.01) in association with an increase in ESV (+17%±16%, P<0.01) and no changes in EDV. In a 3rd subgroup of 15 patients, EF decreased (-0.02±0.06, P<0.01) despite a reduction in ESV (-7%±6%, P<0.01) because of a dramatic EDV decrease (-10%±6%, P<0.05). In this subgroup, changes in EF were inversely correlated with changes in ESV (r=-0.55, P<0.01) and positively related to EDV variations (r=0.42, P=0.02). EDV changes were weakly, but significantly, correlated to RF decrease (r=0.39, P<0.05). We conclude that changes in left ventricular ejection fraction during exercise in patients with chronic aortic regurgitation are significantly related in some patients to changes in ventricular loading conditions as well as contractile state. (orig./MG)

  8. Treatment of severe mitral regurgitation caused by lesions in both ...

    Mitral valve plasty (MVP) is preferred over mitral valve replacement (MVR) for mitral regurgitation in humans because of its favorable effect on quality of life. In small dogs, it is difficult to repair multiple lesions in both leaflets using MVP. Herein, we report a case of severe mitral regurgitation caused by multiple severe lesions ...

  9. Transcatheter Therapies for Treating Tricuspid Regurgitation.

    Rodés-Cabau, Josep; Hahn, Rebecca T; Latib, Azeem; Laule, Michael; Lauten, Alexander; Maisano, Francesco; Schofer, Joachim; Campelo-Parada, Francisco; Puri, Rishi; Vahanian, Alec

    2016-04-19

    Tricuspid valve (TV) disease has been relatively neglected, despite the known association between severe tricuspid regurgitation (TR) and mortality. Few patients undergo isolated tricuspid surgery, which remains associated with high in-hospital mortality rates, particularly in patients with prior left-sided valve surgery. Patients with severe TR are often managed medically for years before TV repair or replacement. Current guidelines recommend TV repair in the presence of a dilated tricuspid annulus at the time of a left-sided valve surgical intervention, even if regurgitation is mild. This proposed algorithm aims to prevent the inevitable progression to severe TR and the need for a second surgical intervention. Recently, novel transcatheter treatment options were developed for treating patients with severe TR and right heart failure with prohibitive surgical risk. Here we describe currently available transcatheter treatment options for severe TR implanted at different levels: the junction between vena cavae and right atrium; the tricuspid annulus; or between TV leaflets, improving coaptation. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  10. Regurgitation in healthy and non healthy infants

    Cavallo Luciano

    2009-12-01

    Full Text Available Abstract Uncomplicate regurgitation in otherwise healthy infants is not a disease. It consists of milk flow from mouth during or after feeding. Common causes include overfeeding, air swallowed during feeding, crying or coughing; physical exam is normal and weight gain is adequate. History and physical exam are diagnostic, and conservative therapy is recommended. Pathologic gastroesophageal reflux or gastroesophageal reflux disease refers to infants with regurgitation and vomiting associated with poor weight gain, respiratory symptoms, esophagitis. Reflux episodes occur most often during transient relaxations of the lower esophageal sphincter unaccompanied by swallowing, which permit gastric content to flow into the esophagus. A minor proportion of reflux episodes occurs when the lower esophageal sphincter fails to increase pressure during a sudden increase in intraabdominal pressure or when lower esophageal sphincter resting pressure is chronically reduced. Alterations in several protective mechanisms allow physiologic reflux to become gastroesophageal reflux disease; diagnostic approach is both clinical and instrumental: radiological series are useful to exclude anatomic abnormalities; pH-testing evaluates the quantity, frequency and duration of the acid reflux episodes; endoscopy and biopsy are performed in the case of esophagitis. Therapy with H2 receptor antagonists and proton pump inhibitors are suggested.

  11. Determinants of perception of heartburn and regurgitation

    Bredenoord, A J; Weusten, B L A M; Curvers, W L; Timmer, R; Smout, A J P M

    2006-01-01

    Background and aim It is not known why some reflux episodes evoke symptoms and others do not. We investigated the determinants of perception of gastro‐oesophageal reflux. Methods In 32 patients with symptoms suggestive of gastro‐oesophageal reflux, 24 hour ambulatory pH and impedance monitoring was performed after cessation of acid suppressive therapy. In the 20 patients who had at least one symptomatic reflux episode, characteristics of symptomatic and asymptomatic reflux episodes were compared. Results A total of 1807 reflux episodes were detected, 203 of which were symptomatic. Compared with asymptomatic episodes, symptomatic episodes were associated with a larger pH drop (pheartburn; 14.8% of the symptomatic reflux episodes were weakly acidic. In total, 426 pure gas reflux episodes occurred, of which 12 were symptomatic. Symptomatic pure gas reflux was more frequently accompanied by a pH drop than asymptomatic gas reflux (pHeartburn and regurgitation are more likely to be evoked when the pH drop is large, proximal extent of the refluxate is high, and volume and acid clearance is delayed. Sensitisation of the oesophagus occurs by preceding acid exposure. Weakly acidic reflux is responsible for only a minority of symptoms in patients off therapy. Pure gas reflux associated with a pH drop (“acid vapour”) can be perceived as heartburn and regurgitation. PMID:16120760

  12. Radionuclide data

    Anon.

    1992-01-01

    Chapter 8 presents tables on selected alpha, beta, gamma and x-ray emitters by increasing energy; information on specific activity for selected radionuclides; naturally occurring radionuclides; the natural decay series; and the artificially produced neptunium series. A table of alpha emitters is listed by increasing atomic number and by energy. The table of β emitters presented is useful in identifying β emitters whose energies and possibly half-lives have been determined by standard laboratory techniques. It is also a handy guide to β-emitting isotopes for applications requiring specific half-lives and/or energies. Gamma rays for radionuclides of importance to radiological assessments and radiation protection are listed by increasing energy. The energies and branching ratios are important for radionuclide determinations with gamma spectrometry detectors. This section also presents a table of x-ray energies which are useful for radiochemical analyses. A number of nuclides emit x-rays as part of their decay scheme. These x-rays may be counted with Ar proportional counters, Ge planar or n-type Ge co-axial detectors, or thin crystal NaI(T1) scintillation counters. In both cases, spectral measurements can be made and both qualitative and quantitative information obtained on the sample. Nuclear decay data (energy and probability by radiation type) for more than one hundred radionuclides that are important to health physicists are presented in a schematic manner

  13. Radionuclide generators

    Lambrecht, R.M.

    1983-01-01

    The status of radionuclide generators for chemical research and applications related to the life sciences and biomedical research are reviewed. Emphasis is placed upon convenient, efficient and rapid separation of short-lived daughter radionuclides in a chemical form suitable for use without further chemical manipulation. The focus is on the production of the parent, the radiochemistry associated with processing the parent and daughter, the selection and the characteristic separation methods, and yields. Quality control considerations are briefly noted. The scope of this review includes selected references to applications of radionuclide generators in radiopharmaceutical chemistry, and the life sciences, particularly in diagnostic and therapeutic medicine. The 99 Mo-sup(99m)Tc generator was excluded. 202 references are cited. (orig.)

  14. Impact of persistent, frequent regurgitation on quality of life in heartburn responders treated with acid suppression: a multinational primary care study.

    Kahrilas, P J; Howden, C W; Wernersson, B; Denison, H; Nuevo, J; Gisbert, J P

    2013-05-01

    In gastro-oesophageal reflux disease (GERD), heartburn responds well to acid suppression, but regurgitation is a common cause of incomplete treatment response. To assess the prevalence and burden of persistent, frequent regurgitation in primary care patients with GERD treated with acid suppression. We analysed observational data from 134 sites across six European countries in patients diagnosed with GERD. Within 3 months of the index visit, symptoms were assessed using the Reflux Disease Questionnaire, and their impact on sleep and work productivity with the Quality of Life in Reflux and Dyspepsia questionnaire and the Work Productivity and Activity Impairment Questionnaire, respectively. Patients provided information on concomitant over-the-counter (OTC) GERD medication use. Persistent, frequent (3-7 days/week) regurgitation was reported by 13.2% (153/1156) of GERD patients with no heartburn on acid suppression; the prevalence was very similar for patients with up to 2 days/week of ongoing mild heartburn. Among patients without heartburn, sleep disturbance of any type was reported by 50.7-60.1% with persistent, frequent regurgitation, compared with 38.1-51.1% and 14.4-19.2% of those with less frequent or no regurgitation respectively. Persistent, frequent regurgitation was associated with increased use of OTC medication and more hours of work missed, whether mild, infrequent heartburn was present or not. Frequent regurgitation, which persisted in 12-13% of patients with no or infrequent, mild heartburn on acid suppression, negatively affected sleep and work productivity, and increased use of OTC medication. Persistent, frequent regurgitation is problematic for primary care patients with GERD. © 2013 Blackwell Publishing Ltd.

  15. Radionuclide generators

    Lambrecht, R.M.; Wollongong Univ.; Tomiyoshi, K.; Sekine, T.

    1997-01-01

    The present status and future directions of research and development on radionuclide generator technology are reported. The recent interest to develop double-neutron capture reactions for production of in vivo generators; neutron rich nuclides for radio-immunotherapeutic pharmaceuticals: and advances with ultra-short lived generators is highlighted. Emphasis is focused on: production of the parent radionuclide; the selection and the evaluation of support materials and eluents with respect to the resultant radiochemical yield of the daughter, and the breakthrough of the radionuclide parent: and, the uses of radionuclide generators in radiopharmaceutical chemistry, biomedical and industrial applications. The 62 Zn → 62 Cu, 66 Ni → 66 Cu, 103m Rh → 103 Rh, 188 W → 188 Re and the 225 Ac → 221 Fr → 213 Bi generators are predicted to be emphasized for future development. Coverage of the 99 Mo → 99m Tc generator was excluded, as it the subject of another review. The literature search ended June, 1996. (orig.)

  16. Radionuclide scanning

    Shapiro, B.

    1986-01-01

    Radionuclide scanning is the production of images of normal and diseased tissues and organs by means of the gamma-ray emissions from radiopharmaceutical agents having specific distributions in the body. The gamma rays are detected at the body surface by a variety of instruments that convert the invisible rays into visible patterns representing the distribution of the radionuclide in the body. The patterns, or images, obtained can be interpreted to provide or to aid diagnoses, to follow the course of disease, and to monitor the management of various illnesses. Scanning is a sensitive technique, but its specificity may be low when interpreted alone. To be used most successfully, radionuclide scanning must be interpreted in conjunction with other techniques, such as bone radiographs with bone scans, chest radiographs with lung scans, and ultrasonic studies with thyroid scans. Interpretation is also enhanced by providing pertinent clinical information because the distribution of radiopharmaceutical agents can be altered by drugs and by various procedures besides physiologic and pathologic conditions. Discussion of the patient with the radionuclide scanning specialist prior to the study and review of the results with that specialist after the study are beneficial

  17. Single Coronary Artery with Aortic Regurgitation

    Katsetos, Manny C.; Toce, Dale T.

    2003-01-01

    An isolated single coronary artery can be associated with normal life expectancy; however, patients are at an increased risk of sudden death. A case is reported of a 54-year-old man with several months of chest pressure with activity. On exercise Sestamibi stress testing, the patient developed a hypotensive response with no symptoms and minimal electrocardiographic changes. Nuclear scanning demonstrated reversible septal and lateral perfusion defects consistent with severe ischemia. Coronary angiography revealed a single coronary artery with the right coronary artery arising from the left main. There were high-grade stenotic lesions in the left anterior descending and circumflex arteries with only moderate atherosclerotic disease in the right coronary artery. An aortogram showed 2-3+ aortic regurgitation, with an ejection fraction of 45% on ventriculography. The patient underwent four-vessel revascularization and aortic valve replacement and did well postoperatively

  18. An Asymptomatic Patient with Severe Mitral Regurgitation

    Blase A. Carabello, MD

    2018-01-01

    Full Text Available In primary mitral regurgitation there are anatomic abnormalities of the mitral valve causing backward flow, placing a hemodynamic burden on the left ventricle. If this burden is severe and prolonged, it leads to left ventricular damage, heart failure, and death. The preferred therapy is restoration of mitral competence through mitral valve repair, which is safer than mitral valve replacement. When repair is performed in a timely fashion, lifespan can be returned to that of a normal individual. Triggers for timely repair include the onset of symptoms and evidence of left ventricular dysfunction as determined by ejection fraction falling toward 60% and/or end-systolic dimension increasing toward 40 mm.

  19. Functional Tricuspid Regurgitation and Ring Annuloplasty Repair

    William B. Weir, MD

    2018-01-01

    Full Text Available Functional tricuspid regurgitation (TR primarily arises from asymmetric dilation of the tricuspid annulus in the setting of right ventricular dysfunction and enlargement in response to left-sided myocardial and valvular abnormalities. Even if the TR is not severe at the time of mitral valve surgery, it can worsen and even appear late after successful mitral valve surgery, which portends a poor prognosis. Despite data demonstrating inferior outcomes in the presence of residual TR, surgical repair for functional TR remains underused. Acceptance of TR, in the presence of tricuspid annular dilation, may be unacceptable. Surgical repair should consist of placement of a rigid or semirigid annular ring, which has been shown to provide superior durability as compared with suture and flexible band techniques. Finally, percutaneous annuloplasty for correction of functional TR may allow treatment of patients with recurrent TR at high risk of reoperation.

  20. Reverse remodeling and the mechanism of mitral regurgitation improvement in patients with dilated cardiomyopathy.

    Kuperstein, Rafael; Blechman, Ido; Ben Zekry, Sagit; Klempfner, Robert; Freimark, Dov; Arad, Michael

    2015-01-01

    Functional mitral regurgitation (MR) is a common finding in dilated cardiomyopathy. Left ventricular (LV) reverse remodeling with LV size reduction and improvement in LV function is a well recognized phenomenon. We aimed to evaluate the impact of LV remodeling on the mechanism leading to functional MR. Among 188 patients with non-ischemic dilated cardiomyopathy, 10 patients significantly improved their LV function, reduced LV size and MR severity during follow-up (RRMR). A comparison was made between their baseline and follow-up echocardiographic examinations and to a matched-control group of patients who did not improve (no RRMR). LV and left atrium (LA) dimensions and volumes, LV mass (LVM), LV ejection fraction (LVEF) (Simpsons), sphericity index (SI), mitral valve tenting area (TA) coaptation distance (CD), effective regurgitant orifice (ERO), and regurgitant volume were calculated. Multivariable analysis was performed in order to evaluate which echocardiographic parameters related to MR improvement in reverse remodeling. LV and LA dimensions and volumes, LVM, SI, TA, CD, ERO and right ventricle, in the RRMR group significantly decreased at follow-up (p < 0.04 for all). When compared to no RRMR, despite a similar ERO (0.2 ± 0.05 vs. 0.2 ± 0.08, p = 0.13) and a larger regurgitant volume (38 ± 9 vs. 29 ± 8 mL, p = 0.05) and despite similar clinical characteristics and medical treatment we found significantly higher LVEF, smaller LV dimensions and volumes, smaller LVM and SI in the RRMR group (p < 0.05 for all). On multivariable analysis the SI was the sole predictor of RRMR (p = 0.04, OR = 0.76, CI 0.58-0.99). Reverse remodeling characterized by improvement in LV function, reduction in LV size and an associated reduction in MR severity is related to LV SI at baseline.

  1. Radionuclide examinations

    Lentle, B.C.

    1989-01-01

    This paper reports on radionuclide examinations of the pancreas. The pancreas, situated retroperitonally high in the epigastrium, was a particularly difficult organ to image noninvasively before ultrasonography and computed tomography (CT) became available. Indeed the organ still remains difficult to examine in some patients, a fact reflected in the variety of methods available to evaluate pancreatic morphology. It is something of a paradox that the pancreas is metabolically active and physiologically important but that its examination by radionuclide methods has virtually ceased to have any role in day-to-day clinical practice. To some extent this is caused by the tendency of the pancreas's commonest gross diseases emdash carcinoma and pancreatitis, for example emdash to result in nonfunction of the entire organ. Disorders of pancreatic endocrine function have generally not required imaging methods for diagnosis, although an understanding of diabetes mellitus and its nosology has been advanced by radioimmunoassay of plasma insulin concentrations

  2. Contemporary Management of Ischemic Mitral Regurgitation: a Review.

    Sandoval, Yader; Sorajja, Paul; Harris, Kevin M

    2018-02-28

    Ischemic mitral regurgitation occurs relatively frequently in patients with coronary artery disease and is associated with an increased long term risk. The pathophysiology of ischemic mitral regurgitation is vexing, and poses both diagnostic and therapeutic challenges, leading to the need for a comprehensive, multidisciplinary approach. The management is largely focused on medical therapy, and for those eligible, coronary revascularization and/or cardiac resynchronization therapy may be considered. In select patients, mitral valve surgery or catheter-based therapy may be undertaken with careful consideration of the underlying pathophysiology, surgical risk, and expected long-term outcomes. The appropriate evaluation of patients with ischemic mitral regurgitation involves a careful multidisciplinary approach that carefully considers symptomatology, the etiology and severity of the mitral regurgitation, as well as the assessment of comorbidities and operative risk to individualize the care of these patients. Copyright © 2018. Published by Elsevier Inc.

  3. Radionuclide transfer

    Gerber, G.B.

    1993-01-01

    The research project described here had the aim to obtain further information on the transfer of nuclides during pregnancy and lactation. The tests were carried out in mini-pigs and rats receiving unchanging doses of radionuclides with the food. The following findings were revealed for the elements examined: Fe, Se, Cs and Zn were characterized by very high transfer levels in the mother, infant and foetus. A substantial uptake by the mother alone was observed for Co, Ag and Mn. The uptake by the foetus and infant here was 1 to 10 times lower. A preferential concentration in certain tissues was seen for Sr and Tc; the thyroid levels of Tc were about equally high in mothers and infants, while Sr showed less accumulation in the maternal bone. The lanthanide group of substances (Ce, Eu and Gd as well as Y and Ru) were only taken up to a very limited extent. The uptake of the examined radionuclides (Fe, Co, Ag, Ce) with the food ingested was found here to be ten times greater in rats as compared to mini-pigs. This showed that great caution must be observed, if the behaviour of radionuclides in man is extrapolated from relevant data obtained in rodents. (orig./MG) [de

  4. Vanishing De Vega annuloplasty for functional tricuspid regurgitation.

    Duran, C M; Kumar, N; Prabhakar, G; Ge, Z; Bianchi, S; Gometza, B

    1993-10-01

    Annuloplasty is performed for significant functional tricuspid regurgitation even if it is presumed that in some cases the regurgitation will regress spontaneously after correction of the left-sided lesion. In an attempt to avoid the drawbacks of a permanent annuloplasty, we used a reabsorbable De Vega annuloplasty in a selected group of patients. Of 73 patients with functional tricuspid regurgitation operated on between May 1989 and May 1991, 25 with pulmonary arteriolar resistance below 400 dyne.sec.cm-5 underwent a De Vega annuloplasty with 2-0 polydioxanone suture. The diagnosis of significant functional tricuspid regurgitation (mean 2.74 +/- 1.05) was established by transthoracic color Doppler echocardiography in all patients. The degree of functional tricuspid regurgitation and pulmonary arteriolar resistance were measured with the patients anesthetized. In 16 patients the regurgitation remained severe (3+ to 4+) and in 9 it was moderate (2+). Twenty-three patients had mitral (12 repairs, 11 replacements) and 9 had aortic (4 repairs, 5 replacements) valve operations. The immediate postbypass residual functional tricuspid regurgitation was 0 to 1+ in 23 and 0 in 2. There was 1 (4%) operative death. The maximum follow-up period was 24 months (mean 13.9 months). There were 2 (8.3%) late deaths. Six patients underwent reoperation because of mitral dysfunction. Four of them who were reoperated on between 2 and 5 weeks after the initial procedure showed no recurrence of functional tricuspid regurgitation. The other 2, reoperated on at 5 and 10 months after the first operation, had recurrence of functional tricuspid regurgitation. Visual inspection of these two tricuspid valves showed a dilated anulus with otherwise normal valves. All surviving patients are in New York Heart Association functional class I or II without significant functional tricuspid regurgitation (mean 0.78 +/- 0.56). We concluded that functional tricuspid regurgitation in patients with low

  5. Role of Imaging Techniques in Percutaneous Treatment of Mitral Regurgitation.

    Li, Chi-Hion; Arzamendi, Dabit; Carreras, Francesc

    2016-04-01

    Mitral regurgitation is the most prevalent valvular heart disease in the United States and the second most prevalent in Europe. Patients with severe mitral regurgitation have a poor prognosis with medical therapy once they become symptomatic or develop signs of significant cardiac dysfunction. However, as many as half of these patients are inoperable because of advanced age, ventricular dysfunction, or other comorbidities. Studies have shown that surgery increases survival in patients with organic mitral regurgitation due to valve prolapse but has no clinical benefit in those with functional mitral regurgitation. In this scenario, percutaneous repair for mitral regurgitation in native valves provides alternative management of valvular heart disease in patients at high surgical risk. Percutaneous repair for mitral regurgitation is a growing field that relies heavily on imaging techniques to diagnose functional anatomy and guide repair procedures. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  6. Tricuspid but not Mitral Regurgitation Determines Mortality After TAVI in Patients With Nonsevere Mitral Regurgitation.

    Amat-Santos, Ignacio J; Castrodeza, Javier; Nombela-Franco, Luis; Muñoz-García, Antonio J; Gutiérrez-Ibanes, Enrique; de la Torre Hernández, José M; Córdoba-Soriano, Juan G; Jiménez-Quevedo, Pilar; Hernández-García, José M; González-Mansilla, Ana; Ruano, Javier; Tobar, Javier; Del Trigo, María; Vera, Silvio; Puri, Rishi; Hernández-Luis, Carolina; Carrasco-Moraleja, Manuel; Gómez, Itziar; Rodés-Cabau, Josep; San Román, José A

    2018-05-01

    Many patients undergoing transcatheter aortic valve implantation (TAVI) have concomitant mitral regurgitation (MR) of moderate grade or less. The impact of coexistent tricuspid regurgitation (TR) remains to be determined. We sought to analyze the impact of moderate vs none-to-mild MR and its trend after TAVI, as well as the impact of concomitant TR and its interaction with MR. Multicenter retrospective study of 813 TAVI patients treated through the transfemoral approach with MR ≤ 2 between 2007 and 2015. The mean age was 81 ± 7 years and the mean Society of Thoracic Surgeons score was 6.9% ± 5.1%. Moderate MR was present in 37.3% of the patients, with similar in-hospital outcomes and 6-month follow-up mortality to those with MR 2 post-TAVI. The presence of concomitant moderate/severe TR was associated with in-hospital and follow-up mortality rates of 13% and 34.1%, respectively, regardless of MR grade. Moderate-severe TR was independently associated with mortality (HR, 18.4; 95%CI, 10.2-33.3; P < .001). The presence of moderate MR seemed not to impact short- and mid-term mortality post-TAVI, but was associated with more rehospitalizations. The presence of moderate or severe TR was associated with higher mortality. This suggests that a thorough evaluation of the mechanisms underlying concomitant mitral and tricuspid valve regurgitation should be performed to determine the best strategy for avoiding TAVI-related futility. Copyright © 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  7. Tricuspid valve regurgitation after heart transplantation.

    Kwon, Murray H; Shemin, Richard J

    2017-05-01

    Tricuspid valve regurgitation (TVR) in the orthotopic heart transplant (OHT) recipient is quite common and has varied clinical sequelae. In its severest forms, it can lead to right-sided failure symptoms indistinguishable from that seen in native heart TVR disease. While certain implantation techniques are widely recognized to reduce the risk of TVR in the cardiac allograft, concomitant tricuspid annuloplasty, while having advocates, is not currently accepted as a routinely established adjunct. Decisions to surgically correct TVR in the OHT recipient must be made carefully, as certain clinical scenarios have high risk of failure. Like in the native heart, anatomic etiologies typically have the greatest chances for success compared to functional etiologies. While repair options have been utilized, there is emerging data to support replacement as the more durable option. While mechanical prostheses are impractical in the heart transplant recipient, biologic valves offer the advantage of continued access to the right ventricle for biopsies in addition to acceptable durability in the low pressure system of the right side.

  8. Radionuclide radiology

    Scarsbrook, A.F.; Graham, R.N.J.; Perriss, R.W.; Bradley, K.M.

    2006-01-01

    This is the fourth in a series of short reviews of internet-based radiological educational resources, and will focus on radionuclide radiology and nuclear medicine. What follows is a list of carefully selected websites to save time in searching them out. Most of the sites cater for trainee or non-specialist radiologists, but may also be of interest to specialists for use in teaching. This article may be particularly useful to radiologists interested in the rapidly expanding field of positron emission tomography computed tomography (PET-CT). Hyperlinks are available in the electronic version of this article and were all active at the time of going to press (February 2006)

  9. Exercise pulmonary hypertension in asymptomatic degenerative mitral regurgitation.

    Magne, Julien; Lancellotti, Patrizio; Piérard, Luc A

    2010-07-06

    Current guidelines recommend mitral valve surgery for asymptomatic patients with severe degenerative mitral regurgitation and preserved left ventricular systolic function when exercise pulmonary hypertension (PHT) is present. However, the determinants of exercise PHT have not been evaluated. The aim of this study was to identify the echocardiographic predictors of exercise PHT and the impact on symptoms. Comprehensive resting and exercise transthoracic echocardiography was performed in 78 consecutive patients (age, 61+/-13 years; 56% men) with at least moderate degenerative mitral regurgitation (effective regurgitant orifice area =43+/-20 mm(2); regurgitant volume =71+/-27 mL). Exercise PHT was defined as a systolic pulmonary arterial pressure (SPAP) >60 mm Hg. Exercise PHT was present in 46% patients. In multivariable analysis, exercise effective regurgitant orifice was an independent determinant of exercise SPAP (Pexercise PHT (P=0.002). Resting PHT and exercise PHT were associated with markedly reduced 2-year symptom-free survival (36+/-14% versus 59+/-7%, P=0.04; 35+/-8% versus 75+/-7%, Pexercise PHT was identified as an independent predictor of the occurrence of symptoms (hazard ratio=3.4; P=0.002). Receiver-operating characteristics curves revealed that exercise PHT (SPAP >56 mm Hg) was more accurate than resting PHT (SPAP >36 mm Hg) in predicting the occurrence of symptoms during follow-up (P=0.032). Exercise PHT is frequent in patients with asymptomatic degenerative mitral regurgitation. Exercise mitral regurgitation severity is a strong independent predictor of both exercise SPAP and exercise PHT. Exercise PHT is associated with markedly low 2-year symptom-free survival, emphasizing the use of exercise echocardiography. An exercise SPAP >56 mm Hg accurately predicts the occurrence of symptoms.

  10. Tricuspid Regurgitation Associated With Ischemic Mitral Regurgitation: Characterization, Evolution After Mitral Surgery, and Value of Tricuspid Repair.

    Navia, José L; Elgharably, Haytham; Javadikasgari, Hoda; Ibrahim, Ahmed; Koprivanac, Marijan; Lowry, Ashley M; Blackstone, Eugene H; Klein, Allan L; Gillinov, A Marc; Roselli, Eric E; Svensson, Lars G

    2017-08-01

    Tricuspid regurgitation (TR) often accompanies ischemic mitral regurgitation and is generally assumed to be a secondary consequence of altered hemodynamics of the left-sided regurgitation. We hypothesized that it may also be a direct consequence of right-sided ischemic disease. Therefore, our objectives were to (1) characterize the nature of this TR and (2) describe its time course after mitral valve surgery for ischemic mitral regurgitation, with or without concomitant tricuspid valve repair. From 2001 to 2011, 568 patients with ischemic mitral regurgitation underwent mitral valve surgery. They had varying degrees of TR and altered right-side heart morphology and function; 131 had concomitant tricuspid valve repair. Postoperatively, 1,395 echocardiograms were available to assess residual and recurrent TR. Greater severity of preoperative TR was accompanied by larger tricuspid valve diameter, greater leaflet tethering, worse right ventricular function, and higher right ventricular pressure (all p [trend] ≤ 0.002). Without tricuspid valve repair, 31% of patients with no preoperative TR had moderate or greater TR by 5 years, as did 62% with moderate TR. With tricuspid valve repair, 25% with moderate preoperative TR remained in that grade at 5 years, but 11% had severe TR. Tricuspid regurgitation accompanying ischemic mitral regurgitation is associated with right-side heart remodeling and dysfunction often mirroring that occurring in the left side of the heart-ischemic TR. Tricuspid valve repair is effective initially, but as with mitral valve repair, TR progressively returns. Therefore, when the severity of TR and right-sided remodeling reaches the point of irreversibility, it may be an indication to eliminate the TR by replacing the tricuspid valve. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Simple repair approach for mitral regurgitation in Barlow disease.

    Ben Zekry, Sagit; Spiegelstein, Dan; Sternik, Leonid; Lev, Innon; Kogan, Alexander; Kuperstein, Rafael; Raanani, Ehud

    2015-11-01

    Mitral valve repair for myxomatous Barlow disease is a challenging procedure requiring complex surgery with less than optimal results. The use of ring-only repair has been previously reported but never analyzed or followed-up. We investigated this simple valve repair approach for patients with Barlow disease and multisegment involvement causing mainly central jet. Of 572 patients who underwent mitral valve repair for mitral regurgitation at our medical center, 24 with Barlow disease (aged 47 ± 14 years; 46% male) underwent ring-only repair. Patients were characterized by severely enlarged mitral valve annulus, multisegment prolapse involving both leaflets, and demonstrated mainly a central wide regurgitant jet. Surgical technique included only the implantation of a large mitral annuloplasty ring. Early and late outcome results were compared with those of the remaining patients who underwent conventional mitral valve repair for degenerative disease (controls). All ring-only patients presented with moderate-severe/severe mitral regurgitation (vena contracta, 0.6 ± 0.1 cm; regurgitation volume, 52 ± 17 mL), with mainly a central jet and almost preserved ejection fraction (59% ± 6%). Cardiopulmonary bypass and crossclamp times were significantly shorter compared with controls (P Barlow disease patients with multisegment involvement and mainly central regurgitant jet is both simple and reproducible with excellent late outcomes. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  12. Pathophysiology of Degenerative Mitral Regurgitation: New 3-Dimensional Imaging Insights.

    Antoine, Clemence; Mantovani, Francesca; Benfari, Giovanni; Mankad, Sunil V; Maalouf, Joseph F; Michelena, Hector I; Enriquez-Sarano, Maurice

    2018-01-01

    Despite its high prevalence, little is known about mechanisms of mitral regurgitation in degenerative mitral valve disease apart from the leaflet prolapse itself. Mitral valve is a complex structure, including mitral annulus, mitral leaflets, papillary muscles, chords, and left ventricular walls. All these structures are involved in physiological and pathological functioning of this valvuloventricular complex but up to now were difficult to analyze because of inherent limitations of 2-dimensional imaging. The advent of 3-dimensional echocardiography, computed tomography, and cardiac magnetic resonance imaging overcoming these limitations provides new insights into mechanistic analysis of degenerative mitral regurgitation. This review will detail the contribution of quantitative and qualitative dynamic analysis of mitral annulus and mitral leaflets by new imaging methods in the understanding of degenerative mitral regurgitation pathophysiology. © 2018 American Heart Association, Inc.

  13. HEALTH-RELATED QUALITY OF LIFE OF PREGNANT WOMEN WITH HEARTBURN AND REGURGITATION

    Valesca DALL'ALBA; Sidia Maria CALLEGARI-JACQUES; Cláudio KRAHE; Juliana Paula BRUCH; Bruna Cherubini ALVES; Sérgio Gabriel Silva de BARROS

    2015-01-01

    Background Heartburn and regurgitation frequently occur in the third trimester of pregnancy, but their impact on quality of life has not been thoroughly investigated. Objective To measure health-related quality of life of third-trimester pregnant women with heartburn and regurgitation. Methods Data on obstetric history, heartburn and regurgitation frequency and intensity, history of heartburn and regurgitation and health-related quality of life were collected of 82 third-trimester pregnant wo...

  14. Hyperthyroidism presenting as isolated tricuspid regurgitation and right heart failure.

    Whitner, Tanya E; Hudson, Christopher J; Smith, Timothy D; Littmann, Laszlo

    2005-01-01

    Although hyperthyroidism has many signs and symptoms, right heart failure can occasionally be the main presenting symptom. We describe the case of a previously healthy 42-year-old woman whose chief complaint was progressive bilateral lower extremity edema. The echocardiogram revealed right atrial dilatation and moderate-to-severe tricuspid regurgitation. Results of laboratory studies were consistent with hyperthyroidism. Thyroid ablation resulted in permanent resolution of symptoms and resolution of tricuspid incompetence on echocardiography. In a case of isolated, unexplained tricuspid regurgitation, it is important to consider indolent hyperthyroidism in the differential diagnosis.

  15. Treatment with pioglitazone induced significant, reversible mitral regurgitation.

    Dorkhan, Mozhgan; Dencker, Magnus; Frid, Anders

    2008-04-30

    There has in recent years been great concern about possible cardiac side effects of thiazolidinediones (TZDs). We present a case-report of a 60 year-old male who developed significant mitral regurgitation during six months treatment with pioglitazone in parallel with laboratory indications of fluid retention. Echocardiography six months after discontinuation of medication showed regression of mitral regurgitation and the laboratory parameters were also normalized. It is noteworthy that six months treatment with pioglitazone could induce significant valve dysfunction, which was reversible, and this underlines the importance of carefully monitoring patients when placing them on treatment with TZDs.

  16. Treatment with pioglitazone induced significant, reversible mitral regurgitation

    Frid Anders

    2008-04-01

    Full Text Available Abstract There has in recent years been great concern about possible cardiac side effects of thiazolidinediones (TZDs. We present a case-report of a 60 year-old male who developed significant mitral regurgitation during six months treatment with pioglitazone in parallel with laboratory indications of fluid retention. Echocardiography six months after discontinuation of medication showed regression of mitral regurgitation and the laboratory parameters were also normalized. It is noteworthy that six months treatment with pioglitazone could induce significant valve dysfunction, which was reversible, and this underlines the importance of carefully monitoring patients when placing them on treatment with TZDs.

  17. Mitral valve repair and redo repair for mitral regurgitation in a heart transplant recipient

    Bouma, Wobbe; Brugemann, Johan; Wijdh-den Hamer, Inez J.; Klinkenberg, Theo J.; Koene, Bart M.; Kuijpers, Michiel; Erasmus, Michiel E.; van der Horst, Iwan C. C.; Mariani, Massimo A.

    2012-01-01

    A 37-year-old man with end-stage idiopathic dilated cardiomyopathy underwent an orthotopic heart transplant followed by a reoperation with mitral annuloplasty for severe mitral regurgitation. Shortly thereafter, he developed severe tricuspid regurgitation and severe recurrent mitral regurgitation

  18. Grading of vesicoureteral reflux by radionuclide cystography

    Fretzayas, A.; Karpathios, T.; Dimitriou, P.; Nicolaidou, P.; Matsaniotis, N.

    1984-01-01

    Thirty-six children with urinary tract infection aged 6 months to 14 years (mean age 4 1/2 years) were studied sequentially using direct radionuclide (RNC) and conventional voiding cystourethrography (VCU). Vesicoureteral reflux (VUR) was detected equally well by both methods. Twenty-seven refluxing ureters were found by RNC, 23 by VCU and 22 by both methods. Radiologic grade of reflux may be determined approximately with the isotope technique from the volume of regurgitating urine und duration of reflux, at a much decreased radiation exposure. Residual urine was also measured by RNC and found to be higher in children with VUR. RNC is a reliable method for detecting and grading VUR and should effectively replace VCU as the follow-up examination of choice. (orig.)

  19. Mapping of mitral regurgitant defects by cardiovascular magnetic resonance in moderate or severe mitral regurgitation secondary to mitral valve prolapse

    Raffel Owen C

    2008-04-01

    Full Text Available Abstract Purpose In mitral valve prolapse, determining whether the valve is suitable for surgical repair depends on the location and mechanism of regurgitation. We assessed whether cardiovascular magnetic resonance (CMR could accurately identify prolapsing or flail mitral valve leaflets and regurgitant jet direction in patients with known moderate or severe mitral regurgitation. Methods CMR of the mitral valve was compared with trans-thoracic echocardiography (TTE in 27 patients with chronic moderate to severe mitral regurgitation due to mitral valve prolapse. Contiguous long-axis high temporal resolution CMR cines perpendicular to the valve commissures were obtained across the mitral valve from the medial to lateral annulus. This technique allowed systematic valve inspection and mapping of leaflet prolapse using a 6 segment model. CMR mapping was compared with trans-oesophageal echocardiography (TOE or surgical inspection in 10 patients. Results CMR and TTE agreed on the presence/absence of leaflet abnormality in 53 of 54 (98% leaflets. Prolapse or flail was seen in 36 of 54 mitral valve leaflets examined on TTE. CMR and TTE agreed on the discrimination of prolapse from flail in 33 of 36 (92% leaflets and on the predominant regurgitant jet direction in 26 of the 27 (96% patients. In the 10 patients with TOE or surgical operative findings available, CMR correctly classified presence/absence of segmental abnormality in 49 of 60 (82% leaflet segments. Conclusion Systematic mitral valve assessment using a simple protocol is feasible and could easily be incorporated into CMR studies in patients with mitral regurgitation due to mitral valve prolapse.

  20. Mitral-valve repair versus replacement for severe ischemic mitral regurgitation.

    Acker, Michael A; Parides, Michael K; Perrault, Louis P; Moskowitz, Alan J; Gelijns, Annetine C; Voisine, Pierre; Smith, Peter K; Hung, Judy W; Blackstone, Eugene H; Puskas, John D; Argenziano, Michael; Gammie, James S; Mack, Michael; Ascheim, Deborah D; Bagiella, Emilia; Moquete, Ellen G; Ferguson, T Bruce; Horvath, Keith A; Geller, Nancy L; Miller, Marissa A; Woo, Y Joseph; D'Alessandro, David A; Ailawadi, Gorav; Dagenais, Francois; Gardner, Timothy J; O'Gara, Patrick T; Michler, Robert E; Kron, Irving L

    2014-01-02

    Ischemic mitral regurgitation is associated with a substantial risk of death. Practice guidelines recommend surgery for patients with a severe form of this condition but acknowledge that the supporting evidence for repair or replacement is limited. We randomly assigned 251 patients with severe ischemic mitral regurgitation to undergo either mitral-valve repair or chordal-sparing replacement in order to evaluate efficacy and safety. The primary end point was the left ventricular end-systolic volume index (LVESVI) at 12 months, as assessed with the use of a Wilcoxon rank-sum test in which deaths were categorized below the lowest LVESVI rank. At 12 months, the mean LVESVI among surviving patients was 54.6±25.0 ml per square meter of body-surface area in the repair group and 60.7±31.5 ml per square meter in the replacement group (mean change from baseline, -6.6 and -6.8 ml per square meter, respectively). The rate of death was 14.3% in the repair group and 17.6% in the replacement group (hazard ratio with repair, 0.79; 95% confidence interval, 0.42 to 1.47; P=0.45 by the log-rank test). There was no significant between-group difference in LVESVI after adjustment for death (z score, 1.33; P=0.18). The rate of moderate or severe recurrence of mitral regurgitation at 12 months was higher in the repair group than in the replacement group (32.6% vs. 2.3%, P<0.001). There were no significant between-group differences in the rate of a composite of major adverse cardiac or cerebrovascular events, in functional status, or in quality of life at 12 months. We observed no significant difference in left ventricular reverse remodeling or survival at 12 months between patients who underwent mitral-valve repair and those who underwent mitral-valve replacement. Replacement provided a more durable correction of mitral regurgitation, but there was no significant between-group difference in clinical outcomes. (Funded by the National Institutes of Health and the Canadian Institutes of

  1. Left ventricular remodeling in preclinical experimental mitral regurgitation of dogs.

    Dillon, A Ray; Dell'Italia, Louis J; Tillson, Michael; Killingsworth, Cheryl; Denney, Thomas; Hathcock, John; Botzman, Logan

    2012-03-01

    Dogs with experimental mitral regurgitation (MR) provide insights into the left ventricular remodeling in preclinical MR. The early preclinical left ventricular (LV) changes after mitral regurgitation represent progressive dysfunctional remodeling, in that no compensatory response returns the functional stroke volume (SV) to normal even as total SV increases. The gradual disease progression leads to mitral annulus stretch and enlargement of the regurgitant orifice, further increasing the regurgitant volume. Remodeling with loss of collagen weave and extracellular matrix (ECM) is accompanied by stretching and hypertrophy of the cross-sectional area and length of the cardiomyocyte. Isolated ventricular cardiomyocytes demonstrate dysfunction based on decreased cell shortening and reduced intracellular calcium transients before chamber enlargement or decreases in contractility in the whole heart can be clinically appreciated. The genetic response to increased end-diastolic pressure is down-regulation of genes associated with support of the collagen and ECM and up-regulation of genes associated with matrix remodeling. Experiments have not demonstrated any beneficial effects on remodeling from treatments that decrease afterload via blocking the renin-angiotensin system (RAS). Beta-1 receptor blockade and chymase inhibition have altered the progression of the LV remodeling and have supported cardiomyocyte function. The geometry of the LV during the remodeling provides insight into the importance of regional differences in responses to wall stress. Copyright © 2012 Elsevier B.V. All rights reserved.

  2. Uncontrolled acromegaly is associated with progressive mitral valvular regurgitation

    van der Klaauw, A. A.; Bax, J. J.; Roelfsema, F.; Bleeker, G. B.; Holman, E. R.; Corssmit, E. P. M.; van der Wall, E. E.; Smit, J. W. A.; Romijn, J. A.; Pereira, A. M.

    2006-01-01

    Recent cross-sectional studies have documented an association between acromegaly and regurgitant valvular heart disease. The aim of this study was to evaluate the change in prevalence of valvular heart disease in relation to the clinical activity, because the natural history of valvular changes in

  3. Evaluation of mitral regurgitation by cine magnetic resonance imaging

    Kobayashi, Shiro; Kishi, Naohiro; Kumai, Toshihiko

    1993-01-01

    Valvular regurgitation can be detected as a region of signal loss ('flow void') by cardiac cine magnetic resonance (MR) imaging. Cine MR images of 36 patients with mitral regurgitation caused by mitral valve prolapse (MVP) and non-MVP were evaluated and compared with color Doppler flow images. The direction, distance, area and timing of flow void were detected in all patients in several different planes at mitral level with a 0.5 Tesla superconducting magnet by an ECG-gated fast field echo technique. In 23 of the 36 patients contiguous multiple transaxial images were also obtained to calculate the volumes of flow void and the left atrium. The direction of flow void tended to deviate to the opposite side within the left atrium in MVP. The frame showing maximal area of flow void was demonstrated in mid-systole in 24 of the 36 patients (67%). The distance, area and volume of flow void were concordant with the grade from color Doppler flow images. The volumes of flow void and the left atrium correlated (n=19, r=0.74, p<0.05) in MVP. In conclusion, cine MR images in several different planes or contiguous multiple slices are useful in determining spatial orientation and the extent and timing of mitral regurgitation noninvasively. Furthermore, calculation of the volume of flow void enables the assessment of the semiquantitation of mitral regurgitation. (author)

  4. Intermittent, Non Cyclic Severe Mechanical Aortic Valve Regurgitation

    Choi, Jong Hyun; Song, Seunghwan; Lee, Myung-Yong

    2013-01-01

    Mechanical aortic prosthesis dysfunction can result from thrombosis or pannus formation. We describe an unusual case of intermittent, non cyclic mechanical aortic prosthesis dysfunction due to pannus formation with thrombus in the absence of systolic restriction of disk excursion, that presented with intermittent severe aortic regurgitation. PMID:24459568

  5. Regression in left ventricular mass after aortic valve replacement for chronic aortic regurgitation is unrelated to prosthetic valve size.

    Brown, Morgan L; Schaff, Hartzell V; Suri, Rakesh M; Li, Zhuo; Sundt, Thoralf M; Dearani, Joseph A; Enriquez-Sarano, Maurice

    2011-08-01

    We examined the role of prosthesis-patient mismatch on left ventricular mass regression after aortic valve replacement for chronic aortic valve regurgitation. We selected patients who had complete preoperative and follow-up echocardiograms with measurement of left ventricular mass. Patients were excluded who had moderate or greater aortic valve stenosis, concomitant coronary artery bypass grafting, or mitral valve procedures. Patients' mean age was 55 ± 17 years; 21% were female. The mean preoperative indexed left ventricular mass was 150 ± 45 g/m(2). Patients with mildly (n = 44; mean indexed mass, 126 ± 15 g/m(2)), moderately (n = 31; mean indexed mass, 168 ± 11 g/m(2)), or severely (n = 15; mean indexed mass, 241 ± 34 g/m(2)) increased preoperative indexed left ventricular mass, were similar, except for lower ejection fractions, larger end-diastolic dimensions, and larger ventricular wall thicknesses in the severely enlarged group (P regression was unrelated to labeled valve size, prosthesis-patient mismatch, or measured indexed effective aortic valve area. A greater preoperative indexed left ventricular mass (P regression. Despite having greater left ventricular mass regression, patients with severe preoperative indexed left ventricular mass did not return to normal values (mean, 142 ± 25 g/m(2)). Left ventricular mass regression after aortic valve replacement for chronic aortic regurgitation is unrelated to indexed prosthetic valve area. Although incomplete, regression is greatest in patients with the largest preoperative indexed left ventricular mass. Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  6. Clinical application of radionuclide cardiac study to the right heart diseases

    Shimizu, Tatsuro; Ozaki, Masaharu; Ikezono, Tohru

    1984-01-01

    We experienced the four cases of rare right heart diseases: those are two-chambered right ventricle, ball thrombus in right ventricle, right ventricular hypertrophy and tricuspid valve regurgitation due to multiple pulmonary infarction, and right ventricular and right atrial infarction. The preoperative or ante mortem diagnosis of these diseases is difficult, especially by use of a noninvasive technique. This report shows the usefulness of radionuclide cardiac study for diagnosis of these cases. In the two-chambered right ventricle, abnormal muscle bundle was visualized by 201 Tlcl and was observed as the filling defect by sup(99m)Tc-HSA radionuclide angiography. The ball thrombus showed the filling defect of sup(99m)Tc-HSA in the right ventricle but was not extracted by 201 Tlcl in the site of the defect area. In the multiple pulmonary infarction, the right ventricular free wall was visualized by 201 Tlcl, and during right ventricular systole, regurgitation from right atrium to inferior vena cava was noticed by means of sup(99m)Tc-HSA radionuclide angiography. These findings suggested right ventricular hypertrophy and tricuspid valve regurgitation. In the right ventricular and right atrial infarction, right ventricular ejection fraction and right atrial fractional emptying were lower than those of normal controls. (author)

  7. Dilatation of the ascending aorta is associated with presence of aortic regurgitation in patients after repair of tetralogy of Fallot

    Ordovas, Karen Gomes; Keedy, Alexander; Naeger, David M.; Kallianos, Kimberly; Foster, Elyse; Liu, Jing; Saloner, David; Hope, Michael D.

    2016-01-01

    To evaluate the association between aortic morphology and elasticity with aortic regurgitation in surgically corrected of tetralogy of Fallot (TOF) patients. We retrospectively identified 72 consecutive patients with surgically corrected TOF and 27 healthy controls who underwent cardiac MRI evaluation. Velocity-encoded cine MRI was used to quantify degree of aortic regurgitation (AR) in TOF patients. Ascending aorta diameters were measured at standard levels on MRA images. Aortic pulse-wave velocity (PWV) was quantified with MRI. Morphological and functional MRI variables were compared between groups of TOF patients with and without clinically relevant AR and controls. The association between aortic morphology and elasticity with the presence of AR was evaluated using univariate and multivariate logistic regression. The majority of TOF patients had only trace AR. Nine TOF patients (12 %) had an AR fraction higher than 15 %. Indexed aorta diameter at the sinotubular junction (p = 0.007), at the RPA level (p = 0.006), and low left ventricular ejection fraction (LVEF) (p = 0.015) showed the strongest associations with the presence of at least mild AR, which persisted after controlling for age and gender. Increased ascending aorta dimension is associated with AR in patients after repair of TOF. LVEF was also low in the group of patients with relevant AR compared to those without, suggesting even mild to moderate AR may contribute to LV dysfunction in these patients. Enlarged ascending aorta may be an indication for precise quantification of regurgitant fraction with MRI, since symptomatic patients may need aortic valve repair when moderate regurgitation is present. PMID:27240599

  8. Radionuclides in terrestrial ecosystems

    Allen, S.E.; Horrill, A.D.; Howard, B.J.; Lowe, V.P.W.; Parkinson, J.A.

    1983-07-01

    The subject is discussed under the headings: concentration and spatial distribution of radionuclides in grazed and ungrazed saltmarshes; incorporation of radionuclides by sheep grazing on an estuarine saltmarsh; inland transfer of radionuclides by birds feeding in the estuaries and saltmarshes at Ravenglass; radionuclides in contrasting types of coastal pastures and taken up by individual plant species found in west Cumbria; procedures developed and used for the measurement of alpha and gamma emitters in environmental materials. (U.K.)

  9. Evaluation of aortic regurgitation using cine magnetic resonance imaging

    Tamai, Takuya; Konishi, Tokuji; Okamoto, Shinya; Sakuma, Hajime; Takeda, Kan; Nakano, Takeshi

    1993-01-01

    Cine magnetic resonance imaging (MRI) was used to assess aortic regurgitation (AR) in 13 patients with valvular disease and 3 normal subjects, and the results were compared to color Doppler flow mapping findings. AR produced a signal void in the left ventricle during the diastolic phase in all patients by MRI. There were no false positive or negative results compared with echocardiographic findings. Visual grading of cine MRI gave results similar to color flow Doppler echocardiography (88%). The distance and the area of aortic regurgitation using MRI correlated well with color Doppler flow mapping (r=0.82 and 0.88). However, measurements of distance and area by color flow Doppler tended to be larger than those by cine MRI. With current techniques echocardiography may overestimate the severity of AR as compared with cine MRI. In addition, MRI gives clinically useful information in patients in whom transthoracic Doppler echocardiography is not adequate. (author)

  10. Hyperthyroidism: Presenting as Isolated Tricuspid Regurgitation and Right Heart Failure

    Whitner, Tanya E.; Hudson, Christopher J.; Smith, Timothy D.; Littmann, Laszlo

    2005-01-01

    Although hyperthyroidism has many signs and symptoms, right heart failure can occasionally be the main presenting symptom. We describe the case of a previously healthy 42-year-old woman whose chief complaint was progressive bilateral lower extremity edema. The echocardiogram revealed right atrial dilatation and moderate-to-severe tricuspid regurgitation. Results of laboratory studies were consistent with hyperthyroidism. Thyroid ablation resulted in permanent resolution of symptoms and resolu...

  11. Heartburn and regurgitation in pregnancy: the effect of fat ingestion.

    Dall'Alba, Valesca; Fornari, Fernando; Krahe, Cláudio; Callegari-Jacques, Sidia Maria; Silva de Barros, Sérgio Gabriel

    2010-06-01

    Reflux symptoms are common in pregnancy, but their association with fat ingestion is unclear. To investigate an association of dietary fats with heartburn and regurgitation in pregnancy. This is a prospective study in which 89 pregnant women (gestational age 34 +/- 4 weeks) attending a low-risk prenatal outpatient clinic were asked to provide information on the frequency they experienced heartburn and regurgitation. Fat ingestion was estimated by means of a 24-h diet record. Symptomatic patients were compared with those with no reflux symptoms (n = 20). Heartburn once a week or more often occurred in 56 of the 89 patients (63%). The ingested amount of polyunsaturated fatty acids was higher in patients with heartburn (11.2 +/- 6.4 vs. 7.7 +/- 3.5 mg; P = 0.022) than in controls after adjusting for age, gain weight during pregnancy, ingestion of caffeine and vitamin C, and total energetic intake. The ingestion of monounsaturated fatty acids was higher in patients with heartburn, but with a borderline statistical significance (16.1 +/- 11 vs. 11.8 +/- 6.5 mg; P = 0.061). No association was observed between the consumption of fats and regurgitation. This study suggests that heartburn in the third trimester of pregnancy is associated with the ingestion of polyunsaturated fatty acids.

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

    Hager, Alfred; Schubert, Stephan; Ewert, Peter

    2017-01-01

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

  13. Hemodynamic aspects of mitral regurgitation assessed by generalized phase-contrast MRI

    Dyverfeldt, Petter; Escobar Kvitting, John-Peder; Carlhäll, Carl Johan; Boano, Gabriella; Sigfridsson, Andreas; Hermansson, Ulf; Bolger, Ann F.; Engvall, Jan; Ebbers, Tino

    2011-01-01

    Purpose: Mitral regurgitation creates a high velocity jet into the left atrium (LA), contributing both volume andpressure; we hypothesized that the severity of regurgitation would be reflected in the degree of LA flowdistortion. Material and Methods: Three-dimensional cine PC-MRI was applied to determine LA flow patterns andturbulent kinetic energy (TKE) in seven subjects (five patients with posterior mitral leaflet prolapse, two normalsubjects). In addition, the regurgitant volume and the ti...

  14. Association of Tricuspid Regurgitation and Severity of Mitral Stenosis in Patients with Rheumatic Heart Disease

    Ahmed, R.; Kazmi, N.; Naz, F.; Malik, S.; Gillani, S.

    2016-01-01

    Background: Rheumatic heart disease is a common ailment in Pakistan and Mitral stenosis is its flag bearer Severity of mitral stenosis is the key factor in deciding for mitral valve surgery. Methods: This case series study was conducted at Ayub Teaching Hospital .Cases of Rheumatic heart disease with mitral stenosis were diagnosed clinically. 2D echocardiography was used to find severity of mitral stenosis. Data was entered into SPSS-17.0 and results were recorded and analysed. Pearsons two tailed correlation was used to find the correlation between presence of tricuspid regurgitation in patients with severe mitral stenosis, p was <0.05. Results: A total 35 patients with pure mitral stenosis were included in study, out of which 8 were male and 27 were females. Mean age in males was 34.5±15.85 years while in females it was 31±8 years. Twenty-two out of 35 (62.86 percent) patients had tricuspid regurgitation while 13 out 35 (37.14 percent) had no tricuspid regurgitation. Mean (MVA) mitral valve area in patients with tricuspid regurgitation was 0.84±0.3 cm/sup 2/ while mean (MVA) mitral valve area in patients without tricuspid regurgitation was 1.83±0.7 cm/sup 2/. Mean left atrial (L.A) size was 45.23±1.5mm/sup 2/ in patients with tricuspid regurgitation, while it was 44.13±6.14mm/sup 2/ in patients without tricuspid regurgitation. Mean RSVP was 57.5mmHg in patients with tricuspid regurgitation while RSVP could not be calculated in patients without tricuspid regurgitation. Conclusions: It was concluded that tricuspid regurgitation was strongly associated with severe mitral stenosis as almost all patients with severe mitral stenosis had tricuspid regurgitation and none of the patients with mild mitral stenosis had tricuspid regurgitation. (author)

  15. Evaluation of postoperative pulmonary regurgitation after surgical repair of tetralogy of Fallot: comparison between Doppler echocardiography and MR velocity mapping

    Grothoff, Matthias; Spors, Birgit; Gutberlet, Matthias [Charite Campus Virchow Klinikum, Department of Radiology and Nuclear Medicine, Berlin (Germany); Abdul-Khaliq, Hasim [Deutsches Herzzentrum, Department of Congenital Heart Disease/Pediatric Cardiology, Berlin (Germany)

    2008-02-15

    Pulmonary regurgitation is a common finding in patients after correction of tetralogy of Fallot (TOF). Right ventricular impairment and even ventricular arrhythmia have been ascribed to pulmonary valve insufficiency (PI), which is therefore an important issue in follow-up examinations. To compare PI measured by echocardiography (ECHO) with data provided by cardiac MRI (CMR). We studied 54 selected patients (18 female; median age 14.0 years, range 3.8-53.4 years) after surgical correction of TOF. To quantify pulmonary regurgitant fraction (PRF) by CMR, flow velocity mapping was performed. On Doppler ECHO, length, width and localization of regurgitant flow was measured. The severity of PI was categorized as mild, moderate or severe and compared to the data obtained by CMR. On CMR the mean PRF was 29.2 {+-} 13.4%. Patients with a transannular patch had a significantly higher PRF (39.9 {+-} 11.6%) than patients with an intact annular ring (23.6 {+-} 11.4%). Differentiation by Doppler ECHO between the categories mild, moderate and severe PI was confirmed by significant differences in PRF measured by CMR (mild vs. moderate P < 0.04; moderate vs. severe P < 0.014; mild vs. severe P < 0.001). Furthermore, PRF correlated with right ventricular end diastolic volume index (r = 0.45, P < 0.01) and right ventricular end systolic volume index (r = 0.39, P < 0.01). Doppler ECHO can estimate the severity of PI after repair of TOF with acceptable results compared to CMR flow measurement. In univariate analysis there is only a weak influence of PRF on right ventricular volume. (orig.)

  16. Evaluation of postoperative pulmonary regurgitation after surgical repair of tetralogy of Fallot: comparison between Doppler echocardiography and MR velocity mapping

    Grothoff, Matthias; Spors, Birgit; Gutberlet, Matthias; Abdul-Khaliq, Hasim

    2008-01-01

    Pulmonary regurgitation is a common finding in patients after correction of tetralogy of Fallot (TOF). Right ventricular impairment and even ventricular arrhythmia have been ascribed to pulmonary valve insufficiency (PI), which is therefore an important issue in follow-up examinations. To compare PI measured by echocardiography (ECHO) with data provided by cardiac MRI (CMR). We studied 54 selected patients (18 female; median age 14.0 years, range 3.8-53.4 years) after surgical correction of TOF. To quantify pulmonary regurgitant fraction (PRF) by CMR, flow velocity mapping was performed. On Doppler ECHO, length, width and localization of regurgitant flow was measured. The severity of PI was categorized as mild, moderate or severe and compared to the data obtained by CMR. On CMR the mean PRF was 29.2 ± 13.4%. Patients with a transannular patch had a significantly higher PRF (39.9 ± 11.6%) than patients with an intact annular ring (23.6 ± 11.4%). Differentiation by Doppler ECHO between the categories mild, moderate and severe PI was confirmed by significant differences in PRF measured by CMR (mild vs. moderate P < 0.04; moderate vs. severe P < 0.014; mild vs. severe P < 0.001). Furthermore, PRF correlated with right ventricular end diastolic volume index (r = 0.45, P < 0.01) and right ventricular end systolic volume index (r = 0.39, P < 0.01). Doppler ECHO can estimate the severity of PI after repair of TOF with acceptable results compared to CMR flow measurement. In univariate analysis there is only a weak influence of PRF on right ventricular volume. (orig.)

  17. Speciation analysis of radionuclides

    Salbu, B.

    2010-01-01

    Full text: Naturally occurring and artificially produced radionuclides in the environment can be present in different physico-chemical forms (i. e. radionuclide species) varying in size (nominal molecular mass), charge properties and valence, oxidation state, structure and morphology, density, complexing ability etc. Low molecular mass (LMM) species are believed to be mobile and potentially bioavailable, while high molecular mass (HMM) species such as colloids, polymers, pseudocolloids and particles are considered inert. Due to time dependent transformation processes such as mobilization of radionuclide species from solid phases or interactions of mobile and reactive radionuclide species with components in soils and sediments, however, the original distribution of radionuclides deposited in ecosystems will change over time and influence the ecosystem behaviour. To assess the environmental impact from radionuclide contamination, information on radionuclide species deposited, interactions within affected ecosystems and the time-dependent distribution of radionuclide species influencing mobility and biological uptake is essential. The development of speciation techniques to characterize radionuclide species in waters, soils and sediments should therefore be essential for improving the prediction power of impact and risk assessment models. The present paper reviews fractionation techniques which should be utilised for radionuclide speciation purposes. (author)

  18. Quantitative radionuclide angiocardiography

    Scholz, P.M.; Rerych, S.K.; Moran, J.F.; Newman, G.E.; Douglas, J.M.; Sabiston, D.C. Jr.; Jones, R.H.

    1980-01-01

    This study introduces a new method for calculating actual left ventricular volumes and cardiac output from data recorded during a single transit of a radionuclide bolus through the heart, and describes in detail current radionuclide angiocardiography methodology. A group of 64 healthy adults with a wide age range were studied to define the normal range of hemodynamic parameters determined by the technique. Radionuclide angiocardiograms were performed in patients undergoing cardiac catherization to validate the measurements. In 33 patients studied by both techniques on the same day, a close correlation was documented for measurement of ejection fraction and end-diastolic volume. To validate the method of volumetric cardiac output calcuation, 33 simultaneous radionuclide and indocyanine green dye determinations of cardiac output were performed in 18 normal young adults. These independent comparisons of radionuclide measurements with two separate methods document that initial transit radionuclide angiocardiography accurately assesses left ventricular function

  19. Growth and reproductive attributes of radionuclide phytoremediators ...

    The study reveals that growth attributes including relative growth rate, net assimilation rate, leaf are index and specific leaf area, dry matter allocated to stem and leaves and number of reproductive organs decreased with the increase of radionuclide content of the plant, while the dry matter allocated to root and reproductive ...

  20. Impact of papillary muscle infarction on ischemic mitral regurgitation assessed by magnetic resonance imaging

    Bretschneider, Christiane [Klinikum Frankfurt Hochst GmbH, Frankfurt am Main (Germany). Radiology; Heinrich, Hannah-Klara; Kramer, Ulrich; Nikolaou, Konstantin; Klumpp, Bernhard [Universitaetsklinikum Tuebingen, Tuebingen (Germany). Diagnostic and Interventional Radiology; Seeger, Achim; Miller, Stephan [Radiologiepraxis Tuebingen, Tuebingen (Germany); Burgstahler, Christof [Universitaetsklinikum Tuebingen, Tuebingen (Germany). Sports Medicine; Gawaz, Meinrad [Universitaetsklinikum Tuebingen, Tuebingen (Germany). Cardiology

    2018-01-15

    Objective Ischemic mitral regurgitation is a predictor of heart failure resulting in increased mortality in patients with chronic myocardial infarction. It is uncertain whether the presence of papillary muscle (PM) infarction contributes to the development of mitral regurgitation in patients with chronic myocardial infarction (MI). The aim of the present study was to assess the correlation of PM infarction depicted by MRI with mitral regurgitation and left ventricular function. 48 patients with chronic MI and recent MRI and echocardiography were retrospectively included. The location and extent of MI depicted by MRI were correlated with left ventricular function assessed by MRI and mitral regurgitation assessed by echocardiography. The presence, location and extent of PM infarction depicted by late gadolinium enhancement (LGE-) MRI were correlated with functional parameters and compared with patients with chronic MI but no PM involvement. PM infarction was found in 11 of 48 patients (23 %) using LGE-MRI. 8/11 patients (73 %) with PM infarction and 22/37 patients (59 %) without PM involvement in MI had ischemic mitral regurgitation. There was no significant difference between location, extent of MI and presence of mitral regurgitation between patients with and without PM involvement in myocardial infarction. In 4/4 patients with complete and in 4/7 patients with partial PM infarction, mitral regurgitation was present. The normalized mean left ventricular end-diastolic volume was increased in patients with ischemic mitral regurgitation. The presence of PM infarction does not correlate with ischemic mitral regurgitation. In patients with complete PM infarction and consequent discontinuity of viable tissue in the PM-chorda-mitral valve complex, the probability of developing ischemic mitral regurgitation seems to be increased. However, the severity of mitral regurgitation is not increased compared to patients with partial or no PM infarction.

  1. Primary Cardiac Leiomyoma Causing Right Ventricular Obstruction and Tricuspid Regurgitation.

    Careddu, Lucio; Foà, Alberto; Leone, Ornella; Agostini, Valentina; Gargiulo, Gaetano Domenico; Rapezzi, Claudio; Di Bartolomeo, Roberto; Pacini, Davide

    2017-09-01

    We report the unique case of a primary cardiac leiomyoma originating from the right ventricle and involving the tricuspid valve in a 43-year-old woman. Echocardiography showed a giant mass causing severe pulmonary stenosis and tricuspid valve regurgitation. The patient underwent surgical excision and histologic examination revealed a primary cardiac leiomyoma. To the best of our knowledge only three cases of primary cardiac leiomyoma have so far been reported, and this is the first case of primary cardiac leiomyoma involving the tricuspid valve apparatus. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Impact of prosthesis-patient mismatch on the regression of secondary mitral regurgitation after isolated aortic valve replacement with a bioprosthetic valve in patients with severe aortic stenosis.

    Angeloni, Emiliano; Melina, Giovanni; Pibarot, Philippe; Benedetto, Umberto; Refice, Simone; Ciavarella, Giuseppino M; Roscitano, Antonino; Sinatra, Riccardo; Pepper, John R

    2012-01-01

    Secondary mitral regurgitation (SMR) is generally reduced after isolated aortic valve replacement (AVR), but there is important interindividual variability in the magnitude of this reduction. Prosthesis-patient mismatch (PPM) may hinder normalization of left ventricular geometry and pressure overload following AVR, therefore we aimed to investigate the relationship between PPM and regression of SMR following AVR for aortic valve stenosis. A total of 419 patients with AS who underwent isolated AVR at 2 institutions and presenting moderate SMR (mitral regurgitant volume 30 to 45 mL/beat) not considered for surgical correction were included in this study. Clinical and echocardiographic follow-up were completed at a median follow-up time of 37 months. PPM was defined as an indexed effective orifice area ≤0.85 cm(2)/m(2) and was found in 170/419 patients (40.6%). There were no significant differences in baseline and operative characteristics between patients with or without PPM. Patients with PPM had less regression of SMR following AVR compared with those with no PPM (change in mitral regurgitant volume: -11±4 versus -17±5 mL, respectively; Pregression model, which showed indexed effective orifice area (Pregression of SMR following AVR. This unfavorable effect was associated with worse functional capacity. These findings emphasize the importance of operative strategies aiming to prevent PPM in patients with aortic valve stenosis and concomitant SMR.

  3. Marine biogeochemistry of radionuclides

    Fowler, S.W.

    1997-01-01

    Radionuclides entering the ocean from runoff, fallout, or deliberate release rapidly become involved in marine biogeochemical cycles. Sources, sinks and transport of radionuclides and analogue elements are discussed with emphasis placed on how these elements interact with marine organisms. Water, food and sediments are the source terms from which marine biota acquire radionuclides. Uptake from water occurs by surface adsorption, absorption across body surfaces, or a combination of both. Radionuclides ingested with food are either assimilated into tissue or excreted. The relative importance of the food and water pathway in uptake varies with the radionuclide and the conditions under which exposure occurs. Evidence suggests that, compared to the water and food pathways, bioavailability of sediment-bound radionuclides is low. Bioaccumulation processes are controlled by many environmental and intrinsic factors including exposure time, physical-chemical form of the radionuclide, salinity, temperature, competitive effects with other elements, organism size, physiology, life cycle and feeding habits. Once accumulated, radionuclides are transported actively by vertical and horizontal movements of organisms and passively by release of biogenic products, e.g., soluble excreta, feces, molts and eggs. Through feeding activities, particles containing radionuclides are ''packaged'' into larger aggregates which are redistributed upon release. Most radionuclides are not irreversibly bound to such particles but are remineralized as they sink and/or decompose. In the pelagic zones, sinking aggregates can further scavenge particle-reactive elements thus removing them from the surface layers and transporting them to depth. Evidence from both radiotracer experiments and in situ sediment trap studies is presented which illustrates the importance of biological scavenging in controlling the distribution of radionuclides in the water column. (author)

  4. Radionuclide investigations in clinical cardiology - 10 years of cooperation in Frankfurt/FRG

    Klepzig, H. Jr.; Kaltenbach, M.

    1989-01-01

    Radionuclide investigations today are an important tool in cardiology. They close the diagnostic gap in cases where non-invasive procedures of cardiological diagnosis such as ecg, exercise-ecg, echocardiography and chest-x-ray remains unrevealing. Further, they are helpful when an exact quantitation of the disease or a precise follow-up is required. Radionuclide techniques are very useful to detect myocardial ischemia in patients with coronary heart disease and to judge myocardial function in patients with aortic or mitral regurgitation. Follow-up investigations after therapy (aortocoronary bypass, PTCA, valve replacement) permit conclusions regarding the benefit of these measures. Results of radionuclide investigations should consider the Bayes' theorem in order to keep false-negative and false-positive reports as low as possible. (orig.) [de

  5. Moderate exercise does not increase the severity of mitral regurgitation due to mitral valve prolapse

    Pecini, Redi; Dalsgaard, Morten; Møller, Daniel Vega

    2010-01-01

    Mitral regurgitation (MR) secondary to ischemic heart disease (IHD) increases during exercise. We tested the hypothesis that the same is also true for MR due to mitral valve prolapse (MVP).......Mitral regurgitation (MR) secondary to ischemic heart disease (IHD) increases during exercise. We tested the hypothesis that the same is also true for MR due to mitral valve prolapse (MVP)....

  6. Health-related quality of life of pregnant women with heartburn and regurgitation.

    Dall'alba, Valesca; Callegari-Jacques, Sidia Maria; Krahe, Cláudio; Bruch, Juliana Paula; Alves, Bruna Cherubini; Barros, Sérgio Gabriel Silva de

    2015-01-01

    Heartburn and regurgitation frequently occur in the third trimester of pregnancy, but their impact on quality of life has not been thoroughly investigated. To measure health-related quality of life of third-trimester pregnant women with heartburn and regurgitation. Methods Data on obstetric history, heartburn and regurgitation frequency and intensity, history of heartburn and regurgitation and health-related quality of life were collected of 82 third-trimester pregnant women. Sixty-two (76%) women had heartburn, and 58 (71%), regurgitation; 20 were asymptomatic. Mean gestational age was 33.8±3.7 weeks; 35 (43%) women had a family history of heartburn and/or regurgitation, and 57 (70%) were asymptomatic before pregnancy. The following quality of life concepts were significantly reduced: physical problems and social functioning for heartburn; physical problems and emotional functioning for regurgitation. There was agreement between heartburn in present and previous pregnancies. Heartburn and/or regurgitation affected health-related quality of life of third trimester pregnant women.

  7. HEALTH-RELATED QUALITY OF LIFE OF PREGNANT WOMEN WITH HEARTBURN AND REGURGITATION

    Valesca DALL'ALBA

    2015-06-01

    Full Text Available Background Heartburn and regurgitation frequently occur in the third trimester of pregnancy, but their impact on quality of life has not been thoroughly investigated. Objective To measure health-related quality of life of third-trimester pregnant women with heartburn and regurgitation. Methods Data on obstetric history, heartburn and regurgitation frequency and intensity, history of heartburn and regurgitation and health-related quality of life were collected of 82 third-trimester pregnant women. Results Sixty-two (76% women had heartburn, and 58 (71%, regurgitation; 20 were asymptomatic. Mean gestational age was 33.8±3.7 weeks; 35 (43% women had a family history of heartburn and/or regurgitation, and 57 (70% were asymptomatic before pregnancy. The following quality of life concepts were significantly reduced: physical problems and social functioning for heartburn; physical problems and emotional functioning for regurgitation. There was agreement between heartburn in present and previous pregnancies. Conclusion Heartburn and/or regurgitation affected health-related quality of life of third trimester pregnant women

  8. Diagnostic value of Doppler echocardiography for identifying hemodynamic significant pulmonary valve regurgitation in tetralogy of Fallot: comparison with cardiac MRI.

    Beurskens, Niek E G; Gorter, Thomas M; Pieper, Petronella G; Hoendermis, Elke S; Bartelds, Beatrijs; Ebels, Tjark; Berger, Rolf M F; Willems, Tineke P; van Melle, Joost P

    2017-11-01

    Quantification of pulmonary regurgitation (PR) is essential in the management of patients with repaired tetralogy of Fallot (TOF). We sought to evaluate the accuracy of first-line Doppler echocardiography in comparison with cardiac magnetic resonance imaging (MRI) to identify hemodynamic significant PR. Paired cardiac MRI and echocardiographic studies (n = 97) in patients with repaired TOF were retrospectively analyzed. Pressure half time (PHT) and pulmonary regurgitation index (PRi) were measured using continuous wave Doppler. The ratio of the color flow Doppler regurgitation jet width to pulmonary valve (PV) annulus (jet/annulus ratio) and diastolic to systolic time velocity integral (DSTVI; pulsed wave Doppler) were assessed. Accuracy of echocardiographic measurements was tested to identify significant PR as determined by phase-contrast MRI (PR fraction [PRF] ≥ 20%). Mean PRF was 29.4 ± 15.7%. PHT < 100 ms had a sensitivity of 93%, specificity 75%, positive predictive value (PPV) 92% and negative predictive value (NPV) 78% for identifying significant PR (C-statistic 0.82). PRi < 0.77 had sensitivity and specificity of 66% and 54%, respectively (C-statistic 0.63). Jet/annulus ratio ≥1/3 had sensitivity 96%, specificity 75%, PPV 92% and NPV 82% (C-statistic 0.87). DSTVI had sensitivity 84%, specificity 33%, PPV 84% and NPV 40%, (C-statistic 0.56). Combined jet/annulus ratio ≥1/3 and PHT < 100 ms was highly accurate in identifying PRF ≥ 20%, with sensitivity 97% and specificity 100%. PHT and jet/annulus ratio on Doppler echocardiography, especially when combined, are highly accurate in identifying significant PR and therefore seem useful in the follow-up of patients with repaired TOF.

  9. Radionuclides in terrestrial ecosystems

    Bocock, K.L.

    1981-01-01

    This report summarizes information on the distribution and movement of radionuclides in semi-natural terrestrial ecosystems in north-west England with particular emphasis on inputs to, and outputs from ecosystems; on plant and soil aspects; and on radionuclides in fallout and in discharges by the nuclear industry. (author)

  10. Evaluation of valvular regurgitation by cine magnetic resonance imaging in patients with various cardiac diseases

    Kubota, Shuuhei; Nishimura, Tsunehiko

    1990-01-01

    In order to evaluate the clinical value and limitation of magnetic resonance imaging (MRI) for detection and quantification of valvular regurgitation, 98 patients with various cardiac diseases were studied by cine MRI and the results were compared with contrast angiography and doppler color-flow imaging. Cine MRI was carried out using FLASH (fast low angle shot) which employs TE of 10∼20 msec and TR of 30∼40 msec. 22 transverse tomograms per cardiac cycle with a slice thickness of 10 mm were obtained at the level of atrium and ventricle. The jet of valvular regurgitation was easily seen as a discrete are of low signal with cine MRI. Identification of the regurgitation and its severity were visually evaluated based on the relative size of the regurgitant jet from the incompetent valve orifice. Using contrast angiography as a gold standard, the sensitivity of cine MRI for detecting mitral regurgitation was 83% and was 94% for aortic regurgitation, with the specificity of 82% and 100%, respectively. For mitral requrgitation and aortic regurgitation, evaluation by cine MRI and severity agreed well with contrast angiography. By the comparative study with doppler color-flow imaging, relatively good agreement was found between the two methods in detection and quantitative evaluation of valvular regurgitation in any of four valves. Cine MRI was suggested to be useful for both the detection and semiquantification of valvular regurgitation in generally, but its clinical limitation at this point was also found because, 1)its images are not acquired in real times, as in contrast angiography or doppler color-flow imaging, but are compiled from the cumulative information from 128 heart beats, 2)the evaluation of regurgitation is made from only two-dimensional transverse tomograms. (author)

  11. Effects of Mitral Annulus Remodeling Following MitraClip Procedure on Reduction of Functional Mitral Regurgitation.

    Hidalgo, Francisco; Mesa, Dolores; Ruiz, Martín; Delgado, Mónica; Rodríguez, Sara; Pardo, Laura; Pan, Manuel; López, Amador; Romero, Miguel A; Suárez de Lezo, José

    2016-11-01

    The percutaneous mitral valve repair procedure (MitraClip) appears to reduce mitral annulus diameter in patients with functional mitral regurgitation, but the relationship between this and regurgitation severity has not been demonstrated. The aim of this study was to determine the effect of mitral annulus remodeling on the reduction of mitral regurgitation in patients with functional etiology. The study included all patients with functional mitral regurgitation treated with MitraClip at our hospital until January 2015. Echocardiogram (iE33 model, Philips) was performed in all patients immediately after device positioning. Changes in the mitral annulus correlated with mitral regurgitation severity, as assessed using the effective regurgitant orifice area. The study included 23 patients (age, 65±14 years; 74% men; left ventricular ejection fraction, 31%±13%; systolic pulmonary artery pressure, 47±10 mmHg). After the procedure, the regurgitant orifice area decreased by 0.30 cm 2 ±0.04 cm 2 (P<.0005), from a baseline of 0.49 cm 2 ±0.09 cm 2 . Anteroposterior diameter decreased by 3.14 mm±1.01 mm (P<.0005) from a baseline of 28.27 mm±4.9 mm, with no changes in the intercommissural diameter (0.50 mm±0.91 mm vs 40.68 mm±4.7 mm; P=.26). A significant association was seen between anteroposterior diameter reduction and regurgitant orifice area reduction (r=.49; P=.020). In patients with functional mitral regurgitation, the MitraClip device produces an immediate reduction in the anteroposterior diameter. This remodeling may be related to the reduction in mitral regurgitation. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  12. Process for encapsulating radionuclides

    Brownell, L.E.; Isaacson, R.E.

    1976-01-01

    Radionuclides are immobilized in virtually an insoluble form by reacting at a temperature of at least 90 0 C as an aqueous alkaline mixture having a solution pH of at least 10, containing a source of silicon, the radionuclide waste, and a metal cation. The molar ratio of silicon to the metal cation is on the order of unity to produce a gel from which complex metalosilicates crystallize to entrap the radionuclides within the resultant condensed crystal lattice. The product is a silicious stone-like material which is virtually insoluble and nonleachable in alkaline or neutral environment. One embodiment provides for the formation of the complex metalo-silicates, such as synthetic pollucite, by gel formation with subsequent calcination to the solid product; another embodiment utilizes a hydrothermal process, either above ground or deep within basalt caverns, at greater than atmospheric pressures and a temperature between 90 and 500 0 C to form complex metalo-silicates, such as strontium aluminosilicate. Another embodiment provides for the formation of complex metalo-silicates, such as synthetic pollucite, by slurrying an alkaline mixture of bentonite or kaolinite with a source of silicon and the radionuclide waste in salt form. In each of the embodiments a mobile system is achieved whereby the metalo-silicate constituents reorient into a condensed crystal lattice forming a cage structure with the condensed metalo-silicate lattice which completely surrounds the radionuclide and traps the radionuclide therein; thus rendering the radionuclide virtually insoluble

  13. Foodstuffs, radionuclides, monitoring

    Denisikov, A.I.

    2000-01-01

    Radionuclide contamination of water and food stuffs as a result of the Chernobyl accident and permissible contents of 90 Sr and 137 Cs are considered in brief. A method of radiation monitoring of food stuffs and water for the radionuclides mentioned is suggested. The method permits employment of the simplest and cheapest radiometric equipment for analysis, whole the high degree of radionuclide concentration using fiber sorbents permits using the instrumentation without expensive shields against external radiation. A description of ion-exchange unit for radiation monitoring of liquid samples of food stuffs or water, is provided [ru

  14. Generator for radionuclide

    Weisner, P.S.; Forrest, T.R.F.

    1985-01-01

    This invention provides a radionuclide generator of the kind in which a parent radionuclide, adsorbed on a column of particulate material, generates a daughter radionuclide which is periodically removed from the column. This invention is particularly concerned with technetium generators using single collection vials. The generator comprises a column, a first reservoir for the eluent, a second reservoir to contain the volume of eluent required for a single elution, and means connecting the first reservoir to the second reservoir and the second reservoir to the column. Such a generator is particularly suitable for operation by vacuum elution

  15. About estimation of the contamination of territorial-administrative regions of the Chernobyl genesis radionuclides

    Berezhnoj, A.V.

    2005-01-01

    It is recommended to realize the matching territorial-administrative regions on degree of the contamination their of the Chernobyl genesis radionuclides to size generalised index gravity of the radionuclide soiling region. The methodology of the calculation indexes is offered. The results executed estimation are briefly stated. (authors)

  16. Improvement of tricuspid regurgitation after transcatheter ASD closure in older patients.

    Chen, L; Shen, J; Shan, X; Wang, F; Kan, T; Tang, X; Zhao, X; Qin, Y

    2017-07-19

    Adult patients with undiagnosed atrial septal defect (ASD) may have right heart cavity enlargement and functional tricuspid valve insufficiency. Moderate or more severe tricuspid regurgitation has been associated with a worse prognosis, and more serious complications are typically seen in older patients. This study aimed to evaluate the improvement in functional tricuspid regurgitation and heart geometry after transcatheter ASD closure in older patients. The data of 111 patients over 60 years of age with moderate or severe tricuspid regurgitation before ASD closure were analyzed. At the 1‑month and 6‑month follow-up after closure, both tricuspid regurgitation jet area and right atrial volume decreased significantly. Right ventricular volume decreased 1 month after closure, showing a further decrease at the end of the 6‑month follow-up. However, 24 patients (21.6%) still had persistent severe tricuspid regurgitation after the procedure. Multivariate analysis revealed that patient age at ASD closure and pulmonary artery systolic pressure determined by echocardiography before closure were predictors of persistent tricuspid regurgitation after closure. Transcatheter ASD closure in older patients could significantly decrease tricuspid regurgitation and improve right heart geometry.

  17. Surgical indication for functional tricuspid regurgitation at initial operation: judging from long term outcomes.

    Pozzoli, Alberto; Lapenna, Elisabetta; Vicentini, Luca; Alfieri, Ottavio; De Bonis, Michele

    2016-09-01

    The assessment and management of tricuspid valve disease have evolved substantially during the past several years. Whereas tricuspid stenosis is uncommon, tricuspid regurgitation is frequently encountered and it is most often secondary due to annular dilatation and leaflet tethering from right ventricular remodelling. The indications for tricuspid valve surgery to treat tricuspid regurgitation are several and mainly related to the underlying disease, to the severity of insufficiency and to the right ventricular function. Surgical tricuspid repair has been avoided for years, because of the misleading concept that tricuspid regurgitation should disappear once the primary left-sided problem has been eliminated. Instead, during the last decade, many investigators have reported evidence in favor of a more aggressive surgical approach to functional tricuspid regurgitation, recognising the risk of progressive tricuspid insufficiency in patients with moderate or lesser degrees of tricuspid regurgitation and tricuspid annular dilatation. This concept, along with the long-term outcomes of principal surgical repair techniques are reported and discussed. Last, novel transcatheter therapies have begun to emerge for the treatment of severe tricuspid regurgitation in high-risk patients. Hence, very preliminary pre-clinical and clinical experiences are illustrated. The scope of this review is to explore the anatomic basis, the pathophysiology, the outcomes and the new insights in the management of functional tricuspid regurgitation.

  18. Myocardial ischemia in severe aortic regurgitation despite angiographically normal coronary arteries

    Aksoy, S.; Cam, N.; Guney, M.R.; Gurkan, U.; Oz, D.; Poyraz, E.; Eksik, A.; Agirbasli, M.

    2012-01-01

    Patients with severe aortic regurgitation frequently present with angina pectoris. The exact pathophysiology for angina in aortic regurgitation is not clear. Left ventricular hypertrophy and myocardial blood supply-demand mismatch have been the suggested mechanisms to explain ischemia. However, no conclusive clinical study exists to define the incidence of ischemia in patients with severe aortic regurgitation and normal coronary arteries. We, therefore, investigated the frequency of myocardial ischemia in relation to left ventricular hypertrophy or dilatation in patients with severe aortic regurgitation and normal coronary arteries. We reviewed the medical records of all patients (n=311) with aortic valve replacement due to aortic regurgitation between 2007 and 2010. We selected subjects with normal coronary arteries (n=182) for the study purpose, and we identified 35 patients who underwent myocardial perfusion scintigraphy prior to the coronary angiography (19 female and 16 male subjects; age 45.0±8.9 years). Left ventricular hypertrophy and dilatation were detected in 9 (26%) and 5 (14%) patients, respectively. Myocardial perfusion scintigraphy showed evidence of ischemia in 10 (29%) patients with normal coronary arteries. The presence of ischemia did not relate to the presence of left ventricular hypertrophy and/or dilatation. As a potential mechanism, aortic regurgitation causes backflow of blood from the aorta into the left ventricle, hence disturbs coronary flow dynamics. In conclusion, myocardial ischemia is common (nearly one-third) among patients with severe aortic regurgitation even in the absence of coronary obstruction, left ventricular hypertrophy and/or dilatation. (author)

  19. Transcatheter mitral valve repair in osteogenesis imperfecta associated mitral valve regurgitation.

    van der Kley, Frank; Delgado, Victoria; Ajmone Marsan, Nina; Schalij, Martin J

    2014-08-01

    Osteogenesis imperfecta is associated with increased prevalence of significant mitral valve regurgitation. Surgical mitral valve repair and replacement are feasible but are associated with increased risk of bleeding and dehiscence of implanted valves may occur more frequently. The present case report describes the outcomes of transcatheter mitral valve repair in a patient with osteogenesis imperfecta. A 60 year-old patient with osteogenesis imperfecta and associated symptomatic moderate to severe mitral regurgitation underwent transthoracic echocardiography which showed a nondilated left ventricle with preserved systolic function and moderate to severe mitral regurgitation. On transoesophageal echocardiography the regurgitant jet originated between the anterolateral scallops of the anterior and posterior leaflets (A1-P1). Considering the comorbidities associated with osteogenesis imperfecta the patient was accepted for transcatheter mitral valve repair using the Mitraclip device (Abbott vascular, Menlo, CA). Under fluoroscopy and 3D transoesophageal echocardiography guidance, a Mitraclip device was implanted between the anterolateral and central scallops with significant reduction of mitral regurgitation. The postoperative evolution was uneventful. At one month follow-up, transthoracic echocardiography showed a stable position of the Mitraclip device with no mitral regurgitation. Transcatheter mitral valve repair is feasible and safe in patients with osteogenesis imperfecta and associated symptomatic significant mitral regurgitation. Copyright © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  20. Radionuclides in analytical chemistry

    Tousset, J.

    1984-01-01

    Applications of radionuclides in analytical chemistry are reviewed in this article: tracers, radioactive sources and activation analysis. Examples are given in all these fields and it is concluded that these methods should be used more widely [fr

  1. Radionuclide Basics: Iodine

    ... Centers Radiation Protection Contact Us Share Radionuclide Basics: Iodine Iodine (chemical symbol I) is a chemical element. ... in the environment Iodine sources Iodine and health Iodine in the Environment All 37 isotopes of iodine ...

  2. Mitral valve plasty for mitral regurgitation after blunt chest trauma.

    Kumagai, H; Hamanaka, Y; Hirai, S; Mitsui, N; Kobayashi, T

    2001-06-01

    A 21 year-old woman was admitted to our hospital because of chest and back pain after blunt chest trauma. On admission, consciousness was clear and a physical examination showed labored breathing. Her vital signs were stable, but her breathing gradually worsened, and artificial respiration was started. The chest roentgenogram and a subsequent chest computed tomographic scans revealed contusions, hemothorax of the left lung and multiple rib fractures. A transthoracic echocardiography (TTE) revealed normal left ventricular wall motion and mild mitral regurgitation (MR). TTE was carried out repeatedly, and revealed gradually progressive MR and prolapse of the posterior medial leaflet, although there was no congestive heart failure. After her general condition had recovered, surgery was performed. Intraoperative transesophageal echocardiography (TEE) revealed torn chordae at the posterior medial leaflet. The leaflet where the chorda was torn was cut and plicated, and posterior mitral annuloplasty was performed using a prosthetic ring. One month later following discharge, the MR had disappeared on TTE.

  3. The hemodynamic basis of exercise intolerance in tricuspid regurgitation

    Andersen, Mads Jønsson; Nishimura, Rick a; Borlaug, Barry A

    2014-01-01

    ≥3 TR underwent high-fidelity invasive hemodynamic exercise testing with simultaneous expired gas analysis and were compared with 13 age- and sex-matched controls. At rest, TR subjects had lower pulmonary blood flow (3.6±0.4 versus 5.1±1.9 L/min; P=0.01), increased right atrial pressure (12±5 versus.......001). TR subjects displayed higher pulmonary capillary wedge pressure with exercise, but this was solely because of RA hypertension (27±9 versus 8±3 mm Hg; P......BACKGROUND:Patients with severe tricuspid regurgitation (TR) frequently present with exertional fatigue and dyspnea, but the hemodynamic basis for exercise limitation in people with TR remains unclear. METHODS AND RESULTS:Twelve subjects with normal left ventricular (LV) ejection fraction and grade...

  4. Contemporary management of tricuspid regurgitation: an updated clinical review.

    Taylor, Joshua T; Chidsey, Geoffrey; Disalvo, Thomas G; Byrne, John G; Maltais, Simon

    2013-01-01

    Tricuspid regurgitation (TR) is a complex and insidious valvular pathology that represents a complex decision and management algorithm for patients. TR is present in a significant proportion of the population and is especially prevalent in patients with advanced heart failure. Patients with TR have been demonstrated to have a decreased survival even with normal left heart function. TR can be a result of pathology that directly affects the valvular structure (i.e., Ebstein anomaly) or as a result of increased forward pressures (ie, pulmonary hypertension, left heart failure). Conservative management of patients with TR is primarily symptomatic relief. Definitive therapy involves surgical repair of the tricuspid valve. Furthermore, as more patients develop advanced heart failure, the management of TR in patients with left ventricular assist devices has become necessary because of the evidence of increased in-hospital morbidity and a trend toward decreased survival.

  5. Acute Severe Aortic Regurgitation: Imaging with Pathological Correlation.

    Janardhanan, Rajesh; Pasha, Ahmed Khurshid

    2016-03-01

    Acute aortic regurgitation (AR) is an important finding associated with a wide variety of disease processes. Its timely diagnosis is of utmost importance. Delay in diagnosis could prove fatal. We describe a case of acute severe AR that was timely diagnosed using real time three-dimensional (3D) transesophageal echocardiogram (3D TEE). Not only did it diagnose but also the images obtained by 3D TEE clearly matched with the pathologic specimen. Using this sophisticated imaging modality that is mostly available at the tertiary centers helped in the timely diagnosis, which lead to the optimal management saving his life. Echocardiography and especially 3D TEE can diagnose AR very accurately. Surgical intervention is the definitive treatment but medical therapy is utilized to stabilize the patient initially.

  6. Abscess detection with radionuclides

    Alavi, J.B.

    1988-01-01

    Radionuclide studies may aid in the diagnosis and localization of intra-abdominal infections. Despite the introduction of new radiographic and ultrasound methods, there are several clinical situations in which radionuclide scans have proved useful. Those include detection of postoperative intra-abdominal abscess, evaluation of liver abscess, differentiation between pancreatic pseudocyst or abscess, evaluation of fever of unknown origin, and evaluation of inflammatory bowel disease. Each clinical situation is discussed separately here

  7. Predisposing factors to development of mitral regurgitation and valve area

    Kazemi Khaledi A

    1999-07-01

    Full Text Available Background: Percutaneous Transeptal Mitral Commisurotomy (PTMC has been used in treating mitral stenosis with variable success, its main complication being mitral incompetence. There is a need to define the subgroup of the patients who benefit mostly from the procedure. Methods: We studied 110 patients (age 17 to 60 years; mean 33.2 with mitral stenosis. PTMC was performed though femoral vein. All patients underwent echocardiographic evaluation, both before and after the procedure. Clinical, hemodynamic and echocardiographic data were gathered and used to predict the outcome. Results: PTMC was successful in all 110 patients in alleviating the stenosis (mean transmitral gradient before procedure was 17.1 mmHg; after procedure 4.4 mmHg. There was no mortality or major complication other than occurrence of mitral regurgitation in 9 cases. In this group only one patient subsequently needed a mitral valve replacement operation. The following parameters were found to have a significant correlation with the success rate of PTMC: lower age, shorter duration of illness, functional class III and IV, larger EF slope, smaller EPSS, smaller amplitude of valve motion, limitation of the posterior leaflet motion and negative history for open commisurotomy. The incidence of mitral regurgitation after procedure was found to be correlated with: atrial fibrillation rhythm before PTMC, lower age, longer duration of illness, more frequent relapse of rheumatic fever, functional class III and IV, less EF slope, limitation of the valve motion, larger left atrium, calcification of posterior leaflet and subvalvular extension. Conclusions: Balloon Mitral Valvuloplasty is an effective and relatively safe procedure in the management of the mitral stenosis. With the proper selection of the patients with the favorable outcome parameters, the rate of complication can be reduced.

  8. Permanent Pacemaker Lead Induced Severe Tricuspid Regurgitation in Patient Undergoing Multiple Valve Surgery

    Jung Hee Lee

    2015-04-01

    Full Text Available Severe and permanent tricuspid regurgitation induced by pacemaker leads is rarely reported in the literature. The mechanism of pacemaker-induced tricuspid regurgitation has been identified, but its management has not been well established. Furthermore, debate still exists regarding the proper surgical approach. We present the case of a patient with severe tricuspid regurgitation induced by a pacemaker lead, accompanied by triple valve disease. The patient underwent double valve replacement and tricuspid valve repair without removal of the pre-existing pacemaker lead. The operation was successful and the surgical procedure is discussed in detail.

  9. Permanent pacemaker lead induced severe tricuspid regurgitation in patient undergoing multiple valve surgery.

    Lee, Jung Hee; Kim, Tae Ho; Kim, Wook Sung

    2015-04-01

    Severe and permanent tricuspid regurgitation induced by pacemaker leads is rarely reported in the literature. The mechanism of pacemaker-induced tricuspid regurgitation has been identified, but its management has not been well established. Furthermore, debate still exists regarding the proper surgical approach. We present the case of a patient with severe tricuspid regurgitation induced by a pacemaker lead, accompanied by triple valve disease. The patient underwent double valve replacement and tricuspid valve repair without removal of the pre-existing pacemaker lead. The operation was successful and the surgical procedure is discussed in detail.

  10. Left atrial myxoma, ruptured chordae tendinae causing mitral regurgitation and coronary artery disease

    Bhupesh Kumar

    2014-01-01

    Full Text Available Mitral regurgitation is uncommon with left atrial myxoma. The echocardiographic assessment of presence of mitral regurgitation and its severity are impaired by the presence of left atrial myxoma. We describe an uncommon association of left atrial myxoma with coronary artery disease and mitral regurgitation. MR was reported as mild on pre-operative transthoracic echocardiography but found to be severe due to ruptured chordae tendinae during intra-operative transesophageal echocardiography, which lead to change in the surgical plan to mitral valve replacement in addition to excision of myxoma.

  11. Preoperative left ventricular ejection fraction and left atrium reverse remodeling after mitral regurgitation surgery.

    Machado, Lucia R; Meneghelo, Zilda M; Le Bihan, David C S; Barretto, Rodrigo B M; Carvalho, Antonio C; Moises, Valdir A

    2014-11-06

    Left atrium enlargement has been associated with cardiac events in patients with mitral regurgitation (MR). Left atrium reverse remodeling (LARR) occur after surgical correction of MR, but the preoperative predictors of this phenomenon are not well known. It is therefore important to identify preoperative predictors for postoperative LARR. We enrolled 62 patients with chronic severe MR (prolapse or flail leaflet) who underwent successful mitral valve surgery (repair or replacement); all with pre- and postoperative echocardiography. LARR was defined as a reduction in left atrium volume index (LAVI) of ≥ 25%. Stepwise multiple regression analysis was used to identify independent predictors of LARR. LARR occurred in 46 patients (74.2%), with the mean LAVI decreasing from 85.5 mL/m2 to 49.7 mL/m2 (p <0.001). These patients had a smaller preoperative left ventricular systolic volume (p =0.022) and a higher left ventricular ejection fraction (LVEF) (p =0.034). LVEF was identified as the only preoperative variable significantly associated with LARR (odds ratio, 1.086; 95% confidence interval, 1.002-1.178). A LVEF cutoff value of 63.5% identified patients with LARR of ≥ 25% with a sensitivity of 71.7% and a specificity of 56.3%. LARR occurs frequently after mitral valve surgery and is associated with preoperative LVEF higher than 63.5%.

  12. Correlation between local hemodynamics and lesion distribution in a novel aortic regurgitation murine model of atherosclerosis.

    Hoi, Yiemeng; Zhou, Yu-Qing; Zhang, Xiaoli; Henkelman, R Mark; Steinman, David A

    2011-05-01

    Following surgical induction of aortic valve regurgitation (AR), extensive atherosclerotic plaque development along the descending thoracic and abdominal aorta of Ldlr⁻/⁻ mice has been reported, with distinct spatial distributions suggestive of a strong local hemodynamic influence. The objective of this study was to test, using image-based computational fluid dynamics (CFD), whether this is indeed the case. The lumen geometry was reconstructed from micro-CT scanning of a control Ldlr⁻/⁻ mouse, and CFD simulations were carried out for both AR and control flow conditions derived from Doppler ultrasound measurements and literature data. Maps of time-averaged wall shear stress magnitude (TAWSS), oscillatory shear index (OSI) and relative residence time (RRT) were compared against the spatial distributions of plaque stained with oil red O, previously acquired in a group of AR and control mice. Maps of OSI and RRT were found to be consistent with plaque distributions in the AR mice and the absence of plaque in the control mice. TAWSS was uniformly lower under control vs. AR flow conditions, suggesting that levels (> 100 dyn/cm²) exceeded those required to alone induce a pro-atherogenic response. Simulations of a straightened CFD model confirmed the importance of anatomical curvature for explaining the spatial distribution of lesions in the AR mice. In summary, oscillatory and retrograde flow induced in the AR mice, without concomitant low shear, may exacerbate or accelerate lesion formation, but the distinct anatomical curvature of the mouse aorta is responsible for the spatial distribution of lesions.

  13. Mitral valve repair for ischemic moderate mitral regurgitation in patients undergoing coronary artery bypass grafting

    Toktas, Faruk; Yavuz, Senol; Ozsin, Kadir K.; Sanri, Umut S.

    2016-01-01

    Objectives: To investigate whether mitral valve repair (MVR) at the time of coronary artery bypass grafting (CABG) in patients with ischemic moderate mitral regurgitation (MR) and coronary artery disease could improve short- and mid-term postoperative outcomes. Methods: Between March 2013 and December 2015, 90 patients with moderate ischemic MR underwent first-time CABG in Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey. Out of 90 patients, 44 (48.9%) underwent combined CABG+MVR. The remaining 46 (51.1%) underwent CABG alone. Ventricular functions and effort capacities of patients in both groups were evaluated echocardiographically and clinically in the preoperative period, and in the first postoperative year. Results: Postoperative regurgitant volume changes according to preoperative values were -24.76±19 ml/beat in the combined CABG+MVR group, and -8.70±7.2 ml/beat in the CABG alone group (p=0.001). The change of vena contracta width was -3.40±0.2 mm in the combined CABG+MVR group whereas in the CABG alone -1.45±0.7 mm (p=0.019). The changes of left ventricular end-systolic volume index were -30.77±25.9 ml/m2 in the combined CABG+MVR group and -15.6±9.4 ml/m2 in the CABG alone group (p=0.096). Ejection fraction changes in the combined CABG+MVR group was +1.51±5.3% and in the CABG alone group was +1.15±4.3%. No statistically significant difference was found between both groups (p=0.604). Preoperative New York Heart Association class values in the combined CABG+MVR group was 2.18±0.45, and in the CABG alone group was 2.13±0.54. Conclusions: Moderate MR in patients undergoing CABG affects the outcome adversely and it does not reliably improve after CABG alone. Therefore, patients with ischemic moderate MR should undergo simultaneous MVR at the time of CABG. PMID:27464861

  14. Radionuclide fixation mechanisms in rocks

    Nakashima, S.

    1991-01-01

    In the safety evaluation of the radioactive waste disposal in geological environment, the mass balance equation for radionuclide migration is given. The sorption of radionuclides by geological formations is conventionally represented by the retardation of the radionuclides as compared with water movement. In order to quantify the sorption of radionuclides by rocks and sediments, the distribution ratio is used. In order to study quantitatively the long term behavior of waste radionuclides in geological environment, besides the distribution ratio concept in short term, slower radionuclide retention reaction involving mineral transformation should be considered. The development of microspectroscopic method for long term reaction path modeling, the behavior of iron during granite and water interaction, the reduction precipitation of radionuclides, radionuclide migration pathways, and the representative scheme of radionuclide migration and fixation in rocks are discussed. (K.I.)

  15. Diverticulum of the mitral valve, a rare cause of mitral regurgitation.

    Soo, Alan

    2010-12-01

    Non-infective mitral valve diverticulum is extremely rare. We present a case of intraoperatively diagnosed mitral valve diverticulum of a 69-year-old man presenting with mitral regurgitation who was successfully treated with mitral valve replacement.

  16. Preoperative Three-Dimensional Valve Analysis Predicts Recurrent Ischemic Mitral Regurgitation After Mitral Annuloplasty

    Bouma, Wobbe; Lai, Eric K.; Levack, Melissa M.; Shang, Eric K.; Pouch, Alison M.; Eperjesi, Thomas J.; Plappert, Theodore J.; Yushkevich, Paul A.; Mariani, Massimo A.; Khabbaz, Kamal R.; Gleason, Thomas G.; Mahmood, Feroze; Acker, Michael A.; Woo, Y. Joseph; Cheung, Albert T.; Jackson, Benjamin M.; Gorman, Joseph H.; Gorman, Robert C.

    Background. Valve repair for ischemic mitral regurgitation (IMR) with undersized annuloplasty rings is characterized by high IMR recurrence rates. Patient-specific preoperative imaging-based risk stratification for recurrent IMR would optimize results. We sought to determine if prerepair

  17. Transaortic Alfieri Edge-to-Edge Repair for Functional Mitral Regurgitation.

    Imasaka, Ken-Ichi; Tayama, Eiki; Morita, Shigeki; Toriya, Ryohei; Tomita, Yukihiro

    2018-03-01

    There is controversy about handling functional mitral regurgitation in patients undergoing aortic valve or proximal aortic operations. We describe a transaortic Alfieri edge-to-edge repair for functional mitral regurgitation that reduces operative excessive invasion and prolonged cardiopulmonary bypass time. Between May 2013 and December 2016, 10 patients underwent transaortic Alfieri edge-to-edge mitral repair. There were no operative deaths. The severity of mitral regurgitation immediately after the operation by transesophageal echocardiography was none or trivial in all patients. A transaortic Alfieri edge-to-edge repair for functional mitral regurgitation is a simple and safe approach. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  18. Mitral valve replacement in a 12 year old boy with Marfan syndrome and severe mitral regurgitation

    Md. Alauddin

    2017-02-01

    Full Text Available A 12 year old boy with Marfan syndrome associated with severe mitral regurgitation underwent successful mitral valve replacement. Careful evaluation of the cardiovascular system and specific surgical intervention help long-term survival of  patients.

  19. User's guide to the radionuclide inventory and hazard code INVENT

    Nancarrow, D.J.; Thorne, M.C.

    1986-05-01

    This report constitutes the user's guide to the radionuclide inventory and hazard index code INVENT and provides an explanation of the mathematical basis of the code, the database used and operation of the code. INVENT was designed to facilitate the post-closure radiological assessment of land-based repositories for low and intermediate-level wastes. For those radionuclides identified to be of potential significance, it allows the calculation of time-dependent radionuclide activities, hazard indices for both inhalation and ingestion of activity, and photon spectra. (author)

  20. Radioactivity: radionuclides in foods

    Simpson, R.E.; Baratta, E.J.; Jelinek, C.F.

    1977-01-01

    The results are summarized of the analysis for strontium-90, cesium-137, iodine-131, ruthenium-106, and potassium-40, a naturally occurring radionuclide, in samples of total diet and selected import commodities in the foods compliance program of the Food and Drug Administration. On the basis of the radionuclide intake guidelines established by the Federal Radiation Council (FRC), the low content of radionuclides found in the total diet samples for fiscal years 1973 and 1974 demonstrates the need for surveillance only at the present level. The low levels of radionuclides found in a limited number of edible imported commodities indicate that their contribution to the total diet would not increase the levels of these radionuclides above those recommended for only periodic surveillance by the FRC. The potassium levels, determined from potassium-40 activity, found in meats and fish agree with the value for normal muscle tissue for the reference man reported by the International Commission on Radiation Protection. Of the other commodities, nuts contained the highest levels, while sugar, beverages, and processed foods contained the lowest levels of potassium. Although cesium and potassium are chemical analogs with similar metabolic properties, because of their variable content in some leafy samples as a result of surface contamination, a correlation between cesium-137 levels and the cesium-137-to-potassium ratio was inconclusive

  1. The effects of breath-holding on pulmonary regurgitation measured by cardiovascular magnetic resonance velocity mapping

    Babu-Narayan Sonya V

    2009-01-01

    Full Text Available Abstract Background Pulmonary regurgitation is a common and clinically important residual lesion after repair of tetralogy of Fallot. Cardiovascular magnetic resonance (CMR phase contrast velocity mapping is widely used for measurement of pulmonary regurgitant fraction. Breath-hold acquisitions, usually acquired during held expiration, are more convenient than the non-breath-hold approach, but we hypothesized that breath-holding might affect the amount of pulmonary regurgitation. Methods Forty-three adult patients with a previous repair of tetralogy of Fallot and residual pulmonary regurgitation were investigated with CMR. In each, pulmonary regurgitant fraction was measured from velocity maps transecting the pulmonary trunk, acquired during held expiration, held inspiration, by non-breath-hold acquisition, and also from the difference of right and left ventricular stroke volume measurements. Results Pulmonary regurgitant fraction was lower when measured by velocity mapping in held expiration compared with held inspiration, non-breath-hold or stroke volume difference (30.8 vs. 37.0, 35.6, 35.4%, p = 0.00017, 0.0035, 0.026. The regurgitant volume was lower in held expiration than in held inspiration (41.9 vs. 48.3, p = 0.0018. Pulmonary forward flow volume was larger during held expiration than during non-breath-hold (132 vs. 124 ml, p = 0.0024. Conclusion Pulmonary regurgitant fraction was significantly lower in held expiration compared with held inspiration, free breathing and stroke volume difference. Altered airway pressure could be a contributory factor. This information is relevant if breath-hold acquisition is to be substituted for non-breath-hold in the investigation of patients with a view to re-intervention.

  2. Doppler-echocardiographic assessment of valvular regurgitation in healthy young subjects

    Filcheva, K.; Gochev, D.; Petrovski, P.; Kotsev, P.

    1995-01-01

    The study covers 300 clinically healthy, randomly selected young subjects, aged 17 to 21 years. The incidence and characteristic features of the valvular regurgitations are assayed by means of pulsed and continuous transthoracic Doppler echocardiography. Valvular insufficiency is registered in total of 198 cases (66%). Regurgitation of single valve is observed in 122 cases (61%), regurgitation of two valves - in 70 (36%) and three valves - in six (3%). Right-sided regurgitations (tricuspid, pulmonic and a combination of both) are detected in 156 subjects, and left-sided (mitral and/or aortic) in twenty-six of which only one regurgitation of the aortic valve. There is a definite tendency of the first two to prevail at a ratio 6:1. A constellation of various anatomical and physiological factors are considered as a likely underlying cause. Whenever atrio-ventricular valves are examined (the mitral one in particular), it is necessary that the regurgitation jet involves over 50% of systole in order to avoid hyperdiagnostics and the so-called 'Doppler's disease'. 14 refs., 1 tab., 2 figs. (author)

  3. Lagrangian coherent structures in the left ventricle in the presence of aortic valve regurgitation

    di Labbio, Giuseppe; Vetel, Jerome; Kadem, Lyes

    2017-11-01

    Aortic valve regurgitation is a rather prevalent condition where the aortic valve improperly closes, allowing filling of the left ventricle of the heart to occur partly from backflow through the aortic valve. Although studies of intraventricular flow are rapidly gaining popularity in the fluid dynamics research community, much attention has been given to the left ventricular vortex and its potential for early detection of disease, particularly in the case of dilated cardiomyopathy. Notably, the subsequent flow in the left ventricle in the presence of aortic valve regurgitation ought to be appreciably disturbed and has yet to be described. Aortic valve regurgitation was simulated in vitro in a double-activation left heart duplicator and the ensuing flow was captured using two-dimensional time-resolved particle image velocimetry. Further insight into the regurgitant flow is obtained by computing attracting and repelling Lagrangian coherent structures. An interesting interplay between the two inflowing jets and their shear layer roll-up is observed for various grades of regurgitation. This study highlights flow features which may find use in further assessing regurgitation severity.

  4. Radionuclides in house dust

    Fry, F A; Green, N; Hammond, D J

    1985-01-01

    Discharges of radionuclides from the British Nuclear Fuel plc (BNFL) reprocessing plant at Sellafield in Cumbria have led to elevated concentrations radionuclides in the local environment. The major routes of exposure of the public are kept under review by the appropriate Government departments and monitoring is carried out both by the departments and by BNFL itself. Recently, there has been increasing public concern about general environmental contamination resulting from the discharges and, in particular, about possible exposure of members of the public by routes not previously investigated in detail. One such postulated route of exposure that has attracted the interest of the public, the press and Parliament arises from the presence of radionuclides within houses. In view of this obvious and widespread concern, the Board has undertaken a sampling programme in a few communities in Cumbria to assess the radiological significance of this source of exposure. From the results of our study, we conclude that, alt...

  5. Radionuclides in foods

    1994-01-01

    This report contains data on the levels of radionuclides in the UK foodchain. Most data derive from monitoring programmes that exist around nuclear sites, and in some cases date back to the 1960s. Some comparative data from site operator and government-run programmes are included. Data from monitoring undertaken after the Chernobyl accident are summarised. General monitoring of the foodchain for both artificial and natural radionuclides, and the results of relevant government-sponsored research are also described. The report includes basic information on radioactivity in the environment, radiation protection standards and describes what measures are taken to routinely monitor the foodchain and assess public risk. (Author)

  6. Targeted Radionuclide Therapy

    David Cheng

    2011-10-01

    Full Text Available Targeted radiotherapy is an evolving and promising modality of cancer treatment. The killing of cancer cells is achieved with the use of biological vectors and appropriate radionuclides. Among the many advantages of this approach are its selectiveness in delivering the radiation to the target, relatively less severe and infrequent side effects, and the possibility of assessing the uptake by the tumor prior to the therapy. Several different radiopharmaceuticals are currently being used by various administration routes and targeting mechanisms. This article aims to briefly review the current status of targeted radiotherapy as well as to outline the advantages and disadvantages of radionuclides used for this purpose.

  7. Targeted Radionuclide Therapy

    Ersahin, Devrim, E-mail: devrimersahin@yahoo.com; Doddamane, Indukala; Cheng, David [Department of Diagnostic Radiology, School of Medicine, Yale University, 333 Cedar St., New Haven, CT 06520 (United States)

    2011-10-11

    Targeted radiotherapy is an evolving and promising modality of cancer treatment. The killing of cancer cells is achieved with the use of biological vectors and appropriate radionuclides. Among the many advantages of this approach are its selectiveness in delivering the radiation to the target, relatively less severe and infrequent side effects, and the possibility of assessing the uptake by the tumor prior to the therapy. Several different radiopharmaceuticals are currently being used by various administration routes and targeting mechanisms. This article aims to briefly review the current status of targeted radiotherapy as well as to outline the advantages and disadvantages of radionuclides used for this purpose.

  8. Radionuclide deposition control

    1980-01-01

    A method is described for controlling the deposition, on to the surfaces of reactor components, of the radionuclides manganese-54, cobalt-58 and cobalt-60 from a liquid stream containing the radionuclides. The method consists of disposing a getter material (nickel) in the liquid stream, and a non-getter material (tantalum, tungsten or molybdenum) as a coating on the surfaces where deposition is not desired. The process is described with special reference to its use in the coolant circuit in sodium cooled fast breeder reactors. (U.K.)

  9. Radionuclide examination in rheumatology

    Streda, A.; Kolar, J.; Valesova, M.

    1984-01-01

    On the basis of twenty years of experience with the use of radionuclides in bone and articular rheumatic diseases indications for such examinations are summed up. The main advantage of the use of radionuclide methods is that they bring forward early diagnosis of tissue reconstruction which can thus be detected at the stage of microstructural changes. They also provide earlier and more reliable detection of the degree of the pathological process than is provided by X-ray examination. In some cases scintiscan may also be found useful as a method for following up the results of treatment of rheumatic diseases. (author)

  10. Targeted Radionuclide Therapy

    Ersahin, Devrim; Doddamane, Indukala; Cheng, David

    2011-01-01

    Targeted radiotherapy is an evolving and promising modality of cancer treatment. The killing of cancer cells is achieved with the use of biological vectors and appropriate radionuclides. Among the many advantages of this approach are its selectiveness in delivering the radiation to the target, relatively less severe and infrequent side effects, and the possibility of assessing the uptake by the tumor prior to the therapy. Several different radiopharmaceuticals are currently being used by various administration routes and targeting mechanisms. This article aims to briefly review the current status of targeted radiotherapy as well as to outline the advantages and disadvantages of radionuclides used for this purpose

  11. Rest and exercise radionuclide ventriculography in the ambulatory monitoring of patients with valvular heart disease

    Raichlen, J.S.; Brest, A.N.

    1988-01-01

    Radionuclide angiography serves as a valuable adjunct in the noninvasive evaluation and monitoring of patients with valvular heart disease. Although estimations of regurgitant fractions and the differences between left and right ventricular stroke volumes can be made, the limitations of the techniques do not enable adequate quantitation of the severity of valvular insufficiency to warrant routine use in ambulatory management. The importance of radionuclide ventriculography, however, lies in its ability to examine global ventricular function both at rest and with exercise, thus enabling assessment of the functional reserve of the left and right ventricles. Such data are of considerable value in determining the need for invasive evaluation and the timing of valve replacement in patients with valvular heart disease. 41 references.

  12. Rest and exercise radionuclide ventriculography in the ambulatory monitoring of patients with valvular heart disease

    Raichlen, J.S.; Brest, A.N.

    1988-01-01

    Radionuclide angiography serves as a valuable adjunct in the noninvasive evaluation and monitoring of patients with valvular heart disease. Although estimations of regurgitant fractions and the differences between left and right ventricular stroke volumes can be made, the limitations of the techniques do not enable adequate quantitation of the severity of valvular insufficiency to warrant routine use in ambulatory management. The importance of radionuclide ventriculography, however, lies in its ability to examine global ventricular function both at rest and with exercise, thus enabling assessment of the functional reserve of the left and right ventricles. Such data are of considerable value in determining the need for invasive evaluation and the timing of valve replacement in patients with valvular heart disease. 41 references

  13. Taking radionuclides to heart

    Kleynhans, P.H.T.; Lotter, M.G.; Van Aswegen, A.; Minnaar, P.C.; Iturralde, M.; Herbst, C.P.; Marx, D.

    1980-01-01

    Ischaemic heart disease is a main cause of death in South Africa. Non-invasive ECG gated radionuclide bloodpool imaging plays an increasingly useful role in the evalution of the function of the heart as a pump, and the extent of heart muscle perfusion defects is further pinpointed by invasive krypton-81m studies to improve patient management

  14. Radionuclides deposition over Antarctica

    Pourchet, M.; Magand, O.; Frezzotti, M.; Ekaykin, A.; Winther, J.-G.

    2003-01-01

    A detailed and comprehensive map of the distribution patterns for both natural and artificial radionuclides over Antarctica has been established. This work integrates the results of several decades of international programs focusing on the analysis of natural and artificial radionuclides in snow and ice cores from this polar region. The mean value (37±20 Bq m -2 ) of 241 Pu total deposition over 28 stations is determined from the gamma emissions of its daughter 241 Am, presenting a long half-life (432.7 yrs). Detailed profiles and distributions of 241 Pu in ice cores make it possible to clearly distinguish between the atmospheric thermonuclear tests of the fifties and sixties. Strong relationships are also found between radionuclide data ( 137 Cs with respect to 241 Pu and 210 Pb with respect to 137 Cs), make it possible to estimate the total deposition or natural fluxes of these radionuclides. Total deposition of 137 Cs over Antarctica is estimated at 760 TBq, based on results from the 90-180 deg. East sector. Given the irregular distribution of sampling sites, more ice cores and snow samples must be analyzed in other sectors of Antarctica to check the validity of this figure

  15. Soil burden by radionuclides

    Blum, W.E.H.; Wenzel, W.W.

    1989-01-01

    Natural radioactivity - half-lifes and radiation type of man-made nuclides, radionuclide behaviour in soils, effects on soil condition and soil functions are described. The only mode of decontamination is by decay and thus primarily dependent on the half-life of nuclides

  16. Radionuclides in house dust

    Fry, F A; Green, N; Dodd, N J; Hammond, D J

    1985-04-01

    Discharges of radionuclides from the British Nuclear Fuel plc (BNFL) reprocessing plant at Sellafield in Cumbria have led to elevated concentrations radionuclides in the local environment. The major routes of exposure of the public are kept under review by the appropriate authorising Government departments and monitoring is carried out both by the departments and by BNFL itself. Recently, there has been increasing public concern about general environmental contamination resulting from the discharges and, in particular, about possible exposure of members of the public by routes not previously investigated in detail. One such postulated route of exposure that has attracted the interest of the public, the press and Parliament arises from the presence of radionuclides within houses. In view of this obvious and widespread concern, the Board has undertaken a sampling programme in a few communities in Cumbria to assess the radiological significance of this source of exposure. From the results of our study, we conclude that, although radionuclides originating rom the BNFL site can be detected in house dust, this source of contamination is a negligible route of exposure for members of the public in West Cumbria. This report presents the results of the Board's study of house dust in twenty homes in Cumbria during the spring and summer of 1984. A more intensive investigation is being carried out by Imperial College. (author)

  17. Radionuclide body function imager

    Stoddart, H.F.

    1983-01-01

    A transverse radionuclide scan field imaging apparatus is claimed. It comprises: a plurality of highly focused closely laterally adjacent collimators arranged inwardly focused in an array which surrounds a scan field, each collimator being moveable relative to its adjacent collimator; means for rotating the array about the scan field and means for imparting travel to the collimators

  18. Reversal of severe mitral regurgitation by device closure of a large patent ductus arteriosus in a premature infant.

    Kheiwa, Ahmed; Ross, Robert D; Kobayashi, Daisuke

    2017-01-01

    We report a critically ill premature infant with severe mitral valve regurgitation associated with pulmonary hypertension and a severely dilated left atrium from a large patent ductus arteriosus. The mitral valve regurgitation improved significantly with normalisation of left atrial size 4 weeks after percutaneous closure of the patent ductus arteriosus. This case highlights the potential reversibility of severe mitral valve regurgitation with treatment of an underlying cardiac shunt.

  19. Heartburn and regurgitation have different impacts on life quality of patients with gastroesophageal reflux disease.

    Lee, Shou-Wu; Lien, Han-Chung; Lee, Teng-Yu; Yang, Sheng-Shun; Yeh, Hong-Jeh; Chang, Chi-Sen

    2014-09-14

    To investigate the impact of heartburn and regurgitation on the quality of life among patients with gastroesophageal reflux disease (GERD). Data from patients with GERD, who were diagnosed according to the Montreal definition, were collected between January 2009 and July 2010. The enrolled patients were assigned to a heartburn or a regurgitation group, and further assigned to an erosive esophagitis (EE) or a non-erosive reflux disease (NERD) subgroup, depending on the predominant symptoms and endoscopic findings, respectively. The general demographic data, the scores of the modified Chinese version of the GERDQ and the Short-form 36 (SF-36) questionnaire scores of these groups of patients were compared. About 108 patients were classified in the heartburn group and 124 in the regurgitation group. The basic characteristics of the two groups were similar, except for male predominance in the regurgitation group. Patients in the heartburn group had more sleep interruptions (22.3% daily vs 4.8% daily, P = 0.021), more eating or drinking problems (27.8% daily vs 9.7% daily, P = 0.008), more work interferences (11.2% daily vs none, P = 0.011), and lower SF-36 scores (57.68 vs 64.69, P = 0.042), than patients in the regurgitation group did. Individuals with NERD in the regurgitation group had more impaired daily activities than those with EE did. GERD patients with heartburn or regurgitation predominant had similar demographics, but those with heartburn predominant had more severely impaired daily activities and lower general health scores. The NERD cases had more severely impaired daily activity and lower scores than the EE ones did.

  20. Transcatheter aortic valve replacement in patients with severe mitral or tricuspid regurgitation at extreme risk for surgery.

    Little, Stephen H; Popma, Jeffrey J; Kleiman, Neal S; Deeb, G Michael; Gleason, Thomas G; Yakubov, Steven J; Checuti, Stan; O'Hair, Daniel; Bajwa, Tanvir; Mumtaz, Mubashir; Maini, Brijeshwar; Hartman, Alan; Katz, Stanley; Robinson, Newell; Petrossian, George; Heiser, John; Merhi, William; Moore, B Jane; Li, Shuzhen; Adams, David H; Reardon, Michael J

    2018-05-01

    Patients with symptomatic severe aortic stenosis and severe mitral regurgitation or severe tricuspid regurgitation were excluded from the major transcatheter aortic valve replacement trials. We studied these 2 subgroups in patients at extreme risk for surgery in the prospective, nonrandomized, single-arm CoreValve US Expanded Use Study. The primary end point was all-cause mortality or major stroke at 1 year. A favorable medical benefit was defined as a Kansas City Cardiomyopathy Questionnaire overall summary score greater than 45 at 6 months and greater than 60 at 1 year and with a less than 10-point decrease from baseline. There were 53 patients in each group. Baseline characteristics for the severe mitral regurgitation and severe tricuspid regurgitation cohorts were age 84.2 ± 6.4 years and 84.9 ± 6.5 years; male, 29 (54.7%) and 22 (41.5%), and mean Society of Thoracic Surgeons score 9.9% ± 5.0% and 9.2% ± 4.0%, respectively. Improvement in valve regurgitation from baseline to 1 year occurred in 72.7% of the patients with severe mitral regurgitation and in 61.8% of patients with severe tricuspid regurgitation. A favorable medical benefit occurred in 31 of 47 patients (66.0%) with severe mitral regurgitation and 33 of 47 patients (70.2%) with severe tricuspid regurgitation at 6 months, and in 25 of 44 patients (56.8%) with severe mitral regurgitation and 24 of 45 patients (53.3%) with severe tricuspid regurgitation at 1 year. All-cause mortality or major stroke for the severe mitral regurgitation and severe tricuspid regurgitation cohorts were 11.3% and 3.8% at 30 days and 21.0% and 19.2% at 1 year, respectively. There were no major strokes in either group at 1 year. Transcatheter aortic valve replacement in patients with severe mitral regurgitation or severe tricuspid regurgitation is reasonable and safe and leads to improvement in atrioventricular valve regurgitation. Copyright © 2018 The American Association for Thoracic Surgery

  1. Radionuclide cardiography in medical practice

    Strangfeld, D.; Mohnike, W.; Schmidt, J.; Heine, H.; Correns, H.J.

    1986-01-01

    This publication is a compendium on all aspects of radionuclide diagnostics concerning cardiovascular system diseases. Starting with introductory remarks on the control of cardiovascular diseases the contribution of radionuclide cardiology to functional cardiovascular diagnostics as well as pathophysiological and pathobiochemical aspects of radiocardiography are outlined. Radiopharmaceuticals used in radiocardiography, physical and technical problems in application of radionuclides and their measuring techniques are discussed. In individual chapters radionuclide ventriculography, myocardial scintiscanning, circulatory diagnostics, radionuclide diagnostics of arterial hypertension, of thrombosis and in vitro diagnostics of thrombophilia are treated in the framework of clinical medicine

  2. A new relative hazard index

    Smith, C.F.; Burnett, T.W.T; Kastenberg, W.E.

    1976-01-01

    Several indexes for the evaluation of relative radionuclide hazards have been previously developed. In this paper, a new relative hazard index is derived for use in the assessment of the future burden to mankind from the presence of radionuclides in the environment. Important features of this hazard index are that it takes into account multiple decay schemes, non-equilibrium conditions, and finite time periods. As an application of this hazard index, a comparison is made between thermal reactor radioactive waste and the uranium required as fuel with the following conclusions: (1) For short time intervals (d 234 U breaking the uranium decay chain. (3) For long time intervals of concern (d >= 500 000 years), the reactor waste and consumed uranium indexes are equal after a much shorter decay time (approximately 10 years.) (author)

  3. Predictors of ischaemic mitral regurgitation recurrence in patients undergoing combined surgery: additional value of cardiovascular magnetic resonance imaging.

    Glaveckaite, Sigita; Uzdavinyte-Gateliene, Egle; Petrulioniene, Zaneta; Palionis, Darius; Valeviciene, Nomeda; Kalinauskas, Gintaras; Serpytis, Pranas; Laucevicius, Aleksandras

    2018-03-09

    We aimed to evaluate (i) the effectiveness of combined surgery (coronary artery bypass grafting with restrictive mitral valve annuloplasty) and (ii) the late gadolinium enhancement cardiovascular magnetic resonance-based predictors of ischaemic mitral regurgitation (IMR) recurrence. The prospective analysis included 40 patients with multivessel coronary artery disease, IMR >II° and left ventricular (LV) dysfunction undergoing combined surgery. The degree of IMR and LV parameters were assessed preoperatively by transthoracic echocardiography, 3D transoesophageal echocardiography and cardiovascular magnetic resonance and postoperatively by transthoracic echocardiography. The effective mitral valve repair group (n = 30) was defined as having recurrent ischaemic mitral regurgitation (RIMR) ≤II° at the end of follow-up (25 ± 11 months). The surgery was effective: freedom from RIMR >II° at 1 and 2 years after surgery was 80% and 75%, respectively. Using multivariable logistic regression, 2 independent predictors of RIMR >II° were identified: ≥3 non-viable LV segments (odds ratio 22, P = 0.027) and ≥1 non-viable segment in the LV posterior wall (odds ratio 11, P = 0.026). Using classification trees, the best combinations of cardiovascular magnetic resonance-based and 3D transoesophageal echocardiography-based predictors for RIMR >II° were (i) posterior mitral valve leaflet angle >40° and LV end-systolic volume index >45 ml/m2 (sensitivity 100%, specificity 89%) and (ii) scar transmurality >68% in the inferior LV wall and EuroSCORE II >8 (sensitivity 83%, specificity 78%). There is a clear relationship between the amount of non-viable LV segments, especially in the LV posterior and inferior walls, and the recurrence of IMR after the combined surgery.

  4. Radionuclides in food

    Fernandez Gomez, Isis Maria

    2008-01-01

    The sources of the presence of radionuclides in food are presented: natural radiation and artificial radiation. The transfer of radionuclides through food chains, intakes of radionuclides to the body with its partners effective doses and typical consumption of basic foods of a rural adult population are exposed as main topics. Also the radiation doses from natural sources and exposure to man by ingestion of contaminated food with radionuclides of artificial origin are shown. The contribution of the food ingestion to the man exposure depends on: characteristics of radionuclide, natural conditions, farming practices and eating habits of the population. The principal international organizations in charge of setting guide levels for radionuclides in food are mentioned: standards, rules and the monitoring. It establishes that a guide is necessary for the food monitoring; the alone CODEX ALIMENTARIUS is applicable to emergency situations and the generic action levels proposed by the CODEX not satisfy all needs (no guiding international levels for planned or existing situations such as NORM). There are handled mainly socio-economic and political aspects. Among the actions to be taken are: to assure a public comprehensive information over the risk evaluation in food; to reinforce the collaboration among the different international organizations (WHO, IAEA, ICRP, EC) in relation with the food of set; to give follow-up to the control of the drinkable water and NORM's presence in the food. In addition, it is possible to create the necessary mechanisms to reduce the number of irrelevant measures and bureaucratic useless steps (certificates); to promote the exchange between the different institutions involved in the topic of the food, with relation to the acquired experiences and learned lessons. Likewise, it might examine the possibility of a multidisciplinary approximation (radioactive and not radioactive pollutants); to elaborate a technical guide to assure the

  5. EBS Radionuclide Transport Abstraction

    J. Prouty

    2006-01-01

    The purpose of this report is to develop and analyze the engineered barrier system (EBS) radionuclide transport abstraction model, consistent with Level I and Level II model validation, as identified in Technical Work Plan for: Near-Field Environment and Transport: Engineered Barrier System: Radionuclide Transport Abstraction Model Report Integration (BSC 2005 [DIRS 173617]). The EBS radionuclide transport abstraction (or EBS RT Abstraction) is the conceptual model used in the total system performance assessment (TSPA) to determine the rate of radionuclide releases from the EBS to the unsaturated zone (UZ). The EBS RT Abstraction conceptual model consists of two main components: a flow model and a transport model. Both models are developed mathematically from first principles in order to show explicitly what assumptions, simplifications, and approximations are incorporated into the models used in the TSPA. The flow model defines the pathways for water flow in the EBS and specifies how the flow rate is computed in each pathway. Input to this model includes the seepage flux into a drift. The seepage flux is potentially split by the drip shield, with some (or all) of the flux being diverted by the drip shield and some passing through breaches in the drip shield that might result from corrosion or seismic damage. The flux through drip shield breaches is potentially split by the waste package, with some (or all) of the flux being diverted by the waste package and some passing through waste package breaches that might result from corrosion or seismic damage. Neither the drip shield nor the waste package survives an igneous intrusion, so the flux splitting submodel is not used in the igneous scenario class. The flow model is validated in an independent model validation technical review. The drip shield and waste package flux splitting algorithms are developed and validated using experimental data. The transport model considers advective transport and diffusive transport

  6. EBS Radionuclide Transport Abstraction

    J. Prouty

    2006-07-14

    The purpose of this report is to develop and analyze the engineered barrier system (EBS) radionuclide transport abstraction model, consistent with Level I and Level II model validation, as identified in Technical Work Plan for: Near-Field Environment and Transport: Engineered Barrier System: Radionuclide Transport Abstraction Model Report Integration (BSC 2005 [DIRS 173617]). The EBS radionuclide transport abstraction (or EBS RT Abstraction) is the conceptual model used in the total system performance assessment (TSPA) to determine the rate of radionuclide releases from the EBS to the unsaturated zone (UZ). The EBS RT Abstraction conceptual model consists of two main components: a flow model and a transport model. Both models are developed mathematically from first principles in order to show explicitly what assumptions, simplifications, and approximations are incorporated into the models used in the TSPA. The flow model defines the pathways for water flow in the EBS and specifies how the flow rate is computed in each pathway. Input to this model includes the seepage flux into a drift. The seepage flux is potentially split by the drip shield, with some (or all) of the flux being diverted by the drip shield and some passing through breaches in the drip shield that might result from corrosion or seismic damage. The flux through drip shield breaches is potentially split by the waste package, with some (or all) of the flux being diverted by the waste package and some passing through waste package breaches that might result from corrosion or seismic damage. Neither the drip shield nor the waste package survives an igneous intrusion, so the flux splitting submodel is not used in the igneous scenario class. The flow model is validated in an independent model validation technical review. The drip shield and waste package flux splitting algorithms are developed and validated using experimental data. The transport model considers advective transport and diffusive transport

  7. EBS Radionuclide Transport Abstraction

    Schreiner, R.

    2001-01-01

    The purpose of this work is to develop the Engineered Barrier System (EBS) radionuclide transport abstraction model, as directed by a written development plan (CRWMS M and O 1999a). This abstraction is the conceptual model that will be used to determine the rate of release of radionuclides from the EBS to the unsaturated zone (UZ) in the total system performance assessment-license application (TSPA-LA). In particular, this model will be used to quantify the time-dependent radionuclide releases from a failed waste package (WP) and their subsequent transport through the EBS to the emplacement drift wall/UZ interface. The development of this conceptual model will allow Performance Assessment Operations (PAO) and its Engineered Barrier Performance Department to provide a more detailed and complete EBS flow and transport abstraction. The results from this conceptual model will allow PA0 to address portions of the key technical issues (KTIs) presented in three NRC Issue Resolution Status Reports (IRSRs): (1) the Evolution of the Near-Field Environment (ENFE), Revision 2 (NRC 1999a), (2) the Container Life and Source Term (CLST), Revision 2 (NRC 1999b), and (3) the Thermal Effects on Flow (TEF), Revision 1 (NRC 1998). The conceptual model for flow and transport in the EBS will be referred to as the ''EBS RT Abstraction'' in this analysis/modeling report (AMR). The scope of this abstraction and report is limited to flow and transport processes. More specifically, this AMR does not discuss elements of the TSPA-SR and TSPA-LA that relate to the EBS but are discussed in other AMRs. These elements include corrosion processes, radionuclide solubility limits, waste form dissolution rates and concentrations of colloidal particles that are generally represented as boundary conditions or input parameters for the EBS RT Abstraction. In effect, this AMR provides the algorithms for transporting radionuclides using the flow geometry and radionuclide concentrations determined by other

  8. Initial Radionuclide Inventories

    H. Miller

    2004-09-19

    The purpose of this analysis is to provide an initial radionuclide inventory (in grams per waste package) and associated uncertainty distributions for use in the Total System Performance Assessment for the License Application (TSPA-LA) in support of the license application for the repository at Yucca Mountain, Nevada. This document is intended for use in postclosure analysis only. Bounding waste stream information and data were collected that capture probable limits. For commercially generated waste, this analysis considers alternative waste stream projections to bound the characteristics of wastes likely to be encountered using arrival scenarios that potentially impact the commercial spent nuclear fuel (CSNF) waste stream. For TSPA-LA, this radionuclide inventory analysis considers U.S. Department of Energy (DOE) high-level radioactive waste (DHLW) glass and two types of spent nuclear fuel (SNF): CSNF and DOE-owned (DSNF). These wastes are placed in two groups of waste packages: the CSNF waste package and the codisposal waste package (CDSP), which are designated to contain DHLW glass and DSNF, or DHLW glass only. The radionuclide inventory for naval SNF is provided separately in the classified ''Naval Nuclear Propulsion Program Technical Support Document'' for the License Application. As noted previously, the radionuclide inventory data presented here is intended only for TSPA-LA postclosure calculations. It is not applicable to preclosure safety calculations. Safe storage, transportation, and ultimate disposal of these wastes require safety analyses to support the design and licensing of repository equipment and facilities. These analyses will require radionuclide inventories to represent the radioactive source term that must be accommodated during handling, storage and disposition of these wastes. This analysis uses the best available information to identify the radionuclide inventory that is expected at the last year of last emplacement

  9. Clinical course of tricuspid regurgitation in repaired tetralogy of Fallot.

    Woudstra, O I; Bokma, J P; Winter, M M; Kiès, P; Jongbloed, M R M; Vliegen, H W; Groenink, M; Meijboom, F J; Mulder, B J M; Bouma, B J

    2017-09-15

    Little is known on the clinical course of tricuspid regurgitation (TR) in patients with repaired tetralogy of Fallot (rTOF) and which patients are at particular risk. This study aims to determine TR course, characteristics associated with TR progression, and the prognostic relevance of TR in rTOF patients. In this dualcenter cohort study, rTOF patients from a prospective national registry with ≥1 cardiac magnetic resonance imaging study and ≥2 echocardiograms available were included. Clinical and imaging data were collected. Cox hazards regression analysis was used to assess patient characteristics associated with progression to severe TR and whether severe TR was associated with the combined clinical endpoint of tachyarrhythmia, heart failure, and death, as time-dependent factor. A total of 216 patients were included (57% men, age 34±12years); 11 patients (5%) had severe TR at baseline. During 7.6±3.5years of follow-up, progression to severe TR occurred in 15 patients (7%). NYHA class ≥2 (HR 5.38, 95%-C.I. 1.91-15.16, p=0.001) and moderate baseline TR (HR 13.10, 95%-C.I. 2.95-58.21, p=0.001) were independently associated with progression to severe TR. Adverse events occurred in 47 patients (22%). The occurrence of severe TR was independently associated with adverse events (HR 3.48, 95%-C.I. 1.68-7.21, p=0.001). In this study, severe TR was present in 12% of adult rTOF patients during 7.6years, and progression to severe TR was most likely in symptomatic patients with moderate baseline TR. In these patients, close surveillance is warranted, because the occurrence of severe TR was associated with worse prognosis. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Leaving Moderate Tricuspid Valve Regurgitation Alone at the Time of Pulmonary Valve Replacement: A Worthwhile Approach.

    Kogon, Brian; Mori, Makoto; Alsoufi, Bahaaldin; Kanter, Kirk; Oster, Matt

    2015-06-01

    Pulmonary valve disruption in patients with tetralogy of Fallot and congenital pulmonary stenosis often results in pulmonary insufficiency, right ventricular dilation, and tricuspid valve regurgitation. Management of functional tricuspid regurgitation at the time of subsequent pulmonary valve replacement remains controversial. Our aims were to (1) analyze tricuspid valve function after pulmonary valve replacement through midterm follow-up and (2) determine the benefits, if any, of concomitant tricuspid annuloplasty. Thirty-five patients with tetralogy of Fallot or congenital pulmonary stenosis were analyzed. All patients had been palliated in childhood by disrupting the pulmonary valve, and all patients had at least moderate tricuspid valve regurgitation at the time of subsequent pulmonary valve replacement. Preoperative and serial postoperative echocardiograms were analyzed. Pulmonary and tricuspid regurgitation, along with right ventricular dilation and dysfunction were scored as 0 (none), 1 (mild), 2 (moderate), and 3 (severe). Right ventricular volume and area were also calculated. Comparisons were made between patients who underwent pulmonary valve replacement alone and those who underwent concomitant tricuspid valve annuloplasty. At 1 month after pulmonary valve replacement, there were significant reductions in pulmonary valve regurgitation (mean 3 vs 0.39, p tricuspid valve regurgitation (mean 2.33 vs 1.3, p tricuspid regurgitation 1 month postoperatively between patients who underwent concomitant tricuspid annuloplasty and those who underwent pulmonary valve replacement alone (mean 1.31 vs 1.29, p = 0.81). However, at latest follow-up (mean 7.0 ± 2.8 years), the degree of tricuspid regurgitation was significantly higher in the concomitant annuloplasty group (mean 1.87 vs 1.12, p = 0.005). In patients with at least moderate tricuspid valve regurgitation, significant improvement in tricuspid valve function and right ventricular size occurs in the first

  11. Behaviors of radionuclides in wet underground soil

    Inoue, Y.; Morisawa, S.

    Experimental studies were made of the variations of the distribution coefficient of 65 Zn, 60 Co, and /sup 110 m/Ag with Ca ion contents in sand--water and resin--water systems. It is concluded that: (1) The distribution coefficient of a radionuclide is not constant but varies greatly especially with calcium ion concentration in underground water. (2) The Saturation Index I=pH-pHs can be used as a parameter to indicate such variations. (3) Some radionuclides, existing as radiocolloids like (sup 110m/Ag and 59 Fe, are inactive toward ion exchange reactions as with hydroxide. In such cases, the nuclides migrate underground as fast as underground water

  12. Tricuspid valve repair for severe tricuspid regurgitation due to pacemaker leads.

    Uehara, Kyokun; Minakata, Kenji; Watanabe, Kentaro; Sakaguchi, Hisashi; Yamazaki, Kazuhiro; Ikeda, Tadashi; Sakata, Ryuzo

    2016-07-01

    Tricuspid valve regurgitation due to pacemaker leads is a well-known complication. Although some reports have suggested that pacemaker leads should be surgically explanted, strongly adhered leads cannot always be removed. The aim of this study was to describe our tricuspid valve repair techniques with pacemaker leads left in situ. Our retrospective study investigated 6 consecutive patients who required tricuspid valve surgery for severe regurgitation induced by pacemaker leads. From the operative findings, we identified 3 patterns of tricuspid valve and pacemaker lead involvement. In 3 patients, the leads were caught in the chordae, in 2 patients, tricuspid regurgitation was caused by lead impingement on the septal leaflet, and in 3 patients, tricuspid valve leaflets had been perforated by the pacemaker leads. During surgery, all leads were left in situ after being separated from the leaflet or valvular apparatus. In addition, suture annuloplasty was performed for annular dilatation in all cases. In one patient, the lead was reaffixed to the annulus after the posterior leaflet was cut back towards the annulus, and the leaflet was then closed. There was one hospital death due to sepsis. The degree of tricuspid regurgitation was trivial in all surviving patients at discharge. During a mean follow-up of 21 months, one patient died from pneumonia 20 months after tricuspid valve repair. In patients undergoing tricuspid valve surgery due to severe tricuspid regurgitation caused by pacemaker leads, the leads can be left in situ after proper repair with annuloplasty. © The Author(s) 2016.

  13. Prevalence of gastro-oesophageal reflux disease with upper gastrointestinal symptoms without heartburn and regurgitation.

    Vakil, Nimish; Wernersson, Börje; Ohlsson, Lis; Dent, John

    2014-06-01

    Symptomatically 'silent' gastro-oesophageal reflux disease (GORD) may be underdiagnosed. To determine the prevalence of untreated GORD without heartburn and/or regurgitation in primary care. Patients were included if they had frequent upper gastrointestinal symptoms and had not taken a proton pump inhibitor in the previous 2 months (Diamond study: NCT00291746). GORD was diagnosed based on the presence of reflux oesophagitis, pathological oesophageal acid exposure, and/or a positive symptom-acid association probability. Patients completed the Reflux Disease Questionnaire (RDQ) and were interviewed by physicians using a prespecified symptom checklist. GORD was diagnosed in 197 of 336 patients investigated. Heartburn and/or regurgitation were reported in 84.3% of patients with GORD during the physician interviews and in 93.4% of patients with GORD when using the RDQ. Of patients with heartburn and/or regurgitation not identified at physician interview, 58.1% (18/31) reported them at a 'troublesome' frequency and severity on the RDQ. Nine patients with GORD did not report heartburn or regurgitation either at interview or on the RDQ. Structured patient-completed questionnaires may help to identify patients with GORD not identified during physician interview. In a small proportion of consulting patients, heartburn and regurgitation may not be present in those with GORD.

  14. EFFECT OF MITRAL REGURGITATION ON CHRONIC HEART FAILURE COURSE AND STRUCTURE-FUNCTIONAL HEART STATE

    V. N. Larina

    2009-01-01

    Full Text Available Aim. To evaluate chronic heart failure (CHF course, functional and structural heart changes in patients with functional mitral regurgitation (MR of various degrees.Material and methods. A total of 104 outpatients (60-85 y. o. with CHF of functional class II-IV by NYHA and functional MR of I-II degrees and MR of III-IV degrees were included into the study groups.Results: Patients in both groups were comparable in sex, age, CHF duration, body mass index, systolic and diastolic blood pressure, clinical state by the clinical state scale, quality of life, anxious and depressive status. The majority of patients with MR III had significant left ventricle (LV systolic dysfunction (p=0,029, severe CHF course (p=0,034, received furosemide (p=0.004 and digoxin (p=0,004. They had significant increase in end-diastolic dimension (p<0,001, end-systolic dimension (p<0,001, left atrium (p=0,004, end-diastolic volume (p<0,001, end-systolic volume (p<0,001, pulmonary artery pressure (p<0,001, decrease in LV relative wall thickness (p=0,021 and LV ejection fraction (p<0,001. Patients of this group were hospitalized because of CHF decompensation and ischemic heart disease exacerbation more often (p=0,045.Conclusion. MR can be considered as one of sensitive predictors of LV geometry and function alteration in CHF patients and play an important role in symptoms development.

  15. EFFECT OF MITRAL REGURGITATION ON CHRONIC HEART FAILURE COURSE AND STRUCTURE-FUNCTIONAL HEART STATE

    V. N. Larina

    2016-01-01

    Full Text Available Aim. To evaluate chronic heart failure (CHF course, functional and structural heart changes in patients with functional mitral regurgitation (MR of various degrees.Material and methods. A total of 104 outpatients (60-85 y. o. with CHF of functional class II-IV by NYHA and functional MR of I-II degrees and MR of III-IV degrees were included into the study groups.Results: Patients in both groups were comparable in sex, age, CHF duration, body mass index, systolic and diastolic blood pressure, clinical state by the clinical state scale, quality of life, anxious and depressive status. The majority of patients with MR III had significant left ventricle (LV systolic dysfunction (p=0,029, severe CHF course (p=0,034, received furosemide (p=0.004 and digoxin (p=0,004. They had significant increase in end-diastolic dimension (p<0,001, end-systolic dimension (p<0,001, left atrium (p=0,004, end-diastolic volume (p<0,001, end-systolic volume (p<0,001, pulmonary artery pressure (p<0,001, decrease in LV relative wall thickness (p=0,021 and LV ejection fraction (p<0,001. Patients of this group were hospitalized because of CHF decompensation and ischemic heart disease exacerbation more often (p=0,045.Conclusion. MR can be considered as one of sensitive predictors of LV geometry and function alteration in CHF patients and play an important role in symptoms development.

  16. INDEXING AND INDEX FUNDS

    HAKAN SARITAŞ

    2013-06-01

    Full Text Available Proponents of the efficient market hypothesis believe that active portfolio management is largely wasted effort and unlikely to justify the expenses incurred. Therefore, they advocate a passive investment strategy that makes no attempt to outsmart the market. One common strategy for passive management is indexing where a fund is designed to replicate the performance of a broad-based index of stocks and bonds. Traditionally, indexing was used by institutional investors, but today, the use of index funds proliferated among individual investors. Over the years, both international and domestic index funds have disproportionately outperformed the market more than the actively managed funds have.

  17. Fukushima Daiichi Radionuclide Inventories

    Cardoni, Jeffrey N. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Jankovsky, Zachary Kyle [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2016-09-01

    Radionuclide inventories are generated to permit detailed analyses of the Fukushima Daiichi meltdowns. This is necessary information for severe accident calculations, dose calculations, and source term and consequence analyses. Inventories are calculated using SCALE6 and compared to values predicted by international researchers supporting the OECD/NEA's Benchmark Study on the Accident at Fukushima Daiichi Nuclear Power Station (BSAF). Both sets of inventory information are acceptable for best-estimate analyses of the Fukushima reactors. Consistent nuclear information for severe accident codes, including radionuclide class masses and core decay powers, are also derived from the SCALE6 analyses. Key nuclide activity ratios are calculated as functions of burnup and nuclear data in order to explore the utility for nuclear forensics and support future decommissioning efforts.

  18. Radionuclide table. Pt. 1

    Legrand, Jean; Perolat, J.-P.; Lagoutine, Frederic; Le Gallic, Yves.

    The evaluation of the following 29 radionuclides is presented: 22 Na, 24 Na, sup(24m)Na, 51 Cr, 54 Mn, 57 Co, 58 Co, sup(58m)Co, 60 Co, sup(60m)Co, 75 Se, 103 Ru, sup(103m)Rh, sup(110m)Ag- 110 Ag, 109 Cd, 125 Sb, sup(125mTe), 125 I, 133 Xe, sup(133m)Xe, 131 Cs, 134 Cs, sup(134m)Cs, 139 Ce, 144 Ce- 144 Pr, 144 Pr, 169 Er, 186 Re, 203 Hg. The introduction contains a brief description of radioactive processes and the evaluation rules followed. The best values and associated uncertainties are given for each radionuclide for the major parameters of the decay scheme and the radiation intensities emitted, together with a decay table. Gamma, X-rays and sometimes conversion electron spectra are also provided [fr

  19. Acute Effects of Positive Airway Pressure on Functional Mitral Regurgitation in Patients with Systolic Heart Failure

    Takao Kato

    2017-11-01

    Full Text Available Background: Acute effects of positive airway pressure (PAP [including continuous PAP (CPAP and adaptive servo-ventilation, an advanced form of bi-level PAP] on functional mitral regurgitation (fMR in patients with heart failure (HF with left ventricular (LV systolic dysfunction remain unclear. Thus, whether PAP therapy reduces fMR in such patients with HF was investigated.Methods and Results: Twenty patients with HF and LV systolic dysfunction defined as LV ejection fraction (LVEF <50% (14 men; mean LVEF, 35.0 ± 11.5% with fMR underwent echocardiography during 10-min CPAP (4 and 8 cm H2O and adaptive servo-ventilation. For fMR assessment, MR jet area fraction, defined as the ratio of MR jet on color Doppler to the left atrial area, was measured. The forward stroke volume (SV index (fSVI was calculated from the time-velocity integral, cross-sectional area of the aortic annulus, and body surface area. fMR significantly reduced on CPAP at 8 cm H2O (0.30 ± 0.12 and adaptive servo-ventilation (0.29 ± 0.12, compared with the baseline phase (0.37 ± 0.12 and CPAP at 4 cm H2O (0.34 ± 0.12 (P < 0.001. The fSVI did not change in any of the PAP sessions (P = 0.888. However, significant differences in fSVI responses to PAP were found between sexes (P for interaction, 0.006, with a significant reduction in fSVI in women (P = 0.041 and between patients with baseline fSVI ≥ and < the median value (27.8 ml/m2, P for interaction, 0.018, with a significant fSVI reduction in patients with high baseline fSVI (P = 0.028. In addition, significant differences were found in fSVI responses to PAP between patients with LV end-systolic volume (LVESV index ≥ and < the median value (62.0 ml/m2, P for interaction, 0.034, with a significant fSVI increase in patients with a high LVESV index (P = 0.023.Conclusion: In patients with HF, LV systolic dysfunction, and fMR, PAP can alleviate fMR without any overall changes in forward SV. However, MR alleviation due to PAP

  20. Distinguishing the impact of dexlansoprazole on heartburn vs. regurgitation in patients with gastro-oesophageal reflux disease.

    Peura, D A; Pilmer, B; Hunt, B; Mody, R; Perez, M C

    2013-11-01

    Gastro-oesophageal reflux disease (GERD) is characterised by symptomatic heartburn and regurgitation. Treatment with proton pump inhibitors (PPI) effectively decreases heartburn symptoms, but their effects on symptomatic regurgitation are less clear. To determine the impact of PPI therapy on heartburn and regurgitation severity in patients with either non-erosive GERD (NERD) or erosive oesophagitis (EE). Endoscopically-confirmed NERD patients received dexlansoprazole 30 or 60 mg or placebo in a randomised, blinded, 4-week study. Endoscopically-confirmed EE patients received dexlansoprazole 60 mg or lansoprazole 30 mg in two 8-week, randomised, blinded healing studies. The Patient Assessment of Upper Gastrointestinal Symptom Severity questionnaire, which includes a heartburn/regurgitation subscale, was administered to assess symptom severity at baseline, and at weeks 2 and 4 of the NERD study and at weeks 4 and 8 during the EE trials. We defined separate subscales for heartburn and regurgitation for this post-hoc analysis. Among patients with both symptoms at baseline, improvements in individual heartburn and regurgitation subscales along with the original combined heartburn/regurgitation subscale were determined. In the NERD and EE studies, 661 and 1909 patients, respectively, had both heartburn and regurgitation at baseline. NERD patients receiving dexlansoprazole 30 and 60 mg experienced significantly greater improvements in symptom severity for both heartburn and regurgitation compared with placebo. EE patients receiving dexlansoprazole 60 mg had significantly greater improvements in heartburn/regurgitation and heartburn-only subscales at week 4 compared with those receiving lansoprazole. Dexlansoprazole appears to be effective in improving both heartburn and regurgitation, and this improvement is maintained for the duration of treatment. © 2013 John Wiley & Sons Ltd.

  1. Radionuclide co-precipitation

    Bruno, J.; Sandino, A.

    1987-12-01

    The thermodynamic and kinetic behaviour of the minor components of the spent fuel matrix has been theoretically and experimentally investigated. Two different situations have been studied: Part I, the near field scenario, where the release and migration of the minor components is dependent on the solubility behaviour of UO 2 (s); Part II, the far field, where the solubility and transport of the radionuclides is related to the major geochemical processes occurring. (orig.)

  2. Radionuclide fate and effects

    Anon.

    1983-01-01

    The studies reported here deal with the full range of contaminant behavior and fate, from the initial physicochemical factors that govern radionuclide availability in terrestrial and aquatic environments to studies of contaminant transport by biological means. By design, we focus more on the biologically and chemically mediated transport processes and food-chain pathways than on the purely physical forms of contaminant transport, such as transport by wind and water

  3. Concentration levels of alpha emitting radionuclides in natural waters. Implications in the use of various radionuclides of reference for the determination of total alpha activity index; Niveles de concentracion de radionucleidos emisores alfa en aguas de origen natural. Implicaciones en el uso de los distintos radionucleidos de referencia para la determinacion del indice de actividad total alfa

    Corbacho, J. A.; Baeza, A.; Guillen, J.; Valles, I.; Serrano, I.; Camacho, A.; Montana, M.

    2013-07-01

    The present study was carried out a statistical evaluation of the natural radioactive contents of a large number of water samples collected at different points of the Spanish geography, in order to meet its controlling radioactive composition and assessing the implications of total alpha activity index can have in this type of samples. (Author)

  4. Geochemistry and radionuclide migration

    Isherwood, D.

    1978-01-01

    Theoretically, the geochemical barrier can provide a major line of defense in protecting the biosphere from the hazards of nuclear waste. The most likely processes involved are easily identified. Preliminary investigations using computer modeling techniques suggest that retardation is an effective control on radionuclide concentrations. Ion exchange reactions slow radionuclide migration and allow more time for radioactive decay and dispersion. For some radionuclides, solubility alone may limit concentrations to less than the maximum permissible now considered acceptable by the Federal Government. The effectiveness of the geochemical barrier is ultimately related to the repository site characteristics. Theory alone tells us that geochemical controls will be most efficient in an environment that provides for maximum ion exchange and the precipitation of insoluble compounds. In site selection, consideration should be given to rock barriers with high ion exchange capacity that might also act as semi-permeable membranes. Also important in evaluating the site's potential for effective geochemical controls are the oxidation potentials, pH and salinity of the groundwater

  5. Radionuclides in terrestrial ecosystems

    Howard, B.J.; Kennedy, V.H.; Nelson, A.

    1983-06-01

    A bibliographical database has been developed to provide quick access to research and background literature in the field of radioecology. This is a development of an earlier database described by Nelson (Bocock 1981). ITE's particular fields of interest have led to a subject bias in the bibliography towards studies in Cumbria, especially those concerned with radionuclides originating from the reprocessing plant at Sellafield, and towards ecological research studies that are complementary to radionuclide studies. Other subjects covered, include the chemistry of radionuclides, budgets and transfers within ecosystems and techniques for the analysis of environmental samples. ITE's research objectives have led to the establishment of a specialized database which is intended to complement rather than compete with the large international databases made available by suppliers such as IRS-DIALTECH or DIALOG. Currently the database holds about 1900 references which are stored on a 2 1/2 megabyte hard disk on a Digital PDP11/34 computer operating under a time shared system. The references follow a standard format. (author)

  6. Radionuclides in marine organisms

    Honda, Teruyuki

    2001-01-01

    The concentration and accumulation of radionuclides in marine organisms were explained in this paper. Secular change of the radioactivity concentration of 137 Cs in seaweed in coastal area of Japan showed more than 5Bq/kg-fresh in the first half of 1960, but decreased less than 1 Bq/kg-fresh after then and attained to less than 0.1 Bq/kg-fresh in 1990s. However, the value increased a while in 1986, which indicated the effect of Chernobyl accident. The accident increased 137 Cs of shellfish near Japan. The concentration of 239+240 Pu was the lowest value in muscles of fish, but increased from 1.7 to 42.3 mBq/kg wet wt in seaweed in 1999. 99 Tc concentration of seaweed showed from 100 to 1000 times as much as that of seawater. Radionuclides in the Irish Sea are originated from Sellafield reprocessing plant. The concentration factors of macro-algae and surface water fish (IAEA,1985) were shown. Analytical results of U in 61 kinds of marine organs showed that the concentration was different in the part of organ. The higher concentration of U was observed in hard tissue of fish. The concentration factor was different between chemical substances with the same radionuclides. (S.Y.)

  7. Proficiency testing for radionuclides

    Faanhof, A.; Kotze, O.; Louw, I.

    2010-01-01

    Proficiency testing in general is only useful when it suites a certain purpose. With regards to radionuclides basically three fields of interest can be identified: (I)Foodstuffs-Introduced in the early 1960's to monitor the fall-out of nuclear tests and eventually the pathway to foodstuffs fit for human consumption. The demand for analysis increased substantially after the Chernobyl accident. (II) Natural radioactivity-Associated with mining and mineral processing of uranium and thorium baring mineral resources throughout the world where the radionuclides from the natural uranium and thorium decay series are found to pose concern for professional and public exposure. (III) Artificial radioactivity-This category covers mostly the long-lived nuclides generated by nuclear fission of the fuel used in nuclear power plants, research reactors and nuclear bomb tests. All three categories require a specific approach for laboratories to test their ability to analyze specific radio nuclides of interest in a variety of matrices. In this lecture I will give a compiled overview of the required radioanalytical skills, analysis sensitivity needed and radionuclides of interest, with more specific emphasis on QAQC of water sources and the recommended monitoring approach. And provide information on available reference materials and organizations/institutes that provide regular exercises for participating laboratories. I will also briefly communicate on the advantages and disadvantages of ISO/IEC 17025 accreditation for test laboratories, which is these days a prerequisite in national and international trade especially where foodstuffs and mineral products are concerned.

  8. Radionuclides in thyroid cancer

    Mahadev, V.

    1980-01-01

    The three main areas of application of radionuclides in thyroid disease will be reviewed. Firstly thyroid radionuclide imaging in thyroid swellings, in relationship to lumps in the neck and ectopic thyroid tissue such as retrosternal goitre, and lingual goitre will be described. Future developments in the field including tomographic scanning, using the coded aperture method, and fluorescent scans and ultrasound are reviewed. The second area of application is the assessment and evaluation of thyroid function and the therapy of Grave's Disease and Plummer's Disease using radioiodine. The importance of careful collection of the line of treatment, results of treatment locally and the follow-up of patients after radioiodine therapy will be described. The third area of application is in the diagnosis and therapy of thyroid cancer. Investigation of thyroid swelling, and the diagnosis of functioning metastases are reported. The therapeutic iodine scan as the sole evidence of functioning metastatic involvement is recorded. Histological thyroid cancer appears to be increasingly encountered in clinical practice and the plan of management in relation to choice of cases for therapeutic scanning is discussed with case reports. Lastly the role of whole body scanning in relationship to biochemical markers is compared. In the changing field of nuclear medicine radionuclide applications in thyroid disease have remained pre-eminent and this is an attempt to reassess its role in the light of newer developments and local experience in the Institute of Radiotherapy, Oncology and Nuclear Medicine. (author)

  9. Left ventricular remodelling in chronic primary mitral regurgitation: implications for medical therapy.

    McCutcheon, Keir; Manga, Pravin

    Surgical repair or replacement of the mitral valve is currently the only recommended therapy for severe primary mitral regurgitation. The chronic elevation of wall stress caused by the resulting volume overload leads to structural remodelling of the muscular, vascular and extracellular matrix components of the myocardium. These changes are initially compensatory but in the long term have detrimental effects, which ultimately result in heart failure. Understanding the changes that occur in the myocardium due to volume overload at the molecular and cellular level may lead to medical interventions, which potentially could delay or prevent the adverse left ventricular remodelling associated with primary mitral regurgitation. The pathophysiological changes involved in left ventricular remodelling in response to chronic primary mitral regurgitation and the evidence for potential medical therapy, in particular beta-adrenergic blockers, are the focus of this review.

  10. Correction of moderate secondary mitral regurgitation due to aortic valve disease: immediate results

    В. М. Назаров

    2015-10-01

    Full Text Available To evaluate the impact of surgical strategy in concomitant mitral valve surgery or isolated aortic valve replacement (AVR in patients with moderate secondary mitral regurgitation (MR, 1 574 patients underwent AVR over a period from January 2003 to December 2011. 241 patients had secondary MR 2+ and constituted the study population. Patients were stratified into two groups, those without concomitant mitral valve surgery (Group A, n = 113 and with it (Group B, n = 128. It was found out that AVR plastic correction of MI reduces its recurrence during short-term follow-up but increases the intervention time leading to an insignificant rise in lethality. In patients with aortic stenosis the age exceeding 70 years and the presence of atrial fibrillation are found to be the most significant predictors of preservation of residual mitral regurgitation in the early postoperative period, while more indicative for patients with aortic insufficiency is the presence of tricuspid regurgitation grade 2 or higher.

  11. Percutaneous interventional mitral regurgitation treatment using the Mitra-Clip system

    Boekstegers, P; Hausleiter, J; Baldus, S

    2014-01-01

    The interventional treatment of mitral valve regurgitation by the MitraClip procedure has grown rapidly in Germany and Europe during the past years. The MitraClip procedure has the potential to treat high-risk patients with secondary mitral valve regurgitation and poor left ventricular function....... Furthermore, patients with primary mitral valve regurgitation may be treated successfully by the MitraClip procedure in case of high surgical risk or in very old patients. At the same time it has been emphasised that the MitraClip interventional treatment is still at an early stage of clinical development....... The largest clinical experience with the MitraClip procedure so far is probably present in some German cardiovascular centers, which here summarise their recommendations on the current indications and procedural steps of the MitraClip treatment. These recommendations of the AGIK and ALKK may present a basis...

  12. Regurgitations in a Lamb with Acute Coenurosis-A case Report.

    Evi Ioannidou

    2015-06-01

    Full Text Available Coenurosis is a disease of the central nervous system in sheep, caused by Coenurus cerebralis, the larval stage of Multiceps multiceps, which inhabits the small intestine of Canidae. A case of regurgitations in a 2.5 month old lamb with acute coenurosis is being reported. The lamb was presented with a sudden onset of ataxia and regurgitations for 10 days. The post-mortem examination revealed 4 immature C. cerebralis cysts between 0.5 and 1.5 cm in diameter located in the brainstem and cerebellum, and histopathological examination revealed multifocal pyogranulomatous meningoencephalitis, so a diagnosis of acute coenurosis was established. Thus, acute coenurosis should be included in the differential diagnosis of regurgitations in lambs.

  13. An unusual presentation of ischaemic mitral regurgitation as P2 prolapse.

    Thompson, David S; Punjabi, Prakash P

    2017-11-01

    A 54-year-old gentleman presented with pulmonary oedema secondary to anterolateral papillary muscle (PPM) rupture and acute mitral regurgitation subsequent to myocardial ischaemia (MI). Angiography revealed complete occlusion of the first obtuse marginal (OM1) branch of the circumflex coronary artery and a 70% occlusion of the left anterior descending (LAD) coronary artery. Operatively, unusual anatomy was noted; an accessory head was attached superiorly to the anterior lateral PPM. This gave rise to chordae that were subsequently attached to the posterior second (P2) scallop. Additionally, the P2 scallop was deficient in chordae from the posteromedial PPM, thus, loss of this accessory head led to severe mitral regurgitation. We review the PPM anatomy and pathological context of PPM rupture and ischaemic mitral regurgitation.

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

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

    1982-06-01

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

  15. Criteria of reference radionuclides for safety analysis of spent fuel waste disposal

    Suryanto

    1998-01-01

    Study on the criteria for reference radionuclides selection for assessment on spent fuel disposal have done. The reference radionuclides in this study means radionuclides are predicted to contribute of the most radiological effect for man if spent fuel waste are discharged on deep geology formation. The research was done by investigate critically of parameters were used on evaluation a kind of radionuclide. Especially, this research study of parameter which relevant disposal case and or spent fuel waste on deep geology formation . The research assumed that spent fuel discharged on deep geology by depth 500-1000 meters from surface of the land. The migration scenario Radionuclides from waste form to man was assumed particularly for normal release in which Radionuclides discharge from waste form in a series thorough container, buffer, geological, rock, to fracture(fault) and move together with ground water go to biosphere and than go into human body. On this scenario, the parameter such as radionuclides inventory, half life, heat generation, hazard index based on maximum permissible concentration (MPC) or annual limit on intake (ALI) was developed as criteria of reference radionuclides selection. The research concluded that radionuclides inventory, half live, heat generated, hazard index base on MPC or ALI can be used as criteria for selection of reference Radionuclide. The research obtained that the main radionuclides are predicted give the most radiological effect to human are as Cs-137, Sr-90, I-129, Am-243, Cm-244, Pu-238, Pu-239, Pu-240. The radionuclides reasonable to be used as reference radionuclides in safety analysis at spent fuel disposal. (author)

  16. Initial experience of percutaneous treatment of mitral regurgitation with MitraClip® therapy in Spain.

    Carrasco-Chinchilla, Fernando; Arzamendi, Dabit; Romero, Miguel; Gimeno de Carlos, Federico; Alonso-Briales, Juan Horacio; Li, Chi-Hion; Mesa, Maria Dolores; Arnold, Roman; Serrador Frutos, Ana María; Pan, Manuel; Roig, Eulalia; Rodríguez-Bailón, Isabel; de la Fuente Galán, Luis; Hernández, José María; Serra, Antonio; Suárez de Lezo, José

    2014-12-01

    Symptomatic mitral regurgitation has an unfavorable prognosis unless treated by surgery. However, the European registry of valvular heart disease reports that 49% of patients with this condition do not undergo surgery. Percutaneous treatment of mitral regurgitation with MitraClip® has been proved a safe, efficient adjunct to medical treatment in patients with this profile. The objective of the present study is to describe initial experience of MitraClip® therapy in Spain. Retrospective observational study including all patients treated between November 2011 and July 2013 at the 4 Spanish hospitals recording the highest numbers of implantations. A total of 62 patients (77.4% men) were treated, mainly for restrictive functional mitral regurgitation (85.4%) of grade III (37%) or grade IV (63%), mean (standard deviation) ejection fraction 36% (14%), and New York Heart Association functional class III (37%) or IV (63%). Device implantation was successful in 98% of the patients. At 1 year, 81.2% had mitral regurgitation ≤ 2 and 90.9% were in New York Heart Association functional class ≤ II. One periprocedural death occurred (sepsis at 20 days post-implantation) and another 3 patients died during follow-up (mean, 9.1 months). Two patients needed a second implantation due to partial dehiscence of the first device and 2 others underwent heart transplantation. In Spain, MitraClip® therapy has principally been aimed at patients with functional mitral regurgitation, significant systolic ventricular dysfunction, and high surgical risk. It is considered a safe alternative treatment, which can reduce mitral regurgitation and improve functional capacity. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  17. Echocardiographic and clinical outcomes of central versus noncentral percutaneous edge-to-edge repair of degenerative mitral regurgitation

    Estévez-Loureiro, Rodrigo; Franzen, Olaf; Winter, Reidar

    2013-01-01

    This study aimed to assess the clinical and echocardiographic results of MitraClip implantation in noncentral degenerative mitral regurgitation (dMR) compared with central dMR.......This study aimed to assess the clinical and echocardiographic results of MitraClip implantation in noncentral degenerative mitral regurgitation (dMR) compared with central dMR....

  18. The relationship between mitral regurgitation and ejection fraction as predictors for the prognosis of patients with heart failure

    Thune, Jens Jakob; Torp-Pedersen, Christian; Hassager, Christian

    2011-01-01

    To study whether there is interaction between mitral regurgitation (MR) and left ventricular ejection fraction (LVEF) in the mortality risk of heart failure (HF) patients.......To study whether there is interaction between mitral regurgitation (MR) and left ventricular ejection fraction (LVEF) in the mortality risk of heart failure (HF) patients....

  19. Synergistic Utility of Brain Natriuretic Peptide and Left Ventricular Global Longitudinal Strain in Asymptomatic Patients With Significant Primary Mitral Regurgitation and Preserved Systolic Function Undergoing Mitral Valve Surgery.

    Alashi, Alaa; Mentias, Amgad; Patel, Krishna; Gillinov, A Marc; Sabik, Joseph F; Popović, Zoran B; Mihaljevic, Tomislav; Suri, Rakesh M; Rodriguez, L Leonardo; Svensson, Lars G; Griffin, Brian P; Desai, Milind Y

    2016-07-01

    In asymptomatic patients with ≥3+ mitral regurgitation and preserved left ventricular (LV) ejection fraction who underwent mitral valve surgery, we sought to discover whether baseline LV global longitudinal strain (LV-GLS) and brain natriuretic peptide provided incremental prognostic utility. Four hundred and forty-eight asymptomatic patients (61±12 years and 69% men) with ≥3+ primary mitral regurgitation and preserved left ventricular ejection fraction, who underwent mitral valve surgery (92% repair) at our center between 2005 and 2008, were studied. Baseline clinical and echocardiographic data (including LV-GLS using Velocity Vector Imaging, Siemens, PA) were recorded. The Society of Thoracic Surgeons score was calculated. The primary outcome was death. Mean Society of Thoracic Surgeons score, left ventricular ejection fraction, mitral effective regurgitant orifice, indexed LV end-diastolic volume, and right ventricular systolic pressure were 4±1%, 62±3%, 0.55±0.2 cm(2), 58±13 cc/m(2), and 37±15 mm Hg, respectively. Forty-five percent of patients had flail. Median log-transformed BNP and LV-GLS were 4.04 (absolute brain natriuretic peptide: 60 pg/dL) and -20.7%. At 7.7±2 years, death occurred in 41 patients (9%; 0% at 30 days). On Cox analysis, a higher Society of Thoracic Surgeons score (hazard ratio 1.55), higher baseline right ventricular systolic pressure (hazard ratio 1.11), more abnormal LV-GLS (hazard ratio 1.17), and higher median log-transformed BNP (hazard ratio 2.26) were associated with worse longer-term survival (all Pright ventricular systolic pressure) provided incremental prognostic utility (χ(2) for longer-term mortality increased from 31-47 to 61; Pleft ventricular ejection fraction who underwent mitral valve surgery, brain natriuretic peptide and LV-GLS provided synergistic risk stratification, independent of established factors. © 2016 American Heart Association, Inc.

  20. Transcatheter valve-in-valve implantation due to severe aortic regurgitation in a degenerated aortic homograft

    Olsen, Lene Kjaer; Engstrøm, Thomas; Søndergaard, Lars

    2009-01-01

    Transcatheter aortic valve implantation (TAVI) in severe aortic stenosis has proven to be a feasible and effective treatment modality for inoperable patients. Until now, neither aortic regurgitation nor degenerated bioprostheses has been an indication for TAVI. However, this article reports...... a successful valve-in-valve implantation of a CoreValve aortic valve prosthesis through the right subclavian artery in a case of severe aortic regurgitation within a degenerated aortic homograft. The case exemplifies the possibilities of expanding the indications for TAVI, as well as other vascular access...

  1. Percutaneous Repair of Postoperative Mitral Regurgitation After Left Ventricular Assist Device Implant.

    Cork, David P; Adamson, Robert; Gollapudi, Raghava; Dembitsky, Walter; Jaski, Brian

    2018-02-01

    Mitral regurgitation commonly improves after implantation of a left ventricular assist device without concomitant valvular repair owing to the mechanical unloading of the left ventricle. However, the development (or persistence) of significant mitral regurgitation after implantation of a left ventricular assist device is associated with adverse clinical events. We present a case of a left ventricular assist device patient who successfully underwent a percutaneous MitraClip procedure for repair of persistent late postoperative mitral insufficiency with demonstrable clinical and hemodynamic improvement. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Determinants of Atrial Electromechanical Delay in Patients with Functional Mitral Regurgitation and Non-ischemic Dilated Cardiomyopathy

    Bengi Bakal Ruken

    2014-12-01

    Full Text Available Introduction: Atrial conduction time has important hemodynamic effects on ventricular filling and is accepted as a predictor of atrial fibrillation. In this study we assessed atrial conduction time in patients with non ischemic dilated cardiomyopathy (NIDCMP and functional mitral regurgitation (MR and aimed to determine factors predicting atrial conduction time prolongation. Methods: Sixty five patients with non ischemic dilated cardiomyopathy who have moderate to severe MR and 60 control subjects were included in the study. In addition to conventional echocardiographic measures used to asses left ventricle and MR, atrial electromechanical coupling (time interval from the onset of P wave on surface electrocardiogram [ECG] to the beginning of A wave interval with tissue Doppler echocardiography [PA], intra- and interatrial electromechanical delay (intra and inter AEMD were measured. Results: The correlations between inter AEMD and left atrial (LA size, MR volume, isovolumetric relaxation time (IVRT, deceleration time (DT, systolic pulmonary artery pressure (PAPs, E/A ratio and E/e’ were very poor. Similarly, intra AEMD was not correlated to LA size , MR volume, IVRT, DT, PAPs, E/A ratio and E/e’. However, both inter AEMD and intra AEMD had good correlation with left ventricular mass index, tenting area (TA, tenting distance (TD, coaptation septal distance (CSD, sphericity index (SI. Conclusion: Prolongation of inter and intra AEMDs were found to be well correlated with parameters reflecting left ventricular and mitral annular remodeling.

  3. Chapter 2. Radionuclides in the biosphere

    Toelgyessy, J.; Harangozo, M.

    2000-01-01

    This is a chapter of textbook of radioecology for university students. In this chapter authors deal with role of radionuclides in the biosphere. Chapter consists of next parts: (1) Natural radionuclides in biosphere; (2) Man-made radionuclides in the biosphere; (3) Ecologically important radionuclides; (4) Natural background; (5) Radiotoxicity and (6) Paths of transfer of radionuclides from the source to human

  4. Radionuclide diagnosis of emergency states

    Ishmukhametov, A.I.

    1985-01-01

    Solution of emergency state radionuclide diagnostics from the technical point of view is provided by the application of the mobile quick-operating equipment in combination with computers, by the use of radionuclides with acceptable for emergency medicine characteristics and by development of radionuclide investigation data propcessing express-method. Medical developments include the study of acute disease and injury radioisotope semiotics, different indication diagnostic value determining, comparison of the results, obtained during radionuclide investigation, with clinicolaboratory and instrumental data, separation of methodical complex series

  5. History of medical radionuclide production.

    Ice, R D

    1995-11-01

    Radionuclide production for medical use originally was incidental to isotope discoveries by physicists and chemists. Once the available radionuclides were identified they were evaluated for potential medical use. Hevesy first used 32P in 1935 to study phosphorous metabolism in rats. Since that time, the development of cyclotrons, linear accelerators, and nuclear reactors have produced hundreds of radionuclides for potential medical use. The history of medical radionuclide production represents an evolutionary, interdisciplinary development of applied nuclear technology. Today the technology is represented by a mature industry and provides medical benefits to millions of patients annually.

  6. EBS Radionuclide Transport Abstraction

    J.D. Schreiber

    2005-08-25

    The purpose of this report is to develop and analyze the engineered barrier system (EBS) radionuclide transport abstraction model, consistent with Level I and Level II model validation, as identified in ''Technical Work Plan for: Near-Field Environment and Transport: Engineered Barrier System: Radionuclide Transport Abstraction Model Report Integration'' (BSC 2005 [DIRS 173617]). The EBS radionuclide transport abstraction (or EBS RT Abstraction) is the conceptual model used in the total system performance assessment for the license application (TSPA-LA) to determine the rate of radionuclide releases from the EBS to the unsaturated zone (UZ). The EBS RT Abstraction conceptual model consists of two main components: a flow model and a transport model. Both models are developed mathematically from first principles in order to show explicitly what assumptions, simplifications, and approximations are incorporated into the models used in the TSPA-LA. The flow model defines the pathways for water flow in the EBS and specifies how the flow rate is computed in each pathway. Input to this model includes the seepage flux into a drift. The seepage flux is potentially split by the drip shield, with some (or all) of the flux being diverted by the drip shield and some passing through breaches in the drip shield that might result from corrosion or seismic damage. The flux through drip shield breaches is potentially split by the waste package, with some (or all) of the flux being diverted by the waste package and some passing through waste package breaches that might result from corrosion or seismic damage. Neither the drip shield nor the waste package survives an igneous intrusion, so the flux splitting submodel is not used in the igneous scenario class. The flow model is validated in an independent model validation technical review. The drip shield and waste package flux splitting algorithms are developed and validated using experimental data. The transport

  7. EBS Radionuclide Transport Abstraction

    J.D. Schreiber

    2005-01-01

    The purpose of this report is to develop and analyze the engineered barrier system (EBS) radionuclide transport abstraction model, consistent with Level I and Level II model validation, as identified in ''Technical Work Plan for: Near-Field Environment and Transport: Engineered Barrier System: Radionuclide Transport Abstraction Model Report Integration'' (BSC 2005 [DIRS 173617]). The EBS radionuclide transport abstraction (or EBS RT Abstraction) is the conceptual model used in the total system performance assessment for the license application (TSPA-LA) to determine the rate of radionuclide releases from the EBS to the unsaturated zone (UZ). The EBS RT Abstraction conceptual model consists of two main components: a flow model and a transport model. Both models are developed mathematically from first principles in order to show explicitly what assumptions, simplifications, and approximations are incorporated into the models used in the TSPA-LA. The flow model defines the pathways for water flow in the EBS and specifies how the flow rate is computed in each pathway. Input to this model includes the seepage flux into a drift. The seepage flux is potentially split by the drip shield, with some (or all) of the flux being diverted by the drip shield and some passing through breaches in the drip shield that might result from corrosion or seismic damage. The flux through drip shield breaches is potentially split by the waste package, with some (or all) of the flux being diverted by the waste package and some passing through waste package breaches that might result from corrosion or seismic damage. Neither the drip shield nor the waste package survives an igneous intrusion, so the flux splitting submodel is not used in the igneous scenario class. The flow model is validated in an independent model validation technical review. The drip shield and waste package flux splitting algorithms are developed and validated using experimental data. The transport model considers

  8. Incidence and progression of mild aortic regurgitation after Tirone David reimplantation valve-sparing aortic root replacement.

    Stephens, Elizabeth H; Liang, David H; Kvitting, John-Peder Escobar; Kari, Fabian A; Fischbein, Michael P; Mitchell, R Scott; Miller, D Craig

    2014-01-01

    The study objective was to determine whether recurrent or residual mild aortic regurgitation, which occurs after valve-sparing aortic root replacement, progresses over time. Between 2003 and 2008, 154 patients underwent Tirone David-V valve-sparing aortic root replacement; 96 patients (62%) had both 1-year (median, 12 ± 4 months) and mid-term (62 ± 22 months) transthoracic echocardiograms available for analysis. Age of patients averaged 38 ± 13 years, 71% were male, 31% had a bicuspid aortic valve, 41% had Marfan syndrome, and 51% underwent aortic valve repair, predominantly cusp free margin shortening. Forty-one patients (43%) had mild aortic regurgitation on 1-year echocardiogram. In 85% of patients (n = 35), mild aortic regurgitation remained stable on the most recent echocardiogram (median, 57 ± 20 months); progression to moderate aortic regurgitation occurred in 5 patients (12%) at a median of 28 ± 18 months and remained stable thereafter; severe aortic regurgitation developed in 1 patient, eventually requiring reoperation. Five patients (5%) had moderate aortic regurgitation at 1 year, which did not progress subsequently. Two patients (2%) had more than moderate aortic regurgitation at 1 year, and both ultimately required reoperation. Although mild aortic regurgitation occurs frequently after valve-sparing aortic root replacement, it is unlikely to progress over the next 5 years and should not be interpreted as failure of the valve-preservation concept. Further, we suggest that mild aortic regurgitation should not be considered nonstructural valve dysfunction, as the 2008 valve reporting guidelines would indicate. We need 10- to 15-year follow-up to learn the long-term clinical consequences of mild aortic regurgitation early after valve-sparing aortic root replacement. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  9. Osteopetrosis: Radiological & Radionuclide Imaging

    Sit, Cherry; Agrawal, Kanhaiyalal; Fogelman, Ignac; Gnanasegaran, Gopinath

    2015-01-01

    Osteopetrosis is a rare inherited bone disease where bones harden and become abnormally dense. While the diagnosis is clinical, it also greatly relies on appearance of the skeleton radiographically. X-ray, radionuclide bone scintigraphy and magnetic resonance imaging have been reported to identify characteristics of osteopetrosis. We present an interesting case of a 59-year-old man with a history of bilateral hip fractures. He underwent 99m Tc-methylene diphosphonate whole body scan supplemented with single-photon emission computed tomography/computed tomography of spine, which showed increased uptake in the humeri, tibiae and femora, which were in keeping with osteopetrosis

  10. Modifying radionuclide effects

    Sasser, L.B.

    1983-01-01

    This project involves a study of the relationship of physiological and environmental factors to the metabolism and effects of radionuclides. We have studied placental transfer and suckling as pathways of americium entry into the newborn or juvenile rat. Rats were injected intravenously with 5 μCi of 241 Am while nulliparous (30 days prior to mating), pregnant (day 19 of gestation), or lactating (1 day after parturition), and subsequent litters were killed to determine 241 Am retention. A deficit in reproductive performance was observed in the group injected before mating, as evidenced by reduced number and weight of offspring

  11. Radionuclides in the sea

    NONE

    1971-07-01

    Water covers a little more than two-thirds of the earth's surface. What is thrown into the sea from a ship may be washed up on a shore thousands of miles away; wastes discharged into the seas or into rivers flowing into them can affect marine life and possibly also the health of man. The study, prevention and control of pollution of the seas and oceans by radionuclides introduced as by-products of man's use of nuclear energy is thus of global interest. (author)

  12. Sherlock Holmes for radionuclides

    Schmitzer, C.

    2002-01-01

    At the end of 2001 ARC Seibersdorf research has taken the management of the first worldwide certified laboratory to control the realization of the international Comprehensive Nuclear Test Ban Treaty (CTBT). Altogether there will be 16 CTBT certified laboratories worldwide; therefore a global network of radionuclides measurements stations and test laboratories as well as seismic, radiation and hydroacustic measurements stations is necessary . In the future air samples will be taken from these stations and analyzed in one of these certified laboratories, when appears the suspicion that an atomic test was carried out. (nevyjel)

  13. Radionuclide Therapy. Chapter 19

    Flux, G.; Du, Yong [Royal Marsden Hospital and Institute of Cancer Research, Surrey (United Kingdom)

    2014-12-15

    Cancer has been treated with radiopharmaceuticals since the 1940s. The radionuclides originally used, including 131I and 32P, are still in use. The role of the physicist in radionuclide therapy encompasses radiation protection, imaging and dosimetry. Radiation protection is of particular importance given the high activities of the unsealed sources that are often administered, and must take into account medical staff, comforters and carers, and, as patients are discharged while still retaining activity, members of the public. Regulations concerning acceptable levels of exposure vary from country to country. If the administered radiopharmaceutical is a γ emitter, then imaging can be performed which may be either qualitative or quantitative. While a regular system of quality control must be in place to prevent misinterpretation of image data, qualitative imaging does not usually rely on the image corrections necessary to determine the absolute levels of activity that are localized in the patient. Accurate quantitative imaging is dependent on these corrections and can permit the distribution of absorbed doses delivered to the patient to be determined with sufficient accuracy to be clinically beneficial.

  14. Intervention procedures for radionuclides

    Adelstein, S.J.

    1991-01-01

    As in the case of smoking and lung cancer, for large radionuclide releases, an ounce of prevention is worth a pound of cure. On the other hand, we feel compelled to do something sensible after an accident even if the principal benefit of intervention may be to comfort the population at risk. Of course, for populations near the site of an accident, evacuation should be considered, but it is unreasonable to apply this measure to distant populations, e.g., large segments of the European community could not be moved about as we observe the shifting of a radioactive cloud in response to changing winds. If the radionuclides are delivered as particulates, bringing people indoors and employing primitive air filters can temporarily reduce exposures, but these stratagems are not very effective against gaseous or volatile elements. What, then, can be done for populations downwind of a radioactive release whose air, water, and/or food supply are, or are about to become contaminated? 5 refs

  15. Vertical soil migration of radionuclide fallout from the Chernobyl' accident

    Silant'ev, A.N.; Shkuratova, I.G.; Bobovnikova, T.I.

    1989-01-01

    The most suitable model for describing the behavior of radionuclide fallout on a soil surface is quasidiffusion transfer with directional transfer taken into account. The parameter values for this have been determined previously and are supplemented by the results of this work. To investigate the initial radionuclide distribution along the soil profile, monolithic soil samples 5 cm thick were taken in June-September 1986 in areas which had been subjected to contamination due to the Chernobyl' accident. The samples taken were cut up into layers. The first layer, 0.5 cm thick, was cut off from the surface of the soil monolith together with the grass. The next layer cut off was also 0.5 cm thick. Then two layers, each 1 cm in thickness, were cut off. The thickness of the last layer was 2 cm. The vertical distribution of radionuclides along the soil profile which was examined may be called the initial distribution, which will then change due to nonimmediate migration of radionuclides in the soil. Based on the research which has been performed, the following conclusions may be drawn. One portion of the radionuclides resulting from fallout is trapped by plant cover, while the other enters immediately into the soil. For a thick plant covering, about 80% of the radionuclide fallout is sorbed by the grass; for sparse cover, about 40%. The radionuclides entering the soil along with rainwater penetrate into the soil depths, producing contamination which falls off exponentially with depth. The exponent index is close to 1 cm -1 . In a forest, the main amount of radionuclide fallout is trapped by litter. Approximately 10% of the contamination fallout penetrates beneath the litter

  16. Cine MR imaging in mitral valve prolapse; Study on mitral regurgitation and left atrial volume

    Kumai, Toshihiko [Chiba Univ. (Japan). School of Medicine

    1993-02-01

    This study was undertaken to assess the ability of cine MR imaging to evaluate the direction, timing, and severity of mitral regurgitation in patients with mitral valve prolapse (MVP). The population of this study was 33 patients with MVP diagnosed by two-dimensional echocardiography and 10 patients with rheumatic mitral valve disease (MSR) for comparison. 7 patients with MVP and 5 with MSR had atrial fibrillation and/or history of congestive heart failure as complications. Mitral regurgitation was graded for severity by color Doppler flow imaging in all patients. Direction and size of systolic flow void in the left atrium were analyzed by contiguous multilevel cine MR images and the maximum volumes of flow void and left atrium were measured. Although flow void was found at the center of the left atrium in most of MSR, it was often directed along the postero-caudal atrial wall in anterior leaflet prolapse and along the anterocranial atrial wall in posterior leaflet prolapse. In MVP, the maximum volume of flow void was often seen in late systole. The maximum volume of flow void and that of left atrium were significantly larger in patients with atrial fibrillation and/or history of congestive heart failure. The length and volume of flow void were increased with clinical severity and degree of regurgitation determined by color Doppler flow imaging. Thus cine MR imaging provides a useful means for detection and semiquantitative evaluation of mitral regurgitation in subjects with MVP. (author).

  17. Surgical Management of Mitral Regurgitation in Patients with Marfan Syndrome during Infancy and Early Childhood

    Eung Re Kim

    2015-02-01

    Full Text Available Background: Mitral regurgitation is one of the leading causes of cardiovascular morbidity in pediatric patients with Marfan syndrome. The purpose of this study was to contribute to determining the appropriate surgical strategy for these patients. Methods: From January 1992 to May 2013, six patients with Marfan syndrome underwent surgery for mitral regurgitation in infancy or early childhood. Results: The median age at the time of surgery was 47 months (range, 3 to 140 months and the median follow-up period was 3.6 years (range, 1.3 to 15.5 years. Mitral valve repair was performed in two patients and four patients underwent mitral valve replacement with a mechanical prosthesis. There was one reoperation requiring valve replacement for aggravated mitral regurgitation two months after repair. The four patients who underwent mitral valve replacement did not experience any complications related to the prosthetic valve. One late death occurred due to progressive emphysema and tricuspid regurgitation. Conclusion: Although repair can be an option for some patients, it may not be durable in infantile-onset Marfan syndrome patients who require surgical management during infancy or childhood. Mitral valve replacement is a feasible treatment option for these patients.

  18. Managing the right ventricular outflow tract for pulmonary regurgitation after tetralogy of Fallot repair

    Hauser, Michael; Eicken, Andreas; Kuehn, Andreas; Hess, John; Fratz, Sohrab; Ewert, Peter; Kaemmerer, Harald

    2013-01-01

    The long-term outcome of patients with tetralogy of Fallot (TOF) with reconstruction of the right ventricular (RV) outflow tract is often complicated by the sequelae of severe pulmonary regurgitation. Progressive enlargement of the right ventricle, biventricular dysfunction and arrhythmia are apparent in more than 50% of the patients in the fourth decade of life. Pathophysiologic implications, clinical assessment and diagnostic modalities are discussed, whereas CMR imaging seems to be the procedure of choice. Therapeutical options for rereconstruction of the RV outflow tract are mentioned, surgical and interventional procedures are explained in detail. The optimal timing of reoperation for significant pulmonary regurgitation after TOF repair is still a matter of controversy given the limited runtime of the lately implanted prostheses and the risk of further reoperation. Early surgery is recommended in these patients before symptoms develop, or RV function has declined. Today we believe that waiting for the patient to become symptomatic is too late. All in all, pulmonary valve replacement is at least indicated in patients developing symptoms due to severe pulmonary regurgitation, particularly if associated with substantial or progressive RV dilatation, tricuspid regurgitation and/or supraventricular or ventricular arrhythmias. PMID:27326099

  19. Oral regurgitation after reflux provoking meals: a possible cause of dental erosion?

    Bartlett, D W; Evans, D F; Smith, B G

    1997-02-01

    Certain foods and drinks such as alcohol, heavily spiced or fatty meals are known to provoke gastro-oesophageal reflux (GOR). This may give rise to symptoms of heartburn, epigastric pain and occasionally oral regurgitation of the gastric contents. Oral regurgitation of gastric juice is important in dentistry because of its association with dental erosion. This study measured oesophageal and oral reflux in 12 healthy subjects after a curry meal taken with alcohol 2 h before sleep. Each subject repeated the test with a bland non-reflux provoking control meal. GOR was measured by recording distal and proximal oesophageal pH on a dual channel, portable pH monitor. Oral pH was measured with a pH sensitive radio-telemetry capsule (RTC) held on the palate in a vacuum formed splint. Signals from the RTC were received by an aerial worn around the head. The pH change produced by GOR was estimated as the percentage time that pH (PTpH) was less than 4 in the distal oesophagus. Similarly, the PTpH was estimated reflux in only two subjects. In one of these subjects the bland meal provoked oral regurgitation with a PTpH < 5.5 of 13.5%. In the remaining subjects little oral regurgitation occurred.

  20. Quantitating aortic regurgitation by cardiovascular magnetic resonance: significant variations due to slice location and breath holding

    Chaturvedi, Abhishek; Hamilton-Craig, Christian; Cawley, Peter J.; Maki, Jeffrey H.; Mitsumori, Lee M.; Otto, Catherine M.

    2016-01-01

    Compare variability in flow measurements by phase contrast MRI, performed at different locations in the aorta and pulmonary artery (PA) using breath-held (BH) and free-breathing (FB) sequences. Fifty-seven patients with valvular heart disease, confirmed by echocardiography, were scanned using BH technique at 3 locations in the ascending aorta (SOV = sinus of Valsalva, STJ = sinotubular junction, ASC = ascending aorta at level of right pulmonary artery) and 2 locations in PA. Single FB measurement was obtained at STJ for aorta. Obtained metrics (SV = stroke volume, FV = forward volume, BV = backward volume, RF = regurgitant fraction) were evaluated separately for patients with aortic regurgitation (AR, n = 31) and mitral regurgitation (n = 26). No difference was noted between the two measurements in the PA. Significant differences were noted in measured SV at different aortic locations. SV measurements obtained at ASC correlated best with the measurements obtained in the PA. Strongest correlation of AR was measured at the STJ. Measurements of flow volumes by phase contrast MRI differ depending on slice location. When using stroke volumes to calculate pulmonary to systemic blood flow ratio (Qp/Qs), ASC should be used. For quantifying aortic regurgitation, measurement should be obtained at STJ. (orig.)

  1. Intermittent acute aortic valve regurgitation: A case report of a prosthetic valve dysfunction

    S.E. Karagiannis (Stefanos); G. Karatasakis (George); K. Spargias (Konstantinos); L. Louka; D. Poldermans (Don); D.V. Cokkinos (Dennis)

    2008-01-01

    textabstractComplications of any mechanical prosthesis include thrombus or pannus formation. In our case report we demonstrate that prosthetic aortic valve regurgitation due to pannus formation may be intermittent and non-cyclic in pattern and therefore not obvious at the time of original clinical

  2. Current concepts and issues in the management of regurgitation of infants : A reappraisal

    Vandenplas, Y; Belli, D; Benhamou, PH; Cadranel, S; Cezard, JP; Cucchiara, S; Dupont, C; Faure, C; Gottrand, F; Hassall, E; Heymans, HSA; Kneepkens, CMF; Sandhu, BK

    Regurgitation in infants is a common problem. Recent issues, such as the increased risk of sudden infant death in the prone sleeping position, the finding of persisting occult gastro-oesophageal reflux with feed thickeners, and the increasing awareness of the cost-benefit ratio of medications may

  3. Real-world experience of MitraClip for treatment of severe mitral regurgitation

    Chan, Pak Hei; She, Hoi Lam; Alegria-Barrero, Eduardo

    2012-01-01

     Percutaneous edge-to-edge mitral valve repair with the MitraClip(®) was shown to be a safe and feasible alternative compared to conventional surgical mitral valve repair. Herein is reported our experience on MitraClip(®) for high-risk surgical candidates with severe mitral regurgitation (MR)....

  4. Durability of mitral valve repair for mitral regurgitation due to degenerative mitral valve disease.

    David, Tirone E

    2015-09-01

    Degenerative diseases of the mitral valve (MV) are the most common cause of mitral regurgitation in the Western world and the most suitable pathology for MV repair. Several studies have shown excellent long-term durability of MV repair for degenerative diseases. The best follow-up results are obtained with isolated prolapse of the posterior leaflet, however even with isolated prolapse of the anterior leaflet or prolapse of both leaflets the results are gratifying, particularly in young patients. The freedom from reoperation on the MV at 15 years exceeds 90% for isolated prolapse of the posterior leaflet and it is around 70-85% for prolapse of the anterior leaflet or both leaflets. The degree of degenerative change in the MV also plays a role in durability of MV repair. Most studies have used freedom from reoperation to assess durability of the repair but some studies that examined valve function late after surgery suggest that recurrent mitral regurgitation is higher than estimated by freedom from reoperation. We can conclude that MV repair for degenerative mitral regurgitation is associated with low probability of reoperation for up to two decades after surgery. However, almost one-third of the patients develop recurrent moderate or severe mitral regurgitation suggesting that surgery does not arrest the degenerative process.

  5. Color Doppler flow mapping of stenotic and regurgitant natural heart valves

    Nanda, N.C.

    1986-01-01

    Color Doppler echocardiography has found widest application in reliable detection and assessment of severity of both atrio-ventricular and semi-lunar valve incompetence. The authors believe both the sensitivity and specificity of color Doppler for the detection of mitral and aortic regurgitation is very high in patients with adequate acoustic windows. In 82 patients with proven mitral regurgitation studied, the best correlations with angiography were noted when the maximum or average regurgitant jet are obtained by color Doppler from three standard 2-D echo planes (parasternal long and short axis and apical four chamber view) and expressed as a percentage of the left atrial area were considered. The criteria the authors used for assessment of tricuspid and pulmonary valve incompetence are similar to those used for mitral and aortic valve incompetence, but the lack of a good ''gold'' standard has hampered validation. The color Doppler technique also supplements conventional Doppler in the assessment of severity of stenotic lesions by facilitating parallel alignment of the continuous wave Doppler cursor line with the stenotic jet for accurate recording of maximal velocities and pressure gradients. The authors have found this method especially useful in the assessment of aortic stenosis. In conclusion, color Doppler flow mapping combined with conventional echocardiography provides, for the first time, a comprehensive noninvasive assessement of the severity of regurgitant and stenotic lesions

  6. Some parameters of radionuclide kinetics

    Prokof'ev, O.N.; Smirnov, V.A.; Belen'kij, E.I.

    1978-01-01

    Numerical values of the rates of radionuclide absorption into, and elimination from, bovine organs were determined. Kinetic rate constants of radionuclides such as 89 Sr, 99 Mo, 131 I, 132 Tl, and 140 Be were calculated. The calculations were done for muscle, liver, and kidney

  7. Radionuclide - Soil Organic Matter Interactions

    Carlsen, Lars

    1985-01-01

    Interactions between soil organic matter, i.e. humic and fulvic acids, and radionuclides of primary interest to shallow land burial of low activity solid waste have been reviewed and to some extent studied experimentally. The radionuclides considered in the present study comprise cesium, strontium...

  8. Chapter 13. Radionuclides in medicine

    Toelgyessy, J.; Harangozo, M.

    2000-01-01

    This is a chapter of textbook of radioecology for university students. In this chapter authors deal with problems connected with using of radionuclides in medicine. Methods of treatment with using of radionuclides are reviewed. Chapter consists of next parts: (1) Remotion of thyroid gland; (2) Treatment of cerebrally tumour in nuclear reactor; (3) Artificial heart

  9. Quantitative assessment of pure aortic valve regurgitation with dual-source CT

    Li, Z., E-mail: lzlcd01@126.com [Department of Radiology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, Sichuan 610041 (China); Huang, L.; Chen, X.; Xia, C.; Yuan, Y.; Shuai, T. [Department of Radiology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, Sichuan 610041 (China)

    2012-07-15

    Aim: To assess the severity of pure aortic regurgitation by measuring regurgitation volumes (RV) and fractions (RF) with dual-source computed tomography (DSCT) as compared to magnetic resonance imaging (MRI) and echocardiography. Materials and methods: Thirty-eight patients (15 men, 23 women; mean age 46 {+-} 11 years) with isolated aortic valve regurgitation underwent retrospectively electrocardiogram (ECG)-gated DSCT, echocardiography, and MRI. Stroke volumes of the left and right ventricles were measured at DSCT and MRI. Thus, RVs and RFs were calculated and compared. The agreement between DSCT and MRI was tested by intraclass correlation coefficient and Bland-Altman analyses. Spearman's rank order correlation and weighted {kappa} tests were used for testing correlations of AR severity between DSCT results and corresponding echocardiographic grades. Results: The RV and RF measured by DSCT were not significantly different from those measured using MRI (p = 0.71 and 0.79). DSCT correlated well with MRI for the measurement of RV (r{sub I} = 0.86, p<0.001) and calculation of the RF (r{sub I} =0.90, p<0.001). Good agreement between the techniques was obtained by using Bland-Altman analyses. The severity of regurgitation estimated by echocardiography correlated well with DSCT (r{sub s} = 0.95, p<0.001) and MRI (r{sub s} = 0.95, p<0.001). Inter-technique agreement between DSCT and two-dimensional transthoracic echocardiography (2DTTE) regarding the grading of the severity of AR was excellent ({kappa} = 0.90), and good agreement was also obtained between MRI and 2DTTE assessments of the severity of AR ({kappa} = 0.87). Conclusion: DSCT using a volume approach can be used to quantitatively determine the severity of pure aortic regurgitation when compared with MRI and echocardiography.

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

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

    2001-05-01

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

  11. Decline in perception of acid regurgitation symptoms from gastroesophageal reflux disease in diabetes mellitus patients.

    Kosuke Sakitani

    Full Text Available To determine if a discrepancy exists between subjective symptoms and the grade of endoscopic gastroesophageal reflux disease (GERD in diabetes mellitus (DM patients.All 2,884 patients who underwent esophagogastroduodenoscopy completed the modified Gastrointestinal Symptom Rating Scale (GSRS, an interview-based rating scale consisting of 16 items including a question on acid regurgitation. Patients were divided into DM and non-DM groups (1,135 and 1,749 patients, respectively. GERD was diagnosed endoscopically and graded according to the Los Angeles classification. Grade B or more severe GERD was defined as severe endoscopic GERD. The intergroup GSRS score was compared statistically.In severe endoscopic GERD patients, the prevalence of patients with a positive GSRS score in the acid regurgitation question was statistically lower in DM patients than non-DM patients. Of the 60 non-DM patients with severe endoscopic GERD, 40 patients (67% had a positive GSRS score for acid regurgitation; however, of the 51 DM patients with severe endoscopic GERD, 23 patients (45% had a positive GSRS score. Multivariate analysis showed that severe endoscopic GERD (OR: 2.01; 95% CI: 1.21-3.33; p = 0.0066, non-DM (OR: 0.74; 95% CI: 0.54-0.94; p = 0.0157, younger age (OR: 0.98; 95% CI: 0.97-0.99; p = 0.0125, and hiatal hernia (OR: 1.46; 95% CI: 1.12-1.90; p = 0.0042 were associated with acid regurgitation symptoms.There is a discrepancy between subjective symptoms and endoscopic GERD grade in DM patients. The ability of DM patients to feel acid regurgitation may be decreased.

  12. Quantitation of valve regurgitation severity by three-dimensional vena contracta area is superior to flow convergence method of quantitation on transesophageal echocardiography.

    Abudiab, Muaz M; Chao, Chieh-Ju; Liu, Shuang; Naqvi, Tasneem Z

    2017-07-01

    Quantitation of regurgitation severity using the proximal isovelocity acceleration (PISA) method to calculate effective regurgitant orifice (ERO) area has limitations. Measurement of three-dimensional (3D) vena contracta area (VCA) accurately grades mitral regurgitation (MR) severity on transthoracic echocardiography (TTE). We evaluated 3D VCA quantitation of regurgitant jet severity using 3D transesophageal echocardiography (TEE) in 110 native mitral, aortic, and tricuspid valves and six prosthetic valves in patients with at least mild valvular regurgitation. The ASE-recommended integrative method comprising semiquantitative and quantitative assessment of valvular regurgitation was used as a reference method, including ERO area by 2D PISA for assigning severity of regurgitation grade. Mean age was 62.2±14.4 years; 3D VCA quantitation was feasible in 91% regurgitant valves compared to 78% by the PISA method. When both methods were feasible and in the presence of a single regurgitant jet, 3D VCA and 2D PISA were similar in differentiating assigned severity (ANOVAP<.001). In valves with multiple jets, however, 3D VCA had a better correlation to assigned severity (ANOVAP<.0001). The agreement of 2D PISA and 3D VCA with the integrative method was 47% and 58% for moderate and 65% and 88% for severe regurgitation, respectively. Measurement of 3D VCA by TEE is superior to the 2D PISA method in determination of regurgitation severity in multiple native and prosthetic valves. © 2017, Wiley Periodicals, Inc.

  13. Radionuclide transverse section imager

    Stoddart, H.F.

    1980-01-01

    A radioisotope scanning apparatus for use in nuclear medicine is described in detail. The apparatus enables the quantification and spatial location of the radioactivity in a body section of a patient to be determined with high sensitivity. It consists of an array of highly focussed collimators arranged such that adjacent collimators move in the same circumferential but opposite radial directions. The explicit movements of the gantry are described in detail and may be controlled by a general purpose computer. The use of highly focussed collimators allows both a reasonable solid angle of acceptance and also high target to background images; additionally, dual radionuclide pharmaceutical studies can be performed simultaneously. It is claimed that the high sensitivity of the system permits the early diagnosis of pathological changes and the images obtained show accurately the location and shape of physiological abnormalities. (UK)

  14. Radioactivity, radionuclides, radiation

    Magill, Joseph

    2005-01-01

    RADIOACTIVITY – RADIONUCLIDES – RADIATION is suitable for a general audience interested in topical environmental and human health radiological issues such as radiation exposure in aircraft, food sterilisation, nuclear medicine, radon gas, radiation dispersion devices ("dirty bombs")… It leads the interested reader through the three Rs of nuclear science, to the forefront of research and developments in the field. The book is also suitable for students and professionals in the related disciplines of nuclear and radiochemistry, health physics, environmental sciences, nuclear and astrophysics. Recent developments in the areas of exotic decay modes (bound beta decay of ‘bare’ or fully ionized nuclei), laser transmutation, nuclear forensics, radiation hormesis and the LNT hypothesis are covered. Atomic mass data for over 3000 nuclides from the most recent (2003) evaluation are included.

  15. Deep sea radionuclides

    Kanisch, G.; Vobach, M.

    1993-01-01

    Every year since 1979, either in sping or in summer, the fishing research vessel 'Walther Herwig' goes to the North Atlantic disposal areas of solid radioactive wastes, and, for comparative purposes, to other areas, in order to collect water samples, plankton and nekton, and, from the deep sea bed, sediment samples and benthos organisms. In addition to data on the radionuclide contents of various media, information about the plankton, nekton and benthos organisms living in those areas and about their biomasses could be gathered. The investigations are aimed at acquiring scientifically founded knowledge of the uptake of radioactive substances by microorganisms, and their migration from the sea bottom to the areas used by man. (orig.) [de

  16. Radionuclide reporter gene imaging

    Min, Jung Joon

    2004-01-01

    Recent progress in the development of non-invasive imaging technologies continues to strengthen the role of molecular imaging biological research. These tools have been validated recently in variety of research models, and have been shown to provide continuous quantitative monitoring of the location(s), magnitude, and time-variation of gene expression. This article reviews the principles, characteristics, categories and the use of radionuclide reporter gene imaging technologies as they have been used in imaging cell trafficking, imaging gene therapy, imaging endogenous gene expression and imaging molecular interactions. The studies published to date demonstrate that reporter gene imaging technologies will help to accelerate model validation as well as allow for clinical monitoring of human diseases

  17. Radionuclide reporter gene imaging

    Min, Jung Joon [School of Medicine, Chonnam National Univ., Gwangju (Korea, Republic of)

    2004-04-01

    Recent progress in the development of non-invasive imaging technologies continues to strengthen the role of molecular imaging biological research. These tools have been validated recently in variety of research models, and have been shown to provide continuous quantitative monitoring of the location(s), magnitude, and time-variation of gene expression. This article reviews the principles, characteristics, categories and the use of radionuclide reporter gene imaging technologies as they have been used in imaging cell trafficking, imaging gene therapy, imaging endogenous gene expression and imaging molecular interactions. The studies published to date demonstrate that reporter gene imaging technologies will help to accelerate model validation as well as allow for clinical monitoring of human diseases.

  18. Natural radionuclides in groundwaters

    Laul, J.C.

    1990-01-01

    The U-234 and Th-230 radionuclides are highly retarded by factors of 10 4 to 10 5 in basalt groundwater (Hanford) and briny groundwaters from Texas and geothermal brine from the Salton Sea Geothermal Field (SSGF). In basalt groundwaters (low ionic strength), Ra is highly sorbed, while in brines (high ionic strength), Ra is soluble. This is probably because the sorption sites are saturated with Na + and Cl - ions and RaCl 2 is soluble in brines. Pb-210 is soluble in SSGF brine, probably as a chloride complex. The U-234/Th-230 ratios in basalt groundwaters and brines from Texas and SSGF are nearly unity, indicating that U is in the +4 state, suggesting a reducing environment for these aquifers. 19 refs., 3 figs

  19. Natural radionuclides in groundwaters

    Laul, J.C.

    1992-01-01

    The 234 U and 230 Th radionuclides are highly retarded by factors of 10 4 to 10 5 in basalt groundwater (Hanford) and briny groundwaters from Texas, and geothermal brine form the Salton Sea Geothermal Field (SSGF). In basalt groundwaters (low ionic strength), Ra is highly sorbed, while in brines (high ionic strength), Ra is soluble. This is probably because the sorption sites are saturated with Na + and Cl - ions, and RaCl 2 is soluble in brines. 210 Pb is soluble in SSGF brine, probably as a chloride complex. The 234 U/ 230 Th ratios in basalt groundwaters and brines from Texas and SSGF are nearly unity, indicating that U is in the +4 state, suggesting a reducing environment for these aquifers. (author) 19 refs.; 3 figs

  20. Right ventricular reduction for repair of functional tricuspid valve regurgitation: one-year follow up.

    Ouda, Ahmed; Matschke, Klaus; Ghazy, Tamer; Speiser, Uwe; Alexiou, Konstantin; Tugtekin, Sems-Malte; Schoen, Steffen; Kappert, Utz

    2013-09-01

    The study aim was to assess the impact of reducing the right ventricular (RV) cavity in order to optimize the outcome of tricuspid valve (TV) repair in cases of functional tricuspid regurgitation (FTR) with dilated right ventricle. Between May 2007 and February 2010, a total of 17 patients (six males, 11 females; mean age 69.5 +/- 10.1 years; mean logistic EuroSCORE 24 +/- 13%) with severe FTR and severe RV dilation were included. Echocardiography and magnetic resonance imaging (MRI) were performed for geometric assessment of the right ventricle. Intraoperatively, the lateral RV free wall was plicated to reduce the RV cavum to approximate the papillary muscles and decrease tethering of the TV; a conventional ring annuloplasty was then performed. Follow up included echocardiography and MRI at one month and one year postoperatively. The mean operative time was 157 +/- 30 min, and the cross-clamp time 63 13 min. Postoperatively, the mean bleeding volume was 486 +/- 455 ml, the rethoracotomy rate 5.9%, intensive therapy unit (ITU) stay 6.0 +/- 4.4 days, and hospital stay 19.0 +/- 8.8 days. In-hospital mortality was 17.6%. The mean follow up was 14.4 +/- 2.4 months. The one-year follow up revealed a survival of 82.3%, a slight decrease in RV ejection fraction (from 33.5 +/- 4.2% to 31.7 +/- 5.7%; p = 0.13), a significant reduction in the RV end-diastolic volume index (from 160 +/- 15.6 to 128 +/- 10 ml/m2; p = 0.0001), a reduction in TV tenting area (from 3.3 +/- 0.9 to 0.9 +/- 0.3 cm2; p = 0.0001), and a significant reduction in the ratio of TR jet to right atrial surface area (from 54.8 +/- 8.2% to 14.1 +/- 3.5%; p = 0.0001). In cases of FTR, RV dilation may be considered as a correctable factor at subvalvular level to optimize the outcome of TV repair.

  1. Significant Radionuclides Determination

    Jo A. Ziegler

    2001-07-31

    The purpose of this calculation is to identify radionuclides that are significant to offsite doses from potential preclosure events for spent nuclear fuel (SNF) and high-level radioactive waste expected to be received at the potential Monitored Geologic Repository (MGR). In this calculation, high-level radioactive waste is included in references to DOE SNF. A previous document, ''DOE SNF DBE Offsite Dose Calculations'' (CRWMS M&O 1999b), calculated the source terms and offsite doses for Department of Energy (DOE) and Naval SNF for use in design basis event analyses. This calculation reproduces only DOE SNF work (i.e., no naval SNF work is included in this calculation) created in ''DOE SNF DBE Offsite Dose Calculations'' and expands the calculation to include DOE SNF expected to produce a high dose consequence (even though the quantity of the SNF is expected to be small) and SNF owned by commercial nuclear power producers. The calculation does not address any specific off-normal/DBE event scenarios for receiving, handling, or packaging of SNF. The results of this calculation are developed for comparative analysis to establish the important radionuclides and do not represent the final source terms to be used for license application. This calculation will be used as input to preclosure safety analyses and is performed in accordance with procedure AP-3.12Q, ''Calculations'', and is subject to the requirements of DOE/RW-0333P, ''Quality Assurance Requirements and Description'' (DOE 2000) as determined by the activity evaluation contained in ''Technical Work Plan for: Preclosure Safety Analysis, TWP-MGR-SE-000010'' (CRWMS M&O 2000b) in accordance with procedure AP-2.21Q, ''Quality Determinations and Planning for Scientific, Engineering, and Regulatory Compliance Activities''.

  2. Radionuclide calibrators performance evaluation

    Mora Ramirez, E.; Zeledon Fonseca, P.; Jimenez Cordero, M.

    2008-01-01

    Radionuclide calibrators are used to estimate accurately activity prior to administration to a patient, so it is very important that this equipment meets its performance requirements. The purpose of this paper is to compare the commercially available 'Calicheck' (Calcorp. Inc), used to assess linearity, versus the well-known source decay method, and also to show our results after performing several recommended quality control tests. The parameters that we wanted to evaluate were carried on using the Capintec CRC-15R and CRC-15 β radionuclide calibrators. The evaluated tests were: high voltage, display, zero adjust, background, reproducibility, source constancy, accuracy, precision and linearity. The first six tests were evaluated on the daily practice, here we analyzed the 2007 recorded data; and the last three were evaluated once a year. During the daily evaluation both calibrators performance were satisfactory comparing with the manufacture's requirements. The accuracy test show result within the ± 10% allowed for a field instrument. Precision performance is within the ± 1 % allowed. On the other hand, the linearity test shows that using the source decay method the relative coefficient is 0.9998, for both equipment and using the Calicheck the relative coefficient is 0.997. However, looking the percentage of error, during the 'Calicheck' test, its range goes from 0.0 % up to -25.35%, and using the source decay method, the range goes from 0.0 % up to -31.05 %, taking into account both instruments. Checking the 'Calicheck' results we can see that the results varying randomly, but using the source decay method the percentage of error increase as the source activity decrease. We conclude that both devices meet its manufactures requirements, in the case of the linearity using the decay method, decreasing the activity source, increasing the percentage of error, this may happen because of the equipment age. (author)

  3. Effects of milrinone and epinephrine or dopamine on biventricular function and hemodynamics in right heart failure after pulmonary regurgitation.

    Hyldebrandt, Janus Adler; Agger, Peter; Sivén, Eleonora; Wemmelund, Kristian Borup; Heiberg, Johan; Frederiksen, Christian Alcaraz; Ravn, Hanne Berg

    2015-09-01

    Right ventricular failure (RVF) secondary to pulmonary regurgitation (PR) impairs right ventricular (RV) function and interrupts the interventricular relationship. There are few recommendations for the medical management of severe RVF after prolonged PR. PR was induced in 16 Danish landrace pigs by plication of the pulmonary valve leaflets. Twenty-three pigs served as controls. At reexamination the effect of milrinone, epinephrine, and dopamine was evaluated using biventricular conductance and pulmonary catheters. Seventy-nine days after PR was induced, RV end-diastolic volume index (EDVI) had increased by 33% (P = 0.006) and there was a severe decrease in the load-independent measurement of contractility (PRSW) (-58%; P = 0.003). Lower cardiac index (CI) (-28%; P Milrinone improved RV-PRSW and CI and maintained systemic pressure while reducing central venous pressure (CVP). Epinephrine and dopamine further improved biventricular PRSW and CI equally in a dose-dependent manner. Systemic and pulmonary pressures were higher in the dopamine-treated animals compared with epinephrine-treated animals. None of the treatments improved stroke volume index (SVI) despite increases in contractility. Strong correlation was detected between SVI and LV-EDVI, but not SVI and biventricular contractility. In RVF due to PR, milrinone significantly improved CI, SvO2, and CVP and increased contractility in the RV. Epinephrine and dopamine had equal inotropic effect, but a greater vasopressor effect was observed for dopamine. SV was unchanged due to inability of both treatments to increase LV-EDVI. Copyright © 2015 the American Physiological Society.

  4. Geomorphological applications of environmental radionuclides

    Quine, T.A.; Walling, D.

    1998-01-01

    Geomorphologists have shown increasing interest in environmental radionuclides since pioneering studies by Ritchie and McHenry in the USA and Campbell, Longmore and Loughran in Australia. Environmental radionuclides have attracted this interest because they provide geomorphologists with the means to trace sediment movement within the landscape. They, therefore, facilitate investigation of subjects at the core of geomorphology, namely the rates and patterns of landscape change. Most attention has been focussed on the artificial radionuclide caesium-137 ( 137 Cs) but more recently potential applications of the natural radionuclides lead-210 ( 210 Pb) and beryllium-7( 7 Be) have been investigated (Walling et al., 1995; Wallbrink and Murray, 1996a, 1996b). The origin, characteristics and applications of these radionuclides are summarised. These radionuclides are of value as sediment tracers because of three important characteristics: a strong affinity for sediment; a global distribution and the possibility of measurement at low concentration. Geomorphological applications of environmental radionuclides provide unique access to detailed qualitative data concerning landscape change over a range of timescales

  5. Radionuclide and ultrasonic investigations in liver cirrhosis with portal hypertension

    Khodzhibekov, M.Kh.; Rikhsieva, L.Eh.; Nazyrov, F.G.

    1988-01-01

    Combined radionuclide and ultrasonic investigations (UNI) were performed in 95 patients with liver cirrhosis complicated by portal hypertension. Liver and splenic shape structure and the presence of fluid in the abdominal cavity were assessed in USI. Radionuclide methods of investigation of the hepatic blood flow, assessment of the shape, size and structure of RP distribution in the liver and spleen, and for calculation of the hepatosplenic index. The most significant signs of differentiation of stages of portal hypertension were the presence and amount of fluid in the abdominal cavity and a hepatic blood flow value reflecting the gravity of portal hypertension. Combined radionuclide and ultrasonic investigations permitted a differentiated approach to staging of portal hypertension and assessment of liver and splenic morphofunctional state that could play an important role in the choice of tactics of surgery of liver cirrhosis

  6. Radionuclide and ultrasonic investigations in liver cirrhosis with portal hypertension

    Khodzhibekov, M Kh; Rikhsieva, L Eh; Nazyrov, F G

    1988-08-01

    Combined radionuclide and ultrasonic investigations (UNI) were performed in 95 patients with liver cirrhosis complicated by portal hypertension. Liver and splenic shape structure and the presence of fluid in the abdominal cavity were assessed in USI. Radionuclide methods of investigation of the hepatic blood flow, assessment of the shape, size and structure of RP distribution in the liver and spleen, and for calculation of the hepatosplenic index. The most significant signs of differentiation of stages of portal hypertension were the presence and amount of fluid in the abdominal cavity and a hepatic blood flow value reflecting the gravity of portal hypertension. Combined radionuclide and ultrasonic investigations permitted a differentiated approach to staging of portal hypertension and assessment of liver and splenic morphofunctional state that could play an important role in the choice of tactics of surgery of liver cirrhosis.

  7. Activity measurement of 33P and 32P radionuclide mixture

    Hanker, I.; Kansky, Z.

    1984-01-01

    The possibilities are briefly summed up of measuring mixtures of 33 P and 32 P with special regard to the method of simultaneous determination of both radionuclides in a liquid scintillator. This method was experimentally tested for special detection sensitivity and intended special applications in plant physiology and biochemistry using a dioxane scintillator (SLD-31, Spolana Neratovice, CSSR) and a Packard Tri-Carb 300 C, USA. The method gave erroneous results. The main cause of the errors in measurements of the 33 P and 32 P mixture in the SLD-31 was the adsorption of radionuclides on the inner wall of glass tubes. This phenomenon is not accompanied by changes in the quenching index. However, the effectiveness of measurement dropped and the relative contribution of the spectra of the two radionuclides changed with the time following sample preparation. The said effects were removed by adding 0.4% silicon dioxide (Cab-O-Sil M5, Serva) to the liquid scintillator. (author)

  8. Radionuclides in Canada goose eggs

    Rickard, W.H.; Sweany, H.A.

    1975-01-01

    Low levels of radionuclides were measured in Canada goose eggs taken from deserted nests from Columbia River islands on the Energy Research and Development Administration's Hanford Reservation. Potassium-40, a naturally occurring radionuclide, was the most abundant radionuclide measured in egg contents and egg shell. Strontium-90 was incorporated into egg shells and cesium-137 into inner egg contents. Manganese-54, cobalt-60, and zinc-65 were more abundant in inner egg contents than in egg shell. Cerium-144 was detected in egg shell but not in inner shell

  9. Radionuclide migration in water reservoirs

    Rodionova, L.F.

    1983-01-01

    Toxicity degree and radiation effect of different radionuclides depend on multiple factors, whose interaction can strengthen or weaken the effects through the mechanism of nuclide accumulation by hydrobiontes. Stage of development of an aquatic organism, its age, mass and sex as well as lifetime and residence time of the organism in the given medium are of importance. The radionuclide build up depends on illumination, locale of the bioobject residence, on the residence nature. The concentration of radionuclides in aquatic organisms and bionts survival depend on a season, temperature of the residence medium, as well as salinity and mineral composition of water influence

  10. Quantification of mitral regurgitation on cardiac computed tomography: comparison with qualitative and quantitative echocardiographic parameters.

    Arnous, Samer

    2012-02-01

    PURPOSE: To assess whether cardiac computed tomographic angiography (CCTA) can quantify the severity of chronic mitral regurgitation (MR) compared to qualitative and quantitative echocardiographic parameters. MATERIALS AND METHODS: Cardiac computed tomographic angiography was performed in 23 patients (mean +\\/- SD age, 63 +\\/- 16 years; range, 24-86 years) with MR and 20 patients without MR (controls) as determined by transthoracic echocardiography. Multiphasic reconstructions (20 data sets reconstructed at 5% increments of the electrocardiographic gated R-R interval) were used to analyze the mitral valve. Using CCTA planimetry, 2 readers measured the regurgitant mitral orifice area (CCTA ROA) during systole. A qualitative echocardiographic assessment of severity of MR was made by visual assessment of the length of the regurgitant jet. Quantitative echocardiographic measurements included the vena contracta, proximal isovelocity surface area, regurgitant volume, and estimated regurgitant orifice (ERO). Comparisons were performed using the independent t test, and correlations were assessed using the Spearman rank test. RESULTS: All controls and the patients with MR were correctly identified by CCTA. For patients with mild, moderate, or severe MR, mean +\\/- SD EROs were 0.16 +\\/- 0.03, 0.31 +\\/- 0.08, and 0.52 +\\/- 0.03 cm(2) (P < 0.0001) compared with mean +\\/- SD CCTA ROAs 0.09 +\\/- 0.05, 0.30 +\\/- 0.04, and 0.97 +\\/- 0.26 cm(2) (P < 0.0001), respectively. When echocardiographic measurements were graded qualitatively as mild, moderate, or severe, strong correlations were seen with CCTA ROA (R = 0.89; P < 0.001). When echocardiographic measurements were graded quantitatively, the vena contracta and the ERO showed modest correlations with CCTA ROA (0.48 and 0.50; P < 0.05 for both). Neither the proximal isovelocity surface area nor the regurgitant volume demonstrated significant correlations with CCTA ROA. CONCLUSIONS: Single-source 64-slice CCTA provides a

  11. Artificial radionuclides in soil, flora and fauna

    Marej, A.N.

    1984-01-01

    Sources and ways of soil contamination by radionuclides, as well as the main regularities of radionuclide behaviour in soils, are discussed. Ways of radionuclide uptake by plants are discussed in detail, since radionuclide contamination of vegetation, and agricultural plants and pastures in particular, is one of the main factors, determining sanitary value of environmental contamination by radioactive substances

  12. The value of preoperative 3-dimensional over 2-dimensional valve analysis in predicting recurrent ischemic mitral regurgitation after mitral annuloplasty

    Wijdh-den Hamer, Inez J.; Bouma, Wobbe; Lai, Eric K.; Levack, Melissa M.; Shang, Eric K.; Pouch, Alison M.; Eperjesi, Thomas J.; Plappert, Theodore J.; Yushkevich, Paul A.; Hung, Judy; Mariani, Massimo A.; Khabbaz, Kamal R.; Gleason, Thomas G.; Mahmood, Feroze; Acker, Michael A.; Woo, Y. Joseph; Cheung, Albert T.; Gillespie, Matthew J.; Jackson, Benjamin M.; Gorman, Joseph H.; Gorman, Robert C.

    Objectives: Repair for ischemic mitral regurgitation with undersized annuloplasty is characterized by high recurrence rates. We sought to determine the value of pre-repair 3-dimensional echocardiography over 2-dimensional echocardiography in predicting recurrence at 6 months. Methods: Intraoperative

  13. Speckle-tracking echocardiography for predicting outcome in chronic aortic regurgitation during conservative management and after surgery

    Olsen, Niels Thue; Søgaard, Peter; Larsson, Henrik B W

    2011-01-01

    Objectives The aim of this study was to test myocardial deformation imaging using speckle-tracking echocardiography for predicting outcomes in chronic aortic regurgitation. Background In chronic aortic regurgitation, left ventricular (LV) dysfunction must be detected early to allow timely surgery....... Speckle-tracking echocardiography has been proposed for this purpose, but the clinical value of this method in aortic regurgitation has not been established. Methods A longitudinal study was performed in 64 patients with moderate to severe aortic regurgitation. Thirty-five patients were managed...... conservatively with frequent clinical visits and sequential echocardiography and followed for an average of 19 ± 8 months, while 29 patients underwent surgery for the valve lesion and were followed for 6 months post-operatively. Baseline LV function by speckle-tracking and conventional echocardiography...

  14. Nanotargeted Radionuclides for Cancer Nuclear Imaging and Internal Radiotherapy

    Gann Ting

    2010-01-01

    Full Text Available Current progress in nanomedicine has exploited the possibility of designing tumor-targeted nanocarriers being able to deliver radionuclide payloads in a site or molecular selective manner to improve the efficacy and safety of cancer imaging and therapy. Radionuclides of auger electron-, α-, β-, and γ-radiation emitters have been surface-bioconjugated or after-loaded in nanoparticles to improve the efficacy and reduce the toxicity of cancer imaging and therapy in preclinical and clinical studies. This article provides a brief overview of current status of applications, advantages, problems, up-to-date research and development, and future prospects of nanotargeted radionuclides in cancer nuclear imaging and radiotherapy. Passive and active nanotargeting delivery of radionuclides with illustrating examples for tumor imaging and therapy are reviewed and summarized. Research on combing different modes of selective delivery of radionuclides through nanocarriers targeted delivery for tumor imaging and therapy offers the new possibility of large increases in cancer diagnostic efficacy and therapeutic index. However, further efforts and challenges in preclinical and clinical efficacy and toxicity studies are required to translate those advanced technologies to the clinical applications for cancer patients.

  15. Radionuclide methods in pediatric cardiology

    Reich, O.; Ruth, C.; Samanek, M.

    1990-01-01

    The use of radionuclide methods in pediatric cardiology is discussed for non-invasive evaluation of myocardial function and perfusion, regional lung perfusion and ventilation, and for measuring central and peripheral hemodynamics. (H.W.). 16 refs

  16. Radionuclide Retention in Concrete Wasteforms

    Bovaird, Chase C.; Jansik, Danielle P.; Wellman, Dawn M.; Wood, Marcus I.

    2011-09-30

    Assessing long-term performance of Category 3 waste cement grouts for radionuclide encasement requires knowledge of the radionuclide-cement interactions and mechanisms of retention (i.e., sorption or precipitation); the mechanism of contaminant release; the significance of contaminant release pathways; how wasteform performance is affected by the full range of environmental conditions within the disposal facility; the process of wasteform aging under conditions that are representative of processes occurring in response to changing environmental conditions within the disposal facility; the effect of wasteform aging on chemical, physical, and radiological properties; and the associated impact on contaminant release. This knowledge will enable accurate prediction of radionuclide fate when the wasteforms come in contact with groundwater. The information present in the report provides data that (1) measures the effect of concrete wasteform properties likely to influence radionuclide migration; and (2) quantifies the rate of carbonation of concrete materials in a simulated vadose zone repository.

  17. Radionuclides in the food chain

    Harley, J.H.; Schmidt, G.D.

    1988-01-01

    Radionuclides in the Food Chain reviews past experience in meeting the challenge of radionuclide contamination of foodstuffs and water sources and, in the wake of the reactor accidents at Chernobyl and Three Mile Island, presents current concepts and programs relating to measurement, surveillance, effects, risk management, evaluation guidelines, and control and regulatory activities. This volume, based on a symposium sponsored by the International Life Sciences Institute in association with the International Institute for Applied Systems Analysis, which brought together both radiation experts and food industry policymakers, examines such vital topics as structural problems in large-scale crisis-managment systems; dose assessment from man-made sources; international recommendations on radiation protection; airborne contamination, as well as aquatic and soilborne radionuclides; food-chain contamination from testing nuclear devices; long-term health effects of radionuclides in food and water supplies; and use of mathematical models in risk assessment and management. (orig.)

  18. Drift-Scale Radionuclide Transport

    Houseworth, J.

    2004-01-01

    The purpose of this model report is to document the drift scale radionuclide transport model, taking into account the effects of emplacement drifts on flow and transport in the vicinity of the drift, which are not captured in the mountain-scale unsaturated zone (UZ) flow and transport models ''UZ Flow Models and Submodels'' (BSC 2004 [DIRS 169861]), ''Radionuclide Transport Models Under Ambient Conditions'' (BSC 2004 [DIRS 164500]), and ''Particle Tracking Model and Abstraction of Transport Process'' (BSC 2004 [DIRS 170041]). The drift scale radionuclide transport model is intended to be used as an alternative model for comparison with the engineered barrier system (EBS) radionuclide transport model ''EBS Radionuclide Transport Abstraction'' (BSC 2004 [DIRS 169868]). For that purpose, two alternative models have been developed for drift-scale radionuclide transport. One of the alternative models is a dual continuum flow and transport model called the drift shadow model. The effects of variations in the flow field and fracture-matrix interaction in the vicinity of a waste emplacement drift are investigated through sensitivity studies using the drift shadow model (Houseworth et al. 2003 [DIRS 164394]). In this model, the flow is significantly perturbed (reduced) beneath the waste emplacement drifts. However, comparisons of transport in this perturbed flow field with transport in an unperturbed flow field show similar results if the transport is initiated in the rock matrix. This has led to a second alternative model, called the fracture-matrix partitioning model, that focuses on the partitioning of radionuclide transport between the fractures and matrix upon exiting the waste emplacement drift. The fracture-matrix partitioning model computes the partitioning, between fractures and matrix, of diffusive radionuclide transport from the invert (for drifts without seepage) into the rock water. The invert is the structure constructed in a drift to provide the floor of the

  19. Factors associated with the development of aortic valve regurgitation over time after two different techniques of valve-sparing aortic root surgery.

    Hanke, Thorsten; Charitos, Efstratios I; Stierle, Ulrich; Robinson, Derek; Gorski, Armin; Sievers, Hans-H; Misfeld, Martin

    2009-02-01

    Early results after aortic valve-sparing root reconstruction are excellent. Longer-term follow-up, especially with regard to aortic valve function, is required for further judgment of these techniques. Between July of 1993 and September of 2006, 108 consecutive patients (mean age 53.0 +/- 15.8 years) underwent the Yacoub operation (group Y) and 83 patients underwent the David operation (group D). Innovative multilevel hierarchic modeling methods were used to analyze aortic regurgitation over time. In general, aortic regurgitation increased with time in both groups. Factors associated with the development of a significant increase in aortic regurgitation were Marfan syndrome, concomitant cusp intervention, and preoperative aortic anulus dimension. In Marfan syndrome, the initial aortic regurgitation was higher in group Y versus group D (0.56 aortic regurgitation vs 0.29 aortic regurgitation, P = .049), whereas the mean annual progression rate of aortic regurgitation was marginally higher in group Y (0.132 aortic regurgitation vs 0.075 aortic regurgitation, P = .1). Concomitant cusp intervention was associated with a significant aortic regurgitation increase in both groups (P Marfan syndrome and a large preoperative aortic annulus diameter were better treated with the reimplantation technique, whereas those with a smaller diameter were better treated with the remodeling technique. Concomitant free-edge plication of prolapsing cusps was disadvantageous in both groups. Considering these factors may serve to improve the aortic valve longevity after valve-sparing aortic root surgery.

  20. Surface diffusion of sorbed radionuclides

    Berry, J.A.; Bond, K.A.

    1991-01-01

    Surface diffusion has in the past been invoked to explain rates of radionuclide migration which were greater than those predicted. Results were generally open to interpretation but the possible existence of surface diffusion, whereby sorbed radionuclides could potentially migrate at much enhanced rates, necessitated investigation. In this work through-diffusion experiments have shown that although surface diffusion does exist for some nuclides, the magnitude of the phenomenon is not sufficient to affect repository safety assessment modelling. (author)

  1. Radionuclide generators for biomedical applications

    Finn, R.D.; Molinski, V.J.; Hupf, H.B.; Kramer, H.

    1983-10-01

    This document reviews the chemical literature of those radionuclide generators that have gained or appear to possess utility in medical imaging. The text represents a conscientious effort to peruse the scientific literature through 1980. The intent of this work is to provide a reference point for the investigator who is interested in the development of a particular generator system and the refinements which have been reported. Moreover, the incorporation of the particular daughter radionuclide into a suitable radiodiagnostic agent is presented

  2. Radionuclide migration in soils

    Demir, M [Ingenieurgesellschaft Bonnenberg und Drescher, Juelich (Germany, F.R.)

    1979-01-01

    Unplanned releases from a nuclear installation - e.g., leakage from a storage tank or other incident - can result in the escape of contaminants such as U, Pu, Cs, Sr, T etc. Nuclide transport through the ground is governed by characteristics of the subsurface hydrology and the specific nuclides under consideration. Unsaturated soil layers result in a transport rate so low as to negligible. Radionuclides reaching the ground water are assumed to endanger human life because of potential uncontrolled ingestion. The most dangerous nuclides are long-lived and not absorbed, or very poorly absorbed, in the soil. During migration of nuclides through saturated soil layers, the concentration can be reduced by dilution. Preliminary results indicate that tritium is spread with ground water velocity. Its concentration can be reduced only by diffusion, dispersion and radioactive decay. Alpha-emitters are strongly retained velocities of alpha-emitters are approximately one thousandth (10/sup -3/) that of T. Transport velocities of Cs and Sr are approximately one hundreth (10/sup -2/) and one tenth (10/sup -1/) that of T respectively.

  3. Radionuclide migration in soils

    Demir, M.

    1979-01-01

    Unplanned releases from a nuclear installation - e.g., leakage from a storage tank or other incident - can result in the escape of contaminants such as U, Pu, Cs, Sr, T etc. Nuclide transport through the ground is governed by characteristics of the subsurface hydrology and the specific nuclides under consideration. Unsaturated soil layers result in a transport rate so low as to negligible. Radionuclides reaching the ground water are assumed to endanger human life because of potential uncontrolled ingestion. The most dangerous nuclides are long-lived and not absorbed, or very poorly absorbed, in the soil. During migration of nuclides through saturated soil layers, the concentration can be reduced by dilution. Preliminary results indicate that tritium is spread with ground water velocity. Its concentration can be reduced only by diffusion, dispersion and radioactive decay. Alpha-emitters are strongly retained velocities of alpha-emitters are approximately one thousandth (10 -3 ) that of T. Transport velocities of Cs and Sr are approximately one hundreth (10 -2 ) and one tenth (10 -1 ) that of T respectively. (orig./HP) [de

  4. Radionuclide salivary gland imaging

    Mishkin, F.S.

    1981-10-01

    Salivary gland imaging with 99mTc as pertechnetate provides functional information concerning trapping and excretion of the parotid and submandibular glands. Anatomic information gained often adds little to clinical evaluation. On the other hand, functional information may detect subclinical involvement, which correlates well with biopsy of the minor labial salivary glands. Salivary gland abnormalities in systemic disease such as sarcoidosis, rheumatoid arthritis, lupus erythematosus, and other collagenvascular disorders may be detected before they result in the clinical manifestaions of Sjoegren's syndrome. Such glands, after initially demonstrating increased trapping in the acute phase, tend to have decreased trapping and failure to discharge pertechnetate in response to an appropriate physiologic stimulus. Increased uptake of gallium-67 citrate often accompanies these findings. Inflammatory parotitis can be suspected when increased perfusion is evident on radionuclide angiography with any agent. The ability of the salivary gland image to detect and categorize mass lesions, which result in focal areas of diminished activity such as tumors, cysts, and most other masses, is disappointing, while its ability to detect and categorize Warthin's tumor, which concentrates pertechnetate, is much more valuable, although not specific.

  5. Radionuclide brain scanning

    Abdel-Dayem, H.

    1992-01-01

    At one stage of medical imaging development, radionuclide brain scanning was the only technique available for imaging of the brain. Advent of CT and MRI pushed it to the background. It regained some of the grounds lost to ''allied advances'' with the introduction of brain perfusion radiopharmaceuticals. Positron emission tomography is a promising functional imaging modality that at present will remain as a research tool in special centres in developed countries. However, clinically useful developments will gradually percolate from PET to SPECT. The non-nuclear imaging methods are totally instrument dependent; they are somewhat like escalators, which can go that far and no further. Nuclear imaging has an unlimited scope for advance because of the new developments in radiopharmaceuticals. As the introduction of a radiopharmaceutical is less costly than buying new instruments, the recent advances in nuclear imaging are gradually perfusing through the developing countries also. Therefore, it is essential to follow very closely PET developments because what is research today might become routine tomorrow

  6. Radionuclides migration or isolation?

    Toulhoat, P.; Grambow, B.; Simoni, E.

    2005-01-01

    After 20 years of research, the chemical behaviour of actinides and fission products in nuclear waste disposal environments is much better understood. Consistent thermodynamic data have been gathered and allow much more accurate previsions. Through the considerable development of analytical spectroscopy, including time resolved laser fluorescence and X ray absorption, a better understanding of the chemical reactivity (complexation, sorption) of actinides and fission products at a molecular scale has been possible. Chemically reducing conditions are found in most selected disposal host rock formations, generally chosen for their high sorption capacity (clays); such conditions favour the chemical confinement of most radionuclides through precipitation or sorption. Low permeability host rocks participate to this confinement, as convective fluxes are lower than diffusive fluxes. The most recent performance assessment exercises have taken into account the recent progress of knowledge in the chemical evolution of the near field. They show that the dose rates at the outlet are far lower than existing recommendations for normal and most altered evolution scenarios. (authors)

  7. Radionuclide salivary gland imaging

    Mishkin, F.S.

    1981-01-01

    Salivary gland imaging with 99mTc as pertechnetate provides functional information concerning trapping and excretion of the parotid and submandibular glands. Anatomic information gained often adds little to clinical evaluation. On the other hand, functional information may detect subclinical involvement, which correlates well with biopsy of the minor labial salivary glands. Salivary gland abnormalities in systemic disease such as sarcoidosis, rheumatoid arthritis, lupus erythematosus, and other collagenvascular disorders may be detected before they result in the clinical manifestaions of Sjoegren's syndrome. Such glands, after initially demonstrating increased trapping in the acute phase, tend to have decreased trapping and failure to discharge pertechnetate in response to an appropriate physiologic stimulus. Increased uptake of gallium-67 citrate often accompanies these findings. Inflammatory parotitis can be suspected when increased perfusion is evident on radionuclide angiography with any agent. The ability of the salivary gland image to detect and categorize mass lesions, which result in focal areas of diminished activity such as tumors, cysts, and most other masses, is disappointing, while its ability to detect and categorize Warthin's tumor, which concentrates pertechnetate, is much more valuable, although not specific

  8. Radionuclide brain scanning

    Abdel-Dayem, H

    1993-12-31

    At one stage of medical imaging development, radionuclide brain scanning was the only technique available for imaging of the brain. Advent of CT and MRI pushed it to the background. It regained some of the grounds lost to ``allied advances`` with the introduction of brain perfusion radiopharmaceuticals. Positron emission tomography is a promising functional imaging modality that at present will remain as a research tool in special centres in developed countries. However, clinically useful developments will gradually percolate from PET to SPECT. The non-nuclear imaging methods are totally instrument dependent; they are somewhat like escalators, which can go that far and no further. Nuclear imaging has an unlimited scope for advance because of the new developments in radiopharmaceuticals. As the introduction of a radiopharmaceutical is less costly than buying new instruments, the recent advances in nuclear imaging are gradually perfusing through the developing countries also. Therefore, it is essential to follow very closely PET developments because what is research today might become routine tomorrow

  9. Anthropogenic radionuclides in the environment

    Hu, Q; Weng, J; Wang, J

    2007-11-15

    Studies of radionuclides in the environment have entered a new era with the renaissance of nuclear energy and associated fuel reprocessing, geological disposal of high-level nuclear wastes, and concerns about national security with respect to nuclear non-proliferation. This work presents an overview of anthropogenic radionuclide contamination in the environment, as well as the salient geochemical behavior of important radionuclides. We first discuss the following major anthropogenic sources and current development that contribute to the radionuclide contamination of the environment: (1) nuclear weapons program; (2) nuclear weapons testing; (3) nuclear power plants; (4) commercial fuel reprocessing; (5) geological repository of high-level nuclear wastes, and (6) nuclear accidents. Then, we summarize the geochemical behavior for radionuclides {sup 99}Tc, {sup 129}I, and {sup 237}Np, because of their complex geochemical behavior, long half-lives, and presumably high mobility in the environment. Biogeochemical cycling and environment risk assessment must take into account speciation of these redox-sensitive radionuclides.

  10. Management of tricuspid regurgitation in congenital heart disease: is survival better with valve repair?

    Said, Sameh M; Dearani, Joseph A; Burkhart, Harold M; Connolly, Heidi M; Eidem, Ben; Stensrud, Paul E; Schaff, Hartzell V

    2014-01-01

    Tricuspid valve (TV) regurgitation in congenital heart disease includes a heterogeneous group of lesions, and few series have documented the outcomes. We reviewed the records of 553 patients with congenital heart disease who had undergone TV surgery for tricuspid regurgitation from January 1993 to December 2010. Patients with Ebstein malformation were excluded. Their mean age was 32 ± 21 years, and 300 were female (54%). The most common diagnoses were conotruncal anomaly in 216 patients (39%), previous ventricular septal defect closure in 83 (15%), atrioventricular septal defect in 77 (14%), and pulmonary atresia with an intact ventricular septum in 11 (2%). Preoperative right-sided heart failure was present in 124 patients (22%), and 55 patients (10%) had pulmonary hypertension. TV repair was performed in 442 (80%) and TV replacement in 111 (20%) patients. Repeat sternotomy was performed in 415 patients (75%). Previous TV repair was present in 44 patients (8%); of these, 17 (38.6%) underwent repeat TV repair. The overall early mortality was 3.1% (17 patients) and was 2.5% for TV repair and 5.4% for TV replacement (P = .001). The mean follow-up period was 4.5 ± 4.1 years (maximum, 18). The overall survival at 1, 5, and 10 years was 97%, 93%, and 85%, respectively. Survival was better for patients with repair than with replacement. TV repair was an independent predictor of better survival (P = .001). Important tricuspid regurgitation can occur with a variety of congenital diagnoses. Early mortality is low and late survival is superior with tricuspid repair than with valve replacement. Surgical treatment of tricuspid regurgitation in congenital heart disease should be performed before the onset of heart failure. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  11. Quantification of Mitral Regurgitation in Anatolian Shepherd Dogs with Asymptomatic Degenerative Mitral Valve Disease

    Kursad Turgut1*, Yilmaz Koc2, Hasan Guzelbektes1,3, Amir Naseri1, Mehmet Ege Ince1 and Ismail Sen1

    2016-11-01

    Full Text Available Degenerative mitral valvular disease (DMVD is the most frequent cardiac disease, causing mitral regurgitation (MR in dogs. The purpose of this study was to compare the ratio of the regurgitant jet area (RJA to the left atrial area (LAA (RJA/LAA with subtracting method to quantify regurgitant volume (RegV and regurgitant fraction (RF in asymptomatic Anatolian Shepherd Dogs (ASHs with DMVD. Thirty-eight ASHs with DMVD were used as experimental group. The control group consisted of 35 healthy ASHs. In 38 ASHs with DMVD (20 B1 dogs and 18 B2 dogs, the severity of MR was assessed by RJA/LAA and subtraction method. No differences were noted between the assays measuring the severity of MR by χ2 analysis. The observed agreement between the assays was 81% for RJA/LAA vs RegV and was 73% for RJA/LAA vs RF, and the kappa statistic values for RJA/LAA vs RegV and for RJA/LAA vs RF were 0.63 (substantial agreement and 0.50 (moderate agreement, respectively. Our results indicate that each quantification method was valuable to estimate the acuteness of the disease in ASHs with MR and all were in good accordance with the echocardiographic heart size and N-terminal Pro-Brain Natriuretic Peptide (NT-proBNP measurements. Therefore, the each of these non-invasive methods may be functional to serially estimate the acuteness of MR in DMVD in order to monitor the progression of disease. Future studies have to evaluate, if these will be useful to anticipate the risk or time of decompensation in asymptomatic dogs.

  12. Mitral regurgitation jet around neoannulus: Mitral valve replacement in erysipelothrix rhusiopathiae endocarditis

    Rahul Basu

    2013-01-01

    Full Text Available A 50-year-old male presented with erysipelothrix rhusiopathiae (ER endocarditis of the mitral valve, severe mitral regurgitation, and heart failure. The ER endocarditis destroyed the native mitral annulus therefore a new annulus was created for the suspension of the mitral bioprosthesis. Postoperative neoannulus dehiscence and leak prompted to redo surgery where transesophageal echocardiography (TEE played an important role in pointing out the exact location of perineoannular leaks for repair.

  13. Transcatheter treatment of severe tricuspid regurgitation with the MitraClip system.

    Hammerstingl, Christoph; Schueler, Robert; Malasa, Margarita; Werner, Nikos; Nickenig, Georg

    2016-03-07

    The aim of this study was to show technical principles and feasibility of transcatheter tricuspid valve repair by use of the MitraClip system. Three consecutive patients were treated successfully for severe symptomatic Tricuspid regurgitation. Three-dimensional transoesophageal echocardiography confirmed reduction of measured effective regurgitant orifice in all patients [effective regurgitant orifice area-baseline/post-procedure (cm(2)): 0.7/0.3; 1.5/0.8; 0.4/0.1], which was accompanied by an increase in left ventricular stroke volumes [baseline/post-procedure (mL): 42.8/45.4; 38/45; 35.2/45], decrease of measured levels of N terminal pro brain natriuretic peptide (pg/mL: baseline/post-procedure: 548/440; 2526/1702; 1754/623), and significant relief of clinical symptoms for chronic right heart failure in all patients. Transcatheter tricuspid valve repair by use of interventional edge-to-edge repair with the MitraClip system was feasible, and safe in three consecutive patients. Reduction of tricuspid insufficiency associates with relief of clinical symptoms for right heart failure. This strategy seems a promising treatment option for patients at prohibitive surgical risk. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

  14. Floppy Mitral Valve (FMV) - Mitral Valve Prolapse (MVP) - Mitral Valvular Regurgitation and FMV/MVP Syndrome.

    Boudoulas, Konstantinos Dean; Pitsis, Antonios A; Boudoulas, Harisios

    2016-01-01

    Mitral valve prolapse (MVP) results from the systolic movement of a portion(s) or segment(s) of the mitral valve leaflet(s) into the left atrium during left ventricular (LV) systole. It should be emphasised that MVP alone, as defined by imaging techniques, may comprise a non-specific finding because it also depends on the LV volume, myocardial contractility and other LV hemodynamics. Thus, a floppy mitral valve (FMV) should be the basis for the diagnosis of MVP. Two types of symptoms may be defined in these patients. In one group, symptoms are directly related to progressive mitral regurgitation and its complications. In the other group, symptoms cannot be explained only by the degree of mitral regurgitation alone; neuroendocrine dysfunction has been implicated for the explanation of symptoms in this group of patients that today is referred as the FMV/MVP syndrome. When significant mitral regurgitation is present in a patient with FMV/MVP, surgical intervention is recommended. In patients with a prohibitive risk for surgery, transcatheter mitral valve repair using a mitraclip device may be considered. Furthermore, transcatheter mitral valve replacement may represent an option in the near future as clinical trials are underway. In this brief review, the current concepts related to FMV/MVP and FMV/MVP syndrome will be discussed. Copyright © 2016 Hellenic Cardiological Society. Published by Elsevier B.V. All rights reserved.

  15. Methods of estimation of mitral valve regurgitation for the cardiac surgeon

    Baikoussis Nikolaos G

    2009-07-01

    Full Text Available Abstract Mitral valve regurgitation is a relatively common and important heart valve lesion in clinical practice and adequate assessment is fundamental to decision on management, repair or replacement. Disease localised to the posterior mitral valve leaflet or focal involvement of the anterior mitral valve leaflet is most amenable to mitral valve repair, whereas patients with extensive involvement of the anterior leaflet or incomplete closure of the valve are more suitable for valve replacement. Echocardiography is the recognized investigation of choice for heart valve disease evaluation and assessment. However, the technique is depended on operator experience and on patient's hemodynamic profile, and may not always give optimal diagnostic views of mitral valve dysfunction. Cardiac catheterization is related to common complications of an interventional procedure and needs a hemodynamic laboratory. Cardiac magnetic resonance (MRI seems to be a useful tool which gives details about mitral valve anatomy, precise point of valve damage, as well as the quantity of regurgitation. Finally, despite of its higher cost, cardiac MRI using cine images with optimized spatial and temporal resolution can also resolve mitral valve leaflet structural motion, and can reliably estimate the grade of regurgitation.

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

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

    1985-01-01

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

  17. Safety and Efficacy of Transcatheter Closure of Patent Ductus Arteriosus With Severe Mitral Regurgitation in Adults.

    Wang, Zhongkai; Chen, Tao; Chen, Liang; Qin, Yongwen; Zhao, Xianxian

    2016-01-01

    Transcatheter closure is the usual treatment for patent ductus arteriosus (PDA), but its safety and efficacy have not been reported in adult PDA patients with severe mitral regurgitation. A retrospective study on 27 consecutive patients diagnosed with PDA and severe mitral regurgitation and treated using transcatheter closure between September 2010 and September 2012 at the Department of Cardiology of Changhai Hospital in Changhai, China. Left ventricular (LV) diastolic volume and function, pulmonary artery pressure, and instantaneous reverse-flow volume were examined by echocardiography before PDA closure, immediately after closure, and 1 year after closure. After the procedure, the LV diastolic volume (P.05). Pulmonary arterial systolic pressure was unchanged 1 year after closure (from 46.41 ± 19.92 mm Hg to 45.43 ± 13.64 mm Hg; P=.58). All procedures were uneventful and only mild complications occurred (hemolysis in 2 cases, subcutaneous hematoma in 4 cases, and fever in 2 cases). Transcatheter closure can decrease the LV volume and instantaneous reverse-flow volume in adult PDA patients with severe mitral regurgitation. This procedure is effective and has a good safety profile.

  18. Dosimetry in radionuclide therapy

    Riccabona, G.

    2001-01-01

    While it is known that therapeutic effects of radionuclides are due to absorbed radiation dose and to radiosensitivity, individual dosimetry in 'Gy' is practiced rarely in clinical Nuclear Medicine but 'doses' are described in 'mCi' or 'MBq', which is only indirectly related to 'Gy' in the target. To estimate 'Gy', the volume of the target, maximum concentration of the radiopharmaceutical in it and residence time should be assessed individually. These parameters can be obtained usually only with difficulty, involving possibly also quantitative SPET or PET, modern imaging techniques (sonography, CT, MRT), substitution of y- or positron emitting radiotracers for β - emitting radiopharmaceuticals as well as whole-body distribution studies. Residence time can be estimated by obtaining data on biological half-life of a comparable tracer and transfer of these data in the physical characteristics of the therapeutic agent. With all these possibilities for gross dosimetry the establishment of a dose-response-relation should be possible. As distribution of the radiopharmaceutical in lesions is frequently inhomogenous and microdosimetric conditions are difficult to assess in vivo as yet, it could be observed since decades that empirically set, sometimes 'fixed' doses (mCi or MBq) can also be successful in many diseases. Detailed dosimetric studies, however, are work- and cost-intensive. Nevertheless, one should be aware at a time when more sophisticated therapeutic possibilities in Nuclear Medicine arise, that we should try to estimate radiation dose (Gy) in our new methods even as differences in individual radiosensitivity cannot be assessed yet and studies to define individual radiosensitivity in lesions should be encouraged. (author)

  19. Radionuclide Sensors for Water Monitoring

    Grate, Jay W.; Egorov, Oleg B.; DeVol, Timothy A.

    2004-01-01

    Radionuclide contamination in the soil and groundwater at U.S. Department of Energy (DOE) sites is a severe problem that requires monitoring and remediation. Radionuclide measurement techniques are needed to monitor surface waters, groundwater, and process waters. Typically, water samples are collected and transported to an analytical laboratory, where costly radiochemical analyses are performed. To date, there has been very little development of selective radionuclide sensors for alpha- and beta-emitting radionuclides such as 90Sr, 99Tc, and various actinides of interest. The objective of this project is to investigate novel sensor concepts and materials for sensitive and selective determination of beta- and alpha-emitting radionuclide contaminants in water. To meet the requirements for loW--level, isotope-specific detection, the proposed sensors are based on radiometric detection. As a means to address the fundamental challenge of the short ranges of beta and alpha particle s in water, our overall approach is based on localization of preconcentration/separation chemistries directly on or within the active area of a radioactivity detector. Automated microfluidics is used for sample manipulation and sensor regeneration or renewal. The outcome of these investigations will be the knowledge necessary to choose appropriate chemistries for selective preconcentration of radionuclides from environmental samples, new materials that combine chemical selectivity with scintillating properties, new materials that add chemical selectivity to solid-state diode detectors, new preconcentrating column sensors, and improved instrumentation and signal processing for selective radionuclide sensors. New knowledge will provide the basis for designing effective probes and instrumentation for field and in situ measurements

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

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

    2017-10-17

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

  1. Content of naturally occurring radionuclides in samples taken from world historical sites

    Nikolic, J.; Jankovic, M.; Todorovic, D.; Sarap, N.

    2011-01-01

    This paper presents the results of the investigation of naturally occurring radionuclides content in different samples taken from the historical sites in Iran, China, Syria and Jordan. Samples contained different natural materials used in masonry, for making artefacts for personal use as well as water, sand and mud from the Dead sea. The aim was to ascertain the content of naturally occurring radionuclides, calculation of hazard indexes and their comparison to the values recommended and obtained in modern days materials [sr

  2. Radionuclide kineventriculographic evaluation of the heart pump function in valvular prosthesis

    Ivanov, Zh; Shejretova, E; Trindev, P; Topalov, V; Denchev, S; Khadzhikostova, Kh

    1986-01-01

    The heart pump function was investigated by the methods of radionuclide kineventriculography, standart opaque ventryculography and echocardiography. The statistical analysis revealed lack of correlation for the ejection fraction, determined by the three methods. The methodological advantages of radionuclide kineventriculography are pointed out for exact and objective evaluation of the ejection fraction of the left cardiac ventricle, as well as some limitations in the application of this index in the clinical assessment of the heart pump function in patients, indicated for valvular prosthesis.

  3. Inverse problem in radionuclide transport

    Yu, C.

    1988-01-01

    The disposal of radioactive waste must comply with the performance objectives set forth in 10 CFR 61 for low-level waste (LLW) and 10 CFR 60 for high-level waste (HLW). To determine probable compliance, the proposed disposal system can be modeled to predict its performance. One of the difficulties encountered in such a study is modeling the migration of radionuclides through a complex geologic medium for the long term. Although many radionuclide transport models exist in the literature, the accuracy of the model prediction is highly dependent on the model parameters used. The problem of using known parameters in a radionuclide transport model to predict radionuclide concentrations is a direct problem (DP); whereas the reverse of DP, i.e., the parameter identification problem of determining model parameters from known radionuclide concentrations, is called the inverse problem (IP). In this study, a procedure to solve IP is tested, using the regression technique. Several nonlinear regression programs are examined, and the best one is recommended. 13 refs., 1 tab

  4. Radionuclide Retention in Concrete Wasteforms

    Wellman, Dawn M.; Jansik, Danielle P.; Golovich, Elizabeth C.; Cordova, Elsa A.

    2012-09-24

    Assessing long-term performance of Category 3 waste cement grouts for radionuclide encasement requires knowledge of the radionuclide-cement interactions and mechanisms of retention (i.e., sorption or precipitation); the mechanism of contaminant release; the significance of contaminant release pathways; how wasteform performance is affected by the full range of environmental conditions within the disposal facility; the process of wasteform aging under conditions that are representative of processes occurring in response to changing environmental conditions within the disposal facility; the effect of wasteform aging on chemical, physical, and radiological properties; and the associated impact on contaminant release. This knowledge will enable accurate prediction of radionuclide fate when the wasteforms come in contact with groundwater. Data collected throughout the course of this work will be used to quantify the efficacy of concrete wasteforms, similar to those used in the disposal of LLW and MLLW, for the immobilization of key radionuclides (i.e., uranium, technetium, and iodine). Data collected will also be used to quantify the physical and chemical properties of the concrete affecting radionuclide retention.

  5. Radionuclide injury to the lung

    Dagle, G.E.; Sanders, C.L.

    1984-01-01

    Radionuclide injury to the lung has been studied in rats, hamsters, dogs, mice and baboons. Exposure of the lung to high dose levels of radionuclides produces a spectrum of progressively more severe functional and morphological changes, ranging from radiation pneumonitis and fibrosis to lung tumors. These changes are somewhat similar for different species. Their severity can be related to the absorbed radiation dose (measured in rads) produced by alpha, beta or gamma radiation emanating from various deposited radionuclides. The chemicophysical forms of radionuclides and spatial-temporal factors are also important variables. As with other forms of injury to the lung, repair attempts are highlighted by fibrosis and proliferation of pulmonary epithelium. Lung tumors are the principal late effect observed in experimental animals following pulmonary deposition of radionuclides at dose levels that do not result in early deaths from radiation pneumonitis or fibrosis. The predominant lung tumors described have been of epithelial origin and have been classified, in decreasing frequency of occurrence, as adenocarcinoma, bronchioloalveolar carcinoma, epidermoid carcinomas and combined epidermoid and adenocarcinoma. Mesothelioma and fibrosarcoma have been observed in rats, but less commonly in other species. Hemangiosarcomas were frequently observed in dogs exposed to beta-gamma emitters, and occasionally in rats exposed to alpha emitters. These morphologic changes in the lungs of experimental animals were reviewed and issues relevant to the prediction of human hazards discussed. 88 references

  6. Factors associated with moderate or severe left atrioventricular valve regurgitation within 30 days of repair of incomplete atrioventricular septal defect

    Marcelo Felipe Kozak

    2015-04-01

    Full Text Available AbstractIntroduction:Left atrioventricular valve regurgitation is the most concerning residual lesion after surgical correction of atrioventricular septal defect.Objective:To determine factors associated with moderate or greater left atrioventricular valve regurgitation within 30 days of surgical repair of incomplete atrioventricular septal defect.Methods:We assessed the results of 51 consecutive patients 14 years-old and younger presenting with incomplete atrioventricular septal defect that were operated on at our practice between 2002 and 2010. The following variables were considered: age, weight, absence of Down syndrome, grade of preoperative left atrioventricular valve regurgitation, abnormalities on the left atrioventricular valve and the use of annuloplasty. The median age was 4.1 years; the median weight was 13.4 Kg; 37.2% had Down syndrome. At the time of preoperative evaluation, there were 23 cases with moderate or greater left atrioventricular valve regurgitation (45.1%. Abnormalities on the left atrioventricular valve were found in 17.6%; annuloplasty was performed in 21.6%.Results:At the time of postoperative evaluation, there were 12 cases with moderate or greater left atrioventricular valve regurgitation (23.5%. The variation between pre- and postoperative grades of left atrioventricular valve regurgitation of patients with atrioventricular valve malformation did not reach significance (P=0.26, unlike patients without such abnormalities (P=0.016. During univariate analysis, only absence of Down syndrome was statistically significant (P=0.02. However, after a multivariate analysis, none of the factors reached significance.Conclusion:None of the factors studied was determinant of a moderate or greater left atrioventricular valve regurgitation within the first 30 days of repair of incomplete atrioventricular septal defect in the sample. Patients without abnormalities on the left atrioventricular valve benefit more of the operation.

  7. Method of preparing radionuclide doses

    Kuperus, J.H.

    1987-01-01

    A method is described of preparing aliquot dosea of a tracer material useful in diagnostic nuclear medicine comprising: storing discrete quantities of a lyophilized radionuclide carrier in separate tubular containers from which air and moisture is excluded, selecting from the tubular containers a container in which is stored a carrier appropriate for a nuclear diagnostic test to be performed, interposing the selected container between the needle and the barrel of a hypodermic syringe, and drawing a predetermined amount of a liquid containing a radionuclide tracer in known concentration into the hypodermic syringe barrel through the hypodermic needle and through the selected container to dissolve the discrete quantity of lyophilized carrier therein to combine the carrier with the radionuclide tracer to form an aliquot dose of nuclear diagnostic tracer material, as needed

  8. Methods of separating short half-life radionuclides from a mixture of radionuclides

    Bray, L.A.; Ryan, J.L.

    1998-01-01

    The present invention is a method of obtaining a radionuclide product selected from the group consisting of 223 Ra and 225 Ac, from a radionuclide ''cow'' of 227 Ac or 229 Th respectively. The method comprises the steps of (a) permitting ingrowth of at least one radionuclide daughter from said radionuclide ''cow'' forming an ingrown mixture; (b) insuring that the ingrown mixture is a nitric acid ingrown mixture; (c) passing the nitric acid ingrown mixture through a first nitrate form ion exchange column which permits separating the ''cow'' from at least one radionuclide daughter; (d) insuring that the at least one radionuclide daughter contains the radionuclide product; (e) passing the at least one radionuclide daughter through a second ion exchange column and separating the at least one radionuclide daughter from the radionuclide product and (f) recycling the at least one radionuclide daughter by adding it to the ''cow''. In one embodiment the radionuclide ''cow'' is the 227 Ac, the at least one daughter radionuclide is a 227 Th and the product radionuclide is the 223 Ra and the first nitrate form ion exchange column passes the 227 Ac and retains the 227 Th. In another embodiment the radionuclide ''cow'' is the 229 Th, the at least one daughter radionuclide is a 225 Ra and said product radionuclide is the 225 Ac and the 225 Ac and nitrate form ion exchange column retains the 229 Th and passes the 225 Ra/Ac. 8 figs

  9. Producing new radionuclides for medicine

    Michaut, C.

    2009-01-01

    The Arronax cyclotron, a new particle accelerator dedicated to the production of radionuclides for medicine and research has been commissioned in Nantes (France). Because of its unique features: an energy of 70 MeV and an intensity of 750 μA, Arronax will produce radionuclides that can not be produce in present cyclotrons. Among others it will produce Strontium-82 and Germanium-68 that are the precursors for Rubidium-82 and Gallium-68 respectively. 20 per cent of the research works will be dedicated to other domains like radioactive wastes, the radiation biological damage and the radiation damage on electronic devices. (A.C.)

  10. Radionuclide migration in geological formations

    Barbreau, A.; Heremans, R.; Skytte Jensen, B.

    1980-01-01

    Radioactive waste disposal into geological formation is based on the capacity of rocks to confine radioactivity for a long period of time. Radionuclide migration from the repository to the environment depends on different mechanisms and phenomena whose two main ones are groundwater flow and the retention and ion-exchange property of rocks. Many studies are underway presently in EEC countries concerning hydrodynamic characteristics of deep geological formations as well as in radionuclide retention capacity and modelling. Important results have already been achieved which show the complexity of some phenomena and further studies shall principally be developed taking into account real conditions of the repository and its environment

  11. Automatic alignment of radionuclide images

    Barber, D.C.

    1982-01-01

    The variability of the position, dimensions and orientation of a radionuclide image within the field of view of a gamma camera hampers attempts to analyse the image numerically. This paper describes a method of using a set of training images of a particular type, in this case right lateral brain images, to define the likely variations in the position, dimensions and orientation for that type of image and to provide alignment data for a program that automatically aligns new images of the specified type to a standard position, size and orientation. Examples are given of the use of this method on three types of radionuclide image. (author)

  12. Radionuclide techniques for brain imaging

    Cowan, R.J.; Moody, D.M.

    1984-01-01

    Over the past decade, many of the prime indications for radionuclide brain scanning have become instead indications for CCT, and nuclear medicine studies of the brain have assumed more of a complementary, supportive role. However, there is great promise for improvement in central nervous system radionuclide applications with advances anticipated in both radiopharmaceuticals and instrumentation. Nuclear medicine is continuing to function as a powerful research tool and, in the relatively near future, may regain its role as a major clinical test of the central nervous system

  13. Mitochondrial apoptotic pathway activation in the atria of heart failure patients due to mitral and tricuspid regurgitation.

    Chang, Jen-Ping; Chen, Mien-Cheng; Liu, Wen-Hao; Lin, Yu-Sheng; Huang, Yao-Kuang; Pan, Kuo-Li; Ho, Wan-Chun; Fang, Chih-Yuan; Chen, Chien-Jen; Chen, Huang-Chung

    2015-08-01

    Apoptosis occurs in atrial cardiomyocytes in mitral and tricuspid valve disease. The purpose of this study was to examine the respective roles of the mitochondrial and tumor necrosis factor-α receptor associated death domain (TRADD)-mediated death receptor pathways for apoptosis in the atrial cardiomyocytes of heart failure patients due to severe mitral and moderate-to-severe tricuspid regurgitation. This study comprised eighteen patients (7 patients with persistent atrial fibrillation and 11 in sinus rhythm). Atrial appendage tissues were obtained during surgery. Three purchased normal human left atrial tissues served as normal controls. Moderately-to-severely myolytic cardiomyocytes comprised 59.7±22.1% of the cardiomyocytes in the right atria and 52.4±12.9% of the cardiomyocytes in the left atria of mitral and tricuspid regurgitation patients with atrial fibrillation group and comprised 58.4±24.8% of the cardiomyocytes in the right atria of mitral and tricuspid regurgitation patients with sinus rhythm. In contrast, no myolysis was observed in the normal human adult left atrial tissue samples. Immunohistochemical analysis showed expression of cleaved caspase-9, an effector of the mitochondrial pathways, in the majority of right atrial cardiomyocytes (87.3±10.0%) of mitral and tricuspid regurgitation patients with sinus rhythm, and right atrial cardiomyocytes (90.6±31.4%) and left atrial cardiomyocytes (70.7±22.0%) of mitral and tricuspid regurgitation patients with atrial fibrillation. In contrast, only 5.7% of cardiomyocytes of the normal left atrial tissues showed strongly positive expression of cleaved caspase-9. Of note, none of the atrial cardiomyocytes in right atrial tissue in sinus rhythm and in the fibrillating right and left atria of mitral and tricuspid regurgitation patients, and in the normal human adult left atrial tissue samples showed cleaved caspase-8 expression, which is a downstream effector of TRADD of the death receptor pathway

  14. Predicting device failure after percutaneous repair of functional mitral regurgitation in advanced heart failure: Implications for patient selection.

    Stolfo, Davide; De Luca, Antonio; Morea, Gaetano; Merlo, Marco; Vitrella, Giancarlo; Caiffa, Thomas; Barbati, Giulia; Rakar, Serena; Korcova, Renata; Perkan, Andrea; Pinamonti, Bruno; Pappalardo, Aniello; Berardini, Alessandra; Biagini, Elena; Saia, Francesco; Grigioni, Francesco; Rapezzi, Claudio; Sinagra, Gianfranco

    2018-04-15

    Patients with heart failure (HF) and severe symptomatic functional mitral regurgitation (FMR) may benefit from MitraClip implantation. With increasing numbers of patients being treated the success of procedure becomes a key issue. We sought to investigate the pre-procedural predictors of device failure in patients with advanced HF treated with MitraClip. From April 2012 to November 2016, 76 patients with poor functional class (NYHA class III-IV) and severe left ventricular (LV) remodeling underwent MitraClip implantation at University Hospitals of Trieste and Bologna (Italy). Device failure was assessed according to MVARC criteria. Patients were subsequently followed to additionally assess the patient success after 12months. Mean age was 67±12years, the mean Log-EuroSCORE was 23.4±16.5%, and the mean LV end-diastolic volume index and ejection fraction (EF) were 112±33ml/m 2 and 30.6±8.9%, respectively. At short-term evaluation, device failure was observed in 22 (29%) patients. Univariate predictors of device failure were LVEF, LV and left atrial volumes and anteroposterior mitral annulus diameter. Annulus dimension (OR 1.153, 95% CI 1.002-1.327, p=0.043) and LV end-diastolic volume (OR 1.024, 95% CI 1.000-1.049, p=0.049) were the only variables independently associated with the risk of device failure at the multivariate model. Pre-procedural anteroposterior mitral annulus diameter accurately predicted the risk of device failure after MitraClip in the setting of advanced HF. Its assessment might aid the selection of the best candidates to percutaneous correction of FMR. Copyright © 2018 Elsevier B.V. All rights reserved.

  15. Determination of alpha radionuclides in fish

    Pernicka, L.; Matel, L.; Rosskopfova, O.

    2001-01-01

    In atmospheric water, external water and undercurrent the occurrence of radionuclides is usual. It is an important factor of quality of the environment. Plants ingest radionuclides from water and with they everyone. And it arises radioactivity infest food-chain. Radiotoxicity of this radionuclides is very deer sometimes. The sensitive radiochemical procedures for their determination are necessarily important. The poster presents the combined procedure used at our laboratory for determination of alpha radionuclides in biological samples. (authors)

  16. The principal radionuclides in high level radioactive waste management

    Mulyanto

    1998-01-01

    The principal radionuclides in high level radioactive waste management. The selection of the principal radionuclides in the high level waste (HLW) management was developed in order to improve the disposal scenario of HLW. In this study the unified criteria for selection of the principal radionuclides were proposed as; (1) the value of hazard index estimated by annual limit of intake (ALI) for long-term tendency,(2) the relative dose factor related to adsorbed migration rate transferred by ground water, and (3) heat generation in the repository. From this study it can be concluded that the principal radionuclides in the HLW management were minor actinide (MA=Np, Am, Cm, etc), Tc, I, Cs and Sr, based on the unified basic criteria introduced in this study. The remaining short-lived fission product (SLFPs), after the selected nuclides are removed, should be immobilized and solidified in a glass matrix. Potential risk due to the remaining SLFPs can be lower than that of uranium ore after about 300 year. (author)

  17. Impact of timing and surgical approach on outcomes after mitral valve regurgitation operations.

    Stevens, Louis-Mathieu; Rodriguez, Evelio; Lehr, Eric J; Kindell, Linda C; Nifong, L Wiley; Ferguson, T Bruce; Chitwood, W Randolph

    2012-05-01

    This study investigated whether the timing of mitral valve (MV) repair or surgical approach affects outcomes in patients with MV regurgitation. Between 1992 and 2009, 2,255 patients underwent MV operations, including 1,305 with isolated MV regurgitation operations (1,054 repairs, 251 replacements). Surgical approaches were sternotomy in 377, video-assisted right minithoracotomy in 481, or robot-assisted in 447. Mean follow-up was 6.4±4.5 years (maximum, 19 years). Sternotomy MV repairs decreased during the study while minimally invasive MV repairs increased. Robotic MV repair patients were younger, with fewer women, had better left ventricular ejection fractions, and were more likely to have myxomatous degeneration (all p<0.001). The robotic approach led to a higher MV repair rate and increased use of leaflet/chordal procedures but had longer cardiopulmonary bypass and aortic cross-clamp times (all p<0.001). The 30-day mortality for isolated MV repair was similar for all approaches (p=0.409). Fewer neurological events were observed in the videoscopic and robotic groups (p=0.013). Adjusted survival was similar for all approaches (p=0.357). Survival in patients in New York Heart Association class I to II with myxomatous degeneration or annular dilatation was similar to a matched population but was worse for patients in class III to IV or undergoing MV replacement. MV repair in patients with severe MV regurgitation should be performed before New York Heart Association class III to IV symptoms develop. Minimally invasive MV repair techniques render similar outcomes as the sternotomy approach. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  18. Analysis of chronic aortic regurgitation by 2D and 3D echocardiography and cardiac MRI

    Stoebe, Stephan; Metze, Michael; Jurisch, Daniel; Tayal, Bhupendar; Solty, Kilian; Laufs, Ulrich; Pfeiffer, Dietrich; Hagendorff, Andreas

    2018-01-01

    Purpose The study compares the feasibility of the quantitative volumetric and semi-quantitative approach for quantification of chronic aortic regurgitation (AR) using different imaging modalities. Methods Left ventricular (LV) volumes, regurgitant volumes (RVol) and regurgitant fractions (RF) were assessed retrospectively by 2D, 3D echocardiography and cMRI in 55 chronic AR patients. Semi-quantitative parameters were assessed by 2D echocardiography. Results 22 (40%) patients had mild, 25 (46%) moderate and 8 (14%) severe AR. The quantitative volumetric approach was feasible using 2D, 3D echocardiography and cMRI, whereas the feasibility of semi-quantitative parameters varied considerably. LV volume (LVEDV, LVESV, SVtot) analyses showed good correlations between the different imaging modalities, although significantly increased LV volumes were assessed by cMRI. RVol was significantly different between 2D/3D echocardiography and 2D echocardiography/cMRI but was not significantly different between 3D echocardiography/cMRI. RF was not statistically different between 2D echocardiography/cMRI and 3D echocardiography/cMRI showing poor correlations (r echocardiography and 2D echocardiography/cMRI and good agreement was observed between 3D echocardiography/cMRI. Conclusion Semi-quantitative parameters are difficult to determine by 2D echocardiography in clinical routine. The quantitative volumetric RF assessment seems to be feasible and can be discussed as an alternative approach in chronic AR. However, RVol and RF did not correlate well between the different imaging modalities. The best agreement for grading of AR severity by RF was observed between 3D echocardiography and cMRI. LV volumes can be verified by different approaches and different imaging modalities. PMID:29519957

  19. Grading of mitral regurgitation in mitral valve prolapse using the average pixel intensity method.

    Kamoen, Victor; El Haddad, Milad; De Buyzere, Marc; De Backer, Tine; Timmermans, Frank

    2018-05-01

    We recently reported the feasibility of the average pixel intensity (API) method for grading mitral regurgitation (MR) in a heterogeneous MR population. Since mitral valve prolapse (MVP) is an important cause of primary MR, we more specifically investigated the feasibility of the API method and the MR flow dynamics in patients with MVP. Transthoracic echocardiography was performed by a single operator in consecutive MVP patients (n=112). MR was assessed using the API method, color Doppler, vena contracta width (VCW), effective regurgitant orifice area (PISA-EROA) and regurgitant volume (PISA-RV). The API method was feasible in 89% of all MVP patients (68%, 71% for VCW and PISA method, respectively ;pMVP with non-holosystolic MR were 0.989 and 0.995. For the overall MVP-MR population, API had significant correlations with direct and indirect measures of MR severity. Based on ROC curves, an API cutoff value of 125 au was suggested to identify severe MR in MVP and a MR duration/systolic time ratioMVP-MR) identifies patients with non-severe MR (APIMVP had severe MR (API>125). Finally, API analysis of the proto-, mid- and telesystolic phases of MR in MVP showed different kinetics in non-holosystolic compared to holosystolic MVP. The API method is a feasible and reproducible method for grading MVP-MR. As the API method takes into account the temporal MR flow changes during the entire systolic cycle, it may be of added value in clinical practice. Copyright © 2018 Elsevier B.V. All rights reserved.

  20. Aortic regurgitation after valve-sparing aortic root replacement: modes of failure.

    Oka, Takanori; Okita, Yutaka; Matsumori, Masamichi; Okada, Kenji; Minami, Hitoshi; Munakata, Hiroshi; Inoue, Takeshi; Tanaka, Akiko; Sakamoto, Toshihito; Omura, Atsushi; Nomura, Takuo

    2011-11-01

    Despite the positive clinical results of valve-sparing aortic root replacement, little is known about the causes of reoperations and the modes of failure. From October 1999 to June 2010, 101 patients underwent valve-sparing aortic root replacement using the David reimplantation technique. The definition of aortic root repair failure included the following: (1) intraoperative conversion to the Bentall procedure; (2) reoperation performed because of aortic regurgitation; and (3) aortic regurgitation equal to or greater than a moderate degree at the follow-up. Sixteen patients were considered to have repair failure. Three patients required intraoperative conversion to valve replacement, 3 required reoperation within 3 months, and another 8 required reoperation during postoperative follow-up. At initial surgery 5 patients had moderate to severe aortic regurgitation, 6 patients had acute aortic dissections, 3 had Marfan syndrome, 2 had status post Ross operations, 3 had bicuspid aortic valves, and 1 had aortitis. Five patients had undergone cusp repair, including Arantius plication in 3 and plication at the commissure in 2. The causes of early failure in 6 patients included cusp perforation (3), cusp prolapse (3), and severe hemolysis (1). The causes of late failure in 10 patients included cusp prolapse (4), commissure dehiscence (3), torn cusp (2), and cusp retraction (1). Patients had valve replacements at a mean of 23 ± 20.9 months after reimplantation and survived. Causes of early failure after valve-sparing root replacement included technical failure, cusp lesions, and steep learning curve. Late failure was caused by aortic root wall degeneration due to gelatin-resorcin-formalin glue, cusp degeneration, or progression of cusp prolapse. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Naturally occurring radionuclides in food

    Djujic, I.

    1995-01-01

    The naturally occurring radionuclides are the major source of radiation exposure to humans. The principal way of natural radiation exposure is the inhalation of 222 Rn decay products (about 85% of the total). The remainder is equally divided between internally deposited radionuclides, cosmic and terrestrial sources. In the present study, the content of 40 K, 210 Pb, 226 Ra, 230 Th, 232 Th and 238 U in representative food samples (milk, pork, beef, potatoes, wheat and corn flour) and samples of different food items that do not represent entire national production but provide interesting additional data for approximative calculation of naturally occurring radionuclide intake is presented. Daily weight of food eaten, participation of food groups, as well as daily intake by food of mentioned naturally occurring radionuclides in the Serbian diet was obtained on the base of house hold budget surveys. The result obtained for daily intake estimates in mBq for Serbian population are 78.1 ( 40 K), 38.2( 210 Pb), 52.3( 226 Ra), 2.0( 230 Th) and 12.5( 238 U). (author)

  2. 100 Years of radionuclide metrology

    Judge, S.M.; Arnold, D.; Chauvenet, B.; Collé, R.; De Felice, P.; García-Toraño, E.; Wätjen, U.

    2014-01-01

    The discipline of radionuclide metrology at national standards institutes started in 1913 with the certification by Curie, Rutherford and Meyer of the first primary standards of radium. In early years, radium was a valuable commodity and the aim of the standards was largely to facilitate trade. The focus later changed to providing standards for the new wide range of radionuclides, so that radioactivity could be used for healthcare and industrial applications while minimising the risk to patients, workers and the environment. National measurement institutes responded to the changing demands by developing new techniques for realising primary standards of radioactivity. Looking ahead, there are likely to be demands for standards for new radionuclides used in nuclear medicine, an expansion of the scope of the field into quantitative imaging to facilitate accurate patient dosimetry for nuclear medicine, and an increasing need for accurate standards for radioactive waste management and nuclear forensics. - Highlights: • The driving forces for the development of radionuclide metrology. • Radium standards to facilitate trade of this valuable commodity in the early years. • After 1950, focus changes to healthcare and industrial applications. • National Measurement Institutes develop new techniques, standards, and disseminate the best practice in measurement. • Challenges in nuclear medicine, radioactive waste management and nuclear forensics

  3. Chemistry and analysis of radionuclides

    Lehto, Jukka

    2010-01-01

    Written by chemists for chemists, this is a comprehensive guide to the important radionuclides as well as techniques for their separation and analysis. It introduces readers to the important laboratory techniques and methodologies in the field, providing practical instructions on how to handle nuclear waste and radioactivity in the environment.

  4. Radionuclide migration studies in soil

    Marumo, J.T.

    1989-01-01

    In this work a brief description about retention and migration parameters of radionuclides in soil, including main methods to determine the distribution coefficient (K) are given. Some of several factors that can act on the migration are also mentioned. (author) [pt

  5. Measurement of radionuclides in waste packages

    Brodzinski, R.L.; Perkins, R.W.; Rieck, H.G.; Wogman, N.A.

    1984-09-12

    A method is described for non-destructively assaying the radionuclide content of solid waste in a sealed container by analysis of the waste's gamma-ray spectrum and neutron emissions. Some radionuclides are measured by characteristic photopeaks in the gamma-ray spectrum; transuranic nuclides are measured by neutron emission rate; other radionuclides are measured by correlation with those already measured.

  6. Aortitis With Severe Aortic Regurgitation in Behcet's Disease: A Case Report

    Hsin-Hui Chiu

    2010-01-01

    Full Text Available Behcet's aortitis is a rare, but one of the most severe complications of Behcet's disease. We report a 24-year-old woman who was noted initially to have aortitis and severe aortic regurgitation caused by Behcet's disease. After receiving aortic valve replacement, aortoplasty and immunosuppressant therapy, her condition became stationary. As far as we are aware, she is the youngest case that has undergone surgery. The early onset of hemodynamic decompensation is considered to be related to delay in diagnosis and lack of steroid treatment.

  7. Development of left ventricular hypertrophy in a novel porcine model of mitral regurgitation

    Ravn, Nathja; Zois, Nora Elisabeth; Moesgaard, Sophia Gry

    2014-01-01

    OBJECTIVES: We aimed to develop a porcine model for chronic nonischemic mitral regurgitation (MR) to investigate left ventricular (LV) enlargement and eccentric hypertrophy. DESIGN: Nonischemic MR was induced in 30 pigs by open-chest immobilization of the posterior mitral leaflet by transannular...... (LVIDd) from baseline to follow-up was significantly higher in the sMR group compared to that of the control group (P = 0.0017). Furthermore, LV weight was significantly increased in the mMR (P = 0.047) and the sMR (P = 0.0087) groups compared to that of the control group. CONCLUSIONS: A new model...

  8. Cine MR imaging of valvular regurgitant flow: Correlations with a phantom study

    Evans, A.J.; Blinder, R.A.; Herfkens, R.J.; Spritzer, C.E.; Hedlund, L.W.; Podolak, M.J.

    1987-01-01

    Dynamic gradient echo MR images reveal that flow through diseased valves is usually associated with a decrease in signal intensity. The authors used a phantom to create turbulent flow through an orifice, analogous to a stenotic heart valve. Signal intensity decreased linearly ( r = .97) as a function of increase in Reynolds number. The area of signal loss also increased linearly ( r = .96) as the Reynolds number increased. The image appearance changed in an orderly fashion as turbulence and velocity increased. At low turbulence, flow is bright (velocity 123 cm/sec, Reynolds number >4,300). Similar findings have been observed in cine images of regurgitant lesions in cardiac patients

  9. Structure and function of the tricuspid and bicuspid regurgitant aortic valve: an echocardiographic study.

    Rönnerfalk, Mattias; Tamás, Éva

    2015-07-01

    The emerging new treatment options for aortic valve disease call for more sophisticated diagnostics. We aimed to describe the echocardiographic pathophysiology and characteristics of the purely regurgitant aortic valve in detail. Twenty-nine men, with chronic aortic regurgitation without concomitant heart disease referred for aortic valve intervention, underwent 2D transoesophageal echocardiographic (TEE) examination prior to surgery according to a previously published matrix. Measurements of the aortic valve apparatus in long and short axis view were made in systole and diastole and analysed off-line. The aortic valves were grouped as tricuspid (TAV) or bicuspid (BAV), and classified by regurgitation mechanism. Twenty-four examinations were eligible for analysis of which 13 presented TAV and 11 BAV. The regurgitation mechanism was classified as dilatation of the aorta in 6 cases, as prolapse in 11 cases and as poor cusp tissue quality or quantity in 7 cases. The ventriculo-aortic junction (VAJ) and valve opening were closely related (TAV r = 0.5, BAV r = 0.73) but no correlation was found between the VAJ and the maximal sinus diameter (maxSiD) or the sinotubular junction (STJ). However, the STJ and maxSiD were significantly related (TAV vs BAV: systole r = 0.9, r = 0.8; diastole r = 0.9, r = 0.7), forming an entity. The conjoined BAV cusps were shorter than the anterior cusps when closed (P = 0.002); the inter-commissural distances of the cusps in the BAV group were significantly different (P = 0.001 resp. 0.03) in both systole and diastole. The VAJ was independent of other aortic dimensions and should thereby be considered as a separate entity with influence on valve opening. The detailed 2D TEE measurements of this study add further important information to our knowledge about the function and echocardiographic anatomy of the pathological aortic valve and root either as a stand-alone examination or as a benchmark and complement to 3D echocardiography. This may

  10. Tachycardia-Induced Right Heart Failure and Severe Tricuspid Regurgitation That Improved with Medication.

    Yang, Young Ae; Yang, Dong Heon; Kim, Hong Nyun; Kwon, Sang Hoon; Jang, Se Young; Bae, Myung Hwan; Lee, Jang Hoon; Chae, Shung Chull

    2015-12-01

    Secondary tricuspid regurgitation (TR) primarily develops due to left heart failure or primary pulmonary diseases. Tricuspid annular dilation, which is commonly caused by right ventricular volume and pressure overload followed by right ventricle dilation, is believed to be the main mechanism underlying secondary TR. It is reported that once the tricuspid annulus is dilated, its size cannot spontaneously return to normal, and it may continue to dilate. These reports also suggest the use of an aggressive surgical approach for secondary TR. In the present report, we describe a case of tachycardia-induced severe TR that was completely resolved without the need for surgery.

  11. Status report on radionuclide transfer

    1980-01-01

    At the suggestion of the Federal Minstry of the Interior, in June 1978, a group of scientists from several institutions who are active in the field of radionuclide transfer or are interested in these problems got together. During the discussions of the work team, especially the transfer soil/plants was emphasized. Then the work team set up a status report on the transfer of the radionuclides relevant in the sense of the radiation protection act. The nuclides H 3 and C14, the isotopes of the Sr, J, and Cs, Tc99, the so-called corrosion nuclides Mn54, Fe59, co-isotopes and Zn65, and isotopes of Pu, Am, and Cm were regarded as important for a possible radiation exposition. Recent investigations revealed that also the natural radionuclides Ra226, Po210, and Pb210 should be covered by the investigations. The goal of this status report is to present the level of knowledge on the transfer of these radionuclides to man in a brief form, giving hints at the most important literature. It was requested by the Federal Ministry of the Interior, as fas as possible, to indicate transfer factors which are necessary for the radio-occology act to be decreed according to Para. 45 of the radiation protection act. Another goal of the report was to show the gap in the knowledge on the radio nuclide transfer. This was thought to help to create a basis for the decisions of the Federal Ministry concerning the support of other investigation projects in the field of transfer of radionuclides. (orig./MG) [de

  12. Radionuclide scintigraphy in detection of gastroesophageal reflux in survivors of congenital diaphragmatic hernia

    Thomas, E.J.; Bharathi Dasan, J.; Patel, C.D.; Bal, C.S.; Malhotra, A.; Kumar, R.; Mitra, D.K.; Agarwala, S.; Padhy, A.K.

    2003-01-01

    Gastro-esophageal Reflux is a common cause of long-term morbidity in survivors of congenital diaphragmatic hernia. The present retrospective analysis was undertaken to find out the incidence of GER in survivors of congenital diaphragmatic hernia (CDH). A total of 26 survivors of congenital diaphragmatic hernia with a mean age of 19 months were studied. Of these, only 7 had clinical symptoms suggestive of GER such as recurrent respiratory tract infection, vomiting, regurgitation, and epigastric pain. The remaining 19 were asymptomatic and had radionuclide scintigraphy for detection of GER as a part of routine follow-up. All the 26 underwent radionuclide scintigraphy with 100-200 μCi (3.7 -7.4MBq) of Tc99m-Sulphur Colloid. GER was detected in 11 out of 26 patients (4 out of 7 symptomatic patients and 7 out of 19 asymptomatic patients). We concluded that there is high incidence of GER in survivors of congenital diaphragmatic hernia and these patients should be followed up for GER regularly. Scintiscanning being a simple, noninvasive test, may be used for initial evaluation and follow-up of survivors of CDH for GER. (author)

  13. Biventricular MR volumetric analysis and MR flow quantification in the ascending aorta and pulmonary trunk for quantification of valvular regurgitation

    Rominger, M.B.

    2004-01-01

    Purpose: To test the value of biventricular volumetric analysis and the combination of biventricular volumetric analysis with flow quantification in the ascending aorta (Ao) and pulmonary trunk (Pu) for quantification of regurgitation volume and cardiac function in valvular regurgitation (VR) according to location and presence of single or multivalvular disease. Materials and Methods: In 106 patients, the stroke volumes were assessed by measuring the biventricular volumes and the forward-stroke volumes in the great and small circulation by measuring the flow in the Ao and Pu. Valve regurgitation volumes and quotients were calculated for single and multivalvular disease and correlated with semiquantitative 2D-echocardiography (grade I-IV). For the assessment of the cardiac function in VR, the volumetric parameters of ejection fraction and end-diastolic (EDV) and end-systolic (ESV) volumes were determined. Results: The detection rate was 49% for left ventricular (LV) VR and 42% for right ventricular (RV) VR. Low LV VR and RV VR usually could not be detected quantitatively, with the detection rate improving with echocardiographically higher insufficiency grades. Quantitative MRI could detect a higher grade solitary aortic valve insufficiency (≥2) in 11 of 12 patients and higher grade mitral valve insufficiency in 4 of 10 patients. A significant increase in RV and LV ventricular EDV and ESV was seen more often with increased MR regurgitation volumes. Aortic stenosis did not interfere with flow measurements in the Ao. Conclusions: Biventricular volumetry combined with flow measurements in Ao and Pu is a robust, applicable and simple method to assess higher grade regurgitation volumes and the cardiac function in single and multivalvular regurgitation at different locations. It is an important application for the diagnosis of VR by MRI [de

  14. Echocardiographic evaluation of changes in left ventricular size and valvular regurgitation associated with physical training during and after maturity in standardbred trotters

    Buhl, Rikke; Ersbøll, Annette Kjær

    2012-01-01

    To assess whether physical training induces cardiac hypertrophy and valvular regurgitation in maturing Standardbred trotters and to establish a prediction model for the size of the left ventricle.......To assess whether physical training induces cardiac hypertrophy and valvular regurgitation in maturing Standardbred trotters and to establish a prediction model for the size of the left ventricle....

  15. Conditions and processes affecting radionuclide transport

    Simmons, Ardyth M.; Neymark, Leonid A.

    2012-01-01

    Characteristics of host rocks, secondary minerals, and fluids would affect the transport of radionuclides from a previously proposed repository at Yucca Mountain, Nevada. Minerals in the Yucca Mountain tuffs that are important for retarding radionuclides include clinoptilolite and mordenite (zeolites), clay minerals, and iron and manganese oxides and hydroxides. Water compositions along flow paths beneath Yucca Mountain are controlled by dissolution reactions, silica and calcite precipitation, and ion-exchange reactions. Radionuclide concentrations along flow paths from a repository could be limited by (1) low waste-form dissolution rates, (2) low radionuclide solubility, and (3) radionuclide sorption onto geological media.

  16. Bioavailability in ecological risk. Assessment for radionuclides

    Garnier-Laplace, J.; Gilbin, R.; Della-Vedova, C.; Adam, C.; Simon, O.; Denison, F.; Beaugelin, K.

    2005-01-01

    -uptake, on the basis of well-defined experiments under controlled conditions. Finally, the implication of bioavailability in risk characterisation is illustrated for radionuclides for which there are a lack of internal exposure and effect data. The use of the Species Sensitivity Distribution technique is proposed to derive an appropriate Predicted No-effect Dose Rate value to be used in the calculation of the risk index combining both exposure and no-effect dose-rates. A number of numerical applications are given as examples for pelagic invertebrates under chronic exposure conditions, demonstrating the sensitivity of this risk formulation to bioavailability. (authors)

  17. Radionuclide transfer from mother to embryo

    Toader, M.; Vasilache, R.A.; Scridon, R.; Toader, M.L.

    1998-01-01

    The transfer of radionuclides from mother to embryo is still a matter of high interest. Therefore, the relation was investigated between the amount of radionuclides in the embryo and the dietary intake of the mother, this for two scenarios: a recurrent intake of variable amounts of radionuclides, and a long-term intake of a relatively constant amount of radionuclides, the radionuclide being 137 Cs. In the first case, the amount of radionuclides present in the embryo increases with the age of the embryo and with the intake of the mother. In the second case, no correlation could be found between the age of the embryo and its radioactive content; only the correlation between the intake of the mother and the radionuclide content of the embryo remained. (A.K.)

  18. Regurgitated pellets of Merops apiaster as fomites of infective Nosema ceranae (Microsporidia) spores.

    Higes, Mariano; Martín-Hernández, Raquel; Garrido-Bailón, Encarna; Botías, Cristina; García-Palencia, Pilar; Meana, Aránzazu

    2008-05-01

    The importance of transmission factor identification is of great epidemiological significance. The bee-eater (Merops apiaster) is a widely distributed insectivorous bird, locally abundant mainly in arid and semi-arid areas of southern Europe, northern Africa and western Asia but recently has been seen breeding in central Europe and Great Britain. Bee-eaters predominantly eat insects, especially bees, wasps and hornets. On the other hand, Nosema ceranae is a Microsporidia recently described as a parasite in Apis mellifera honeybees in Europe. Due to the short time since its description scarce epidemiological data are available. In this study we investigate the role of the regurgitated pellets of the European bee-eater as fomites of infective spores of N. ceranae. Spore detection in regurgitated pellets of M. apiaster is described [phase-contrast microscopy (PCM) and polymerase chain reaction (PCR) methods]. Eighteen days after collection N. ceranae spores still remain viable and their infectivity is shown after artificial infection of Nosema-free 8-day-old adult bees. The epidemiological consequences of the presence of Nosema spores in this fomites are discussed.

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

    Redoy Ranjan

    2017-11-01

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

  20. A pulsatile flow model for in vitro quantitative evaluation of prosthetic valve regurgitation

    S. Giuliatti

    2000-03-01

    Full Text Available A pulsatile pressure-flow model was developed for in vitro quantitative color Doppler flow mapping studies of valvular regurgitation. The flow through the system was generated by a piston which was driven by stepper motors controlled by a computer. The piston was connected to acrylic chambers designed to simulate "ventricular" and "atrial" heart chambers. Inside the "ventricular" chamber, a prosthetic heart valve was placed at the inflow connection with the "atrial" chamber while another prosthetic valve was positioned at the outflow connection with flexible tubes, elastic balloons and a reservoir arranged to mimic the peripheral circulation. The flow model was filled with a 0.25% corn starch/water suspension to improve Doppler imaging. A continuous flow pump transferred the liquid from the peripheral reservoir to another one connected to the "atrial" chamber. The dimensions of the flow model were designed to permit adequate imaging by Doppler echocardiography. Acoustic windows allowed placement of transducers distal and perpendicular to the valves, so that the ultrasound beam could be positioned parallel to the valvular flow. Strain-gauge and electromagnetic transducers were used for measurements of pressure and flow in different segments of the system. The flow model was also designed to fit different sizes and types of prosthetic valves. This pulsatile flow model was able to generate pressure and flow in the physiological human range, with independent adjustment of pulse duration and rate as well as of stroke volume. This model mimics flow profiles observed in patients with regurgitant prosthetic valves.

  1. The "clover technique" as a novel approach for correction of post-traumatic tricuspid regurgitation.

    Alfieri, O; De Bonis, M; Lapenna, E; Agricola, E; Quarti, A; Maisano, F

    2003-07-01

    To describe a novel technique, named "clover," to correct complex post-traumatic tricuspid valve lesions. Five patients with severe post-traumatic tricuspid insufficiency underwent valve reconstruction with the clover technique, a new surgical approach that consists of stitching together the middle point of the free edges of the tricuspid leaflets, producing a clover-shaped valve. The mechanism of tricuspid regurgitation was complex in all patients, and right ventricular function was always moderately to severely depressed. An echocardiographic study was performed after cardiopulmonary bypass, at discharge, and at follow-up. Cardiopulmonary bypass time was 32 +/- 6.3 minutes and crossclamp time was 23 +/- 7.4. There was no hospital mortality or morbidity. Intraoperative transesophageal and predischarge transthoracic echocardiography showed perfect results in all patients. No late deaths occurred. At the latest follow-up, extending to 14.2 months (mean 11.3; median 12.4), all patients were asymptomatic (New York Heart Association class I) with trivial (2 patients) or no residual regurgitation (3 patients) on 2-dimensional echocardiogram. No transvalvular gradient was revealed in any patient. A significant reduction of the right ventricular end-diastolic dimensions was noted as well (from 54 +/- 7.1 mm to 40 +/- 7.5 mm, P tricuspid valve repair in case of severe traumatic tricuspid valve insufficiency, leading to very satisfactory mid-term results even in the presence of complex lesions or dilatation and deterioration of the right ventricle.

  2. A new surgical approach for treating dilated cardiomyopathy with mitral regurgitation

    Buffolo Enio

    2000-01-01

    Full Text Available OBJECTIVE: To evaluate the early outcome of mitral valve prostheses implantation and left ventricular remodeling in 23 patients with end-stage cardiomyopathy and secondary mitral regurgitation (NYHA class III and IV. METHODS: Mitral valvular prosthesis implantation with preservation of papillary muscles and chordae tendinae, and plasty of anteriun cuspid for remodeling of the left ventricle. RESULTS: The surgery was performed in 23 patients, preoperative ejection fraction (echocardiography varied from 13% to 44% (median: 30%. In 13 patients associated procedures were performed: myocardial revascularization (9, left ventricle plicature repair (3 and aortic prosthese implantation (1. Early deaths (2 occurred on the 4th PO day (cardiogenic shock and on the 20th PO day (upper gastrointestinal bleeding, and a late death in the second month PO (ventricular arrhythmia. Improvement occurred in NYHA class in 82.6% of the patients (P<0.0001, with a survival rate of 86.9% (mean of 8.9 months of follow-up. CONCLUSION: This technique offers a promising therapeutic alternative for the treatment of patients in refractory heart failure with cardiomyopathy and secondary mitral regurgitation.

  3. Effects of the Mueller maneuver on functional mitral regurgitation and implications for obstructive sleep apnea.

    Pressman, Gregg S; Orban, Marek; Leinveber, Pavel; Parekh, Kunal; Singh, Manmeet; Kara, Tomas; Somers, Virend K

    2015-06-01

    Obstructive sleep apnea is prevalent and adversely affects cardiovascular health. However, little is known of the acute effects of an obstructive apnea on cardiovascular physiology. We hypothesized that pre-existing functional mitral regurgitation (MR) would worsen during performance of a Mueller maneuver (MM) used to simulate an obstructive apnea; 15 subjects with an ejection fraction ≤35% and pre-existing functional MR were studied with Doppler echocardiography. The radius of the proximal flow convergence was used as a measure of mitral regurgitant flow. Measurements were made at baseline, during the MM, and post-MM. Areas of all 4 chambers were also measured at these time points, both in systole and diastole. Mean flow convergence radius for the group decreased significantly during the transition from the late-MM to post-MM (0.65 → 0.57 mm, p = 0.001), implying increased MR during the MM. In addition, in 3 subjects, duration of MR increased during the MM. Right atrial (RA) areas, both systolic and diastolic, increased during the maneuver, whereas RA fractional area change decreased, indicating reduced RA emptying. Left ventricular emptying decreased early in the maneuver, probably because of the increased afterload burden, and then recovered. In conclusion, high negative intrathoracic pressure produces changes that, repeated hundreds of times per night in patients with obstructive sleep apnea, have the potential to worsen heart failure and predispose affected subjects to atrial fibrillation. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Radionuclide behavior at underground environment

    Hahn, Phil Soo; Park, Chung Kyun; Keum, Dong Kwon; Cho, Young Hwan; Kang, Moon Ja; Baik, Min Hoon; Hahn, Kyung Won; Chun, Kwan Sik; Park, Hyun Soo

    2000-03-01

    This study of radionuclide behavior at underground environment has been carried out as a part of the study of high-level waste disposal technology development. Therefore, the main objectives of this project are constructing a data-base and producing data for the safety assessment of a high-level radioactive waste, and verification of the objectivity of the assessment through characterization of the geochemical processes and experimental validation of the radionuclide migration. The various results from the this project can be applicable to the preliminary safety and performance assessments of the established disposal concept for a future high-level radioactive waste repository. Providing required data and technical basis for assessment methodologies could be a direct application of the results. In a long-term view, the results can also be utilized as a technical background for the establishment of government policy for high-level radioactive waste disposal

  5. Choice of radionuclides for radioimmunotherapy

    DeNardo, S.J.; Jungerman, J.A.; DeNardo, G.L.; Lagunas-Solar, M.C.; Cole, W.C.; Meares, C.F.

    1985-01-01

    Innumerable questions need to be answered and obstacles overcome before radioimmunotherapy can be generally successful in cancer patients. Major developments have greatly enhanced the likelihood of success. The important development of appropriate radionuclides and radiochemistry for this therapy must be intimately linked with the biological and biochemical realities. All aspects must be considered, such as the specific nature of the antigenic target, the pharmacokinetics of the antibody fragment carrier, the capability of in vivo quantitation of tumor uptake and turnover time, as well as total body kinetics. With this knowledge, then, practical radiochemistry methods can be integrated with the suitable radionuclide choices, and production methods can be developed which will deliver effective and dependable products for patient therapy

  6. Radionuclide transfer in terrestrial animals

    DiGregorio, D.; Kitchings, T.; Van Voris, P.

    1978-01-01

    The analysis of dispersion of radionuclides in terrestrial food chains, generally, is a series of equations identifying the fractional input and outflow rates from trophic level to trophic level. Data that are prerequisite inputs for these food chain transport models include: (1) identification of specific transport pathway, (2) assimilation at each pathway link, and (3) the turnover rate or retention function by successive receptor species in the appropriate food chain. In this report, assimilation coefficients, biological half-lives, and excretion rates for a wide variety of vertebrate and invertebrate species and radionuclides have been compiled from an extensive search of the available literature. Using the information accumulated from the literature, correlations of nuclide metabolism and body weight are also discussed. (author)

  7. Applications of radionuclides in industry

    Leveque, P.

    1955-01-01

    After a brief recall of a few concepts (mass number, charge and beams properties) and the description of used detectors (ionization chamber, Geiger-Mueller counter, scintillation counters), some radionuclides applications are described. In a first part, the well-developed applications are presented in three distinct groups: continuous applications such as β and γ gauges (determination hydrogen content of an hydrocarbon and content of an emulsion; discharge of static electricity), discontinuous applications such as radiography and autoradiography, wear or manufacture problems (distribution of a fungicide on tobacco) and finally, applications in research laboratories such as diffusion, exchange and solubility. It also describes the applications which are still in development such as the action of beams on matter (reticulation and degradation of polymers, monomers polymerisation, cold sterilization). In conclusion, few advices on the opportunity of such applications and the choice of the radionuclides are given. (M.P.)

  8. Radionuclide imaging of musculoskeletal infection

    Palestr, Christopher J.; North Shore Long Island Jewish Health System, Manhasset and New Hyde Park, NY; Love, Charito

    2007-01-01

    Radionuclide imaging studies are routinely used to evaluate patients suspected of having musculoskeletal infection. Three-phase bone imaging is readily available, relatively inexpensive, and very accurate in the setting of otherwise normal bone. Labeled leukocyte imaging should be used in cases of 'complicating osteomyelitis' such as prosthetic joint infection. This test also is useful in clinically unsuspected diabetic pedal osteomyelitis as well as in the neuropathic joint. It is often necessary, however, to perform complementary bone marrow imaging, to maximize the accuracy of labeled leukocyte imaging. In contrast to other regions in the skeleton, labeled leukocyte imaging is not useful for diagnosing spinal osteomyelitis. At the moment, gallium is the preferred radionuclide procedure for this condition and is a useful adjunct to magnetic resonance imaging. FDG-PET likely will play an important role in the evaluation of musculoskeletal infection, especially spinal osteomyelitis, and may replace gallium imaging for this purpose. (author)

  9. Radionuclide behavior at underground environment

    Hahn, Phil Soo; Park, Chung Kyun; Keum, Dong Kwon; Cho, Young Hwan; Kang, Moon Ja; Baik, Min Hoon; Hahn, Kyung Won; Chun, Kwan Sik; Park, Hyun Soo

    2000-03-01

    This study of radionuclide behavior at underground environment has been carried out as a part of the study of high-level waste disposal technology development. Therefore, the main objectives of this project are constructing a data-base and producing data for the safety assessment of a high-level radioactive waste, and verification of the objectivity of the assessment through characterization of the geochemical processes and experimental validation of the radionuclide migration. The various results from the this project can be applicable to the preliminary safety and performance assessments of the established disposal concept for a future high-level radioactive waste repository. Providing required data and technical basis for assessment methodologies could be a direct application of the results. In a long-term view, the results can also be utilized as a technical background for the establishment of government policy for high-level radioactive waste disposal.

  10. Radionuclide imaging of musculoskeletal infection

    Palestr, Christopher J. [Albert Einstein College of Medicine, Bronx, NY (United States); North Shore Long Island Jewish Health System, Manhasset and New Hyde Park, NY (United States). Div. of Nuclear Medicine and Molecular Imaging; E-mail: palestro@lij.edu; Love, Charito [North Shore Long Island Jewish Health System, Manhasset and New Hyde Park, NY (United States). Div. of Nuclear Medicine and Molecular Imaging

    2007-09-15

    Radionuclide imaging studies are routinely used to evaluate patients suspected of having musculoskeletal infection. Three-phase bone imaging is readily available, relatively inexpensive, and very accurate in the setting of otherwise normal bone. Labeled leukocyte imaging should be used in cases of 'complicating osteomyelitis' such as prosthetic joint infection. This test also is useful in clinically unsuspected diabetic pedal osteomyelitis as well as in the neuropathic joint. It is often necessary, however, to perform complementary bone marrow imaging, to maximize the accuracy of labeled leukocyte imaging. In contrast to other regions in the skeleton, labeled leukocyte imaging is not useful for diagnosing spinal osteomyelitis. At the moment, gallium is the preferred radionuclide procedure for this condition and is a useful adjunct to magnetic resonance imaging. FDG-PET likely will play an important role in the evaluation of musculoskeletal infection, especially spinal osteomyelitis, and may replace gallium imaging for this purpose. (author)

  11. Terrestrial pathways of radionuclide particulates

    Boone, F.W.; Ng, Y.C.

    1981-01-01

    Formulations are developed for computing potential human intake of 13 radionuclides via the terrestrial food chains. The formulations are an extension of the NRC methodology. Specific regional crop and livestock transfer and fractional distribution data from the southern part of the U.S.A. are provided and used in the computation of comparative values with those computed by means of USNRC Regulatory Guide 1.109 formulations. In the development of the model, emphasis was also placed on identifying the various time-delay compartments of the food chains and accounting for all of the activity initially deposited. For all radionuclides considered, except 137 Cs, the new formulations predict lower potential intakes from the total of all food chains combined than do the comparable Regulatory Guide formulations by as much as a factor of 40. For 137 Cs the new formulations predict 10% higher potential intakes. (author)

  12. Radionuclide cinematography of the heart

    Adam, W.E.; Sigel, H.; Geffers, H.; Bitter, F.; Meyer, G.; Kampmann, H.; Stauch, M.

    1976-01-01

    Radionuclide cinematography is described as a procedure making use of radiation-level variations above the heart after equipartitioning of sup(99m)Tc-labelled human serum albumin in the blood pool. Regional ventricular and vestibular variations are phase-shifted. This procedure permits delineation of aneurysmas with interphasic course, cicatrization of the cardiac wall not producing any cyclical variation. The study included normal subjects and 16 patients with full course infarction. Characteristic disturbances of motility distribution were found in all cases of scarred or aneurysmic alterations in the frontal and side walls of the left ventricle. The procedure was unable to detect two small infarction scars on the rear wall. The possibility of using radionuclide cinematography to prove coronary insufficiency as well as a comparison with other methods are discussed

  13. Radionuclide 252Cf neutron source

    Kolevatov, Yu.I.; Trykov, L.A.

    1979-01-01

    Characteristics of radionuclide neutron sourses of 252 Cf base with the activity from 10 6 to 10 9 n/s have been investigated. Energetic distributions of neutrons and gamma-radiation have been presented. The results obtained have been compared with other data available. The hardness parameter of the neutron spectrum for the energy range from 3 to 15 MeV is 1.4 +- 0.02 MeV

  14. Radionuclide diagnosis of Meckel's diverticulum

    Conway, J.J.; Northwestern Univ., Chicago, IL

    1980-01-01

    Meckel's diverticulum can be detected with a high degree of accuracy by radionuclide scintigraphy using technetium-99m pertechnetate. The technique is without risk and should precede roentgenographic studies when the diagnosis is suspected. The method is described and the causes for false positive and false negative examinations are discussed. False negatives are rare and false positives are usually secondary to other surgical entities. Overall accuracy is 85 to 90%. (orig.) [de

  15. Radionuclides for therapy: a review

    Roesler, H.; Noelpp, U.; Triller, K.J.; Steffen, R.

    1986-01-01

    Progress in angiographic techniques has been a gradual evolutionary development which now permits the selective and superselective access to a tumor's vascular bed. A diagnostic angiographic procedure can be supplemented by a one-step, quick application of embolizing radioactive material. This endoarterial radionuclide embolizing tumor therapy has the maximum selectivity among radiotherapeutic methods, with the highest radiation doses to the tumor and neglectible exposure of normal tissue. Spread of radioactivity by diffusion or leaching can be prevented

  16. Radionuclide dispersion in the atmosphere

    Moura Neto, C. de; Amorim, E.S. do; Panetta, J.

    1979-05-01

    The instantaneous liberation of radionuclides in the atmosphere is studied in three dimensions, according to the formalism of the diffusion theory. The analytical solution, expose to gravitational and an atmospherical effects, is combined with the discretization of space and time in the calculation of levels of exposure. A typical inventory (for a PWR) was considered in the calculation of immersion doses, and the results permitted a comparative analysis among the different existing models. (Author) [pt

  17. Radiation protection in radionuclide investigations

    Taylor, D.M.

    1985-01-01

    The subject is covered in sections: introduction; radiation and radioactivity; alpha particles; beta particles; neutrons; electromagnetic radiation; units of radioactivity and radiation; biological effects of radiation; the philosophy of radiation protection (ALARA principle); practical aspects of radiation protection; work with unsealed radiation sources; radionuclide studies in experimental animals; radiation safety during clinical investigations; legislative control of radiation work; radioactive waste disposal; emergency procedures; conclusion. (U.K.)

  18. Radionuclide evaluation of renal transplants

    Yang Hong; Zhao Deshan

    2000-01-01

    Radionuclide renal imaging and plasma clearance methods can quickly quantitate renal blood flow and function in renal transplants. They can diagnose acute tubular necrosis and rejection, renal scar, surgical complications such as urine leaks, obstruction and renal artery stenosis after renal transplants. At the same time they can assess the therapy effect of renal transplant complications and can also predict renal transplant survival from early post-operative function studies

  19. Radionuclide behavior in the environment

    Tveten, U.

    1991-09-01

    The purpose of this report is to document the results of the following task: Review for quality and consistency the available data on measurements of initial ground contamination of Chernobyl radionuclides in various parts of Norway and subsequent concentrations of these radionuclides in various environmental media as functions of time. Utilize the data obtained to verify the existing models, or to improve them, for describing radionuclide behavior in the environment. Some of the processes standard were: migration into soil; weathering; resuspension; food-chain contamination; and loss or reconcentration by run-off. The task performed within this contract has been to use post-Chernobyl data from Norway to verify or find areas for possible improvement in the chronic exposure pathway models utilized in MACCS. Work has consisted mainly of collecting and evaluating post-Chernobyl information from Norway or other countries when relevant; but has also included experimental work performed specifically for the current task. In most connections the data available show the models and data in MACCS to be appropriate. A few areas where the data indicate that the MACCS approach is faulty or inadequate are, however, pointed out in the report. These should be examined carefully, and appropriate modifications should eventually be made. 14 refs., 12 figs., 22 tabs

  20. Walkability Index

    The Walkability Index dataset characterizes every Census 2010 block group in the U.S. based on its relative walkability. Walkability depends upon characteristics of the built environment that influence the likelihood of walking being used as a mode of travel. The Walkability Index is based on the EPA's previous data product, the Smart Location Database (SLD). Block group data from the SLD was the only input into the Walkability Index, and consisted of four variables from the SLD weighted in a formula to create the new Walkability Index. This dataset shares the SLD's block group boundary definitions from Census 2010. The methodology describing the process of creating the Walkability Index can be found in the documents located at ftp://newftp.epa.gov/EPADataCommons/OP/WalkabilityIndex.zip. You can also learn more about the Smart Location Database at https://edg.epa.gov/data/Public/OP/Smart_Location_DB_v02b.zip.

  1. Radionuclide daughter inventory generator code: DIG

    Fields, D.E.; Sharp, R.D.

    1985-09-01

    The Daughter Inventory Generator (DIG) code accepts a tabulation of radionuclide initially present in a waste stream, specified as amounts present either by mass or by activity, and produces a tabulation of radionuclides present after a user-specified elapsed time. This resultant radionuclide inventory characterizes wastes that have undergone daughter ingrowth during subsequent processes, such as leaching and transport, and includes daughter radionuclides that should be considered in these subsequent processes or for inclusion in a pollutant source term. Output of the DIG code also summarizes radionuclide decay constants. The DIG code was developed specifically to assist the user of the PRESTO-II methodology and code in preparing data sets and accounting for possible daughter ingrowth in wastes buried in shallow-land disposal areas. The DIG code is also useful in preparing data sets for the PRESTO-EPA code. Daughter ingrowth in buried radionuclides and in radionuclides that have been leached from the wastes and are undergoing hydrologic transport are considered, and the quantities of daughter radionuclide are calculated. Radionuclide decay constants generated by DIG and included in the DIG output are required in the PRESTO-II code input data set. The DIG accesses some subroutines written for use with the CRRIS system and accesses files containing radionuclide data compiled by D.C. Kocher. 11 refs

  2. Radionuclide migration test using undisturbed aerated soil

    Yamamoto, Tadatoshi; Ohtsuka, Yoshiro; Ogawa, Hiromichi; Wadachi, Yoshiki

    1988-01-01

    As one of the most important part of safety assessment on the shallow land disposal of lowlevel radioactive waste, the radionuclide migration was studied using undisturbed soil samples, in order to evaluate an exact radionuclide migration in an aerated soil layer. Soil samples used in the migration test were coastal sand and loamy soil which form typical surface soil layers in Japan. The aqueous solution containing 60 CoCl 2 , 85 SrCl 2 and 137 CsCl was fed into the soil column and concentration of each radionuclide both in effluent and in soil was measured. Large amount of radionuclides was adsorbed on the surface of soil column and small amount of radionuclides moved deep into the soil column. Difference in the radionuclide profile was observed in the low concentration portion particularly. It is that some fractions of 60 Co and 137 Cs are stable in non-ionic form and move downward through the soil column together with water. The radionuclide distribution in the surface of soil column can be fairly predicted with a conventional migration equation for ionic radionuclides. As a result of radionuclide adsorption, both aerated soil layers of coastal sand and loamy soil have large barrier ability on the radionuclide migration through the ground. (author)

  3. Metabolism of radionuclides in domestic animals

    Wirth, E.; Leising, C.

    1986-01-01

    The reactor accident at Chernobyl has shown that shortly after the contamination of the environment radionuclides can be found in animal products. The main contamination pathways of domestic animas are: uptake of radionuclides by foodstuffs; uptake of radionuclides by contaminated drinking water; uptake of radionuclides by inhalation; uptake of radionuclides through skin; uptake of radionuclides by ingestion of soil particles. Generally the uptake of radionuclides by food is the dominant exposure pathway. In rare cases the inhalation of radionuclides or the uptake by drinking water may be of importance. The metabolism of incorporated radionuclides is comparable to the respective metabolism of essential mass or trace elements or heavy metals. Radioisotopes of essential elements are for instance iron 55, manganese 54, cobalt 58 and cobalt 60. Other elements are typical antagonists to essential elements, e.g. strontium 90 is an antagonist to calcium or cesium 137 to potassium. Lead 210 and plutonium 239 behave similarly as heavy metals. Generally the knowledge of the metabolism of trace and mass elements, of antagonistic and synergistic elements and heavy metals can be applied to these radionuclides

  4. The ratio of right ventricular volume to left ventricular volume reflects the impact of pulmonary regurgitation independently of the method of pulmonary regurgitation quantification

    Śpiewak, Mateusz; Małek, Łukasz A.; Petryka, Joanna; Mazurkiewicz, Łukasz; Miłosz, Barbara; Biernacka, Elżbieta K.; Kowalski, Mirosław; Hoffman, Piotr; Demkow, Marcin; Miśko, Jolanta; Rużyłło, Witold

    2012-01-01

    Background: Previous studies have advocated quantifying pulmonary regurgitation (PR) by using PR volume (PRV) instead of commonly used PR fraction (PRF). However, physicians are not familiar with the use of PRV in clinical practice. The ratio of right ventricle (RV) volume to left ventricle volume (RV/LV) may better reflect the impact of PR on the heart than RV end-diastolic volume (RVEDV) alone. We aimed to compare the impact of PRV and PRF on RV size expressed as either the RV/LV ratio or RVEDV (mL/m 2 ). Methods: Consecutive patients with repaired tetralogy of Fallot were included (n = 53). PRV, PRF and ventricular volumes were measured with the use of cardiac magnetic resonance. Results: RVEDV was more closely correlated with PRV when compared with PRF (r = 0.686, p 2.0 [area under the curve (AUC) PRV = 0.770 vs AUC PRF = 0.777, p = 0.86]. Conversely, with the use of the RVEDV-based criterion (>170 mL/m 2 ), PRV proved to be superior over PRF (AUC PRV = 0.770 vs AUC PRF = 0.656, p = 0.0028]. Conclusions: PRV and PRF have similar significance as measures of PR when the RV/LV ratio is used instead of RVEDV. The RV/LV ratio is a universal marker of RV dilatation independent of the method of PR quantification applied (PRF vs PRV)

  5. Catheter-based intervention for symptomatic patient with severe mitral regurgitation and very poor left ventricular systolic function

    Loh, Poay Huan; Bourantas, Christos V; Chan, Pak Hei

    2015-01-01

    Many patients with left ventricular systolic dysfunction have concomitant mitral regurgitation (MR). Their symptoms and prognosis worsen with increasing severity of MR. Percutaneous MitraClip(®) can be used safely to reduce the severity of MR even in patients with advanced heart failure and is as...

  6. Aortic valve calcification as a predictor of location and severity of paravalvular regurgitation after transcatheter aortic valve implantation

    Koh, Ezra Y.; Lam, Kayan Y.; Bindraban, Navin R.; Cocchieri, Riccardo; Planken, R. Nils; Koch, Karel T.; Baan, Jan; de Mol, Bas A.; Marquering, Henk A.

    2015-01-01

    To determine whether the location of aortic valve calcium (AVC) influences the location of paravalvular regurgitation (PR). PR is an adverse effect of transcatheter aortic valve implantation (TAVI) with a negative effect on long-term patient survival. The relationship between AVC and the occurrence

  7. Impacts of acute severe pulmonary regurgitation on right ventricular geometry and contractility assessed by tissue-Doppler echocardiography

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

    2010-01-01

    AIMS: Little is known of the impact of acute right ventricular (RV) volume overload on RV function. We assessed the impact of acute severe pulmonary regurgitation (PR) on global and regional RV function by applying novel quantitative echocardiographic markers of myocardial performance in an animal...

  8. The interaction of de novo and pre-existing aortic regurgitation after TAVI: insights from a new quantitative aortographic technique

    Tateishi, Hiroki; Abdelghani, Mohammad; Cavalcante, Rafael; Miyazaki, Yosuke; Campos, Carlos M.; Collet, Carlos; Slots, Tristan L. B.; Leite, Rogério S.; Mangione, José A.; Abizaid, Alexandre; Soliman, Osama I. I.; Spitzer, Ernest; Onuma, Yoshinobu; Serruys, Patrick W.; Lemos, Pedro A.; de Brito, Fabio S.

    2017-01-01

    The aim of this study was to evaluate the intermediate-term clinical impact of aortic regurgitation (AR) after transcatheter aortic valve implantation (TAVI) using a novel quantitative angiographic method taking into account the influence of pre-existing AR. AR after TAVI was quantified in 338

  9. Impacts of acute severe pulmonary regurgitation on right ventricular geometry and contractility assessed by tissue-Doppler echocardiography

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

    2010-01-01

    Little is known of the impact of acute right ventricular (RV) volume overload on RV function. We assessed the impact of acute severe pulmonary regurgitation (PR) on global and regional RV function by applying novel quantitative echocardiographic markers of myocardial performance in an animal model....

  10. Examination of mitral regurgitation with a goat heart model for the development of intelligent artificial papillary muscle.

    Shiraishi, Y; Yambe, T; Yoshizawa, M; Hashimoto, H; Yamada, A; Miura, H; Hashem, M; Kitano, T; Shiga, T; Homma, D

    2012-01-01

    Annuloplasty for functional mitral or tricuspid regurgitation has been made for surgical restoration of valvular diseases. However, these major techniques may sometimes be ineffective because of chamber dilation and valve tethering. We have been developing a sophisticated intelligent artificial papillary muscle (PM) by using an anisotropic shape memory alloy fiber for an alternative surgical reconstruction of the continuity of the mitral structural apparatus and the left ventricular myocardium. This study exhibited the mitral regurgitation with regard to the reduction in the PM tension quantitatively with an originally developed ventricular simulator using isolated goat hearts for the sophisticated artificial PM. Aortic and mitral valves with left ventricular free wall portions of isolated goat hearts (n=9) were secured on the elastic plastic membrane and statically pressurized, which led to valvular leaflet-papillary muscle positional change and central mitral regurgitation. PMs were connected to the load cell, and the relationship between the tension of regurgitation and PM tension were measured. Then we connected the left ventricular specimen model to our hydraulic ventricular simulator and achieved hemodynamic simulation with the controlled tension of PMs.

  11. Methods of separating short half-life radionuclides from a mixture of radionuclides

    Bray, Lane A.; Ryan, Jack L.

    1998-01-01

    The present invention is a method of obtaining a radionuclide product selected from the group consisting of .sup.223 Ra and .sup.225 Ac, from a radionuclide "cow" of .sup.227 Ac or .sup.229 Th respectively. The method comprises the steps of a) permitting ingrowth of at least one radionuclide daughter from said radionuclide "cow" forming an ingrown mixture; b) insuring that the ingrown mixture is a nitric acid ingrown mixture; c) passing the nitric acid ingrown mixture through a first nitrate form ion exchange column which permits separating the "cow" from at least one radionuclide daughter; d) insuring that the at least one radionuclide daughter contains the radionuclide product; e) passing the at least one radionuclide daughter through a second ion exchange column and separating the at least one radionuclide daughter from the radionuclide product and f) recycling the at least one radionuclide daughter by adding it to the "cow". In one embodiment the radionuclide "cow" is the .sup.227 Ac, the at least one daughter radionuclide is a .sup.227 Th and the product radionuclide is the .sup.223 Ra and the first nitrate form ion exchange column passes the .sup.227 Ac and retains the .sup.227 Th. In another embodiment the radionuclide "cow"is the .sup.229 Th, the at least one daughter radionuclide is a .sup.225 Ra and said product radionuclide is the .sup.225 Ac and the .sup.225 Ac and nitrate form ion exchange column retains the .sup.229 Th and passes the .sup.225 Ra/Ac.

  12. Survey of data on the radionuclide content of fish in Canada

    1987-01-01

    A computerized database of uranium and thorium decay-series radionuclide concentrations in Canadian fish was compiled, including concentrations of U-total, Th-total, Th-230, Th-232, Th-228, Ra-226, Po-210 and Pb-210 in various fish tissues. Each record represents a specific tissue from a particular fish sample, indexed by province, lake or river of origin, nearest mine/mill, mine status, distance to mill, sampling date, fish species, tissue type, weight basis of measurement, analytical laboratory, and a number of data quality factors. Additional information includes exact location, UTM coordinates, sample collector, literature reference, fish weight, length, age and sex, number of fish, and radionuclide concentrations in water and sediment. Records are retrievable by any combination of index variables, radionuclide ranges and/or data quality criteria. The database uses the DBase II software package. 51 refs

  13. Survey of data on the radionuclide content of fish in Canada

    1987-01-01

    The appendices of a computerized database of uranium and thorium decay-series radionuclide concentrations in Canadian fish are presented, including concentrations of U-total, Th-total, Th-230, Th-232, Th-228, Ra-226, Po-210 and Pb-210 in various fish tissues. Each record represents a specific tissue from a particular fish sample, indexed by province, lake or river of origin, nearest mine/mill, mine status, distance to mill, sampling date, fish species, tissue type, weight basis of measurement, analytical laboratory, and a number of data quality factors. Additional information includes exact location, UTM cooridnates, sample collector, literature reference, fish weight, length, age and sex, number of fish, and radionuclide concentrations in water and sediment. Records are retrievable by any combination of index variables, radionuclide ranges and/or data quality criteria

  14. AP Index

    National Oceanic and Atmospheric Administration, Department of Commerce — Planetary Amplitude index - Bartels 1951. The a-index ranges from 0 to 400 and represents a K-value converted to a linear scale in gammas (nanoTeslas)--a scale that...

  15. Phytoremediation of radionuclides: an emerging alternative

    Singh, Shraddha

    2013-01-01

    Proliferation of nuclear power industry, nuclear weapon testing, dismantling of existing nuclear weapons and occasional accidents have contributed to an enhancement in the level of radionuclides in the environment. The radionuclides due to their long half life and transfer through the food chain effect adversely to normal biological systems. Hence, it is essential to effectively remove the radionuclides from contaminated soils and solutions. Phytoremediation - the use of plants for remediation of toxic metals and radionuclides has been recognized as an aesthetically pleasing, low cost and environment friendly in situ method. Phytoremediation is an umbrella term which covers several plant based approaches. Plants have shown the potential of remediation of these radionuclides from spiked solutions, low level nuclear waste and soil. Various aspects of phytoremediation as well as potential of various plants for remediation of radionuclides will be discussed here. (author)

  16. Radionuclide transport processes in terrestrial ecosystems

    Whicker, F.W.

    1983-01-01

    Some major principles and the status of knowledge concerning the transport of radionuclides through terrestrial ecosystems are reviewed. Fundamental processes which control the flow of radionuclides between ecosystem components such as air, soil, plants, and animals are described, with emphasis on deposition, resuspension, plant uptake, ingestion, and assimilation. Properties of radionuclides, organisms, and ecosystems are examined in relation to their influence on the accumulation of radioactive materials by plants and animals. The effects of the physicochemical nature of the radionuclide; morphology, physiology, and behavior of the organism; and soil, nutrient, and trophic characteristics of the ecosystem are highlighted. Observations in natural ecosystems on radionuclides such as 137 Cs, 90 Sr, 131 I, 3 H, and 239 Pu are used to illustrate current concepts. An assessment of the degree to which the processes controlling radionuclide behavior are understood and of our ability to simulate and predict such behavior with computerized models is offered. Finally, brief comments are made on research needs

  17. Radionuclides in the study of marine processes

    Kershaw, P.J.; Woodhead, D.S.

    1991-01-01

    For many years, the radioactive properties of the naturally occurring radionuclides have been used to determine their distributions in the marine environment and, more generally, to gain an understanding of the dynamic processes which control their behaviour in attaining these distributions. More recently the inputs from human activities of both natural and artificial (i.e. man-made) radionuclides have provided additional opportunities for the study of marine processes on local, regional and global scales. The primary objective of the symposium is to provide a forum for an open discussion of the insights concerning processes in the marine environment which can be gained from studies of radionuclide behaviour. Papers have been grouped within the following principal themes; the uses of radionuclides as tracers of water transport; scavenging and particulate transport processes in the oceans as deduced from radionuclide behaviour; processes in the seabed and radionuclides in biological systems. (Author)

  18. Chemical speciation of radionuclides migrating in groundwaters

    Robertson, D.; Schilk, A.; Abel, K.; Lepel, E.; Thomas, C.; Pratt, S.; Cooper, E.; Hartwig, P.; Killey, R.

    1994-04-01

    In order to more accurately predict the rates and mechanisms of radionuclide migration from low-level waste disposal facilities via groundwater transport, ongoing studies are being conducted at field sites at Chalk River Laboratories to identify and characterize the chemical speciation of mobile, long-lived radionuclides migrating in groundwaters. Large-volume water sampling techniques are being utilized to separate and concentrate radionuclides into particular, cationic, anionic, and nonionic chemical forms. Most radionuclides are migrating as soluble, anionic species that appear to be predominantly organoradionuclide complexes. Laboratory studies utilizing anion exchange chromatography have separated several anionically complexed radionuclides, e.g., 60 Co and 106 Ru, into a number of specific compounds or groups of compounds. Further identification of the anionic organoradionuclide complexes is planned utilizing high resolution mass spectrometry. Large-volume ultra-filtration experiments are characterizing the particulate forms of radionuclides being transported in these groundwaters

  19. Production of radionuclides with generators

    Khujaev, S.; Egamediev, S.Kh.

    2004-01-01

    Full text: The radionuclide generator provides a convenient means for researchers and clinicians to obtain a source of radionuclides without dependence on nuclear facilities (nuclear reactor or cyclotron). It should be noted that radionuclide generator technique yields products of very high purity and it offers moreover the only possible way of obtaining very short-lived radionuclides for practical applications. Therefore at present radionuclide generators have found important uses in nuclear medicine. This talk reviews the development of preparation methods for radionuclide generators of current interest: 99 Mo- 99m Tc, 188 W- 188 Re and 68 Ge- 68 Ga. 99 Mo- 99m Tc generator. 99m Tc is presently the most widely used radionuclide in diagnostic nuclear medicine. The reason for such a preeminent position of 99m Tc in clinical uses is its extremely favorable nuclear properties with γ-energy of 140 keV and short half-life of 6 hours. Chromatographic generator of 99 Mo- 99m Tc based on aluminium oxide using as eluent of isotonic saline solution, containing nitrate-ions has been produced in INP AS RU. However, the main disadvantage of this generator is that the eluent-saline solution contains some amount of nitrate-ions. Nitrate-ions added to maximize and stabilize 99m Tc yields would interfere with the chemical reactions which involve Sn(II) reduction of the pertechnetate ion and which are used subsequently in the preparation of radiopharmaceuticals. Therefore we proposed the new method for preliminary treatment of aluminium oxide by the external gamma (Co-60) irradiation. It is found that the aluminium oxide has got electron-acceptor properties after gamma-irradiation. Adsorption of 99 Mo radionuclide as isopolymolybdate on gamma-irradiated aluminium oxide is very high and molybdenum is firmly retained. Adsorption capacity of gamma-irradiated aluminium oxide at pH 2-4 is 60-80 mg Mo per gram of Al 2 O 3 . The yields of 99m Tc from experimental generators remained high

  20. DKPRO: A radionuclide decay and reprocessing code

    Wootan, D.; Schmittroth, F.A.

    1997-01-01

    The DKPRO code solves the general problem of modeling complex nuclear wastes streams using ORIGEN2 radionuclide production files. There is a continuing need for estimates of Hanford radionuclides. Physical measurements are one basis; calculational estimates, the approach represented here, are another. Given a known nuclear fuel history, it is relatively straightforward to calculate radionuclide inventories with codes such as the widely-used Oak Ridge National Laboratory code ORIGEN2

  1. Radionuclide usage survey 1979-80

    Woods, M.J.

    1980-08-01

    Details of a survey by the Life Sciences Working Group of the International Committee for Radionuclide Metrology (ICRM) on radionuclide usage by medical physicists in 11 countries are presented. The results indicate that the radionuclide which will be of most significance in the future will be F-18, Fe-52, Ga-67, Ga-68, Kr-81m, Tc-99m, In-111, I-123, Xe-127 and Tl-201, (U.K.)

  2. Preparation of porous materials for radionuclides capture

    Bajzikova, Anna; Smrcek, Stanislav; Kozempel, Jan; Vlk, Martin; Barta, Jan

    2015-01-01

    Porous materials showing promise for radionuclide capture from water at contaminated sites were prepared. Nanoporous materials (size of pores 1-100 nm) and some polymers are well suited to this purpose owing their affinity for selected radionuclides. Nanoporous metal oxides and silica gel with styrene-divinylbenzene-TODGA-modified surface were prepared, characterized and tested for radionuclide ( 227 Ac, 227 Th, 223 Ra) capture efficiency. (orig.)

  3. Severe Tricuspid Regurgitation Diagnosed 13 Years after a Car Accident: A Case Report

    Acar, Burak; Suleymanoglu, Muhammed; Burak, Cengiz; Demirkan, Burcu Mecit; Guray, Yesim; Tufekcioglu, Omac; Aydogdu, Sinan

    2015-01-01

    Abstract Blunt chest traumas mostly occur due to car accidents and can cause many cardiac complications such as septal rupture, free-wall rupture, coronary artery dissection or thrombosis, heart failure, arrhythmias, and chordae and papillary muscle rupture. One of the most serious complication is tricuspid regurgitation (TR), which can be simply diagnosed by physical examination and confirmed by echocardiography. We describe a 48-year-old female patient, diagnosed with severe TR 13 years after a blunt chest trauma due to a car accident. TR was diagnosed with transthoracic echocardiography and three dimensional transthoracic echocardiography had defined the exact pathology of the tricuspid valve. The patient underwent successful surgery with bioprosthetic valve implantation and was discharged at 6th postoperative day without any complication. The patient had no problem according to the follow-up one month and six months after operation. PMID:26157464

  4. Clinical presentation, diagnosis and management of acute mitral regurgitation following acute myocardial infarction

    Rengin Çetin Güvenç

    2016-03-01

    Full Text Available Acute mitral regurgitation (MR is a frequent complication of acute myocardial infarction, with a variable presentation depending on the severity of MR and the integrity of the subvalvular apparatus. While most cases are asymptomatic or have mild dyspnea, rupture of chordae tendinea or papillary muscles are catastrophic complications that may rapidly lead to cardiogenic shock and death. Despite the presence of pulmonary edema and/or cardiogrenic shock, the murmur of acute MR is usually subtle due to rapid equalization of left atrial and left ventricular pressure gradient, and therefore misleading. Echocardiography is the definite diagnostic modality, allowing quantification of the severity of MR and the structural abnormalities within the subvalvular apparatus. Severe MR accompanied by rupture of chordae or papillary muscles should be managed with temporary stabilization with medical treatment or with mechanical circulatory support, with subsequent surgical intervention to repair or replace the valve.

  5. Two-dimensional aortographic coronary angiography with synchrotron radiation at aortic regurgitation state

    Takeda, Tohoru; Umetani, Keiji; Doi, Toshiki; Itai, Yuji; Yu, Quanwen; Akatsuka, Takao

    1999-10-01

    At aortic regurgitation state, 2D synchrotron radiation (SR) coronary arteriography (CAG) with aortographic contrast injection was examined theoretically and animal experiments were performed to confirm its diagnostic ability. This system consisted of a silicon monocrystal, fluorescent plate, avalanche-type pickup tube camera, and image acquisition system. The experiment was performed at synchrotron sources in the Photon Factory of Tsukuba. The x- ray energy was adjusted to just above the iodine K-edge. Theoretical calculation described that the coronary arteries overlapping on left ventricle could not be demonstrated well with a high signal-to-noise ratio by using the aortographic CAG with SR. The canine coronary arteries without overlap over the left ventricle were demonstrated clearly, however, the image quality appear to be reduced. The coronary artery overlapping over left ventricle could not be demonstrated well, however the transient reduction of left ventricular wall motion was revealed by transient stenotic procedure of left anterior descending coronary artery.

  6. Effects of surgery on ischaemic mitral regurgitation: a prospective multicentre registry (SIMRAM registry)

    Lancellotti, P.; Donal, E.; Cosyns, B.

    2008-01-01

    at rest. Exercise echocardiography may help identify a subset of patients at higher risk of cardiovascular events by revealing the dynamic component of IMR. METHODS: A large prospective, multicentre, non-randomized registry is designed to evaluate the effects of surgery on IMR at rest and on its dynamic......AIMS: Functional ischaemic mitral regurgitation (IMR) is common in patients with ischaemic left ventricular dysfunction undergoing coronary artery bypass surgery. Although the presence of IMR negatively affects prognosis, the additional benefit of valve repair is debated, particularly with mild IMR...... component at exercise (z). SIMRAM will enrol approximately 550 patients with IMR in up to 17 centres with clinical and exercise follow-up for 1 year. Three sets of outcomes will be prospectively assessed and several hypotheses will be tested including determinants of adverse outcome and progressive left...

  7. Aortic compliance in patients with aortic regurgitation. Evaluation with magnetic resonance imaging

    Murai, Sachiko; Hamada, Seiki; Ueguchi, Takashi

    2005-01-01

    The purpose of this study was to assess by means of cine magnetic resonance imaging (MRI) aortic compliance before and after aortic valve replacement (AVR with SJM (St. Jude Medical, St paul, MN) valve) in patients with aortic regurgitation (AR). Two groups (healthy controls and patients with severe isolated AR) of 10 subjects each were included in this study. Cine MRI was performed at three locations of the aorta, and aortic compliance was calculated by dividing the maximum change in the aortic area by pulse pressure. Cine MRI is useful to assess abnormalities of aortic compliance in patients with AR. Compared with the control group, aortic compliance in the AR group was significantly less in the ascending aorta (p<0.05), decreasing in order of aortic location. After AVR, aortic compliance improved for all locations. Cine MRI enables assessment of aortic biophysical properties such as a compliance for evaluating the progression of AR and the efficacy of treatment. (author)

  8. Role of percutaneous mitral valve repair in the contemporary management of mitral regurgitation.

    Rana, Bushra S; Calvert, Patrick A; Punjabi, Prakash P; Hildick-Smith, David

    2015-10-01

    Percutaneous mitral valve (MV) repair has been performed in over 20,000 patients worldwide. As clinical experience in this technique grows indications for its use are being defined. Mitral regurgitation (MR) encompasses a complex heterogeneous group and its treatment is governed by determining a clear understanding of the underlying aetiology. Surgical MV repair remains the gold standard therapy for severe MR. However in select groups of high-risk surgical patients, a percutaneous approach to MV repair is establishing its role. This review gives an overview of the published data in percutaneous MV repair and its impact on the contemporary management of MR. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  9. Circulating concentrations of insulin-like growth factor-1 in dogs with naturally occurring mitral regurgitation

    Pedersen, Henrik Duelund; Falk, Bo Torkel; Häggström, Jens

    2005-01-01

    Insulin-like growth factor-1 (IGF-1), which mediates most effects of growth hormone, has effects on cardiac mass and function, and plays an important role in the regulation of vascular tone. In humans, an inverse relationship between degree of heart failure (HF) and circulating IGF-1 concentrations...... has been found in several studies. In dogs with HF, few studies have focused on IGF-1. We examined circulating IGF-1 concentrations in dogs with mitral regurgitation (MR) caused by myxomatous mitral valve disease. Study 1 included 88 Cavalier King Charles Spaniels (CKCSs) with a broad range...... of asymptomatic MR (median serum IGF-1: 76.7 µg/L; 25-75 percentile, 59.8-104.9 µg/L). As expected, standard body weight and percentage under- or overweight correlated directly with IGF-1. MR (assessed in 4 different ways) did not correlate with IGF-1. In study 2, 28 dogs with severe MR and stable, treated...

  10. Environmental behaviour of radionuclides and transfer to man

    Smith, H.

    1982-01-01

    The environmental behaviour of the radionuclides making the major contribution to man's irradiation through diet is described. The following stages are emphasized: transfer of radionuclides to plants; transfer of radionuclides to animals; metabolism of inhaled or ingested radionuclides in animals providing food for man; transfer of radionuclides through the aquatic environment; application of food chain models. (43 references)

  11. Radionuclide accumulation peculiarities demonstrated by vegetable varieties

    Kruk, A.V.; Goncharenko, G.G.; Kilchevsky, A.V.

    2004-01-01

    This study focused on ecological and genetic aspects of radionuclide accumulation demonstrated by a number of vegetable varieties. The researches resulted in determining the cabbage varieties which were characterised by the minimal level of radionuclide accumulation. It was shown that the above varieties manifested the relation between radionuclide accumulation and morphobiological characteristics such as vegetation period duration and yield criteria. The study specified the genotypes with high ecological stability as regards to radionuclide accumulation: 'Beloruskaya 85' cabbage and 'Dokhodny' tomato showed the best response to Cs 137, while 'Beloruskaya 85', 'Rusinovka', 'Amager 611' cabbage varieties and 'Sprint' tomato showed the minimal level of Sr 90 accumulation. (authors)

  12. Therapy for incorporated radionuclides: scope and need

    Smith, V.H.

    1981-03-01

    In the United States the recent termination of funding for research on therapy for incorporated radionuclides has virtually halted progress on improved or new agents and procedures for removing radioactivity from the body. Research was eliminated, but is still needed on new removal agents, improved delivery system, in vitro test systems, and the toxicology of treatments. For many radionuclides, no adequate therapy exists. The relationship between radionuclide removal and reduction in cancer risk is still unanswered. Without proper research support, needed improvements in the treatment for incorporated radionuclides in the US are uncertain

  13. Evidence-based Surgery of Aortic Regurgitation: Results of a Questionnaire in German-speaking Countries.

    Dinges, Christian; Steindl, Johannes; Hitzl, Wolfgang; Kiesslich, Tobias; Seitelberger, Rainald

    2017-03-04

    Background  evidence-based medicine (EBM) approaches have reached broad acceptance, both in conservative and surgical disciplines. The aim of this study is to clarify the role of EBM in a rare condition of aortic regurgitation (AR) with surgical indication. Methods  A purpose-built Internet-based questionnaire was sent to 607 cardiovascular surgeons in Germany, Austria, and Switzerland. A virtual 64-year-old patient's medical history was presented, including two ultrasound images and one computed tomography scan, showing a 58-mm aortic root aneurysm and a severe trileaflet regurgitant aortic valve. Participants had to choose their preferred therapeutic strategy from a list. Additionally, demographics including nationality, the center size, and the frequency of similar types of patients referred to their departments were collected. Results  Of 607 questionnaires, 100 were returned (16%). One participant was excluded due to conflicting answers. Most surgeons ( n  = 84; 84%) chose a valve-sparing root replacement (VSRR). A Bentall procedure was preferred by 13 surgeons (13%). Two surgeons voted for aortic valve replacement combined with partial root resection. The decision-making process was not significantly influenced by center size, nationality, or frequency of patients. Conclusion  Applying the current guidelines to our virtual study patient, 84% of participants acted accordingly choosing VSRR. Remarkably, 14% of these surgeons see less than 10 and 43% see not more than 20 comparable patients per year. Since the guidelines reserve VSRR for competent centers, those numbers as well as the guidelines themselves should be further discussed. Georg Thieme Verlag KG Stuttgart · New York.

  14. Semi-quantitative assessment of tricuspid regurgitation on contrast-enhanced multidetector CT

    Groves, A.M.; Win, T.; Charman, S.C.; Wisbey, C.; Pepke-Zaba, J.; Coulden, R.A.

    2004-01-01

    AIM: To assess whether the early regurgitation of intravenous contrast medium into the inferior vena cava (IVC) and/or hepatic veins on computed tomography (CT), indicates tricuspid regurgitation (TR), and if so, whether it be used to grade severity. MATERIALS AND METHODS: We identified 86 consecutive patients that had been investigated for possible pulmonary endarterectomy at Papworth Hospital. From these, 61 patients were selected in whom CT, transthoracic echocardiography, and right heart catheterization (RHC) had been performed within 6 weeks. Using an arbitrary visual scale, the degree of TR assessed by intravenous contrast-enhanced CT was compared with echocardiography. Results were analysed using a kappa weighted statistical test. In addition, CT and echocardiographic assessments of TR severity were correlated with pulmonary artery pressure measurements obtained by RHC (Spearman's rank correlation coefficient). RESULTS: CT assessment of TR had a sensitivity of 90.4% and a specificity of 100% in detecting echocardiographic TR. For TR graded as more than trivial by echocardiography, sensitivity of CT was 100%. With respect to RHC data, the correlation between severity assessment of TR between CT and echocardiography using the Kappa weighted coefficient was 0.56 (moderately good agreement). With respect to RHC data, the correlation between mean pulmonary pressure and TR grading on CT and echocardiography was r=0.685 (p<0.001) and r=0.727 (p<0.001), respectively. CONCLUSION: Early opacification of the IVC or hepatic veins on first-pass contrast-enhanced CT almost invariably indicates TR. There is moderately good agreement between CT and echocardiographic assessment of the severity of TR. Both CT and echocardiographic grading of TR correlate well with RHC measurements of pulmonary artery pressure

  15. Clinical Outcome of Degenerative Mitral Regurgitation: Critical Importance of Echocardiographic Quantitative Assessment in Routine Practice.

    Antoine, Clemence; Benfari, Giovanni; Michelena, Hector I; Malouf, Joseph F; Nkomo, Vuyisile T; Thapa, Prabin; Enriquez-Sarano, Maurice

    2018-05-31

    Background -Echocardiographic quantitation of degenerative mitral regurgitation (DMR) is recommended whenever possible in clinical guidelines but is criticized and its scalability to routine clinical practice doubted. We hypothesized that echocardiographic DMR quantitation, performed in routine clinical practice by multiple practitioners predicts independently long-term survival, and thus is essential to DMR management. Methods -We included patients diagnosed with isolated mitral-valve-prolapse 2003-2011 and any degree of MR quantified by any physician/sonographer in routine clinical practice. Clinical/echocardiographic data acquired at diagnosis were retrieved electronically. Endpoint was mortality under medical treatment analyzed by Kaplan-Meir method and Proportional-Hazard models. Results -The cohort included 3914 patients (55% male) aged 62±17 years, with left ventricular ejection fraction (LVEF) 63±8% and routinely measured effective regurgitant orifice area (EROA) 19[0-40] mm 2 During follow-up (6.7±3.1 years) 696 patients died under medical management and 1263 underwent mitral surgery. In multivariate analysis, routinely measured EROA was associated with mortality (adjusted-hazard-ratio 1.19[1.13-1.24] p 40 mm 2 threshold. Conclusions -Echocardiographic DMR quantitation is scalable to routine practice and is independently associated with clinical outcome. Routinely measured EROA is strongly associated with long-term survival under medical treatment. Excess mortality vs. the general population appears in the "moderate" DMR range and steadily increases with higher EROA. Hence, individual EROA values should be integrated into therapeutic considerations, additionally to categorical DMR grading.

  16. Modelling the effects of spatial variability on radionuclide migration

    1998-01-01

    The NEA workshop reflect the present status in national waste management program, specifically in spatial variability and performance assessment of geologic disposal sites for deed repository system the four sessions were: Spatial Variability: Its Definition and Significance to Performance Assessment and Site Characterisation; Experience with the Modelling of Radionuclide Migration in the Presence of Spatial Variability in Various Geological Environments; New Areas for Investigation: Two Personal Views; What is Wanted and What is Feasible: Views and Future Plans in Selected Waste Management Organisations. The 26 papers presented on the four oral sessions and on the poster session have been abstracted and indexed individually for the INIS database. (R.P.)

  17. Radionuclide transport through heteogeneous media

    Hadermann, J.

    1980-01-01

    One-dimensional radionuclide migration for conevective water transport with sorption and longitudinal dispersion is investigated. A semianalytic solution for layered media with piecewise constant parametes can be written when taking into account mass conservation and approximate flux conservation at interlayer boundaries. The solution is analytic in the first layer and allows for a recursive calculation in the following layers. Scaling laws for the relevant parameters can be formulated. Numerical examples exhibit the importance of at least a single highly sorbing layer. Small values of dispersivity may not lead to a conservative estimate of conservation at the geological column's end

  18. Radionuclide transfer to meadow vegetation

    Goncharova, N.; Matsko, N.; Zhebrakova, I.; Montik, T.

    1999-01-01

    In the paper results of radioecological monitoring of natural plant populations in the 30 km zone of the Chernobyl Nuclear Power Plant (Polesky State Radioecological Reserve) during the period from 1987 to 1998 are presented. The level of radiation background in experimental areas varied from 0.1 to 30 mR/h that correspond to the total soil activity of 300-24000 kBq/m 2 (for May 1997). Monitoring was carried out including the radionuclide migration in natural plant complexes and transfer of 137 Cs between some plant organs. Refs. 3 (author)

  19. Dosimetry of incorporated transuranic radionuclides

    Loessner, V.

    1983-01-01

    Modern in vivo and in vitro techniques for detecting transuranic radionuclides within the human body are described with special emphasis on multiparameter measuring methods developed at the National Board of Nuclear Safety and Radiation Protection. Furthermore, problems related to calibration and interpretation of measuring data are discussed and new methods presented for the calculation of committed dose equivalents on the basis of data from ICRP Publication 30. Also included is an introductory chapter on radiobiological fundamentals of intake, translocation and metabolism of these nuclides. (author)

  20. Dietary intake of natural radionuclides

    Smith-Briggs, J L; Bradley, E J [National Radiological Protection Board, Chilton (UK)

    1984-09-01

    The levels of the natural radionuclides, radium-226, lead-210 and polonium-210 were measured in food samples collected for a National Food Survey, thus reflecting current consumption patterns in the UK. Daily intakes of radium-226, lead-210 and inferred values of polonium-210 were calculated for 20 food groups. From these data, the annual effective dose equivalents from radium-226, lead-210 and polonium-210 in the UK diet were estimated to be 3..mu..Sv, 41..mu..Sv and 13..mu..Sv respectively.

  1. Dietary intake of natural radionuclides

    Smith-Briggs, J.L.; Bradley, E.J.

    1984-01-01

    The levels of the natural radionuclides, radium-226, lead-210 and polonium-210 were measured in food samples collected for a National Food Survey, thus reflecting current consumption patterns in the UK. Daily intakes of radium-226, lead-210 and inferred values of polonium-210 were calculated for 20 food groups. From these data, the annual effective dose equivalents from radium-226, lead-210 and polonium-210 in the UK diet were estimated to be 3μSv, 41μSv and 13μSv respectively. (U.K.)

  2. Predicting ischemic mitral regurgitation in patients with acute ST-elevation myocardial infarction: Does time to reperfusion really matter and what is the role of collateral circulation?

    Valuckiene, Zivile; Budrys, Povilas; Jurkevicius, Renaldas

    2016-01-15

    Ischemic mitral regurgitation (MR) is an adverse prognostic factor. We aimed to assess the role of time delay from symptom onset to reperfusion, and the impact of collateral circulation to incidence of MR in relation to established echocardiographic and clinical risk factors. Patients with STEMI presenting within 12 h from symptom onset and treated with primary percutaneous coronary intervention (PPCI) at Hospital of Lithuanian University of Health Sciences were enrolled. Echocardiography was performed after PPCI. Based on MR grade, patients were divided into no significant MR (NMR, grade 0-I MR, N = 102) and ischemic MR (IMR, grade ≥ 2 MR, N = 71) groups. Well-developed collaterals were defined as grade ≥ 2 by Rentrop classification. Continuous variables were compared by independent samples Student's T-test. Multivariate logistic regression analysis was used to identify independent predictors of ischemic MR. Time to reperfusion, MI localization, TIMI flow before/after PCI was similar between the groups. IMR group patients were elder, more often females and non-smokers, had lower body mass index, higher prevalence of multi-vessel coronary artery disease (CAD), better-developed collateral supply, greater left ventricular end-diastolic diameter index, left atrial index, pulmonary artery systolic pressure and lower ejection fraction. Multivariate logistic regression analysis revealed that ischemic MR is predicted by female gender, well-developed collateral supply, presence of multi-vessel CAD, and lower EF. In acute STEMI significant MR is unrelated to ischemic time and is predicted by female gender, lower EF, multi-vessel CAD and well-developed collateral supply to the infarct region.

  3. AA Index

    National Oceanic and Atmospheric Administration, Department of Commerce — The geomagnetic aa index provides a long climatology of global geomagnetic activity using 2 antipodal observatories at Greenwich and Melbourne- IAGA Bulletin 37,...

  4. Walkability Index

    U.S. Environmental Protection Agency — The Walkability Index dataset characterizes every Census 2010 block group in the U.S. based on its relative walkability. Walkability depends upon characteristics of...

  5. Diversity Index

    Town of Chapel Hill, North Carolina — This map service summarizes racial and ethnic diversity in the United States in 2012.The Diversity Index shows the likelihood that two persons chosen at random from...

  6. AUTHOR INDEX

    a granitic terrain of southern India using factor analysis and GIS. 1059. Radhakrishna M see Dev Sheena V .... Landslide susceptibility analysis using Probabilistic. Certainty Factor ... index via entropy-difference analysis. 687. Yidana Sandow ...

  7. Intelligent indexing

    Farkas, J.

    1992-01-01

    In this paper we discuss the relevance of artificial intelligence to the automatic indexing of natural language text. We describe the use of domain-specific semantically-based thesauruses and address the problem of creating adequate knowledge bases for intelligent indexing systems. We also discuss the relevance of the Hilbert space ι 2 to the compact representation of documents and to the definition of the similarity of natural language texts. (author). 17 refs., 2 figs

  8. Intelligent indexing

    Farkas, J

    1993-12-31

    In this paper we discuss the relevance of artificial intelligence to the automatic indexing of natural language text. We describe the use of domain-specific semantically-based thesauruses and address the problem of creating adequate knowledge bases for intelligent indexing systems. We also discuss the relevance of the Hilbert space {iota}{sup 2} to the compact representation of documents and to the definition of the similarity of natural language texts. (author). 17 refs., 2 figs.

  9. Study on vertical distribution of radionuclides ({sup 40}K, Th and U) in soil collected from Manjung district

    Zainal, Fetri; Hamzah, Zaini; Wood, Khalik [Faculty of Sciences, Universiti Teknologi MARA, 40450, Shah Alam, Selangor (Malaysia); Saat, Ahmad [Faculty of Sciences, Universiti Teknologi MARA, 40450, Shah Alam, Selangor (Malaysia); Institute of Science, Universiti Teknologi MARA, 40450, Shah Alam, Selangor (Malaysia); Alias, Masitah [TNB Research Sdn. Bhd. 43000 Kajang, Selangor (Malaysia)

    2016-01-22

    The accumulation of radionuclides in soil is a greatest concerns due to their toxicity. This study investigated the vertical distribution of radionuclides and radiological assessment in a soil profile were collected in three different directions [North (N), North-East (NE) and South-East (SE)] within 40 km from Manjung district. All profile samples were collected down to 45cm at 7.5cm interval using hand auger. Soil density and radionuclides ({sup 40}K, Th and U) concentrations were determined by gravimetric method and Energy Dispersive X-Ray Fluorescence (EDXRF) technique, respectively. The radionuclides concentrations was in decreasing order of {sup 40}K > Th > U. Soil quality assessment was carried out using Enrichment Factor (EF), Pollution Index (PI) and Geoaccumulation Index (I {sub geo}) where all radionuclides show significant enrichment (5 < EF < 20), PI classified as middle pollution classes and 0 < Igeo < 1, indicating moderately polluted, respectively. From the concentration of radionuclides, the radiological risk was calculated and the present result show external hazard index (H{sub ex}) is below than unity indicate low radiological risk.

  10. Accumulation of radionuclides in selected marine biota from Manjung coastal area

    Abdullah, Anisa; Hamzah, Zaini; Saat, Ahmad; Wood, Ab. Khalik; Alias, Masitah

    2015-04-01

    Distribution of radionuclides from anthropogenic activities has been intensively studied due to the accumulation of radionuclides in marine ecosystem. Manjung area is affected by rapid population growth and socio-economic development such as heavy industrial activities including coal fired power plant, iron foundries, port development and factories, agricultural runoff, waste and toxic discharge from factories.It has radiological risk and toxic effect when effluent from the industries in the area containing radioactive materials either being transported to the atmosphere and deposited back over the land or by run off to the river and flow into coastal area and being absorbed by marine biota. Radionuclides presence in the marine ecosystem can be adversely affect human health when it enters the food chain. This study is focusing on the radionuclides [thorium (Th), uranium (U), radium-226 (226Ra), radium-228 (228Ra) and potassium-40 (40K)] content in marine biota and sea water from Manjung coastal area. Five species of marine biota including Johnius dussumieri (Ikan Gelama), Pseudorhombus malayanus (Ikan Sebelah), Arius maculatus (Ikan Duri), Portunus pelagicus (Ketam Renjong) and Charybdis natator (Ketam Salib) were collected during rainy and dry seasons. Measurements were carried out using Inductively Coupled Plasma Mass Spectrometer (ICPMS). The results show that the concentration of radionuclides varies depends on ecological environment of respective marine biota species. The concentrations and activity concentrations are used for the assessment of potential internal hazard index (Hin), transfer factor (TF), ingestion dose rate (D) and health risk index (HRI) to monitor radiological risk for human consumption.

  11. Detection of gastroesophageal reflux in survivors of congenital diaphragmatic hernia: A radionuclide scintigraphic study in 26 children

    Thomas, E.J.; Bharathi Dasan, J.; Chandrasekhar, N.; Tripathi, M.; Kumar, R.; Kumar, A.; Malhotra, A.; Gupta, D.K.; Mitra, D.K.

    2002-01-01

    Introduction: Anatomical and functional esophageal abnormalities in survivors with CDH are well known. Gastro-esophageal Reflux (GER) is a common cause of long-term morbidity in survivors of congenital diaphragmatic hernia. The incidence of GER in these patients varies from 20-70% using various modalities. Aims: The present retrospective analysis was undertaken to find out the incidence of GER detected by radionuclide scintigraphy in survivors of congenital diaphragmatic hernia. Materials and Methods: Radionuclide scintigraphy for GER detection were performed in 26 survivors of congenital diaphragmatic hernia (17 male and 9 female) with a mean age of 19 months; age range 10 days to 56 months. Seven of the children had symptoms suggestive of GER. Of these 7, 3 had recurrent respiratory tract infection, 2 had regurgitation, 1 had vomiting and 1 had epigastric pain. The remaining 19 children were referred as part of routine follow up. All the children underwent radionuclide scintigraphy with 100-200 micro curie (3.7 -7.4MBq) of Tc99m-Sulphur Colloid. Results: The radionuclide scintigraphy detected GER in 11 out of 26(42.3%) children. Among the 7 symptomatic children, 4 (57%) had positive scintigraphic studies for reflux. Of these 4, 3(75%) had proximal reflux and 1 had distal reflux. Of the 19 asymptomatic patients, 7 (37%) were positive for GER on scintigraphy. Of these 7, 4 (57%) had proximal reflux and 3 (43%) had distal reflux. Conclusions: There is high incidence of GER in survivors of congenital diaphragmatic hernia irrespective of the presence or absence of symptoms suggestive of GER. Scintiscanning being a simple, noninvasive test can be used for initial evaluation of survivors of CDH for GER

  12. Radionuclide behavior at underground environment

    Hahn, Phil Soo; Park, Chung Kyun; Keum, Dong Kwon; Cho, Young Hwan; Kang, Moon Ja; Baik, Min Hoon; Hahn, Kyung Won; Park, Hyun Soo

    2003-04-01

    This study of radionuclide behavior at underground environment has been carried out as a part of the study of high-level waste disposal technology development. Therefore, the main objectives of this project are constructing a data-base and producing data for the safety assessment of a high-level radioactive waste, and verification of the objectivity of the assessment through characterization of the geochemical processes and experimental validation of the radionuclide migration. This project is composed of 6 subjects such as data production required for safety assessments, sorption properties and mechanisms, nuclide migration in the fractured rock, colloid formation and migration, nuclide speciation in deep geological environments, and total evaluation of geochemical behaviors considering multi-factors. The various results from the this project can be applicable to the preliminary safety and performance assessments of the established disposal concept for a future high-level radioactive waste repository. Providing required data and technical basis for assessment methodologies could be a direct application of the results. In a long-term view, the results can also be utilized as a technical background for the establishment of government policy for high-level radioactive waste disposal

  13. Radionuclide diagnostics of right ventricle

    Zaorska-Rajca, J.

    1993-01-01

    Difficulties in evaluating the right ventricle function motivate to making research into new non-invasive methods. Four radionuclide methods that are used to access the right ventricle have been discussed in this paper: first-pass angiocardiography, gated equilibrium ventriculography with red blood cells labelled in vivo technetium- 99 Tc, ventriculography with radioactive xenon 133 and a computerized single probe. Advantages and disadvantages of using each method have been discussed. RNV 99m Tc method has been recognized as the best one to evaluate RV function. Results of the right ventricle assessment in patients have been discussed in the following clinical groups: chronic cor pulmonale (CP), chronic lung disease without pulmonary arterial hypertension (LD), coronary artery disease (CAD), in patients after infarction (IMA and IMi), dilated cardiomyopathy (KZ) and valvular heart diseases (Wm and Wa). Abnormals in right ventricle function occur with different intensity in all groups, although they no specificity. The highest abnormality occurs in patients with KZ, CP, IMi and Wm, the lowest one - in patients with CAD. Abnormalities are higher in patients with congestive heart failure. In most pathological groups the right ventricle dysfunction is connected with the left ventricle insufficiency. The interdependence between the dysfunction of both ventricles is differs in particular diseases. Assessment of right ventricle function with radionuclide methods plays an important role in diagnosis and control therapy of cardiopulmonary diseases. (author). 385 refs, 48 figs, 6 tabs

  14. Miscellaneous applications of radionuclide imaging

    Mishkin, F.S.; Freeman, L.M.

    1984-01-01

    The procedures discussed in this chapter are either developmental, in limited clinical use, or frankly moribund. A number of radionuclide imaging techniques have proved disappointing when approached from a purely anatomic point of view. This is particularly evident to our colleagues with the explosive growth of the noninvasive imaging procedures, magnetic resonance imaging (NMR), CT, and ultrasound, and the introduction of the less invasive digital radiographic approach to vascular opacification, all of which are capable of providing exquisite anatomic or tissue detail beyond the reach of current or reasonably priced nuclear medicine imaging systems. Yet, most nuclear medicine procedures possess the unique advantage of portraying a physiologic function without interfering with that function. Moreover, the procedures can be employed under conditions of stress, which are likely to bring out pathophysiologic abnormalities that remain masked when unchallenged. Information concerning form without functional data has less meaning than both together. The physiologic information inherent in nuclear medicine imaging may often provide not only key diagnostic information but also illuminate a therapeutic trail. Yet, it is often slighted in favor of the anatomic quest. While mastery of the nuances of imaging details remains critical, radionuclide image interpretation must rest upon a firm physiologic foundation. For this reason, this chapter emphasizes the physiologic approach

  15. Stochastic approach for radionuclides quantification

    Clement, A.; Saurel, N.; Perrin, G.

    2018-01-01

    Gamma spectrometry is a passive non-destructive assay used to quantify radionuclides present in more or less complex objects. Basic methods using empirical calibration with a standard in order to quantify the activity of nuclear materials by determining the calibration coefficient are useless on non-reproducible, complex and single nuclear objects such as waste packages. Package specifications as composition or geometry change from one package to another and involve a high variability of objects. Current quantification process uses numerical modelling of the measured scene with few available data such as geometry or composition. These data are density, material, screen, geometric shape, matrix composition, matrix and source distribution. Some of them are strongly dependent on package data knowledge and operator backgrounds. The French Commissariat à l'Energie Atomique (CEA) is developing a new methodology to quantify nuclear materials in waste packages and waste drums without operator adjustment and internal package configuration knowledge. This method suggests combining a global stochastic approach which uses, among others, surrogate models available to simulate the gamma attenuation behaviour, a Bayesian approach which considers conditional probability densities of problem inputs, and Markov Chains Monte Carlo algorithms (MCMC) which solve inverse problems, with gamma ray emission radionuclide spectrum, and outside dimensions of interest objects. The methodology is testing to quantify actinide activity in different kind of matrix, composition, and configuration of sources standard in terms of actinide masses, locations and distributions. Activity uncertainties are taken into account by this adjustment methodology.

  16. Infusion of radionuclides throughout pregnancy

    Mountford-Lister, P.G.; Lambert, B.E.; Milner, A.C.; Kang, X.Z.

    1992-01-01

    This work is part of a long-term study to examine the cancer incidence in the offspring of mice exposed to 239 Pu or 147 Pm throughout pregnancy. The need to model the human intake scenario and the possibility of a critical period during uterine development necessitates constant availability of radionuclides throughout pregnancy. Various methods (multiple daily injections, infusion by external cannula and infusion by indwelling osmotic pump) have been examined and osmotic infusion pumps chosen. These pumps result in a near-constant blood concentration for up to 21 days. Part of the study is the estimation of dose to the critical haemopoietic tissues of the pup from a knowledge of the radionuclide distribution and kinetics. At present the distribution has been followed from birth to 180 days. Activity in the suckling pups at 7 days old is around 1 percent of the infused activity, though most of this is accounted for by the contents of the stomach and gastrointestinal tract. The liver and femur account for around 0.025 percent and 0.012 percent respectively per pup. Activity increases in both liver and femur during lactation after which both concentration and activity fall with time. Long-term studies with the pups of dams exposed to a range of 239 Pu concentrations between 0-70 kBq/kg are underway. Correlation of average organ dose with tumour incidence will be determined at completion of the life-span study. (Author) 39 refs., 5 tabs., 6 figs

  17. Sedimentary Processes. Quantification Using Radionuclides

    Carroll, J.; Lerche, I.

    2003-01-01

    The advent of radionuclide methods in geochronology has revolutionized our understanding of modern sedimentary processes in aquatic systems. This book examines the principles of the method and its use as a quantitative tool in marine geology, with emphasis on the Pb-210 method. The assumptions and consequences of models and their behaviour are described providing the necessary background to assess the advantages and trade-offs involved when choosing a particular model for application. One of the purposes of this volume is to disentangle the influences of complicating factors, such as sediment flux variations, post-depositional diffusion of radionuclides, and bio-irrigation of sediments, to arrive at sediment ages and to properly assess the attendant data uncertainty. Environmental impacts of chemical, nuclear, or other waste material are of concern in a variety of areas around the world today. A number of relevant examples are included, demonstrating how dating models are useful for determining sources of contaminants and interpreting their influence on the environment. The book is set at a level so that an able student or professional should have no difficulty in following the procedures and methods developed. Each chapter includes case histories showing the strengths and weaknesses of a given procedure with respect to a data example. Included with this volume is the computer source code of a new generation of modelling tools based on inverse numerical analysis techniques. This first generation of the modelling tool is included, along with detailed instructions and examples for its use, in an appendix

  18. Radionuclide transit in esophageal varices

    Yeh, S.H.; Wang, S.J.; Wu, L.C.; Liu, R.S.; Tsai, Y.T.; Chiang, T.T.

    1985-01-01

    This study assessed esophageal motility in patients with esophageal varices by radionuclide transit studies. Data were acquired in list mode after an oral dose of 0.5 mCi Tc-99m sulfur colloid in 10 ml of water in the supine position above a low-energy all-purpose collimator of a gamma camera. The condensed image (CI) superimposed with a centroid curve was also produced in each case. Twenty-five normal subjects (N) and 32 patients (pts) with esophageal varices by endoscopy (large varices in Grades IV and V in 8 and small varices in Grade III or less in 24) were studied. TMTT, RTT, RF, and RI were all significantly increased in pts as compared to N. Especially, the transit time for the middle third (6.7 +- 2.6 sec vs 3.5 +- 0.9 sec in N, rho < 0.005) had the optimal sensitivy and specificity of 88% each at the cutoff value of 4.2 sec as determined by ROC analysis. In summary, radionuclide transit disorders occur in the majority of pts with esopageal varices. The middle RTT and CI are both optimal in sensitivity and specificity for detecting the abnormalities

  19. Radionuclide analysis of bush food

    Koperski, J.; Bywater, J.

    1985-01-01

    A model diet for an Aboriginal adult living entirely on bush foods collected from the Alligator Rivers Region of the Northern Territory has been established. Results of investigations of the specific activities of thorium-230, radium-226, lead-210 and polonium-210 in 123 samples of bush foods collected by Ranger Uranium Mines Pty Ltd during pre-production and production periods are presented. For all the investigated bush food items, excluding freshwater mussels (Velesunio angasi), no systematic differences were found between the specific activities of the radionuclides monitored in food items sampled during preproduction and production periods. Preliminary estimates of annual effective dose equivalent (DE) rates for stochastic effects on an adult living entirely on the model bush diet are presented. Of the four radionuclides monitored the major contributor to the effective DE rates appears to be lead-210 followed by radium-226. Among the selected nine components of the diet the major contributor to the effective DE rates appear to be mussels, water lilies and fish

  20. Radionuclide analysis of bush food

    Koperski, J; Bywater, J [Ranger Uranium Mines Proprietary Ltd., Chatswood (Australia)

    1985-04-01

    A model diet for an Aboriginal adult living entirely on bush foods collected from the Alligator Rivers Region of the Northern Territory has been established. Results of investigations of the specific activities of thorium-230, radium-226, lead-210 and polonium-210 in 123 samples of bush foods collected by Ranger Uranium Mines Pty. Ltd. during pre-production and production periods are presented. For all the investigated bush food items, excluding freshwater mussels (Velesunio angasi), no systematic differences were found between the specific activities of the radionuclides monitored in food items sampled during preproduction and production periods. Preliminary estimates of annual effective dose equivalent (DE) rates for stochastic effects on an adult living entirely on the model bush diet are presented. Of the four radionuclides monitored the major contributor to the effective DE rates appears to be lead-210 followed by radium-226. Among the selected nine components of the diet the major contributor to the effective DE rates appear to be mussels, water lilies and fish.

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

    Celermajer David S

    2007-02-01

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

  2. The radionuclide migration model in river system

    Zhukova, O.M.; Shiryaeva, N.M.; Myshkina, M.K.; Shagalova, Eh.D.; Denisova, V.V.; Skurat, V.V.

    2001-01-01

    It was propose the model of radionuclide migration in river system based on principle of the compartmental model at hydraulically stationary and chemically equilibrium conditions of interaction of radionuclides in system water-dredge, water-sediments. Different conditions of radioactive contamination entry in river system were considered. The model was verified on the data of radiation monitoring of Iput' river

  3. Modeling Radionuclide Decay Chain Migration Using HYDROGEOCHEM

    Lin, T. C.; Tsai, C. H.; Lai, K. H.; Chen, J. S.

    2014-12-01

    Nuclear technology has been employed for energy production for several decades. Although people receive many benefits from nuclear energy, there are inevitably environmental pollutions as well as human health threats posed by the radioactive materials releases from nuclear waste disposed in geological repositories or accidental releases of radionuclides from nuclear facilities. Theoretical studies have been undertaken to understand the transport of radionuclides in subsurface environments because that the radionuclide transport in groundwater is one of the main pathway in exposure scenarios for the intake of radionuclides. The radionuclide transport in groundwater can be predicted using analytical solution as well as numerical models. In this study, we simulate the transport of the radionuclide decay chain using HYDROGEOCHEM. The simulated results are verified against the analytical solution available in the literature. Excellent agreements between the numerical simulation and the analytical are observed for a wide spectrum of concentration. HYDROGECHEM is a useful tool assessing the ecological and environmental impact of the accidental radionuclide releases such as the Fukushima nuclear disaster where multiple radionuclides leaked through the reactor, subsequently contaminating the local groundwater and ocean seawater in the vicinity of the nuclear plant.

  4. Fire fighting in a radionuclide laboratory

    Wenzel, H.

    1991-01-01

    A fire-brigade was called to a laboratory which held a handling licence for the radionuclides C-14, T, P-32, Se-75, Mo-99, and S-35. The fire-brigade was unaware of a release of radionuclides. Therefore they used respiratory equipment, and all persons present were subsequently examined for contamination. (DG) [de

  5. Mechanisms of radionuclide transition in natural environment

    Pacyna, J.

    1974-01-01

    Mechanisms of radionuclide transition in various elements of the environment have been dealt with in an ecological aspect. The knowledge of the radionuclide propagation tracks will make possible to ascertain precisely causes and effects of the radiation and to reduce the contamination value. Particular attention has been paid to test methods. (author)

  6. Virginia ESI: INDEX (Index Polygons)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains vector polygons representing the boundaries of all hardcopy cartographic products produced as part of the Environmental Sensitivity Index...

  7. Sensors and Automated Analyzers for Radionuclides

    Grate, Jay W.; Egorov, Oleg B.

    2003-01-01

    The production of nuclear weapons materials has generated large quantities of nuclear waste and significant environmental contamination. We have developed new, rapid, automated methods for determination of radionuclides using sequential injection methodologies to automate extraction chromatographic separations, with on-line flow-through scintillation counting for real time detection. This work has progressed in two main areas: radionuclide sensors for water monitoring and automated radiochemical analyzers for monitoring nuclear waste processing operations. Radionuclide sensors have been developed that collect and concentrate radionuclides in preconcentrating minicolumns with dual functionality: chemical selectivity for radionuclide capture and scintillation for signal output. These sensors can detect pertechnetate to below regulatory levels and have been engineered into a prototype for field testing. A fully automated process monitor has been developed for total technetium in nuclear waste streams. This instrument performs sample acidification, speciation adjustment, separation and detection in fifteen minutes or less

  8. Speciation of radionuclides in the environment

    Gunten, H.R. von; Benes, P.

    1994-02-01

    Methods for the determination of the speciation of radionuclides in aerosols, in aquatic solutions, in sediments, soils and rocks are reviewed. At present, most of the results about speciation are deduced from model calculations, model experiments, and separation of species (forms) of radionuclides, e.g., by sequential extraction procedures. Methods of direct determination of speciation of radionuclides (e.g. by laser induced spectroscopy) are in general not yet sensitive enough for a measurement of the very low concentrations of radionuclides in the environment. The methodological part of this paper is followed by a review of the very abundant literature about speciation of important radionuclides in the environment, i.e. in the atmosphere, hydrosphere and lithosphere. The review does not include the biosphere. Literature up to spring 1993 is included (with a few more recent additions). (author)

  9. Radionuclide transport in a single fissure

    Eriksen, T.E.

    1983-01-01

    Radionuclide migration have been studied in natural fissures orieted parallel to the axis of granite drill cores. A short pulse of the radionuclides solution was injected at one end of the fissure and the temporal change in radionuclide concentration of the eluate measured. After several hundred fissure volumes water had been pumped through the fissure following the radionuclide pulse the activity distribution on the fissure surfaces was measured. From the retardation of 152 Eu, 235 Np and 237 Pu it is concluded that these radionuclides are transported in the oxidation states Eu(III), Pu(IV) and Np(V). The distribution coefficients K sub (d) calculated from flow and activity distribution data on the basis of geometric surface area/volume ratios are of the same order as published K sub (d) values obtained from batch equilibrium experiments. (Author)

  10. Radionuclides in the environment: Risks and opportunities

    Elzerman, A.W.

    1993-01-01

    Environmental chemistry plays a critical role in the open-quotes nuclear ageclose quotes. It makes a vital contribution to understanding of the sources, fate and effects of radionuclides in the environment, both man-made and natural. Risk assessment of radionuclides in the environment relies heavily on the tools of environmental chemistry. On the other hand, radionuclides provide unique opportunities to exploit in environmental chemistry investigations due to their well-defined sources, traceability in environmental processes, analytical sensitivities, and open-quotes built-inclose quotes radioactive decay open-quotes clocksclose quotes. In some cases naturally present radionuclides are utilized, while in others tracers are deliberately added or have already been added by the nuclear fuel cycle or nuclear testing. Several examples in each of these categories are discussed to spotlight the current status of environmental chemistry and radionuclides in the environment as an example application

  11. Mobility and Bioavailability of Radionuclides in Soils

    Iurian, A.; Olufemi Phaneuf, M.; Mabit, L.

    2016-01-01

    It is crucial to understand the behavior of radionuclides in the environment, their potential mobility and bioavailability related to long-term persistence, radiological hazards, and impact on human health. Such key information is used to develop strategies that support policy decisions. The environmental behavior of radionuclides depends on ecosystem characteristics. A given soil’s capacity to immobilize radionuclides has been proved to be the main factor responsible for their resulting activity concentrations in plants. The mobility and bioavailability of radionuclides in soils is complex, depending on clay-sized soil fraction, clay mineralogy, organic matter, cation exchange capacity, pH and quantities of competing cations. Moreover, plant species have different behaviors regarding radionuclide absorption depending on soil and plan characteristics

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

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

    2010-01-01

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

  13. Radionuclide imaging of spinal infections

    Gemmel, Filip; Dumarey, Nicolas; Palestro, Christopher J.

    2006-01-01

    The diagnosis of spinal infection, with or without implants, has been a challenge for physicians for many years. Spinal infections are now being recognised more frequently, owing to aging of the population and the increasing use of spinal-fusion surgery. The diagnosis in many cases is delayed, and this may result in permanent neurological damage or even death. Laboratory evidence of infection is variable. Conventional radiography and radionuclide bone imaging lack both sensitivity and specificity. Neither in vitro labelled leucocyte scintigraphy nor 99m Tc-anti-granulocyte antibody scintigraphy is especially useful, because of the frequency with which spinal infection presents as a non-specific photopenic area on these tests. Sequential bone/gallium imaging and 67 Ga-SPECT are currently the radionuclide procedures of choice for spinal osteomyelitis, but these tests lack specificity, suffer from poor spatial resolution and require several days to complete. [ 18 F]Fluoro-2-deoxy-D-glucose (FDG) PET is a promising technique for diagnosing spinal infection, and has several potential advantages over conventional radionuclide tests. The study is sensitive and is completed in a single session, and image quality is superior to that obtained with single-photon emitting tracers. The specificity of FDG-PET may also be superior to that of conventional tracers because degenerative bone disease and fractures usually do not produce intense FDG uptake; moreover, spinal implants do not affect FDG imaging. However, FDG-PET images have to be read with caution in patients with instrumented spinal-fusion surgery since non-specific accumulation of FDG around the fusion material is not uncommon. In the future, PET-CT will likely provide more precise localisation of abnormalities. FDG-PET may prove to be useful for monitoring response to treatment in patients with spinal osteomyelitis. Other tracers for diagnosing spinal osteomyelitis are also under investigation, including radiolabelled

  14. Radionuclide imaging of spinal infections

    Gemmel, Filip [Ghent Maria-Middelares, General Hospital, Division of Nuclear Medicine, Ghent (Belgium); Medical Center Leeuwarden (MCL), Division of Nuclear Medicine, Henri Dunantweg 2, Postbus 888, Leeuwarden (Netherlands); Dumarey, Nicolas [Universite Libre de Bruxelles, Hopital Erasme, Division of Nuclear Medicine, Brussels (Belgium); Palestro, Christopher J. [Long Island Jewish Medical Center, Division of Nuclear Medicine, Long Island, NY (United States)

    2006-10-15

    The diagnosis of spinal infection, with or without implants, has been a challenge for physicians for many years. Spinal infections are now being recognised more frequently, owing to aging of the population and the increasing use of spinal-fusion surgery. The diagnosis in many cases is delayed, and this may result in permanent neurological damage or even death. Laboratory evidence of infection is variable. Conventional radiography and radionuclide bone imaging lack both sensitivity and specificity. Neither in vitro labelled leucocyte scintigraphy nor {sup 99m}Tc-anti-granulocyte antibody scintigraphy is especially useful, because of the frequency with which spinal infection presents as a non-specific photopenic area on these tests. Sequential bone/gallium imaging and {sup 67}Ga-SPECT are currently the radionuclide procedures of choice for spinal osteomyelitis, but these tests lack specificity, suffer from poor spatial resolution and require several days to complete. [{sup 18}F]Fluoro-2-deoxy-D-glucose (FDG) PET is a promising technique for diagnosing spinal infection, and has several potential advantages over conventional radionuclide tests. The study is sensitive and is completed in a single session, and image quality is superior to that obtained with single-photon emitting tracers. The specificity of FDG-PET may also be superior to that of conventional tracers because degenerative bone disease and fractures usually do not produce intense FDG uptake; moreover, spinal implants do not affect FDG imaging. However, FDG-PET images have to be read with caution in patients with instrumented spinal-fusion surgery since non-specific accumulation of FDG around the fusion material is not uncommon. In the future, PET-CT will likely provide more precise localisation of abnormalities. FDG-PET may prove to be useful for monitoring response to treatment in patients with spinal osteomyelitis. Other tracers for diagnosing spinal osteomyelitis are also under investigation, including

  15. Impact of regurgitation on health-related quality of life in gastro-oesophageal reflux disease before and after short-term potent acid suppression therapy.

    Kahrilas, Peter J; Jonsson, Andreas; Denison, Hans; Wernersson, Börje; Hughes, Nesta; Howden, Colin W

    2014-05-01

    Limited data exist on the impact of regurgitation on health-related quality of life (HRQOL) in gastro-oesophageal reflux disease (GORD). We assessed the relationship between regurgitation frequency and HRQOL before and after acid suppression therapy in GORD. We used data from two randomised trials of AZD0865 25-75 mg/day versus esomeprazole 20 or 40 mg/day in non-erosive reflux disease (NERD) (n=1415) or reflux oesophagitis (RO) (n=1460). The Reflux Disease Questionnaire was used to select patients with frequent and intense heartburn for inclusion and to assess treatment response. The Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire was used to assess HRQOL. At baseline, 93% of patients in both the NERD and RO groups experienced regurgitation. Mean QOLRAD scores were similar for NERD and RO at baseline and at week 4 and disclosed decremental HRQOL with increasing frequency of regurgitation; a clinically relevant difference of >0.5 in mean QOLRAD scores was seen with regurgitation ≥4 days/week versus <4 days/week. The prevalence of frequent, persistent regurgitation (≥4 days/week) at week 4 among heartburn responders (≤1 day/week of mild heartburn) was 28% in NERD and 23% in RO. QOLRAD scores were higher among heartburn responders. There was a similar pattern of impact related to regurgitation frequency in heartburn responders compared with the group as a whole. Frequent regurgitation was associated with a clinically relevant, incremental decline in HRQOL beyond that associated with heartburn before and after potent acid suppression in both NERD and RO. NCT00206284 and NCT00206245.

  16. Indexing mechanisms

    Wood, A.G.; Parker, G.E.; Berry, R.

    1976-01-01

    It is stated that the indexing mechanism described can be used in a nuclear reactor fuel element inspection rig. It comprises a tubular body adapted to house a canister containing a number of fuel elements located longtitudinally, and has two chucks spaced apart for displacing the fuel elements longitudinally in a stepwise manner, together with a plunger mechanism for displacing them successively into the chucks. A measuring unit is located between the chucks for measuring the diameter of the fuel elements at intervals about their circumferences, and a secondary indexing mechanism is provided for rotating the measuring unit in a stepwise manner. (U.K.)

  17. Radionuclide assessment of renal function in the transplanted kidney

    Kawasaki, Yukiko; Maki, Masako; Nara, Shigeko; Hiroe, Michiaki; Kusakabe, Kiyoko; Shigeta, Akiko; Toma, Hiroshi; Kohno, Hiroko

    1985-01-01

    The ability of radionuclide renal function to detect rejection and to presume the prognosis of the transplanted kidney was evaluated in 70 patients. Effective renal plasma flow (ERPF), excretory index (EI) and perfusion index (PI) were examined by I-123 OIH and Tc-99 m DTPA. Numbers of the study in various status were as follows; 51 studies in good function, 43 in acute rejection and 18 in chronic rejection. Significant reduction in ERPF and EI and increase of PI were observed in the acute rejection (p<0.01). In the chronic rejection, there was a progressive decrease of ERPF (p<0.01). The patients were divided into two groups: group A; 46 patients with good function more than 9 months after transplantation and group B; 20 patients of whom recurrence of hemodialysis or nephectomy was done. In living transplantation, ERPF of group B at the first week after transplantation was remarkably lower than group A (p<0.05). In cadaveric transplantation, ERPF of group B at the sixth week was lower than that of group B (p<0.05). This study indicates that serial measurements of renal function by radionuclide methods may provide the state of rejection and prognosis of the transplanted kidney. (author)

  18. The ratio of right ventricular volume to left ventricular volume reflects the impact of pulmonary regurgitation independently of the method of pulmonary regurgitation quantification

    Śpiewak, Mateusz, E-mail: mspiewak@ikard.pl [Department of Coronary Artery Disease and Structural Heart Diseases, Institute of Cardiology, Warsaw (Poland); Cardiac Magnetic Resonance Unit, Institute of Cardiology, Warsaw (Poland); Małek, Łukasz A., E-mail: lmalek@ikard.pl [Cardiac Magnetic Resonance Unit, Institute of Cardiology, Warsaw (Poland); Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw (Poland); Petryka, Joanna, E-mail: joannapetryka@hotmail.com [Department of Coronary Artery Disease and Structural Heart Diseases, Institute of Cardiology, Warsaw (Poland); Cardiac Magnetic Resonance Unit, Institute of Cardiology, Warsaw (Poland); Mazurkiewicz, Łukasz, E-mail: lmazurkiewicz@ikard.pl [Cardiac Magnetic Resonance Unit, Institute of Cardiology, Warsaw (Poland); Department of Cardiomyopathy, Institute of Cardiology, Warsaw (Poland); Miłosz, Barbara, E-mail: barbara-milosz@o2.pl [Cardiac Magnetic Resonance Unit, Institute of Cardiology, Warsaw (Poland); Department of Radiology, Institute of Cardiology, Warsaw (Poland); Biernacka, Elżbieta K., E-mail: kbiernacka@ikard.pl [Department of Congenital Heart Diseases, Institute of Cardiology, Warsaw (Poland); Kowalski, Mirosław, E-mail: mkowalski@ikard.pl [Department of Congenital Heart Diseases, Institute of Cardiology, Warsaw (Poland); Hoffman, Piotr, E-mail: phoffman@ikard.pl [Department of Congenital Heart Diseases, Institute of Cardiology, Warsaw (Poland); Demkow, Marcin, E-mail: mdemkow@ikard.pl [Department of Coronary Artery Disease and Structural Heart Diseases, Institute of Cardiology, Warsaw (Poland); Miśko, Jolanta, E-mail: jmisko@wp.pl [Cardiac Magnetic Resonance Unit, Institute of Cardiology, Warsaw (Poland); Department of Radiology, Institute of Cardiology, Warsaw (Poland); Rużyłło, Witold, E-mail: wruzyllo@ikard.pl [Institute of Cardiology, Warsaw (Poland)

    2012-10-15

    Background: Previous studies have advocated quantifying pulmonary regurgitation (PR) by using PR volume (PRV) instead of commonly used PR fraction (PRF). However, physicians are not familiar with the use of PRV in clinical practice. The ratio of right ventricle (RV) volume to left ventricle volume (RV/LV) may better reflect the impact of PR on the heart than RV end-diastolic volume (RVEDV) alone. We aimed to compare the impact of PRV and PRF on RV size expressed as either the RV/LV ratio or RVEDV (mL/m{sup 2}). Methods: Consecutive patients with repaired tetralogy of Fallot were included (n = 53). PRV, PRF and ventricular volumes were measured with the use of cardiac magnetic resonance. Results: RVEDV was more closely correlated with PRV when compared with PRF (r = 0.686, p < 0.0001, and r = 0.430, p = 0.0014, respectively). On the other hand, both PRV and PRF showed a good correlation with the RV/LV ratio (r = 0.691, p < 0.0001, and r = 0.685, p < 0.0001, respectively). Receiver operating characteristic analysis showed that both measures of PR had similar ability to predict severe RV dilatation when the RV/LV ratio-based criterion was used, namely the RV/LV ratio > 2.0 [area under the curve (AUC){sub PRV} = 0.770 vs AUC{sub PRF} = 0.777, p = 0.86]. Conversely, with the use of the RVEDV-based criterion (>170 mL/m{sup 2}), PRV proved to be superior over PRF (AUC{sub PRV} = 0.770 vs AUC{sub PRF} = 0.656, p = 0.0028]. Conclusions: PRV and PRF have similar significance as measures of PR when the RV/LV ratio is used instead of RVEDV. The RV/LV ratio is a universal marker of RV dilatation independent of the method of PR quantification applied (PRF vs PRV)

  19. 9. Incidence of tricuspid valve regurgitation following pacemaker/defibrillator lead extraction

    A. AlFagih

    2016-07-01

    Full Text Available Despite advanced sterile techniques in cardiac device implantations, long-term complications such as wound infections and/or lead-induced endocarditis can develop mandating lead and device extraction. It has been suggested that lead extraction carries a risk of new-onset Tricuspid Regurgitation (TR, or a deterioration of a formerly known regurgitant valve. Yet, there is no enough scientific evidence to our knowledge to back this claim. In this study we aim to explore the risk of TR following lead extraction.We conducted a retrospective chart review in 113 patients whom underwent lead extraction at Prince Sultan Cardiac Center in Saudi Arabia during the period of Jan, 2002 to Jul, 2015. Six patients underwent lead extraction twice, making the total number of extractions to be 119. Of this study cohort, we include 52 cases who had Tricuspid valve function evaluation via Transthoracic Echocardiography (TTE prior to and after device and lead extraction. TR severity was assessed using a grading system as the following; normal, mild, mild-to-moderate, moderate-to-severe, and severe. Worsening or improvement by more than 1 grade was considered clinically significant. TR following lead extraction was examined over a median of 5 months. Of the 52 cases included in this study, 37 (71.2% were males and 15 (28.8% were females, with a mean age of 46 (SD = 18 years. Eleven patients (21.2% experienced worsening of TR (3 had normal functioning valves before extraction, and 8 were known to have TR prior to extraction, 2 (3.8% had improvement, and the majority (75.0% did not experience any significant changes. Compared with those who had no change, average lead duration was higher in the worsening TR group (67.2 vs. 27.9 months. A lead-attached vegetation was detected in 4 out of the 11 patients with TR. Lead type (High-voltage vs. Pacing was not predictive of TR, 5 (45.5% of the patients in the worsening group had high-voltage leads, while the remaining (54

  20. Radionuclide interactions with marine sediments

    Higgo, J.J.W.

    1987-09-01

    A critical review of the literature on the subject of the interactions of radionuclides with marine sediments has been carried out. On the basis of the information available, an attempt has been made to give ranges and 'best estimates' for the distribution ratios between seawater and sediments. These estimates have been based on an understanding of the sediment seawater system and the porewater chemistry and mineralogy. Field measurements, laboratory measurements and estimates based on stable-element geochemical data are all taken into account. Laboratory measurements include distribution-ratio and diffusion-coefficient determinations. The elements reviewed are carbon, chlorine, calcium, nickel, selenium, strontium, zirconium, niobium, technetium, tin, iodine, caesium, lead, radium, actinium, thorium, protactinium, uranium, neptunium, plutonium, americium and curium. (author)

  1. Expert system based radionuclide identification

    Aarnio, P.A.; Ala-Heikkil, J.J.; Hakulinen, T.T.; Nikkinen, M.T.

    1998-01-01

    An expert system coupled with the gamma spectrum analysis system SAMPO has been developed for automating the qualitative identification of radionuclides as well as for determining the quantitative parameters of the spectrum components. The program is written in C-language and runs in various environments ranging from PCs to UNIX workstations. The expert system utilizes a complete gamma library with over 2600 nuclides and 80,000 lines, and a rule base of about fifty criteria including energies, relative peak intensities, genesis modes, half lives, parent-daughter relationships, etc. The rule base is furthermore extensible by the user. This is not an original contribution but a somewhat updated version of papers and reports previously published elsewhere. (author)

  2. Radionuclide diagnosis of allograft rejection

    George, E.A.

    1982-01-01

    Interaction with one or more anatomical and physiopathological characteristics of the rejecting renal allograft is suggested by those radioagents utilized specifically for the diagnosis of allograft rejection. Rejection, the most common cause of declining allograft function, is frequently mimicked clinically or masked by other immediate or long term post transplant complications. Understanding of the anatomical pathological features and kinetics of rejection and their modification by immunosuppressive maintenance and therapy are important for the proper clinical utilization of these radioagents. Furthermore, in selecting these radionuclides, one has to consider the comparative availability, preparatory and procedural simplicity, acquisition and display techniques and the possibility of timely report. The clinical utilities of radiofibrinogen, /sup 99m/Tc sulfur colloid and 67 Ga in the diagnosis of allograft rejection have been evaluated to a variable extent in the past. The potential usefulness of the recently developed preparations of 111 In labeled autologous leukocytes and platelets are presently under investigation

  3. Quality assurance in radionuclide laboratories

    Otto, R.; Voelkle, H.; Wershofen, H.; Wilhelm, C.

    2003-01-01

    The authors are members of an ad-hoc working group preparing a contribution to the procedures manual (''Loseblattsammlung'') dealing with quality assurance and quality control in radionuclide laboratories. The Loseblattsammlung is edited by the working group ''Environmental Monitoring'' of the German-Swiss Radiological Protection Association. The intention of the manual under preparation is not to give a procedure on how to establish a quality management system allowing for an accreditation in accordance with the international standard DIN EN ISO/IEC 17025:2000 04 (''ISO 17025'') [1] but to compile routine quality control procedures necessary for reliable measurements and to give tips to the practitioner on how to keep both the extent and the frequency of procedures on a reasonable level. A short version of the Loseblatt is presented here. (orig.)

  4. Placental transfer of other radionuclides

    Stieve, F.-E.

    1987-01-01

    This paper comments upon some basic principles of the transfer of radioactive substances in human beings to the embryo and fetus and their age-dependence. These principles may apply to the main effects currently known from the uptake, accumulation, retention and excretion of those radioactive substances, which may be of special interest in assessing the dose and therefore the risk of exposure in nuclear medicine, in connection with environmental problems of nuclear power production as well as nuclear explosions. As an example the age-dependence of several typical radionuclides and their age-dependence during the development of the human embryo and fetus and its correlation to observations on several animal species are presented. 30 refs.; 5 figs

  5. Transverse section radionuclide scanning system

    Kuhl, D.E.; Edwards, R.Q.

    1976-01-01

    This invention provides a transverse section radionuclide scanning system for high-sensitivity quantification of brain radioactivity in cross-section picture format in order to permit accurate assessment of regional brain function localized in three dimensions. High sensitivity crucially depends on overcoming the heretofore known raster type scanning, which requires back and forth detector movement involving dead-time or partial enclosure of the scan field. Accordingly, this invention provides a detector array having no back and forth movement by interlaced detectors that enclose the scan field and rotate as an integral unit around one axis of rotation in a slip ring that continuously transmits the detector data by means of laser emitting diodes, with the advantages that increased amounts of data can be continuously collected, processed and displayed with increased sensitivity according to a suitable computer program. 5 claims, 11 figures

  6. Radionuclide evaluation of brain death

    Pjura, G.A.; Kim, E.E.

    1987-01-01

    The criteria employed for clinical determination of death have evolved in response to advances in life support and other medical technology. The technical feasibility of organ transplantation has amplified the need for a definition of brain death that can be applied in the shortest possible time in the presence of artificial maintenance of vegetative functions, including circulation. Radionuclide cerebral angiography is one of a group of diagnostic procedures that can be employed to confirm the clinical diagnosis of brain death through demonstration of absence of cerebral blood flow. The focus of this work is to assess its use as a confirmatory test for determination of brain death in the context of currently available alternative technologies

  7. Radionuclide diagnosis of vasculogenic impotence

    Sorokin, A.I.; Gerasimov, V.G.; Lenskaya, O.P.; Narkevich, B.Ya.; Bogdasarov, Yu.B.; Krotovskij, G.S.

    1988-01-01

    Pathogenesis of vasculogenic impotence is most adequately revealed by modern methods of the investigation of the hemodynamic mechanisms of erection with the enhancement of arterial perfusion of corpora cavernosa by artificial sexual stimulation. Radionuclide diagnostic methods effectively differ from the methods of radiocontrast phalloangiography by the simplicity of investigation and the absence of traumatism for a patient. The authors have proposed a mathematical model of a process of filling in the functioning volume of the penile vascular bed with a radiopharmaceutical prepation against the background of erection induced by intracavernous administration of papaverine hydrochloride solution. Parameters of the model determine the ratio of blood flow volumetric rates in the penis at rest and when erect

  8. Decontamination of radionuclides in food

    Ohmomo, Yoichiro [Institute for Environmental Sciences, Aomori (Japan)

    1994-03-01

    The release of radionuclides arising from the Chernobyle accident led to widespread contamination of the northern hemisphere through fallout. This accident provided again an opportunity to investigate how and to what extent the radionuclides contamination in crops and animal derived foods could be reduced. The following topics are included in this paper. (1) How to reduce the transfer of radiostrontium and/or cesium from soil to crops: A pH increase of soil is effective for reducing their plant uptake. (2) How to reduce the transfer of radiocesium to animal derived foods: Ammonium-ferric-cyanoferrate (AFCF) should be the most effective compound for radiocesium excretion in the feces. Experiments with lactating cows and/or poultry gave extremely good results with respect to low radiocesium concentrations in milk, meat and eggs. (3) Removal coefficients of radiostrontium, cesium and iodine from contaminated leaf vegetables and cereals during food processing and culinary preparation: Though different by species, more than 80% of cesium and about 50% of strontium and iodine can be removed during culinary preparation of washing and boiling. (4) Simultaneous decontamination of radiocesium and iodine from drinking water and liquid milk: Metal ferrocyanide-anion exchange resin, specifically Fe ferrocyanide one, was successfully used for a rapid and simple decontamination of radiocesium and iodine in the liquid samples arising from the Chernobyle accident. (5) Removal of radiocesium from meat: The meat structurally contaminated with radiocesium is easily and very successfully decontaminated by pickling in NaCl solution and the decontamination is much speeded up by freezing meat before pickling. (author).

  9. Illicit Trafficking of Natural Radionuclides

    Friedrich, Steinhaeusler; Lyudmila, Zaitseva

    2008-01-01

    Natural radionuclides have been subject to trafficking worldwide, involving natural uranium ore (U 238), processed uranium (yellow cake), low enriched uranium ( 20% U 235), radium (Ra 226), polonium (Po 210), and natural thorium ore (Th 232). An important prerequisite to successful illicit trafficking activities is access to a suitable logistical infrastructure enabling an undercover shipment of radioactive materials and, in case of trafficking natural uranium or thorium ore, capable of transporting large volumes of material. Covert en route diversion of an authorised uranium transport, together with covert diversion of uranium concentrate from an operating or closed uranium mines or mills, are subject of case studies. Such cases, involving Israel, Iran, Pakistan and Libya, have been analyzed in terms of international actors involved and methods deployed. Using international incident data contained in the Database on Nuclear Smuggling, Theft and Orphan Radiation Sources (DSTO) and international experience gained from the fight against drug trafficking, a generic Trafficking Pathway Model (TPM) is developed for trafficking of natural radionuclides. The TPM covers the complete trafficking cycle, ranging from material diversion, covert material transport, material concealment, and all associated operational procedures. The model subdivides the trafficking cycle into five phases: (1) Material diversion by insider(s) or initiation by outsider(s); (2) Covert transport; (3) Material brokerage; (4) Material sale; (5) Material delivery. An Action Plan is recommended, addressing the strengthening of the national infrastructure for material protection and accounting, development of higher standards of good governance, and needs for improving the control system deployed by customs, border guards and security forces

  10. Illicit Trafficking of Natural Radionuclides

    Friedrich, Steinhäusler; Lyudmila, Zaitseva

    2008-08-01

    Natural radionuclides have been subject to trafficking worldwide, involving natural uranium ore (U 238), processed uranium (yellow cake), low enriched uranium (20% U 235), radium (Ra 226), polonium (Po 210), and natural thorium ore (Th 232). An important prerequisite to successful illicit trafficking activities is access to a suitable logistical infrastructure enabling an undercover shipment of radioactive materials and, in case of trafficking natural uranium or thorium ore, capable of transporting large volumes of material. Covert en route diversion of an authorised uranium transport, together with covert diversion of uranium concentrate from an operating or closed uranium mines or mills, are subject of case studies. Such cases, involving Israel, Iran, Pakistan and Libya, have been analyzed in terms of international actors involved and methods deployed. Using international incident data contained in the Database on Nuclear Smuggling, Theft and Orphan Radiation Sources (DSTO) and international experience gained from the fight against drug trafficking, a generic Trafficking Pathway Model (TPM) is developed for trafficking of natural radionuclides. The TPM covers the complete trafficking cycle, ranging from material diversion, covert material transport, material concealment, and all associated operational procedures. The model subdivides the trafficking cycle into five phases: (1) Material diversion by insider(s) or initiation by outsider(s); (2) Covert transport; (3) Material brokerage; (4) Material sale; (5) Material delivery. An Action Plan is recommended, addressing the strengthening of the national infrastructure for material protection and accounting, development of higher standards of good governance, and needs for improving the control system deployed by customs, border guards and security forces.

  11. Decontamination of radionuclides in food

    Ohmomo, Yoichiro

    1994-01-01

    The release of radionuclides arising from the Chernobyle accident led to widespread contamination of the northern hemisphere through fallout. This accident provided again an opportunity to investigate how and to what extent the radionuclides contamination in crops and animal derived foods could be reduced. The following topics are included in this paper. (1) How to reduce the transfer of radiostrontium and/or cesium from soil to crops: A pH increase of soil is effective for reducing their plant uptake. (2) How to reduce the transfer of radiocesium to animal derived foods: Ammonium-ferric-cyanoferrate (AFCF) should be the most effective compound for radiocesium excretion in the feces. Experiments with lactating cows and/or poultry gave extremely good results with respect to low radiocesium concentrations in milk, meat and eggs. (3) Removal coefficients of radiostrontium, cesium and iodine from contaminated leaf vegetables and cereals during food processing and culinary preparation: Though different by species, more than 80% of cesium and about 50% of strontium and iodine can be removed during culinary preparation of washing and boiling. (4) Simultaneous decontamination of radiocesium and iodine from drinking water and liquid milk: Metal ferrocyanide-anion exchange resin, specifically Fe ferrocyanide one, was successfully used for a rapid and simple decontamination of radiocesium and iodine in the liquid samples arising from the Chernobyle accident. (5) Removal of radiocesium from meat: The meat structurally contaminated with radiocesium is easily and very successfully decontaminated by pickling in NaCl solution and the decontamination is much speeded up by freezing meat before pickling. (author)

  12. Leachability of radionuclides from cement solidified waste forms produced at operating nuclear power plants

    Croney, S.T.

    1985-03-01

    This study determined the leachability indexes of radionuclides contained in solidified liquid wastes from operating nuclear power plants. Different sizes of samples of cement-solidified liquid wastes were collected from two nuclear power plants - a pressurized water reactor and a boiling water reactor - to correlate radionuclide leaching from small- and full-sized (55-gallon) waste forms. Diffusion-based model analysis (ANS 16.1) of measured radionuclide leach data from both small- and full-sized samples was performed and indicate that leach data from small samples can be used to determine leachability indexes for full-sizes waste forms. The leachability indexes for cesium, strontium, and cobalt isotopes were determined for waste samples from both plants according to the models used for ANS 16.1. The leachability indexes for the pressurized water reactor samples were 6.4 for cesium, 7.1 for strontium, and 10.4 for cobalt. Leachability indexes for the boiling water reactor samples were 6.5 for cesium, 8.6 for strontium, and 11.1 for cobalt

  13. Management of mitral regurgitation in Marfan syndrome: Outcomes of valve repair versus replacement and comparison with myxomatous mitral valve disease.

    Helder, Meghana R K; Schaff, Hartzell V; Dearani, Joseph A; Li, Zhuo; Stulak, John M; Suri, Rakesh M; Connolly, Heidi M

    2014-09-01

    The study objective was to evaluate patients with Marfan syndrome and mitral valve regurgitation undergoing valve repair or replacement and to compare them with patients undergoing repair for myxomatous mitral valve disease. We reviewed the medical records of consecutive patients with Marfan syndrome treated surgically between March 17, 1960, and September 12, 2011, for mitral regurgitation and performed a subanalysis of those with repairs compared with case-matched patients with myxomatous mitral valve disease who had repairs (March 14, 1995, to July 5, 2013). Of 61 consecutive patients, 40 underwent mitral repair and 21 underwent mitral replacement (mean [standard deviation] age, 40 [18] vs 31 [19] years; P = .09). Concomitant aortic surgery was performed to a similar extent (repair, 45% [18/40] vs replacement, 43% [9/21]; P = .87). Ten-year survival was significantly better in patients with Marfan syndrome with mitral repair than in those with replacement (80% vs 41%; P = .01). Mitral reintervention did not differ between mitral repair and replacement (cumulative risk of reoperation, 27% vs 15%; P = .64). In the matched cohort, 10-year survival after repair was similar for patients with Marfan syndrome and myxomatous mitral disease (84% vs 78%; P = .63), as was cumulative risk of reoperation (17% vs 12%; P = .61). Patients with Marfan syndrome and mitral regurgitation have better survival with repair than with replacement. Survival and risk of reoperation for patients with Marfan syndrome were similar to those for patients with myxomatous mitral disease. These results support the use of mitral valve repair in patients with Marfan syndrome and moderate or more mitral regurgitation, including those having composite replacement of the aortic root. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  14. Three dimensional transesophageal echocardiography guided transcatheter closure of mitral paraprosthesis regurgitation – A case report

    Vinay Kumar Sharma

    2013-05-01

    Full Text Available The last two decades have witnessed vast advances in the field of cardiac intervention, particularly with regard to nonsurgical closure of structural heart diseases including para prosthetic valvular leaks. The use of imaging techniques to guide even well-established procedures enhances the efficiency and safety of these procedures. The present case report aims to highlight the role of three dimensional transesophageal echocardiography in pre, intra and post operative management of patients with mitral para prosthetic valvular regurgitation.

  15. Author Index

    user1

    Astr. (2012) 33, 419–420. Author Index. 419. AGGARWAL SUNNY. Photoionization Cross-Section of Chlorine-like Iron, 291. AMBASTHA ASHOK see Das, A. C., 1. ARAKIDA HIDEYOSHI. Effect of Inhomogeneity of the Universe on a Gravitationally. Bound Local System: A No-Go Result for Explaining the Secular Increase in.

  16. AUTHOR INDEX

    automorphic solutions to fractional order abstract integro-differential equations. 323. Afrouzi G A see Ala Samira ... 521. Agarwal Praveen. Certain fractional integral operators and the generalized multi-index Mittag- ... of positive solutions for sys- tems of second order multi-point bound- ary value problems on time scales 353.

  17. Large animal model of functional tricuspid regurgitation in pacing induced end-stage heart failure.

    Malinowski, Marcin; Proudfoot, Alistair G; Langholz, David; Eberhart, Lenora; Brown, Michael; Schubert, Hans; Wodarek, Jeremy; Timek, Tomasz A

    2017-06-01

    Functional tricuspid regurgitation (FTR) is common in patients with advanced heart failure and frequently complicates left ventricular assist device implantation yet remains poorly understood. We set out to establish large animal model of FTR that could serve as a research platform to investigate the pathogenesis of FTR associated with end-stage heart failure. : Through right thoracotomy, ten adult sheep underwent implantation of pacemaker with epicardial LV lead, five sonomicrometry crystals on the right ventricle, and left and right ventricular telemetry pressure sensors during a beating heart off-pump procedure. After 5 ± 1 days of recovery, baseline haemodynamic, echocardiographic and sonomicrometry data were collected. Animals were paced thereafter at a rate of 220-240 beats/min until the development of heart failure and concomitant tricuspid regurgitation. : Three animals died during early recovery period and one during the pacing phase. Six surviving animals were paced for a mean of 14 ± 5 days. Cardiac function was significantly depressed compared to baseline, with LV ejection fraction falling from 69 ± 2% to 22 ± 4% ( P  tricuspid annulus (from 29.5 ± 1.6 to 36.5 ± 4.5 mm; P  = 0.01) and right ventricle (from 21.9 ± 0.2 to 30.3 ± 0.6 mm; P  = 0.03). Sonomicrometry derived contractility of RV free wall was depressed and at least moderate tricuspid insufficiency developed in all animals. : Biventricular dysfunction, tricuspid annular dilatation and significant FTR were observed in our model of ovine tachycardia induced cardiomyopathy. This animal model reflects the clinical situation of end-stage heart failure patients presenting for mechanical support. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  18. Mechanisms of recurrent aortic regurgitation after aortic valve repair: predictive value of intraoperative transesophageal echocardiography.

    le Polain de Waroux, Jean-Benoît; Pouleur, Anne-Catherine; Robert, Annie; Pasquet, Agnès; Gerber, Bernhard L; Noirhomme, Philippe; El Khoury, Gébrine; Vanoverschelde, Jean-Louis J

    2009-08-01

    The aim of the present study was to examine the intraoperative echocardiographic features associated with recurrent severe aortic regurgitation (AR) after an aortic valve repair surgery. Surgical valve repair for AR has significant advantages over valve replacement, but little is known about the predictors and mechanisms of its failure. We blindly reviewed all clinical, pre-operative, intraoperative, and follow-up transesophageal echocardiographic data of 186 consecutive patients who underwent valve repair for AR during a 10-year period and in whom intraoperative and follow-up echo data were available. After a median follow-up duration of 18 months, 41 patients had recurrent 3+ AR, 23 patients presented with residual 1+ to 2+ AR, and 122 had no or trivial AR. In patients with recurrent 3+ AR, the cause of recurrent AR was the rupture of a pericardial patch in 3 patients, a residual cusp prolapse in 26 patients, a restrictive cusp motion in 9 patients, an aortic dissection in 2 patients, and an infective endocarditis in 1 patient. Pre-operatively, all 3 groups were similar for aortic root dimensions and prevalence of bicuspid valve (overall 37%). Patients with recurrent AR were more likely to display Marfan syndrome or type 3 dysfunction pre-operatively. At the opposite end, patients with continent AR repair at follow-up were more likely to have type 2 dysfunction pre-operatively. After cardiopulmonary bypass, a shorter coaptation length, the degree of cusp billowing, a lower level of coaptation (relative to the annulus), a larger diameter of the aortic annulus and the sino-tubular junction, the presence of a residual AR, and the width of its vena contracta were associated with the presence of AR at follow-up. Multivariate Cox analysis identified a shorter coaptation length (odds ratio [OR]: 0.8, p = 0.05), a coaptation occurring below the level of the aortic annulus (OR: 7.9, p < 0.01), a larger aortic annulus (OR: 1.2, p = 0.01), and residual aortic regurgitation

  19. Routine cine-CMR for prosthesis-associated mitral regurgitation: a multicenter comparison to echocardiography.

    Simprini, Lauren A; Afroz, Anika; Cooper, Mitchell A; Klem, Igor; Jensen, Christoph; Kim, Raymond J; Srichai, Monvadi B; Heitner, John F; Sood, Michael; Chandy, Elizabeth; Shah, Dipan J; Lopez-Mattei, Juan; Biederman, Robert W; Grizzard, John D; Fuisz, Anthon; Ghafourian, Kambiz; Farzaneh-Far, Afshin; Weinsaft, Jonathan

    2014-09-01

    Mitral regurgitation (MR) is an important complication after prosthetic mitral valve (PMV) implantation. Transthoracic echocardiography is widely used to screen for native MR, but can be limited with PMV. Cine-cardiac magnetic resonance (CMR) holds the potential for the non-invasive assessment of regurgitant severity based on MR-induced inter-voxel dephasing. The study aim was to evaluate routine cine-CMR for the visual assessment of PMV-associated MR. Routine cine-CMR was performed at nine sites. A uniform protocol was used to grade MR based on jet size in relation to the left atrium (mild 2/3). MR was graded in each long-axis orientation, with overall severity based on cumulative grade. Cine-CMR was also scored for MR density and pulmonary vein systolic flow reversal (PVSFR). Visual interpretation was compared to quantitative analysis in a single-center (derivation) cohort, and to transesophageal echocardiography (TEE) in a multicenter (validation) cohort. The population comprised 85 PMV patients (59% mechanical valves, 41% bioprostheses). Among the derivation cohort (n = 25), quantitative indices paralleled visual scores, with stepwise increases in jet size and density in relation to visually graded MR severity (both p = 0.001). Patients with severe MR had an almost three-fold increase in quantitative jet area (p = 0.002), and a two-fold increase in density (p = 0.04) than did other patients. Among the multicenter cohort, cine-CMR and TEE (Δ =. 2 ± 3 days) demonstrated moderate agreement (κ = 0.44); 64% of discordances differed by ≤ 1 grade (Δ = 1.2 ± 0.5). Using a TEE reference, cine-CMR yielded excellent diagnostic performance for severe MR (sensitivity, negative predictive value = 100%). Patients with visually graded severe MR also had more frequent PVSFR (p cine-CMR. Cine-CMR is useful for the assessment of PMV-associated MR, which manifests concordant quantitative and qualitative changes in size and density of inter-voxel dephasing. Visual MR

  20. Routine Cine-CMR for Prosthesis Associated Mitral Regurgitation – A Multicenter Comparison to Echocardiography

    Simprini, Lauren A.; Afroz, Anika; Cooper, Mitchell A.; Klem, Igor; Jensen, Christoph; Kim, Raymond J.; Srichai, Monvadi B.; Heitner, John F.; Sood, Michael; Chandy, Elizabeth; Shah, Dipan J.; Lopez-Mattei, Juan; Biederman, Robert W.; Grizzard, John D.; Fuisz, Anthon; Ghafourian, Kambiz; Farzaneh-Far, Afshin; Weinsaft, Jonathan

    2016-01-01

    Background/Aim MR is an important complication after PMV. Transthoracic echocardiography is widely used to screen for native MR, but can be limited with PMV. Cine-CMR holds potential to non-invasively assess regurgitant severity based on MR-induced inter-voxel dephasing. This study evaluated routine cine-CMR for visual assessment of prosthetic mitral valve (PMV) associated mitral regurgitation (MR). Methods Routine cine-CMR was performed at 9 sites. A uniform protocol was used to grade MR based on jet size in relation to the left atrium (mild 2/3): MR was graded in each long axis orientation, with overall severity based on cumulative grade. Cine-CMR was also scored for MR density and pulmonary vein systolic flow reversal (PSFR). Visual interpretation was compared to quantitative analysis in a single center (derivation) cohort, and to transesophageal echocardiography (TEE) in a multicenter (validation) cohort. Results The population comprised 85 PMV patients (59% mechanical, 41% bioprosthetic). Among the derivation cohort (n=25), quantitative indices paralleled visual scores, with stepwise increases in jet size and density in relation to visually graded MR severity (both p=0.001): Patients with severe MR had nearly a 3-fold increase in quantitative jet area (p=0.002), and 2-fold increase in density (p=0.04) than did others. Among the multicenter cohort, cine-CMR and TEE (Δ=2±3 days) demonstrated moderate agreement (κ=0.44); 64% of discordances differed by ≤ 1 grade (Δ=1.2±0.5). Using a TEE reference, cine-CMR yielded excellent diagnostic performance for severe MR (sensitivity, negative predictive value=100%). Patients with visually graded severe MR also had more frequent PVSFR (pcine-CMR. Conclusions Cine-CMR is useful for assessment of PMV-associated MR, which manifests concordant quantitative and qualitative changes in size and density of inter-voxel dephasing. Visual MR assessment based on jet size provides an accurate non-invasive means of screening for

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

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

    2012-09-11

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

  2. Human dose pathways of radionuclides in forests

    Rantavaara, A.

    2009-01-01

    Forest soil, understorey vegetation and trees are all sources of radionuclides and human radiation doses after contaminating atmospheric deposition. People are exposed to radiation externally from sources outside the body and internally via ingestion and inhalation of radionuclides. Understorey vegetation contributes to ingestion doses through berries, herbs, wild honey, mushrooms and game meat; also trees provide feed to terrestrial birds and big game. During stay in forests people are subject to external radiation from forest floor and overstorey, and they may inhale airborne radioactive aerosol or gaseous radionuclides in ground level air. In the early phase of contamination also resuspended radionuclides may add to the internal dose of people via inhalation. People in Nordic countries are most exposed to radiation via ingestion of radionuclides in wild foods. The distribution of radionuclides in forests is changed by environmental processes, and thereby also the significance of various dose pathways to humans will change with time. External exposure is received in living environment from contaminated stemwood used as building timber and for manufacturing of furniture and other wood products. The aim of this paper is to outline the significance of various human dose pathways of radionuclides in forests considering the public and workers in forestry and production of bioenergy. Examples on effective doses are given based on two historical events, atmospheric nuclear weapon tests (mostly in 1950's and in 1960's) and the Chernobyl nuclear power plant accident in 1986. (au)

  3. Radionuclides: Accumulation and Transport in Plants.

    Gupta, D K; Chatterjee, S; Datta, S; Voronina, A V; Walther, C

    Application of radioactive elements or radionuclides for anthropogenic use is a widespread phenomenon nowadays. Radionuclides undergo radioactive decays releasing ionizing radiation like gamma ray(s) and/or alpha or beta particles that can displace electrons in the living matter (like in DNA) and disturb its function. Radionuclides are highly hazardous pollutants of considerable impact on the environment, food chain and human health. Cleaning up of the contaminated environment through plants is a promising technology where the rhizosphere may play an important role. Plants belonging to the families of Brassicaceae, Papilionaceae, Caryophyllaceae, Poaceae, and Asteraceae are most important in this respect and offer the largest potential for heavy metal phytoremediation. Plants like Lactuca sativa L., Silybum marianum Gaertn., Centaurea cyanus L., Carthamus tinctorius L., Helianthus annuus and H. tuberosus are also important plants for heavy metal phytoremediation. However, transfer factors (TF) of radionuclide from soil/water to plant ([Radionuclide]plant/[Radionuclide]soil) vary widely in different plants. Rhizosphere, rhizobacteria and varied metal transporters like NRAMP, ZIP families CDF, ATPases (HMAs) family like P1B-ATPases, are involved in the radio-phytoremediation processes. This review will discuss recent advancements and potential application of plants for radionuclide removal from the environment.

  4. Radionuclides in air, water, and biota

    Seymour, A.H.; Nelson, V.A.

    1977-01-01

    Air, water, and biological samples collected before and after the 1965, 1969, and 1971 underground nuclear detonations at Amchitka Island were analyzed for natural and fallout radionuclides by gamma spectrometry. Selected samples were also analyzed for tritium, 55 Fe, and 90 Sr. The objectives were to search for and identify radionuclides of Amchitka origin in the samples and to contribute to the general knowledge of the distribution of radionuclides in the environment. The studies showed that there has been no escape of radionuclides from the underground sites of the three nuclear detonations at Amchitka Island except for trace quantities of radionuclides, principally tritium, in water and soil gas samples from the immediate vicinity of the surface ground zero for the 1965 event. Two naturally occurring radionuclides, 40 K and 7 Be, were the most abundant radionuclides in the samples, usually by a factor of 10 or more, except for 137 Cs in lichen samples. All levels were well below applicable Radiation Protction Guides, often being near the statistical limit of detection

  5. Gastroesophageal reflux in children: radionuclide gastroesophagography

    Blumhagen, J.D.; Rudd, T.G.; Christie, D.L.

    1980-01-01

    Sixty-five symptomatic infants and children underwent radionuclide gastroesophagography, acid reflux testing, and barium esophagography with water-siphon testing to evaluate the clinical efficacy of the scintigraphic technique in detecting gastroesophageal reflux. After ingesting /sup 99m/Tc sulfur colloid in fruit juice, patients rested beneath the gamma camera for 30 to 60 min while esophageal activity was monitored continuously. By using the acid reflux test as a standard of comparison, the senstivity of radionuclide gastroesophagography was 75%. Because of its physiologic nature, low radiation exposure, and convenience, radionuclide gastroesophagography warrants further evaluation as a screening test for gastroesophageal reflux

  6. Determination of natural occurring radionuclides concentrations

    Stajic, J.; Markovic, V.; Krstic, D.; Nikezic, D.

    2011-01-01

    Tobacco smoke contains certain concentrations of naturally occurring radionuclides from radioactive chains of uranium and thorium - 214 Pb, 214 Bi, 228 Ac, 208 Tl, 226 Ra, 232 Th and 40 K. Inhaling of tobacco smoke leads to internal exposure of man. In order to estimate absorbed dose of irradiation it is necessary to determine concentrations of radionuclides present in the tobacco leaves. In this paper specific activities of naturally occurring radionuclides were measured in tobacco samples from cigarettes which are used in Serbia. [sr

  7. 2008 LANL radionuclide air emissions report

    Fuehne, David P.

    2009-06-01

    The emissions of radionuclides from Department of Energy Facilities such as Los Alamos National Laboratory (LANL) are regulated by the Amendments to the Clean Air Act of 1990, National Emissions Standards for Hazardous Air Pollutants (40 CFR 61 Subpart H). These regulations established an annual dose limit of 10 mrem to the maximally exposed member of the public attributable to emissions of radionuclides. This document describes the emissions of radionuclides from LANL and the dose calculations resulting from these emissions for calendar year 2008. This report meets the reporting requirements established in the regulations.

  8. 2010 LANL radionuclide air emissions report /

    Fuehne, David P.

    2011-06-01

    The emissions of radionuclides from Department of Energy Facilities such as Los Alamos National Laboratory (LANL) are regulated by the Amendments to the Clean Air Act of 1990, National Emissions Standards for Hazardous Air Pollutants (40 CFR 61 Subpart H). These regulations established an annual dose limit of 10 mrem to the maximally exposed member of the public attributable to emissions of radionuclides. This document describes the emissions of radionuclides from LANL and the dose calculations resulting from these emissions for calendar year 2010. This report meets the reporting requirements established in the regulations.

  9. Manual of bioassay procedures for radionuclides

    Pleskach, S.; Petkau, A.

    1986-06-01

    A monitoring program is described by which atomic radiation workers ar monitored for internal contamination with radionuclides in the workplace. The program involves analytical procedures for measuring alpha, beta and gamma activity in biological specimens, usually urine. Radionuclides are identified by their characteristic radiation using liquid scintillation counting, and alpha, beta and gamma spectrometry. Examples of calculating the minimum detectable activity for specific radionuclides are given and used to derive call-in-criteria in accordance with which the different groups of workers are monitored each month

  10. Solubility limited radionuclide transport through geologic media

    Muraoka, Susumu; Iwamoto, Fumio; Pigford, T.H.

    1980-11-01

    Prior analyses for the migration of radionuclides neglect solubility limits of resolved radionuclide in geologic media. But actually some of the actinides may appear in chemical forms of very low solubility. In the present report we have proposed the migration model with no decay parents in which concentration of radionuclide is limited in concentration of solubility in ground water. In addition, the analytical solutions of the space-time-dependent concentration are presented in the case of step release, band release and exponential release. (author)

  11. Soil - plant experimental radionuclide transfer factors

    Dobrin, R.I.; Dulama, C.N.; Toma, Al.

    2006-01-01

    Some experimental research was performed in our institute to assess site specific soil-plant transfer factors. A full characterization of an experimental site was done both from pedo-chemical and radiological point of view. Afterwards, a certain number of culture plants were grown on this site and the evolution of their radionuclide burden was then recorded. Using some soil amendments one performed a parallel experiment and the radionuclide root uptake was evaluated and recorded. Hence, transfer parameters were calculated and some conclusions were drawn concerning the influence of site specific conditions on the root uptake of radionuclides. (authors)

  12. DNA damage induced by radionuclide internal irradiation

    Cui Fengmei; Zhao Jingyong; Hong Chengjiao; Lao Qinhua; Wang Liuyi; Yang Shuqin

    2004-01-01

    Objective: To study the DNA damage of peripheral blood mononuclear cell (PBMC) in rats exposed to radionuclide internal irradiation. Methods: The radionuclides were injected into the rats and single cell get electrophoresis (SCGE) was performed to detect the length of DNA migration in the rat PBMC. Results: DNA migration in the rat PBMC increased with accumulative dose or dose-rate. It showed good relationship of dose vs. response and of dose-rate vs. response, both relationship could be described as linear models. Conclusion: Radionuclide internal irradiation could cause DNA damage in rat PBMC. (authors)

  13. Multi-Modality Imaging in the Evaluation and Treatment of Mitral Regurgitation.

    Bouchard, Marc-André; Côté-Laroche, Claudia; Beaudoin, Jonathan

    2017-10-13

    Mitral regurgitation (MR) is frequent and associated with increased mortality and morbidity when severe. It may be caused by intrinsic valvular disease (primary MR) or ventricular deformation (secondary MR). Imaging has a critical role to document the severity, mechanism, and impact of MR on heart function as selected patients with MR may benefit from surgery whereas other will not. In patients planned for a surgical intervention, imaging is also important to select candidates for mitral valve (MV) repair over replacement and to predict surgical success. Although standard transthoracic echocardiography is the first-line modality to evaluate MR, newer imaging modalities like three-dimensional (3D) transesophageal echocardiography, stress echocardiography, cardiac magnetic resonance (CMR), and computed tomography (CT) are emerging and complementary tools for MR assessment. While some of these modalities can provide insight into MR severity, others will help to determine its mechanism. Understanding the advantages and limitations of each imaging modality is important to appreciate their respective role for MR assessment and help to resolve eventual discrepancies between different diagnostic methods. With the increasing use of transcatheter mitral procedures (repair or replacement) for high-surgical-risk patients, multimodality imaging has now become even more important to determine eligibility, preinterventional planning, and periprocedural guidance.

  14. All you need to know about the tricuspid valve: Tricuspid valve imaging and tricuspid regurgitation analysis.

    Huttin, Olivier; Voilliot, Damien; Mandry, Damien; Venner, Clément; Juillière, Yves; Selton-Suty, Christine

    2016-01-01

    The acknowledgment of tricuspid regurgitation (TR) as a stand-alone and progressive entity, worsening the prognosis of patients whatever its aetiology, has led to renewed interest in the tricuspid-right ventricular complex. The tricuspid valve (TV) is a complex, dynamic and changing structure. As the TV is not easy to analyse, three-dimensional imaging, cardiac magnetic resonance imaging and computed tomography scans may add to two-dimensional transthoracic and transoesophageal echocardiographic data in the analysis of TR. Not only the severity of TR, but also its mechanisms, the mode of leaflet coaptation, the degree of tricuspid annulus enlargement and tenting, and the haemodynamic consequences for right atrial and right ventricular morphology and function have to be taken into account. TR is functional and is a satellite of left-sided heart disease and/or elevated pulmonary artery pressure most of the time; a particular form is characterized by TR worsening after left-sided valve surgery, which has been shown to impair patient prognosis. A better description of TV anatomy and function by multimodality imaging should help with the appropriate selection of patients who will benefit from either surgical TV repair/replacement or a percutaneous procedure for TR, especially among patients who are to undergo or have undergone primary left-sided valvular surgery. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  15. Evaluation of aortic regurgitation in congenital heart disease: value of MR imaging in comparison to echocardiography

    Ley, Sebastian [German Cancer Research Centre (DKFZ), Department of Radiology (E010), Heidelberg (Germany); University Hospital, Department of Pediatric Radiology, Heidelberg (Germany); Eichhorn, Joachim; Ulmer, Herbert [University Hospital, Department of Pediatric Cardiology, Heidelberg (Germany); Ley-Zaporozhan, Julia [German Cancer Research Centre (DKFZ), Department of Radiology (E010), Heidelberg (Germany); University Hospital Mainz, Department of Radiology, Mainz (Germany); Schenk, Jens-Peter [University Hospital, Department of Pediatric Radiology, Heidelberg (Germany); Kauczor, Hans-Ulrich [German Cancer Research Centre (DKFZ), Department of Radiology (E010), Heidelberg (Germany); Arnold, Raoul [University Hospital, Department of Pediatric Cardiology, Heidelberg (Germany); University Hospital, Department of Pediatric Cardiology, Freiburg (Germany)

    2007-05-15

    Evaluation of the severity and the follow-up of aortic insufficiency (AI) are important tasks in paediatric cardiology. Assessment is based on clinical and echocardiographic (ECHO) findings such as the configuration of the valve and the regurgitation fraction (RF). The goal of this study was to evaluate MRI compared to ECHO for determination of clinical severity, valve morphology and RF. Thirty patients (age 3-27 years) with mild-to-severe AI were evaluated by clinical examination, ECHO (2-D and Doppler), and MRI at 1.5 T (2-D true-FISP cine short axis, phase-contrast flow in the ascending aorta). Both methods identified 13 bicuspid and 17 tricuspid valves. Good correlations between ECHO and cine MRI were found for ventricular mass, stroke volume, and ejection fraction. A good linear correlation was found for the RF determined by ECHO and phase-contrast MRI (r = 0.7). The RF was 6% in mild AI, 17% in moderate AI, and 30% in severe AI. The different severity groups showed significantly different RF and it was possible to discriminate between clinical severity grades (P = 0.01). ECHO and MRI showed good agreement in evaluating morphology and function of the left ventricle. The clinical severity of the disease can be evaluated correctly using MRI. (orig.)

  16. Evaluation of aortic regurgitation in congenital heart disease: value of MR imaging in comparison to echocardiography

    Ley, Sebastian; Eichhorn, Joachim; Ulmer, Herbert; Ley-Zaporozhan, Julia; Schenk, Jens-Peter; Kauczor, Hans-Ulrich; Arnold, Raoul

    2007-01-01

    Evaluation of the severity and the follow-up of aortic insufficiency (AI) are important tasks in paediatric cardiology. Assessment is based on clinical and echocardiographic (ECHO) findings such as the configuration of the valve and the regurgitation fraction (RF). The goal of this study was to evaluate MRI compared to ECHO for determination of clinical severity, valve morphology and RF. Thirty patients (age 3-27 years) with mild-to-severe AI were evaluated by clinical examination, ECHO (2-D and Doppler), and MRI at 1.5 T (2-D true-FISP cine short axis, phase-contrast flow in the ascending aorta). Both methods identified 13 bicuspid and 17 tricuspid valves. Good correlations between ECHO and cine MRI were found for ventricular mass, stroke volume, and ejection fraction. A good linear correlation was found for the RF determined by ECHO and phase-contrast MRI (r = 0.7). The RF was 6% in mild AI, 17% in moderate AI, and 30% in severe AI. The different severity groups showed significantly different RF and it was possible to discriminate between clinical severity grades (P 0.01). ECHO and MRI showed good agreement in evaluating morphology and function of the left ventricle. The clinical severity of the disease can be evaluated correctly using MRI. (orig.)

  17. Serotonin markers show altered transcription levels in an experimental pig model of mitral regurgitation

    Cremer, Signe Emilie; Zois, Nora Elisabeth; Moesgaard, S. G.

    2015-01-01

    surgically induced MR or sham-operation, resulting in three MR groups: control (CON, n = 12), mild MR (mMR, n = 10) and severe MR (sMR, n = 6). The gene expression levels of 5-HT1BR, 5-HT2AR, 5-HT2BR, SERT and TPH-1 were analysed using quantitative PCR (qPCR) in the mitral valve (MV), anterior papillary......-uptake transporter (SERT) in MMVD-affected valves, increased valvular 5-HT synthesis and decreased clearance have been suggested. It remains unknown how haemodynamic changes associated with mitral regurgitation (MR) affect 5-HT markers in the mitral valve, myocardium and circulation. Twenty-eight pigs underwent...... muscle (AP) and left ventricle (LV). MV 5-HT2BR was also analysed with immunohistochemistry (IHC) in relation to histological lesions and valvular myofibroblasts. All 5-HTR mRNAs were up-regulated in MV compared to AP and LV (P SERT and TPH-1 were up-regulated in AP and LV compared...

  18. Mast cell stabilization decreases cardiomyocyte and LV function in dogs with isolated mitral regurgitation.

    Pat, Betty; Killingsworth, Cheryl; Chen, Yuanwen; Gladden, James D; Walcott, Greg; Powell, Pamela C; Denney, Thomas; Gupta, Himanshu; Desai, Ravi; Tillson, Michael; Dillon, A Ray; Dell'italia, Louis J

    2010-09-01

    Mast cells are increased in isolated mitral regurgitation (MR) in the dog and may mediate extracellular matrix loss and left ventricular (LV) dilatation. We tested the hypothesis that mast cell stabilization would attenuate LV remodeling and improve function in the MR dog. MR was induced in adult dogs randomized to no treatment (MR, n = 5) or to the mast cell stabilizer, ketotifen (MR + MCS, n = 4) for 4 months. LV hemodynamics were obtained at baseline and after 4 months of MR and magnetic resonance imaging (MRI) was performed at sacrifice. MRI-derived, serial, short-axis LV end-diastolic (ED) and end-systolic (ES) volumes, LVED volume/mass ratio, and LV 3-dimensional radius/wall thickness were increased in MR and MR + MCS dogs compared with normal dogs (n = 6) (P < .05). Interstitial collagen was decreased by 30% in both MR and MR + MCS versus normal dogs (P < .05). LV contractility by LV maximum time-varying elastance was significantly depressed in MR and MR + MCS dogs. Furthermore, cardiomyocyte fractional shortening was decreased in MR versus normal dogs and further depressed in MR + MCS dogs (P < .05). In vitro administration of ketotifen to normal cardiomyocytes also significantly decreased fractional shortening and calcium transients. Chronic mast cell stabilization did not attenuate eccentric LV remodeling or collagen loss in MR. However, MCS therapy had a detrimental effect on LV function because of a direct negative inotropic effect on cardiomyocyte function. Published by Elsevier Inc.

  19. Belching, regurgitation, chest tightness and dyspnea: not gastroesophageal reflux disease but asthma.

    Zhang, Jing-Xi; Zhan, Xian-Bao; Bai, Chong; Li, Qiang

    2015-02-07

    Belching is a common symptom of gastroesophageal reflux disease. If the symptoms are not relieved after anti-reflux treatment, another etiology should be considered. Here, we report a case of a 43-year-old man who presented with belching, regurgitation, chest tightness and dyspnea for 18 mo, which became gradually more severe. Gastroscopic examination suggested superficial gastritis. Twenty-four-hour esophageal pH monitoring showed that the Demeester score was 11.4, in the normal range. High-resolution manometry showed that integrated relaxation pressure and intrabolus pressure were higher than normal (20 mmHg and 22.4 mmHg, respectively), indicating gastroesophageal junction outflow tract obstruction. Pulmonary function test showed severe obstructive ventilation dysfunction [forced expiratory volume in 1 second (FEV1)/forced vital capacity 32%, FEV1 was 1.21 L, occupying 35% predicted value after salbuterol inhalation], and positive bronchial dilation test (∆FEV1 260 mL, ∆FEV1% 27%). Skin prick test showed Dermatophagoides farinae (++), house dust mite (++++), and shrimp protein (++). Fractional exhaled nitric oxide measurement was 76 ppb. All the symptoms were alleviated completely and pulmonary function increased after combination therapy with corticosteroids and long-acting β2-agonist. Bronchial asthma was eventually diagnosed by laboratory tests and the effect of anti-asthmatic treatment, therefore, physicians, especially the Gastrointestinal physicians, should pay attention to the belching symptoms of asthma.

  20. Effect of mitral regurgitation on cerebrovascular accidents in patients with atrial fibrillation and left atrial thrombus.

    Nair, Chandra K; Aronow, Wilbert S; Shen, Xuedong; Anand, Kishlay; Holmberg, Mark J; Esterbrooks, Dennis J

    2009-11-01

    The effect of mitral regurgitation (MR) on the incidence of new cerebrovascular accidents (CVA) and mortality in patients with atrial fibrillation (AF) and left atrial thrombus (LAT) is unknown. To investigate the effect of MR in patients with AF and LAT on new CVA and mortality. Eighty nine consecutive patients, mean age 71 years, with AF and LAT documented by transesophageal echocardiography were investigated to determine the prevalence and severity of MR and the association of the severity of MR with new cerebrovascular accidents (CVA) and mortality at 34-mo follow-up. Of 89 patients, 1 + MR was present in 23 patients (26%), 2 + MR in 44 patients (50%), 3 + MR in 17 patients (19%), and 4 + MR in 3 patients (4%). Mean follow-up was 34 +/- 28 mo. The Cox proportional hazards model showed that the severity of increased MR did not significantly increase new CVA or mortality at 34-mo follow-up. The only variable predictive of mortality was left ventricular ejection fraction (LVEF), and with every unit increase in LVEF, the risk decreased by 3%. MR occurred in 87 of 89 patients (98%) with AF and LAT. There was no association between the severity of MR and the incidence of CVA or mortality.

  1. When Is the Optimal Timing of Surgical Intervention for Severe Functional Tricuspid Regurgitation?

    Nobuhiro Nakanishi

    2017-01-01

    Full Text Available Functional tricuspid regurgitation (TR is a serious pathology to be noted for severe right heart failure (HF and poor prognosis; however, the conventional assessment of TR has some limitations and the optimal timing of surgical intervention remains unclear. A 79-year-old Japanese female was admitted to our hospital to undergo cardiac surgery, because edema gradually got worse despite the increase in diuretics. She had a history of atrial fibrillation (AF and chronic HF due to severe TR and had been treated with a furosemide for leg edema 4 years ago. A transthoracic echocardiogram (TTE, transesophageal echocardiogram, cardiac magnetic resonance imaging, and cardiac pool scintigraphy demonstrated severe functional TR with tricuspid annular dilation, insufficient tricuspid valve coaptation, and reduced right ventricular ejection fraction (EF but preserved left ventricular EF. In addition, Swan-Ganz catheter study showed normal pulmonary arterial wedge pressure and mean pulmonary arterial pressure. Tricuspid ring annuloplasty was performed with MC3 ring. Postoperative TTE showed trivial TR, and she had no edema with normal sinus rhythm two months later. Annuloplasty to severe functional TR caused by tricuspid annular dilation due to AF dramatically improved right HF. Cardiologist should pay strict attention to the optimal timing of surgical intervention for TR.

  2. Automatic assessment of mitral regurgitation severity based on extensive textural features on 2D echocardiography videos.

    Moghaddasi, Hanie; Nourian, Saeed

    2016-06-01

    Heart disease is the major cause of death as well as a leading cause of disability in the developed countries. Mitral Regurgitation (MR) is a common heart disease which does not cause symptoms until its end stage. Therefore, early diagnosis of the disease is of crucial importance in the treatment process. Echocardiography is a common method of diagnosis in the severity of MR. Hence, a method which is based on echocardiography videos, image processing techniques and artificial intelligence could be helpful for clinicians, especially in borderline cases. In this paper, we introduce novel features to detect micro-patterns of echocardiography images in order to determine the severity of MR. Extensive Local Binary Pattern (ELBP) and Extensive Volume Local Binary Pattern (EVLBP) are presented as image descriptors which include details from different viewpoints of the heart in feature vectors. Support Vector Machine (SVM), Linear Discriminant Analysis (LDA) and Template Matching techniques are used as classifiers to determine the severity of MR based on textural descriptors. The SVM classifier with Extensive Uniform Local Binary Pattern (ELBPU) and Extensive Volume Local Binary Pattern (EVLBP) have the best accuracy with 99.52%, 99.38%, 99.31% and 99.59%, respectively, for the detection of Normal, Mild MR, Moderate MR and Severe MR subjects among echocardiography videos. The proposed method achieves 99.38% sensitivity and 99.63% specificity for the detection of the severity of MR and normal subjects. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Does Surgical Repair of Moderate Ischemic Mitral Regurgitation Improve Survival? A Systematic Review.

    Chatterjee, Saurav; Tripathi, Byomesh; Virk, Hafeez Ul Hassan; Ahmed, Mohammed; Bavishi, Chirag; Krishnamoorthy, Parasuram; Sardar, Partha; Giri, Jay; Omidvari, Karan; Chikwe, Joanna

    2016-03-01

    Mitral regurgitation (MR) is one of the common complications in myocardial infarction (MI) patients. Almost half of the post MI patients have MR (ischemic MR)(17) which is moderate to severe (grade II-IV). Whether there is a mortality benefit of performing mitral valve repair (MVR) along with coronary artery bypass grafting (CABG) in patients with post MI moderate MR remains inconclusive. Literature search was done from PubMed, Google scholar, Ovid, and Medline databases. Studies which included post MI patients with moderate ischemic MR and reported mortality outcomes of performing CABG and MVR were chosen for the systematic review. Our preliminary literature search identified 194 studies, of which 11 studies met our inclusion criteria. Nine studies showed no survival benefit of performing simultaneous MVR and CABG. One study demonstrated survival benefit of performing CABG plus MVR only in the New York Heart Association (NYHA) class III-IV, and one study suggested survival benefit of performing CABG plus MVR as compared to CABG alone in patient with ischemic MR irrespective of preoperative NYHA functional class. Review of current literature showed mixed results in terms of improvement in functional status but failed to show any survival benefit of performing MVR along with CABG. Limitations of studies include small sample size, difference in baseline demographic variables, and short follow-up period which might influence the outcome of the study. Prospective randomized studies are required to establish clear benefit of performing MVR simultaneously with CABG.

  4. The management of patients with aortic regurgitation and severe left ventricular dysfunction: a systematic review.

    Badar, Athar A; Brunton, Alan P T; Mahmood, Ammad H; Dobbin, Stephen; Pozzi, Andrea; McMinn, Jenna F; Sinclair, Andrew J E; Gardner, Roy S; Petrie, Mark C; Curry, Phil A; Al-Attar, Nawwar H K; Pettit, Stephen J

    2015-01-01

    A systematic search of Medline, EMBASE and CINAHL electronic databases was performed. Original research articles reporting all-cause mortality following surgery in patients with aortic regurgitation and severe left ventricular systolic dysfunction (LVSD) were identified. Nine of the 10 eligible studies were observational, single-center, retrospective analyses. Survival ranged from 86 to 100% at 30 days; 81 to 100% at 1 year and 68 to 84% at 5 years. Three studies described an improvement in mean left ventricular ejection fraction (LVEF) following aortic valve replacement (AVR) of 5-14%; a fourth study reported an increase in mean left ventricular ejection fraction (LVEF) of 9% in patients undergoing isolated AVR but not when AVR was combined with coronary artery bypass graft and/or mitral valve surgery. Three studies demonstrated improvements in functional New York Heart Association (NYHA) class following AVR. Additional studies are needed to clarify the benefits of AVR in patients with more extreme degrees of left ventricular systolic dysfunction (LVSD) and the potential roles of cardiac transplantation and transaortic valve implantation.

  5. Multi-parametric quantification of tricuspid regurgitation using cardiovascular magnetic resonance: A comparison to echocardiography

    Medvedofsky, Diego [Department of Medicine, University of Chicago Medical Center, Chicago, IL (United States); Jimenez, Javier Leon [Complejo Hospitalario Universitario de Huelva, Huelva (Spain); Addetia, Karima; Singh, Amita; Lang, Roberto M. [Department of Medicine, University of Chicago Medical Center, Chicago, IL (United States); Mor-Avi, Victor, E-mail: vmoravi@bsd.uchicago.edu [Department of Medicine, University of Chicago Medical Center, Chicago, IL (United States); Patel, Amit R. [Department of Medicine, University of Chicago Medical Center, Chicago, IL (United States)

    2017-01-15

    Background: Velocity-encoding is used to quantify tricuspid regurgitation (TR) by cardiovascular magnetic resonance (CMR), but requires additional dedicated imaging. We hypothesized that size and signal intensity (SI) of the cross-sectional TR jet area in the right atrium in short-axis steady-state free-precession images could be used to assess TR severity. Methods: We studied 61 patients with TR, who underwent CMR and echocardiography within 24 h. TR severity was determined by vena contracta: severe (N = 20), moderate or mild (N = 41). CMR TR jet area and normalized SI were measured in the plane and frame that depicted maximum area. ROC analysis was performed in 21/61 patients to determine diagnostic accuracy of differentiating degrees of TR. Optimal cutoffs were independently tested in the remaining 40 patients. Results: Measurable regions of signal loss depicting TR jets were noted in 51/61 patients, while 9/10 remaining patients had mild TR by echocardiography. With increasing TR severity, jet area significantly increased (15 ± 14 to 38 ± 20 mm{sup 2}), while normalized SI decreased (57 ± 27 to 23 ± 11). ROC analysis showed high AUC values in the derivation group and good accuracy in the test group. Conclusion: TR can be quantified from short-axis CMR images in agreement with echocardiography, while circumventing additional image acquisition.

  6. Managing Ventricular Septal Defect with Associated Aortic Regurgitation: Two Decades of Experience.

    Sanoussi, Ahmed; Demanet, Helene; Dessy, Hughes; Massin, Martial; Biarent, Dominique; Deville, Andree; Wauthy, Pierre

    2015-09-01

    Ventricular septal defect (VSD) with aortic regurgitation (AR) is a well-known association. However, there is still no agreement about its management, particularly regarding the technical details of its operative treatment. The study aim was to describe all components of the syndrome and to evaluate the various techniques used with regards to its anatomical and functional features. A total of 31 patients (mean age 7.4 years; range: 1.0-14.3 years) who underwent repair of VSD and AR between 1990 and 2013 was reviewed. The VSD was perimembranous in 22 patients, and subarterial in nine. Trusler's valvuloplasty technique was used in 15 patients, Yacoub's technique in seven, and Carpentier's technique (triangular resection) in four. Two patients underwent aortic valve replacement (AVR), and three patients with no significant aortic valve lesions underwent a simple patch repair of the VSD. The aortic valvuloplasty results were generally good, with an initial aortic valvuloplasty avoiding AVR. During the immediate postoperative period, valvuloplasty failure occurred in three patients, regardless of the technique used, and all three patients were reoperated on. The mean duration of follow up was 8.5 years (range: 3.2-20.6 years). The initial result was maintained in all patients, except for four who underwent late AVR. The study findings contributed to an analysis of VSD and AR, and helped to clarify the best surgical strategy. The results obtained suggest that adequacy of the initial repair is the most important determinant of subsequent evolution.

  7. The changing spectrum of rheumatic mitral regurgitation in Soweto, South Africa.

    Meel, Ruchika; Peters, Ferande; Libhaber, Elena; Essop, Mohammed Rafique

    To determine the clinical and echocardiographic characteristics of contemporary patients with rheumatic mitral regurgitation (MR) at Chris Hani Baragwanath Academic Hospital. This prospective, cross-sectional study included 84 patients with isolated moderate or severe rheumatic MR who underwent clinical and echocardiographic assessment. Mean age of the patients was 44 ± 15.3 years (84% females). Acute rheumatic fever was rare. Hypertension and HIV were present in 52 and 26%, respectively. Echocardiography showed leaflet thickening and calcification, restricted motion and subvalvular disease in 41, 25 and 34%, respectively. Carpentier IIIa leaflet dysfunction occurred in 80% of patients and leaflet prolapse was seen in only 20%. These findings contrast with the previous literature, where patients were younger, they had rheumatic carditis and there were no co-morbidities. Leaflets were pliable, isolated leaflet prolapse was common and commissural fusion was absent. Contemporary patients with rheumatic MR were older, fewer had rheumatic fever and there were more co-morbidities. Echocardiographic features had evolved to greater leaflet thickening, calcification and reduced motion with minimal prolapse. These findings may have important implications for surgical management of this disease.

  8. Baseline mitral regurgitation predicts outcome in patients referred for dobutamine stress echocardiography.

    O'Driscoll, Jamie M; Gargallo-Fernandez, Paula; Araco, Marco; Perez-Lopez, Manuel; Sharma, Rajan

    2017-11-01

    A number of parameters recorded during dobutamine stress echocardiography (DSE) are associated with worse outcome. However, the relative importance of baseline mitral regurgitation (MR) is unknown. The aim of this study was to assess the prevalence and associated implications of functional MR with long-term mortality in a large cohort of patients referred for DSE. 6745 patients (mean age 64.9 ± 12.2 years) were studied. Demographic, baseline and peak DSE data were collected. All-cause mortality was retrospectively analyzed. DSE was successfully completed in all patients with no adverse outcomes. MR was present in 1019 (15.1%) patients. During a mean follow up of 5.1 ± 1.8 years, 1642 (24.3%) patients died and MR was significantly associated with increased all-cause mortality (p statistic models significantly improved discrimination. MR is associated with all-cause mortality and adds incremental prognostic information among patients referred for DSE. The presence of MR should be taken into account when evaluating the prognostic significance of DSE results.

  9. Combined computational and experimental approach to improve the assessment of mitral regurgitation by echocardiography.

    Sonntag, Simon J; Li, Wei; Becker, Michael; Kaestner, Wiebke; Büsen, Martin R; Marx, Nikolaus; Merhof, Dorit; Steinseifer, Ulrich

    2014-05-01

    Mitral regurgitation (MR) is one of the most frequent valvular heart diseases. To assess MR severity, color Doppler imaging (CDI) is the clinical standard. However, inadequate reliability, poor reproducibility and heavy user-dependence are known limitations. A novel approach combining computational and experimental methods is currently under development aiming to improve the quantification. A flow chamber for a circulatory flow loop was developed. Three different orifices were used to mimic variations of MR. The flow field was recorded simultaneously by a 2D Doppler ultrasound transducer and Particle Image Velocimetry (PIV). Computational Fluid Dynamics (CFD) simulations were conducted using the same geometry and boundary conditions. The resulting computed velocity field was used to simulate synthetic Doppler signals. Comparison between PIV and CFD shows a high level of agreement. The simulated CDI exhibits the same characteristics as the recorded color Doppler images. The feasibility of the proposed combination of experimental and computational methods for the investigation of MR is shown and the numerical methods are successfully validated against the experiments. Furthermore, it is discussed how the approach can be used in the long run as a platform to improve the assessment of MR quantification.

  10. Afghanistan Index

    Linnet, Poul Martin

    2007-01-01

    basis. The data are divided into different indicators such as security, polls, drug, social, economic, refugees etc. This represents a practical division and does not indicate that a picture as to for instance security can be obtained by solely looking at the data under security. In order to obtain...... a more valid picture on security this must incorporate an integrated look on all data meaning that for instance the economic data provides an element as to the whole picture of security.......The Afghanistan index is a compilation of quantitative and qualitative data on the reconstruction and security effort in Afghanistan. The index aims at providing data for benchmarking of the international performance and thus provides the reader with a quick possibility to retrieve valid...

  11. Research progess on treatment of cancer with targeted radionuclide therapy

    Luo Jiawen; Zhang Caixia

    2008-01-01

    The new development and situation of targeted radionuclide therapy in oncology is described, which include radioimmunotherapy, peptide receptor radionuclide therapy, gene therapy and radionuclide labled chemotherapeutics therapy. The application research on labled carrier of those therapy is emphasized. Meanwhile, the research progess of indomethacin and its combined with targeted radionuclide therapy is also described. (authors)

  12. SR 97 - Radionuclide transport calculations

    Lindgren, Maria [Kemakta Konsult AB, Stockholm (Sweden); Lindstroem, Fredrik [Swedish Nuclear Fuel and Waste Management Co., Stockholm (Sweden)

    1999-12-01

    An essential component of a safety assessment is to calculate radionuclide release and dose consequences for different scenarios and cases. The SKB tools for such a quantitative assessment are used to calculate the maximum releases and doses for the hypothetical repository sites Aberg, Beberg and Ceberg for the initial canister defect scenario and also for the glacial melting case for Aberg. The reasonable cases, i.e. all parameters take reasonable values, results in maximum biosphere doses of 5x10{sup -8} Sv/yr for Aberg, 3x10{sup -8} Sv/yr for Beberg and 1x10{sup -8} Sv/yr for Ceberg for peat area. These doses lie significantly below 0.15 mSv/yr. (A dose of 0.15 mSv/yr for unit probability corresponds to the risk limit of 10{sup -5} per year for the most exposed individuals recommended in regulations.) The conclusion that the maximum risk would lie well below 10{sup -5} per year is also demonstrated by results from the probabilistic calculations, which directly assess the resulting risk by combining dose and probability estimates. The analyses indicate that the risk is 2x10{sup -5} Sv/yr for Aberg, 8x10{sup -7} Sv/yr for Beberg and 3x10{sup -8} Sv/yr for Ceberg. The analysis shows that the most important parameters in the near field are the number of defective canisters and the instant release fraction. The influence from varying one parameter never changes the doses as much as an order of magnitude. In the far field the most important uncertainties affecting release and retention are associated with permeability and connectivity of the fractures in the rock. These properties affect several parameters. Highly permeable and well connected fractures imply high groundwater fluxes and short groundwater travel times. Sparsely connected or highly variable fracture properties implies low flow wetted surface along migration paths. It should, however, be remembered that the far-field parameters have little importance if the near-field parameters take their reasonable

  13. SR 97 - Radionuclide transport calculations

    Lindgren, Maria; Lindstroem, Fredrik

    1999-12-01

    An essential component of a safety assessment is to calculate radionuclide release and dose consequences for different scenarios and cases. The SKB tools for such a quantitative assessment are used to calculate the maximum releases and doses for the hypothetical repository sites Aberg, Beberg and Ceberg for the initial canister defect scenario and also for the glacial melting case for Aberg. The reasonable cases, i.e. all parameters take reasonable values, results in maximum biosphere doses of 5x10 -8 Sv/yr for Aberg, 3x10 -8 Sv/yr for Beberg and 1x10 -8 Sv/yr for Ceberg for peat area. These doses lie significantly below 0.15 mSv/yr. (A dose of 0.15 mSv/yr for unit probability corresponds to the risk limit of 10 -5 per year for the most exposed individuals recommended in regulations.) The conclusion that the maximum risk would lie well below 10 -5 per year is also demonstrated by results from the probabilistic calculations, which directly assess the resulting risk by combining dose and probability estimates. The analyses indicate that the risk is 2x10 -5 Sv/yr for Aberg, 8x10 -7 Sv/yr for Beberg and 3x10 -8 Sv/yr for Ceberg. The analysis shows that the most important parameters in the near field are the number of defective canisters and the instant release fraction. The influence from varying one parameter never changes the doses as much as an order of magnitude. In the far field the most important uncertainties affecting release and retention are associated with permeability and connectivity of the fractures in the rock. These properties affect several parameters. Highly permeable and well connected fractures imply high groundwater fluxes and short groundwater travel times. Sparsely connected or highly variable fracture properties implies low flow wetted surface along migration paths. It should, however, be remembered that the far-field parameters have little importance if the near-field parameters take their reasonable values. In that case almost all

  14. Radionuclide imaging of musculoskeletal infection

    Christopher J. Palestro

    2007-09-01

    Full Text Available Radionuclide imaging studies are routinely used to evaluate patients suspected of having musculoskeletal infection. Three-phase bone imaging is readily available, relatively inexpensive, and very accurate in the setting of otherwise normal bone. Labeled leukocyte imaging should be used in cases of "complicating osteomyelitis" such as prosthetic joint infection. This test also is useful in clinically unsuspected diabetic pedal osteomyelitis as well as in the neuropathic joint. It is often necessary, however, to perform complementary bone marrow imaging, to maximize the accuracy of labeled leukocyte imaging. In contrast to other regions in the skeleton, labeled leukocyte imaging is not useful for diagnosing spinal osteomyelitis. At the moment, gallium is the preferred radionuclide procedure for this condition and is a useful adjunct to magnetic resonance imaging. FDG-PET likely will play an important role in the evaluation of musculoskeletal infection, especially spinal osteomyelitis, and may replace gallium imaging for this purpose.Estudos através de imagens com o uso de radionuclídeos são rotineiramente usadas para avaliar pacientes suspeitos de terem infecção músculo-esquelética. A imagem óssea em tridimensional é facilmente avaliável, relativamente de baixo custo, e muito precisa na localização de alterações ósseas. Imagem com leucócito marcado poderia ser usada nos casos de "osteomielite com complicações" tais como infecção prostética articular. Esse teste também é útil na não suspeita clinica de osteomielite associada ao pé diabético tanto quanto nas junções neuropáticas. É sempre necessário, por outro lado, realizar imagem complementar da medula óssea para aumentar a precisão da imagem com leucócito marcado. Em contraste com outras regiões no esqueleto, imagem com leucócito marcado não é útil para diagnosticar osteomielite da coluna vertebral. Até agora, o gálio é o radionuclídeo preferido para

  15. Impact of bileaflet mitral valve prolapse on quantification of mitral regurgitation with cardiac magnetic resonance: a single-center study.

    Vincenti, Gabriella; Masci, Pier Giorgio; Rutz, Tobias; De Blois, Jonathan; Prša, Milan; Jeanrenaud, Xavier; Schwitter, Juerg; Monney, Pierre

    2017-07-27

    To quantify mitral regurgitation (MR) with CMR, the regurgitant volume can be calculated as the difference between the left ventricular (LV) stroke volume (SV) measured with the Simpson's method and the reference SV, i.e. the right ventricular SV (RVSV) in patients without tricuspid regurgitation. However, for patients with prominent mitral valve prolapse (MVP), the Simpson's method may underestimate the LV end-systolic volume (LVESV) as it only considers the volume located between the apex and the mitral annulus, and neglects the ventricular volume that is displaced into the left atrium but contained within the prolapsed mitral leaflets at end systole. This may lead to an underestimation of LVESV, and resulting an over-estimation of LVSV, and an over-estimation of mitral regurgitation. The aim of the present study was to assess the impact of prominent MVP on MR quantification by CMR. In patients with MVP (and no more than trace tricuspid regurgitation) MR was quantified by calculating the regurgitant volume as the difference between LVSV and RVSV. LVSV uncorr was calculated conventionally as LV end-diastolic (LVEDV) minus LVESV. A corrected LVESV corr was calculated as the LVESV plus the prolapsed volume, i.e. the volume between the mitral annulus and the prolapsing mitral leaflets. The 2 methods were compared with respect to the MR grading. MR grades were defined as absent or trace, mild (5-29% regurgitant fraction (RF)), moderate (30-49% RF), or severe (≥50% RF). In 35 patients (44.0 ± 23.0y, 14 males, 20 patients with MR) the prolapsed volume was 16.5 ± 8.7 ml. The 2 methods were concordant in only 12 (34%) patients, as the uncorrected method indicated a 1-grade higher MR severity in 23 (66%) patients. For the uncorrected/corrected method, the distribution of the MR grades as absent-trace (0 vs 11, respectively), mild (20 vs 18, respectively), moderate (11 vs 5, respectively), and severe (4 vs 1, respectively) was significantly different (p

  16. Determination of alpha radionuclides in fish

    Pernicka, L.; Matel, L.; Rosskopfova, O.

    2002-01-01

    The specific activity of alpha radionuclides was determined in biological samples. The biological samples were chosen in kinds of fish, concretely mackerels, herrings and haddocks. Experimental data were presented on the poster

  17. Phytoremediation of soils contaminated with radionuclides

    Yamaguchi, Isamu

    2004-01-01

    Aiming at efficient phytoremediation of soils contaminated with radionuclides, we examined the effect of soil microbes on the uptake ability of plants using the multitracer technique to find that tomato rhizofungi in Fusarium spp. can stimulate the uptake of 85 Sr and 137 Cs by the plants. The synergic effect of a nonpathogenic strain of F. oxysporum on the uptake of radionuclides by plants proved to be enhanced by introducing a phytochelatin synthase gene into the fungus. Since soil contamination by radionuclides is still an unsolved problem in many parts of the world. Studies on phytoremediation of polluted soil environment will be important for developing effective strategies and devising adequate techniques to reduce human risks caused by food contamination of radionuclides. (author)

  18. Radiation safety requirements for radionuclide laboratories

    2000-01-01

    The guide lays down the requirements for laboratories and storage rooms in which radioactive substances are used or stored as unsealed sources. In addition, some general instructions concerning work in radionuclide laboratories are set out

  19. Natural and anthropogenic radionuclides in the environment

    Hille, R.

    1984-01-01

    A survey is given on the actual knowledge about occurence and environmental relevancy of the most important radionuclides from natural and anthropogenic origin. The contribution of AGF installation is emphasized. (orig.) [de

  20. Application of radionuclides in nuclear technology

    Boeck, H.

    1983-07-01

    Four main applications of radionuclides in nuclear technology are presented which are level-, density- and thickness gauging and moisture determination. Each method is surveyed for its general principle, various designs, accuracy, errors and practical designs. (Author)

  1. Transfer of radionuclides into human milk

    Steiner, M.; Wirth, E.

    1998-01-01

    Up until now the potential radiation exposure to breast-fed babies due to contaminated human milk has not been taken into account, when deriving international limit values and reference levels for radionuclides in foodstuffs, in air at monitored work places or for exposures in the medical field. It was the aim of the research project 'Transfer of radionuclides into human milk' to quantify the transfer of incorporated radionuclides into mother's milk, and develop simple models to estimate the radiation exposure of babies through the ingestion of human milk. The study focused on considerations of the radiation exposure due to the ingestion of contaminated foodstuffs by the mother, the inhalation of radionuclides at monitored work places, and the administration of radiopharmaceuticals to breast-feeding mothers. The blocking of infant thyroid glands by stable iodine in the case of accidental releases of radioiodine was considered as well. (orig.) [de

  2. Radiation safety requirements for radionuclide laboratories

    NONE

    2000-07-01

    The guide lays down the requirements for laboratories and storage rooms in which radioactive substances are used or stored as unsealed sources. In addition, some general instructions concerning work in radionuclide laboratories are set out.

  3. Radionuclide transport in a single fissure

    Eriksen, T.E.

    1984-01-01

    Radionuclide migration has been studied in natural fissures running parallel to the axes of granitic drill cores. A short pulse of radionuclide solution was injected at one end of the fissure and the temporal change in radionuclide concentration of the eluate measured. At the end of each experiment the fissure was opened and the radionuclide distribution on the fissure surfaces measured. The retardation of 241 Am(III) at pH 8.2 as well as the variation in 235 Np(V) retardation with pH are found to be in good agreement with K d-values obtained in batch experiments. The reduction of (TcO - 4 ) to Tc(IV) leads as expected to increasing retardation.(author)

  4. Metabolic transformation of radionuclides in marine organisms

    Koyanagi, Taku

    1987-01-01

    Physico-chemical form of radionuclides is one of the important factors governing the concentration by marine organisms, whereas biological activities affect the existing states of radionuclides especially in coastal waters. Radioiodine in the form of iodate which is predominant species in seawater is reduced to iodide ion by biological activities and concentration factor of iodide is an order of magnitude higher than those of iodate. Extremely high accumulation of transition elements, actinides, or natural radionuclides in branchial heart of octopus is explained by the fuction of adenochrome, a glandular pigment in the organ as a natural complexing agent, and similar metal-binding proteins with relatively low molecular weight have been found in various marine invertebrates. High accumulation of some elements also found in mollusk kidney is considered to be caused by the intracellular concretions composed of calcium phosphate. All these biological processes suggest the significance of further investigations on metabolic transformation of radionuclides in marine organisms. (author)

  5. Relating β+ radionuclides' properties by order theory

    Quintero, N.Y.; Guillermo Restrepo; Cohen, I.M.; Universidad Tecnologica Nacional, Buenos Aires

    2013-01-01

    We studied 27 β + radionuclides taking into account some of their variants encoding information of their production, such as integral yield, threshold energy and energy of projectiles used to generate them; these radionuclides are of current use in clinical diagnostic imaging by positron emission tomography (PET). The study was conducted based on physical, physico-chemical, nuclear, dosimetric and quantum properties, which characterise the β + radionuclides selected, with the aim of finding meaningful relationships among them. In order to accomplish this objective the mathematical methodology known as formal concept analysis was employed. We obtained a set of logical assertions (rules) classified as implications and associations, for the set of β + radionuclides considered. Some of them show that low mass defect is related to high and medium values of maximum β + energy, and with even parity and low mean lives; all these parameters are associated to the dose received by a patient subjected to a PET analysis. (author)

  6. Behaviour of the radionuclides in the environment

    Lauria, Dejanira da Costa

    2007-01-01

    This chapter approaches the behaviour of radionuclides in the environment, the isotopes of the natural radioactive series, some aspects of the isotope behaviour on the environment and fission and activation radioactive isotopes

  7. Natural and Synthetic Barriers to Immobilize Radionuclides

    Um, W.

    2011-01-01

    The experiments of weathering of glass waste form and the reacted sediments with simulated glass leachates show that radionuclide sequestration can be significantly enhanced by promoting the formation of secondary precipitates. In addition, synthetic phosphate-bearing nanoporous material exhibits high stability at temperature and has a very high K d value for U(VI) removal. Both natural and synthetic barrier materials can be used as additional efficient adsorbents for retarding transport of radionuclides for various contaminated waste streams and waste forms present at U. S. Department of Energy clean-up sites and the proposed geologic radioactive waste disposal facility. In the radioactive waste repository facility, natural or synthetic materials are planned to be used as a barrier material to immobilize and retard radionuclide release. The getter material can be used to selectively scavenge the radionuclide of interest from a liquid waste stream and subsequently incorporate the loaded getters in a cementitious or various monolithic waste forms. Also, the getter material is to reduce the release of radionuclides from monolithic waste forms. Also, the getter material is to reduce the release of radionuclides from monolithic waste forms. Also, the getter material is to reduce the release of radionuclides form monolithic waste forms by being emplaced as a backfill barrier material around the wastes or waste form to minimize the potential around the wastes or waste form to minimize the potential hazard of leached radioactive wastes. The barrier material should be highly efficient to sequester radionuclides and possess physical and chemical stability for long-term exposure to severe weathering conditions. Because potential leaching of radionuclides depends on various environmental and weathering conditions of the near-field repository, the barrier materials must be durable and not disintegrate under a range of moisture, temperature, pressure, radiation, Eh, ph. and

  8. Radionuclides in plants in urban areas

    Todorovic, D.; Ajtic, J.; Popovic, D.; Nikolic, J.

    2009-01-01

    The results of a long-term study (from 2002 to 2008) on the concentrations of natural ( 7 Be, 210 Pb, 40 K) and fission ( 137 Cs) radionuclides in leaves of higher plants (linden and chestnut) in an urban area (city of Belgrade) are presented. The activity of the radionuclides was determined on an HPGe detector by standard gamma spectrometry. The study is a part of the ongoing air quality monitoring programme in urban areas in the Republic of Serbia. (author) [sr

  9. Limit of the radionuclides in granite

    Wang Shaling; Jiang Rangrong

    2003-01-01

    Granite is an important sort of building materials. Their radionuclide contents are limited by the national standard GB6566-2001 just as other building materials. This standard divides them into main materials and decorative materials, and relaxes the limit of the latter obviously. Owing to the consideration of public dose limit and environment protection, this method needs discussion. Otherwise, red granite contains high radionuclide contents relatively, especially the sort of Indian Red, and need be paid more attention

  10. Biogeochemistry of radionuclides in ecosystems (historical aspect)

    Ivanov, V.I.

    1991-01-01

    The paper presents the most important results of the study on the radionuclides' behaviour in natural and model biogeocenoses(ecosystems) obtained by N.W.Timofeev-Ressovskij and co-workers during the period 1947-1968. As early as at that period, radionuclides were classified according to the types of distribution, accumulation and migration within the surface and freshwater ecosystems, and the methods of biological purification of radioactive sewage were proposed

  11. Livermore Accelerator Source for Radionuclide Science (LASRS)

    Anderson, Scott [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Bleuel, Darren [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Johnson, Micah [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Rusnak, Brian [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Soltz, Ron [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Tonchev, Anton [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2016-05-05

    The Livermore Accelerator Source for Radionuclide Science (LASRS) will generate intense photon and neutron beams to address important gaps in the study of radionuclide science that directly impact Stockpile Stewardship, Nuclear Forensics, and Nuclear Material Detection. The co-location of MeV-scale neutral and photon sources with radiochemical analytics provides a unique facility to meet current and future challenges in nuclear security and nuclear science.

  12. The uptake of radionuclides by plants

    Cawse, P.A.; Turner, G.S.

    1982-02-01

    A review of the literature, since 1970, on the research into the uptake of radionuclides by plants, with references to earlier soil and plant studies on the fate of nuclear weapons fallout. Experimental data on the uptake of plutonium isotopes, americium 241, cesium 137, radium 226, curium 244 and neptunium 237 and details of the chemical form of the radionuclide, soil type and plant growth period are tabulated. (U.K.)

  13. Transport of radionuclides from the LAMPF lagoons

    Ferenbaugh, R.W.; Purtymun, W.D.

    1985-01-01

    Monitoring of the discharge water from the Los Alamos Meson Physics Facility lagoons continued during June and December of 1983. The list of radionuclides being monitoring includes 7 Be, 57 Co, 134 Cs, 3 H, 54 Mn, 22 Na, and 83 Rb. The sampling locations and the data obtained to date are presented. Movement of radionuclides around the lagoons has been described in a previous report. 1 reference, 1 table

  14. Radionuclides in forest biogeocenose elements

    Bulavik, I.M.; Zhuchenko, T.A.

    1992-01-01

    In 1991 year investigations are made on a studying of the radionuclide distribution (CS-137 and Sr-90) through the main forest biogeocenose elements (a litter a mineral soil layer, overground trees parts) on 5 experimental objects of Gomel' region with a various contamination. Radiation characters of the objects are done. As compared with 1989 year cesium and strontium migration from tress into the litter and from the litter to the soil is shown. In the litter and upper soil layer (5 m) contents of Cs-137 and Sr-90 are 95 and 80% accordingly. The Sr-90 concentration in the wood and the isotope concentration change through yearly layers (1986-1991 years) are studied. Wood layers formed to the accident have a lesser cesium concentration, especially in the oax-tree. The highest Cs and Se translocation, into the wood is noted in the pine the lesse one in the oax-tree. Among all elements of the biogeocenose the highest Cs-137 concentration the litter has and then one-year-old shoots, needles, lives, the bark and the wood go on. Even on the sixth year after the accident Cs concentration in the wood was 20-30 times less, than the one in needes and one-year-old shoot of this year. 4 refs.; 5 tabs

  15. Radionuclide transport in fractured media

    Williams, M.M.R.

    1993-01-01

    Until recently, the classical advective-dispersive transport equation was considered to be an adequate model for describing the motion of a solute (e.g. radionuclides) in porous and fractured media. In this model, the dispersion coefficient is either obtained from a microscopic model of the porous medium or by carefully controlled experiments. As a result of such experiments, a large body of data has been accumulated on the dispersivity. Detailed examination of these data has resulted in a curious phenomenon being discovered; namely, that the longitudinal dispersion length is 'scale-dependent'. That is to say the value deduced depends on the 'size' of the experiment, i.e. on the distance over which measurements are made. Several interesting attempts have been made to develop theories which explain this phenomenon, all based on treating the velocity of the water in the porous medium as a spatially random variable, but retaining the advective-dispersive balance equation. In this work we present an entirely new approach to the problem of solute transport in fractured media based upon an analogy with neutron transport. The new method has several advantages over the previous theories and these will be explained below. Results from the new theory are in agreement with experimental trends and do not require any further adjustment to explain the scale-dependent effect

  16. Monitoring radionuclides in marine organisms

    Ishii, T.; Matsuba, M.; Kurosawa, M.; Koyanagi, T.

    1990-01-01

    Concentration of stable elements corresponding to important radionuclides was determined by inductively coupled plasma atomic emission spectrometry (ICP-AES) and inductively coupled plasma mass spectrometry (ICP-MS) for various marine organisms to find indicator organisms for environmental monitoring. Both analytical techniques indicated linearity over a range of concentrations covering 2-4 orders of magnitude. Detection limits of elements by ICP-MS were 10 or 100 times higher than those of ICP-AES, although the precision and accuracy of ICP-MS was slightly inferior to that of ICP-AES. For quantitative analysis of elements with medium mass numbers (chromium, manganese, iron, nickel, copper, zinc, etc.), matrix interferences in ICP-MS were caused mainly by overlaps of spectra from coexisting elements in biological samples. The presence of background ions from atmosphere, water, and argon plasma interfered with determination of some isotopes. Most elements of high mass number could not be determined by ICP-AES because of its poor detection limits, whereas ICP-MS indicated high sensitivity and low background for elements of interest. We used ICP-MS analysis to determine the specific accumulation of certain elements in organs or tissues of 30 marine organisms

  17. Gut-related radionuclide studies

    Sullivan, M.F.

    1982-01-01

    This project is concerned with the behavior of radioactive materials that may be ingested as a consequence of a reactor accident, unavoidable occupational exposure, or after release to the environment and incorporation into the food chain. Current emphasis is directed toward evaluating hazards from ingested actinides as a function of animal age, species, nutrition, and diet, or chemicophysical state of the actinide. Recent observations indicate that the influence of chemical form on plutonium absorption observed at high mass levels does not occur at low mass concentrations. For example, at doses of 0.6 μg/kg there was no difference between absorption of the carbonate, citrate or nitrate forms of plutonium. However, at 1.5 mg/kg, the citrate was absorbed in quantities 30 times higher than the nitrate. The opposite effect occurred for neptunium GI absorption. Furthermore, it was demonstrated that materials such as citrus fruit juices and calcium, as well as drugs that affect GI function (such as aspirin and DTPA), markedly influence GI absorption of plutonium. Such studies provide evidence that diet and nutritional state should be considered in establishing safe limits for radionuclides that may be ingested

  18. Solubility limits on radionuclide dissolution

    Kerrisk, J.F.

    1984-12-31

    This paper examines the effects of solubility in limiting dissolution rates of a number of important radionuclides from spent fuel and high-level waste. Two simple dissolution models were used for calculations that would be characteristics of a Yucca Mountain repository. A saturation-limited dissolution model, in which the water flowing through the repository is assumed to be saturated with each waste element, is very conservative in that it overestimates dissolution rates. A diffusion-limited dissolution model, in which element-dissolution rates are limited by diffusion of waste elements into water flowing past the waste, is more realistic, but it is subject to some uncertainty at this time. Dissolution rates of some elements (Pu, Am, Sn, Th, Zr, Sm) are always limited by solubility. Dissolution rates of other elements (Cs, Tc, Np, Sr, C, I) are never solubility limited; their release would be limited by dissolution of the bulk waste form. Still other elements (U, Cm, Ni, Ra) show solubility-limited dissolution under some conditions. 9 references, 3 tables.

  19. Radionuclides in an underground environment

    Thompson, J.L.

    1996-01-01

    In the 100 years since Becquerel recognized radioactivity, mankind has been very successful in producing large amounts of radioactive materials. We have been less successful in reaching a consensus on how to dispose of the billions of curies of fission products and transuranics resulting from nuclear weapons testing, electrical power generation, medical research, and a variety of other human endeavors. Many countries, including the United States, favor underground burial as a means of disposing of radioactive wastes. There are, however, serious questions about how such buried wastes may behave in the underground environment and particularly how they might eventually contaminate water, air and soil resources on which we are dependent. This paper describes research done in the United States in the state of Nevada on the behavior of radioactive materials placed underground. During the last thirty years, a series of ''experiments'' conducted for other purposes (testing of nuclear weapons) have resulted in a wide variety of fission products and actinides being injected in rock strata both above and below the water table. Variables which seem to control the movement of these radionuclides include the physical form (occlusion versus surface deposition), the chemical oxidation state, sorption by mineral phases of the host rock, and the hydrologic properties of the medium. The information gained from these studies should be relevant to planning for remediation of nuclear facilities elsewhere in the world and for long-term storage of nuclear wastes

  20. Radionuclides sorption in clay soils

    Siraky, G.; Lewis, C.; Hamlat, S.; Nollmann, C.E.

    1987-01-01

    The sorption behaviour of clay soils is examined through a parametric study of the distribution coefficient (Kd) for the radionuclides of interest, Cs and Sr. This work is a preliminary stage of the migration studies of these nuclides in a porous medium (ground of Ezeiza, Argentina) and the evaluation of radiologic impact of the removal of low and intermediate activity wastes in shallow trenches. The determination of Kd is performed by a static technique or batch. The phases are separated by centrifugation at 20000 g during 1 hour. The activity of supernatant solution of Cs-137 and Sr-85 is measured in a detecting system of I Na(Tl) well-type. Two types of parameters were changed: a) those related to the determination method: phase separation (centrifugation vs. centrifugation plus filtration); equilibrium period, ratio solid/liquid; b) those related to the geochemical system: pH of contact solution, carrier concentration, competitive ions, ionic strength, desorption. It was observed that the modification of parameters in the Kd-measurement does not change the order of magnitude of results. (Author)