WorldWideScience

Sample records for severe cardiac damage

  1. Severe fuel damage projects

    International Nuclear Information System (INIS)

    Sdouz, G.

    1987-10-01

    After the descriptions of the generation of a Severe Fuel Damage Accident in a LWR the hypothetical course of such an accident is explained. Then the most significant projects are described. At each project the experimental facility, the most important results and the concluding models and codes are discussed. The selection of the projects is concentrated on the German Projekt Nukleare Sicherheit (PNS), tests performed at the Idaho National Engineering Laboratory (INEL) and smaller projects in France and Great Britain. 25 refs., 26 figs. (Author)

  2. Myostatin as a Marker for Doxorubicin Induced Cardiac Damage.

    Science.gov (United States)

    Kesik, Vural; Honca, Tevfik; Gulgun, Mustafa; Uysal, Bulent; Kurt, Yasemin Gulcan; Cayci, Tuncer; Babacan, Oguzhan; Gocgeldi, Ercan; Korkmazer, Nadir

    2016-01-01

    Doxorubicin (DXR) is an effective chemotherapeutic agent but causes severe cardiac failure over known doses. Thus, early detection and prevention of cardiac damage is important. Various markers have been tested for early detection of cardiac damage. Myostatin is a protein produced in skeletal muscle cells inhibits muscle differentiation and growth during myogenesis. We evaluated the role of myostatin as a marker for showing DXR induced cardiac damage and compared with well known cardiac markers like NT-proBNP, hs-TnT and CK in a rat model of chronic DXR cardiotoxicity. Myostatin, NT-proBNP, and hs-TnT but not CK rose significantly during DXR treatment. Myostatin can be used as an early marker of DXR induced cardiotoxicity. © 2016 by the Association of Clinical Scientists, Inc.

  3. Severe ASR damaged concrete bridges

    DEFF Research Database (Denmark)

    Antonio Barbosa, Ricardo; Gustenhoff Hansen, Søren

    2015-01-01

    Technical University of Denmark (DTU) and University of Southern Denmark (SDU) have conducted several full-scale experiments with severe ASR deteriorated bridges. This paper presents few and preliminary results from both the shear tests and the measuring of the material properties. The shear test...... show that the shear capacity is almost unaffected of ASR despite significant reduction in compressive concrete strength. Furthermore, measurements show a significant tensile reinforcement strain developed due to ASR expansion....

  4. Predicting severe winter coastal storm damage

    International Nuclear Information System (INIS)

    Hondula, David M; Dolan, Robert

    2010-01-01

    Over the past 40 years residents of, and visitors to, the North Carolina coastal barrier islands have experienced the destructive forces of several 'named' extratropical storms. These storms have caused large-scale redistributions of sand and loss of coastal structures and infrastructure. While most of the population living on the islands are familiar with the wintertime storms, the damage and scars of the 'super northeasters'-such as the Ash Wednesday storm of 7 March 1962, and the Halloween storm of 1989-are slipping away from the public's memory. In this research we compared the damage zones of the 1962 Ash Wednesday storm, as depicted on aerial photographs taken after the storm, with photos taken of the same areas in 2003. With these high-resolution aerial photos we were able to estimate the extent of new development which has taken place along the Outer Banks of North Carolina since 1962. Three damage zones were defined that extend across the islands from the ocean landward on the 1962 aerial photos: (1) the zone of almost total destruction on the seaward edge of the islands where the storm waves break; (2) the zone immediately inland where moderate structural damage occurs during severe storms; and (3) the zone of flood damage at the landward margin of the storm surge and overwash. We considered the rate of coastal erosion, the rate of development, and increases in property values as factors which may contribute to changing the financial risk for coastal communities. In comparing the values of these four factors with the 1962 damage data, we produced a predicted dollar value for storm damage should another storm of the magnitude of the 1962 Ash Wednesday storm occur in the present decade. This model also provides an opportunity to estimate the rate of increase in the potential losses through time as shoreline erosion continues to progressively reduce the buffer between the development and the edge of the sea. Our data suggest that the losses along the North

  5. Predicting severe winter coastal storm damage

    Energy Technology Data Exchange (ETDEWEB)

    Hondula, David M; Dolan, Robert, E-mail: hondula@virginia.edu [Department of Environmental Sciences, University of Virginia, PO Box 400123, Charlottesville, VA 22903 (United States)

    2010-07-15

    Over the past 40 years residents of, and visitors to, the North Carolina coastal barrier islands have experienced the destructive forces of several 'named' extratropical storms. These storms have caused large-scale redistributions of sand and loss of coastal structures and infrastructure. While most of the population living on the islands are familiar with the wintertime storms, the damage and scars of the 'super northeasters'-such as the Ash Wednesday storm of 7 March 1962, and the Halloween storm of 1989-are slipping away from the public's memory. In this research we compared the damage zones of the 1962 Ash Wednesday storm, as depicted on aerial photographs taken after the storm, with photos taken of the same areas in 2003. With these high-resolution aerial photos we were able to estimate the extent of new development which has taken place along the Outer Banks of North Carolina since 1962. Three damage zones were defined that extend across the islands from the ocean landward on the 1962 aerial photos: (1) the zone of almost total destruction on the seaward edge of the islands where the storm waves break; (2) the zone immediately inland where moderate structural damage occurs during severe storms; and (3) the zone of flood damage at the landward margin of the storm surge and overwash. We considered the rate of coastal erosion, the rate of development, and increases in property values as factors which may contribute to changing the financial risk for coastal communities. In comparing the values of these four factors with the 1962 damage data, we produced a predicted dollar value for storm damage should another storm of the magnitude of the 1962 Ash Wednesday storm occur in the present decade. This model also provides an opportunity to estimate the rate of increase in the potential losses through time as shoreline erosion continues to progressively reduce the buffer between the development and the edge of the sea. Our data suggest that the

  6. Predicting severe winter coastal storm damage

    Science.gov (United States)

    Hondula, David M.; Dolan, Robert

    2010-07-01

    Over the past 40 years residents of, and visitors to, the North Carolina coastal barrier islands have experienced the destructive forces of several 'named' extratropical storms. These storms have caused large-scale redistributions of sand and loss of coastal structures and infrastructure. While most of the population living on the islands are familiar with the wintertime storms, the damage and scars of the 'super northeasters'—such as the Ash Wednesday storm of 7 March 1962, and the Halloween storm of 1989—are slipping away from the public's memory. In this research we compared the damage zones of the 1962 Ash Wednesday storm, as depicted on aerial photographs taken after the storm, with photos taken of the same areas in 2003. With these high-resolution aerial photos we were able to estimate the extent of new development which has taken place along the Outer Banks of North Carolina since 1962. Three damage zones were defined that extend across the islands from the ocean landward on the 1962 aerial photos: (1) the zone of almost total destruction on the seaward edge of the islands where the storm waves break; (2) the zone immediately inland where moderate structural damage occurs during severe storms; and (3) the zone of flood damage at the landward margin of the storm surge and overwash. We considered the rate of coastal erosion, the rate of development, and increases in property values as factors which may contribute to changing the financial risk for coastal communities. In comparing the values of these four factors with the 1962 damage data, we produced a predicted dollar value for storm damage should another storm of the magnitude of the 1962 Ash Wednesday storm occur in the present decade. This model also provides an opportunity to estimate the rate of increase in the potential losses through time as shoreline erosion continues to progressively reduce the buffer between the development and the edge of the sea. Our data suggest that the losses along the

  7. Assessment of outcome after severe brain damage.

    Science.gov (United States)

    Jennett, B; Bond, M

    1975-03-01

    Persisting disability after brain damage usually comprises both mental and physical handicap. The mental component is often the more important in contributing to overall social disability. Lack of an objective scale leads to vague and over-optimistic estimates of outcome, which obscure the ultimate results of early management. A five-point scale is described--death, persistent vegetative state, severe disability, moderate disability, and good recovery. Duration as well as intensity of disability should be included in an index of ill-health; this applies particularly after head injury, because many disabled survivors are young.

  8. Medulla oblongata damage and cardiac autonomic dysfunction in Parkinson disease.

    Science.gov (United States)

    Pyatigorskaya, Nadya; Mongin, Marie; Valabregue, Romain; Yahia-Cherif, Lydia; Ewenczyk, Claire; Poupon, Cyril; Debellemaniere, Eden; Vidailhet, Marie; Arnulf, Isabelle; Lehéricy, Stephane

    2016-12-13

    To characterize medulla oblongata damage using diffusion tensor imaging (DTI) in Parkinson disease (PD) and correlate it with dysfunction of the cardiac sympathetic/vagal balance. Fifty-two patients with PD and 24 healthy controls were included in the study. All participants underwent clinical examination and 3T MRI using 3D T1-weighted imaging and DTI. DTI metrics were calculated within manually drawn regions of interest. Heart rate variability was evaluated using spectral analysis of the R-R cardiac interval during REM and slow-wave sleep based on continuous overnight electrocardiographic monitoring. Respiratory frequency was measured in 30-second contiguous epochs of REM and slow-wave sleep. The relationships between imaging and cardiac variables were calculated using partial correlations followed by the multiple comparisons permutation approach. The changes in heart rate and respiratory frequency variability from slow-wave sleep to REM sleep in healthy controls were no longer detectable in patients with PD. There were significant increases in the mean (p = 0.006), axial (p = 0.006), and radial diffusivities (p = 0.005) in the medulla oblongata of patients with PD. In PD, diffusion changes were specifically correlated with a lower heart rate and respiratory frequency variability during REM sleep. This study provides evidence that medulla oblongata damage underlies cardiac sympathetic/vagal balance and respiratory dysfunction in patients with PD. © 2016 American Academy of Neurology.

  9. Severe fuel-damage scoping test performance

    International Nuclear Information System (INIS)

    Gruen, G.E.; Buescher, B.J.

    1983-01-01

    As a result of the Three Mile Island Unit-2 (TMI-2) accident, the Nuclear Regulatory Commission has initiated a severe fuel damage test program to evaluate fuel rod and core response during severe accidents similar to TMI-2. The first test of Phase I of this series has been successfully completed in the Power Burst Facility at the Idaho National Engineering Laboratory. Following the first test, calculations were performed using the TRAC-BD1 computer code with actual experimental boundary conditions. This paper discusses the test conduct and performance and presents the calculated and measured test bundle results. The test resulted in a slow heatup to 2000 K over about 4 h, with an accelerated reaction of the zirconium cladding at temperatures above 1600 K in the lower part or the bundle and 2000 K in the upper portion of the bundle

  10. Behavior of fission products released from severely damaged fuel during the PBF severe fuel damage tests

    International Nuclear Information System (INIS)

    Osetek, D.J.; Cronenberg, A.W.; Hagrman, D.L.; Broughton, J.M.; Rest, J.

    1984-01-01

    The results of fission product release behavior during the first two Power Burst Facility Severe Fuel Damage tests are presented. Measured fission product release is compared with calculated release using temperature dependent release rate correlations and FASTGRASS analysis. The test results indicate that release from fuel of the high volatility fission products (Xe, Kr, I, Cs, and Te) is strongly influenced by parameters other than fuel temperature; namely fuel/fission product morphology, fuel and cladding oxidation state, extent of fuel liquefaction, and quench induced fuel shattering. Fission product transport from the test fuel through the sample system was strongly influenced by chemical effects. Holdup of I and Cs was affected by fission product chemistry, and transport time while Te release was primarily influenced by the extent of zircaloy oxidation. Analysis demonstrates that such integral test data can be used to confirm physical, chemical, and mechanistic models of fission product behavior for severe accident conditions

  11. Analysis and research status of severe core damage accidents

    International Nuclear Information System (INIS)

    1984-03-01

    The Severe Core Damage Research and Analysis Task Force was established in Nuclear Safety Research Center, Tokai Research Establishment, JAERI, in May, 1982 to make a quantitative analysis on the issues related with the severe core damage accident and also to survey the present status of the research and provide the required research subjects on the severe core damage accident. This report summarizes the results of the works performed by the Task Force during last one and half years. The main subjects investigated are as follows; (1) Discussion on the purposes and necessities of severe core damage accident research, (2) proposal of phenomenological research subjects required in Japan, (3) analysis of severe core damage accidents and identification of risk dominant accident sequences, (4) investigation of significant physical phenomena in severe core damage accidents, and (5) survey of the research status. (author)

  12. Milrinone and esmolol decrease cardiac damage after resuscitation from prolonged cardiac arrest.

    Science.gov (United States)

    Zoerner, F; Lennmyr, F; Wiklund, L; Martijn, C; Semenas, E

    2015-04-01

    Long-term survival after cardiac arrest (CA) due to shock-refractory ventricular fibrillation (VF) is low. Clearly, there is a need for new pharmacological interventions in the setting of cardiopulmonary resuscitation (CPR) to improve outcome. Here, hemodynamic parameters and cardiac damage are compared between the treatment group (milrinone, esmolol and vasopressin) and controls (vasopressin only) during resuscitation from prolonged CA in piglets. A total of 26 immature male piglets were subjected to 12-min VF followed by 8-min CPR. The treatment group (n=13) received i.v. (intravenous) boluses vasopressin 0.4 U/kg, esmolol 250 μg/kg and milrinone 25 μg/kg after 13 min, followed by i.v. boluses esmolol 375 μg/kg and milrinone 25 μg/kg after 18 min and continuous esmolol 15 μg/kg/h infusion during 180 min reperfusion, whereas controls (n=13) received equal amounts of vasopressin and saline. A 200 J monophasic counter-shock was delivered to achieve resumption of spontaneous circulation (ROSC) after 8 min CPR. If ROSC was not achieved, another 200 J defibrillation and bolus vasopressin 0.4 U/kg would be administered in both groups. Direct current shocks at 360 J were applied as one shot per minute over maximally 5 min. Hemodynamic variables and troponin I as a marker of cardiac injury were recorded. Troponin I levels after 180 min reperfusion were lower in the treatment group than in controls (Pmilrinone, esmolol and vasopressin decreased cardiac injury compared with vasopressin alone. © 2015 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  13. Later Onset Fabry Disease, Cardiac Damage Progress in Silence: Experience With a Highly Prevalent Mutation.

    Science.gov (United States)

    Hsu, Ting-Rong; Hung, Sheng-Che; Chang, Fu-Pang; Yu, Wen-Chung; Sung, Shih-Hsien; Hsu, Chia-Lin; Dzhagalov, Ivan; Yang, Chia-Feng; Chu, Tzu-Hung; Lee, Han-Jui; Lu, Yung-Hsiu; Chang, Sheng-Kai; Liao, Hsuan-Chieh; Lin, Hsiang-Yu; Liao, Tsan-Chieh; Lee, Pi-Chang; Li, Hsing-Yuan; Yang, An-Hang; Ho, Hui-Chen; Chiang, Chuan-Chi; Lin, Ching-Yuang; Desnick, Robert J; Niu, Dau-Ming

    2016-12-13

    Recently, several studies revealed a much higher prevalence of later onset Fabry disease (FD) than previously expected. It suggested that later onset FD might present as an important hidden health issue in certain ethnic or demographic populations in the world. However, the natural history of its phenotype has not been systemically investigated, especially the cardiac involvement. The study analyzed a large-scale newborn screening program for FD to understand the natural course of later onset FD. To date, 916,383 newborns have been screened for FD in Taiwan, including more than 1,200 individuals with the common, later onset IVS4+919G>A (IVS4) mutation. Echocardiography was performed in 620 adults with the IVS4 mutation to analyze the prevalence of left ventricular hypertrophy (LVH), and gadolinium-enhanced cardiac magnetic resonance imaging was performed in 129 patients with FD, including 100 IVS4 adults. LVH was observed in 67% of men and 32% of women older than 40 years. Imaging evidenced significant late gadolinium enhancement in 38.1% of IVS4 men and 16.7% of IVS4 women with the IVS4 mutation but without LVH. Seventeen patients underwent endomyocardial biopsies, which revealed significant globotriaosylceramide substrate accumulation in their cardiomyocytes. Significant cardiomyocyte substrate accumulation in IVS4 patients led to severe and irreversible cardiac fibrosis before development of LVH or other significant cardiac manifestations. Thus, it might be too late to start enzyme replacement therapy after the occurrence of LVH or other significant cardiac manifestations in patients with later onset FD. This study also indicated the importance of newborn screening for early detection of the insidious, ongoing, irreversible cardiac damage in patients with later onset FD. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  14. Present status and needs of research on severe core damage

    International Nuclear Information System (INIS)

    1982-05-01

    The needs for research on severe core damage accident have been emphasized recently, in particular, since TMI-2 accident. The Severe Core Damage Research Task Force was established by the Divisions of Reactor Safety and Reactor Safety Evaluation to evaluate individual phenomenon, to survey the present status of research and to provide the recommended research subjects on severe accidents. This report describes the accident phenomena involving some analytical results, status of research and recommended research subjects on severe core damage accidents, divided into accident sequence, fuel damage, and molten material behavior, fission product behavior, hydrogen generation and combustion, steam explosion and containment integrity. (author)

  15. The American 'severe fuel damage program'

    International Nuclear Information System (INIS)

    Sdouz, G.

    1982-03-01

    The TMI-2 accident has initiated a new phase of safety research. It is necessary to consider severe accidents with degraded or molten core. For NRC there was a need for an improved understanding of this reactor behaviour and the 'Severe Fuel Dage Program' was initiated. Planned are in-pile experiments in PBF, NRU and ESSOR and in addition separate effects tests and results from TMI-2. The analytical component of the program is the development of different versions of the code SCDAP for the detailed analysis during severe accident transients. (Author) [de

  16. The impact of obesity in the cardiac lipidome and its consequences in the cardiac damage observed in obese rats.

    Science.gov (United States)

    Marín-Royo, Gema; Martínez-Martínez, Ernesto; Gutiérrez, Beatriz; Jurado-López, Raquel; Gallardo, Isabel; Montero, Olimpio; Bartolomé, Mª Visitación; Román, José Alberto San; Salaices, Mercedes; Nieto, María Luisa; Cachofeiro, Victoria

    To explore the impact of obesity on the cardiac lipid profile in rats with diet-induced obesity, as well as to evaluate whether or not the specific changes in lipid species are associated with cardiac fibrosis. Male Wistar rats were fed either a high-fat diet (HFD, 35% fat) or standard diet (3.5% fat) for 6 weeks. Cardiac lipids were analyzed using by liquid chromatography-tandem mass spectrometry. HFD rats showed cardiac fibrosis and enhanced levels of cardiac superoxide anion (O 2 ), HOMA index, adiposity, and plasma leptin, as well as a reduction in those of cardiac glucose transporter (GLUT 4), compared with control animals. Cardiac lipid profile analysis showed a significant increase in triglycerides, especially those enriched with palmitic, stearic, and arachidonic acid. An increase in levels of diacylglycerol (DAG) was also observed. No changes in cardiac levels of diacyl phosphatidylcholine, or even a reduction in total levels of diacyl phosphatidylethanolamine, diacyl phosphatidylinositol, and sphingomyelins (SM) was observed in HFD, as compared with control animals. After adjustment for other variables (oxidative stress, HOMA, cardiac hypertrophy), total levels of DAG were independent predictors of cardiac fibrosis while the levels of total SM were independent predictors of the cardiac levels of GLUT 4. These data suggest that obesity has a significant impact on cardiac lipid composition, although it does not modulate the different species in a similar manner. Nonetheless, these changes are likely to participate in the cardiac damage in the context of obesity, since total DAG levels can facilitate the development of cardiac fibrosis, and SM levels predict GLUT4 levels. Copyright © 2017 Sociedad Española de Arteriosclerosis. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Ichthyophonus-induced cardiac damage: a mechanism for reduced swimming stamina in salmonids.

    Science.gov (United States)

    Kocan, R; Lapatra, S; Gregg, J; Winton, J; Hershberger, P

    2006-09-01

    Swimming stamina, measured as time-to-fatigue, was reduced by approximately two-thirds in rainbow trout experimentally infected with Ichthyophonus. Intensity of Ichthyophonus infection was most severe in cardiac muscle but multiple organs were infected to a lesser extent. The mean heart weight of infected fish was 40% greater than that of uninfected fish, the result of parasite biomass, infiltration of immune cells and fibrotic (granuloma) tissue surrounding the parasite. Diminished swimming stamina is hypothesized to be due to cardiac failure resulting from the combination of parasite-damaged heart muscle and low myocardial oxygen supply during sustained aerobic exercise. Loss of stamina in Ichthyophonus-infected salmonids could explain the poor performance previously reported for wild Chinook and sockeye salmon stocks during their spawning migration.

  18. Cardiac and renal damage in the elderly hypertensive

    Directory of Open Access Journals (Sweden)

    Jean Ribstein

    2002-03-01

    Full Text Available In the elderly patient with essential hypertension of long duration or de novo systolic hypertension, the prevalence of co-morbid conditions, be they apparent or not, the burden of associated diseases and the alteration in nutritional status and lifestyle, result in specific problems with regards to hypertension-related target organ damage. Accumulating data suggest that left ventricular (LV remodelling is a common finding in the nor-motensive elderly, and that LV hypertrophy (LVH will herald the development of heart failure in a fraction of patients with either systolic/diastolic or isolated systolic hypertension. Increased arterial stiffness, as well as impaired myocardial relaxation, reduced early diastolic filling and decreased ?-adrenergic responsiveness, contribute to the large prevalence of abnormalities in LV function in the elderly hypertensive. The response to exercise is clearly attenuated, and coronary heart disease, although highly prevalent, may be misdiagnosed because symptoms are altered. The elderly hypertensive is exquisitely sensitive to both volume depletion and excessive sodium intake, due to a marked sodium sensitivity of blood pressure (BP. A decline in renal blood flow and glomerular filtration rate (GFR is a common finding in the elderly. Although structural alterations attributed to age and hypertension may differ, hypertension is often looked upon as an accelerated form of ageing with regards to the heart and the kidney. Lifestyle modifications and initial monotherapy with a low-dose diuretic are warranted in the elderly hypertensive with no co-morbidity; a variety of specific approaches are considered when associated clinical conditions are present. Blockers of the renin-angiotensin system (RAS may be the preferred first-line agents in many patients with cardiac or renal damage.

  19. CORA-13 experiment on severe fuel damage

    International Nuclear Information System (INIS)

    Firnhaber, M.; Trambauer, K.; Hagen, S.; Hofmann, P.; Schanz, G.; Sepold, L.

    1993-07-01

    The major objectives of the experiment were to investigate the behavior of PWR fuel elements during early core degradation and fast cooldown due to refill. Measured quantities are boundary conditions, bundle temperatures, hydrogen generation and the final bundle configuration. Boundary conditions which could not be measured, but which are necessary for simplified test simulation (axial power profile, shroud insulation temperature, bundle refill flow) were estimated using ATHLET-CD. The capability of the codes in calculating the main degradation phenomena has been clearly illustrated and weaknesses concerning the modelling of some degradation processes have been identified. Among the degradation phenomena involved in the test, the more severe limitations concern the UO 2 -ZrO 2 dissolution by molten Zr, the solubility limits in the resulting U-Zr-O mixture and the cladding failure by the molten mixture. There is a lack concerning the Inconel spacer-grid interactions with the rods, the material interaction between control rod material and fuel rods, and in the modelling of hydrogen generation during cooldown. (orig./DG)

  20. Damage severity estimation from the global stiffness decrease

    International Nuclear Information System (INIS)

    Nitescu, C; Gillich, G R; Manescu, T; Korka, Z I; Abdel Wahab, M

    2017-01-01

    In actual damage detection methods, localization and severity estimation can be treated separately. The severity is commonly estimated using fracture mechanics approach, with the main disadvantage of involving empirically deduced relations. In this paper, a damage severity estimator based on the global stiffness reduction is proposed. This feature is computed from the deflections of the intact and damaged beam, respectively. The damage is always located where the bending moment achieves maxima. If the damage is positioned elsewhere on the beam, its effect becomes lower, because the stress is produced by a diminished bending moment. It is shown that the global stiffness reduction produced by a crack is the same for all beams with a similar cross-section, regardless of the boundary conditions. One mathematical relation indicating the severity and another indicating the effect of removing damage from the beam. Measurements on damaged beams with different boundary conditions and cross-sections are carried out, and the location and severity are found using the proposed relations. These comparisons prove that the proposed approach can be used to accurately compute the severity estimator. (paper)

  1. Cardiac damage in athlete's heart: When the "supernormal" heart fails!

    Science.gov (United States)

    Carbone, Andreina; D'Andrea, Antonello; Riegler, Lucia; Scarafile, Raffaella; Pezzullo, Enrica; Martone, Francesca; America, Raffaella; Liccardo, Biagio; Galderisi, Maurizio; Bossone, Eduardo; Calabrò, Raffaele

    2017-06-26

    Intense exercise may cause heart remodeling to compensate increases in blood pressure or volume by increasing muscle mass. Cardiac changes do not involve only the left ventricle, but all heart chambers. Physiological cardiac modeling in athletes is associated with normal or enhanced cardiac function, but recent studies have documented decrements in left ventricular function during intense exercise and the release of cardiac markers of necrosis in athlete's blood of uncertain significance. Furthermore, cardiac remodeling may predispose athletes to heart disease and result in electrical remodeling, responsible for arrhythmias. Athlete's heart is a physiological condition and does not require a specific treatment. In some conditions, it is important to differentiate the physiological adaptations from pathological conditions, such as hypertrophic cardiomyopathy, arrhythmogenic dysplasia of the right ventricle, and non-compaction myocardium, for the greater risk of sudden cardiac death of these conditions. Moreover, some drugs and performance-enhancing drugs can cause structural alterations and arrhythmias, therefore, their use should be excluded.

  2. Markers of Intestinal Damage and their Relation to Cytokine Levels in Cardiac Surgery Patients

    NARCIS (Netherlands)

    Habes, Q.L.M.; Linssen, V.; Nooijen, S.; Kiers, D.; Gerretsen, J.; Pickkers, P.; Scheffer, G.J.; Kox, M.

    2017-01-01

    OBJECTIVES: In patients undergoing cardiac surgery, both extracorporeal circulation (ECC) and intraoperative mesenterial hypoperfusion may account for increased cytokine levels and lead to postoperative gastrointestinal (GI) symptoms. METHODS: We investigated levels of the intestinal damage markers

  3. PBF severe fuel damage program: results and comparison to analysis

    International Nuclear Information System (INIS)

    McDonald, P.E.; Buescher, B.J.; Gruen, G.E.; Hobbins, R.R.; McCardell, R.K.

    1983-01-01

    The United States Nuclear Regulatory Commission has initiated a severe fuel damage research program in the Power Burst Facility (PBF) to investigate fuel rod and core response, and fission product and hydrogen release and transport under degraded core cooling accident conditions. This paper presents a description of Phase I of the PBF Severe Fuel Damage Program, discusses the results of the first experiment, and compares those results with analysis performed using the TRAC-BD1 computer code

  4. Gut permeability and myocardial damage in paediatric cardiac surgery

    NARCIS (Netherlands)

    Malagon, Ignacio

    2005-01-01

    Cardiopulmonary bypass (CPB) induces a systemic inflammatory response syndrome (SIRS) in patients following cardiac surgery that can lead to major organ injury and postoperative morbidity. Initiation of CPB sets in motion an extremely complex and multifaceted response involving complement

  5. Ongoing myocardial damage relates to cardiac sympathetic nervous disintegrity in patients with heart failure

    International Nuclear Information System (INIS)

    Arimoto, Takanori; Takeishi, Yasuchika; Niizeki, Takeshi

    2005-01-01

    Iodine-123-metaiodobenzylguanidine ( 123 I-MIBG) has been used to assess the integrity and function of the cardiac sympathetic nervous system in patients with heart failure. Heart-type fatty acid binding protein (H-FABP) is released into the circulation when the myocardium is injured, and H-FABP has been recently used as a novel marker for the diagnosis of ongoing myocardial damage. The aim of the present study was to compare cardiac sympathetic nervous activity assessed by 123 I-MIBG imaging with serum levels of H-FABP in patients with heart failure. Fifty patients with chronic heart failure were studied. 123 I-MIBG imaging was carried out at 30 min (early) and 240 min (delayed) after the tracer injection. We measured serum levels of H-FABP using a sandwich enzyme linked immunosorbent assay. Heart to mediastinum (H/M) ratios of 123 I-MIBG decreased and washout rate increased with higher New York Heart Association (NYHA) functional class. H-FABP, norepinephrine and brain natriuretic peptide (BNP) levels increased as the severity of NYHA class advanced. Delayed H/M ratio was significantly correlated with H-FABP (r=-0.296, p=0.029) and BNP (r=-0.335, p=0.0213). Myocardial washout rate of 123 I-MIBG was also correlated with H-FABP (r=0.469, p 123 I-MIBG imaging is an appropriate approach to evaluate non-invasively not only cardiac sympathetic nervous activity, but also latent ongoing myocardial damage in the failing heart. (author)

  6. Damage Localization of Severely Damaged RC-Structures Based on Measured Eigenperiods from a Single Response

    DEFF Research Database (Denmark)

    Skjærbæk, P. S.; Nielsen, Søren R.K.; Cakmak, A. S.

    This paper deals with the estimation of the damage location of severely damaged Reinforced Concrete (RC) structures excited by earthquakes. It is assumed that the building is instrumented with a sensor measuring the earthquake acceleration signal at ground surface and a sensor measuring only...

  7. Power Burst Facility severe-fuel-damage test program

    International Nuclear Information System (INIS)

    McCardell, R.K.; MacDonald, P.E.

    1982-01-01

    As a result of the Three Mile Island Unit 2 (TMI-2) accident, the United States Nuclear Regulatory Commission (USNRC) has initiated a severe fuel damage research program to investigate fuel rod and core response, and fission product and hydrogen release and transport during degraded core cooling accidents. This paper presents a discussion of the expected benefits of the PBF severe fuel damage tests to the nuclear industry, a description of the first five planned experiments, the results of pretest analysis performed to predict the fuel bundle heatup for the first two experiments, and a discussion of Phase II severe fuel damage experiments. Modifications to the fission product detection system envisioned for the later experiments are also described

  8. Evaluation of myocardial damage and cardiac residual capacity by Tl-201 myocardial scintigraphy in valvular heart diseases

    International Nuclear Information System (INIS)

    Indo, Shunju

    1992-01-01

    This study was performed to clarify whether the extent-score (Ex-Score) calculated by Tl-201 myocardial scintigraphy is a reliable indicator of the severity of myocardial damage and cardiac residual capacity in valvular heart diseases. The subjects consisted of 38 patients (10 with aortic regurgitation (AR), 4 with aortic stenosis (AS), 13 with mitral regurgitation (MR) and 11 with mitral stenosis (MS)). Ex-Scores were significantly correlated with the severity of myocardial damage found in biopsied specimens obtained intraoperatively (correlation efficiency to Ex-Score with cell diameter in AR, % fibrosis in AR, cell diameter in AS, electron microscopic score in MR and % fibrosis in MS was 0.873, 0.734, 0.970, 0.913 and 0.659, respectively). Ex-Scores were also correlated with cardiac residual capacity determined by radioisotope angiography (correlation efficiency to Ex-Score with %Δ ejection fraction in AR, %Δ end-systolic volume in MR, %Δ end-diastolic volume in MS was -0.764, 0.790 and -0.763, respectively). These results suggest that the severity of myocardial damage and cardiac residual capacity can be estimated by Tl-201 myocardial scintigraphy (Ex-Score) in valvular heart diseases. (author)

  9. Cardiac Light Chain Amyloidosis: The Role of Metal Ions in Oxidative Stress and Mitochondrial Damage.

    Science.gov (United States)

    Diomede, Luisa; Romeo, Margherita; Rognoni, Paola; Beeg, Marten; Foray, Claudia; Ghibaudi, Elena; Palladini, Giovanni; Cherny, Robert A; Verga, Laura; Capello, Gian Luca; Perfetti, Vittorio; Fiordaliso, Fabio; Merlini, Giampaolo; Salmona, Mario

    2017-09-20

    The knowledge of the mechanism underlying the cardiac damage in immunoglobulin light chain (LC) amyloidosis (AL) is essential to develop novel therapies and improve patients' outcome. Although an active role of reactive oxygen species (ROS) in LC-induced cardiotoxicity has already been envisaged, the actual mechanisms behind their generation remain elusive. This study was aimed at further dissecting the action of ROS generated by cardiotoxic LC in vivo and investigating whether transition metal ions are involved in this process. In the absence of reliable vertebrate model of AL, we used the nematode Caenorhabditis elegans, whose pharynx is an "ancestral heart." LC purified from patients with severe cardiac involvement intrinsically generated high levels of ROS and when administered to C. elegans induced ROS production, activation of the DAF-16/forkhead transcription factor (FOXO) pathway, and expression of proteins involved in stress resistance and survival. Profound functional and structural ROS-mediated mitochondrial damage, similar to that observed in amyloid-affected hearts from AL patients, was observed. All these effects were entirely dependent on the presence of metal ions since addition of metal chelator or metal-binding 8-hydroxyquinoline compounds (chelex, PBT2, and clioquinol) permanently blocked the ROS production and prevented the cardiotoxic effects of amyloid LC. Innovation and Conclusion: Our findings identify the key role of metal ions in driving the ROS-mediated toxic effects of LC. This is a novel conceptual advance that paves the way for new pharmacological strategies aimed at not only counteracting but also totally inhibiting the vicious cycle of redox damage. Antioxid. Redox Signal. 27, 567-582.

  10. Blunt Cardiac Injury in the Severely Injured - A Retrospective Multicentre Study.

    Directory of Open Access Journals (Sweden)

    Marc Hanschen

    Full Text Available Blunt cardiac injury is a rare trauma entity. Here, we sought to evaluate the relevance and prognostic significance of blunt cardiac injury in severely injured patients.In a retrospective multicentre study, using data collected from 47,580 patients enrolled to TraumaRegister DGU (1993-2009, characteristics of trauma, prehospital / hospital trauma management, and outcome analysis were correlated to the severity of blunt cardiac injury. The severity of cardiac injury was assessed according to the abbreviated injury score (AIS score 1-6, the revised injury severity score (RISC allowed comparison of expected outcome with injury severity-dependent outcome. N = 1.090 had blunt cardiac trauma (AIS 1-6 (2.3% of patients.Predictors of blunt cardiac injury could be identified. Sternal fractures indicate a high risk of the presence of blunt cardiac injury (AIS 0 [control]: 3.0%; AIS 1: 19.3%; AIS 2-6: 19.1%. The overall mortality rate was 13.9%, minor cardiac injury (AIS 1 and severe cardiac injury (AIS 2-6 are associated with higher rates. Severe blunt cardiac injury (AIS 4 and AIS 5-6 is associated with a higher mortality (OR 2.79 and 4.89, respectively as compared to the predicted average mortality (OR 2.49 of the study collective.Multiple injured patients with blunt cardiac trauma are at high risk to be underestimated. Careful evaluation of trauma patients is able to predict the presence of blunt cardiac injury. The severity of blunt cardiac injury needs to be stratified according to the AIS score, as the patients' outcome is dependent on the severity of cardiac injury.

  11. Severe fuel damage investigations of KFK/PNS

    International Nuclear Information System (INIS)

    Fiege, A.

    1983-01-01

    This report is a comprehensive review of the objectives, the program planning, the status and the further procedure of the investigations of KfK/PNS on severe core damage. The investigations were started in 1981 and will be finished in 1985/86. (orig.) [de

  12. Neglect severity after left and right brain damage.

    Science.gov (United States)

    Suchan, Julia; Rorden, Chris; Karnath, Hans-Otto

    2012-05-01

    While unilateral spatial neglect after left brain damage is undoubtedly less common than spatial neglect after a right hemisphere lesion, it is also assumed to be less severe. Here we directly test this latter hypothesis using a continuous measure of neglect severity: the so-called Center of Cancellation (CoC). Rorden and Karnath (2010) recently validated this index for right brain damaged neglect patients. A first aim of the present study was to evaluate this new measure for spatial neglect after left brain damage. In a group of 48 left-sided stroke patients with and without neglect, a score greater than -0.086 on the Bells Test and greater than -0.024 on the Letter Cancellation Task turned out to indicate neglect behavior for acute left brain damaged patients. A second aim was to directly compare the severity of spatial neglect after left versus right brain injury by using the new CoC measure. While neglect is less frequent following left than right hemisphere injury, we found that when this symptom occurs it is of similar severity in acute left brain injury as in patients after acute right brain injury. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. Melcor benchmarking against integral severe fuel damage tests

    Energy Technology Data Exchange (ETDEWEB)

    Madni, I.K. [Brookhaven National Lab., Upton, NY (United States)

    1995-09-01

    MELCOR is a fully integrated computer code that models all phases of the progression of severe accidents in light water reactor nuclear power plants, and is being developed for the U.S. Nuclear Regulatory Commission (NRC) by Sandia National Laboratories (SNL). Brookhaven National Laboratory (BNL) has a program with the NRC to provide independent assessment of MELCOR, and a very important part of this program is to benchmark MELCOR against experimental data from integral severe fuel damage tests and predictions of that data from more mechanistic codes such as SCDAP or SCDAP/RELAP5. Benchmarking analyses with MELCOR have been carried out at BNL for five integral severe fuel damage tests, namely, PBF SFD 1-1, SFD 14, and NRU FLHT-2, analyses, and their role in identifying areas of modeling strengths and weaknesses in MELCOR.

  14. Efficacy of pasireotide in controlling severe hypercortisolism until cardiac transplantation

    Directory of Open Access Journals (Sweden)

    Roberto Attanasio

    2017-03-01

    Full Text Available Cushing’s syndrome is associated with increased morbidity and mortality. Although surgery is the first-line treatment, drugs can still play a role as an ancillary treatment to be employed while waiting for surgery, after unsuccessful operation or in patients unsuitable for surgery. We were asked to evaluate a 32-year-old male waiting for cardiac transplantation. Idiopathic hypokinetic cardiomyopathy had been diagnosed since 6 years. He was on treatment with multiple drugs, had a pacemaker, an implantable cardioverter and an external device for the support of systolic function. Physical examination showed severely impaired general status, signs of hypercortisolism and multiple vertebral compression fractures. We administered teriparatide, and the few evaluable parameters supported the diagnosis of ACTH-dependent hypercortisolism: serum cortisol was 24.2 μg/dL in the morning and 20.3 μg/dL after overnight 1 mg dexamethasone, urinary free cortisol (UFC was 258 μg/24 h and ACTH 125 pg/mL. Pituitary CT was negative. Pasireotide 300 μg bid was administered and uptitrated to 600 μg bid. Treatment was well tolerated, achieving dramatic improvement of clinical picture with progressive normalization of serum cortisol and ACTH levels as well as UFC. After 4 months, the patient underwent successful heart transplantation. Many complications ensued and were overcome. Pituitary MRI was negative. On pasireotide 300 μg bid and prednisone 2.5 mg/day (as part of immunosuppressive therapy, morning serum cortisol and ACTH were 15.6 μg/dL and 54 pg/mL respectively, UFC was 37 μg/24 h, fasting glucose: 107 mg/dL and HbA1c: 6.5%. In conclusion, primary treatment with pasireotide achieved remission of hypercortisolism, thus allowing the patient to undergo heart transplantation.

  15. Secoisolariciresinol diglucoside abrogates oxidative stress-induced damage in cardiac iron overload condition.

    Directory of Open Access Journals (Sweden)

    Stephanie Puukila

    Full Text Available Cardiac iron overload is directly associated with cardiac dysfunction and can ultimately lead to heart failure. This study examined the effect of secoisolariciresinol diglucoside (SDG, a component of flaxseed, on iron overload induced cardiac damage by evaluating oxidative stress, inflammation and apoptosis in H9c2 cardiomyocytes. Cells were incubated with 50 μ5M iron for 24 hours and/or a 24 hour pre-treatment of 500 μ M SDG. Cardiac iron overload resulted in increased oxidative stress and gene expression of the inflammatory mediators tumor necrosis factor-α, interleukin-10 and interferon γ, as well as matrix metalloproteinases-2 and -9. Increased apoptosis was evident by increased active caspase 3/7 activity and increased protein expression of Forkhead box O3a, caspase 3 and Bax. Cardiac iron overload also resulted in increased protein expression of p70S6 Kinase 1 and decreased expression of AMP-activated protein kinase. Pre-treatment with SDG abrogated the iron-induced increases in oxidative stress, inflammation and apoptosis, as well as the increased p70S6 Kinase 1 and decreased AMP-activated protein kinase expression. The decrease in superoxide dismutase activity by iron treatment was prevented by pre-treatment with SDG in the presence of iron. Based on these findings we conclude that SDG was cytoprotective in an in vitro model of iron overload induced redox-inflammatory damage, suggesting a novel potential role for SDG in cardiac iron overload.

  16. Therapeutic Hypothermia Reduces Oxidative Damage and Alters Antioxidant Defenses after Cardiac Arrest

    Science.gov (United States)

    Hackenhaar, Fernanda S.; Medeiros, Tássia M.; Heemann, Fernanda M.; Behling, Camile S.; Putti, Jordana S.; Mahl, Camila D.; Verona, Cleber; da Silva, Ana Carolina A.; Guerra, Maria C.; Gonçalves, Carlos A. S.; Oliveira, Vanessa M.; Riveiro, Diego F. M.; Vieira, Silvia R. R.

    2017-01-01

    After cardiac arrest, organ damage consequent to ischemia-reperfusion has been attributed to oxidative stress. Mild therapeutic hypothermia has been applied to reduce this damage, and it may reduce oxidative damage as well. This study aimed to compare oxidative damage and antioxidant defenses in patients treated with controlled normothermia versus mild therapeutic hypothermia during postcardiac arrest syndrome. The sample consisted of 31 patients under controlled normothermia (36°C) and 11 patients treated with 24 h mild therapeutic hypothermia (33°C), victims of in- or out-of-hospital cardiac arrest. Parameters were assessed at 6, 12, 36, and 72 h after cardiac arrest in the central venous blood samples. Hypothermic and normothermic patients had similar S100B levels, a biomarker of brain injury. Xanthine oxidase activity is similar between hypothermic and normothermic patients; however, it decreases posthypothermia treatment. Xanthine oxidase activity is positively correlated with lactate and S100B and inversely correlated with pH, calcium, and sodium levels. Hypothermia reduces malondialdehyde and protein carbonyl levels, markers of oxidative damage. Concomitantly, hypothermia increases the activity of erythrocyte antioxidant enzymes superoxide dismutase, glutathione peroxidase, and glutathione S-transferase while decreasing the activity of serum paraoxonase-1. These findings suggest that mild therapeutic hypothermia reduces oxidative damage and alters antioxidant defenses in postcardiac arrest patients. PMID:28553435

  17. Vascular and Cardiac Target Organ Damage in Type 2 Diabetics With and Without Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    Francisco Leon-Garrigosa

    2013-08-01

    Conclusions: Although the sample size limited the conclusions that could be drawn between diabetic retinopathy and levels of vascular and cardiac target organ damage, trends were observed in a number of indices for these conditions and measures thereof. [Arch Clin Exp Surg 2013; 2(4.000: 212-218

  18. [Causes and management of severe acute liver damage during pregnancy].

    Science.gov (United States)

    Sepulveda-Martinez, Alvaro; Romero, Carlos; Juarez, Guido; Hasbun, Jorge; Parra-Cordero, Mauro

    2015-05-01

    Abnormalities in liver function tests appear in 3% of pregnancies. Severe acute liver damage can be an exclusive condition of pregnancy (dependent or independent of pre-eclampsia) or a concomitant disease. HELLP syndrome and acute fatty liver of pregnancy are the most severe liver diseases associated with pregnancy. Both appear during the third trimester and have a similar clinical presentation. Acute fatty liver may be associated with hypoglycemia and HELLP syndrome is closely linked with pre-eclampsia. Among concomitant conditions, fulminant acute hepatitis caused by medications or virus is the most severe disease. Its clinical presentation may be hyper-acute with neurological involvement and severe coagulation disorders. It has a high mortality and patients should be transplanted. Fulminant hepatic failure caused by acetaminophen overdose can be managed with n-acetyl cysteine. Because of the high fetal mortality rate, the gestational age at diagnosis is crucial.

  19. Severe core damage experiments and analysis for CANDU applications

    International Nuclear Information System (INIS)

    Mathew, P.M.; White, A.J.; Snell, V.G.; Bonechi, M.

    2003-01-01

    AECL uses the MAAP CANDU code to calculate the progression of a severe core damage accident in a CANDU reactor to support Level 2 Probabilistic Safety Assessment and Severe Accident Management activities. Experimental data are required to ensure that the core damage models used in MAAP CANDU code are adequate. In SMiRT 16, details of single channel experiments were presented to elucidate the mechanisms of core debris formation. This paper presents the progress made in severe core damage experiments since then using single channels in an inert atmosphere and results of the model development work to support the experiments. The core disassembly experiments are conducted with one-fifth scale channels made of Zr-2.5wt%Nb containing twelve simulated fuel bundles in an inert atmosphere. The reference fuel channel geometry consists of a pressure tube/calandria tube composite, with the pressure tube ballooned into circumferential contact with the calandria tube. Experimental results from single channel tests showed the development of time-dependent sag when the reference channel temperature exceeded 850 degC. The test results also showed significant strain localization in the gap at the bundle junctions along the bottom side of the channel, thus suggesting creep to be the main deformation mechanism for debris formation. An ABAQUS finite element model using two-dimensional beam elements with circular cross-section was developed to explain the experimental findings. A comparison of the calculated central sag (at mid-span), the axial displacement at the free end of the channel and the post-test sag profile showed good agreement with the experiments, when strain localization was included in the model, suggesting such a simple modelling approach would be adequate to explain the test findings. The results of the tests are important not only in the context of the validation of the analytical tools and models adopted by AECL for the severe accident analysis of CANDU reactors but

  20. Power Burst Facility Severe Fuel Damage test series

    International Nuclear Information System (INIS)

    Buescher, B.J.; Osetek, D.J.; Ploger, S.A.

    1982-01-01

    The Severe Fuel Damage (SFD) tests planned for the Power Burst Facility (PBF) are described. Bundles containing 32 zircaloy-clad, PWR-type fuel rods will be subjected to severe overheating transients in a high-pressure, superheated-steam environment. Cladding temperatures are expected to reach 2400 0 K, resulting in cladding ballooning and rupture, severe cladding oxidation, cladding melting, fuel dissolution, fuel rod fragmentation, and possibly, rubble bed formation. An experiment effluent collection system is being installed and the PBF fission product monitoring system is being upgraded to meet the special requirements of the SFD tests. Scoping calculations were performed to evaluate performance of the SFD test design and to establish operational requirements for the PBF loop

  1. Management of severely damaged nuclear fuel and related waste

    International Nuclear Information System (INIS)

    1991-01-01

    This report is concerned primarily with severe fuel damage accidents in large electric power producing reactors such as those in the TMI and Chernobyl plants. It does include, as appropriate, knowledge gained from accidents in other power, research and military reactors. It is believed that the conclusions and recommendations apply to a large extent to severe fuel damage accidents in all types of reactors. The period considered in this publication begins after the initial crisis of an accident has been brought under control. (This initial crisis could be from one day to several weeks after the event, depending on the specific conditions). Accordingly, it is assumed that the plant is shut down, the reactor is under control and decay heat removal is in progress in a stable manner so that attention must be given to cleanup. This report addresses the principles involved in planning, engineering, construction, operation and other activities to characterize, clean up and dispose of the fuel and related waste. The end of the period under consideration is when the fuel and abnormal wastes are packaged either for interim storage or final disposal and activities are started either to restore the plant to service or to establish a safe state from which decommissioning planning can start. 36 refs, 3 figs, 4 tabs.

  2. Instrumentation needs in LWR severe fuel damage experiments

    International Nuclear Information System (INIS)

    McCormick, R.D.

    1980-01-01

    The Class 9 type nuclear accident is defined and the Three Mile Island type accident and proposed Idaho National Engineering Laboratory experiment series are described in some detail. Different types of severe fuel damage experiments are briefly discussed in order to show typical measurement requirements. General instrumentation needs and problems encountered in Class 9 accident research are outlined. It is concluded that the extremely high temperatures, high nuclear radiation fields, and oxidizing atmosphere will necessitate instrument development programs. Noncontact type sensing will be necessary in most of the molten core experiments

  3. Cardiac tamponade in a patient with severe dengue fever

    Directory of Open Access Journals (Sweden)

    Ana Isabel Vieira Fernandes

    Full Text Available Abstract A 26-year-old postpartum female presented with symptoms characteristic of dengue fever on the 16th day of puerperium. On the third day of the illness, the patient presented a clinical picture consistent with shock. Tests determined primary infection with dengue virus serotype 2. Cardiac tamponade was confirmed by echocardiography. This rare manifestation is described in a patient without any associated comorbidity.

  4. Modeling of reflood of severely damaged reactor core

    International Nuclear Information System (INIS)

    Bachrata, A.

    2012-01-01

    The TMI-2 accident and recently Fukushima accident demonstrated that the nuclear safety philosophy has to cover accident sequences involving massive core melt in order to develop reliable mitigation strategies for both, existing and advanced reactors. Although severe accidents are low likelihood and might be caused only by multiple failures, accident management is implemented for controlling their course and mitigating their consequences. In case of severe accident, the fuel rods may be severely damaged and oxidized. Finally, they collapse and form a debris bed on core support plate. Removal of decay heat from a damaged core is a challenging issue because of the difficulty for water to penetrate inside a porous medium. The reflooding (injection of water into core) may be applied only if the availability of safety injection is recovered during accident. If the injection becomes available only in the late phase of accident, water will enter a core configuration that will differ from original rod bundle geometry and will resemble to the severe damaged core observed in TMI-2. The higher temperatures and smaller hydraulic diameters in a porous medium make the coolability more difficult than for intact fuel rods under typical loss of coolant accident conditions. The modeling of this kind of hydraulic and heat transfer is a one of key objectives of this. At IRSN, part of the studies is realized using an European thermo-hydraulic computer code for severe accident analysis ICARE-CATHARE. The objective of this thesis is to develop a 3D reflood model (implemented into ICARE-CATHARE) that is able to treat different configurations of degraded core in a case of severe accident. The proposed model is characterized by treating of non-equilibrium thermal between the solid, liquid and gas phase. It includes also two momentum balance equations. The model is based on a previously developed model but is improved in order to take into account intense boiling regimes (in particular

  5. Severe antiphospholipid syndrome and cardiac surgery: Perioperative management.

    Science.gov (United States)

    Mishra, Pankaj Kumar; Khazi, Fayaz Mohammed; Yiu, Patrick; Billing, John Stephen

    2016-06-01

    Antiphospholipid syndrome is an antiphospholipid antibody-mediated prothrombotic state leading to arterial and venous thrombosis. This condition alters routine in-vitro coagulation tests, making results unreliable. Antiphospholipid syndrome patients requiring cardiac surgery with cardiopulmonary bypass present a unique challenge in perioperative anticoagulation management. We describe 3 patients with antiphospholipid syndrome who had successful heart valve surgery at our institution. We have devised an institutional protocol for antiphospholipid syndrome patients, and all 3 patients were managed according to this protocol. An algorithm-based approach is recommended because it improves team work, optimizes treatment, and improves patient outcome. © The Author(s) 2015.

  6. The diagnosis of anthracycline-induced cardiac damage and heart failure

    Directory of Open Access Journals (Sweden)

    Jarosław Dudka

    2009-05-01

    Full Text Available Routine examinations during chemotherapy containing anthracyclines evaluate heart function before treatment and monitor cardiotoxic effects during and after therapy. A number of methods are useful in cardiac assessment, including electrocardiography, radiology techniques (RTG, CT, MRI, PET-CT, PET-MRI, echocardiography, radioisotope imaging techniques (scyntygraphy, MUGA, PET, and ultra-structure evaluation in biopsy samples. Nevertheless, there is a continuous need for new methods to predict future damage at the initial stages of cardiac changes. In recent years the therapeutic usefulness of biochemical blood parameters in anthracycline-treated patients has been assessed. The levels of cardiac troponines (cTnI, cTnT, natriuretic peptides (ANP, BNP, and endothelin 1 have been included in the studies. Heart-type fatty acid binding protein (H-FABP is another promising factor showing cardiomyocytic impairment. However, the clinical use of biochemical parameters in diagnosing anthracycline-related cardiotoxicity is still a controversial issue.

  7. Role of the immune system in cardiac tissue damage and repair following myocardial infarction.

    Science.gov (United States)

    Saparov, Arman; Ogay, Vyacheslav; Nurgozhin, Talgat; Chen, William C W; Mansurov, Nurlan; Issabekova, Assel; Zhakupova, Jamilya

    2017-09-01

    The immune system plays a crucial role in the initiation, development, and resolution of inflammation following myocardial infarction (MI). The lack of oxygen and nutrients causes the death of cardiomyocytes and leads to the exposure of danger-associated molecular patterns that are recognized by the immune system to initiate inflammation. At the initial stage of post-MI inflammation, the immune system further damages cardiac tissue to clear cell debris. The excessive production of reactive oxygen species (ROS) by immune cells and the inability of the anti-oxidant system to neutralize ROS cause oxidative stress that further aggravates inflammation. On the other hand, the cells of both innate and adaptive immune system and their secreted factors are critically instrumental in the very dynamic and complex processes of regulating inflammation and mediating cardiac repair. It is important to decipher the balance between detrimental and beneficial effects of the immune system in MI. This enables us to identify better therapeutic targets for reducing the infarct size, sustaining the cardiac function, and minimizing the likelihood of heart failure. This review discusses the role of both innate and adaptive immune systems in cardiac tissue damage and repair in experimental models of MI.

  8. Elevated Plasma Cardiac Troponin T Levels Caused by Skeletal Muscle Damage in Pompe Disease.

    Science.gov (United States)

    Wens, Stephan C A; Schaaf, Gerben J; Michels, Michelle; Kruijshaar, Michelle E; van Gestel, Tom J M; In 't Groen, Stijn; Pijnenburg, Joon; Dekkers, Dick H W; Demmers, Jeroen A A; Verdijk, Lex B; Brusse, Esther; van Schaik, Ron H N; van der Ploeg, Ans T; van Doorn, Pieter A; Pijnappel, W W M Pim

    2016-02-01

    Elevated plasma cardiac troponin T (cTnT) levels in patients with neuromuscular disorders may erroneously lead to the diagnosis of acute myocardial infarction or myocardial injury. In 122 patients with Pompe disease, the relationship between cTnT, cardiac troponin I, creatine kinase (CK), CK-myocardial band levels, and skeletal muscle damage was assessed. ECG and echocardiography were used to evaluate possible cardiac disease. Patients were divided into classic infantile, childhood-onset, and adult-onset patients. cTnT levels were elevated in 82% of patients (median 27 ng/L, normal values normal in all patients, whereas CK-myocardial band levels were increased in 59% of patients. cTnT levels correlated with CK levels in all 3 subgroups (Pmass index measured with echocardiography was normal in all the 3 subgroups. cTnT mRNA expression in skeletal muscle was not detectable in controls but was strongly induced in patients with Pompe disease. cTnT protein was identified by mass spectrometry in patient-derived skeletal muscle tissue. Elevated plasma cTnT levels in patients with Pompe disease are associated with skeletal muscle damage, rather than acute myocardial injury. Increased cTnT levels in Pompe disease and likely other neuromuscular disorders should be interpreted with caution to avoid unnecessary cardiac interventions. © 2016 American Heart Association, Inc.

  9. Influence of coffee pruning on the severity of frost damage

    Directory of Open Access Journals (Sweden)

    Armando Androcioli Filho

    2000-01-01

    Full Text Available Frost damages in a field experiment of pruning types and systems for the cultivars of Coffea arabica Catuaí and Mundo Novo, were evaluated at Londrina (23º22’S, 52º10´W, State of Parana, southern Brazil, during the winter of 1990 and 1994. Pruning types evaluated were ‘esqueletamento’ (cutting off all plagiotropic branches at 20-30 cm from the orthotropic branch, ‘decote’ (cutting off the orthotropic branch at 1.5 m and 2.0 m above ground and ‘recepa’ (cutting off the orthotropic branch at 0.8 m above ground, performed on all rows and on alternate rows, and on different sections of the plant. Results indicated that frost damage could increase according to the type and height of pruning. The pruning type ‘esqueletamento’ and prunings at higher levels were more suitable for regions with frost risk. Under severe frost condition, pruning type did not affect the damage in anyone of the treatments evaluated.Foram avaliados os danos causados pelas geadas ocorridas em 1990 e 1994 em cafeeiros de duas cultivares de Coffea arabica L., Catuaí e Mundo Novo, conduzidos em Londrina-PR. Os tipos e sistemas de podas aplicados foram o esqueletamento a 20-30 cm do tronco, decote a 1,5 m e 2,0 m de altura e recepa a 0,80 m de altura. As podas foram feitas em área total e em linhas alternadas e em diferentes partes da planta. Os dados obtidos indicaram que os danos por geada podem ser intensificados em função do tipo e altura da poda. A poda do tipo esqueletamento e as podas altas são mais indicadas para o manejo das lavouras nas regiões mais sujeitas ao fenômeno de geada. No caso de geada severa, todos os cafeeiros foram afetados, independente do tipo de poda.

  10. Cardiac sympathetic neuronal damage precedes myocardial fibrosis in patients with Anderson-Fabry disease

    International Nuclear Information System (INIS)

    Imbriaco, Massimo; Piscopo, Valentina; Ponsiglione, Andrea; Nappi, Carmela; Puglia, Marta; Dell'Aversana, Serena; Spinelli, Letizia; Cuocolo, Alberto; Pellegrino, Teresa; Petretta, Mario; Riccio, Eleonora; Pisani, Antonio

    2017-01-01

    Cardiac sympathetic denervation may be detectable in patients with Anderson-Fabry disease (AFD), suggesting its usefulness for early detection of the disease. However, the relationship between sympathetic neuronal damage measured by 123 I-metaiodobenzylguanidine (MIBG) imaging with myocardial fibrosis on cardiac magnetic resonance (CMR) is still unclear. Cardiac sympathetic innervation was assessed by 123 I-MIBG single-photon emission computed tomography (SPECT) in 25 patients with genetically proved AFD. Within one month from MIBG imaging, all patients underwent contrast-enhanced CMR. MIBG defect size and fibrosis size on CMR were measured for the left ventricle (LV) and expressed as %LV. Patients were divided into three groups according to MIBG and CMR findings: (1) matched normal, without MIBG defects and without fibrosis on CMR (n = 10); (2) unmatched, with MIBG defect but without fibrosis (n = 5); and (3) matched abnormal, with MIBG defect and fibrosis (n = 10). The three groups did not differ with respect to age, gender, α-galactosidase, proteinuria, glomerular filtration rate, and troponin I, while New York Heart Association class (p = 0.008), LV hypertrophy (p = 0.05), and enzyme replacement therapy (p = 0.02) were different among groups. Although in patients with matched abnormal findings, there was a significant correlation between MIBG defect size and area of fibrosis at CMR (r 2 = 0.98, p < 0.001), MIBG defect size was larger than fibrosis size (26 ± 23 vs. 18 ± 13%LV, p = 0.02). Sympathetic neuronal damage is frequent in AFD patients, and it may precede myocardial damage, such as fibrosis. Thus, 123 I-MIBG imaging can be considered a challenging technique for early detection of cardiac involvement in AFD. (orig.)

  11. Cardiac sympathetic neuronal damage precedes myocardial fibrosis in patients with Anderson-Fabry disease

    Energy Technology Data Exchange (ETDEWEB)

    Imbriaco, Massimo; Piscopo, Valentina; Ponsiglione, Andrea; Nappi, Carmela; Puglia, Marta; Dell' Aversana, Serena; Spinelli, Letizia; Cuocolo, Alberto [University Federico II, Department of Advanced Biomedical Sciences, Naples (Italy); Pellegrino, Teresa [National Council of Research, Institute of Biostructure and Bioimaging, Naples (Italy); Petretta, Mario [University Federico II, Department of Translational Medical Sciences, Naples (Italy); Riccio, Eleonora; Pisani, Antonio [University of Naples Federico II, Department of Public Health, Naples (Italy)

    2017-12-15

    Cardiac sympathetic denervation may be detectable in patients with Anderson-Fabry disease (AFD), suggesting its usefulness for early detection of the disease. However, the relationship between sympathetic neuronal damage measured by {sup 123}I-metaiodobenzylguanidine (MIBG) imaging with myocardial fibrosis on cardiac magnetic resonance (CMR) is still unclear. Cardiac sympathetic innervation was assessed by {sup 123}I-MIBG single-photon emission computed tomography (SPECT) in 25 patients with genetically proved AFD. Within one month from MIBG imaging, all patients underwent contrast-enhanced CMR. MIBG defect size and fibrosis size on CMR were measured for the left ventricle (LV) and expressed as %LV. Patients were divided into three groups according to MIBG and CMR findings: (1) matched normal, without MIBG defects and without fibrosis on CMR (n = 10); (2) unmatched, with MIBG defect but without fibrosis (n = 5); and (3) matched abnormal, with MIBG defect and fibrosis (n = 10). The three groups did not differ with respect to age, gender, α-galactosidase, proteinuria, glomerular filtration rate, and troponin I, while New York Heart Association class (p = 0.008), LV hypertrophy (p = 0.05), and enzyme replacement therapy (p = 0.02) were different among groups. Although in patients with matched abnormal findings, there was a significant correlation between MIBG defect size and area of fibrosis at CMR (r{sup 2} = 0.98, p < 0.001), MIBG defect size was larger than fibrosis size (26 ± 23 vs. 18 ± 13%LV, p = 0.02). Sympathetic neuronal damage is frequent in AFD patients, and it may precede myocardial damage, such as fibrosis. Thus, {sup 123}I-MIBG imaging can be considered a challenging technique for early detection of cardiac involvement in AFD. (orig.)

  12. Chronic fatigue syndrome: illness severity, sedentary lifestyle, blood volume and evidence of diminished cardiac function.

    Science.gov (United States)

    Hurwitz, Barry E; Coryell, Virginia T; Parker, Meela; Martin, Pedro; Laperriere, Arthur; Klimas, Nancy G; Sfakianakis, George N; Bilsker, Martin S

    2009-10-19

    The study examined whether deficits in cardiac output and blood volume in a CFS (chronic fatigue syndrome) cohort were present and linked to illness severity and sedentary lifestyle. Follow-up analyses assessed whether differences in cardiac output levels between CFS and control groups were corrected by controlling for cardiac contractility and TBV (total blood volume). The 146 participants were subdivided into two CFS groups based on symptom severity data, severe (n=30) and non-severe (n=26), and two healthy non-CFS control groups based on physical activity, sedentary (n=58) and non-sedentary (n=32). Controls were matched to CFS participants using age, gender, ethnicity and body mass. Echocardiographic measures indicated that the severe CFS participants had 10.2% lower cardiac volume (i.e. stroke index and end-diastolic volume) and 25.1% lower contractility (velocity of circumferential shortening corrected by heart rate) than the control groups. Dual tag blood volume assessments indicated that the CFS groups had lower TBV, PV (plasma volume) and RBCV (red blood cell volume) than control groups. Of the CFS subjects with a TBV deficit (i.e. > or = 8% below ideal levels), the mean+/-S.D. percentage deficit in TBV, PV and RBCV were -15.4+/-4.0, -13.2+/-5.0 and -19.1+/-6.3% respectively. Lower cardiac volume levels in CFS were substantially corrected by controlling for prevailing TBV deficits, but were not affected by controlling for cardiac contractility levels. Analyses indicated that the TBV deficit explained 91-94% of the group differences in cardiac volume indices. Group differences in cardiac structure were offsetting and, hence, no differences emerged for left ventricular mass index. Therefore the findings indicate that lower cardiac volume levels, displayed primarily by subjects with severe CFS, were not linked to diminished cardiac contractility levels, but were probably a consequence of a co-morbid hypovolaemic condition. Further study is needed to address

  13. Dependency of blood pressure upon cardiac filling in patients with severe postural hypotension

    DEFF Research Database (Denmark)

    Mehlsen, J; Haedersdal, C; Stokholm, K H

    1994-01-01

    by vasoconstriction. The reduction in cardiac output resulted from reductions in left ventricular end-diastolic volumes with unchanged left ventricular ejection fractions and only moderate increments in heart rate. The study was demonstrated that blood pressure is strongly dependent upon cardiac filling in severe......Autonomic denervation of the vascular bed results theoretically in a stronger dependency of blood pressure upon intravascular volume, and the study described aimed at an investigation of the relation between cardiac filling and arterial blood pressure in patients with severe postural hypotension....... Seven patients were studied during head-up tilt at three different tilt angles using intra-arterial blood pressure recordings and estimates of left ventricular volumes by radioisotope ventriculography. Blood pressure fell dramatically during head-up tilt due to reductions in cardiac output unopposed...

  14. Dependency of blood pressure upon cardiac filling in patients with severe postural hypotension

    DEFF Research Database (Denmark)

    Mehlsen, J; Haedersdal, C; Stokholm, K H

    1994-01-01

    Autonomic denervation of the vascular bed results theoretically in a stronger dependency of blood pressure upon intravascular volume, and the study described aimed at an investigation of the relation between cardiac filling and arterial blood pressure in patients with severe postural hypotension....... Seven patients were studied during head-up tilt at three different tilt angles using intra-arterial blood pressure recordings and estimates of left ventricular volumes by radioisotope ventriculography. Blood pressure fell dramatically during head-up tilt due to reductions in cardiac output unopposed...... by vasoconstriction. The reduction in cardiac output resulted from reductions in left ventricular end-diastolic volumes with unchanged left ventricular ejection fractions and only moderate increments in heart rate. The study was demonstrated that blood pressure is strongly dependent upon cardiac filling in severe...

  15. Cardiac hyporesponsiveness in severe sepsis is associated with nitric oxide-dependent activation of G protein receptor kinase.

    Science.gov (United States)

    Dal-Secco, Daniela; DalBó, Silvia; Lautherbach, Natalia E S; Gava, Fábio N; Celes, Mara R N; Benedet, Patricia O; Souza, Adriana H; Akinaga, Juliana; Lima, Vanessa; Silva, Katiussia P; Kiguti, Luiz Ricardo A; Rossi, Marcos A; Kettelhut, Isis C; Pupo, André S; Cunha, Fernando Q; Assreuy, Jamil

    2017-07-01

    G protein-coupled receptor kinase isoform 2 (GRK2) has a critical role in physiological and pharmacological responses to endogenous and exogenous substances. Sepsis causes an important cardiovascular dysfunction in which nitric oxide (NO) has a relevant role. The present study aimed to assess the putative effect of inducible NO synthase (NOS2)-derived NO on the activity of GRK2 in the context of septic cardiac dysfunction. C57BL/6 mice were submitted to severe septic injury by cecal ligation and puncture (CLP). Heart function was assessed by isolated and perfused heart, echocardiography, and β-adrenergic receptor binding. GRK2 was determined by immunofluorescence and Western blot analysis in the heart and isolated cardiac myocytes. Sepsis increased NOS2 expression in the heart, increased plasma nitrite + nitrate levels, and reduced isoproterenol-induced isolated ventricle contraction, whole heart tension development, and β-adrenergic receptor density. Treatment with 1400W or with GRK2 inhibitor prevented CLP-induced cardiac hyporesponsiveness 12 and 24 h after CLP. Increased labeling of total and phosphorylated GRK2 was detected in hearts after CLP. With treatment of 1400W or in hearts taken from septic NOS2 knockout mice, the activation of GRK2 was reduced. 1400W or GRK2 inhibitor reduced mortality, improved echocardiographic cardiac parameters, and prevented organ damage. Therefore, during sepsis, NOS2-derived NO increases GRK2, which leads to a reduction in β-adrenergic receptor density, contributing to the heart dysfunction. Isolated cardiac myocyte data indicate that NO acts through the soluble guanylyl cyclase/cGMP/PKG pathway. GRK2 inhibition may be a potential therapeutic target in sepsis-induced cardiac dysfunction. NEW & NOTEWORTHY The main novelty presented here is to show that septic shock induces cardiac hyporesponsiveness to isoproterenol by a mechanism dependent on nitric oxide and mediated by G protein-coupled receptor kinase isoform 2. Therefore

  16. Cardiac Organ Damage and Arterial Stiffness in Autonomic Failure: Comparison With Essential Hypertension.

    Science.gov (United States)

    Milazzo, Valeria; Maule, Simona; Di Stefano, Cristina; Tosello, Francesco; Totaro, Silvia; Veglio, Franco; Milan, Alberto

    2015-12-01

    Autonomic failure (AF) is characterized by orthostatic hypotension, supine hypertension, and increased blood pressure (BP) variability. AF patients develop cardiac organ damage, similarly to essential hypertension (EH), and have higher arterial stiffness than healthy controls. Determinants of cardiovascular organ damage in AF are not well known: both BP variability and mean BP values may be involved. The aim of the study was to evaluate cardiac organ damage, arterial stiffness, and central hemodynamics in AF, compared with EH subjects with similar 24-hour BP and a group of healthy controls, and to evaluate determinants of target organ damage in patients with AF. Twenty-seven patients with primary AF were studied (mean age, 65.7±11.2 years) using transthoracic echocardiography, carotid-femoral pulse wave velocity, central hemodynamics, and 24-hour ambulatory BP monitoring. They were compared with 27 EH subjects matched for age, sex, and 24-hour mean BP and with 27 healthy controls. AF and EH had similar left ventricular mass (101.6±33.3 versus 97.7±28.1 g/m(2), P=0.59) and carotid-femoral pulse wave velocity (9.3±1.8 versus 9.2±3.0 m/s, P=0.93); both parameters were significantly lower in healthy controls (Phypertensive heart disease and increased arterial stiffness, similar to EH with comparable mean BP values. Twenty-four-hour and nighttime systolic BP were determinants of cardiovascular damage, independent of BP variability. © 2015 American Heart Association, Inc.

  17. Fission neutron damage rates and efficiencies in several metals

    International Nuclear Information System (INIS)

    Klabunde, C.E.; Coltman, R.R. Jr.

    1981-11-01

    Initial rates of resistivity-measured low-temperature damage production by fission-spectrum fast neutrons have been determined for 14 metals in the same very well characterized irradiation facility. Six of these metals were fcc, 5 bcc, and 3 hcp. Most were of quite high purity. Observed damage rates, after correction for all known extraneous resistivity-producing effects, were compared with rates predicted by the damage calculation code RECOIL, using parameters chosen from the literature. These parameters, effective displacement threshold energy, E/sub d/, and Frenkel-pair resistivity, rho/sub F/, were in many cases only best estimates, the further refinement of which may be aided by the present results. Damage efficiencies (measured/predicted rates) follow the same trends by crystal classes as seen in other fast-neutron studies

  18. Severe Obesity in Adolescents and Young Adults Is Associated With Subclinical Cardiac and Vascular Changes.

    Science.gov (United States)

    Shah, Amy S; Dolan, Lawrence M; Khoury, Philip R; Gao, Zhiqan; Kimball, Thomas R; Urbina, Elaine M

    2015-07-01

    Severe obesity is the fastest growing subgroup of obesity in youth. We sought to explore the association between severe obesity and subclinical measures of cardiac and vascular structure and function in adolescents and young adults. This was a cross-sectional comparison of 265 adolescents and young adults with severe obesity (defined as body mass index [BMI] ≥120% of the 95th percentile) to 182 adolescents and young adults with obesity (defined as BMI ≥100-119th of the 95th percentile) at tertiary medical center. Noninvasive measures of cardiac and vascular structure and function were assessed. Participants were a mean age of 17.9 years, 62% were non-Caucasian, and 68% were female. Systolic blood pressure, fasting insulin, C-reactive protein, IL-6, and frequency of type 2 diabetes were higher in participants with severe obesity (all P obesity as measured by higher left ventricular mass index, worse diastolic function, higher carotid intima media thickness, and pulse wave velocity and lower brachial distensibility (all P obesity (compared with obesity) was independently associated with each of the above outcomes after adjustment for age, race, sex, blood pressure, lipids, and inflammatory markers (P young adults with severe obesity have a more adverse cardiovascular risk profile and worse cardiac and vascular structure and function. More importantly, severe obesity is independently associated with these subclinical cardiac and vascular changes.

  19. A Tensor-Based Structural Damage Identification and Severity Assessment

    Science.gov (United States)

    Anaissi, Ali; Makki Alamdari, Mehrisadat; Rakotoarivelo, Thierry; Khoa, Nguyen Lu Dang

    2018-01-01

    Early damage detection is critical for a large set of global ageing infrastructure. Structural Health Monitoring systems provide a sensor-based quantitative and objective approach to continuously monitor these structures, as opposed to traditional engineering visual inspection. Analysing these sensed data is one of the major Structural Health Monitoring (SHM) challenges. This paper presents a novel algorithm to detect and assess damage in structures such as bridges. This method applies tensor analysis for data fusion and feature extraction, and further uses one-class support vector machine on this feature to detect anomalies, i.e., structural damage. To evaluate this approach, we collected acceleration data from a sensor-based SHM system, which we deployed on a real bridge and on a laboratory specimen. The results show that our tensor method outperforms a state-of-the-art approach using the wavelet energy spectrum of the measured data. In the specimen case, our approach succeeded in detecting 92.5% of induced damage cases, as opposed to 61.1% for the wavelet-based approach. While our method was applied to bridges, its algorithm and computation can be used on other structures or sensor-data analysis problems, which involve large series of correlated data from multiple sensors. PMID:29301314

  20. Cardiac damage after treatment of childhood cancer: A long-term follow-up

    International Nuclear Information System (INIS)

    Velensek, Veronika; Mazic, Uros; Krzisnik, Ciril; Demšar, Damjan; Jazbec, Janez; Jereb, Berta

    2008-01-01

    With improved childhood cancer cure rate, long term sequelae are becoming an important factor of quality of life. Signs of cardiovascular disease are frequently found in long term survivors of cancer. Cardiac damage may be related to irradiation and chemotherapy. We have evaluated simultaneous influence of a series of independent variables on the late cardiac damage in childhood cancer survivors in Slovenia and identified groups at the highest risk. 211 long-term survivors of different childhood cancers, at least five years after treatment were included in the study. The evaluation included history, physical examination, electrocardiograpy, exercise testing and echocardiograpy. For analysis of risk factors, beside univariate analysis, multivariate classification tree analysis statistical method was used. Patients treated latest, from 1989–98 are at highest risk for any injury to the heart (73%). Among those treated earlier are at the highest risk those with Hodgkin's disease treated with irradiation above 30 Gy and those treated for sarcoma. Among specific forms of injury, patients treated with radiation to the heart area are at highest risk of injury to the valves. Patients treated with large doses of anthracyclines or concomitantly with anthracyclines and alkylating agents are at highest risk of systolic function defect and enlarged heart chambers. Those treated with anthracyclines are at highest risk of diastolic function defect. The time period of the patient's treatment is emerged as an important risk factor for injury of the heart

  1. Cardiac Complications, Earlier Treatment, and Initial Disease Severity in Kawasaki Disease.

    Science.gov (United States)

    Abrams, Joseph Y; Belay, Ermias D; Uehara, Ritei; Maddox, Ryan A; Schonberger, Lawrence B; Nakamura, Yosikazu

    2017-09-01

    To assess if observed higher observed risks of cardiac complications for patients with Kawasaki disease (KD) treated earlier may reflect bias due to confounding from initial disease severity, as opposed to any negative effect of earlier treatment. We used data from Japanese nationwide KD surveys from 1997 to 2004. Receipt of additional intravenous immunoglobulin (IVIG) (data available all years) or any additional treatment (available for 2003-2004) were assessed as proxies for initial disease severity. We determined associations between earlier or later IVIG treatment (defined as receipt of IVIG on days 1-4 vs days 5-10 of illness) and cardiac complications by stratifying by receipt of additional treatment or by using logistic modeling to control for the effect of receiving additional treatment. A total of 48 310 patients with KD were included in the analysis. In unadjusted analysis, earlier IVIG treatment was associated with a higher risk for 4 categories of cardiac complications, including all major cardiac complications (risk ratio, 1.10; 95% CI, 1.06-1.15). Stratifying by receipt of additional treatment removed this association, and earlier IVIG treatment became protective against all major cardiac complications when controlling for any additional treatment in logistic regressions (OR, 0.90; 95% CI, 0.80-1.00). Observed higher risks of cardiac complications among patients with KD receiving IVIG treatment on days 1-4 of the illness are most likely due to underlying higher initial disease severity, and patients with KD should continue to be treated with IVIG as early as possible. Published by Elsevier Inc.

  2. Influence of coffee pruning on the severity of frost damage

    OpenAIRE

    Androcioli Filho,Armando; Caramori,Paulo Henrique

    2000-01-01

    Frost damages in a field experiment of pruning types and systems for the cultivars of Coffea arabica Catuaí and Mundo Novo, were evaluated at Londrina (23º22’S, 52º10´W), State of Parana, southern Brazil, during the winter of 1990 and 1994. Pruning types evaluated were ‘esqueletamento’ (cutting off all plagiotropic branches at 20-30 cm from the orthotropic branch), ‘decote’ (cutting off the orthotropic branch at 1.5 m and 2.0 m above ground) and ‘recepa’ (cutting off the orthotropic branch at...

  3. [Relationship between previous severity of illness and outcome of in-hospital cardiac arrest].

    Science.gov (United States)

    Serrano, M; Rodríguez, J; Espejo, A; del Olmo, R; Llanos, S; Del Castillo, J; López-Herce, J

    2014-07-01

    To analyze the relationship between previous severity of illness, lactic acid, creatinine and inotropic index with mortality of in-hospital cardiac arrest (CA) in children, and the value of a prognostic index designed for adults. The study included total of 44 children aged from 1 month to 18 years old who suffered a cardiac arrest while in hospital. The relationship between previous severity of illness scores (PRIMS and PELOD), lactic acid, creatinine, treatment with vasoactive drugs, inotropic index with return of spontaneous circulation and survival at hospital discharge was analyzed. The large majority (90.3%) of patients had a return of spontaneous circulation, and 59% survived at hospital discharge. More than two-thirds (68.2%) were treated with inotropic drugs at the time of the CA. The patients who died had a higher lactic acid before the CA (3.4 mmol/L) than survivors (1.4 mmol/L), P=.04. There were no significant differences in PRIMS, PELOD, creatinine, inotropic drugs, and inotropic index before CA between patients who died and survivors. A high lactic acid previous to cardiac arrest could be a prognostic factor of in-hospital cardiac arrest in children. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  4. Comorbid renal tubular damage and hypoalbuminemia exacerbate cardiac prognosis in patients with chronic heart failure.

    Science.gov (United States)

    Otaki, Yoichiro; Watanabe, Tetsu; Takahashi, Hiroki; Funayama, Akira; Kinoshita, Daisuke; Yokoyama, Miyuki; Takahashi, Tetsuya; Nishiyama, Satoshi; Arimoto, Takanori; Shishido, Tetsuro; Miyamoto, Takuya; Konta, Tsuneo; Kubota, Isao

    2016-02-01

    Renal tubular damage (RTD) and hypoalbuminemia are risks for poor prognosis in patients with chronic heart failure (CHF). Renal tubules play a pivotal role in amino acid and albumin reabsorption, which maintain serum albumin levels. The aims of the present study were to (1) examine the association of RTD with hypoalbuminemia, and (2) assess the prognostic importance of comorbid RTD and hypoalbuminemia in patients with CHF. We measured N-acetyl-β-D-glucosamidase (NAG) levels and the urinary β2-microglobulin to creatinine ratio (UBCR) in 456 patients with CHF. RTD was defined as UBCR ≥ 300 μg/g or NAG ≥ 14.2 U/g. There were moderate correlations between RTD markers and serum albumin (NAG, r = -0.428, P < 0.0001; UBCR, r = -0.399, P < 0.0001). Multivariate logistic analysis showed that RTD was significantly related to hypoalbuminemia in patients with CHF. There were 134 cardiac events during a median period of 808 days. The comorbidity of RTD and hypoalbuminemia was increased with advancing New York Heart Association functional class. Multivariate Cox proportional hazard regression analysis showed that the presence of RTD and hypoalbuminemia was associated with cardiac events. The net reclassification index was significantly improved by adding RTD and hypoalbuminemia to the basic risk factors. Comorbid RTD and hypoalbuminemia are frequently observed and increase the risk for extremely poor outcome in patients with CHF.

  5. DNA damage in lymphocytes induced by cardiac CT and comparison with physical exposure parameters

    Energy Technology Data Exchange (ETDEWEB)

    Fukumoto, Wataru; Tatsugami, Fuminari; Awai, Kazuo [Department of Diagnostic Radiology, Institute of Biomedical Health Sciences, Hiroshima University, Hiroshima (Japan); Ishida, Mari; Sakai, Chiemi [Institute of Biomedical and Health Sciences, Department of Cardiovascular Physiology and Medicine, Hiroshima University, Hiroshima (Japan); Tashiro, Satoshi [Hiroshima University, Department of Cellular Biology, Research Institute for Radiation Biology and Medicine, Hiroshima (Japan); Ishida, Takafumi [Institute of Clinical Research West Medical Center, Hiroshima (Japan); Nakano, Yukiko [Hiroshima University Hospital, Department of Cardiovascular Medicine, Hiroshima (Japan)

    2017-04-15

    To investigate whether physical exposure parameters such as the dose index (CTDI), dose length product (DLP), and size-specific dose estimate (SSDE) are predictive of DNA damage. In vitro, we scanned a phantom containing blood samples from five volunteers at CTDI 50, 100, and 150 mGy. One sample was not scanned. We also scanned samples in three different-size phantoms at CTDI 100 mGy. In vivo, we enrolled 45 patients and obtained blood samples before and after cardiac CT. The γ-H2AX foci were counted. In vitro, in the control and at CTDI 50, 100, and 150 mGy, the number of γ-H2AX was 0.94 ± 0.24 (standard error, SE), 1.28 ± 0.30, 1.91 ± 0.47, and 2.16 ± 0.20. At SSDE 180, 156, and 135 mGy, it was 2.41 ± 0.20, 1.91 ± 0.47, and 1.42 ± 0.20 foci/cell. The γ-H2AX foci were positively correlated with the radiation dose and negatively correlated with the body size. In vivo, the γ-H2AX foci were significantly increased after CT (from 1.21 ± 0.19 to 1.92 ± 0.22 foci/cell) and correlated with CTDI, DLP, and SSDE. DNA damage was induced by cardiac CT. There was a correlation between the physical exposure parameters and γ-H2AX. (orig.)

  6. Experimental study of plasmapheresis therapeutic efficacy in severe radiation damage

    International Nuclear Information System (INIS)

    Legeza, V.I.; Abdul', Yu.A.; Chigareva, N.G.; Petkevich, N.V.; Myasoedov, A.F.; Andryukhin, V.I.; Artemenko, A.G.

    1994-01-01

    In experiments with dogs exposed to 2.9 Gy (LD 80/45 ) it was found that plasmapheresis treatment 4-6 h after irradiation reduce the severity of the radiation sickness clinical manifestations and post-radiation toxemia thus increasing the rate of animal survival up to 60 %. Sham plasmapheresis included all the manipulations of plasmapheretic treatment except plasma substitution and had no detoxication effect and did not affect the irradiated animals survival. This is evidence for leading role of detoxiation in the mechanisms of th therapeutic action of plasmapheresis in acute irradiation

  7. Severe wind phenomena in Southern Africa and the related damage

    CSIR Research Space (South Africa)

    Goliger, Adam M

    2007-10-01

    Full Text Available ) and the major factor promoting the spread of bushfires. 3. Origin and character of severe wind storms A schematic map of the occurrence of strong wind events over southern Africa, based on Griffith (1972), Lundholm (1979), Goliger and Milford (1998... the southern tip of the sub- continent and originate in extra-tropical cyclones. 3. Shallow south-easters, which develop as a result of localised coastal lows. Their influence extends along the western and southern coast of South Africa, from Luderitz...

  8. Validity of Type D personality in Iceland: association with disease severity and risk markers in cardiac patients

    OpenAIRE

    Svansdottir, Erla; Karlsson, Hrobjartur D.; Gudnason, Thorarinn; Olason, Daniel T.; Thorgilsson, Hordur; Sigtryggsdottir, Unnur; Sijbrands, Eric J.; Pedersen, Susanne S.; Denollet, Johan

    2011-01-01

    textabstractType D personality has been associated with poor prognosis in cardiac patients. This study investigated the validity of the Type D construct in Iceland and its association with disease severity and health-related risk markers in cardiac patients. A sample of 1,452 cardiac patients completed the Type D scale (DS14), and a subgroup of 161 patients completed measurements for the five-factor model of personality, emotional control, anxiety, depression, stress and lifestyle factors. Th...

  9. Adult Bone Marrow Mesenchymal Stem Cells Primed for fhe Repair of Damaged Cardiac Tissue After Myocardial Infarction

    Science.gov (United States)

    Marks, Edward D.

    The burden of cardiovascular disease around the world is growing, despite improvements in hospital care and time to treatment. As more people survive an initial myocardial infarction (MI), the decompensated heart tissue is strained, leading to heart failure (HF) and an increased risk for a second MI. While extensive progress has been made in treating the symptoms after MI, including HF and angina, little success has come from repairing the damaged heart tissue to alleviate the progression to these end- stage symptoms. One promising area of regenerative research has been the use of adult stem cells, particularly from the bone marrow (BMSCs). These cells can differentiate towards the cardiac cell lineage in vitro while producing trophic factors that can repair damaged tissue. When placed in the heart after MI though, BMSCs have mixed results, producing profound changes in some patients but zero or even negative effects in others. In this report, we used BMSCs as a stem cell base for a regenerative medicine system for the repair of damaged cardiac tissue. These cells are seeded on a polycaprolactone nanoscaffolding support system, which provides a growth substrate for in vitro work, as well as a housing system for protected in vivo delivery. When the nanoscaffold is pre-coated with a novel combination of a cardiac protein, thymosin beta4 (Tbeta4), and a small molecule effector of the WNT protein pathway, IWP-2, BMSCs differentiated towards the cardiac lineage in as little as 24hours. When injected into rat hearts that have been given an ischemic MI, the nanoscaffolding system slowly dissolves, leaving the cells in place of the damaged cardiac tissue. After two weeks of monitoring, BMSCs are present within the damaged hearts, as evidenced by immunofluorescence and nanoparticle tracking. Injections of the nanoscaffolding/cell system led to robust healing of the rat hearts that had been given small- and medium- damage heart attacks, outperforming PBS sham and cell

  10. Parameters affecting of Akkuyu's safety assessment for severe core damages

    Science.gov (United States)

    Kavun, Yusuf; Karasulu, Muzaffer

    2015-07-01

    We have looked at all past core meltdowns (Three Mile Island, Chernobyl and Fukushima incidents) and postulated the fourth one might be taking place in the future most probably in a newly built reactors anywhere of the earth in any type of NPP. The probability of this observation is high considering the nature of the machine and human interaction. Operation experience is a very significant parameter as well as the safety culture of the host nation. The concerns is not just a lack of experience with industry with the new comers, but also the infrastructure and established institutions who will be dealing with the Emergencies. Lack of trained and educated Emergency Response Organizations (ERO) is a major concern. The culture on simple fire drills even makes the difference when a severe condition occurs in the industry. The study assumes the fourth event will be taking place at the Akkuyu NGS and works backwards as required by the "what went wrong " scenarios and comes up with interesting results. The differences studied in depth to determine the impact to the severe accidents. The all four design have now core catchers. We have looked at the operator errors'like in TMI); Operator errors combined with design deficiencies(like in Chernobyl) and natural disasters( like in Fukushima) and found operator errors to be more probable event on the Akkuyu's postulated next incident. With respect to experiences of the operators we do not have any data except for long and successful operating history of the Soviet design reactors up until the Chernobyl incident. Since the Akkuyu will be built, own and operated by the Russians we have found no alarming concerns at the moment. At the moment, there is no body be able to operate those units in Turkey. Turkey is planning to build the required manpower during the transition period. The resolution of the observed parameters lies to work and educate, train of the host nation and exercise together.

  11. Irradiation induced modest changes in murine cardiac function despite progressive structural damage to the myocardium and microvasculature

    International Nuclear Information System (INIS)

    Seemann, Ingar; Gabriels, Karen; Visser, Nils L.; Hoving, Saske; Poele, Johannes A. te; Pol, Jeffrey F.; Gijbels, Marion J.; Janssen, Ben J.; Leeuwen, Fijs W. van; Daemen, Mat J.; Heeneman, Sylvia; Stewart, Fiona A.

    2012-01-01

    Background: Radiotherapy of thoracic and chest wall tumors increases the long-term risk of cardiotoxicity, but the underlying mechanisms are unclear. Methods: Single doses of 2, 8, or 16 Gy were delivered to the hearts of mice and damage was evaluated at 20, 40, and 60 weeks, relative to age matched controls. Single photon emission computed tomography (SPECT/CT) and ultrasound were used to measure cardiac geometry and function, which was related to histo-morphology and microvascular damage. Results: Gated SPECT/CT and ultrasound demonstrated decreases in end diastolic and systolic volumes, while the ejection fraction was increased at 20 and 40 weeks after 2, 8, and 16 Gy. Cardiac blood volume was decreased at 20 and 60 weeks after irradiation. Histological examination revealed inflammatory changes at 20 and 40 weeks after 8 and 16 Gy. Microvascular density in the left ventricle was decreased at 40 and 60 weeks after 8 and 16 Gy, with functional damage to remaining microvasculature manifest as decreased alkaline phosphatase (2, 8, and 16 Gy), increased von Willebrand Factor and albumin leakage from vessels (8 and 16 Gy), and amyloidosis (16 Gy). 16 Gy lead to sudden death between 30 and 40 weeks in 38% of mice. Conclusions: Irradiation with 2 and 8 Gy induced modest changes in murine cardiac function within 20 weeks but this did not deteriorate further, despite progressive structural and microvascular damage. This indicates that heart function can compensate for significant structural damage, although higher doses, eventually lead to sudden death.

  12. Association of Cardiac Hemodynamic Factors With Severity of White Matter Hyperintensities in Chronic Valvular Heart Disease.

    Science.gov (United States)

    Lee, Woo-Jin; Jung, Keun-Hwa; Ryu, Young Jin; Kim, Jeong-Min; Lee, Soon-Tae; Chu, Kon; Kim, Manho; Lee, Sang Kun; Roh, Jae-Kyu

    2018-01-01

    The cerebral white matter hyperintensity (WMH) is frequently noted in patients with chronic heart disease. Long-term alteration of cardiac hemodynamics might have an influence on the mechanism of cerebral WMH. To investigate the association between chronically altered cardiac hemodynamics and severity of cerebral WMH in patients with chronic valvular heart disease. This cross-sectional analysis identified 303 consecutive patients at a tertiary referral center between 2008 and 2016 who were 50 years or older, and diagnosed with severe chronic valvular heart disease and underwent cardiac catherization, echocardiography, and received brain magnetic resonance imaging. Among these patients, 71 with other demonstrated cardiac disease, central nervous system disease, and/or without sufficient catheterization data were excluded, and the remaining 232 patients were included in further analyses. The site and mechanism of valve diseases, as well as clinical and medication profiles, were reviewed. Cardiac catheterization parameters such as right atrial (RA) mean pressure, right ventricular pressure, and aortic mean pressure were obtained. Comprehensive echocardiographic hemodynamic markers such as left ventricular (LV) ejection fraction, LV mass index, LV end diastolic volume, cardiac index, and E/e' ratio were also obtained. White matter hyperintensity volume was quantitatively evaluated using volumetric analysis. This study included 232 patients (103 men [44.4%] and 129 women [55.6%]; mean [SD] (range) age, 65.6 [8.8] (51-88) years) in the final analysis. The mean (SD) WMH volume was 5.93 (7.14) mL (median [interquartile range], 4.33 [1.33-8.62] mL), and mean (SD) RA pressure was 10.0 (4.7) mm Hg. From the catheterization data, 147 patients (63.4%) were classified as having a disease involving the mitral valve; 93 (40.1%), aortic valve; 37 (15.9%), tricuspid valve; and 4 (1.7%), pulmonary valve. In multivariate linear regression analysis, adjusting the type and mechanism of

  13. Association of cardiac troponin I with disease severity and outcomes in patients with pulmonary hypertension.

    Science.gov (United States)

    Vélez-Martínez, Mariella; Ayers, Colby; Mishkin, Joseph D; Bartolome, Sonja B; García, Christine K; Torres, Fernando; Drazner, Mark H; de Lemos, James A; Turer, Aslan T; Chin, Kelly M

    2013-06-15

    Previous studies have identified cardiac troponin I (cTnI) as an important marker in pulmonary hypertension (PH) prognosis. However, traditional assays are limited by poor sensitivity, even among patients at high risk. cTnI was measured in 255 PH patients using a new highly sensitive (hs) assay. Other measures included demographics, creatinine, 6-minute walk distance, hemodynamics, cardiac magnetic resonance imaging, and B-type natriuretic peptide level. The association between cTnI and survival was assessed using Kaplan-Meier analysis and Cox regression. cTnI was detectable with the hs assay in 95% of the patients with a median level of 6.9 pg/ml (IQR 2.7-12.6 pg/ml). Higher cTnI levels associated with higher levels of B-type natriuretic peptide, shorter 6-minute walk distance, and more severe hemodynamic and cardiac magnetic resonance imaging abnormalities. During a median follow-up of 3.5 years, 60 individuals died. Unadjusted event rates increased across higher cTnI quartiles (3, 5, 13, 17 events/100 person-years, respectively, p trend = 0.002). cTnI in the fourth (vs first) quartile remained associated with death in a final stepwise multivariable model that included clinical variables and hemodynamics (adjusted hazard ratio 5.3, 95% confidence interval 1.8-15.6). In conclusion, cTnI levels, detectable with a novel hs assay, identify patients with PH who have more severe hemodynamic and cardiac structural abnormalities and provide novel and independent prognostic information. This hs assay has the potential to detect more at-risk patients and improve current risk-stratification algorithms. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Effect of fast-track cardiac anesthesia on myocardial oxidative damage, inflammation and nerve related peptides of patients undergoing cardiac operation

    Directory of Open Access Journals (Sweden)

    Xing-Tao Cai

    2016-01-01

    Full Text Available Objective: To study the effect of fast-track cardiac anesthesia on myocardial oxidative damage, inflammation and nerve related peptides of patients undergoing cardiac operation. Methods: Sixty patients with rheumatic heart disease undergoing heart valve surgery were randomly divided into the fast track group (n=30 and conventional group (n=30. Then myocardial injury indicators, mitochondrial oxidative stress indicators, inflammation indicators and nerverelated peptides of both groups were analyzed. Results: cTnI contents at T2-T4 points in time of both groups showed an increasing trend and the increasing trend of fast track group was weaker than that of conventional group; SOD contents as well as mitochondrial tristate respiratory function, respiratory control ratios and phosphorus oxygen ratios in myocardial tissue of fast track group were higher than those of conventional group, and MDA contents was lower than those of conventional group; plasma TNF-α, IL-6, IL-8, NSE, S100β and Aβ contents of fast track group were lower than those of conventional group. Conclusions: Fasttrack cardiac anesthesia can protect myocardial cells, reduce mitochondrial oxidative stress, relieve inflammation and improve nerve function; it is an ideal anesthesia method for cardiac operation.

  15. Medical Image of the Week: Cardiac Magnetic Resonance Imaging Findings of Severe RV Failure

    Directory of Open Access Journals (Sweden)

    Wickstrom K

    2018-05-01

    Full Text Available No abstract available. Article truncated at 150 words. A 56-year-old man with history a of alcohol abuse presents with progressive shortness of breath on exertion, bilateral lower extremity swelling and 12-pound weight gain over two weeks. His transthoracic echocardiography (Figure 1 demonstrated severely increased global right ventricle (RV size, severely dilated right atrium (RA, severe pulmonary artery (PA dilation, moderate tricuspid regurgitation (TR and right ventricular systolic pressure (RVSP estimated at 85 + central venous pressure (CVP in the context of severely reduced RV systolic function. Right heart catheterization (RHC showed PA pressure (systolic/diastolic, mean of 94/28, 51 mmHg with a PA occlusion pressure of 12 mmHg. After extensive evaluation, our patient’s presentation of right heart failure seemed to be a manifestation of idiopathic pulmonary arterial hypertension. Our patient subsequently had cardiac MRI (cMRI with findings shown above (Figure 2. CMRI is a valuable, three-dimensional imaging modality that provides detailed morphology of the cardiac chambers along with accurate …

  16. Global outbreak of severe Mycobacterium chimaera disease after cardiac surgery: a molecular epidemiological study.

    Science.gov (United States)

    van Ingen, Jakko; Kohl, Thomas A; Kranzer, Katharina; Hasse, Barbara; Keller, Peter M; Katarzyna Szafrańska, Anna; Hillemann, Doris; Chand, Meera; Schreiber, Peter Werner; Sommerstein, Rami; Berger, Christoph; Genoni, Michele; Rüegg, Christian; Troillet, Nicolas; Widmer, Andreas F; Becker, Sören L; Herrmann, Mathias; Eckmanns, Tim; Haller, Sebastian; Höller, Christiane; Debast, Sylvia B; Wolfhagen, Maurice J; Hopman, Joost; Kluytmans, Jan; Langelaar, Merel; Notermans, Daan W; Ten Oever, Jaap; van den Barselaar, Peter; Vonk, Alexander B A; Vos, Margreet C; Ahmed, Nada; Brown, Timothy; Crook, Derrick; Lamagni, Theresa; Phin, Nick; Smith, E Grace; Zambon, Maria; Serr, Annerose; Götting, Tim; Ebner, Winfried; Thürmer, Alexander; Utpatel, Christian; Spröer, Cathrin; Bunk, Boyke; Nübel, Ulrich; Bloemberg, Guido V; Böttger, Erik C; Niemann, Stefan; Wagner, Dirk; Sax, Hugo

    2017-10-01

    Since 2013, over 100 cases of Mycobacterium chimaera prosthetic valve endocarditis and disseminated disease were notified in Europe and the USA, linked to contaminated heater-cooler units (HCUs) used during cardiac surgery. We did a molecular epidemiological investigation to establish the source of these patients' disease. We included 24 M chimaera isolates from 21 cardiac surgery-related patients in Switzerland, Germany, the Netherlands, and the UK, 218 M chimaera isolates from various types of HCUs in hospitals, from LivaNova (formerly Sorin; London, UK) and Maquet (Rastatt, Germany) brand HCU production sites, and unrelated environmental sources and patients, as well as eight Mycobacterium intracellulare isolates. Isolates were analysed by next-generation whole-genome sequencing using Illumina and Pacific Biosciences technologies, and compared with published M chimaera genomes. Phylogenetic analysis based on whole-genome sequencing of 250 isolates revealed two major M chimaera groups. Cardiac surgery-related patient isolates were all classified into group 1, in which all, except one, formed a distinct subgroup. This subgroup also comprised isolates from 11 cardiac surgery-related patients reported from the USA, most isolates from LivaNova HCUs, and one from their production site. Isolates from other HCUs and unrelated patients were more widely distributed in the phylogenetic tree. HCU contamination with M chimaera at the LivaNova factory seems a likely source for cardiothoracic surgery-related severe M chimaera infections diagnosed in Switzerland, Germany, the Netherlands, the UK, the USA, and Australia. Protective measures and heightened clinician awareness are essential to guarantee patient safety. Partly funded by the EU Horizon 2020 programme, its FP7 programme, the German Center for Infection Research (DZIF), the Swiss National Science Foundation, the Swiss Federal Office of Public Health, and National Institute of Health Research Oxford Health Protection

  17. PBF Severe Fuel-Damage Program: results and comparison to analysis

    International Nuclear Information System (INIS)

    MacDonald, P.E.; Buescher, B.J.; Hobbins, R.R.; McCardell, R.K.; Gruen, G.E.

    1983-01-01

    The United States Nuclear Regulatory Commission has initiated a severe fuel-damage research program in the Power Burst Facility (PBF) to investigate fuel-rod and core response, and fission-product and hydrogen release and transport under degraded-core-cooling accident conditions. This paper presents a description of Phase I of the PBF Severe Fuel Damage Program, discusses the results of the first experiment, and compares those results with analysis performed using the TRAC-BD1 computer code

  18. Precursors to potential severe core damage accidents: 1992, A status report

    International Nuclear Information System (INIS)

    Cox, D.F.; Cletcher, J.W.; Copinger, D.A.; Cross-Dial, A.E.; Morris, R.H.; Vanden Heuvel, L.N.; Dolan, B.W.; Jansen, J.M.; Minarick, J.W.; Lau, W.; Salyer, W.D.

    1993-12-01

    Twenty-seven operational events with conditional probabilities of subsequent severe core damage of 1.0 x 10E-06 or higher occurring at commercial light-water reactors during 1992 are considered to be precursors to potential core damage. These are described along with associated significance estimates, categorization, and subsequent analyses. The report discusses (1) the general rationale for this study, (2) the selection and documentation of events as precursors, (3) the estimation and use of conditional probabilities of subsequent severe core damage to rank precursor events, and (4) the plant models used in the analysis process

  19. Precursors to potential severe core damage accidents. A status report, 1982--1983

    Energy Technology Data Exchange (ETDEWEB)

    Forester, J.A.; Mitchell, D.B.; Whitehead, D.W. [and others

    1997-04-01

    This study is a continuation of earlier work that evaluated 1969-1981 and 1984-1994 events affecting commercial light-water reactors. One-hundred nine operational events that affected 51 reactors during 1982 and 1983 and that are considered to be precursors to potential severe core damage are described. All these events had conditional probabilities of subsequent severe core damage greater than or equal to 1.0 x 10{sup {minus}6}. These events were identified by first computer screening the 1982-83 licensee event reports from commercial light-water reactors to select events that could be precursors to core damage. Candidates underwent engineering evaluation that identified, analyzed, and documented the precursors. This report discusses the general rationale for the study, the selection and documentation of events as precursors, and the estimation of conditional probabilities of subsequent severe core damage for the events.

  20. Precursors to potential severe core damage accidents. A status report, 1982--1983

    International Nuclear Information System (INIS)

    Forester, J.A.; Mitchell, D.B.; Whitehead, D.W.

    1997-04-01

    This study is a continuation of earlier work that evaluated 1969-1981 and 1984-1994 events affecting commercial light-water reactors. One-hundred nine operational events that affected 51 reactors during 1982 and 1983 and that are considered to be precursors to potential severe core damage are described. All these events had conditional probabilities of subsequent severe core damage greater than or equal to 1.0 x 10 -6 . These events were identified by first computer screening the 1982-83 licensee event reports from commercial light-water reactors to select events that could be precursors to core damage. Candidates underwent engineering evaluation that identified, analyzed, and documented the precursors. This report discusses the general rationale for the study, the selection and documentation of events as precursors, and the estimation of conditional probabilities of subsequent severe core damage for the events

  1. Infarct-like acute myocarditis: relation between electrocardiographic findings and myocardial damage as assessed by cardiac magnetic resonance imaging.

    Science.gov (United States)

    Nucifora, Gaetano; Miani, Daniela; Di Chiara, Antonio; Piccoli, Gianluca; Artico, Jessica; Puppato, Michela; Slavich, Gianaugusto; De Biasio, Marzia; Gasparini, Daniele; Proclemer, Alessandro

    2013-03-01

    Acute myocarditis (AM) may occasionally have an infarct-like presentation. The aim of the present study was to investigate the relation between electrocardiographic (ECG) findings in this group of patients and myocardial damage assessed by cardiac magnetic resonance imaging (MRI) with the late gadolinium enhancement (LGE) technique. Myocardial damage may be associated with ECG changes in infarct-like AM. Forty-one consecutive patients (36 males; mean age, 36 ± 12 years) with diagnosis of AM according to cardiac MRI Lake Louise criteria and infarct-like presentation were included. The relation between site of ST-segment elevation (STE), sum of STE (sumSTE), time to normalization of STE, and development of negative T wave with the extent of LGE (expressed as % of left ventricular mass [%LV LGE]), was evaluated. Most (80%) patients presented with inferolateral STE; mean sumSTE was 5 ± 3 mm. Normalization of STE occurred within 24 hours in 20 (49%) patients. Development of negative T wave occurred in 28 (68%) patients. Cardiac MRI showed LGE in all patients; mean %LV LGE was 9.6 ± 7.2%. Topographic agreement between site of STE and LGE was 68%. At multivariate analysis, sumSTE (β = 0.42, P 24 hours (β = 0.39, P 24 hours, and development of negative T wave) may help to identify patients with larger areas of myocardial damage. © 2012 Wiley Periodicals, Inc.

  2. Indoor microbiota in severely moisture damaged homes and the impact of interventions.

    Science.gov (United States)

    Jayaprakash, Balamuralikrishna; Adams, Rachel I; Kirjavainen, Pirkka; Karvonen, Anne; Vepsäläinen, Asko; Valkonen, Maria; Järvi, Kati; Sulyok, Michael; Pekkanen, Juha; Hyvärinen, Anne; Täubel, Martin

    2017-10-13

    The limited understanding of microbial characteristics in moisture-damaged buildings impedes efforts to clarify which adverse health effects in the occupants are associated with the damage and to develop effective building intervention strategies. The objectives of this current study were (i) to characterize fungal and bacterial microbiota in house dust of severely moisture-damaged residences, (ii) to identify microbial taxa associated with moisture damage renovations, and (iii) to test whether the associations between the identified taxa and moisture damage are replicable in another cohort of homes. We applied bacterial 16S rRNA gene and fungal ITS amplicon sequencing complemented with quantitative PCR and chemical-analytical approaches to samples of house dust, and also performed traditional cultivation of bacteria and fungi from building material samples. Active microbial growth on building materials had significant though small influence on the house dust bacterial and fungal communities. Moisture damage interventions-including actual renovation of damaged homes and cases where families moved to another home-had only a subtle effect on bacterial community structure, seen as shifts in abundance weighted bacterial profiles after intervention. While bacterial and fungal species richness were reduced in homes that were renovated, they were not reduced for families that moved houses. Using different discriminant analysis tools, we were able identify taxa that were significantly reduced in relative abundance during renovation of moisture damage. For bacteria, the majority of candidates belonged to different families within the Actinomycetales order. Results for fungi were overall less consistent. A replication study in approximately 400 homes highlighted some of the identified taxa, confirming associations with observations of moisture damage and mold. The present study is one of the first studies to analyze changes in microbiota due to moisture damage interventions

  3. Prevention of Severe Hypoglycemia-Induced Brain Damage and Cognitive Impairment with Verapamil.

    Science.gov (United States)

    Jackson, David A; Michael, Trevin; Vieira de Abreu, Adriana; Agrawal, Rahul; Bortolato, Marco; Fisher, Simon J

    2018-05-03

    People with insulin-treated diabetes are uniquely at risk for severe hypoglycemia-induced brain damage. Since calcium influx may mediate brain damage, we tested the hypothesis that the calcium channel blocker, verapamil, would significantly reduce brain damage and cognitive impairment caused by severe hypoglycemia. Ten-week-old Sprague-Dawley rats were randomly assigned to one of three treatments; 1) control hyperinsulinemic (200 mU.kg -1 min -1 ) euglycemic (80-100mg/dl) clamps (n=14), 2) hyperinsulinemic hypoglycemic (10-15mg/dl) clamps (n=16), or 3) hyperinsulinemic hypoglycemic clamps followed by a single treatment with verapamil (20mg/kg) (n=11). As compared to euglycemic controls, hypoglycemia markedly increased dead/dying neurons in the hippocampus and cortex, by 16-fold and 14-fold, respectively. Verapamil treatment strikingly decreased hypoglycemia-induced hippocampal and cortical damage, by 87% and 94%, respectively. Morris Water Maze probe trial results demonstrated that hypoglycemia induced a retention, but not encoding, memory deficit (noted by both abolished target quadrant preference and reduced target quadrant time). Verapamil treatment significantly rescued spatial memory as noted by restoration of target quadrant preference and target quadrant time. In summary, a one-time treatment with verapamil following severe hypoglycemia prevented neural damage and memory impairment caused by severe hypoglycemia. For people with insulin treated diabetes, verapamil may be a useful drug to prevent hypoglycemia-induced brain damage. © 2018 by the American Diabetes Association.

  4. Hypoxic pretreatment protects against neuronal damage of the rat hippocampus induced by severe hypoxia.

    Science.gov (United States)

    Gorgias, N; Maidatsi, P; Tsolaki, M; Alvanou, A; Kiriazis, G; Kaidoglou, K; Giala, M

    1996-04-01

    The present study investigates whether under conditions of successive hypoxic exposures pretreatment with mild (15% O(2)) or moderate (10% O(2)) hypoxia, protects hippocampal neurones against damage induced by severe (3% O(2)) hypoxia. The ultrastructural findings were also correlated with regional superoxide dismutase (SOD) activity changes. In unpretreated rats severe hypoxia induced ultrastructural changes consistent with the aspects of delayed neuronal death (DND). However, in preexposed animals hippocampal damage was attenuated in an inversely proportional way with the severity of the hypoxic pretreatment. The ultrastructural hypoxic tolerance findings were also closely related to increased regional SOD activity levels. Thus the activation of the endogenous antioxidant defense by hypoxic preconditioning, protects against hippocampal damage induced by severe hypoxia. The eventual contribution of increased endogenous adenosine and/or reduced excitotoxicity to induce hypoxic tolerance is discussed.

  5. Full-length high-temperature severe fuel damage test No. 2

    International Nuclear Information System (INIS)

    Hesson, G.M.; Lombardo, N.J.; Pilger, J.P.; Rausch, W.N.; King, L.L.; Hurley, D.E.; Parchen, L.J.; Panisko, F.E.

    1993-09-01

    Hazardous conditions associated with performing the Full-Length High- Temperature (FLHT). Severe Fuel Damage Test No. 2 experiment have been analyzed. Major hazards that could cause harm or damage are (1) radioactive fission products, (2) radiation fields, (3) reactivity changes, (4) hydrogen generation, (5) materials at high temperature, (6) steam explosion, and (7) steam pressure pulse. As a result of this analysis, it is concluded that with proper precautions the FLHT- 2 test can be safely conducted

  6. Cardiac I123-MIBG Correlates Better than Ejection Fraction with Symptoms Severity in Systolic Heart Failure

    Energy Technology Data Exchange (ETDEWEB)

    Miranda, Sandra M.; Moscavitch, Samuel D.; Carestiato, Larissa R. [Programa de Pós-Graduação em Ciências Cardiovasculares, Hospital Universitário Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, RJ (Brazil); Felix, Renata M. [Departamento de Medicina Nuclear, Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Rodrigues, Ronaldo C.; Messias, Leandro R. [Programa de Pós-Graduação em Ciências Cardiovasculares, Hospital Universitário Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, RJ (Brazil); Azevedo, Jader C. [Programa de Pós-Graduação em Ciências Cardiovasculares, Hospital Universitário Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, RJ (Brazil); Departamento de Medicina Nuclear, Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Nóbrega, Antonio Cláudio L.; Mesquita, Evandro Tinoco [Programa de Pós-Graduação em Ciências Cardiovasculares, Hospital Universitário Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, RJ (Brazil); Mesquita, Claudio Tinoco, E-mail: ctinocom@cardiol.br [Programa de Pós-Graduação em Ciências Cardiovasculares, Hospital Universitário Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, RJ (Brazil); Departamento de Medicina Nuclear, Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil)

    2013-07-15

    The association of autonomic activation, left ventricular ejection fraction (LVEF) and heart failure functional class is poorly understood. Our aim was to correlate symptom severity with cardiac sympathetic activity, through iodine-123-metaiodobenzylguanidine ({sup 123}I-MIBG) scintigraphy and with LVEF in systolic heart failure (HF) patients without previous beta-blocker treatment. Thirty-one patients with systolic HF, class I to IV of the New York Heart Association (NYHA), without previous beta-blocker treatment, were enrolled and submitted to {sup 123}I-MIBG scintigraphy and to radionuclide ventriculography for LVEF determination. The early and delayed heart/mediastinum (H/M) ratio and the washout rate (WR) were performed. According with symptom severity, patients were divided into group A, 13 patients in NYHA class I/II, and group B, 18 patients in NYHA class III/IV. Compared with group B patients, group A had a significantly higher LVEF (25% ± 12% in group B vs. 32% ± 7% in group A, p = 0.04). Group B early and delayed H/M ratios were lower than group A ratios (early H/M 1.49 ± 0.15 vs. 1.64 ± 0.14, p = 0.02; delayed H/M 1.39 ± 0.13 vs. 1.58 ± 0.16, p = 0.001, respectively). WR was significantly higher in group B (36% ± 17% vs. 30% ± 12%, p= 0.04). The variable that showed the best correlation with NYHA class was the delayed H/M ratio (r= -0.585; p=0.001), adjusted for age and sex. This study showed that cardiac {sup 123}I-MIBG correlates better than ejection fraction with symptom severity in systolic heart failure patients without previous beta-blocker treatment.

  7. Analysis of severe core damage accident progression for the heavy water reactor

    International Nuclear Information System (INIS)

    Tong Lili; Yuan Kai; Yuan Jingtian; Cao Xuewu

    2010-01-01

    In this study, the severe accident progression analysis of generic Canadian deuterium uranium reactor 6 was preliminarily provided using an integrated severe accident analysis code. The selected accident sequences were multiple steam generator tube rupture and large break loss-of-coolant accidents because these led to severe core damage with an assumed unavailability for several critical safety systems. The progressions of severe accident included a set of failed safety systems normally operated at full power, and initiative events led to primary heat transport system inventory blow-down or boil off. The core heat-up and melting, steam generator response,fuel channel and calandria vessel failure were analyzed. The results showed that the progression of a severe core damage accident induced by steam generator tube rupture or large break loss-of-coolant accidents in a CANDU reactor was slow due to heat sinks in the calandria vessel and vault. (authors)

  8. Deficiency of methionine sulfoxide reductase A causes cellular dysfunction and mitochondrial damage in cardiac myocytes under physical and oxidative stresses

    International Nuclear Information System (INIS)

    Nan, Changlong; Li, Yuejin; Jean-Charles, Pierre-Yves; Chen, Guozhen; Kreymerman, Alexander; Prentice, Howard; Weissbach, Herbert; Huang, Xupei

    2010-01-01

    Research highlights: → Deficiency of MsrA in the heart renders myocardial cells more sensitive to oxidative stress. → Mitochondrial damage happens in the heart lacking MsrA. → More protein oxidation in myocardial cells lacking MsrA. → MsrA protects the heart against oxidative stress. -- Abstract: Methionine sulfoxide reductase A (MsrA) is an enzyme that reverses oxidation of methionine in proteins. Using a MsrA gene knockout (MsrA -/- ) mouse model, we have investigated the role of MsrA in the heart. Our data indicate that cellular contractility and cardiac function are not significantly changed in MsrA -/- mice if the hearts are not stressed. However, the cellular contractility, when stressed using a higher stimulation frequency (2 Hz), is significantly reduced in MsrA -/- cardiac myocytes. MsrA -/- cardiac myocytes also show a significant decrease in contractility after oxidative stress using H 2 O 2 . Corresponding changes in Ca 2+ transients are observed in MsrA -/- cardiomyocytes treated with 2 Hz stimulation or with H 2 O 2 . Electron microscope analyses reveal a dramatic morphological change of mitochondria in MsrA -/- mouse hearts. Further biochemical measurements indicate that protein oxidation levels in MsrA -/- mouse hearts are significantly higher than those in wild type controls. Our study demonstrates that the lack of MsrA in cardiac myocytes reduces myocardial cell's capability against stress stimulations resulting in a cellular dysfunction in the heart.

  9. X-ray diagnosis and treatment for severe respiratory complications during cardiac catheterizations on pediatric congenital heart disease

    International Nuclear Information System (INIS)

    Wang Cheng; Zhao Shihua; Jiang Shiliang; Huang Lianjun; Xu Zhongying; Ling Jian; Zheng Hong; Xie Ruolan; Lu Minjie

    2005-01-01

    Objective: To study the radiological features of severe respiratory complications during cardiac catheterizations on pediatric congenital heart disease so as to make early diagnosis and treatment. We also intend to find the mechanism of these complications. Methods: A total of 9 pediatric cases with severe respiratory complications during cardiac catheterizations were included in the study. The clinical manifestations, radiological features, and corresponding treatments were reviewed. Results: Most of the cases had severe hypoxia, with 6 cases presenting with bradycardia. Opacification of two lung fields was found in 7 cases, pulmonary edema in 1 case, and atelectasis of the upper right lung in 1 case. With intubation, oxygen inhalation and administration of certain drugs, all cases were saved except 1 case with pulmonary edema. Conclusion: Severe respiratory complications during cardiac catheterizations on pediatric congenital heart disease are emergent and critical, and they often presented with various manifestations. Early diagnosis and correct treatment are the key to successful salvage. (authors)

  10. Emergency repair of severely damaged reinforced concrete columns using active confinement with shape memory alloys

    International Nuclear Information System (INIS)

    Shin, Moochul; Andrawes, Bassem

    2011-01-01

    This experimental study focuses on investigating the feasibility of utilizing spirals made of shape memory alloys (SMAs) to conduct emergency repair on severely damaged reinforced concrete (RC) columns. The thermally triggered shape memory feature of SMAs is sought in this study, to apply active confinement pressure on the column's damaged region. Two severely damaged 1/3-scale RC columns are repaired using the proposed technique and tested under a quasi-static lateral cyclic load. The repair of each column is conducted in less than 15 h, and the columns are tested 24 h after the starting of the repair process. The experimental results show that the new repair technique is successful in either fully restoring the as-built lateral strength, stiffness, and flexural ductility of the columns or making them even better. The efficacy of the proposed repair technique is mainly attributed to the ability of the SMA spirals to apply and maintain active confining pressure on the damaged region of the columns, which increases the strength of the already damaged concrete and delays its damage

  11. Characteristics of severely damaged fuel from PBF tests and the TMI-2 accident

    International Nuclear Information System (INIS)

    Osetek, D.J.; Cook, B.A.; Dallman, R.J.; Broughton, J.M.

    1986-01-01

    As a result of the TMI-2 reactor accident, the US Nuclear Regulatory Commission initiated a research program to investigate phenomena associated with severe fuel damage accidents. This program is sponsored by several countries and includes in-pile and out-of-pile experiments, separate effects studies, and computer code development. The principal in-pile testing portion of the program includes four integral severe fuel damage (SFD) tests in the Power Burst Facility (PBF) at the Idaho National Engineering Laboratory (INEL). The INEL is also responsible for examining the damaged core in the Three Mile Island-Unit 2 (TMI-2) reactor, which offers the unique opportunity to directly compare the findings of an experimental program to those of an actual reactor accident. The principal core damage phenomena which can occur during a severe accident are discussed, and examples from the INEL research programs are used to illustrate the characteristics of these phenomena. The preliminary results of the programs are presented, and their impact on plant operability during severe accidents is discussed

  12. Patellofemoral Instability in Children: Correlation Between Risk Factors, Injury Patterns, and Severity of Cartilage Damage.

    Science.gov (United States)

    Kim, Hee Kyung; Shiraj, Sahar; Kang, Chang Ho; Anton, Christopher; Kim, Dong Hoon; Horn, Paul S

    2016-06-01

    The purpose of this study was to compare MRI findings between groups with and without patellofemoral instability and to correlate the MRI findings with the severity of patellar cartilage damage. Fifty-three children with patellofemoral instability and 53 age- and sex-matched children without patellofemoral instability (15.9 ± 2.4 years) were included. Knee MRI with T2-weighted mapping was performed. On MR images, femoral trochlear dysplasia, patellofemoral malalignment, medial retinaculum injury, and bone marrow edema were documented. The degree of patellar cartilage damage was evaluated on MR images by use of a morphologic grading scale (0-4) and on T2 maps with mean T2 values at the medial, central, and lateral facets. MRI findings were compared between the two groups. In cases of patellofemoral instability, MRI findings were correlated with the severity of cartilage damage at each region. Trochlear structure and alignment were significantly different between the two groups (Wilcoxon p patellofemoral instability, a high-riding patella was associated with central patellar cartilage damage with a higher morphologic grade and T2 value (Spearman p patellofemoral instability have significantly different trochlear structure and alignment than those who do not, and these differences are known risk factors for patellofemoral instability. However, the only risk factors or injury patterns that directly correlated with the severity of patellar cartilage damage were patella alta, medial stabilizer injury, and bone marrow edema.

  13. ErbB4 localization to cardiac myocyte nuclei, and its role in myocyte DNA damage response

    International Nuclear Information System (INIS)

    Icli, Basak; Bharti, Ajit; Pentassuglia, Laura; Peng, Xuyang; Sawyer, Douglas B.

    2012-01-01

    Highlights: ► ErbB4 localizes to cardiac myocyte nuclei as a full-length receptor. ► Cardiac myocytes express predominantly JM-a/CYT-1 ErbB4. ► Myocyte p53 activation in response to doxorubicin requires ErbB4 activity. -- Abstract: The intracellular domain of ErbB4 receptor tyrosine kinase is known to translocate to the nucleus of cells where it can regulate p53 transcriptional activity. The purpose of this study was to examine whether ErbB4 can localize to the nucleus of adult rat ventricular myocytes (ARVM), and regulate p53 in these cells. We demonstrate that ErbB4 does locate to the nucleus of cardiac myocytes as a full-length protein, although nuclear location occurs as a full-length protein that does not require Protein Kinase C or γ-secretase activity. Consistent with this we found that only the non-cleavable JM-b isoform of ErbB4 is expressed in ARVM. Doxorubicin was used to examine ErbB4 role in regulation of a DNA damage response in ARVM. Doxorubicin induced p53 and p21 was suppressed by treatment with AG1478, an EGFR and ErbB4 kinase inhibitor, or suppression of ErbB4 expression with small interfering RNA. Thus ErbB4 localizes to the nucleus as a full-length protein, and plays a role in the DNA damage response induced by doxorubicin in cardiac myocytes.

  14. [Cardiac and metabolic risk factors in severe mental disorders. Task of a prevention manager].

    Science.gov (United States)

    Lederbogen, F; Schwarz, P; Häfner, S; Schweiger, U; Bohus, M; Deuschle, M

    2015-07-01

    People with severe mental disorders have a reduction in life expectancy of 13-30 % compared with the general population. This severe disadvantage is primarily due to an increased prevalence of cardiac and metabolic disorders, especially coronary heart disease (CHD) and type 2 diabetes mellitus and are the result of untoward health behavior characterized by smoking, low levels of physical activity and unhealthy dietary habits. Obesity, arterial hypertension and lipid disorders are also associated with this behavior and further increase the risk of CHD and type 2 diabetes. Thus, people with mental disorders constitute a population with a high risk of cardiovascular events. Appropriate measures for prevention and therapy are urgently indicated but rarely applied. This article presents new organizational structures to overcome this deficit with a prevention manager playing a central role in organizing and applying preventive and therapeutic care. Results from cardiology and diabetic medicine have shown the effectiveness of pooling this responsibility. The measure has the potential to reduce the increased mortality of people with severe mental disorders.

  15. SCDAP: a light water reactor computer code for severe core damage analysis

    International Nuclear Information System (INIS)

    Marino, G.P.; Allison, C.M.; Majumdar, D.

    1982-01-01

    Development of the first code version (MODO) of the Severe Core Damage Analysis Package (SCDAP) computer code is described, and calculations made with SCDAP/MODO are presented. The objective of this computer code development program is to develop a capability for analyzing severe disruption of a light water reactor core, including fuel and cladding liquefaction, flow, and freezing; fission product release; hydrogen generation; quenched-induced fragmentation; coolability of the resulting geometry; and ultimately vessel failure due to vessel-melt interaction. SCDAP will be used to identify the phenomena which control core behavior during a severe accident, to help quantify uncertainties in risk assessment analysis, and to support planning and evaluation of severe fuel damage experiments and data. SCDAP/MODO addresses the behavior of a single fuel bundle. Future versions will be developed with capabilities for core-wide and vessel-melt interaction analysis

  16. Applications of Earth Remote Sensing for Identifying Tornado and Severe Weather Damage

    Science.gov (United States)

    Schultz, Lori; Molthan, Andrew; Burks, Jason E.; Bell, Jordan; McGrath, Kevin; Cole, Tony

    2016-01-01

    NASA SPoRT (Short-term Prediction Research and Transition Center) provided MODIS (Moderate Resolution Imaging Spectrometer) and ASTER (Advanced Spaceborne Thermal Emission and Reflection Radiometer) imagery to WFOs (Weather Forecast Offices) in Alabama to support April 27th, 2011 damage assessments across the state. SPoRT was awarded a NASA Applied Science: Disasters Feasibility award to investigate the applicability of including remote sensing imagery and derived products into the NOAA/NWS (National Oceanic and Atmospheric Administration/National Weather System) Damage Assessment Toolkit (DAT). Proposal team was awarded the 3-year proposal to implement a web mapping service and associate data feeds from the USGS (U.S. Geological Survey) to provide satellite imagery and derived products directly to the NWS thru the DAT. In the United States, NOAA/NWS is charged with performing damage assessments when storm or tornado damage is suspected after a severe weather event. This has led to the development of the Damage Assessment Toolkit (DAT), an application for smartphones, tablets and web browsers that allows for the collection, geo-location, and aggregation of various damage indicators collected during storm surveys.

  17. Cardiac biomarkers in Neonatology

    OpenAIRE

    Vijlbrief, D.C.

    2015-01-01

    In this thesis, the role for cardiac biomarkers in neonatology was investigated. Several clinically relevant results were reported. In term and preterm infants, hypoxia and subsequent adaptation play an important role in cardiac biomarker elevation. The elevated natriuretic peptides are indicative of abnormal function; elevated troponins are suggestive for cardiomyocyte damage. This methodology makes these biomarkers of additional value in the treatment of newborn infants, separate or as a co...

  18. Severe hepatic trauma: nonoperative management, definitive repair, or damage control surgery?

    Science.gov (United States)

    Leppäniemi, Ari K; Mentula, Panu J; Streng, Mari H; Koivikko, Mika P; Handolin, Lauri E

    2011-12-01

    Management of severe liver injuries has evolved to include the options for nonoperative management and damage control surgery. The present study analyzes the criteria for choosing between nonoperative management and early surgery, and definitive repair versus damage control strategy during early surgery. In a retrospective analysis of 144 patients with severe (AAST grade III-V) liver injuries (94% blunt trauma), early laparotomy was performed in 50 patients. Initial management was nonoperative in 94 blunt trauma patients with 8 failures. Uni- and multivariate analyses were used to calculate predictor odds ratios (OR) with 95% confidence intervals (CI). Factors associated with early laparotomy in blunt trauma included shock on admission, associated grade IV-V splenic injury, grade IV-V head injury, and grade V liver injury. Only shock was an independent predictor (OR, 26.1; 95% CI, 8.9-77.1; P < 0.001). The presence of a grade IV-V splenic injury predicted damage control strategy (OR infinite; P = 0.021). Failed nonoperative management was associated with grade IV-V splenic injury (OR, 14.00; 95% CI, 1.67-117.55), and shock (OR, 6.82; 95% CI, 1.49-31.29). The hospital mortality rate was 15%; 8 of 21 deaths were liver-related. Shock (OR, 9.3; 95% CI, 2.4-35.8; P = 0.001) and severe head injury (OR, 9.25; 95% CI, 3.0-28.9; P = 0.000) were independent predictors for mortality. In patients with severe liver injury, associated severe splenic injury favors early laparotomy and damage control strategy. Patients who arrive in shock or have an associated severe splenic injury should not be managed nonoperatively. In addition to severe head injury, uncontrollable bleeding from the liver injury is still a major cause of early death.

  19. Bacterial mutagenicity and mammalian cell DNA damage by several substituted anilines.

    Science.gov (United States)

    Zimmer, D; Mazurek, J; Petzold, G; Bhuyan, B K

    1980-04-01

    Several substituted alkyl- and haloanilines were tested for their ability to mutate Salmonella typhimurium and to damage the DNA of mammalian (V79) cells. These results were correlated with their reported carcinogenicity. Of 9 suspected carcinogens, 4 were bacterial mutagens and 4 (out of 7 tested) damaged DNA of V79 cells. The following compounds were weakly mutagenic (less than 150 revertants/mumole): 4-fluoroaniline, 2,3-, 2,4-, 2,5- and 3,4-dimethylaniline, and 2-methyl-4-fluoroaniline. The following compounds were strong mutagens: 2,4,5-trimethylaniline, 2-methyl-4-chloro-, and 2-methyl-4-bromo-, 4-methyl-2-chloro-, 4-methyl-2-bromo- and 2-ethyl-4-chloroaniline. The compounds which damaged DNA in V79 cells were: 2 methyl-4-chloroaniline, 2-methyl-4-bromoaniline, 2,4,5- and 2,4,6-trimethylaniline.

  20. Assesment of Severely ASR Damaged Bridges: From Diagnosis to Structural Effects

    DEFF Research Database (Denmark)

    Barbosa, Ricardo Antonio; Hansen, Søren Gustenhoff; Hansen, Kurt Kielsgaard

    2016-01-01

    documented. The majority of the experimental data are based on relatively small scale laboratory specimens accelerated by various exposure conditions. Research on assessment and influence of severely ASR deterioration on the material properties and residual load carrying capacity of real-life structures...... is unfortunately limited. This paper presents an overview and discussion of the Danish experiences with assessment of the residual load carrying capacity of severely non-shear reinforced ASR damaged bridges. The discussion is supported by experimental data acquired from large scale in-situ tests of three severely...

  1. Evidence of direct cardiac damage following high-intensity exercise in chronic energy restriction: A case report and literature review.

    Science.gov (United States)

    Baird, Marianne F; Grace, Fergal; Sculthorpe, Nicholas; Graham, Scott M; Fleming, Audrey; Baker, Julien S

    2017-07-01

    Following prolonged endurance events such as marathons, elevated levels of cardiospecific biomarkers are commonly reported. Although transiently raised levels are generally not considered to indicate clinical myocardial damage, comprehension of this phenomenon remains incomplete. The popularity of high-intensity interval training highlights a paucity of research measuring cardiac biomarker response to this type of exercise. This a posteriori case report discusses the elevation of cardiac troponins (cTn) associated with short interval, high-intensity exercise. In this case report, an apparently healthy 29-year-old recreationally active female presented clinically raised cardiac troponin I (cTnI) levels (>0.04 ng/mL), after performing high-intensity cycle ergometer sprints. As creatine kinase (CK) is expressed by multiple organs (e.g., skeletal muscle, brain, and myocardium), cTnI assays were performed to determine any changes in total serum CK levels not originating from skeletal muscle damage. A posteriori the individual's daily energy expenditure indicated chronically low-energy availability. Psychometric testing suggested that the individual scored positive for disordered eating, highly for fatigue levels, and low in mental health components. The current case report provides novel evidence of elevated cTnI occurring as a result of performing short duration, high intensity, cycle ergometer exercise in an individual with self-reported chronically depleted energy balance. A schematic to identify potentially "at risk" individuals is presented. Considering this as a case report, results cannot be generalized; however, the main findings suggest that individuals who habitually restrict their calorie intake below their bodies' daily energy requirements, may have elevated biomarkers of exercise induced myocardial stress from performing high-intensity exercise.

  2. Effect of maternal age and cardiac disease severity on outcome of pregnancy in women with congenital heart disease.

    Science.gov (United States)

    Furenäs, Eva; Eriksson, Peter; Wennerholm, Ulla-Britt; Dellborg, Mikael

    2017-09-15

    There is an increasing prevalence of women with congenital heart defects reaching childbearing age. In western countries women tend to give birth at a higher age compared to some decades ago. We evaluated the CARdiac disease in PREGnancy (CARPREG) and modified World Health Organization (mWHO) risk classifications for cardiac complications during pregnancies in women with congenital heart defects and analyzed the impact of age on risk of obstetric and fetal outcome. A single-center observational study of cardiac, obstetric, and neonatal complications with data from cardiac and obstetric records of pregnancies in women with congenital heart disease. Outcomes of 496 pregnancies in 232 women, including induced abortion, miscarriage, stillbirth, and live birth were analyzed regarding complications, maternal age, mode of delivery, and two risk classifications: CARPREG and mWHO. There were 28 induced abortions, 59 fetal loss, 409 deliveries with 412 neonates. Cardiac (14%), obstetric (14%), and neonatal (15%) complications were noted, including one maternal death and five stillbirths. The rate of cesarean section was 19%. Age above 35years was of borderline importance for cardiac complications (p=0.054) and was not a significant additional risk factor for obstetric or neonatal complications. Both risk classifications had moderate clinical utility, with area under the curve (AUC) 0.71 for CARPREG and 0.65 for mWHO on cardiac complications. Pregnancy complications in women with congenital heart disease are common but severe complications are rare. Advanced maternal age does not seem to affect complication rate. Existing risk classification systems are insufficient in predicting complications. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. [Severity of disease scoring systems and mortality after non-cardiac surgery].

    Science.gov (United States)

    Reis, Pedro Videira; Sousa, Gabriela; Lopes, Ana Martins; Costa, Ana Vera; Santos, Alice; Abelha, Fernando José

    2018-04-05

    Mortality after surgery is frequent and severity of disease scoring systems are used for prediction. Our aim was to evaluate predictors for mortality after non-cardiac surgery. Adult patients admitted at our surgical intensive care unit between January 2006 and July 2013 was included. Univariate analysis was carried using Mann-Whitney, Chi-square or Fisher's exact test. Logistic regression was performed to assess independent factors with calculation of odds ratio and 95% confidence interval (95% CI). 4398 patients were included. Mortality was 1.4% in surgical intensive care unit and 7.4% during hospital stay. Independent predictors of mortality in surgical intensive care unit were APACHE II (OR=1.24); emergent surgery (OR=4.10), serum sodium (OR=1.06) and FiO 2 at admission (OR=14.31). Serum bicarbonate at admission (OR=0.89) was considered a protective factor. Independent predictors of hospital mortality were age (OR=1.02), APACHE II (OR=1.09), emergency surgery (OR=1.82), high-risk surgery (OR=1.61), FiO 2 at admission (OR=1.02), postoperative acute renal failure (OR=1.96), heart rate (OR=1.01) and serum sodium (OR=1.04). Dying patients had higher scores in severity of disease scoring systems and longer surgical intensive care unit stay. Some factors influenced both surgical intensive care unit and hospital mortality. Copyright © 2017 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  4. Precursors to potential severe core damage accidents: 1995 A status report

    International Nuclear Information System (INIS)

    Belles, R.J.; Cletcher, J.W.; Copinger, D.A.

    1997-04-01

    Ten operational events that affected 10 commercial light-water reactors during 1995 and that are considered to be precursors to potential severe core damage are described. All these events had conditional probabilities of subsequent severe core damage greater than or equal to 1.0 x 10 -6 . These events were identified by first computer-screening the 1995 licensee event reports from commercial light-water reactors to identify those events that could potentially be precursors. Candidate precursors were selected and evaluated in a process similar to that used in previous assessments. Selected events underwent engineering evaluation that identified, analyzed, and documented the precursors. Other events designated by the Nuclear Regulatory Commission (NRC) also underwent a similar evaluation. Finally, documented precursors were submitted for review by licensees and NRC headquarters and regional offices to ensure the plant design and its response to the precursor were correctly characterized. This study is a continuation of earlier work, which evaluated 1969-1981 and 1984-1994 events. The report discusses the general rationale for this study, the selection and documentation of events as precursors, and the estimation of conditional probabilities of subsequent severe core damage for the events

  5. Precursors to potential severe core damage accidents: 1996. A status report. Volume 25

    International Nuclear Information System (INIS)

    Belles, R.J.; Cletcher, J.W.; Copinger, D.A.; Muhlheim, M.D.; Dolan, B.W.; Minarick, J.W.

    1997-12-01

    This report describes the 14 operational events in 1996 that affected 13 commercial light-water reactors and that are considered to be precursors to potential severe core damage accidents. All these events had conditional probabilities of subsequent severe core damage greater than or equal to 1.0 x 10 -6 . These events were identified by first computer-screening the 1996 licensee event reports from commercial light-water reactors to identify those events that could potentially be precursors. Candidate precursors were selected and evaluated in a process similar to that used in previous assessments. Selected events underwent engineering evaluation that identified, analyzed, and documented the precursors. Other events designated by the Nuclear Regulatory Commission (NRC) also underwent a similar evaluation. Finally, documented precursors were submitted for review by licensees and NRC headquarters and regional offices to ensure the plant design and its response to the precursor were correctly characterized. This study is a continuation of earlier work, which evaluated 1969--1995 events. The report discusses the general rationale for this study, the selection and documentation of events as precursors, and the estimation of conditional probabilities of subsequent severe core damage for the events

  6. Precursors to potential severe core damage accidents: 1994, a status report. Volume 22: Appendix I

    International Nuclear Information System (INIS)

    Belles, R.J.; Cletcher, J.W.; Copinger, D.A.; Vanden Heuvel, L.N.; Dolan, B.W.; Minarick, J.W.

    1995-12-01

    Nine operational events that affected eleven commercial light-water reactors (LWRs) during 1994 and that are considered to be precursors to potential severe core damage are described. All these events had conditional probabilities of subsequent severe core damage greater than or equal to 1.0 x 10 -6 . These events were identified by computer-screening the 1994 licensee event reports from commercial LWRs to identify those that could be potential precursors. Candidate precursors were then selected and evaluated in a process similar to that used in previous assessments. Selected events underwent engineering evaluation that identified, analyzed, and documented the precursors. Other events designated by the Nuclear Regulatory Commission (NRC) also underwent a similar evaluation. Finally, documented precursors were submitted for review by licensees and NRC headquarters and regional offices to ensure that the plant design and its response to the precursor were correctly characterized. This study is a continuation of earlier work, which evaluated 1969--1981 and 1984--1993 events. The report discusses the general rationale for this study, the selection and documentation of events as precursors, and the estimation of conditional probabilities of subsequent severe core damage for events. This document is bound in two volumes: Vol. 21 contains the main report and Appendices A--H; Vol. 22 contains Appendix 1

  7. Precursors to potential severe core damage accidents: 1995 A status report

    Energy Technology Data Exchange (ETDEWEB)

    Belles, R.J.; Cletcher, J.W.; Copinger, D.A. [and others

    1997-04-01

    Ten operational events that affected 10 commercial light-water reactors during 1995 and that are considered to be precursors to potential severe core damage are described. All these events had conditional probabilities of subsequent severe core damage greater than or equal to 1.0 x 10{sup {minus}6}. These events were identified by first computer-screening the 1995 licensee event reports from commercial light-water reactors to identify those events that could potentially be precursors. Candidate precursors were selected and evaluated in a process similar to that used in previous assessments. Selected events underwent engineering evaluation that identified, analyzed, and documented the precursors. Other events designated by the Nuclear Regulatory Commission (NRC) also underwent a similar evaluation. Finally, documented precursors were submitted for review by licensees and NRC headquarters and regional offices to ensure the plant design and its response to the precursor were correctly characterized. This study is a continuation of earlier work, which evaluated 1969-1981 and 1984-1994 events. The report discusses the general rationale for this study, the selection and documentation of events as precursors, and the estimation of conditional probabilities of subsequent severe core damage for the events.

  8. Precursors to potential severe core damage accidents: 1994, a status report. Volume 22: Appendix I

    Energy Technology Data Exchange (ETDEWEB)

    Belles, R.J.; Cletcher, J.W.; Copinger, D.A.; Vanden Heuvel, L.N. [Oak Ridge National Lab., TN (United States); Dolan, B.W.; Minarick, J.W. [Oak Ridge National Lab., TN (United States)]|[Science Applications International Corp., Oak Ridge, TN (United States)

    1995-12-01

    Nine operational events that affected eleven commercial light-water reactors (LWRs) during 1994 and that are considered to be precursors to potential severe core damage are described. All these events had conditional probabilities of subsequent severe core damage greater than or equal to 1.0 {times} 10{sup {minus}6}. These events were identified by computer-screening the 1994 licensee event reports from commercial LWRs to identify those that could be potential precursors. Candidate precursors were then selected and evaluated in a process similar to that used in previous assessments. Selected events underwent engineering evaluation that identified, analyzed, and documented the precursors. Other events designated by the Nuclear Regulatory Commission (NRC) also underwent a similar evaluation. Finally, documented precursors were submitted for review by licensees and NRC headquarters and regional offices to ensure that the plant design and its response to the precursor were correctly characterized. This study is a continuation of earlier work, which evaluated 1969--1981 and 1984--1993 events. The report discusses the general rationale for this study, the selection and documentation of events as precursors, and the estimation of conditional probabilities of subsequent severe core damage for events. This document is bound in two volumes: Vol. 21 contains the main report and Appendices A--H; Vol. 22 contains Appendix 1.

  9. Precursors to potential severe core damage accidents: 1997 - A status report. Volume 26

    International Nuclear Information System (INIS)

    Belles, R.J.; Cletcher, J.W.; Copinger, D.A.; Muhlheim, M.D.; Dolan, B.W.; Minarick, J.W.

    1998-11-01

    This report describes the five operational events in 1997 that affected five commercial light-water reactors (LWRs) and that are considered to be precursors to potential severe core damage accidents. All these events had conditional probabilities of subsequent severe core damage greater than or equal to 1.0 x 10 -6 . These events were identified by first computer-screening the 1997 licensee event reports from commercial LWRs to identify those events that could be precursors. Candidate precursors were selected and evaluated in a process similar to that used in previous assessments. Selected events underwent engineering evaluation that identified, analyzed, and documented the precursors. Other events designated by the Nuclear Regulatory Commission (NRC) also underwent a similar evaluation. Finally, documented precursors were submitted for review by licensees and NRC headquarters to ensure that the plant design and its response to the precursor were correctly characterized. This study is a continuation of earlier work, which evaluated 1969--1996 events. The report discusses the general rationale for this study, the selection and documentation of events as precursors, and the estimation of conditional probabilities of subsequent severe core damage for the events

  10. Consequence analysis of core damage states following severe accidents for the CANDU reactor design

    International Nuclear Information System (INIS)

    Wahba, N.N.; Kim, Y.T.; Lie, S.G.

    1997-01-01

    The analytical methodology used to evaluate severe accident sequences is described. The relevant thermal-mechanical phenomena and the mathematical approach used in calculating the timing of the accident progression and source term estimate are summarized. The postulated sever accidents analyzed, in general, mainly differ in the timing to reach and progress through each defined c ore damage state . This paper presents the methodology and results of the timing and steam discharge calculations as well as source term estimate out of containment for accident sequences classified as potentially leading to core disassembly following a small break loss-of-coolant accident (LOCA) scenario as a specific example. (author)

  11. The usefulness of the nuclear cardiology in the cellular implant in patients with severe myocardial damage

    International Nuclear Information System (INIS)

    Omelas A, M.; Arguero S, R.; Garrido G, M.H.; Rodriguez C, A.; Careaga, G.; Castano G, R.; Nambo, M.J.; Pascual P, J.; Ortega R, A.; Gaxiola A, A.; Magana S, J.A.; Estrada A, H.; Equipo de Tecnicos en Medicina Nuclear

    2005-01-01

    The recent therapeutic advances as the cellular implant as well as those different protocols of image acquisition in the field of the Nuclear Cardiology its have allowed that the patient with severe myocardial damage and without some possibility of revascularization is benefited with these advances. Doubtless the Tl-201 par excellence has an important paper for standardize the more appropriate therapeutic behavior for the heart attack patient; reason by this investigation protocol was developed. The objective of the study was to identify the heart attack regions without viable tissue with SPECT in patient with important myocardial damage without some possibility of traditional revascularization; for the 'Stem cell' cellular implantation therapy. The methodology it was carried out by a study of myocardial perfusion in 10 patients with important myocardial damage previous cellular implants, with PICANUC/ SPECT methodology and using a software (Emory Tool Box) for the image processing validated by the University of Emory Atlanta GA; and using as tracer the Tl - 201 to identify the heart attack regions without presence of viable tissue with an analysis model of 17 segments standardized for the left ventricle; qualifying this way the myocardial perfusion in: 0 (normal), 1 (light), 2 (moderate), 3 (severe), 4 (absent) and x (bad technique). The conclusions were that the SPECT study with PICANUC methodology with Tl-201 is safe and effective for the precise localization for the cellular implantation via direct intra myocardial. (Author)

  12. Compound heterozygosity for mutations (W156X and R225W) in SCN5A associated with severe cardiac conduction disturbances and degenerative changes in the conduction system

    NARCIS (Netherlands)

    Bezzina, Connie R.; Rook, Martin B.; Groenewegen, W. Antoinette; Herfst, Lucas J.; van der Wal, Allard C.; Lam, Jan; Jongsma, Habo J.; Wilde, Arthur A. M.; Mannens, Marcel M. A. M.

    2003-01-01

    Cardiac conduction defects associate with mutations in SCN5A, the gene encoding the cardiac Na+ channel. In the present study, we characterized a family in which the proband was born in severe distress with irregular wide complex tachycardia. His older sister died at 1 year of age from severe

  13. Cardiac damage associated with stress hyperglycaemia and acute coronary syndrome changes according to level of presenting blood glucose.

    Science.gov (United States)

    Al Jumaily, Talib; Rose'Meyer, Roselyn B; Sweeny, Amy; Jayasinghe, Rohan

    2015-10-01

    To determine the prevalence of stress hyperglycaemia in people presenting with acute coronary syndrome (ACS), and the relationships between admission glucose and cardiac damage, cardiovascular mortality and morbidity. In a prospective observational study people presenting with ACS at the Gold Coast Hospital had their admission glucose (AG) level tested to determine stress hyperglycaemia. A range of measurements supplemented this data including troponin levels, category of ACS and major adverse coronary events (MACEs) were obtained through hospital records and patient follow-up post-discharge. One hundred eighty-eight participants were recruited. The prevalence of stress hyperglycaemia in ACS was 44% with 31% having a previous diagnosis of type 2 diabetes and 7.7% had undiagnosed diabetes. The stress hyperglycaemic group had a significantly higher median troponin levels compared to participants with normal blood glucose levels on admission (pglucose group (>15 mmol/L) had troponin levels similar to people presenting with normal blood glucose levels and ACS (p>0.05). Cardiac necrosis as measured by troponin levels is significantly increased in people with ACS and stress hyperglycaemia. This study found that one in four participants presenting with ACS and an admission glucose of >7.0 had no previous diagnosis for diabetes. Consistently ordering HbA1C testing on patients with high AG can enable earlier diagnosis and treatment of diabetes. Copyright © 2015. Published by Elsevier Ireland Ltd.

  14. Concrete model for finite element analysis of structures subjected to severe damages

    International Nuclear Information System (INIS)

    Jamet, Ph.; Millard, A.; Hoffmann, A.; Nahas, G.; Barbe, B.

    1984-01-01

    A specific concrete model has been developed, in order to perform mechanical analysis of civil engineering structures, when subjected to accidental loadings, leading to severe damages. Its formulation is based on the physical mechanisms, which have been observed on laboratory specimens. The model has been implemented into the CASTEM finite element system, and the case of a concrete slab perforation by a rigid missile has been considered. The qualitative behaviour of the structure is well predicted by the model. Comparison between numerical and experimental results is also performed, using two main curves: missile velocity versus penetration depth; reaction forces versus time. (Author) [pt

  15. MELCOR modeling of the PBF [Power Burst Facility] Severe Fuel Damage Test 1-4

    International Nuclear Information System (INIS)

    Madni, I.K.

    1990-01-01

    This paper describes a MELCOR Version 1.8 simulation of the Power Burst Facility (PBF) Severe Fuel Damage (SFD) Test 1--4. The input data for the analysis were obtained from the Test Results Report and from SCDAP/RELAP5 input. Results are presented for the transient liquid level in the test bundle, clad temperatures, shroud temperatures, clad oxidation and hydrogen generation, bundle geometry changes, fission product release, and heat transfer to the bypass flow. Comparisons are made with experimental data and with SCDAP/RELAP5 calculations. 10 refs., 7 figs

  16. Full-Length High-Temperature Severe Fuel Damage Test No. 5: Final safety analysis

    International Nuclear Information System (INIS)

    Lanning, D.D.; Lombardo, N.J.; Panisko, F.E.

    1993-09-01

    This report presents the final safety analysis for the preparation, conduct, and post-test discharge operation for the Full-Length High Temperature Experiment-5 (FLHT-5) to be conducted in the L-24 position of the National Research Universal (NRU) Reactor at Chalk River Nuclear Laboratories (CRNL), Ontario, Canada. The test is sponsored by an international group organized by the US Nuclear Regulatory Commission. The test is designed and conducted by staff from Pacific Northwest Laboratory with CRNL staff support. The test will study the consequences of loss-of-coolant and the progression of severe fuel damage

  17. Global outbreak of severe Mycobacterium chimaera disease after cardiac surgery: a molecular epidemiological study.

    NARCIS (Netherlands)

    van Ingen, Jakko; Kohl, Thomas A; Kranzer, Katharina; Hasse, Barbara; Keller, Peter M; Katarzyna Szafrańska, Anna; Hillemann, Doris; Chand, Meera; Schreiber, Peter Werner; Sommerstein, Rami; Berger, Christoph; Genoni, Michele; Rüegg, Christian; Troillet, Nicolas; Widmer, Andreas F; Becker, Sören L; Herrmann, Mathias; Eckmanns, Tim; Haller, Sebastian; Höller, Christiane; Debast, Sylvia B; Wolfhagen, Maurice J; Hopman, Joost; Kluytmans, Jan; Langelaar, Merel; Notermans, Daan W; Ten Oever, Jaap; van den Barselaar, Peter; Vonk, Alexander B A; Vos, Margreet C; Ahmed, Nada; Brown, Timothy; Crook, Derrick; Lamagni, Theresa; Phin, Nick; Smith, E Grace; Zambon, Maria; Serr, Annerose; Götting, Tim; Ebner, Winfried; Thürmer, Alexander; Utpatel, Christian; Spröer, Cathrin; Bunk, Boyke; Nübel, Ulrich; Bloemberg, Guido V; Böttger, Erik C; Niemann, Stefan; Wagner, Dirk; Sax, Hugo

    2017-01-01

    Since 2013, over 100 cases of Mycobacterium chimaera prosthetic valve endocarditis and disseminated disease were notified in Europe and the USA, linked to contaminated heater-cooler units (HCUs) used during cardiac surgery. We did a molecular epidemiological investigation to establish the source of

  18. Frequency and severity of myocardial perfusion abnormalities using Tc-99m MIBI SPECT in cardiac syndrome X

    International Nuclear Information System (INIS)

    Saghari, Mohsen; Assadi, Majid; Eftekhari, Mohammad; Yaghoubi, Mohammad; Fard-Esfahani, Armaghan; Malekzadeh, Jan-Mohammad; Sichani, Babak Fallhi; Beiki, Davood; Takavar, Abbas

    2006-01-01

    Cardiac syndrome X is defined by a typical angina pectoris with normal or near normal (stenosis <40%) coronary angiogram with or without electrocardiogram (ECG) change or atypical angina pectoris with normal or near normal coronary angiogram plus a positive none-invasive test (exercise tolerance test or myocardial perfusion scan) with or without ECG change. Studies with myocardial perfusion imaging on this syndrome have indicated some abnormal perfusion scan. We evaluated the role of myocardial perfusion imaging (MPI) and also the severity and extent of perfusion abnormality using Tc-99m MIBI Single Photon Emission Computed Tomography (SPECT) in these patients. The study group consisted of 36 patients with cardiac syndrome X. The semiquantitative perfusion analysis was performed using exercise Tc-99m MIBI SPECT. The MPI results were analyzed by the number, location and severity of perfusion defects. Abnormal perfusion defects were detected in 13 (36.10%) cases, while the remaining 23 (63.90%) had normal cardiac imaging. Five of 13 (38.4%) abnormal studies showed multiple perfusion defects. The defects were localized in the apex in 3, apical segments in 4, midventricular segments in 12 and basal segments in 6 cases. Fourteen (56%) of all abnormal segments revealed mild, 7(28%) moderate and 4 (16%) severe reduction of tracer uptake. No fixed defects were identified. The vessel territories were approximately the same in all subjects. The Exercise treadmill test (ETT) was positive in 25(69%) and negative in 11(30%) patients. There was no consistent pattern as related to the extent of MPI defects or exercise test results. Our study suggests that multiple perfusion abnormalities with different levels of severity are common in cardiac syndrome X, with more than 30 % of these patients having at least one abnormal perfusion segment. Our findings suggest that in these patients microvascular angina is probably more common than is generally believed

  19. Single histidine button in cardiac troponin I sustains heart performance in response to severe hypercapnic respiratory acidosis in vivo.

    Science.gov (United States)

    Palpant, Nathan J; D'Alecy, Louis G; Metzger, Joseph M

    2009-05-01

    Intracellular acidosis is a profound negative regulator of myocardial performance. We hypothesized that titrating myofilament calcium sensitivity by a single histidine substituted cardiac troponin I (A164H) would protect the whole animal physiological response to acidosis in vivo. To experimentally induce severe hypercapnic acidosis, mice were exposed to a 40% CO(2) challenge. By echocardiography, it was found that systolic function and ventricular geometry were maintained in cTnI A164H transgenic (Tg) mice. By contrast, non-Tg (Ntg) littermates experienced rapid and marked cardiac decompensation during this same challenge. For detailed hemodymanic assessment, Millar pressure-conductance catheterization was performed while animals were treated with a beta-blocker, esmolol, during a severe hypercapnic acidosis challenge. Survival and load-independent measures of contractility were significantly greater in Tg vs. Ntg mice. This assay showed that Ntg mice had 100% mortality within 5 min of acidosis. By contrast, systolic and diastolic function were protected in Tg mice during acidosis, and they had 100% survival. This study shows that, independent of any beta-adrenergic compensation, myofilament-based molecular manipulation of inotropy by histidine-modified troponin I maintains cardiac inotropic and lusitropic performance and markedly improves survival during severe acidosis in vivo.

  20. Testing and Analysis of a Composite Non-Cylindrical Aircraft Fuselage Structure . Part II; Severe Damage

    Science.gov (United States)

    Przekop, Adam; Jegley, Dawn C.; Lovejoy, Andrew E.; Rouse, Marshall; Wu, Hsi-Yung T.

    2016-01-01

    The Environmentally Responsible Aviation Project aimed to develop aircraft technologies enabling significant fuel burn and community noise reductions. Small incremental changes to the conventional metallic alloy-based 'tube and wing' configuration were not sufficient to achieve the desired metrics. One airframe concept identified by the project as having the potential to dramatically improve aircraft performance was a composite-based hybrid wing body configuration. Such a concept, however, presented inherent challenges stemming from, among other factors, the necessity to transfer wing loads through the entire center fuselage section which accommodates a pressurized cabin confined by flat or nearly flat panels. This paper discusses a finite element analysis and the testing of a large-scale hybrid wing body center section structure developed and constructed to demonstrate that the Pultruded Rod Stitched Efficient Unitized Structure concept can meet these challenging demands of the next generation airframes. Part II of the paper considers the final test to failure of the test article in the presence of an intentionally inflicted severe discrete source damage under the wing up-bending loading condition. Finite element analysis results are compared with measurements acquired during the test and demonstrate that the hybrid wing body test article was able to redistribute and support the required design loads in a severely damaged condition.

  1. Full-length high-temperature severe fuel damage test No. 5

    International Nuclear Information System (INIS)

    Lanning, D.D.; Lombardo, N.J.; Hensley, W.K.; Fitzsimmons, D.E.; Panisko, F.E.; Hartwell, J.K.

    1993-09-01

    This report describes and presents data from a severe fuel damage test that was conducted in the National Research Universal (NRU) reactor at Chalk River Nuclear Laboratories (CRNL), Ontario, Canada. The test, designated FLHT-5, was the fourth in a series of full-length high-temperature (FLHT) tests on light-water reactor fuel. The tests were designed and performed by staff from the US Department of Energy's Pacific Northwest Laboratory (PNL), operated by Battelle Memorial Institute. The test operation and test results are described in this report. The fuel bundle in the FLHT-5 experiment included 10 unirradiated full-length pressurized-water reactor (PWR) rods, 1 irradiated PWR rod and 1 dummy gamma thermometer. The fuel rods were subjected to a very low coolant flow while operating at low fission power. This caused coolant boilaway, rod dryout and overheating to temperatures above 2600 K, severe fuel rod damage, hydrogen generation, and fission product release. The test assembly and its effluent path were extensively instrumented to record temperatures, pressures, flow rates, hydrogen evolution, and fission product release during the boilaway/heatup transient. Post-test gamma scanning of the upper plenum indicated significant iodine and cesium release and deposition. Both stack gas activity and on-line gamma spectrometer data indicated significant (∼50%) release of noble fission gases. Post-test visual examination of one side of the fuel bundle revealed no massive relocation and flow blockage; however, rundown of molten cladding was evident

  2. Comprehensive clinical evaluation of a large Spanish family with Anderson-Fabry disease, novel GLA mutation and severe cardiac phenotype.

    Science.gov (United States)

    San Román-Monserrat, Irene; Moreno-Flores, Victoria; López-Cuenca, David; Rodríguez-González-Herrero, Elena; Guillén-Navarro, Encarna; Rodríguez-González-Herrero, Beatriz; Alegría-Fernández, Marisol; Poza-Cisneros, Gabriela; Piñero-Fernández, Juan A; Sornichero-Martínez, Javier; Gimeno-Blanes, Juan R

    2014-06-06

    Fabry disease is an X-linked multisystemic lysosomal-storage condition. We describe a large family with a novel GLA mutation: p.M187R/g7219 T>G. Anamnesis/physical-exam, blood/urine analysis, α-Gal-A activity and/or genetic study of at-risk individuals and multidisciplinary evaluation in confirmed cases. 4 males and 13 heterozygous-females displayed the mutation. Cardiac/renal/neurological disease was diagnosed at a mean age of 41/29/39 years in males and 51/56/46 years in females. Onset mean age was 20 years versus 42 years. 9/15 had cardiomyopathy. Delta wave suggestive of accessory pathway was identified in 1 male and 2 females. 1 female had cardiac arrest (ventricular fibrillation, 61 years). 2 females and 1 male died suddenly (63, 64 and 57 years). Cardiac-subscore of Mainz Severity-Score-Index was severe for males and females over 40 years. 4/15(26%) developed early renal disease. 2 males needed dialysis. 1 male died at 69 years in spite of kidney-heart transplant. We describe the largest genetically confirmed Spanish family using multidisciplinary evaluation and MSSI calculation. The novel mutation p.M187R/g7219 T>G is associated with a particularly malignant cardiac phenotype in males and females over 40 years. Severity was higher than that of the largest Spanish FOS-cohort. Short-PR with delta is being reported for the first time. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  3. Comparative study of radiopharmaceuticals as radiodiagnostic agent of cardiac damage in rats

    International Nuclear Information System (INIS)

    Gallego Heise, R.

    1983-01-01

    Six radiopharmaceuticals were screened in a small-animal model as potential infarct-localizing agents. The model used was subcutaneous inyection of isoproterenol (30 mg/kg of body weight) - induced myocardial lesions in rats, similar to an infarct and ischemia in human beings, corroborated by histological findings. The uptake of each radiopharmaceuticals is measured at various times after lesion initiation. The results are expressed as % I.D./g and through the contrast relations between the activity of whole heart of treated rats and the others tissues. The relation damaged heart/normal heart (DH/NH) of the phosphorated radiopharmaceuticals (sup(99m) Tc-PPi, sup(99m) Tc-MDP, sup(113m) In-EDTMP), and 197 Hg-MPG are significatively greater in rats with heart damaged than in the controls animals (undamaged); these were followed by sup(99m) Tc-GH and sup(99m) Tc-DMSA. Sup(99m) Tc-PPi, was the tracer that showed the mot favorable concentration in the lesion and the best target-non target ratios in most of the time intervals. At early time intervals 197 Hg-MPG showed the best DH/NH relation. (Author)

  4. DNA Damages and White Blood Cell Death Processes in Victims with Severe Injury

    Directory of Open Access Journals (Sweden)

    V. V. Moroz

    2014-01-01

    Full Text Available Objective. To study the mechanisms of posttraumatic changes in the blood cells, by investigating DNA damages associat ed with hypoxia caused by massive blood loss (BL in severe injury.Subjects and methods. Ninetyfive patients aged 40.6±16.5 years (from 20 to 79 years who had sustained severe mechanical injury with different BL volumes (BLV (from 100 to 4000 ml and hemodynamic disorders were examined to study DNA damages and white blood cell necrotic and apop totic processes. In terms of the victims' weight, the mean BL was 21.5±16.5 ml/kg (from 1.4 to 61.5 ml/kg. The victimswere divided into 4 groups according to BLV: 1 26 victims whose BLV was less than 750 ml (5.93±2.41 ml/kg (grade I BL; 2 23 victims whose BLV was 750—1500 ml (11.5±1.5 ml/kg (grade 2 BL; 3 23 victims whose BLV was 1500—2000 ml (23.8±4.0 ml/kg (grade 3 BL; 4 23 victims whose BLV was over 2000 ml (45.6±10.1 ml/kg (grade 4 BL, according to the type of injury: 1 severe skeletal injury (SSI (n=17; 2 brain injury (BI (n=43; 3 a concurrence of SSI and BI (SSI+BI (n=35; according to the development of infectious complications: 1 69 victims who developed infectious com plications on days 5—7 postinjury; 2 26 victims who did not. To evaluate the impact of hypoxia on DNA damages, white blood cell apoptotic and necrotic processes, the victims were divided into 2 groups: 1 hypoxia (18 of the 95 victims who had 4 altered indicators, such as capillary blood pO2, plasma lactate levels, pH, and BE; 2 no hypoxia (10 of the 95 victims whose indicators were within the normal range. DNA damages and necrotic and apoptotic changes in the white blood cells were assessed by the DNA comet assay. The plasma concentration of extracellular DNA was fluorometrically determined using a QuantiTTM HS DNA Assay Kit (Invitrogen, USA. That of 8hydroxy2deoxyguanosine was estimated by enzyme immunoassay employing an 8hydroxy2deoxyGuanosine EIA Kit (Cayman Chemical, USA. The levels of cas

  5. Evaluation of acute cardiac and chest wall damage after shocks with a subcutaneous implantable cardioverter defibrillator in Swine.

    Science.gov (United States)

    Killingsworth, Cheryl R; Melnick, Sharon B; Litovsky, Silvio H; Ideker, Raymond E; Walcott, Gregory P

    2013-10-01

    A subcutaneous implantable cardioverter defibrillator (S-ICD) could ease placement and reduce complications of transvenous ICDs, but requires more energy than transvenous ICDs. Therefore we assessed cardiac and chest wall damage caused by the maximum energy shocks delivered by both types of clinical devices. During sinus rhythm, anesthetized pigs (38 ± 6 kg) received an S-ICD (n = 4) and five 80-Joule (J) shocks, or a transvenous ICD (control, n = 4) and five 35-J shocks. An inactive S-ICD electrode was implanted into the same control pigs to study implant trauma. All animals survived 24 hours. Troponin I and creatine kinase muscle isoenzyme (CK-MM) were measured as indicators of myocardial and skeletal muscle injury. Histopathological injury of heart, lungs, and chest wall was assessed using semiquantitative scoring. Troponin I was significantly elevated at 4 hours and 24 hours (22.6 ± 16.3 ng/mL and 3.1 ± 1.3 ng/mL; baseline 0.07 ± 0.09 ng/mL) in control pigs but not in S-ICD pigs (0.12 ± 0.11 ng/mL and 0.13 ± 0.13 ng/mL; baseline 0.06 ± 0.03 ng/mL). CK-MM was significantly elevated in S-ICD pigs after shocks (6,544 ± 1,496 U/L and 9,705 ± 6,240 U/L; baseline 704 ± 398 U/L) but not in controls. Electrocardiogram changes occurred postshock in controls but not in S-ICD pigs. The myocardium and lungs were histologically normal in both groups. Subcutaneous injury was greater in S-ICD compared to controls. Although CK-MM suggested more skeletal muscle injury in S-ICD pigs, significant cardiac, lung, and chest wall histopathological changes were not detected in either group. Troponin I data indicate significantly less cardiac injury from 80-J S-ICD shocks than 35-J transvenous shocks. ©2013, The Authors. Journal compilation ©2013 Wiley Periodicals, Inc.

  6. Evaluation of acute cardiac and chest wall damage after shocks with a subcutaneous implantable cardioverter-defibrillator in swine

    Science.gov (United States)

    KILLINGSWORTH, CHERYL R.; MELNICK, SHARON B.; LITOVSKY, SILVIO H.; IDEKER, RAYMOND E.; WALCOTT, GREGORY P.

    2013-01-01

    Background A subcutaneous implantable cardioverter defibrillator (S-ICD) could ease placement and reduce complications of transvenous ICDs, but requires more energy than transvenous ICDs. Therefore we assessed cardiac and chest wall damage caused by the maximum energy shocks delivered by both types of clinical devices. Methods During sinus rhythm, anesthetized pigs (38±6 kg) received an S-ICD (n = 4) and five 80-Joule (J) shocks, or a transvenous ICD (control, n = 4) and five 35-J shocks. An inactive S-ICD electrode was implanted into the same control pigs to study implant trauma. All animals survived 24-hours. Troponin I and creatine kinase muscle isoenzyme (CK-MM) were measured as indicators of myocardial and skeletal muscle injury. Histopathological injury of heart, lungs, and chest wall was assessed using semi-quantitative scoring. Results Troponin I was significantly elevated at 4- and 24-hours (22.6±16.3 and 3.1±1.3 ng/ml; baseline 0.07±0.09 ng/ml) in control pigs but not in S-ICD pigs (0.12±0.11 and 0.13±0.13 ng/ml; baseline 0.06±0.03 ng/ml). CK-MM was significantly elevated in S-ICD pigs after shocks (6544±1496 and 9705±6240 U/L; baseline 704±398 U/L) but not in controls. ECG changes occurred post-shock in controls but not in S-ICD pigs. The myocardium and lungs were histologically normal in both groups. Subcutaneous injury was greater in S-ICD compared to controls. Conclusion Although CK-MM suggested more skeletal muscle injury in S-ICD pigs, significant cardiac, lung, and chest wall histopathological changes were not detected in either group. Troponin I data indicate significantly less cardiac injury from 80-J S-ICD shocks than 35-J transvenous shocks. PMID:23713608

  7. Variability in coronary artery anatomy affects consistency of cardiac damage after myocardial infarction in mice.

    Science.gov (United States)

    Chen, Jiqiu; Ceholski, Delaine K; Liang, Lifan; Fish, Kenneth; Hajjar, Roger J

    2017-08-01

    Low reliability and reproducibility in heart failure models are well established. The purpose of the present study is to explore factors that affect model consistency of myocardial infarction (MI) in mice. MI was induced by left coronary artery (LCA) ligation. The coronary artery was casted with resin and visualized with fluorescent imaging ex vivo. LCA characteristics and MI size were analyzed individually in each animal, and MI size was correlated with left ventricular (LV) function by echocardiography. Coronary anatomy varies widely in mice, posing challenges for surgical ligation and resulting in inconsistent MI size postligation. The length of coronary arterial trunk, level of bifurcation, number of branches, and territory supplied by these branches are unique in each animal. When the main LCA trunk is ligated, this results in a large MI, but when a single branch is ligated, MI size is variable due to differing levels of LCA ligation and area supplied by the branches. During the ligation procedure, nearly 40% of LCAs are not grossly visible to the surgeon. In these situations, the surgeon blindly sutures a wider and deeper area of tissue in an attempt to catch the LCA. Paradoxically, these situations have greater odds of resulting in smaller MIs. In conclusion, variation in MI size and LV function after LCA ligation in mice is difficult to avoid. Anatomic diversity of the LCA in mice leads to inconsistency in MI size and functional parameters, and this is independent of potential technical modifications made by the operator. NEW & NOTEWORTHY In the present study, we demonstrate that left coronary artery diversity in mice is one of the primary causes of variable myocardial infarction size and cardiac functional parameters in the left coronary artery ligation model. Recognition of anatomic diversity is essential to improve reliability and reproducibility in heart failure research. Copyright © 2017 the American Physiological Society.

  8. Modelling of Zircaloy-steam-oxidation under severe fuel damage conditions

    International Nuclear Information System (INIS)

    Malang, S.; Neitzel, H.J.

    1983-01-01

    Small break loss-of-coolant accidents and special transients in an LWR, in combination with loss of required safety systems, may lead to an uncovered core for an extended period of time. As a consequence, the cladding temperature could rise up to the melting point due to the decay heat, resulting in severely damaged fuel rods. During heat-up the claddings oxidize due to oxygen uptake from the steam atmosphere in the core. The modeling and assessment of the Zircaloy-steam oxidation under such conditions is important, mainly for two reasons: The oxidation of the cladding influences the temperature transients due to the exothermic heat of reaction; the amount of liquified fuel depends on the oxide layer thickness and the oxygen content of the remaining Zircaloy metal when the melting point is reached. (author)

  9. Micro-CT features of intermediate gunshot wounds severely damaged by fire.

    Science.gov (United States)

    Fais, Paolo; Giraudo, Chiara; Boscolo-Berto, Rafael; Amagliani, Alessandro; Miotto, Diego; Feltrin, Giampietro; Viel, Guido; Ferrara, S Davide; Cecchetto, Giovanni

    2013-03-01

    Incineration or extensive burning of the body, causing changes in the content and distribution of fluids, fixation and shrinking processes of tissues, can alter the typical macroscopic and microscopic characteristics of firearm wounds, hampering or at least complicating the reconstruction of gunshot fatalities. The present study aims at evaluating the potential role of micro-computed tomography (micro-CT) for detecting and quantifying gunshot residue (GSR) particles in experimentally produced intermediate-range gunshot wounds severely damaged by fire. Eighteen experimental shootings were performed on 18 sections of human calves surgically amputated for medical reasons at three different firing distances (5, 15 and 30 cm). Six stab wounds produced with an ice pick were used as controls. Each calf section underwent a charring cycle, being placed in a wood-burning stove for 4 min at a temperature of 400 °C. At visual inspection, the charred entrance wounds could not be differentiated from the exit lesions and the stab wounds. On the contrary, micro-CT analysis showed the presence of GSR particles in all burnt entrance gunshot wounds, while GSR was absent in the exit and stab wounds. The GSR deposits of the firearm lesions inflicted at very close distance (5 cm) were mainly constituted of huge particles (diameter >150 μm) with an irregular shape and well-delineated edges; at greater distances (15 and 30 cm), agglomerates of tiny radiopaque particles scattered in the epidermis and dermis layers were evident. Statistical analysis demonstrated that also in charred firearm wounds the amount of GSR roughly correlates with the distance from which the gun was fired. The obtained results suggest that micro-CT analysis can be a valid screening tool for identifying entrance gunshot wounds and for differentiating firearm wounds from sharp-force injuries in bodies severely damaged by fire.

  10. Cumulative Effects of Several Target Organ Damages in Risk Assessment in Hypertension.

    Science.gov (United States)

    Harbaoui, Brahim; Courand, Pierre-Yves; Defforges, Alice; Khettab, Fouad; Milon, Hugues; Girerd, Nicolas; Lantelme, Pierre

    2016-02-01

    The prognostic value of screening multiple target organ damages (TODs) in hypertensive subjects has not been extensively studied. We estimated the prognostic value of considering 3 TODs in estimating the 10-year survival in hypertensive subjects. At baseline 1,848 out of a cohort of 1,963 hypertensive patients had a previous cardiovascular disease (CVD) or assessments of 3 TODs: Modification in Diet in Renal Disease (MDRD) 300mg/day, Sokolow index >3.5 mV, and advanced hypertensive retinopathy (grades 3 and 4 of Keith-Wagener-Barker classification). The cohort was divided into 5 groups: 0 TOD (N = 978), 1 TOD (N = 308), 2 TODs (N = 94), 3 TODs (N = 30), and previous CVD (N = 438). After 10 years of follow-up, we observed 418 deaths of which 254 from cardiovascular cause. The adjusted hazard ratios for the major cardiovascular risk factors showed a progressive risk associated with the number of TODs. For all-cause death, the hazard ratios [95% confidence intervals] vs. 0 TOD of the other 4 groups were 1.91 [1.39-2.63], 1.99 [1.28-3.10], 4.33 [2.42-7.72], and 3.09 [2.35-4.05], respectively. For cardiovascular death, the hazard ratios [95% confidence intervals] were of the same order of magnitude: 2.14 [1.38-3.32], 2.12 [1.15-3.89], 4.22 [1.83-9.72], and 4.24 [2.95-6.11], respectively. Our results indicate that hypertensive patients with several TODs had a worst outcome. Thus, it seems important to screen for multiple TODs in hypertension; especially check for severe hypertensive retinopathy in patients with left ventricular hypertrophy (LVH) and renal damage. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  11. Microstructural damage of the posterior corpus callosum contributes to the clinical severity of neglect.

    Directory of Open Access Journals (Sweden)

    Marco Bozzali

    Full Text Available One theory to account for neglect symptoms in patients with right focal damage invokes a release of inhibition of the right parietal cortex over the left parieto-frontal circuits, by disconnection mechanism. This theory is supported by transcranial magnetic stimulation studies showing the existence of asymmetric inhibitory interactions between the left and right posterior parietal cortex, with a right hemispheric advantage. These inhibitory mechanisms are mediated by direct transcallosal projections located in the posterior portions of the corpus callosum. The current study, using diffusion imaging and tract-based spatial statistics (TBSS, aims at assessing, in a data-driven fashion, the contribution of structural disconnection between hemispheres in determining the presence and severity of neglect. Eleven patients with right acute stroke and 11 healthy matched controls underwent MRI at 3T, including diffusion imaging, and T1-weighted volumes. TBSS was modified to account for the presence of the lesion and used to assess the presence and extension of changes in diffusion indices of microscopic white matter integrity in the left hemisphere of patients compared to controls, and to investigate, by correlation analysis, whether this damage might account for the presence and severity of patients' neglect, as assessed by the Behavioural Inattention Test (BIT. None of the patients had any macroscopic abnormality in the left hemisphere; however, 3 cases were discarded due to image artefacts in the MRI data. Conversely, TBSS analysis revealed widespread changes in diffusion indices in most of their left hemisphere tracts, with a predominant involvement of the corpus callosum and its projections on the parietal white matter. A region of association between patients' scores at BIT and brain FA values was found in the posterior part of the corpus callosum. This study strongly supports the hypothesis of a major role of structural disconnection between the

  12. Phenomena occurring in the reactor coolant system during severe core damage accidents

    International Nuclear Information System (INIS)

    Malinauskas, A.P.

    1989-01-01

    The reactor coolant system (RCS) of a nuclear power plant consists of the reactor pressure vessel and the piping and associated components that are required for the continuous circulation of the coolant which is used to maintain thermal equilibrium throughout the system. In the event of an accident, the RCS also serves as one of several barriers to the escape of radiotoxic material into the biosphere. In contrast to normal operating conditions, severe core damage accidents are characterized by significant temporal and spatial variations in heat and mass fluxes, and by eventual geometrical changes within the RCS. Furthermore, the difficulties in describing the system in the severe accident mode are compounded by the occurrence of chemical reactions. These reactions can influence both the thermal and the mass transport behavior of the system. In addition, behavior of the reactor vessel internals and of materials released from the core region (especially the radioactive fission products) in the course of the accident likewise become of concern to the analyst. This report addresses these concerns. 9 refs., 1 tab

  13. IAEA Regional Workshop on Development and Validation of EOP/AMG for Effective Prevention/Mitigation of Severe Core Damage

    International Nuclear Information System (INIS)

    1999-01-01

    Materials of the IAEA Regional Workshop contain 24 presented lectures. Authors deal with development and validation of emergency operating procedures as well as with accident management guidelines (EOP/AMG) for effective prevention and mitigation of severe core damage

  14. The effect of sleep apnea severity on cardiac autonomic activity during night time in obstructive sleep apnea patients

    Directory of Open Access Journals (Sweden)

    Gulay Ozkececi

    Full Text Available ABSTRACT CONTEXT AND OBJECTIVE: Impaired autonomic cardiac function is an important consequence of obstructive sleep apnea (OSA. This impairment is mainly due to intermittent hypoxia episodes following apneas. However, the impact of apnea severity on autonomic cardiac function remains unclear. The aim of this study was to evaluate the relationship between the severity of sleep apnea and heart rate turbulence (HRT and heart rate variability (HRV in OSA. DESIGN AND SETTING: Observational cross-sectional study conducted in the Departments of Cardiology and Pulmonary Diseases, Afyon Kocatepe University, Turkey. METHODS: 106 patients with OSA and 27 healthy volunteers were enrolled. Based on apnea hypopnea index (AHI values, obstructive sleep apnea severity was classified as follows: mild OSA (AHI ≥ 5 and 30. HRV and HRT parameters were assessed via 24-hour digital Holter electrocardiogram recordings for all subjects. RESULTS: HRV and HRT results were significantly lower among OSA patients than among control subjects (P < 0.05. However, there were no significant differences in HRT and HRV between the three patient subgroups. Correlations did emerge between AHI and the NN-interval parameter RMSSD and between oxygen desaturation and turbulence slope (respectively: r = -0.22, P = 0.037; and r = -0.28, P = 0.025. CONCLUSION: HRT and HRV results deteriorate in OSA. Correlations between apnea severity and these parameters seem to be present.

  15. Precursors to potential severe core damage accidents: 1992, A status report. Volume 17, Main report and Appendix A

    Energy Technology Data Exchange (ETDEWEB)

    Cox, D.F.; Cletcher, J.W.; Copinger, D.A.; Cross-Dial, A.E.; Morris, R.H.; Vanden Heuvel, L.N. [Oak Ridge National Lab., TN (United States); Dolan, B.W.; Jansen, J.M.; Minarick, J.W. [Science Applications International Corp., Oak Ridge, TN (United States); Lau, W.; Salyer, W.D. [Reliability and Performance Associates (United States)

    1993-12-01

    Twenty-seven operational events with conditional probabilities of subsequent severe core damage of 1.0 {times} 10E-06 or higher occurring at commercial light-water reactors during 1992 are considered to be precursors to potential core damage. These are described along with associated significance estimates, categorization, and subsequent analyses. The report discusses (1) the general rationale for this study, (2) the selection and documentation of events as precursors, (3) the estimation and use of conditional probabilities of subsequent severe core damage to rank precursor events, and (4) the plant models used in the analysis process.

  16. Information on the evolution of severe LWR fuel element damage obtained in the CORA program

    International Nuclear Information System (INIS)

    Schanz, G.; Hagen, S.; Hofmann, P.; Sepold, L.; Schumacher, G.

    1992-01-01

    In the CORA program a series of out-of-pile experiments on LWR severe accidental situations is being performed, in which test bundles of LWR typical components and arrangements (PWR, BWR) are exposed to temperature transients up to about 2400deg C under flowing steam. The individual features of the facility, the test conduct, and the evaluation will be presented. In the frame of the international cooperation in severe fuel damage (SFD) programs the CORA tests are contributing confirmatory and complementary informations to the results from the limited number of in-pile tests. The identification of basic phenomena of the fuel element destruction, observed as a function of temperature, is supported by separate-effects test results. Most important mechanisms are the steam oxidation of the Zircaloy cladding, which determines the temperature escalation, the chemical interaction between UO 2 fuel and cladding, which dominates fuel liquefaction, relocation and resulting blockage formation, as well as chemical interactions with Inconel spacer grids and absorber units ((Ag, In, Cd) alloy or B 4 C), which are leading to extensive low-temperature melt formation around 1200deg C. Interrelations between those basic phenomena, resulting for example in cladding deformation ('flowering') and the dramatic hydrogen formation in response to the fast cooling of a hot bundle by cold water ('quenching') are determining the evolution paths of fuel element destruction, which are to be identified. (orig.)

  17. Mechanistic model for Sr and Ba release from severely damaged fuel

    International Nuclear Information System (INIS)

    Rest, J.; Cronenberg, A.W.

    1985-11-01

    Among radionuclides associated with fission product release during severe accidents, the primary ones with health consequences are the volatile species of I, Te, and Cs, and the next most important are Sr, Ba, and Ru. Considerable progress has been made in the mechanistic understanding of I, Cs, Te, and noble gas release; however, no capability presently exists for estimating the release of Sr, Ba, and Ru. This paper presents a description of the primary physical/chemical models recently incorporated into the FASTGRASS-VFP (volatile fission product) code for the estimation of Sr and Ba release. FASTGRASS-VFP release predictions are compared with two data sets: (1) data from out-of-reactor induction-heating experiments on declad low-burnup (1000 and 4000 MWd/t) pellets, and (2) data from the more recent in-reactor PBF Severe Fuel Damage Tests, in which one-meter-long, trace-irradiated (89 MWd/t) and normally irradiated (approx.35,000 MWd/t) fuel rods were tested under accident conditions. 10 refs

  18. An unusual reason for severe bradycardia leading to cardiac arrest during general anaesthesia: a case report.

    Science.gov (United States)

    Struzkova, Klara; Stourac, Petr; Kanovsky, Jan; Krikava, Ivo; Toukalkova, Michaela; Sevcik, Pavel

    2014-12-01

    Takotsubo cardiomyopathy also known as transient balooning syndrome is an increasingly reported phenomenon characterized by acute reversible apical or midventricular dysfunction. This stress- induced cardiomyopathy mimics myocardial infarction, but without significant coronary artery disease, and rarely presents in perioperative period. We report a case of postmenopausal woman scheduled to undergo elective cholecystectomy, with no history of coronary artery disease. She presented perioperatively with Takotsubo cardiomyopathy by unique manifestation-asystoly. This uncommon cause of cardiac arrest during anaesthesia was possibly induced by preoperative emotional stress. There was full recovery thanks to intensive management. In Takotsubo cardiomyopathy related cardiogenic shock we used the calcium sensitiser levosimendan successfully. Takotsubo cardiomyopathy has an excellent long-term prognosis and nearly all patients have full recovery of left ventricular function. We emphasize the importance of heavy premedication by stress compromised patients and the need of sufficiently deep anaesthesia and analgesia during surgeries.

  19. Damaging Hydrogeological Events: A Procedure for the Assessment of Severity Levels and an Application to Calabria (Southern Italy

    Directory of Open Access Journals (Sweden)

    Tommaso Caloiero

    2014-11-01

    Full Text Available A damaging hydrogeological event (DHE is characterized by two components: a rainfall event and a subsequent damage event, which is the result of floods and landslides triggered by rainfall. The characteristics of both events depend on climatic, geomorphological and anthropogenic factors. In this paper, a methodology to classify the severity of DHEs is presented. A chart which considers indicators of both the damage (Dscore and the daily rainfall (Rscore values recorded in the study area is proposed. According to the chart, the events are classified into four types: ordinary events, with low Dscore and Rscore values; extraordinary events, with high Rscore values but low Dscore values; catastrophic events, characterized by non-exceptional rainfall (low Rscore and severe damage (high Dscore; major catastrophic events, obtained by both high Dscore and Rscore values. Using this approach, the 2013 DHE that occurred in Calabria (Italy was classified as an ordinary event, when compared to the previous ones, even though the widespread diffusion of damage data induced the perception of high severity damage. The rainfall that triggered this event confirms the negative trend of heavy daily precipitation detected in Calabria, and the damage can be ascribed more to sub-daily than daily rainfall affecting urbanized flood-prone areas.

  20. Results of international standard problem No. 36 severe fuel damage experiment of a VVER fuel bundle

    Energy Technology Data Exchange (ETDEWEB)

    Firnhaber, M. [Gesellschaft fuer Anlagen-und Reaktorsicherheit, Koeln (Germany); Yegorova, L. [Nuclear Safety Institute of Russian Research Center, Moscow (Russian Federation); Brockmeier, U. [Ruhr-Univ. of Bochum (Germany)] [and others

    1995-09-01

    International Standard Problems (ISP) organized by the OECD are defined as comparative exercises in which predictions with different computer codes for a given physical problem are compared with each other and with a carefully controlled experimental study. The main goal of ISP is to increase confidence in the validity and accuracy of analytical tools used in assessing the safety of nuclear installations. In addition, it enables the code user to gain experience and to improve his competence. This paper presents the results and assessment of ISP No. 36, which deals with the early core degradation phase during an unmitigated severe LWR accident in a Russian type VVER. Representatives of 17 organizations participated in the ISP using the codes ATHLET-CD, ICARE2, KESS-III, MELCOR, SCDAP/RELAP5 and RAPTA. Some participants performed several calculations with different codes. As experimental basis the severe fuel damage experiment CORA-W2 was selected. The main phenomena investigated are thermal behavior of fuel rods, onset of temperature escalation, material behavior and hydrogen generation. In general, the calculations give the right tendency of the experimental results for the thermal behavior, the hydrogen generation and, partly, for the material behavior. However, some calculations deviate in important quantities - e.g. some material behavior data - showing remarkable discrepancies between each other and from the experiments. The temperature history of the bundle up to the beginning of significant oxidation was calculated quite well. Deviations seem to be related to the overall heat balance. Since the material behavior of the bundle is to a great extent influenced by the cladding failure criteria a more realistic cladding failure model should be developed at least for the detailed, mechanistic codes. Regarding the material behavior and flow blockage some models for the material interaction as well as for relocation and refreezing requires further improvement.

  1. Severe fuel damage in steam and helium environments observed in in-reactor experiments

    International Nuclear Information System (INIS)

    Saito, S.; Shiozawa, S.

    1984-01-01

    The bahavior of severe fuel damages has been studied in gaseous environments simulating core uncovery accidents in the in-reactor experiments utilizing the NSRR. Two types of cladding relocation modes, azimuthal flow and melt-down, were revealed through the parametric experiments. The azimuthal flow was evident in an oxidizing environment in case of no oxide film break. The melt-down can be categorized into flow-down and move-down, according to the velocity of the melt-down. Cinematographies showed that the flow-down was very fast as water flows down while the move-down appeared to be much slower. The flow-down was possible in an unoxidizing environment, whereas the move-down of molten cladding occured through a crack induced in an oxide film in an oxidizing environment. The criterion of the relocation modes was developed as a function of peak cladding temperature and oxidation condition. It was also found that neither immediate quench nor fuel fracture occurred upon flooding when cladding temperature was about 1800 0 C at water injection. The external mechanical force is needed for fuel fracture. (orig.)

  2. Grain boundary sweeping and dissolution effects on fission product behavior under severe fuel damage accident conditions

    International Nuclear Information System (INIS)

    Rest, J.

    1985-10-01

    The theoretical FASTGRASS-VFP model has been used in the interpretation of fission gas, iodine, tellurium, and cesium release from severe-fuel-damage (SFD) tests performed in the PBF reactor in Idaho. A theory of grain boundary sweeping of gas bubbles, gas bubble behavior during fuel liquefaction (destruction of grain boundaries due to formation of a U-rich melt phase), and during U-Zr eutectic melting has been included within the FASTGRASS-VFP formalism. The grain-boundary-sweeping theory considers the interaction between the moving grain boundary and two distinct size classes of bubbles, those on grain faces and on grain edges. The theory of the effects of fuel liquefaction and U-Zr eutectic melting on fission product behavior considers the migration and coalescence of fission gas bubbles in either molten uranium, or a zircaloy-uranium eutectic melt. The FASTGRASS-VFP predictions, measured release rates from the above tests, and previously published release rates are compared and differences between fission product behavior in trace-irradiated and in normally irradiated fuel are highlighted

  3. Fission product behavior during the first two PBF severe fuel damage tests

    International Nuclear Information System (INIS)

    Osetek, D.J.; Cronenberg, A.W.; Hobbins, R.R.; Vinjamuri, K.

    1984-01-01

    The results of the first two severe fuel damage tests performed in the Power Burst Facility are assessed in terms of fission product release and chemical behavior. On-line gamma spectroscopy and grab sample data indicate limited release during solid-phase fuel heatup. Analysis indicates that the fuel morphology conditions for the trace-irradiated fuel employed in these two tests limit initial release. Only upon high temperature fuel restructuring and liquefaction is significant release indicated. Chemical equilibrium predictions, based on steam oxidation or reduction conditions, indicate I to be the primary iodine species during trnsport in the steam environment of the first test and CsI to be the primary species during transport in the hydrogen environment of the second test. However, the higher steam flow rate conditions of the first test transported the released iodine through the sample system; whereas, low-hydrogen flow rate of the second test apparently allowed the vast majority of iodine-bearing compounds to plateout during transport

  4. Conference on the Rehabilitation of Severely Damaged Land and Freshwater Ecosystems in Temperate Zones

    CERN Document Server

    Woodman, M

    1978-01-01

    This volume contains the papers presented at a conference on "The rehabilitation of severely damaged land and freshwater eco­ systems in temperate zones", held at Reykjavik, Iceland, from 4th to 11th July, 1976. The meeting was held under the auspices of the Ecosciences Panel of the N.A.T.O. Science Committee, and the organising expenses and greater part of the expenses of the speakers and chairmen were provided by N.A.T.O. The scientific programme was planned by M. W. Holdgate and M. J. Woodman, in consultation with numerous colleagues, and especially with the Administrative Director of the Conference in Iceland, Dr. Sturla Fridriksson. Iceland proved a particularly suitable location for such a Conference. Geologically, it is one of the youngest countries 1n the world, owing its origin to the up-welling of volcanic rock along the spreading zone of the mid-Atlantic ridge within the past 20 million years. Its structure, northern oceanic situation, recent glaciation and continuing volcanic activity make it dis...

  5. Medical Image of the Week: Cardiac Magnetic Resonance Imaging Findings of Severe RV Failure

    OpenAIRE

    Wickstrom K; Ateeli H; Chaudhary S

    2018-01-01

    No abstract available. Article truncated at 150 words. A 56-year-old man with history a of alcohol abuse presents with progressive shortness of breath on exertion, bilateral lower extremity swelling and 12-pound weight gain over two weeks. His transthoracic echocardiography (Figure 1) demonstrated severely increased global right ventricle (RV) size, severely dilated right atrium (RA), severe pulmonary artery (PA) dilation, moderate tricuspid regurgitation (TR) and right ventricular systo...

  6. Compound risk: History of traumatic stress predicts posttraumatic stress disorder symptoms and severity in sudden cardiac arrest survivors.

    Science.gov (United States)

    Rosman, Lindsey; Ford, Jessica; Whited, Amanda; Cahill, John; Lampert, Rachel; Mosesso, Vincent N; Lawless, Christine; Sears, Samuel F

    2016-08-01

    Sudden cardiac arrest (SCA) survivors can develop posttraumatic stress disorder (PTSD) which is associated with worse clinical outcomes. The purpose of this study was to evaluate the prevalence and predictors of PTSD in a large sample of SCA survivors. Prior history of psychological trauma and the effects of repeated trauma exposure on subsequent PTSD and symptom severity after SCA were also explored. A retrospective, cross-sectional study of 188 SCA survivors from the Sudden Cardiac Arrest Association patient registry completed an online questionnaire that included measures of PTSD, trauma history, sociodemographics, general health, and cardiac history. Sixty-three (36.2%) SCA survivors in this sample scored above the clinical cutoff for PTSD. Female gender, worse general health, and younger age predicted PTSD symptoms after SCA. Additionally, 50.2% of SCA survivors (n = 95) reported a history of trauma exposure and 25.4% (n = 48) of the total sample endorsed a traumatic stress response to a historic trauma. Results indicated that a traumatic stress response to a historic trauma was a stronger predictor of PTSD after SCA (odds ratio = 4.77) than all other variables in the model. PTSD symptoms are present in over one-third of SCA survivors. While demographic or health history variables predicted PTSD after SCA, a history of traumatic stress response to a previous trauma emerged as the strongest predictor of these symptoms. Routine assessment and interdisciplinary management are discussed as potential ways to expedite survivors' recovery and return to daily living. © The European Society of Cardiology 2015.

  7. Acute cardiac support with intravenous milrinone promotes recovery from early brain injury in a murine model of severe subarachnoid haemorrhage.

    Science.gov (United States)

    Mutoh, Tomoko; Mutoh, Tatsushi; Nakamura, Kazuhiro; Yamamoto, Yukiko; Tsuru, Yoshiharu; Tsubone, Hirokazu; Ishikawa, Tatsuya; Taki, Yasuyuki

    2017-04-01

    Early brain injury/ischaemia (EBI) is a serious complication early after subarachnoid haemorrhage (SAH) that contributes to development of delayed cerebral ischaemia (DCI). This study aimed to determine the role of inotropic cardiac support using milrinone (MIL) on restoring acute cerebral hypoperfusion attributable to EBI and improving outcomes after experimental SAH. Forty-three male C57BL/6 mice were assigned to either sham surgery (SAH-sham), SAH induced by endovascular perforation plus postconditioning with 2% isoflurane (Control), or SAH plus isoflurane combined with MIL with and without hypoxia-inducible factor inhibitor (HIF-I) pretreatment. Cardiac output (CO) during intravenous MIL infusion (0.25-0.75 μg/kg/min) between 1.5 and 2.5 hours after SAH induction was monitored with Doppler echocardiography. Magnetic resonance imaging (MRI)-continuous arterial spin labelling was used for quantitative cerebral blood flow (CBF) measurements. Neurobehavioral function was assessed daily by neurological score and open field test. DCI was analyzed 3 days later by determining infarction on MRI. Mild reduction of cardiac output (CO) and global cerebral blood flow (CBF) depression were notable early after SAH. MIL increased CO in a dose-dependent manner (P<.001), which was accompanied by improved hypoperfusion, incidence of DCI and functional recovery than Control (P<.05). The neuroprotective effects afforded by MIL or Control were attenuated by hypoxia-inducible factor (HIF) inhibition (P<.05). These results suggest that MIL improves acute hypoperfusion by its inotropic effect, leading to neurobehavioral improvement in mice after severe SAH, in which HIF may be acting as a critical mediator. © 2017 John Wiley & Sons Australia, Ltd.

  8. Autonomic nervous system dysfunction in children with severe tetanus: dissociation of cardiac and vascular sympathetic control

    Directory of Open Access Journals (Sweden)

    Mazzei de Davila C.A.

    2003-01-01

    Full Text Available The medical records of ten pediatric patients with a clinical diagnosis of tetanus were reviewed retrospectively. The heart rate and blood pressure of all tetanus patients were measured noninvasively every hour during the first two weeks of hospitalization. Six of ten tetanus patients presented clinical evidence of sympathetic hyperactivity (group A and were compared with a control group consisting of four children who required mechanical ventilation for diseases other than tetanus (group B. Heart rate and blood pressure simultaneously and progressively increased to a maximum by day 7. The increase over baseline was 43.70 ± 11.77 bpm (mean ± SD for heart rate (P<0.01 and 38.60 ± 26.40 mmHg for blood pressure (P<0.01. These values were higher and significantly different from those of the control group (group B at day 6, which had an average heart rate increase over baseline of 19.35 ± 12.26 bpm (P<0.05 and blood pressure of 10.24 ± 13.30 mmHg (P<0.05. By the end of the second week of hospitalization, in group A the increase of systolic blood pressure over baseline had diminished to 9.60 ± 15.37 mmHg (P<0.05, but the heart rate continued to be elevated (27.80 ± 33.92 bpm, P = NS, when compared to day 7 maximal values. The dissociation of these two cardiovascular variables at the end of the second week of hospitalization suggests the presence of asymmetric cardiac and vascular sympathetic control. One possible explanation for these observations is a selective and delayed action of tetanus toxin on the inhibitory neurons which control sympathetic outflow to the heart.

  9. Grain boundary sweeping and dissolution effects on fission product behaviour under severe fuel damage accident conditions

    International Nuclear Information System (INIS)

    Rest, J.

    1986-01-01

    The theoretical FASTGRASS-VFP model has been used in the interpretation of fission gas, iodine, tellurium, and cesium release from severe-fuel-damage (SFD) tests performed in the PBF reactor in Idaho. A theory of grain boundary sweeping of gas bubbles, gas bubble behavior during fuel liquefaction (destruction of grain boundaries due to formation of a U-rich melt phase), and during U-Zr eutectic melting has been included within the FASTGRASS-VFP formalism. The grain-boundary-sweeping theory considers the interaction between the moving grain boundary and two distinct size classes of bubbles, those on grain faces and on grain edges. The theory of the effects of fuel liquefaction and U-Zr eutectic melting on fission product behaviour considers the migration and coalescence of fission gas bubbles in either molten uranium, or a Zircaloy-Uranium eutectic melt. Results of the analyses demonstrate that intragranular fission product behavior during the tests can be interpreted in terms of a grain-growth/grain-boundary-sweeping mechanism that enhances the flow of fission products from within the grains to the grain boundaries. Whereas fuel liquefaction leads to an enhanced release of fission products in trace-irradiated fuel, the occurrence of fuel liquefaction in normally-irradiated fuel can degrade fission product release. This phenomenon is due in part to reduced gas-bubble mobilities in a viscous medium as compared to vapor transport, and in part to a degradation of grain growth rates and the subsequent decrease in grain-boundary sweeping of intragranular fission products into the liquified lamina. The analysis shows that total UO 2 dissolution due to eutectic melting leads to increased release for both trace-irradiated and normally-irradiated fuel. The FASTGRASS-VFP predictions, measured release rates from the above tests, and previously published release rates are compared and differences between fission product behavior in trace-irradiated and in normally

  10. Evaluation of cardiac adrenergic neuronal damage in rats with doxorubicin-induced cardiomyopathy using iodine-131 MIBG autoradiography and PGP 9.5 immunohistochemistry

    International Nuclear Information System (INIS)

    Jeon, T.J.; Lee, J.D.; Ha, J.-W.; Yang, W.I.; Cho, S.H.

    2000-01-01

    Doxorubicin is one of the most useful anticancer agents, but its repeated administration can induce irreversible cardiomyopathy as a major complication. The purpose of this study was to investigate doxorubicin toxicity on cardiac sympathetic neurons using iodine-131-metaiodobenzylguanidine (MIBG) and protein gene product (PGP) 9.5 immunohistochemistry, which is a marker of cardiac innervation. Wistar rats were treated with doxorubicin (2 mg/kg, i.v.) once a week for 4 (n=5), 6 (n=6) or 8 (n=7) weeks consecutively. Left ventricular ejection fraction (LVEF), calculated by M-mode echocardiography, was used as an indicator of cardiac function. Plasma noradrenaline (NA) concentration was measured by high-performance liquid chromatography (HPLC). 131 I-MIBG uptake of the left ventricular wall (24 ROIs) was measured by autoradiography. 131 I-MIBG uptake pattern was compared with histopathological results, the neuronal population on PGP 9.5 immunohistochemistry and the degree of myocyte damage assessed using a visual scoring system on haematoxylin and eosin and Masson's trichrome staining. LVEF was significantly decreased in the 8-week group (P 131 I-MIBG uptake ratio of subepicardium to subendocardium were significantly increased (P<0.05) in the 8-week group as compared with the control group. It may be concluded that radioiodinated MIBG is a reliable marker for the detection of cardiac adrenergic neuronal damage in doxorubicin-induced cardiomyopathy; it detects such damage earlier than do other clinical parameters and in this study showed a good correlation with the reduction in the neuronal population on PGP 9.5 stain. The subendocardial layer appeared to be more vulnerable to doxorubicin than the subepicardium. (orig.)

  11. Relation between both oxidative and metabolic-osmotic cell damages and initial injury severity in bombing casualties

    Directory of Open Access Journals (Sweden)

    Vučeljić Marina

    2006-01-01

    Full Text Available Background/Aim. We have recently reported the development of oxidative cell damages in bombing casualties within a very early period after the initial injury. The aim of this study, was to investigate malondialdehyde (MDA, as an indicator of lipid peroxidation, and osmolal gap (OG, as a good indicator of metabolic cell damages and to assess their relationship with the initial severity of the injury in bombing casualties. Methods. The study included the males (n = 52, injured during the bombing with the Injury Severity Score (ISS ranging from 3 to 66. The whole group of casualties was devided into a group of less severely (ISS < 25, n = 24 and a group of severely (ISS ≥ 26, n = 28 injured males. The uninjured volunteers (n = 10 were the controls. Osmolality, MDA, sodium, glucose, urea, creatinine, total bilirubin and total protein levels were measured in the venous blood, sampled daily, within a ten-day period. Results. In both groups of casualties, MDA and OG levels increased, total protein levels decreased, while other parameters were within the control limits. MDA alterations correlated with ISS (r = 0.414, p < 0.01, while a statistically significant correlation between OG and ISS was not obtained. Interestingly, in spite of some differences in MDA and OG trends, at the end of the examined period they were at the similar level in both groups. Conclusion. The initial oxidative damages of the cellular membrane with intracellular metabolic disorders contributed to the gradual development of metabolic-osmotic damages of cells, which, consequently caused the OG increase. In the bombing casualties, oxidative cell damages were dependent on the initial injury severity, while metabolic-osmotic cell damages were not.

  12. Dipyridamole-thallium tests are predictive of severe cardiac arrhythmias in patients with left ventricular hypertrophy

    International Nuclear Information System (INIS)

    Saragoca, M.A.; Canziani, M.E.; Gil, M.A.; Castiglioni, M.L.; Cassiolato, J.L.; Barbieri, A.; Lima, V.C.; Draibe, S.A.; Martinez, E.E.

    1991-01-01

    In a population of patients with chronic renal failure (CRF) and a high prevalence of left ventricular hypertrophy (LVH) undergoing chronic hemodialysis, the authors investigated the association between the results of dipyridamole-thallium tests (DTTs) and the occurrence of ventricular arrhythmias. They observed a positive significant association between positive DTTs and the occurrence of severe forms of ventricular arrhythmias. A significant association was also observed between the presence of severe LVH and the occurrence of severe ventricular arrhythmias. However, no association was found between the presence of LVH and the positivity of the DTT. As most of their patients with positive DTTs had unimpaired coronary circulations, they conclude that positive DTTs, although falsely indicative of impaired myocardial blood supply, does have an important clinical relevance, indicating increased risk of morbidity (and, possibly, mortality) due to ventricular arrhythmias in a population of CRF patients submitted to chronic renal function replacement program

  13. Pulse pressure and nocturnal fall in blood pressure are predictors of vascular, cardiac and renal target organ damage in hypertensive patients (LOD-RISK study).

    Science.gov (United States)

    García-Ortiz, Luis; Gómez-Marcos, Manuel A; Martín-Moreiras, Javier; González-Elena, Luis J; Recio-Rodriguez, Jose I; Castaño-Sánchez, Yolanda; Grandes, Gonzalo; Martínez-Salgado, Carlos

    2009-08-01

    To analyse the relationship between various parameters derived from ambulatory blood pressure monitoring (ABPM) and vascular, cardiac and renal target organ damage. A cross-sectional, descriptive study. It included 353 patients with short-term or recently diagnosed hypertension. ABPM, carotid intima-media thickness (IMT), Cornell voltage-duration product (Cornell VDP), glomerular filtration rate and albumin/creatinine ratio to assess vascular, cardiac and renal damage. Two hundred and twenty-three patients (63.2%) were males, aged 56.12+/-11.21 years. The nocturnal fall in blood pressure was 11.33+/-8.41, with a dipper pattern in 49.0% (173), nondipper in 30.3% (107), extreme dipper in 12.7% (45) and riser in 7.9% (28). The IMT was lower in the extreme dipper (0.716+/-0.096 mm) and better in the riser pattern (0.794+/-0.122 mm) (P<0.05). The Cornell VDP and albumin/creatinine ratio were higher in the riser pattern (1818.94+/-1798.63 mm/ms and 140.78+/-366.38 mg/g, respectively) than in the other patterns. In the multivariate analysis after adjusting for age, sex and antihypertensive treatment, with IMT as dependent variable the 24-h pulse pressure (beta = 0.003), with Cornell VDP the rest pulse pressure (beta = 12.04), and with the albumin/creatinine ratio the percentage of nocturnal fall in systolic blood pressure (beta = -3.59), the rest heart rate (beta = 1.83) and the standard deviation of 24-h systolic blood pressure (beta = 5.30) remain within the equation. The estimated pulse pressure with ABPM is a predictor of vascular and cardiac organ damage. The nocturnal fall and the standard deviation in 24-h systolic blood pressure measured with the ABPM is a predictor of renal damage.

  14. Out-of-pile UO2/Zircaloy-4 experiments under severe fuel damage conditions

    International Nuclear Information System (INIS)

    Hofmann, P.

    1983-01-01

    Chemical interactions between UO 2 fuel and Zircaloy-4 cladding up to the melting point of zircaloy (Zry) are described. Out-of-pile UO 2 /zircaloy reaction experiments have been performed to investigate the chemical interaction behavior under possible severe fuel damage conditions (very high temperatures and external overpressure). The tests have been conducted in inert gas (1 to 80 bar) with 10-cm-long zircaloy cladding specimens filled with UO 2 pellets. The annealing temperature varied between 1000 and 1700 deg. C and the annealing period between 1 and 150 min. The extent of the chemical reaction depends decisively on whether or not good contact between UO 2 and zircaloy has been established. If solid contact exists, zircaloy reduces the UO 2 to form oxygen-stabilized α-Zr(O) and uranium metal. The uranium reacts with zircaloy to form a (U,Zr) alloy rich in uranium. The (U,Zr) alloy, which is liquid above approx. 1150 deg. C, lies between two α-Zr(O) layers. The UO 2 /zircaloy reaction obeys a parabolic rate law. The degree of chemical interaction is determined by the extent of oxygen diffusion into the cladding, and hence by the time and temperature. The affinity of zirconium for oxygen, which results in an oxygen gradient across the cladding, is the driving force for the reaction. The growth of the reaction layers can be represented in an Arrhenius diagram. The UO 2 /Zry-4 reaction occurs as rapidly as the steam/Zry-4 reaction above about 1100 deg. C. The extent of the interaction is independent of external pressure above about 10 bar at 1400 deg. C and 5 bar at 1700 deg. C. The maximum measured oxygen content of the cladding is approx. 6wt.%. Up to approx. 9 volume % of the UO 2 can be chemically dissolved by the zircaloy. In an actual fuel rod, complete release of the fission products in this region of the fuel must therefore be assumed. (author)

  15. What predicts depression in cardiac patients: Sociodemographic factors, disease severity or theoretical vulnerabilities?

    OpenAIRE

    Doyle, Frank; McGee, Hannah; Conroy, Ronán; Delaney, Mary

    2011-01-01

    Depression is associated with increased cardiovascular risk in patients with acute coronary syndrome (ACS), but some argue that elevated depression is actually a marker of cardiovascular disease severity. Therefore, disease indices should be better predictors of depression than established theoretical causes of depression (interpersonal life events, reinforcing events, cognitive distortions, type D personality). However, little theory-based research has been conducted in this area. In a cross...

  16. Leadless Cardiac Pacemaker Implantation After Lead Extraction in Patients With Severe Device Infection.

    Science.gov (United States)

    Kypta, Alexander; Blessberger, Hermann; Kammler, Juergen; Lambert, Thomas; Lichtenauer, Michael; Brandstaetter, Walter; Gabriel, Michael; Steinwender, Clemens

    2016-09-01

    Conventional pacemaker therapy is limited by short- and long-term complications, most notably device infection. Transcatheter pacing systems (TPS) may be beneficial in this kind of patients as they eliminate the need for a device pocket and leads and thus may reduce the risk of re-infection. We assessed a novel procedure in 6 patients with severe device infection who were pacemaker dependent. After lead extraction a single chamber TPS was implanted into the right ventricle. Of the 6 patients who underwent lead extraction due to severe device infection at our institution, 3 were diagnosed with a pocket infection only, whereas the other 3 showed symptoms of both pocket and lead infection. Successful lead extraction and TPS implantation was accomplished in all patients. Four patients were bridged with a temporary pacemaker between 2 hours and 2 days after lead extraction, whereas 2 patients had the TPS implanted during the same procedure just before traditional pacemaker system removal. All patients stayed free of infection during the follow-up period of 12 weeks. An additional positron emission tomography scan was performed in each patient and indicated no signs of an infection around the TPS. Transcather pacemaker implantation was safe and feasible in 6 patients and did not result in re-infection even if implanted before removal of the infected pacemaker system within the same procedure. Therefore, implantation of a TPS may be an option for patients with severe device infection, especially in those with blocked venous access or who are pacemaker dependent. © 2016 Wiley Periodicals, Inc.

  17. [Resuscitation of severely hypothermic and multitraumatised female following long-term cardiac arrest

    DEFF Research Database (Denmark)

    Runitz, K.; Thornberg, K.; Wanscher, M.

    2009-01-01

    We describe the case of a patient who was severely hypothermic after 45 minutes of submersion. The patient received about 90 minutes of basic and advanced life support before being connected to extra corporal heart lung assistance (ECHLA). The core temperature was 28.9 degrees C, plasma potassium...... was 3.7 mmol/l. The patient stabilized and was discharged without significant sequelae after four weeks. This case report describes the importance of basic life support in the hypothermic patient and the use of ECHLA Udgivelsesdato: 2009/1/26...

  18. Association of cardiac disease and alcohol use with the development of severe ciguatera.

    Science.gov (United States)

    Radke, Elizabeth G; Grattan, Lynn M; Morris, John Glenn

    2013-12-01

    Ciguatera is a foodborne illness that causes severe gastrointestinal and neurologic symptoms, but the risk factors for illness are not well established. In St Thomas, US Virgin Islands, we performed a case-control study for ciguatera, enrolling 47 patients primarily through the emergency department and 141 age- and sex-matched controls identified through an island-wide survey. We used conditional logistic regression to assess health-related risk factors for ciguatera, including comorbidities and alcohol and tobacco use. Cases were more likely than controls to report alcohol consumption at least weekly (odds ratio 5.7, 95% confidence interval 2.7-24.8). Cases also more frequently had a history of heart disease (odds ratio 6.3, 95% confidence interval 1.2-32.7). Previous ciguatera episodes, lower levels of education, and frequent fish consumption also were associated with illness. This study provides preliminary evidence that preexisting health status influences an individual's risk of developing severe ciguatera. There may be a benefit to educating high-risk individuals about preventing ciguatera.

  19. What predicts depression in cardiac patients: sociodemographic factors, disease severity or theoretical vulnerabilities?

    Science.gov (United States)

    Doyle, F; McGee, H M; Conroy, R M; Delaney, M

    2011-05-01

    Depression is associated with increased cardiovascular risk in acute coronary syndrome (ACS) patients, but some argue that elevated depression is actually a marker of cardiovascular disease severity. Therefore, disease indices should better predict depression than established theoretical causes of depression (interpersonal life events, reinforcing events, cognitive distortions, type D personality). However, little theory-based research has been conducted in this area. In a cross-sectional design, ACS patients (n = 336) completed questionnaires assessing depression and psychosocial vulnerabilities. Nested logistic regression assessed the relative contribution of demographic or vulnerability factors, or disease indices or vulnerabilities to depression. In multivariate analysis, all vulnerabilities were independent significant predictors of depression (scoring above threshold on any scale, 48%). Demographic variables accounted for vulnerabilities accounting for significantly more (pseudo R² = 0.16, χ²(change) = 150.9, df = 4, p vulnerabilities increased the overall variance explained to 22% (pseudo R² = 0.22, χ² = 58.6, df = 4, p vulnerabilities predicted depression status better than did either demographic or disease indices. The presence of these proximal causes of depression suggests that depression in ACS patients is not simply a result of cardiovascular disease severity.

  20. Successful resuscitation from two cardiac arrests in a female patient with critical aortic stenosis, severe mitral regurgitation and coronary artery disease

    Directory of Open Access Journals (Sweden)

    Mijušković Dragan

    2012-01-01

    Full Text Available Introduction. The incidence of sudden cardiac death in patients with severe symptomatic aortic stenosis is up to 34% and resuscitation is described as highly unsuccessful. Case report. A 72-year-old female patient with severe aortic stenosis combined with severe mitral regurgitation and three-vessel coronary artery disease was successfully resuscitated following two in-hospital cardiac arrests. The first cardiac arrest occurred immediately after intraarterial injection of low osmolar iodinated agent during coronary angiography. Angiography revealed 90% occlusion of the proximal left main coronary artery and circumflex branch. The second arrest followed induction of anesthesia. Following successful open-chest resuscitation, aortic valve replacement, mitral valvuloplasty and three-vessel aortocoronary bypass were performed. Postoperative pericardial tamponade required surgical revision. The patient recovered completely. Conclusion. Decision to start resuscitation may be justified in selected patients with critical aortic stenosis, even though cardiopulmonary resuscitation in such cases is generally considered futile.

  1. Dioxin-induced acute cardiac mitochondrial oxidative damage and increased activity of ATP-sensitive potassium channels in Wistar rats

    International Nuclear Information System (INIS)

    Pereira, Susana P.; Pereira, Gonçalo C.; Pereira, Cláudia V.; Carvalho, Filipa S.; Cordeiro, Marília H.; Mota, Paula C.; Ramalho-Santos, João; Moreno, António J.; Oliveira, Paulo J.

    2013-01-01

    The environmental dioxin 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is classified as a Group 1 human carcinogen and teratogenic agent. We hypothesize that TCDD-induced oxidative stress may also interfere with mitochondrial ATP-sensitive potassium channels (mitoKATP), which are known to regulate and to be regulated by mitochondrial redox state. We investigated the effects of an acute treatment of male Wistar rats with TCDD (50 μg/kg i.p.) and measured the regulation of cardiac mitoKATP. While the function of cardiac mitochondria was slightly depressed, mitoKATP activity was 52% higher in animals treated with TCDD. The same effects were not observed in liver mitochondria isolated from the same animals. Our data also shows that regulation of mitochondrial ROS production by mitoKATP activity is different in both groups. To our knowledge, this is the first report to show that TCDD increases mitoKATP activity in the heart, which may counteract the increased oxidative stress caused by the dioxin during acute exposure. -- Highlights: •Acute TCDD treatment of Wistar rats causes cardiac oxidative stress. •Acute TCDD treatment causes cardiac mitochondrial alterations. •Mitochondrial liver vs. heart alterations are distinct. •TCDD treatment resulted in altered activity of cardiac mitochondrial K-ATP channels. -- Dioxin alters the regulation of cardiac mitochondrial ATP-sensitive potassium channels and disturbs mitochondrial physiology

  2. Climate Risk Modelling of Balsam Woolly Adelgid Damage Severity in Subalpine Fir Stands of Western North America.

    Science.gov (United States)

    Hrinkevich, Kathryn H; Progar, Robert A; Shaw, David C

    2016-01-01

    The balsam woolly adelgid (Adelges piceae (Ratzeburg) (Homoptera: Adelgidae)) (BWA) is a nonnative, invasive insect that threatens Abies species throughout North America. It is well established in the Pacific Northwest, but continues to move eastward through Idaho and into Montana and potentially threatens subalpine fir to the south in the central and southern Rocky Mountains. We developed a climatic risk model and map that predicts BWA impacts to subalpine fir using a two-step process. Using 30-year monthly climate normals from sites with quantitatively derived BWA damage severity index values, we built a regression model that significantly explained insect damage. The sites were grouped into two distinct damage categories (high damage and mortality versus little or no mortality and low damage) and the model estimates for each group were used to designate distinct value ranges for four climatic risk categories: minimal, low, moderate, and high. We then calculated model estimates for each cell of a 4-kilometer resolution climate raster and mapped the risk categories over the entire range of subalpine fir in the western United States. The spatial variation of risk classes indicates a gradient of climatic susceptibility generally decreasing from the Olympic Peninsula in Washington and the Cascade Range in Oregon and Washington moving eastward, with the exception of some high risk areas in northern Idaho and western Montana. There is also a pattern of decreasing climatic susceptibility from north to south in the Rocky Mountains. Our study provides an initial step for modeling the relationship between climate and BWA damage severity across the range of subalpine fir. We showed that September minimum temperature and a metric calculated as the maximum May temperature divided by total May precipitation were the best climatic predictors of BWA severity. Although winter cold temperatures and summer heat have been shown to influence BWA impacts in other locations, these

  3. Cardiac arrest

    Science.gov (United States)

    ... magnesium. These minerals help your heart's electrical system work. Abnormally high or low levels can cause cardiac arrest. Severe physical stress. Anything that causes a severe stress on your ...

  4. Somatic hospital contacts, invasive cardiac procedures, and mortality from heart disease in patients with severe mental disorder.

    Science.gov (United States)

    Laursen, Thomas Munk; Munk-Olsen, Trine; Agerbo, Esben; Gasse, Christiane; Mortensen, Preben Bo

    2009-07-01

    Excess mortality from heart disease is observed in patients with severe mental disorder. This excess mortality may be rooted in adverse effects of pharmacological or psychotropic treatment, lifestyle factors, or inadequate somatic care. To examine whether persons with severe mental disorder, defined as persons admitted to a psychiatric hospital with bipolar affective disorder, schizoaffective disorder, or schizophrenia, are in contact with hospitals and undergoing invasive procedures for heart disease to the same degree as the nonpsychiatric general population, and to determine whether they have higher mortality rates of heart disease. A population-based cohort of 4.6 million persons born in Denmark was followed up from 1994 to 2007. Rates of mortality, somatic contacts, and invasive procedures were estimated by survival analysis. Incidence rate ratios of heart disease admissions and heart disease mortality as well as probability of invasive cardiac procedures. The incidence rate ratio of heart disease contacts in persons with severe mental disorder compared with the rate for the nonpsychiatric general population was only slightly increased, at 1.11 (95% confidence interval, 1.08-1.14). In contrast, their excess mortality rate ratio from heart disease was 2.90 (95% confidence interval, 2.71-3.10). Five years after the first contact for somatic heart disease, the risk of dying of heart disease was 8.26% for persons with severe mental disorder (aged mental disorder as compared with the nonpsychiatric general population (7.04% vs 12.27%, respectively). Individuals with severe mental disorder had only negligible excess rates of contact for heart disease. Given their excess mortality from heart disease and lower rates of invasive procedures after first contact, it would seem that the treatment for heart disease offered to these individuals in Denmark is neither sufficiently efficient nor sufficiently intensive. This undertreatment may explain part of their excess

  5. [Effects of hydrogen on the lung damage of mice at early stage of severe burn].

    Science.gov (United States)

    Qin, C; Bian, Y X; Feng, T T; Zhang, J H; Yu, Y H

    2017-11-20

    Objective: To investigate the effects of hydrogen on the lung damage of mice at early stage of severe burn. Methods: One hundred and sixty ICR mice were divided into sham injury, hydrogen, pure burn, and burn+ hydrogen groups according to the random number table, with 40 mice in each group. Mice in pure burn group and burn+ hydrogen group were inflicted with 40% total body surface area full-thickness scald (hereafter referred to as burn) on the back, while mice in sham injury group and hydrogen group were sham injured. Mice in hydrogen group and burn+ hydrogen group inhaled 2% hydrogen for 1 h at post injury hour (PIH) 1 and 6, respectively, while mice in sham injury group and pure burn group inhaled air for 1 h. At PIH 24, lung tissue of six mice in each group was harvested, and then pathological changes of lung tissue were observed by HE staining and the lung tissue injury pathological score was calculated. Inferior vena cava blood and lung tissue of other eight mice in each group were obtained, and then content of high mobility group box 1 (HMGB1) and interleukin-6 (IL-6) in serum and lung tissue was determined by enzyme-linked immunosorbent assay. Activity of superoxide dismutase (SOD) in serum and lung tissue was detected by spectrophotometry. After arterial blood of other six mice in each group was collected for detection of arterial partial pressure of oxygen (PaO(2)), the wet and dry weight of lung tissue were weighted to calculate lung wet to dry weight ratio. The survival rates of the other twenty mice in each group during post injury days 7 were calculated. Data were processed with one-way analysis of variance, LSD test and log-rank test. Results: (1) At PIH 24, lung tissue of mice in sham injury group and hydrogen group showed no abnormality. Mice in pure burn group were with pulmonary interstitial edema, serious rupture of alveolar capillary wall, and infiltration of a large number of inflammatory cells. Mice in burn+ hydrogen group were with mild

  6. Type of Ground Surface during Plyometric Training Affects the Severity of Exercise-Induced Muscle Damage

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    Hamid Arazi

    2016-03-01

    Full Text Available The purpose of this study was to compare the changes in the symptoms of exercise-induced muscle damage from a bout of plyometric exercise (PE; 10 × 10 vertical jumps performed in aquatic, sand and firm conditions. Twenty-four healthy college-aged men were randomly assigned to one of three groups: Aquatic (AG, n = 8, Sand (SG, n = 8 and Firm (FG, n = 8. The AG performed PE in an aquatic setting with a depth of ~130 cm. The SG performed PE on a dry sand surface at a depth of 20 cm, and the FG performed PE on a 10-cm-thick wooden surface. Plasma creatine kinase (CK activity, delayed onset muscle soreness (DOMS, knee range of motion (KROM, maximal isometric voluntary contraction (MIVC of the knee extensors, vertical jump (VJ and 10-m sprint were measured before and 24, 48 and 72 h after the PE. Compared to baseline values, FG showed significantly (p < 0.05 greater changes in CK, DOMS, and VJ at 24 until 48 h. The MIVC decreased significantly for the SG and FG at 24 until 48 h post-exercise in comparison to the pre-exercise values. There were no significant (p > 0.05 time or group by time interactions in KROM. In the 10-m sprint, all the treatment groups showed significant (p < 0.05 changes compared to pre-exercise values at 24 h, and there were no significant (p > 0.05 differences between groups. The results indicate that PE in an aquatic setting and on a sand surface induces less muscle damage than on a firm surface. Therefore, training in aquatic conditions and on sand may be beneficial for the improvement of performance, with a concurrently lower risk of muscle damage and soreness.

  7. Acute response to 7-day therapy with CPAP in patients with moderate to severe obstructive sleep apnea and cardiac arrhytmia

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    Jerónimo Campos

    Full Text Available Introduction: Obstructive Sleep Apnea (OSA has been associated with an elevated risk of cardiac arrhythmia. Continuous positive airway pressure (CPAP is the selected treatment for moderate to severe OSA and could improve arrhythmias in the long term. However, the acute effect of CPAP has not been studied in detail. Methods: We conducted a prospective study with 25 patients with moderate to severe OSA diagnosed by home respiratory polygraphy (RP and arrhythmia and/or pauses in 24-hour Holter ECG. We analyzed inflammatory parameters and the rate of arrhythmias/pauses after 7 days of auto-adjusting CPAP. Results: 92.5% of the patients were men with a mean age of 61.7±1.9 years. Body mass index (BMI was 59.5±2.2 kg/m2, with a mean apnea hypopnea index (AHI of 37.7±3.8 events/hour (ev/h, and a residual AHI (AHIr of 5.3±0.53 ev/h. After short treatment with CPAP we observed a tendency to improvement in both the severity and number of ventricular extrasystoles (VE (1595.0±850.3 vs. 926.4±434.5 respectively, pauses and the inflammatory parameters (CRP 3.9±3.1 vs. 1.7±1.2, glycemia 131.4±11.6 vs. 121.9±9.8, HOMA 24.4±3.1 vs. 21.7±2.8, insulin 7.6±1.4 vs. 7.2±1.2 (p>0.5. Conclusion: We didn't find significant changes in pauses, VE and inflammatory parameters with CPAP short therapy in CPAP naive patients recently diagnosed with OSA.

  8. Usefulness of 3-Tesla cardiac magnetic resonance imaging in the assessment of aortic stenosis severity in routine clinical practice.

    Science.gov (United States)

    Levy, Franck; Iacuzio, Laura; Civaia, Filippo; Rusek, Stephane; Dommerc, Carine; Hugues, Nicolas; Alexandrescu, Clara; Dor, Vincent; Tribouilloy, Christophe; Dreyfus, Gilles

    2016-11-01

    Recently, 1.5-Tesla cardiac magnetic resonance imaging (CMR) was reported to provide a reliable alternative to transthoracic echocardiography (TTE) for the quantification of aortic stenosis (AS) severity. Few data are available using higher magnetic field strength MRI systems in this context. To evaluate the feasibility and reproducibility of the assessment of aortic valve area (AVA) using 3-Tesla CMR in routine clinical practice, and to assess concordance between TTE and CMR for the estimation of AS severity. Ninety-one consecutive patients (60 men; mean age 74±10years) with known AS documented by TTE were included prospectively in the study. All patients underwent comprehensive TTE and CMR examination, including AVA estimation using the TTE continuity equation (0.81±0.18cm 2 ), direct CMR planimetry (CMRp) (0.90±0.22cm 2 ) and CMR using Hakki's formula (CMRhk), a simplified Gorlin formula (0.70±0.19cm 2 ). Although significant agreement with TTE was found for CMRp (r=0.72) and CMRhk (r=0.66), CMRp slightly overestimated (bias=0.11±0.18cm 2 ) and CMRhk slightly underestimated (bias=-0.11±0.17cm 2 ) AVA compared with TTE. Inter- and intraobserver reproducibilities of CMR measurements were excellent (r=0.72 and r=0.74 for CMRp and r=0.88 and r=0.92 for peak aortic velocity, respectively). 3-Tesla CMR is a feasible, radiation-free, reproducible imaging modality for the estimation of severity of AS in routine practice, knowing that CMRp tends to overestimate AVA and CMRhk to underestimate AVA compared with TTE. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  9. Aortic valve bypass surgery in severe aortic valve stenosis: Insights from cardiac and brain magnetic resonance imaging.

    Science.gov (United States)

    Mantini, Cesare; Caulo, Massimo; Marinelli, Daniele; Chiacchiaretta, Piero; Tartaro, Armando; Cotroneo, Antonio Raffaele; Di Giammarco, Gabriele

    2018-04-13

    To investigate and describe the distribution of aortic and cerebral blood flow (CBF) in patients with severe valvular aortic stenosis (AS) before and after aortic valve bypass (AVB) surgery. We enrolled 10 consecutive patients who underwent AVB surgery for severe AS. Cardiovascular magnetic resonance imaging (CMR) and brain magnetic resonance imaging were performed as baseline before surgery and twice after surgery. Quantitative flow measurements were obtained using 1.5-T magnetic resonance imaging (MRI) scanner phase-contrast images of the ascending aorta, descending thoracic aorta (3 cm proximally and distally from the conduit-to-aorta anastomosis), and ventricular outflow portion of the conduit. The evaluation of CBF was performed using 3.0-T MRI scanner arterial spin labeling (ASL) through sequences acquired at the gray matter, dorsal default-mode network, and sensorimotor levels. Conduit flow, expressed as the percentage of total antegrade flow through the conduit, was 63.5 ± 8% and 67.8 ± 7% on early and mid-term postoperative CMR, respectively (P surgery in patients with severe AS, cardiac output is split between the native left ventricular outflow tract and the apico-aortic bypass, with two-thirds of the total antegrade flow passing through the latter and one-third passing through the former. In our experience, CBF assessment confirms that the flow redistribution does not jeopardize cerebral blood supply. Copyright © 2018 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  10. Correlation of C-Reactive Protein and Cardiac Enzymes with Angiographic Severity of Coronary Artery Disease in Pakistani Patients with Acute Coronary Syndrome.

    Science.gov (United States)

    Saleem, Ayesha; Ali, Azmat

    2017-02-01

    To determine the correlation of C-reactive protein (CRP) levels with the severity of coronary stenosis on angiography and the association of cardiac enzymes with the degree of stenosis in acute coronary syndrome (ACS) patients. Secondly, to compare association of angiographic severity of vascular stenosis with CRP in patients with ST segment elevation myocardial infarction (STEMI) and non-STEMI / Unstable angina (UA). Prospective, descriptive study. Khan Research Laboratories (KRL) Hospital, from October 2014 to March 2015. CRP was measured on diagnosis of ACS in 70 patients. Cardiac enzymes were measured 6 hours after the onset of chest pain. Angiographic scoring for degree of stenosis and number of culprit vessels was done. Two groups consisting of patients with STEMI (group 1) and with NSTEMI/UA (group 2) were made. No correlation was found between CRP levels and angiographic stenosis in patients with ACS (r=0.162, p>0.05). No association was found between eosinophil count and severity of stenosis (p=0.88). Rise of cardiac enzymes and degree of coronary stenosis showed a positive correlation (p Rise in cardiac enzymes still grade high in predicting severity of vascular stenosis than eosinophil count or CRP levels.

  11. Enfermedad cardíaca grave en la esclerosis sistémica Severe cardiac disease in scleroderma

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    Alejandro R. Grinberg

    2004-10-01

    Full Text Available Una mujer de 36 años de edad con diagnóstico de esclerosis sistémica (ES desarrolló un cuadro agudo de miositis esquelética e insuficiencia cardíaca grave. Evolucionó con shock cardiogénico y a pesar del tratamiento con drogas inotrópicas y altas dosis de corticoides falleció a los cinco días de haber ingresado. La autopsia reveló áreas de necrosis coagulativa miocárdicas con miocitolisis y necrosis en banda de contracción. Son muy pocos los casos comunicados de insuficiencia cardíaca grave asociada a la ES.A 36 year-old female with a diagnosis of systemic sclerosis suffered from an acute episode of skeletal myositis and refractory heart failure with cardiogenic shock. Despite immunosuppressive treatment with high doses of corticosteroids and hemodynamic support she died five days after admission. The autopsy showed cardiac myocytolysis, myocyte necrosis and contraction band necrosis. There are very few reported cases of severe heart failure associated to systemic sclerosis.

  12. Precursors to potential severe core damage accidents: 1994, a status report. Volume 21: Main report and appendices A--H

    International Nuclear Information System (INIS)

    Belles, R.J.; Cletcher, J.W.; Copinger, D.A.; Vanden Heuvel, L.N.; Dolan, B.W.; Minarick, J.W.

    1995-12-01

    Nine operational events that affected eleven commercial light-water reactors (LWRs) during 1994 and that are considered to be precursors to potential severe core damage are described. All these events had conditional probabilities of subsequent severe core damage greater than or equal to 1.0 x 10 -6 . These events were identified by computer-screening the 1994 licensee event reports from commercial LWRs to identify those that could be potential precursors. Candidate precursors were then selected and evaluated in a process similar to that used in previous assessments. Selected events underwent engineering evaluation that identified, analyzed, and documented the precursors. Other events designated by the Nuclear Regulatory Commission (NRC) also underwent a similar evaluation. Finally, documented precursors were submitted for review by licensees and NRC headquarters and regional offices to ensure that the plant design and its response to the precursor were correctly characterized. This study is a continuation of earlier work, which evaluated 1969--1981 and 1984--1993 events. The report discusses the general rationale for this study, the selection and documentation of events as precursors, and the estimation of conditional probabilities of subsequent severe core damage for events. This document is bound in two volumes: Vol. 21 contains the main report and Appendices A--H; Vol. 22 contains Appendix 1

  13. Thrombosis, systemic and cardiac oxidative stress and DNA damage induced by pulmonary exposure to diesel exhaust particles, and the effect of nootkatone thereon.

    Science.gov (United States)

    Nemmar, Abderrahim; Al-Salam, Suhail; Beegam, Sumaya; Yuvaraju, Priya; Ali, Badreldin H

    2018-01-05

    Adverse cardiovascular effects of particulate air pollution persist even at lower concentrations than those of the current air quality limit. Therefore, identification of safe and effective measures against particles-induced cardiovascular toxicity is needed. Nootkatone is a sesquiterpenoid in grapefruit with diverse bioactivities including anti-inflammatory and antioxidant effects. However, its protective effect on the cardiovascular injury induced by diesel exhaust particles (DEP) has not been studied before. We assessed the possible protective effect of nootkatone (90 mg/kg) administered by gavage 1h before intratracheal (i.t.) instillation of DEP (30 μg/mouse). Twenty-four h following the i.t. administration of DEP various thrombotic and cardiac parameters were assessed. Nootkatone inhibited the prothrombotic effect induced by DEP in pial arterioles and venules in vivo and platelet aggregation in whole blood in vitro. Also, nootkatone prevented the shortening of activated partial thromboplastin time and prothrombin time induced by DEP. Nootkatone inhibited the increase of plasma concentration of fibrinogen, plasminogen activator inhibitor-1, interleukin-6 and lipid peroxidation induced by DEP. Immunohistochemically, hearts showed an analogous increase in glutathione and nuclear factor erythroid-derived 2-like 2 (Nrf2) expression by cardiac myocytes and endothelial cells following DEP exposure, and these effects were enhanced in mice treated with nootkatone+DEP. Likewise, heme oxygenase-1 (HO-1) was increased in mice treated with nootkatone+DEP compared with those treated with DEP or nootkatone+saline. The DNA damage caused by DEP was prevented by nootkatoone pretreatment. In conclusion, nootkatoone alleviates DEP-induced thrombogenicity and systemic and cardiac oxidative stress and DNA damage, at least partly, through Nrf2 and HO-1 activation.

  14. Taurine prevents arsenic-induced cardiac oxidative stress and apoptotic damage: Role of NF-κB, p38 and JNK MAPK pathway

    International Nuclear Information System (INIS)

    Ghosh, Jyotirmoy; Das, Joydeep; Manna, Prasenjit; Sil, Parames C.

    2009-01-01

    Cardiac dysfunction is a major cause of morbidity and mortality worldwide due to its complex pathogenesis. However, little is known about the mechanism of arsenic-induced cardiac abnormalities and the use of antioxidants as the possible protective agents in this pathophysiology. Conditionally essential amino acid, taurine, accounts for 25% to 50% of the amino acid pool in myocardium and possesses antioxidant properties. The present study has, therefore, been carried out to investigate the underlying mechanism of the beneficial role of taurine in arsenic-induced cardiac oxidative damage and cell death. Arsenic reduced cardiomyocyte viability, increased reactive oxygen species (ROS) production and intracellular calcium overload, and induced apoptotic cell death by mitochondrial dependent caspase-3 activation and poly-ADP ribose polymerase (PARP) cleavage. These changes due to arsenic exposure were found to be associated with increased IKK and NF-κB (p65) phosphorylation. Pre-exposure of myocytes to an IKK inhibitor (PS-1145) prevented As-induced caspase-3 and PARP cleavage. Arsenic also markedly increased the activity of p38 and JNK MAPKs, but not ERK to that extent. Pre-treatment with SP600125 (JNK inhibitor) and SB203580 (p38 MAPK inhibitor) attenuated NF-κB and IKK phosphorylation indicating that p38 and JNK MAPKs are mainly involved in arsenic-induced NF-κB activation. Taurine treatment suppressed these apoptotic actions, suggesting that its protective role in arsenic-induced cardiomyocyte apoptosis is mediated by attenuation of p38 and JNK MAPK signaling pathways. Similarly, arsenic intoxication altered a number of biomarkers related to cardiac oxidative stress and other apoptotic indices in vivo and taurine supplementation could reduce it. Results suggest that taurine prevented arsenic-induced myocardial pathophysiology, attenuated NF-κB activation via IKK, p38 and JNK MAPK signaling pathways and could possibly provide a protection against As

  15. Impact of Chronic Neonatal Intermittent Hypoxia on Severity of Retinal Damage in a Rat Model of Oxygen-Induced Retinopathy.

    Science.gov (United States)

    Beharry, Kay D; Cai, Charles L; Ahmad, Taimur; Guzel, Sibel; Valencia, Gloria B; Aranda, Jacob V

    2018-01-01

    Neonatal intermittent hypoxia (IH) followed by re-oxygenation in normoxia or supplemental oxygen (IHR) increases the risk for severe retinopathy of prematurity (ROP). The exact timing for the onset of retinal damage which may guide strategic interventions during retinal development, is unknown. We tested the hypothesis that chronic exposure of the immature retina to neonatal IH induces early manifestations of retinal damage that can be utilized as key time points for strategic pharmacologic intervention. Newborn rats were exposed to IH within 2 hours of birth (P0) until P14, or allowed to recover in room air (RA) from P14 to P21 (IHR). Retinal integrity and angiogenesis biomarkers were progressively assessed before (P0), during IH, and post IH (recovery in RA), or IHR, and compared to normoxic age-matched controls. Retinal damage occurred as early as day 3 of neonatal IH, consistent with vascular abnormalities and disturbances in the astrocytic template. These abnormalities worsened during IHR. Pharmacologic and non-pharmacologic interventions to identify, prevent, or minimize neonatal IH should be implemented shortly after birth in high risk preterm newborns. This strategy may lead to a reduction in the outcome of severe ROP requiring later invasive treatments.

  16. Transabdominal amnioinfusion to avoid fetal demise and intestinal damage in fetuses with gastroschisis and severe oligohydramnios.

    Science.gov (United States)

    Sapin, E; Mahieu, D; Borgnon, J; Douvier, S; Carricaburu, E; Sagot, P

    2000-04-01

    Despite dramatic improvement in survival rate for neonates with gastroschisis, significant postoperative morbidity and a low mortality rate still occur. Furthermore, even in recent publications, some fetal death has been reported. Does this mean that antenatal diagnosis of gastroschisis is a missed opportunity? In fact, decreased amniotic fluid (AF) volume is observed in some fetuses with gastroschisis. However, oligohydramnios is associated with an increased risk of fetal suffering. When severe oligohydramnios is observed, intrapartum amnioinfusion, to restore AF volume, may help avoid fetal complications. Two fetuses with gastroschisis and severe oligohydramnios were treated antenatally with amnioinfusion of saline solution. In one case, fetal heart beat decelerations were observed at 27 weeks' gestation among with the oligohydroamnios and serial transabdominal amnioinfusions were performed. In the second case, severe oligohydramnios was observed at 31, weeks and an amnioinfusion was performed. The 2 babies were delivered at 31 and 34 weeks, respectively. In both cases, exteriorized bowel was nearly normal at birth, and primary closure could be performed. Outcome was favorable, and they were discharged home on day 43 and day 54, respectively. Because fetuses with gastroschisis and oligohydramnios are part of a particular high-risk group, serial ultrasound examination and computerized fetal heart beat monitoring are necessary during the third trimester. In selected cases of gastroschisis associated with severe oligohydramnios, serial amnioinfusion may be required.

  17. Psychosocial Adjustment and Life Satisfaction until 5 Years after Severe Brain Damage

    Science.gov (United States)

    Sorbo, Ann K.; Blomqvist, Maritha; Emanuelsson, Ingrid M.; Rydenhag, Bertil

    2009-01-01

    The objectives of this study were to describe psychosocial adjustment and outcome over time for severely brain-injured patients and to find suitable outcome measures for clinical practice during the rehabilitation process and for individual rehabilitation planning after discharge from hospital. The methods include a descriptive, prospective,…

  18. Oxidative Damage and Mitochondrial Injuries Are Induced by Various Irrigation Pressures in Rabbit Models of Mild and Severe Hydronephrosis

    Science.gov (United States)

    Cao, Zhixiu; Yu, Weimin; Li, Wei; Cheng, Fan; Rao, Ting; Yao, Xiaobing; Zhang, Xiaobin; Larré, Stéphane

    2015-01-01

    Objective We aimed to study whether tolerance to irrigation pressure could be modified by evaluating the oxidative damage of obstructed kidneys based on rabbit models experiencing different degrees of hydronephrosis. Methods A total of 66 rabbits were randomly divided into two experimental groups and a control group. In the experimental groups, the rabbits underwent a surgical procedure inducing mild (group M, n=24) or severe (group S, n=24) hydronephrosis. In each experimental group, the rabbits were then randomly divided into 4 subgroups (M0-M3 and S0-S3) consisting of 6 rabbits each. Group 0 received no perfusion. Groups 1 through 3 were perfused with 20, 60 and 100 mmHg fluid, respectively. For the control group, after a sham operation was performed, the rabbits were divided into 4 subgroups and were perfused with fluid at 0, 20, 60 or 100 mmHg of pressure. Kidney injuries was evaluated by neutrophil gelatinase associated lipocalin (NGAL). Oxidative damage was assessed by analyzing superoxide dismutase (Mn-SOD) activity, malondialdehyde (MDA) levels, glutathione reductase (GR), catalase (CAT) and peroxide (H2O2) levels, mitochondrial injuries was assessed by mitochondrial membrane potential (MMP), the mitochondrial ultrastructure and tubular cell apoptosis. Results In the experimental groups, all results were similar for groups 0 and 1. In group 2, abnormalities were observed in the S group only, and the kidneys of rabbits in group 3 suffered oxidative damage and mitochondrial injuries with increased NGAL, decreased Mn-SOD, GR and CAT,increased MDA and H2O2, lower levels of MMP, mitochondrial vacuolization and an increased apoptotic index. Conclusion In rabbits, severely obstructed kidneys were more susceptible to oxidative damage and mitochondrial injury than mildly obstructed kidneys when subjected to higher degrees of kidney perfusion pressure. PMID:26090815

  19. Oxidative Damage and Mitochondrial Injuries Are Induced by Various Irrigation Pressures in Rabbit Models of Mild and Severe Hydronephrosis.

    Directory of Open Access Journals (Sweden)

    Zhixiu Cao

    Full Text Available We aimed to study whether tolerance to irrigation pressure could be modified by evaluating the oxidative damage of obstructed kidneys based on rabbit models experiencing different degrees of hydronephrosis.A total of 66 rabbits were randomly divided into two experimental groups and a control group. In the experimental groups, the rabbits underwent a surgical procedure inducing mild (group M, n=24 or severe (group S, n=24 hydronephrosis. In each experimental group, the rabbits were then randomly divided into 4 subgroups (M0-M3 and S0-S3 consisting of 6 rabbits each. Group 0 received no perfusion. Groups 1 through 3 were perfused with 20, 60 and 100 mmHg fluid, respectively. For the control group, after a sham operation was performed, the rabbits were divided into 4 subgroups and were perfused with fluid at 0, 20, 60 or 100 mmHg of pressure. Kidney injuries was evaluated by neutrophil gelatinase associated lipocalin (NGAL. Oxidative damage was assessed by analyzing superoxide dismutase (Mn-SOD activity, malondialdehyde (MDA levels, glutathione reductase (GR, catalase (CAT and peroxide (H2O2 levels, mitochondrial injuries was assessed by mitochondrial membrane potential (MMP, the mitochondrial ultrastructure and tubular cell apoptosis.In the experimental groups, all results were similar for groups 0 and 1. In group 2, abnormalities were observed in the S group only, and the kidneys of rabbits in group 3 suffered oxidative damage and mitochondrial injuries with increased NGAL, decreased Mn-SOD, GR and CAT,increased MDA and H2O2, lower levels of MMP, mitochondrial vacuolization and an increased apoptotic index.In rabbits, severely obstructed kidneys were more susceptible to oxidative damage and mitochondrial injury than mildly obstructed kidneys when subjected to higher degrees of kidney perfusion pressure.

  20. Telomere elongation protects heart and lung tissue cells from fatal damage in rats exposed to severe hypoxia.

    Science.gov (United States)

    Wang, Yaping; Zhao, Zhen; Zhu, Zhiyong; Li, Pingying; Li, Xiaolin; Xue, Xiaohong; Duo, Jie; Ma, Yingcai

    2018-02-17

    The effects of acute hypoxia at high altitude on the telomere length of the cells in the heart and lung tissues remain unclear. This study aimed to investigate the change in telomere length of rat heart and lung tissue cells in response to acute exposure to severe hypoxia and its role in hypoxia-induced damage to heart and lung tissues. Forty male Wistar rats (6-week old) were randomized into control group (n = 10) and hypoxia group (n = 30). Rats in control group were kept at an altitude of 1500 m, while rats in hypoxia group were exposed to simulated hypoxia with an altitude of 5000 m in a low-pressure oxygen chamber for 1, 3, and 7 days (n = 10). The left ventricular and right middle lobe tissues of each rat were collected for measurement of telomere length and reactive oxygen species (ROS) content, and the mRNA and protein levels of telomerase reverse transcriptase (TERT), hypoxia-inducible factor1α (HIF-1α), and hypoxia-inducible factor1α (HIF-2α). Increased exposure to hypoxia damaged rat heart and lung tissue cells and increased ROS production and telomere length. The mRNA and protein levels of TERT and HIF-1α were significantly higher in rats exposed to hypoxia and increased with prolonged exposure; mRNA and protein levels of HIF-2α increased only in rats exposed to hypoxia for 7 days. TERT was positively correlated with telomere length and the levels of HIF-1α but not HIF-2α. Acute exposure to severe hypoxia causes damage to heart and lung tissues due to the production of ROS but promotes telomere length and adaptive response by upregulating TERT and HIF-1α, which protect heart and lung tissue cells from fatal damage.

  1. Relationship between seasonal weather changes, risk of dehydration, and incidence of severe bradyarrhythmias requiring urgent temporary transvenous cardiac pacing in an elderly population

    Science.gov (United States)

    Palmisano, Pietro; Accogli, Michele; Zaccaria, Maria; Vergari, Alessandra; De Luca De Masi, Gabriele; Negro, Luca; De Blasi, Sergio

    2014-09-01

    There is little information on any seasonal variations or meteorological factors associated with symptomatic bradyarrhythmias requiring cardiac pacing. The aim of this single-center study was to investigate the seasonal distribution of the incidence of severe, life-threatening bradyarrhythmias requiring urgent temporary transvenous cardiac pacing in an elderly population. Consecutive patients who underwent urgent temporary transvenous cardiac pacing between 2007 and 2012 were enrolled. The baseline characteristics of the patients and some meteorological parameters, including the calculation the daily heat index (HI), were recorded. During the study period, 79 consecutive patients (mean age 82 ± 8 years, 41 % male) underwent urgent temporary transvenous cardiac pacing, mainly for third-degree atrioventricular block (79 %). The incidence of bradyarrhythmias was significantly higher in summer than in the other seasons ( P 90 °F for >3 h per day for at least 10 days ( P renal function impairment and hyperkalemia (all P < 0.05). This study showed an increased incidence of severe bradyarrhythmias in an elderly population during the hottest months of the year. In these months, in subjects characterized by increased susceptibility to dehydration, the risk of developing bradyarrhythmias was increased significantly.

  2. Utility of Cardiac Magnetic Resonance to assess association between admission hyperglycemia and myocardial damage in patients with reperfused ST-Segment Elevation Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Wolf Jean-Eric

    2008-01-01

    Full Text Available Abstract Aims to investigate the association between admission hyperglycemia and myocardial damage in patients with ST-segment elevation myocardial infarction (STEMI using Cardiac Magnetic Resonance (CMR. Methods We analyzed 113 patients with STEMI treated with successful primary percutaneous coronary intervention. Admission hyperglycemia was defined as a glucose level ≥ 7.8 mmol/l. Contrast-enhanced CMR was performed between 3 and 7 days after reperfusion to evaluate left ventricular function and perfusion data after injection of gadolinium-DTPA. First-pass images (FP, providing assessment of microvascular obstruction and Late Gadolinium Enhanced images (DE, reflecting the extent of infarction, were investigated and the extent of transmural tissue damage was determined by visual scores. Results Patients with a supramedian FP and DE scores more frequently had left anterior descending culprit artery (p = 0.02 and 1c (p = 0.01 and 0.04, peak plasma Creatine Kinase (p In a multivariate model, admission hyperglycemia remains independently associated with increased FP and DE scores. Conclusion Our results show the existence of a strong relationship between glucose metabolism impairment and myocardial damage in patients with STEMI. Further studies are needed to show if aggressive glucose control improves myocardial perfusion, which could be assessed using CMR.

  3. The effects of harassment severity and organizational behavior on damage awards in a hostile work environment sexual harassment case.

    Science.gov (United States)

    Cass, Stacie A; Levett, Lora M; Kovera, Margaret Bull

    2010-01-01

    Community members reporting for jury duty (N = 128) read a sexual harassment trial summary in which harassment severity and the organization's sexual harassment policy and response were manipulated. Jurors who read the severe harassment scenario were more likely to agree that the plaintiff had suffered and should be compensated for her suffering and that the organization should be punished than were jurors who read the mild harassment scenario. When the organization had and enforced a sexual harassment policy, jurors believed that the plaintiff had suffered little and the organization should not be punished compared with conditions in which the organization did not have an enforced sexual harassment policy. Harassment severity influenced jurors' compensatory awards, and organizational behavior influenced jurors' punitive awards. These results have implications for plaintiffs, who must decide whether to claim specific or garden-variety damages; organizations, which could create or modify sexual harassment policy to limit damages; and trial lawyers, who could tailor arguments to maximize or minimize awards. 2009 John Wiley & Sons, Ltd.

  4. White matter damage is related to ataxia severity in SCA3.

    Science.gov (United States)

    Kang, J-S; Klein, J C; Baudrexel, S; Deichmann, R; Nolte, D; Hilker, R

    2014-02-01

    Spinocerebellar ataxia type 3 (SCA3) is the most frequent inherited cerebellar ataxia in Europe, the US and Japan, leading to disability and death through motor complications. Although the affected protein ataxin-3 is found ubiquitously in the brain, grey matter atrophy is predominant in the cerebellum and the brainstem. White matter pathology is generally less severe and thought to occur in the brainstem, spinal cord, and cerebellar white matter. Here, we investigated both grey and white matter pathology in a group of 12 SCA3 patients and matched controls. We used voxel-based morphometry for analysis of tissue loss, and tract-based spatial statistics (TBSS) on diffusion magnetic resonance imaging to investigate microstructural pathology. We analysed correlations between microstructural properties of the brain and ataxia severity, as measured by the Scale for the Assessment and Rating of Ataxia (SARA) score. SCA3 patients exhibited significant loss of both grey and white matter in the cerebellar hemispheres, brainstem including pons and in lateral thalamus. On between-group analysis, TBSS detected widespread microstructural white matter pathology in the cerebellum, brainstem, and bilaterally in thalamus and the cerebral hemispheres. Furthermore, fractional anisotropy in a white matter network comprising frontal, thalamic, brainstem and left cerebellar white matter strongly and negatively correlated with SARA ataxia scores. Tractography identified the thalamic white matter thus implicated as belonging to ventrolateral thalamus. Disruption of white matter integrity in patients suffering from SCA3 is more widespread than previously thought. Moreover, our data provide evidence that microstructural white matter changes in SCA3 are strongly related to the clinical severity of ataxia symptoms.

  5. Severity and Co-occurrence of Oral and Verbal Apraxias in Left Brain Damaged Adults

    Directory of Open Access Journals (Sweden)

    Fariba Yadegari

    2012-04-01

    Full Text Available Objective: Oral and verbal apraxias represent motor programming deficits of nonverbal and verbal movements respectively. Studying their properties may shed light on speech motor control processes. This study was focused on identifying cases with oral or verbal apraxia, their co–occurrences and severities. Materials & Methods: In this non-experimental study, 55 left adult subjects with left brain lesion including 22 women and 33 men with age range of 23 to 84 years, were examined and videotaped using oral apraxia and verbal apraxia tasks. Three speech and language pathologists independently scored apraxia severities. Data were analyzed by independent t test, Pearson, Phi and Contingency coefficients using SPSS 12. Results: Mean score of oral and verbal apraxias in patients with and without oral and verbal apraxias were significantly different (P<0.001. Forty- two patients had simultaneous oral and verbal apraxias, with significant correlation between their oral and verbal apraxia scores (r=0.75, P<0.001. Six patients showed no oral or verbal apraxia and 7 had just one type of apraxia. Comparison of co-occurrence of two disorders (Phi=0.59 and different oral and verbal intensities (C=0.68 were relatively high (P<0.001. Conclusion: The present research revealed co-occurrence of oral and verbal apraxias to a great extent. It appears that speech motor control is influenced by a more general verbal and nonverbal motor control.

  6. Severe damage analysis of VVER 1000 following large break LOCA using Astec code

    International Nuclear Information System (INIS)

    Chatterjee, B.; Mukhopadhyay, D.; Lele, H.G.; Ghosh, A.K.; Kushwaha, H.S.

    2007-01-01

    Severe accident analysis of a reactor is an important aspect in the evaluation of source term. This in turn helps in emergency planning. An analysis has been carried out for VVER-1000 (V320) reactor following Large Break LOCA (loss of coolant accident) along with Station Blackout (SBO). Computer code ASTEC (jointly developed by IRSN, France, and GRS, Germany) is used for analyzing the transient. This integral code has been designed to be used as reference code for PSA2 studies. Severe accident analysis is carried out for an accident initiated by Large break LOCA along with SBO. Two cases have been analysed with the version ASTEC V1.2-rev1. In the first case hydro-accumulators are considered not available while the second case has been analysed with hydro accumulators. In this paper, ASTEC predictions have been studied for the in-vessel phase of the accident till vessel failure. The vessel failure was observed at 6979 s when accumulators were assumed not available. The vessel failure was quite delayed (19294 s) with operating accumulators. The hydrogen production was found to be very large (22% of total Zr inventory) in the case with accumulators compared to the case without accumulators (1.5% of total Zr inventory)

  7. The composition of aerosols generated during a severe reactor accident: Experimental results from the Power Burst Facility Severe Fuel Damage Test 1-4

    International Nuclear Information System (INIS)

    Petti, D.A.; Hobbins, R.R.; Hagrman, D.L.

    1994-01-01

    Experimental results on fission product and aerosol release during the Power Burst Facility Severe Fuel Damages (SFD) Test 1-4 are examined to determine the composition of aerosols that would be generated during a severe reactor accident. The SFD 1-4 measured aerosol contained significant quantities of volatile fission products (VFPs) (cesium, iodine, tellurium), control materials (silver and cadmium), and structural materials (tin), indicating that fission product release, vaporization of control material, and release of tin from oxidized Zircaloy were all important aerosol sources. On average the aerosol composition is between one-quarter and one-half VFPs (especially cesium), with the remainder being control material (especially cadmium), and structural material (especially tin). Source term computer codes like CORSOR-M tend to overpredict the release of structural and control rod material relative to fission products by a factor of between 2 and 15 because the models do not account for relocation of molten control, fuel, and structural material during the degradation process, which tends to reduce the aerosol source. The results indicate that the aerosol generation in a severe reactor accident is intimately linked to the core degradation process. They recommend that these results be used to improve the models in source term computer codes

  8. ELABELA-APJ axis protects from pressure overload heart failure and angiotensin II-induced cardiac damage.

    Science.gov (United States)

    Sato, Teruki; Sato, Chitose; Kadowaki, Ayumi; Watanabe, Hiroyuki; Ho, Lena; Ishida, Junji; Yamaguchi, Tomokazu; Kimura, Akinori; Fukamizu, Akiyoshi; Penninger, Josef M; Reversade, Bruno; Ito, Hiroshi; Imai, Yumiko; Kuba, Keiji

    2017-06-01

    Elabela/Toddler/Apela (ELA) has been identified as a novel endogenous peptide ligand for APJ/Apelin receptor/Aplnr. ELA plays a crucial role in early cardiac development of zebrafish as well as in maintenance of self-renewal of human embryonic stem cells. Apelin was the first identified APJ ligand, and exerts positive inotropic heart effects and regulates the renin-angiotensin system. The aim of this study was to investigate the biological effects of ELA in the cardiovascular system. Continuous infusion of ELA peptide significantly suppressed pressure overload-induced cardiac hypertrophy, fibrosis and impaired contractility in mice. ELA treatment reduced mRNA expression levels of genes associated with heart failure and fibrosis. The cardioprotective effects of ELA were diminished in APJ knockout mice, indicating that APJ is the key receptor for ELA in the adult heart. Mechanistically, ELA downregulated angiotensin-converting enzyme (ACE) expression in the stressed hearts, whereas it showed little effects on angiotensin-converting enzyme 2 (ACE2) expression, which are distinct from the effects of Apelin. FoxM1 transcription factor, which induces ACE expression in the stressed hearts, was downregulated by ELA but not by Apelin. ELA antagonized angiotensin II-induced hypertension, cardiac hypertrophy, and fibrosis in mice. The ELA-APJ axis protects from pressure overload-induced heart failure possibly via suppression of ACE expression and pathogenic angiotensin II signalling. The different effects of ELA and Apelin on the expression of ACE and ACE2 implicate fine-tuned mechanisms for a ligand-induced APJ activation and downstream signalling. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions please email: journals.permissions@oup.com.

  9. Correlation of C-Reactive Protein and Cardiac Enzymes with Angiographic Severity of Coronary Artery Disease in Pakistani Patients with Acute Coronary Syndrome

    International Nuclear Information System (INIS)

    Saleem, A.; Ali, A.

    2017-01-01

    Objective: To determine the correlation of C-reactive protein (CRP) levels with the severity of coronary stenosis on angiography and the association of cardiac enzymes with the degree of stenosis in acute coronary syndrome (ACS) patients. Secondly, to compare association of angiographic severity of vascular stenosis with CRP in patients with ST segment elevation myocardial infarction (STEMI) and non-STEMI / Unstable angina (UA). Study Design: Prospective, descriptive study. Place and Duration of Study: Khan Research Laboratories (KRL) Hospital, from October 2014 to March 2015. Methodology: CRP was measured on diagnosis of ACS in 70 patients. Cardiac enzymes were measured 6 hours after the onset of chest pain. Angiographic scoring for degree of stenosis and number of culprit vessels was done. Two groups consisting of patients with STEMI (group 1) and with NSTEMI/UA (group 2) were made. Results: No correlation was found between CRP levels and angiographic stenosis in patients with ACS (r=0.162, p>0.05). No association was found between eosinophil count and severity of stenosis (p=0.88). Rise of cardiac enzymes and degree of coronary stenosis showed a positive correlation (p <0.001). There was significant difference in the means of coronary artery stenosis scores between the two groups (Gensini score of groups 1 and 2: 35.9 +- 4 and 14 +- 8, respectively) p<0.001, but there was no significant difference in CRP levels. Conclusion: CRP is a marker of inflammation in ACS rather than a risk factor for determining the severity of vascular stenosis. Rise in cardiac enzymes still grade high in predicting severity of vascular stenosis than eosinophil count or CRP levels. (author)

  10. Phebus program main results and status for severe fuel damage studies

    International Nuclear Information System (INIS)

    Duco, J.; Reocreux, M.; Tattegrain, A.

    1986-06-01

    A large experimental in-pile program has been set up at the PHEBUS facility to investigate the actual behavior of .8 m active height, 25-rod PWR-type pressurized fresh fuel bundles under typical accident conditions. The program consists of four stages. Stage 1 was devoted to the adjustment of the operational procedure for stage 2. Stage 2 refers to the simulation of conservatively calculated L.B. LOCA 2 - peak transients. Stages 3/4 refer to four PWR severe accident scenarios retained for in-pile simulation at PHEBUS: a) a large break LOCA with injection failure; b) a small break LOCA associated with an injection failure; c) a prolonged total loss of the steam generator feedwater; and, d) a prolonged core uncovery a few days after reactor shutdown. The main PHEBUS stage 2 results are presented and finally interpreted

  11. Study on severe fuel damage and in-vessel melt progression

    International Nuclear Information System (INIS)

    Kim, Hee Dong; Kim, Sang Baik; Lee, Gyu Jung

    1992-06-01

    In-vessel core melt progression describes the progression of the state of a reactor core from core uncovery up to reactor vessel melt through in uncovered accidents or through temperature stabilization in accidents recovered by core reflooding. Melt progression can be thought as two parts; early melt progression and late melt progression. Early phase of core melt progression includes the progression of core material melting and relocation, which mostly consist of metallic materials. On the other hand, the late phase of core melt progression involves ceramic material melt and relocation to the lower plenum and heat-up the reactor vessel lower head. A large number of information are available for the early melt progression through experiments such as SFD, DF, FLHT test and utilized in the severe accident analysis codes. However, understanding of the late phase melt progression phenomenology is based primary on TMI-2 core examinations and not much experimental information is available. Especilally, the great uncertainties exist in vessel failure mode, melt composition, mass, and temperature. Further research is planned to perform to reduce the uncertainties in understanding of core melt down accidents as parts of long term melt progression research program. A study on the core melt progression at KAERI has been being performed through the Severe Accident Research Program with USNRC. KAERI staff had participated in the PBF SFD experiments at INEL and analyses of experiments were performed using SCDAP code. Experiments of core melt program have not been carried out at KAERI yet. It is planned that further research on core melt down accidents will be performed, which is related to design of future generations of nuclear reactors as parts of long-term project for improvement of nuclear reactor safety. (Author)

  12. Roles of some antioxidants in modulation of cardiac myopathy induced by sodium nitrite via down-regulation of mRNA expression of NF-κB, Bax, and flt-1 and suppressing DNA damage

    Directory of Open Access Journals (Sweden)

    Laila Mohamed Fadda

    2018-02-01

    Full Text Available The underlying pathology of cardiac damage involves various molecular and signaling pathways. Therefore, this study aimed to explore the role of Quercetin (Querc, alone or in combination with Melatonin (Melat against cardiac damage induced by sodium nitrite (Sod nit, as well as to elucidate different signaling pathways. Querc and Melat were injected intraperitoneally (i.p., followed by induction of hypoxia in rats by using a single dose of Sod nit (60 mg/kg, s.c.. Treatment with Sod nit significantly decreased hemoglobin (Hb levels in blood. Pretreatment of hypoxic rats with Querc and/or Melat elevated the declined Hb concentration. The forementioned antioxidants also successfully ameliorated the alteration of heat shock protein 70 (HSP-70 and markers of cardiac injury, including troponin T (Trop. T, creatine kinase-MB (CK-MB, tumor necrosis factor-α (TNF α, and C-reactive protein (CRP in the rats serum. Furthermore, RT-PCR revealed that these antioxidants successfully modulated mRNA expression of NF-κB, Bax, Bcl-2, and flt-1. They also regulated vascular endothelial growth factor (VEGF, the apoptosis marker caspase 3, and oxidative DNA damage in cardiac tissue, compared to Sod nit-intoxicated rats. The present biochemical results are reinforced by histopathological examination. In Conclusion: The results reflected that treatment with Querc in combination with Melat was most effective in improving Sod nit-toxicity induced cardiac damage, thus confirming the promising role of this combination as an effective treatment for cardiac damage induced by other cardio-toxic agents.

  13. Perceived Social Support and Markers of Heart Failure Severity

    Science.gov (United States)

    2011-09-09

    that the heart may be overworking to compensate for cardiac damage (Hunt et al., 2005). To assess the presence and severity of cardiac-related...of depressive symptoms to include hopelessness, irritability, fatigue, appetite, and suicidal ideation. The BDI-II is a widely adopted measure

  14. Parameters affecting of Akkuyu’s safety assessment for severe core damages

    Directory of Open Access Journals (Sweden)

    Kavun Yusuf

    2015-01-01

    Full Text Available We have looked at all past core meltdowns (Three Mile Island, Chernobyl and Fukushima incidents and postulated the fourth one might be taking place in the future most probably in a newly built reactors anywhere of the earth in any type of NPP. The probability of this observation is high considering the nature of the machine and human interaction. Operation experience is a very significant parameter as well as the safety culture of the host nation. The concerns is not just a lack of experience with industry with the new comers, but also the infrastructure and established institutions who will be dealing with the Emergencies. Lack of trained and educated Emergency Response Organizations (ERO is a major concern. The culture on simple fire drills even makes the difference when a severe condition occurs in the industry. The study assumes the fourth event will be taking place at the Akkuyu NGS and works backwards as required by the “what went wrong ” scenarios and comes up with interesting results. The differences studied in depth to determine the impact to the severe accidents. The all four design have now core catchers. We have looked at the operator errors’like in TMI; Operator errors combined with design deficiencies(like in Chernobyl and natural disasters( like in Fukushima and found operator errors to be more probable event on the Akkuyu’s postulated next incident. With respect to experiences of the operators we do not have any data except for long and successful operating history of the Soviet design reactors up until the Chernobyl incident. Since the Akkuyu will be built, own and operated by the Russians we have found no alarming concerns at the moment. At the moment, there is no body be able to operate those units in Turkey. Turkey is planning to build the required manpower during the transition period. The resolution of the observed parameters lies to work and educate, train of the host nation and exercise together.

  15. Quality of life in glaucoma patients and normal subjects related to the severity of damage in each eye.

    Science.gov (United States)

    Pujol Carreras, O; Anton, A; Mora, C; Pastor, L; Gudiña, S; Maull, R; Vega, Z; Castilla, M

    2017-11-01

    To assess the quality of life in glaucoma patients and normal subjects, and to assess its relationship with the severity of damage in each eye. A cross-sectional study was conducted with prospective selection of cases. The study included 464 subjects and were distributed into 4categories. Subjects included in group 1 had both eyes normal, that is with a normal intraocular pressure (IOP), optic disk and visual fields (VF), or mild glaucoma, defined as untreated IOP>21mmHg and abnormal VF with mean defect (MD) over -6dB. Group 2 consisted of patients with both eyes with mild or moderate glaucoma, defined as untreated IOP>21mmHg and abnormal VF with MD between -6 and -12dB. Group 3 included patients with moderate to severe glaucoma, that is, untreated IOP>21mmHg and abnormal VF with MD of less than -12dB in both eyes. Group 4 consisted of patients with asymmetric glaucoma damage, that is, they had one eye with severe glaucoma and the other eye normal or with mild glaucoma. All subjects completed 3 different questionnaires. Global quality of life was evaluated with EuroQol-5D (EQ-5D). Vision related quality of life was assessed with Visual Function Questionnaire (VFQ-25). Quality of life related to ocular surface disease was measured with Ocular Surface Disease Index (OSDI). VFQ-25 showed that group 3 had significantly lower scores than group 1 in mental health (P=.006), dependence (P=.006), colour vision (P=.002), and peripheral vision (P=.002). EQ-5D showed no significant differences between any group, but a trend was found to greater difficulty in group 3 than in groups 1 and 2, and in all dimensions. OSDI showed a higher score, or which was the same as a major disability, in groups 2 and 3 than group 1 (P=.021 and P=.014, respectively). VFQ-25 only found significant differences between group 1 and group 4. Dimensions with significant differences were found between group 1 and 3 (both eyes with advanced or moderate glaucoma). These were not found between group 1 and

  16. Transesophageal echocardiography for cardiac thromboembolic risk assessment in patients with severe, symptomatic aortic valve stenosis referred for potential transcatheter aortic valve implantation.

    Science.gov (United States)

    Lenders, Guy D; Paelinck, Bernard P; Wouters, Kristien; Claeys, Marc J; Rodrigus, Inez E; Van Herck, Paul L; Vrints, Christiaan J; Bosmans, Johan M

    2013-05-15

    Stroke is a devastating complication after transcatheter aortic valve implantation (TAVI) and might partially be related to cardiac embolization. The aim of this single-center prospective study was to determine the incidence of intracardiac thrombi and left atrial spontaneous echo contrast (SEC), both known predictors of cardiac embolic stroke, in patients referred for potential TAVI. One hundred four consecutive patients with severe symptomatic aortic valve stenosis and at high or very high risk for surgery were included and underwent transesophageal echocardiography. In 11 patients (10.6%), intracardiac thrombi were detected, and 25 patients (24%) showed dense grade 2 SEC. Atrial fibrillation (p risk patients with severe aortic valve stenosis referred for potential TAVI is high and can accurately be detected using transesophageal echocardiography. Systematic thromboembolic evaluation using transesophageal echocardiography is thus recommended in patients referred for TAVI. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Phenomena occuring in the reactor coolant system during severe core damage accidents

    International Nuclear Information System (INIS)

    Malinauskas, A.P.

    1990-01-01

    The reactor coolant system (RCS) of a nuclear power plant consists of the reactor pressure vessel and the piping and associated components that are required for the continuous circulation of the coolant which is used to maintain thermal equilibrium throughout the system. This paper discusses, how in the event of an accident, the RCS also serves as one of several barriers to the escape of radiotoxic material into the biosphere. The physical and chemical processes occurring within the RCS during normal operation of the reactor are relatively uncomplicated and are reasonably well understood. When the flow of coolant is properly adjusted, the thermal energy resulting from nuclear fission (or, in the shutdown mode, from radioactive decay processes) and secondary inputs, such as pumps, are exactly balanced by thermal losses through the RCS boundaries and to the various heat sinks that are employed to effect the conversion of heat to electrical energy. Because all of the heat and mass fluxes remain sensibly constant with time, mathematical descriptions of the thermophysical processes are relatively straightforward, even for boiling water reactor (BWR) systems. Although the coolant in a BWR does undergo phase changes, the phase boundaries remain well-defined and time-invariant

  18. THE RISK OF INJURY AND VEHICLE DAMAGE SEVERITY IN VEHICLE MISMATCHED SIDE IMPACT CRASHES IN BRITISH COLUMBIA

    Directory of Open Access Journals (Sweden)

    Ediriweera DESAPRIYA

    2005-01-01

    Full Text Available As occupant protection offered by new passenger vehicles has improved, there has been growing concern about the harm that some vehicle designs may inflict on occupants of other vehicles with which they collide. Preceding analyses of crash statistics have clearly demonstrated the incompatibility between passenger sedan cars (PS and pick-up trucks (PU involved in side impact crashes in British Columbia. A comparison of light truck and passenger car crashes in previous literature reveals that light truck vehicles inflict greater harm than passenger cars for a number of reasons including their greater weight, stiffer structure, and higher ride height. These features place occupants of passenger cars at a disadvantage should they be involved in a collision with a light truck vehicle. The injury risk for passenger sedan car occupants is greater than the risk for pick-up truck occupants in two-vehicle crashes (Odds Ratio (OR 1.87; 95% Confidence Interval (CI 1.38-2.52. In addition, the risk of vehicle damage severity was increased for passenger cars compared with pick-up trucks (write off vehicle-OR 5.35; 95% CI 3.75-7.63, severely damaged vehicles-OR 5.87; 95% CI 4.79–7.19, moderately damaged vehicles-OR 2.86; 95% CI 2.44–3.36. There is strong justification for injury prevention experts and policy makers to step up motor vehicle crash injury prevention advocacy by implementing evidence-based policies to reduce rates of injury as a result of passenger sedan cars and pick-up trucks involved in side impact crashes in the province of British Columbia.

  19. Neuronal damage biomarkers in the identification of patients at risk of long-term postoperative cognitive dysfunction after cardiac surgery

    NARCIS (Netherlands)

    Kok, W F; Koerts, Janneke; Tucha, O; Scheeren, T W L; Absalom, A R

    Biomarkers of neurological injury can potentially predict postoperative cognitive dysfunction. We aimed to identify whether classical neuronal damage-specific biomarkers, including brain fatty acid-binding protein, neuron-specific enolase and S100 calcium-binding protein β, as well as plasma-free

  20. Animal models of cardiac cachexia.

    Science.gov (United States)

    Molinari, Francesca; Malara, Natalia; Mollace, Vincenzo; Rosano, Giuseppe; Ferraro, Elisabetta

    2016-09-15

    Cachexia is the loss of body weight associated with several chronic diseases including chronic heart failure (CHF). The cachectic condition is mainly due to loss of skeletal muscle mass and adipose tissue depletion. The majority of experimental in vivo studies on cachexia rely on animal models of cancer cachexia while a reliable and appropriate model for cardiac cachexia has not yet been established. A critical issue in generating a cardiac cachexia model is that genetic modifications or pharmacological treatments impairing the heart functionality and used to obtain the heart failure model might likely impair the skeletal muscle, this also being a striated muscle and sharing with the myocardium several molecular and physiological mechanisms. On the other hand, often, the induction of heart damage in the several existing models of heart failure does not necessarily lead to skeletal muscle loss and cachexia. Here we describe the main features of cardiac cachexia and illustrate some animal models proposed for cardiac cachexia studies; they include the genetic calsequestrin and Dahl salt-sensitive models, the monocrotaline model and the surgical models obtained by left anterior descending (LAD) ligation, transverse aortic constriction (TAC) and ascending aortic banding. The availability of a specific animal model for cardiac cachexia is a crucial issue since, besides the common aspects of cachexia in the different syndromes, each disease has some peculiarities in its etiology and pathophysiology leading to cachexia. Such peculiarities need to be unraveled in order to find new targets for effective therapies. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. Cardiac and metabolic changes in long-term high fructose-fat fed rats with severe obesity and extensive intramyocardial lipid accumulation.

    Science.gov (United States)

    Axelsen, Lene N; Lademann, Jacob B; Petersen, Jørgen S; Holstein-Rathlou, Niels-Henrik; Ploug, Thorkil; Prats, Clara; Pedersen, Henrik D; Kjølbye, Anne Louise

    2010-06-01

    Metabolic syndrome and obesity-related diseases are affecting more and more people in the Western world. The basis for an effective treatment of these patients is a better understanding of the underlying pathophysiology. Here, we characterize fructose- and fat-fed rats (FFFRs) as a new animal model of metabolic syndrome. Sprague-Dawley rats were fed a 60 kcal/100 kcal fat diet with 10% fructose in the drinking water. After 6, 12, 18, 24, 36, and 48 wk of feeding, blood pressure, glucose tolerance, plasma insulin, glucose, and lipid levels were measured. Cardiac function was examined by in vivo pressure volume measurements, and intramyocardial lipid accumulation was analyzed by confocal microscopy. Cardiac AMP-activated kinase (AMPK) and hepatic phosphoenolpyruvate carboxykinase (PEPCK) levels were measured by Western blotting. Finally, an ischemia-reperfusion study was performed after 56 wk of feeding. FFFRs developed severe obesity, decreased glucose tolerance, increased serum insulin and triglyceride levels, and an initial increased fasting glucose, which returned to control levels after 24 wk of feeding. The diet had no effect on blood pressure but decreased hepatic PEPCK levels. FFFRs showed significant intramyocardial lipid accumulation, and cardiac hypertrophy became pronounced between 24 and 36 wk of feeding. FFFRs showed no signs of cardiac dysfunction during unstressed conditions, but their hearts were much more vulnerable to ischemia-reperfusion and had a decreased level of phosphorylated AMPK at 6 wk of feeding. This study characterizes a new animal model of the metabolic syndrome that could be beneficial in future studies of metabolic syndrome and cardiac complications.

  2. Extracts of Crataegus oxyacantha and Rosmarinus officinalis Attenuate Ischemic Myocardial Damage by Decreasing Oxidative Stress and Regulating the Production of Cardiac Vasoactive Agents

    Directory of Open Access Journals (Sweden)

    Raúl Enrique Cuevas-Durán

    2017-11-01

    Full Text Available Numerous studies have supported a role for oxidative stress in the development of ischemic damage and endothelial dysfunction. Crataegus oxyacantha (Co and Rosmarinus officinalis (Ro extracts are polyphenolic-rich compounds that have proven to be efficient in the treatment of cardiovascular diseases. We studied the effect of extracts from Co and Ro on the myocardial damage associated with the oxidative status and to the production of different vasoactive agents. Rats were assigned to the following groups: (a sham; (b vehicle-treated myocardial infarction (MI (MI-V; (c Ro extract-treated myocardial infarction (MI-Ro; (d Co extract-treated myocardial infarction (MI-Co; or (e Ro+Co-treated myocardial infarction (MI-Ro+Co. Ro and Co treatments increased total antioxidant capacity, the expression of superoxide dismutase (SOD-Cu2+/Zn2+, SOD-Mn2+, and catalase, with the subsequent decline of malondialdehyde and 8-hydroxy-2′-deoxyguanosine levels. The extracts diminished vasoconstrictor peptide levels (angiotensin II and endothelin-1, increased vasodilators agents (angiotensin 1–7 and bradikinin and improved nitric oxide metabolism. Polyphenol treatment restored the left intraventricular pressure and cardiac mechanical work. We conclude that Ro and Co treatment attenuate morphological and functional ischemic-related changes by both an oxidant load reduction and improvement of the balance between vasoconstrictors and vasodilators.

  3. The tsunami's impact on mortality in a town severely damaged by the 2011 Great East Japan Earthquake.

    Science.gov (United States)

    Nagata, Satoko; Teramoto, Chie; Okamoto, Reiko; Koide, Keiko; Nishida, Masumi; Suzuki, Ruriko; Nomura, Michie; Tada, Toshiko; Kishi, Emiko; Sakai, Yoko; Jojima, Noriko; Kusano, Emiko; Iwamoto, Saori; Saito, Miki; Murashima, Sachiyo

    2014-07-01

    This study identifies the relationship between tsunami damage and mortality through a demographic pyramid of a town severely damaged by the tsunami following the Great East Japan Earthquake of 11 March 2011. It uses cross-sectional data collection. Volunteers visited all households, including shelters, and asked residents about the whereabouts of family members and neighbours. The information was collated with lists of evacuees and the dead to confirm the whereabouts of all residents about 50 days after the disaster. Demographic pyramids for the whole population based on pre- and post-disaster data were drawn. In all, 1,412 (8.8 per cent) were dead or missing, 60.2 per cent of whom were aged 65 and over and 37.5 per cent aged 75 and over, suggesting that the very old should be located beyond the reach of tsunamis. The mortality rate of children was lower than that in other studies, which may indicate the efficacy of disaster evacuation drills. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

  4. International standard problem ISP36. Cora-W2 experiment on severe fuel damage for a Russian type PWR

    International Nuclear Information System (INIS)

    1996-01-01

    An OECD/NEA-CSNI International Standard Problem (ISP) has been performed on the experimental comparison basis of the severe fuel damage experiment CORA-W2. The out-of-pile experiment CORA-W2 was executed in February 1993 at he Forschungszentrum Karlsruhe. The objective of this experiment was the investigation of the behavior of a Russian type PWR fuel element (VVER-1000) during early core degradation. The main difference between a Western type and a Russian type PWR bundle is the B 4 C absorber rod instead of AgInCd. Measured quantities ar boundary conditions, bundle temperature, hydrogen generation and the final bundle configurations after cooldown. The ISP was conducted as a blind exercise. Boundary conditions were estimated using ATHLET-CD. Six different severe accident codes were used. The comparisons between experimental and analytical results were grouped by codes and examined separately. The thermal behavior up to significant oxidation has been predicted quite well. Larger deviations have been observed for the oxidation-induced temperature escalation, both time of onset and maximum temperature as well. The bundle behavior is greatly influenced by chemical interactions involving B 4 C absorber rod material, which failed relatively early at low temperature due to eutectic interaction between B 4 C and SS cladding as well as the SS guide tube. Regarding the complex material interaction larger differences can be recognized between calculated and measured results because of inappropriate models for material relocation and solidification processes and the lack of models describing the interactions of absorber rod materials with the fuel rods. For the total amount of H 2 generated, acceptable agreement could be achieved, if the total of oxidized zirconium was calculated correctly. The oxidation of stainless steel components and B 4 C were not treated. In general the confidence in code predictions decreases with processing core damage. (N.T.)

  5. International standard problem ISP36. Cora-W2 experiment on severe fuel damage for a Russian type PWR

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-12-31

    An OECD/NEA-CSNI International Standard Problem (ISP) has been performed on the experimental comparison basis of the severe fuel damage experiment CORA-W2. The out-of-pile experiment CORA-W2 was executed in February 1993 at he Forschungszentrum Karlsruhe. The objective of this experiment was the investigation of the behavior of a Russian type PWR fuel element (VVER-1000) during early core degradation. The main difference between a Western type and a Russian type PWR bundle is the B{sub 4}C absorber rod instead of AgInCd. Measured quantities ar boundary conditions, bundle temperature, hydrogen generation and the final bundle configurations after cooldown. The ISP was conducted as a blind exercise. Boundary conditions were estimated using ATHLET-CD. Six different severe accident codes were used. The comparisons between experimental and analytical results were grouped by codes and examined separately. The thermal behavior up to significant oxidation has been predicted quite well. Larger deviations have been observed for the oxidation-induced temperature escalation, both time of onset and maximum temperature as well. The bundle behavior is greatly influenced by chemical interactions involving B{sub 4}C absorber rod material, which failed relatively early at low temperature due to eutectic interaction between B{sub 4}C and SS cladding as well as the SS guide tube. Regarding the complex material interaction larger differences can be recognized between calculated and measured results because of inappropriate models for material relocation and solidification processes and the lack of models describing the interactions of absorber rod materials with the fuel rods. For the total amount of H{sub 2} generated, acceptable agreement could be achieved, if the total of oxidized zirconium was calculated correctly. The oxidation of stainless steel components and B{sub 4}C were not treated. In general the confidence in code predictions decreases with processing core damage. 36 refs.

  6. [Predictive value of early phrase echocardiography and cardiac biological markers in patients with severe sepsis: a five-year single-center retrospective study].

    Science.gov (United States)

    Zang, Xuefeng; Chen, Wei; Sheng, Bo; Zhao, Lei; Gu, Xuyun; Zhen, Jie; Liu, Ping

    2018-04-01

    To assess the predictive value of early phrase echocardiography and cardiac biomarkers in patients with severe sepsis. A retrospective analysis of severe septic patients (patients with acute coronary syndrome and end stage renal disease were excluded) in department of intensive care unit of Capital Medical University Affiliated Beijing Shijitan Hospital from January 2013 to December 2017 was conducted. The acute physiology and chronic health evaluation II (APACHE II) score, N-terminal prohormone of brain natriuretic peptide (NT-proBNP), cardiac troponin I (cTnI), myoglobin (MYO), creatine kinase (CK), MB isoenzyme of creatine kinase (CK-MB) within 6 hours after admission, and bedside echocardiography indexes [left ventricular ejection fraction (LVEF), the ratio of the peak blood flow velocity in the early stage of the mitral valve and the peak blood flow rate of the mitral valve (E/A ratio)] within 6 hours after diagnosis were recorded. The differences of indexes between patients with decreased contractile function (LVEF value in severe sepsis patients. (1) A total of 316 patients were enrolled in the survey period. Decreased cardiac systolic function (LVEF value for prognosis in severe sepsis patient, among which NT-proBNP and cTnI had higher predictive value [the area under ROC curve (AUC) were 0.920 and 0.901 respectively, both P values measured by echocardiography in early phrase were unrelated to 28-day prognosis. APACHE II score, E/A ratio, NT-proBNP, cTnI, MYO, CK and CK-MB were related to 28-day prognosis. APACHE II scores and NT-proBNP were independent prognostic factors in severe sepsis patient.

  7. ISP-31 OECD/NEA/CSNI International Standard Problem n.31. Cora-13 experiment on severe fuel damage. Comparison report

    International Nuclear Information System (INIS)

    Firnhaber, M.; Trambauer, K.; Hagen, S.; Hofmann, P.; Schanz, G.; Sepold, L.

    1993-07-01

    The severe fuel damage experiment CORA-13 has been offered as CSNI-International Standard Problem (ISP) No. 31. The out-of-pile experiment CORA-13 was executed in November 1990 at Kernforschungszentrum Karlsruhe. The major objectives of this experiment were to investigate the behavior of PWR fuel elements during early core degradation and fast cooldown due to refill. Measured quantities are boundary conditions, bundle temperatures, hydrogen generation and the final bundle configuration. The ISP was conducted as a blind exercise. Boundary conditions which could not be measured, but which are necessary for simplified test simulation (axial power profile, shroud insulation temperature, bundle refill flow) were estimated using ATHLET-CD. Results to the ISP were submitted by 9 participants using different versions of SCDAP/RELAP5, and codes such as FRAS-SFD, ICARE2, KESS-III, MELCOR. The thermal behavior up to significant oxidation has been predicted quite well by most of the codes. In general, the capability of the codes in calculating the main degradation phenomena has been clearly illustrated and weaknesses concerning the modelling of some degradation processes have been identified. Among the degradation phenomena involved in the test, the more severe limitations concern the UO 2 -ZrO 2 dissolution by molten Zr, the solubility limits in the resulting U-Zr-O mixture and the cladding failure by the molten mixture

  8. Diabetes, cardiac disorders and asthma as risk factors for severe organ involvement among adult dengue patients: A matched case-control study.

    Science.gov (United States)

    Pang, Junxiong; Hsu, Jung Pu; Yeo, Tsin Wen; Leo, Yee Sin; Lye, David C

    2017-01-03

    Progression to severe organ involvement due to dengue infection has been associated with severe dengue disease, intensive care treatment, and mortality. However, there is a lack of understanding of the impact of pre-existing comorbidities and other risk factors of severe organ involvement among dengue adults. The aim of this retrospective case-control study is to characterize and identify risk factors that predispose dengue adults at risk of progression with severe organ involvement. This study involved 174 dengue patients who had progressed with severe organ involvement and 865 dengue patients without severe organ involvement, matched by the year of presentation of the cases, who were admitted to Tan Tock Seng Hospital between year 2005 and 2008. Age group of 60 years or older, diabetes, cardiac disorders, asthma, and having two or more pre-existing comorbidities were independent risk factors of severe organ involvement. Abdominal pain, clinical fluid accumulation, and hematocrit rise and rapid platelet count drop at presentation were significantly associated with severe organ involvement. These risk factors, when validated in a larger study, will be useful for triage by clinicians for prompt monitoring and clinical management at first presentation, to minimize the risk of severe organ involvement and hence, disease severity.

  9. Angiotensin converting enzyme DD genotype is associated with acute coronary syndrome severity and sudden cardiac death in Taiwan: a case-control emergency room study.

    Science.gov (United States)

    Chen, Ying-Hsin; Liu, Jui-Ming; Hsu, Ren-Jun; Hu, Sheng-Chuan; Harn, Horng-Jyh; Chen, Shee-Ping; Jeng, Jing-Ren; Wu, Chieh-Lin; Ho, Jar-Yi; Yu, Cheng-Ping

    2012-02-15

    Angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphisms have been associated with acute coronary syndrome (ACS); however, several controversial results have also been found in different studied populations. This hospital-based, emergency room, case-control study in Taiwan retrospectively investigated 111 ACS patients, and 195 non-coronary subjects as a control group, to study the effects of ACE I/D polymorphism in the most urgent ACS patients. ACE I/D polymorphisms were determined by polymerase chain reaction-based assays and their associations with ACS risk, severity, and sudden cardiac death were determined. The ACE DD genotype was associated with ACS incidence. The DD genotype was associated with a significant 4-fold higher risk of ACS in multivariate analysis (odds ratio (OR) = 4.295; 95% confidence interval (CI): 1.436-12.851, p = 0.009), and a 3.35-fold higher risk of acute myocardial infarction. DD genotype carriers also had more than 3-fold higher risks of stenosis in all the three coronary arteries, left anterior descending artery infarction, and anterior wall infarction. In addition, the DD genotype was also associated with a higher risk of sudden cardiac death (OR = 6.484, 95% CI: 1.036-40.598, p = 0.046). This study demonstrated that the ACE DD genotype is an independent risk factor for ACS, and in particular, for acute myocardial infarction. In addition, the ACE DD genotype is also associated with greater ACS severity and a higher risk of sudden cardiac death. ACE genotyping is recommended for patients with a history of ACS, and more intensive preventive care is suggested for patients with the DD genotype.

  10. Time Course and Association of Functional and Biochemical Markers in Severe Semitendinosus Damage Following Intensive Eccentric Leg Curls: Differences between and within Subjects

    Directory of Open Access Journals (Sweden)

    Gerard Carmona

    2018-02-01

    Full Text Available Purpose: To investigate the extent and evolution of hamstring muscle damage caused by an intensive bout of eccentric leg curls (ELCs by (1 assessing the time course and association of different indirect markers of muscle damage such as changes in the force-generating capacity (FGC, functional magnetic resonance (fMRI, and serum muscle enzyme levels and (2 analyzing differences in the degree of hamstring muscle damage between and within subjects (limb-to-limb comparison.Methods: Thirteen male participants performed six sets of 10 repetitions of an ELC with each leg. Before and at regular intervals over 7 days after the exercise, FGC was measured with maximal isometric voluntary contraction (MVC. Serum enzyme levels, fMRI transverse relaxation time (T2 and perceived muscle soreness were also assessed and compared against the FGC.Results: Two groups of subjects were identified according to the extent of hamstring muscle damage based on decreased FGC and increased serum enzyme levels: high responders (n = 10, severe muscle damage and moderate responders (n = 3, moderate muscle damage. In the high responders, fMRI T2 analysis revealed that the semitendinosus (ST muscle suffered severe damage in the three regions measured (proximal, middle, and distal. The biceps femoris short head (BFsh muscle was also damaged and there were significant differences in the FGC within subjects in the high responders.Conclusion: FGC and serum enzyme levels measured in 10 of the subjects from the sample were consistent with severe muscle damage. However, the results showed a wide range of peak MVC reductions, reflecting different degrees of damage between subjects (high and moderate responders. fMRI analysis confirmed that the ST was the hamstring muscle most damaged by ELCs, with uniform T2 changes across all the measured sections of this muscle. During intensive ELCs, the ST muscle could suffer an anomalous recruitment pattern due to fatigue and damage, placing an

  11. Purified rutin and rutin-rich asparagus attenuates disease severity and tissue damage following dextran sodium sulfate-induced colitis.

    Science.gov (United States)

    Power, Krista A; Lu, Jenifer T; Monk, Jennifer M; Lepp, Dion; Wu, Wenqing; Zhang, Claire; Liu, Ronghua; Tsao, Rong; Robinson, Lindsay E; Wood, Geoffrey A; Wolyn, David J

    2016-11-01

    This study investigated the effects of cooked whole asparagus (ASP) versus its equivalent level of purified flavonoid glycoside, rutin (RUT), on dextran sodium sulfate (DSS)-induced colitis and subsequent colitis recovery in mice. C57BL/6 male mice were fed an AIN-93G basal diet (BD), or BD supplemented with 2% cooked ASP or 0.025% RUT for 2 wks prior to and during colitis induction with 2% DSS in water for 7 days, followed by 5 days colitis recovery. In colitic mice, both ASP and RUT upregulated mediators of improved barrier integrity and enhanced mucosal injury repair (e.g. Muc1, IL-22, Rho-A, Rac1, and Reg3γ), increased the proportion of mouse survival, and improved disease activity index. RUT had the greatest effect in attenuating DSS-induced colonic damage indicated by increased crypt and goblet cell restitution, reduced colonic myeloperoxidase, as well as attenuated DSS-induced microbial dysbiosis (reduced Enterobacteriaceae and Bacteroides, and increased unassigned Clostridales, Oscillospira, Lactobacillus, and Bifidobacterium). These findings demonstrate that dietary cooked ASP and its flavonoid glycoside, RUT, may be useful in attenuating colitis severity by modulating the colonic microenvironment resulting in reduced colonic inflammation, promotion of colonic mucosal injury repair, and attenuation of colitis-associated microbial dysbiosis. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  12. Severe fuel damage experiments performed in the QUENCH facility with 21-rod bundles of LWR-type

    International Nuclear Information System (INIS)

    Sepold, L.; Hering, W.; Schanz, G.; Scholtyssek, W.; Steinbrueck, M.; Stuckert, J.

    2006-01-01

    The objective of the QUENCH experimental program at the Karlsruhe Research Center is to investigate core degradation and the hydrogen source term that results from quenching/flooding an uncovered core, to examine the physical/chemical behavior of overheated fuel elements under different flooding conditions, and to create a data base for model development and improvement of severe fuel damage (SFD) code systems. The large-scale 21-rod bundle experiments conducted in the QUENCH out-of-pile facility are supported by an extensive separate-effects test program, by modeling activities as well as application and improvement of SFD code systems. International cooperations exist with institutions mainly within the European Union but e.g. also with the Russian Academy of Science (IBRAE, Moscow) and the CSARP program of the USNRC. So far, eleven experiments have been performed, two of them with B 4 C absorber material. Experimental parameters were: the temperature at initiation of reflood, the degree of peroxidation, the quench medium, i.e. water or steam, and its injection rate, the influence of a B 4 C absorber rod, the effect of steam-starved conditions before quench, the influence of air oxidation before quench, and boil-off behavior of a water-filled bundle with subsequent quenching. The paper gives an overview of the QUENCH program with its organizational structure, describes the test facility and the test matrix with selected experimental results. (author)

  13. Numerical studies of the heat-up-phase of Super-Sara 'severe fuel damage'. Boildown tests

    International Nuclear Information System (INIS)

    Eifler, W.; Shepherd, I.M.

    1983-01-01

    Calculations to investigate the heat-up phase of the Super-Sara 'severe fuel damage' test matrix have been performed using a simple computer code which models a typical pin. In particular the effect of the exothermic zirconium water reaction on the transient is considered. It is shown that it is possible to achieve the desired objectives of all the tests by a test procedure involving a constant power level a simple flow history. This flow history consists of an initial inlet flow, that has the water saturated at outlet. It is then linearly decreased in a time of the order of 200 seconds to a steady lower value. The clad temperature ramp rate is defined by the power and the peak clad temperature by the ratio of the power of the final steady inlet flow rate. If the final inlet flow rate for a particular power is below a certain critical value then the clad will reach melting temperature. The sensitivity of the results are discussed and a sample calculation is made for each test in the matrix

  14. Transmural myocardial perfusion gradients in relation to coronary artery stenoses severity assessed by cardiac multidetector computed tomography

    DEFF Research Database (Denmark)

    Linde, Jesper James; Kühl, Jørgen Tobias; Hove, Jens Dahlgaard

    2015-01-01

    To assess the relationship between epicardial coronary artery stenosis severity and the corresponding regional transmural perfusion at rest and during adenosine stress, using multidetector computed tomography (MDCT). We evaluated the relationship between the severity of coronary artery diameter...

  15. Cardiac function and central haemodynamics in severe chronic obstructive lung disease. Acute and long-term effects of felodipine

    Energy Technology Data Exchange (ETDEWEB)

    Bratel, T; Hedenstierna, G; Lundquist, H; Nyquist, O; Ripe, E

    1988-01-01

    Eleven patients, with advanced chronic obstructive lung disease (COLD), received an infusion of the calcium antagonist felodipine at a rate of 0.9 mg/h. Pulmonary and systemic vascular resistances (PVR and SVR) at rest were reduced by 18% and 33%, respectively. Cardiac output increased by 33%. The right venticular and left venticular ejection fractions (RVEF and LVEF), measured by equilibrium gated radionuclide ventriculography, Increased by 32% and 25%, respectively. During exercise both PVR and SVR fell by a mean of 30%. RVEF and LVEF both increased by about 14%. After three months of oral felopdipine treatment, a dose-related decrease in PVR was noted at rest (r=-0.83) compared with pretreatment values. There was an increase in RVEF which correlated to a reduction in PVR. Three patiens discontinued the trial due to side effects. It is concluded that the reduction of PVR induced by felodipine is accompanied by an improvement in right heart function as measured by ejection fraction measurements.

  16. [Nitrid oxide, levosimendan and sildenafile in a patient with right ventricle dysfunction and severe pulmonary hypertension after cardiac surgery].

    Science.gov (United States)

    Aleixandre, L; Cortell, J; Vicente, R; Herrera, P; Loro, J M; Valera, F

    2014-11-01

    Pulmonary hypertension (PHT) and the resulting right ventricle dysfunction are important risk factors in patients who undergo cardiac surgery. The treatment of PHT and right ventricle dysfunction should be focused on maintaining the correct right ventricle after load, improving right ventricle function and reducing the right ventricle pre-load and therefore reducing pulmonary vascular resistance by means of vasodilators. A combined therapy of vasodilators and medicines which have different mechanisms of action, is becoming an option for the treatment of PHT. We present a 65 year old woman that suffered from mitral regurgitation, aortic valve disease, tricuspid and ascending aortic dilation with 115mmHg of pulmonary artery pressure (by ultrasound evaluation). The patient was operated on of mitral, aortic valve and tricuspid plastia and proximal aortic artery plastia as well. Previosly to surgery the patient suffered right ventricle dysfunction and PHT and was treated with nitric oxide, intravenous sildenafil and levosimendan. Subsequent evolution was satisfactory, PHT being controlled, without arterial hypotension nor respiratory alterations. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Grain boundary sweeping and liquefaction-induced fission product behavior in nuclear fuel under severe-core damage accident conditions

    International Nuclear Information System (INIS)

    Rest, J.

    1984-05-01

    The theoretical FASTGRASS-VFP model has been used in the interpretation of fission gas, iodine, tellurium, and cesium release from: (1) irradiated high-burnup LWR fuel in a flowing steam atmosphere during high-temperature, in-cell heating tests performed at Oak Ridge National Laboratory; and (2) trace-irradiated and high-burnup LWR fuel during severe-fuel-damage (SFD) tests performed in the PBF reactor in Idaho. A theory of grain boundary sweeping of gas bubbles, gas bubble behavior during fuel liquefaction (destruction of grain boundaries due to formation of a U-rich melt phase), and U-Zr eutectic melting has been included within the FASTGRASS-VFP formalism. Results of the analyses demonstrate that intragranular fission product behavior during both types of tests can be interpreted in terms of a grain-growth/grain-boundary-sweeping mechanism that enhances the flow of fission products from within the grains to the grain boundaries. Whereas fuel liquefaction leads to an enhanced release of fission products in trace-irradiated fuel, the occurrence of fuel liquefaction in high-burnup fuel can degrade fission product release. This phenomenon is due in part to reduced gas-bubble mobilities in a viscous medium as compared to vapor transport, and in part to a degradation of grain growth rates and the subsequent decrease in grain-boundary sweeping of intragranular fission products into the liquefied lamina. The analysis shows that total UO 2 dissolution due to eutectic melting leads to increased release for both trace-irradiated and high-burnup fuel. The FASTGRASS-VFP predictions, measured release rates from the above tests, and previously published release rates are compared and differences between fission product behavior in trace-irradiated and in high-burnup fuel are highlighted

  18. [Cardiac cachexia].

    Science.gov (United States)

    Miján, Alberto; Martín, Elvira; de Mateo, Beatriz

    2006-05-01

    Chronic heart failure (CHF), especially affecting the right heart, frequently leads to malnutrition. If the latter is severe and is combined to other factors, it may lead to cardiac cachexia. This one is associated to increased mortality and lower survival of patients suffering from it. The causes of cardiac cachexia are diverse, generally associated to maintenance of a negative energy balance, with increasing evidence of its multifactorial origin. Neurohumoral, inflammatory, immunological, and metabolic factors, among others, are superimposed in the patient with CHF, leading to involvement and deterioration of several organs and systems, since this condition affects both lean (or active cellular) mass and adipose and bone tissue osteoporosis. Among all, the most pronounced deterioration may be seen at skeletal muscle tissue, at both structural and functional levels, the heart not being spared. As for treatment, it should be based on available scientific evidence. Assessment of nutritional status of any patient with CHF is a must, with the requirement of nutritional intervention in case of malnutrition. In this situation, especially if accompanied by cardiac cachexia, it is required to modify energy intake and oral diet quality, and to consider the indication of specific complementary or alternative artificial nutrition. Besides, the causal relationship of the beneficial role of moderate physical exertion is increasing, as well as modulation of metabolic and inflammatory impairments observed in cardiac cachexia with several drugs, leading to a favorable functional and structural response in CHF patients.

  19. Damage Control Strategy and aggressive resuscitation in polytraumatized patient with severe hypothermia. Importance of multidisciplinary management from the territory to the operating room. Case report.

    Science.gov (United States)

    Bellanova, Giovanni; Motta, Alessandro; Mazzetti, Chiara; Motter, Michele; Fabris, Luca; DeVigili, Giorgio; Liguori, Gerardo

    2013-01-01

    Our objective is to describe a case of hypothermic politrauma management in our country. We report the case of a 29-year-old male who was a beating victim and fell off from 4 meters, and was afterwards found after an unknown time interval. The patient came to our DEA in cardiac arrest and underwent to a aggressive and prolonged resuscitation which included sternotomy and extracorporeal circulation. The patient was discharged in 40th postoperative day without neurologic complications and complete recovery. Even without a dedicated protocol for the hypothermic politrauma the correct multidisciplinary approach lead to the complete recovery of the patient. In literature many papers describe the aggressive resuscitation of hypothermic patients underlining that the politrauma management must be multidisciplinar. We want to underline the importance of the "Damage control strategy" in a politrauma team in the major hospitals in our country. Cardiopulmonary resuscitation, Extracorporeal circulation, Hypothermia, Polytrauma, Trauma team.

  20. Investigation of the relationship between venticular fibrillation duration and cardiac/neurological damage in a rabbit model of electrically induced arrhythmia.

    Science.gov (United States)

    Hu, Chun-Lin; Wei, Hong-Yan; Liu, Zi-You; Li, Xing; Liao, Xiao-Xing; Li, Yu-Jie; Zhan, Hong; Jing, Xiao-Li; Xiong, Yan; Liu, Yan-Yan; Wu, Gui-Fu

    2010-12-01

    To establish a simple, economic, and reliable alternating current (AC)-induced cardiac arrest (ACCA) model in rabbits for cardiopulmonary cerebral resuscitation research. Ventricular fibrillation was induced in 27 New Zealand rabbits by external transthoracic AC, which were randomly divided into three groups according to the duration of untreated ACCA (ACCA-3 minutes, ACCA-5 minutes, and ACCA-8 minutes). After ACCA, all animals received cardiopulmonary resuscitation for 2 minutes and subsequent defibrillation until return of spontaneous circulation (ROSC). The troponin I levels were measured at 4 hours after ROSC. Animals died spontaneously or were killed at 72 hours after ROSC. The hippocampus were removed and fixed in 3% formalin. TdT-mediated dUTP-biotin nick end labeling and Nissl stainings were performed in 10-μm thickness coronal sections. Furthermore, two rabbits (without induction of ventricular fibrillation, cardiopulmonary resuscitation, and defibrillation) served as normal control group. Mean survival times after ROSC were 48.57 hours ± 24.70 hours, 18.0 hours ± 15.13 hours, and 3.88 hours ± 2.39 hours for groups ACCA-3 minutes, ACCA-5 minutes, and ACCA-8 minutes, respectively. Survival was significantly different between ACCA-3 minutes and other two groups (p = 0.002 and p = 0.01). Neuronal necrosis and apoptosis were found in the hippocampus CA1, CA2, and CA3 areas of group ACCA-3 minutes. In contrast, neuronal necrosis and TdT-mediated dUTP-biotin nick end labeling positive cells were fewer in control animals. The rabbits in group ACCA-3 minutes had significant neuronal damage with apoptosis in hippocampus CA1, CA2, and CA3 areas at 72 hours after ROSC and survived longer than those in other groups. The model we describe may be a simple, economic, and reliable model for experimental investigation on cardiopulmonary cerebral resuscitation.

  1. Adipose Tissue-Derived Mesenchymal Stromal Cells Protect Mice Infected with Trypanosoma cruzi from Cardiac Damage through Modulation of Anti-parasite Immunity.

    Science.gov (United States)

    Mello, Debora B; Ramos, Isalira P; Mesquita, Fernanda C P; Brasil, Guilherme V; Rocha, Nazareth N; Takiya, Christina M; Lima, Ana Paula C A; Campos de Carvalho, Antonio C; Goldenberg, Regina S; Carvalho, Adriana B

    2015-01-01

    Chagas disease, caused by the protozoan Trypanosoma cruzi (T. cruzi), is a complex disease endemic in Central and South America. It has been gathering interest due to increases in non-vectorial forms of transmission, especially in developed countries. The objective of this work was to investigate if adipose tissue-derived mesenchymal stromal cells (ASC) can alter the course of the disease and attenuate pathology in a mouse model of chagasic cardiomyopathy. ASC were injected intraperitoneally at 3 days post-infection (dpi). Tracking by bioluminescence showed that cells remained in the abdominal cavity for up to 9 days after injection and most of them migrated to the abdominal or subcutaneous fat, an early parasite reservoir. ASC injection resulted in a significant reduction in blood parasitemia, which was followed by a decrease in cardiac tissue inflammation, parasitism and fibrosis at 30 dpi. At the same time point, analyses of cytokine release in cells isolated from the heart and exposed to T. cruzi antigens indicated an anti-inflammatory response in ASC-treated animals. In parallel, splenocytes exposed to the same antigens produced a pro-inflammatory response, which is important for the control of parasite replication, in placebo and ASC-treated groups. However, splenocytes from the ASC group released higher levels of IL-10. At 60 dpi, magnetic resonance imaging revealed that right ventricular (RV) dilation was prevented in ASC-treated mice. In conclusion, the injection of ASC early after T. cruzi infection prevents RV remodeling through the modulation of immune responses. Lymphoid organ response to the parasite promoted the control of parasite burden, while the heart, a target organ of Chagas disease, was protected from damage due to an improved control of inflammation in ASC-treated mice.

  2. Adipose Tissue-Derived Mesenchymal Stromal Cells Protect Mice Infected with Trypanosoma cruzi from Cardiac Damage through Modulation of Anti-parasite Immunity.

    Directory of Open Access Journals (Sweden)

    Debora B Mello

    Full Text Available Chagas disease, caused by the protozoan Trypanosoma cruzi (T. cruzi, is a complex disease endemic in Central and South America. It has been gathering interest due to increases in non-vectorial forms of transmission, especially in developed countries. The objective of this work was to investigate if adipose tissue-derived mesenchymal stromal cells (ASC can alter the course of the disease and attenuate pathology in a mouse model of chagasic cardiomyopathy.ASC were injected intraperitoneally at 3 days post-infection (dpi. Tracking by bioluminescence showed that cells remained in the abdominal cavity for up to 9 days after injection and most of them migrated to the abdominal or subcutaneous fat, an early parasite reservoir. ASC injection resulted in a significant reduction in blood parasitemia, which was followed by a decrease in cardiac tissue inflammation, parasitism and fibrosis at 30 dpi. At the same time point, analyses of cytokine release in cells isolated from the heart and exposed to T. cruzi antigens indicated an anti-inflammatory response in ASC-treated animals. In parallel, splenocytes exposed to the same antigens produced a pro-inflammatory response, which is important for the control of parasite replication, in placebo and ASC-treated groups. However, splenocytes from the ASC group released higher levels of IL-10. At 60 dpi, magnetic resonance imaging revealed that right ventricular (RV dilation was prevented in ASC-treated mice.In conclusion, the injection of ASC early after T. cruzi infection prevents RV remodeling through the modulation of immune responses. Lymphoid organ response to the parasite promoted the control of parasite burden, while the heart, a target organ of Chagas disease, was protected from damage due to an improved control of inflammation in ASC-treated mice.

  3. The effects of calcium and sodium bicarbonate on severe hyperkalaemia during cardiopulmonary resuscitation: A retrospective cohort study of adult in-hospital cardiac arrest.

    Science.gov (United States)

    Wang, Chih-Hung; Huang, Chien-Hua; Chang, Wei-Tien; Tsai, Min-Shan; Yu, Ping-Hsun; Wu, Yen-Wen; Hung, Kuan-Yu; Chen, Wen-Jone

    2016-01-01

    Calcium and sodium bicarbonate (SB) are frequently used in treating patients with severe hyperkalaemia. We evaluated the efficacy of these medications for the treatment of severe hyperkalaemia during cardiopulmonary resuscitation (CPR). We also hypothesised that the effects of these medications might be associated with serum potassium level during CPR. We conducted a retrospective observational study in a single medical centre. From adult patients who had suffered an in-hospital cardiac arrest from 2006 through 2012, we included those with a serum potassium level>6.5 mEq/L measured during CPR. We used multivariable logistic regression analysis to study the association of calcium/SB with sustained return of spontaneous circulation (ROSC). Among the 109 patients included in our analysis, 40 (36.7%) patients achieved sustained ROSC, and only four (3.7%) patients survived to hospital discharge. The mean serum potassium level was 7.8 mEq/L. The analysis indicated that administration of SB was positively associated with sustained ROSC when serum potassium level was <7.9 mEq/L (odds ratio [OR]: 10.51; 95% confidence interval [CI]: 1.50-112.89; p: 0.03); administration of calcium and SB was also positively associated with sustained ROSC when serum potassium level was <9.4 mEq/L (OR: 51.11; 95% CI: 3.12-1639.16; p: 0.01). The use of calcium and SB might be effective in the treatment of severe hyperkalaemia during cardiac arrest. The efficacy of SB/calcium correlated with serum potassium level. However, because the number of patients included in the analysis was small, this conclusion should be further examined in the future. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  4. Comparison of computer codes relative to the aerosol behavior in the reactor containment building during severe core damage accidents in a PWR

    International Nuclear Information System (INIS)

    Fermandjian, J.; Dunbar, I.; Gauvain, J.; Ricchena, R.

    1986-02-01

    The present study concerns a comparative exercise, performed within the framework of the Commission of the European Communities, of the computer codes (AEROSISM-M, UK; AEROSOLS/BI, France; CORRAL-2, CEC and NAUA Mod5, Germany) used in order to assess the aerosol behavior in the reactor containment building during severe core damage accidents in a PWR

  5. Evolution of anti-Trypanosoma cruzi antibody production in patients with chronic Chagas disease: Correlation between antibody titers and development of cardiac disease severity.

    Directory of Open Access Journals (Sweden)

    Ingebourg Georg

    2017-07-01

    Full Text Available Chagas disease is one of the most important endemic infections in Latin America affecting around 6-7 million people. About 30-50% of patients develop the cardiac form of the disease, which can lead to severe cardiac dysfunction and death. In this scenario, the identification of immunological markers of disease progression would be a valuable tool for early treatment and reduction of death rates. In this observational study, the production of anti-Trypanosoma cruzi antibodies through a retrospective longitudinal follow-up in chronic Chagas disease patients´ cohort and its correlation with disease progression and heart commitment was evaluated. Strong inverse correlation (ρ = -0.6375, p = 0.0005 between anti-T. cruzi IgG1 titers and left ventricular ejection fraction (LVEF in chronic Chagas cardiomyopathy (CCC patients were observed after disease progression. Elevated levels of anti-T. cruzi IgG3 titers were detected in all T. cruzi-infected patients, indicating a lack of correlation of this IgG isotype with disease progression. Furthermore, low levels of anti-T. cruzi IgG2, IgG4, and IgA were detected in all patients through the follow-up. Although without statistical significance anti-T. cruzi IgE tends to be more reactive in patients with the indeterminate form (IND of the disease (p = 0.0637. As this study was conducted in patients with many years of chronic disease no anti-T. cruzi IgM was detected. Taken together, these results indicate that the levels of anti-T. cruzi IgG1 could be considered to seek for promising biomarkers to predict the severity of chronic Chagas disease cardiomyopathy.

  6. [Perinatal outcome and cardiac dysfunction in preterm growth-restricted neonates in relation to placental impairment severity].

    Science.gov (United States)

    Candel Pau, Júlia; Castillo Salinas, Félix; Perapoch López, Josep; Carrascosa Lezcano, Antonio; Sánchez García, Olga; Llurba Olivé, Elisa

    2016-10-01

    Intrauterine growth restriction (IUGR) and prematurity have been associated with increased perinatal morbidity and mortality and also with cardiovascular foetal programming. However, there are few studies on the impact of placenta-related IUGR on perinatal outcomes and cardiovascular biomarkers in pre-term infants. To determine differences in neonatal morbidity, mortality and cord blood biomarkers of cardiovascular dysfunction between pre-term placenta-related IUGR and non-IUGR new-borns, and to analyse their relationship with the severity of IUGR according to foetal Doppler evaluation. Prospective cohort study: pre-term infants with placenta-related IUGR and matched pre-term infants without IUGR. A Doppler scan was performed, and placenta-IUGR was classified according to severity. Comparative analysis of perinatal outcomes, neonatal morbidity and mortality, and cord blood levels of biomarkers of cardiovascular dysfunction was performed. IUGR new-borns present lower weight, length, head circumference, and Apgar score at birth, as well as increased neonatal and cardiovascular dysfunction biomarker levels, compared with pre-term new-borns without IUGR. These differences increase with the severity of IUGR determined by prenatal umbilical artery Doppler scan. Placenta-related-IUGR pre-term infants, irrespective of gestational age, present increased neonatal morbidity and mortality that is significantly proportional to the severity of IUGR. Placental impairment and severity also determine levels of cardiovascular dysfunction biomarkers at birth. Copyright © 2015 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Cardiac regeneration therapy: connections to cardiac physiology.

    Science.gov (United States)

    Takehara, Naofumi; Matsubara, Hiroaki

    2011-12-01

    Without heart transplantation, a large number of patients with failing hearts worldwide face poor outcomes. By means of cardiomyocyte regeneration, cardiac regeneration therapy is emerging with great promise as a means for restoring loss of cardiac function. However, the limited success of clinical trials using bone marrow-derived cells and myoblasts with heterogeneous constituents, transplanted at a wide range of cell doses, has led to disagreement on the efficacy of cell therapy. It is therefore essential to reevaluate the evidence for the efficacy of cell-based cardiac regeneration therapy, focusing on targets, materials, and methodologies. Meanwhile, the revolutionary innovation of cardiac regeneration therapy is sorely needed to help the millions of people who suffer heart failure from acquired loss of cardiomyocytes. Cardiac regeneration has been used only in limited species or as a developing process in the rodent heart; now, the possibility of cardiomyocyte turnover in the human heart is being revisited. In the pursuit of this concept, the use of cardiac stem/progenitor stem cells in the cardiac niche must be focused to usher in a second era of cardiac regeneration therapy for the severely injured heart. In addition, tissue engineering and cellular reprogramming will advance the next era of treatment that will enable current cell-based therapy to progress to "real" cardiac regeneration therapy. Although many barriers remain, the prevention of refractory heart failure through cardiac regeneration is now becoming a realistic possibility.

  8. First record of Trialeurodes vaporariorum Westwood (Hemiptera: Aleyrodidae severely damaging field grown potato crops in South Sulawesi, Indonesia

    Directory of Open Access Journals (Sweden)

    Nasruddin Andi

    2016-04-01

    Full Text Available Greenhouse whitefly, Trialeurodes vaporariorum Westwood was reported for the first time in the South Sulawesi Province of Indonesia, and is causing significant damage to field grown potato crops. In an insecticide trial, the tuber yield in infested, untreated plants was reduced by 39%, and the plants had an average number of 68 adult whiteflies per leaflet.

  9. Long term follow-up by gamma angiocardiography of patients with severe cardiac insufficiency bearing an ethylic cardiomyopathy; Suivi a long terme par gamma angiocardiographie de patients en insuffisance cardiaque severe porteurs d`un cardiomyopathie ethylique

    Energy Technology Data Exchange (ETDEWEB)

    Guillo, P. [Service de Medecine Nucleaire, CHU Cavale Blanche Brest 29200 (France); Mansourati, J. [Service de Cardiologie, CHU Cavale Blanche Brest 29200 (France); Le Rest, C.; Pennec, P.Y.; Cavarec, M.; Turzo, A. [Service de Medecine Nucleaire, CHU Cavale Blanche Brest (France); Blanc, J.J. [Service de Cardiologie, CHU Cavale Blanche Brest (France); Bizais, Y. [Service de Medecine Nucleaire, CHU Cavale Blanche Brest (France)

    1997-12-31

    The goal of this prospective study is establishing the evolution and long term prognostication in chronic ethylic patients afflicted with severe cardiac insufficiency (CI), presenting a dilated cardiomyopathy (DCM). Forty patients (average age 44.8 {+-} 9.2 years) are consecutively included according to the following criteria: CI (stage IV), DCM without definite etiology, chronic alcoholism during more than 10 years and superior to 80 g alcohol/day. The telediastolic diameter (TDD) of left ventricle viewed by echo-cardiogram is increased up to 68.4 {+-} 3.6 mm with a fraction of shortening (FS) of 14.2 {+-} 3.7%. The isotopic ejection fraction (EF) is lowered down to 21.6 {+-} 5.9%. All the patients received a conventional treatment of CI while the abstinence was hardly urged. Three patients recurred and subsequently refused the follow-up. By the third month, in absence of any amelioration, a patient benefited by a cardiac transplant and another patient deceased after myocardial biopsy. Nine patients benefited by a complete follow-up of 36 months. After the third month the functional amelioration is notable and confirmed by different parameters: TDD of 64.3 {+-} 3.6 (p < 0.02), FS of 18.8 {+-} 7.2% (NS) and EF of 31.3 {+-} 11.1% (p < 0.03). The amelioration of different criteria is significant by the 6. month and than stabilizes itself up to 3 years as showed by the EF evolution curves. In conclusion, the prognostication of these patients with severe CI is favorable. The functional amelioration is precocious and confirmed by the different ventricular parameters studied. The medical treatment associated with a complete and definitive abstinence is the key of success

  10. Severe structural and functional visual system damage leads to profound loss of vision-related quality of life in patients with neuromyelitis optica spectrum disorders.

    Science.gov (United States)

    Schmidt, Felix; Zimmermann, Hanna; Mikolajczak, Janine; Oertel, Frederike C; Pache, Florence; Weinhold, Maria; Schinzel, Johann; Bellmann-Strobl, Judith; Ruprecht, Klemens; Paul, Friedemann; Brandt, Alexander U

    2017-01-01

    Neuromyelitis optica spectrum disorders (NMOSD) are characterized by devastating optic neuritis attacks causing more structural damage and visual impairment than in multiple sclerosis (MS). The objective of this study was to compare vision-related quality of life in NMOSD and MS patients and correlate it to structural retinal damage and visual function. Thirty-one NMOSD and 31 matched MS patients were included. Vision-related quality of life was assessed with the 39-item National Eye Institute Visual Function Questionnaire (NEI-VFQ). All patients underwent retinal optical coherence tomography and visual acuity and contrast sensitivity measurements. Vision-related quality of life was reduced in NMOSD compared to MS patients. This difference was driven by a higher incidence of bilateral and more severe optic neuritis in the NMOSD group. Retinal thinning and visual impairment were significantly greater in the NMOSD cohort. Lower vision-related quality of life was associated with more retinal damage and reduced visual function as assessed by visual acuity and contrast sensitivity. NMOSD-related bilateral ON-attacks cause severe structural damage and visual impairment that lead to severe loss of vision-related quality of life. The NEI-VFQ is a helpful tool to monitor vision-related quality of life in NMOSD patients. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. Regeneration of alveolar type I and II cells from Scgb1a1-expressing cells following severe pulmonary damage induced by bleomycin and influenza.

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    Dahai Zheng

    Full Text Available The lung comprises an extensive surface of epithelia constantly exposed to environmental insults. Maintaining the integrity of the alveolar epithelia is critical for lung function and gaseous exchange. However, following severe pulmonary damage, what progenitor cells give rise to alveolar type I and II cells during the regeneration of alveolar epithelia has not been fully determined. In this study, we have investigated this issue by using transgenic mice in which Scgb1a1-expressing cells and their progeny can be genetically labeled with EGFP. We show that following severe alveolar damage induced either by bleomycin or by infection with influenza virus, the majority of the newly generated alveolar type II cells in the damaged parenchyma were labeled with EGFP. A large proportion of EGFP-expressing type I cells were also observed among the type II cells. These findings strongly suggest that Scgb1a1-expressing cells, most likely Clara cells, are a major cell type that gives rise to alveolar type I and II cells during the regeneration of alveolar epithelia in response to severe pulmonary damage in mice.

  12. Using Satellite Imagery to Identify Tornado Damage Tracks and Recovery from the April 27, 2011 Severe Weather Outbreak

    Science.gov (United States)

    Cole, Tony A.; Molthan, Andrew L.; Bell, Jordan R.

    2014-01-01

    Emergency response to natural disasters requires coordination between multiple local, state, and federal agencies. Single, relatively weak tornado events may require comparatively simple response efforts; but larger "outbreak" events with multiple strong, long-track tornadoes can benefit from additional tools to help expedite these efforts. Meteorologists from NOAA's National Weather Service conduct field surveys to map tornado tracks, assess damage, and determine the tornado intensity following each event. Moderate and high resolution satellite imagery can support these surveys by providing a high-level view of the affected areas. Satellite imagery could then be used to target areas for immediate survey or to corroborate the results of the survey after it is completed. In this study, the feasibility of using satellite imagery to identify tornado damage tracks was determined by comparing the characteristics of tracks observed from low-earth orbit to tracks assessed during the official NWS storm survey process. Of the 68 NWS confirmed centerlines, 24 tracks (35.3%) could be distinguished from other surface features using satellite imagery. Within each EF category, 0% of EF-0, 3% of EF-1, 50% of EF-2, 77.7% of EF-3, 87.5% of EF-4 and 100% of EF-5 tornadoes were detected. It was shown that satellite data can be used to identify tornado damage tracks in MODIS and ASTER NDVI imagery, where damage to vegetation creates a sharp drop in values though the minimum EF-category which can be detected is dependent upon the type of sensor used and underlying vegetation. Near-real time data from moderate resolution sensors compare favorably to field surveys after the event and suggest that the data can provide some value in the assessment process.

  13. Cardiac gated ventilation

    International Nuclear Information System (INIS)

    Hanson, C.W. III; Hoffman, E.A.

    1995-01-01

    There are several theoretic advantages to synchronizing positive pressure breaths with the cardiac cycle, including the potential for improving distribution of pulmonary and myocardial blood flow and enhancing cardiac output. The authors evaluated the effects of synchronizing respiration to the cardiac cycle using a programmable ventilator and electron beam CT (EBCT) scanning. The hearts of anesthetized dogs were imaged during cardiac gated respiration with a 50 msec scan aperture. Multi slice, short axis, dynamic image data sets spanning the apex to base of the left ventricle were evaluated to determine the volume of the left ventricular chamber at end-diastole and end-systole during apnea, systolic and diastolic cardiac gating. The authors observed an increase in cardiac output of up to 30% with inspiration gated to the systolic phase of the cardiac cycle in a non-failing model of the heart

  14. Neuro-fuzzy computing for vibration-based damage localization and severity estimation in an experimental wind turbine blade with superimposed operational effects

    Science.gov (United States)

    Hoell, Simon; Omenzetter, Piotr

    2016-04-01

    Fueled by increasing demand for carbon neutral energy, erections of ever larger wind turbines (WTs), with WT blades (WTBs) with higher flexibilities and lower buckling capacities lead to increasing operation and maintenance costs. This can be counteracted with efficient structural health monitoring (SHM), which allows scheduling maintenance actions according to the structural state and preventing dramatic failures. The present study proposes a novel multi-step approach for vibration-based structural damage localization and severity estimation for application in operating WTs. First, partial autocorrelation coefficients (PACCs) are estimated from vibrational responses. Second, principal component analysis is applied to PACCs from the healthy structure in order to calculate scores. Then, the scores are ranked with respect to their ability to differentiate different damage scenarios. This ranking information is used for constructing hierarchical adaptive neuro-fuzzy inference systems (HANFISs), where cross-validation is used to identify optimal numbers of hierarchy levels. Different HANFISs are created for the purposes of structural damage localization and severity estimation. For demonstrating the applicability of the approach, experimental data are superimposed with signals from numerical simulations to account for characteristics of operational noise. For the physical experiments, a small scale WTB is excited with a domestic fan and damage scenarios are introduced non-destructively by attaching small masses. Numerical simulations are also performed for a representative fully functional small WT operating in turbulent wind. The obtained results are promising for future applications of vibration-based SHM to facilitate improved safety and reliability of WTs at lower costs.

  15. SUCCESSFUL APPLICATION OF PERIPHERAL VENO-ARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION FOR CARDIAC ALLOGRAFT ANTIBODY-MEDIATED REJECTION WITH SEVERE HEMODYNAMIC COMPROMISE

    Directory of Open Access Journals (Sweden)

    V. N. Poptsov

    2015-01-01

    Full Text Available Introduction. Acute antibody-mediated rejection (AMR is one of the severe complications of early and late period after heart transplantation (HT. Only few case reports and studies presented of mechanical circulatory support (MCS application for refractory acute rejection causing hemodynamic compromise. Aim. We report the case of a woman with cardiogenic shock caused by severe AMR that was successfully treatment by peripheral venoarterial extracorporeal membrane oxygenation (VA ECMO. Material and methods. In december 2014, a 60-year-old woman with dilated cardiomyopathy was operated for HT. The patient had a good initial cardiac allograft function and no and was discharged from ICU on the 4th day after HT. 1st endomyocardial biopsy (EMB (the 7th day after HT showed absence of acute cellular and antibody-mediated rejection. On the 11th day after HT patient aggravated and presented clinical signs of life-threatening acute cardiac allograft dysfunction: arterial blood pressure 78/49/38 mm Hg, HR 111 in min, CVP 20 mm Hg, PAP 47/34/25 mm Hg, PCWP 25 mm Hg, CI 1.5 l/min/m2, adrenalin 110 ng/kg/min, dopamine 15 mcg/kg/min. ECG showed impairment of systolic left (LVEF 25% and right (RVEF 15% ventricle function, left and right ventricle diffuse hypokinesis, thickness of IVS, LV and RV wall 1.7, 1.4 and 0.8 cm, tricuspid and mitral valve regurgitation 2–3 degrees. EMB presented AMR. In conscience peripheral VA ECMO was installed. We used peripheral transcutaneous cannulation technique via femoral vessels – arterial cannula 15 F, venous cannula – 23 F, vascular catheter 14 G for anterograde leg’s perfusion. ACT 130–150 sec. AMR therapy included: methylprednisolon pulse-therapy (10 mg/kg for 5 day, IgG, plasmapheresis (No 7, rituximab. Results. Under MCS by VA ECMO we noted quick improvement of hemodynamic, metabolic homeostasis and organ functions. On the 6th day of VA ECMO (blood flow 1.8 l/min: arterial blood pressure 133/81/54 mm Hg, CVP 5 mm

  16. Comparison of european computer codes relative to the aerosol behavior in PWR containment buildings during severe core damage accidents. (Modelling of steam condensation on the particles)

    International Nuclear Information System (INIS)

    Bunz, H.; Dunbar, L.H.; Fermandjian, J.; Lhiaubet, G.

    1987-11-01

    An aerosol code comparison exercise was performed within the framework of the Commission of European Communities (Division of Safety of Nuclear Installations). This exercise, focused on the process of steam condensation onto the aerosols occurring in PWR containment buildings during severe core damage accidents, has allowed to understand the discrepancies between the results obtained. These discrepancies are due, in particular, to whether the curvature effect is modelled or not in the codes

  17. Comparison of computer codes relative to the aerosol behavior in the reactor containment building during severe core damage accidents in a PWR

    International Nuclear Information System (INIS)

    Fermandjian, J.; Bunz, H.; Dunbar, I.; Gauvain, J.; Ricchena, R.

    1986-01-01

    The present study concerns a comparative exercise, performed within the framework of the Commission of the European Communities, of the computer codes (AEROSIM-M, UK; AEROSOLS/B1, France; CORRAL-2, CEC and NAUA Mod5, Germany) used in order to assess the aerosol behavior in the reactor containment building during severe core damage accidents in a PWR. Topics considered in this paper include aerosols, containment buildings, reactor safety, fission product release, reactor cores, meltdown, and monitoring

  18. Can cardiac surgery cause hypopituitarism?

    Science.gov (United States)

    Francis, Flverly; Burger, Ines; Poll, Eva Maria; Reineke, Andrea; Strasburger, Christian J; Dohmen, Guido; Gilsbach, Joachim M; Kreitschmann-Andermahr, Ilonka

    2012-03-01

    Apoplexy of pituitary adenomas with subsequent hypopituitarism is a rare but well recognized complication following cardiac surgery. The nature of cardiac on-pump surgery provides a risk of damage to the pituitary because the vascular supply of the pituitary is not included in the cerebral autoregulation. Thus, pituitary tissue may exhibit an increased susceptibility to hypoperfusion, ischemia or intraoperative embolism. After on-pump procedures, patients often present with physical and psychosocial impairments which resemble symptoms of hypopituitarism. Therefore, we analyzed whether on-pump cardiac surgery may cause pituitary dysfunction also in the absence of pre-existing pituitary disease. Twenty-five patients were examined 3-12 months after on-pump cardiac surgery. Basal hormone levels for all four anterior pituitary hormone axes were measured and a short synacthen test and a growth hormone releasing hormone plus arginine (GHRH-ARG)-test were performed. Quality of life (QoL), depression, subjective distress for a specific life event, sleep quality and fatigue were assessed by means of self-rating questionnaires. Hormonal alterations were only slight and no signs of anterior hypopituitarism were found except for an insufficient growth hormone rise in two overweight patients in the GHRH-ARG-test. Psychosocial impairment was pronounced, including symptoms of moderate to severe depression in 9, reduced mental QoL in 8, dysfunctional coping in 6 and pronounced sleep disturbances in 16 patients. Hormone levels did not correlate with psychosocial impairment. On-pump cardiac surgery did not cause relevant hypopituitarism in our sample of patients and does not serve to explain the psychosocial symptoms of these patients.

  19. Cardiac pacemaker

    International Nuclear Information System (INIS)

    Kolenik, S.A.

    1976-01-01

    The construction of a cardiac pacemaker is described which is characterized by particularly small dimensions, small weight and long life duration. The weight is under 100g, the specific weight under 1.7. Mass inertia forces which occur through acceleration and retardation processes, thus remain below the threshold values, above which one would have to reckon with considerable damaging of the surrounding body tissue. The maintaining of small size and slight weight is achieved by using an oscillator on COSMOS basis, where by considerably lower energy consumption, amongst others the lifetimes of the batteries used - a lithium anode with thionyl chloride electrolyte - is extended to over 5 years. The reliability can be increased by the use of 2 or more batteries. The designed dimension are 20x60x60 mm 3 . (ORU/LH) [de

  20. Role of permissive hypotension, hypertonic resuscitation and the global increased permeability syndrome in patients with severe hemorrhage: adjuncts to damage control resuscitation to prevent intra-abdominal hypertension.

    Science.gov (United States)

    Duchesne, Juan C; Kaplan, Lewis J; Balogh, Zsolt J; Malbrain, Manu L N G

    2015-01-01

    Secondary intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are closely related to fluid resuscitation. IAH causes major deterioration of the cardiac function by affecting preload, contractility and afterload. The aim of this review is to discuss the different interactions between IAH, ACS and resuscitation, and to explore a new hypothesis with regard to damage control resuscitation, permissive hypotension and global increased permeability syndrome. Review of the relevant literature via PubMed search. The recognition of the association between the development of ACS and resuscitation urged the need for new approach in traumatic shock management. Over a decade after wide spread application of damage control surgery damage control resuscitation was developed. DCR differs from previous resuscitation approaches by attempting an earlier and more aggressive correction of coagulopathy, as well as metabolic derangements like acidosis and hypothermia, often referred to as the 'deadly triad' or the 'bloody vicious cycle'. Permissive hypotension involves keeping the blood pressure low enough to avoid exacerbating uncontrolled haemorrhage while maintaining perfusion to vital end organs. The potential detrimental mechanisms of early, aggressive crystalloid resuscitation have been described. Limitation of fluid intake by using colloids, hypertonic saline (HTS) or hyperoncotic albumin solutions have been associated with favourable effects. HTS allows not only for rapid restoration of circulating intravascular volume with less administered fluid, but also attenuates post-injury oedema at the microcirculatory level and may improve microvascular perfusion. Capillary leak represents the maladaptive, often excessive, and undesirable loss of fluid and electrolytes with or without protein into the interstitium that generates oedema. The global increased permeability syndrome (GIPS) has been articulated in patients with persistent systemic inflammation failing

  1. Complete cardiac regeneration in a mouse model of myocardial infarction.

    Science.gov (United States)

    Haubner, Bernhard Johannes; Adamowicz-Brice, Martyna; Khadayate, Sanjay; Tiefenthaler, Viktoria; Metzler, Bernhard; Aitman, Tim; Penninger, Josef M

    2012-12-01

    Cardiac remodeling and subsequent heart failure remain critical issues after myocardial infarction despite improved treatment and reperfusion strategies. Recently, complete cardiac regeneration has been demonstrated in fish and newborn mice following resection of the cardiac apex. However, it remained entirely unclear whether the mammalian heart can also completely regenerate following a complex cardiac ischemic injury. We established a protocol to induce a severe heart attack in one-day-old mice using left anterior descending artery (LAD) ligation. LAD ligation triggered substantial cardiac injury in the left ventricle defined by Caspase 3 activation and massive cell death. Ischemia-induced cardiomyocyte death was also visible on day 4 after LAD ligation. Remarkably, 7 days after the initial ischemic insult, we observed complete cardiac regeneration without any signs of tissue damage or scarring. This tissue regeneration translated into long-term normal heart functions as assessed by echocardiography. In contrast, LAD ligations in 7-day-old mice resulted in extensive scarring comparable to adult mice, indicating that the regenerative capacity for complete cardiac healing after heart attacks can be traced to the first week after birth. RNAseq analyses of hearts on day 1, day 3, and day 10 and comparing LAD-ligated and sham-operated mice surprisingly revealed a transcriptional programme of major changes in genes mediating mitosis and cell division between days 1, 3 and 10 postnatally and a very limited set of genes, including genes regulating cell cycle and extracellular matrix synthesis, being differentially regulated in the regenerating hearts. We present for the first time a mammalian model of complete cardiac regeneration following a severe ischemic cardiac injury. This novel model system provides the unique opportunity to uncover molecular and cellular pathways that can induce cardiac regeneration after ischemic injury, findings that one day could be translated

  2. Chronic obstructive pulmonary disease severity and its association with obstructive sleep apnea syndrome: impact on cardiac autonomic modulation and functional capacity

    Directory of Open Access Journals (Sweden)

    Zangrando KTL

    2018-04-01

    Full Text Available Katiany Thays Lopes Zangrando,1 Renata Trimer,2 Luiz Carlos Soares de Carvalho Jr,1 Guilherme Peixoto Tinoco Arêas,1 Flávia Cristina Rossi Caruso,1 Ramona Cabiddu,1 Meliza Goi Roscani,3 Fabíola Paula Galhardo Rizzatti,3 Audrey Borghi-Silva1 1Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil; 2Physical Education and Health Department, University of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil; 3Medicine Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil Background: The study was conducted to determine the impact of chronic obstructive pulmonary disease (COPD in association with obstructive sleep apnea syndrome (OSAS on cardiac autonomic control and functional capacity. Subjects and methods: The study was a cross-sectional prospective controlled clinical study. Heart rate variability indices of 24 COPD (n = 12 and COPD+OSAS (n = 12 patients were evaluated and compared by electrocardiographic recordings acquired during rest, active postural maneuver (APM, respiratory sinus arrhythmia maneuver (RSA-m, and the 6-minute walk test (6MWT. Results: The COPD group presented higher parasympathetic modulation during APM when compared to the COPD+OSAS group (P = 0.02. The COPD+OSAS group presented higher sympathetic modulation during RSA-m when compared to the COPD group (P = 0.00. The performance during 6MWT was similarly impaired in both groups, despite the greater severity of the COPD group. Conclusion: Subjects with COPD+OSAS present marked sympathetic modulation, and the presence of OSAS in COPD subjects has a negative impact on functional capacity regardless of the severity of lung disease. Keywords: COPD, OSAS, COPD+OSAS, functional capacity

  3. A heart that beats for 500 years: age-related changes in cardiac proteasome activity, oxidative protein damage and expression of heat shock proteins, inflammatory factors, and mitochondrial complexes in Arctica islandica, the longest-living noncolonial animal.

    Science.gov (United States)

    Sosnowska, Danuta; Richardson, Chris; Sonntag, William E; Csiszar, Anna; Ungvari, Zoltan; Ridgway, Iain

    2014-12-01

    Study of negligibly senescent animals may provide clues that lead to better understanding of the cardiac aging process. To elucidate mechanisms of successful cardiac aging, we investigated age-related changes in proteasome activity, oxidative protein damage and expression of heat shock proteins, inflammatory factors, and mitochondrial complexes in the heart of the ocean quahog Arctica islandica, the longest-lived noncolonial animal (maximum life span potential: 508 years). We found that in the heart of A. islandica the level of oxidatively damaged proteins did not change significantly up to 120 years of age. No significant aging-induced changes were observed in caspase-like and trypsin-like proteasome activity. Chymotrypsin-like proteasome activity showed a significant early-life decline, then it remained stable for up to 182 years. No significant relationship was observed between the extent of protein ubiquitination and age. In the heart of A. islandica, an early-life decline in expression of HSP90 and five mitochondrial electron transport chain complexes was observed. We found significant age-related increases in the expression of three cytokine-like mediators (interleukin-6, interleukin-1β, and tumor necrosis factor-α) in the heart of A. islandica. Collectively, in extremely long-lived molluscs, maintenance of protein homeostasis likely contributes to the preservation of cardiac function. Our data also support the concept that low-grade chronic inflammation in the cardiovascular system is a universal feature of the aging process, which is also manifest in invertebrates. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. Air exposure behavior of the semiterrestrial crab Neohelice granulata allows tolerance to severe hypoxia but not prevent oxidative damage due to hypoxia-reoxygenation cycle.

    Science.gov (United States)

    de Lima, Tábata Martins; Geihs, Márcio Alberto; Nery, Luiz Eduardo Maia; Maciel, Fábio Everton

    2015-11-01

    The air exposure behavior of the semi-terrestrial crab Neohelice granulata during severe hypoxia was studied. This study also verified whether this behavior mitigates possible oxidative damage, namely lipoperoxidation, caused by hypoxia and reoxygenation cycles. The lethal time for 50% of the crabs subjected to severe hypoxia (0.5 mgO2 · L(-1)) with free access to air was compared to that of crabs subjected to severe hypoxia without access to air. Crabs were placed in aquaria divided into three zones: water (when the animal was fully submersed), land (when the animal was completely emerged) and intermediate (when the animal was in contact with both environments) zones. Then the crabs were held in this condition for 270 min, and the time spent in each zone was recorded. Lipid peroxidation (LPO) damage to the walking leg muscles was determined for the following four experimental conditions: a--normoxic water with free access to air; b--hypoxic water without access to air; c--hypoxic water followed by normoxic water without air access; and d--hypoxic water with free access to air. When exposed to hypoxic water, N. granulata spent significantly more time on land, 135.3 ± 17.7 min, whereas control animals (exposed to normoxic water) spent more time submerged, 187.4 ± 20.2 min. By this behavior, N. granulata was able to maintain a 100% survival rate when exposed to severe hypoxia. However, N. granulata must still return to water after periods of air exposure (~ 14 min), causing a sequence of hypoxia/reoxygenation events. Despite increasing the survival rate, hypoxia with air access does not decrease the lipid peroxidation damage caused by the hypoxia and reoxygenation cycle experienced by these crabs.

  5. Severe toxic damage to the rabbit spinal cord after intrathecal administration of preservative-free S(+)-ketamine

    NARCIS (Netherlands)

    Vranken, Jan H.; Troost, Dirk; de Haan, Peter; Pennings, Fritz A.; van der Vegt, Marinus H.; Dijkgraaf, Marcel G. W.; Hollmann, Markus W.

    2006-01-01

    BACKGROUND: Ketamine and S(+)-ketamine have been advocated for neuraxial use in the management of postoperative pain and severe intractable pain syndromes unresponsive to opioid escalation. Although clinical experience has accumulated with S(+)-ketamine, safety data on toxicity in the central

  6. Cardiac involvement in canine babesiosis : review article

    Directory of Open Access Journals (Sweden)

    R.G. Lobetti

    2005-06-01

    Full Text Available Cardiac dysfunction in canine babesiosis has traditionally been regarded as a rare complication, with the majority of lesions reported as incidental findings at post-mortem examination. Recent studies have, however, demonstrated cardiac lesions in canine babesiosis. Cardiac troponins, especially troponin I, are sensitive markers of myocardial injury in canine babesiosis, and the magnitude of elevation of plasma troponin I concentrations appears to be proportional to the severity of the disease. ECG changes in babesiosis are similar to the pattern described for myocarditis and myocardial ischaemia and together with histopathological findings indicate that the heart suffers from the same pathological processes described in other organs in canine babesiosis, namely inflammation and hypoxia. The clinical application of the ECG appears to be limited and thus cardiovascular assessment should be based on functional monitoring rather than an ECG tracing. On cardiac histopathology from dogs that succumbed to babesiosis, haemorrhage, necrosis, inflammation and fibrin microthrombi in the myocardium were documented, all of which would have resulted in ECG changes and elevations in cardiac troponin. Myocardial damage causes left ventricular failure, which will result in hypotension and an expansion of the plasma volume due to homeostatic mechanisms.

  7. Combination Therapies for the Mitigation of Musculoskeletal Pathologic Damage in a Novel Model of Severe Injury and Disuse

    Science.gov (United States)

    2017-10-01

    manuscripts has been accepted/published in a peer-reviewed journal detailing this work to-date. 5 CONCLUSION Both Aim 1 and Aim 2 used our...Dorsal skin amounting to 40% of TBSA was immersed in 95°C-100°C water for 10 seconds. Control animals received sham treatment. Gene and protein...Unauthorized reproduction of this article is prohibited. Journal of Burn Care & Research 12 Song et al January/February 2017 for several major

  8. Gadolinium-enhanced cardiac MR exams of human subjects are associated with significant increases in the DNA repair marker 53BP1, but not the damage marker γH2AX.

    Directory of Open Access Journals (Sweden)

    Jennifer S McDonald

    Full Text Available Magnetic resonance imaging is considered low risk, yet recent studies have raised a concern of potential damage to DNA in peripheral blood leukocytes. This prospective Institutional Review Board-approved study examined potential double-strand DNA damage by analyzing changes in the DNA damage and repair markers γH2AX and 53BP1 in patients who underwent a 1.5 T gadolinium-enhanced cardiac magnetic resonance (MR exam. Sixty patients were enrolled (median age 55 years, 39 males. Patients with history of malignancy or who were receiving chemotherapy, radiation therapy, or steroids were excluded. MR sequence data were recorded and blood samples obtained immediately before and after MR exposure. An automated immunofluorescence assay quantified γH2AX or 53BP1 foci number in isolated peripheral blood mononuclear cells. Changes in foci number were analyzed using the Wilcoxon signed-rank test. Clinical and MR procedural characteristics were compared between patients who had a >10% increase in γH2AX or 53BP1 foci numbers and patients who did not. The number of γH2AX foci did not significantly change following cardiac MR (median foci per cell pre-MR = 0.11, post-MR = 0.11, p = .90, but the number of 53BP1 foci significantly increased following MR (median foci per cell pre-MR = 0.46, post-MR = 0.54, p = .0140. Clinical and MR characteristics did not differ significantly between patients who had at least a 10% increase in foci per cell and those who did not. We conclude that MR exposure leads to a small (median 25% increase in 53BP1 foci, however the clinical relevance of this increase is unknown and may be attributable to normal variation instead of MR exposure.

  9. Cardiac MRI in restrictive cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, A. [Department of Cardiovascular Radiology, All India Institute of Medical Sciences, Ansari Nagar, Delhi (India); Singh Gulati, G., E-mail: gulatigurpreet@rediffmail.com [Department of Cardiovascular Radiology, All India Institute of Medical Sciences, Ansari Nagar, Delhi (India); Seth, S. [Department of Cardiology, All India Institute of Medical Sciences, Ansari Nagar, Delhi (India); Sharma, S. [Department of Cardiovascular Radiology, All India Institute of Medical Sciences, Ansari Nagar, Delhi (India)

    2012-02-15

    Restrictive cardiomyopathy (RCM) is a specific group of heart muscle disorders characterized by inadequate ventricular relaxation during diastole. This leads to diastolic dysfunction with relative preservation of systolic function. Although short axis systolic function is usually preserved in RCM, the long axis systolic function may be severely impaired. Confirmation of diagnosis and information regarding aetiology, extent of myocardial damage, and response to treatment requires imaging. Importantly, differentiation from constrictive pericarditis (CCP) is needed, as only the latter is managed surgically. Echocardiography is the initial cardiac imaging technique but cannot reliably suggest a tissue diagnosis; although recent advances, especially tissue Doppler imaging and spectral tracking, have improved its ability to differentiate RCM from CCP. Cardiac catheterization is the reference standard, but is invasive, two-dimensional, and does not aid myocardial characterization. Cardiac magnetic resonance (CMR) is a versatile technique providing anatomical, morphological and functional information. In recent years, it has been shown to provide important information regarding disease mechanisms, and also been found useful to guide treatment, assess its outcome and predict patient prognosis. This review describes the CMR features of RCM, appearances in various diseases, its overall role in patient management, and how it compares with other imaging techniques.

  10. Gallstone disease is associated with more severe liver damage in patients with non-alcoholic fatty liver disease.

    Directory of Open Access Journals (Sweden)

    Anna Ludovica Fracanzani

    Full Text Available BACKGROUND: Nonalcoholic fatty liver disease (NAFLD and gallstone disease (GD are both highly prevalent in the general population and associated with obesity and insulin resistance. We aimed to evaluate the prevalence of GD in a cross sectional study of NAFLD patients and to define whether the presence of GD is associated with diabetes and predicts more severe liver disease. METHODOLOGY/PRINCIPAL FINDINGS: We merged databases of four Liver Units, comprising 524 consecutive biopsy-proven NAFLD (373 males observed between January 2003 and June 2010. GD was diagnosed in 108 (20%, and 313 cases (60% were classified by liver biopsy as nonalcoholic steatohepatitis (NASH. The GD subgroup was characterized by a significantly higher prevalence of females, prediabetes/diabetes, abdominal obesity and metabolic syndrome, older age, higher BMI, fasting glucose, HOMA-IR and lower ALT. The prevalence of GD progressively increased with advancing fibrosis and with the severity of necroinflammatory activity (p for trend  = 0.0001 and  = 0.01, respectively, without differences in the severity of steatosis. At multivariate analysis GD was associated with female gender (OR 1.37, 95% CI 1.04-1.8, age (OR 1.027, 95% CI1.003-1.05, fasting glucose (OR 1.21, 95% CI 1.10-1.33 and NASH (OR 1.40,95% CI 1.06-1.89, whereas ALT levels were associated with a lower GD risk (OR 0.98, 95% CI 0.97-0.99. When subjects with cirrhosis were excluded from analysis, the association between GD and fasting glucose, female gender, and NASH was maintained. CONCLUSION: Patients with NAFLD have a high prevalence of GD, which characterizes subjects with altered glucose regulation and more advanced liver disease.

  11. A Novel α-Calcitonin Gene-Related Peptide Analogue Protects Against End-Organ Damage in Experimental Hypertension, Cardiac Hypertrophy and Heart Failure

    DEFF Research Database (Denmark)

    Aubdool, Aisah A; Thakore, Pratish; Argunhan, Fulye

    2017-01-01

    cardiovascular disease in two distinct murine models of hypertension and heart failure in vivoMethods -The ability of the αAnalogue to act selectively via the CGRP pathway was shown in skin using a CGRP receptor antagonist. The effect of the αAnalogue on Angiotensin II (AngII)-induced hypertension......, Western blot and histology. Results -The AngII-induced hypertension was attenuated by co-treatment with the αAnalogue (50nmol/kg/day, s.c., at a dose selected for lack of long term hypotensive effects at baseline). The αAnalogue protected against vascular, renal and cardiac dysfunction, characterised...... failure. It preserved heart function, assessed by echocardiography, whilst protecting against adverse cardiac remodelling and apoptosis. Moreover, treatment with the αAnalogue was well-tolerated with neither signs of desensitisation nor behavioural changes. Conclusions -These findings, in two distinct...

  12. Features of RAPTA-SFD code modelling of chemical interactions of basic materials of the WWER active zone in accident conditions with severe fuel damage

    International Nuclear Information System (INIS)

    Bibilashvili, Yu.K.; Sokolov, N.B.; Salatov, A.V.; Nechaeva, O.A.; Andreyeva-Andrievskaya, L.N.; Vlasov, F.Yu.

    1996-01-01

    A brief description of RAPTA-SFD code intended for computer simulations of WWER-type fuel elements (simulator or absorber element) in conditions of accident with severe damage of fuel. Presented are models of chemical interactions of basic materials of the active zone, emphasized are special feature of their application in carrying out of the CORA-W2 experiment within the framework of International Standard Problem ISP-36. Results obtained confirm expediency of phenomenological models application. (author). 6 refs, 7 figs, 1 tab

  13. Cultured cells from a severe combined immunodeficient mouse have a slower than normal rate of repair of potentially lethal damage sensitive to hypertonic treatment

    International Nuclear Information System (INIS)

    Kimura, H.; Terado, T.; Ikebuchi, M.; Aoyama, T.; Komatsu, K.; Nozawa, A.

    1995-01-01

    The effects of hypertonic 0.5 M NaCl treatment after irradiation on the repair of DNA damage were examined in fibroblasts of the severe combined immunodeficient (scid) mouse. These cells are hypersensitive to ionizing radiation because of a deficiency in the repair of double-strand breaks. Hypertonic treatment caused radiosensitization due to a fixation of potentially lethal damage (PLD) in scid cells, demonstrating that scid cells normally repair PLD. To assess the kinetics of the repair of PLD, hypertonic treatment was delayed for various times after irradiation. Potentially lethal damage was repaired during these times in isotonic medium at 37 degrees C. It was found that the rate of repair of PLD was much slower in scid cells than in BALB/c 3T3 cells, which have a open-quotes wild-typeclose quotes level of radiosensitivity. This fact indicates that the scid mutation affects the type of repair of PLD that is sensitive to 0.5 M NaCl treatment. In scid hybrid cells containing fragments of human chromosome 8, which complements the radiosensitivity of the scid cells, the rate of repair was restored to a normal level. An enzyme encoded by a gene on chromosome 8 may also be connected with PLD which is sensitive to hypertonic treatment. 29 refs., 3 figs

  14. Evaluation of plasma sphingosine 1-phosphate, hepcidin and cardiovascular damage biomarkers (cardiac troponin I and homocysteine) in rats infected with brucellosis and vaccinated (Rev-1, RB-51).

    Science.gov (United States)

    Azimzadeh, Kaveh; Nasrollahi Nargesabad, Reza; Vousooghi, Nasim

    2017-08-01

    Brucellosis is known as one of important zoonosis. Studying the histological and biochemical effects of the disease could help to increase our knowledge about it. The aim of the present study was to evaluate changes of plasma parameters after intraperitoneal injection of two species of Brucella (Brucella melitensis and Brucella abortus) and two vaccines (Rev-1, RB-51) in the rat. Forty male rats were divided into five groups (n = 8 in each group). Two groups received suspensions of Brucella abortus and Brucella melitensis and two other groups were injected intraperitoneally with two mentioned vaccines and the last group received only distilled water. The results showed a significant increase in sphingosine 1-phosphate, Malondialdehyde, hepcidin, homocysteine, cardiac troponin I and copper levels and a considerable decrease in the levels of iron and zinc (P ≤ 0.01) in infected groups compared to the control animals. In vaccinated groups, hepcidin was increased but other parameters were not changed in comparison to the control group. It can be concluded that increase of homocysteine and cardiac troponin I in brucellosis could be a warning for cardiac adverse effects. Besides, increase of sphingosine 1-phosphate probably indicates its stimulant and modulatory effects in anti- Brucellosis biochemical pathways of the host. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Comparison of european computer codes relative to the aerosol behavior in PWR containment buildings during severe core damage accidents

    International Nuclear Information System (INIS)

    Fermandjian, J.; Beonio-Brocchieri, F.

    1986-09-01

    The present study concerns a comparative exercise, performed within the framework of the Commission of the European Communities, of the computer codes used in reactor safety in order to assess their capability of realistically describing the aerosol behavior in PWR reactor containment buildings during severe accidents. The codes included in the present study are the following: AEROSIM-M, AEROSOLS/Bl, CORRAL-2, NAUA Mod5. In AEROSIM-M, AEROSOLS/Bl and NAUA Mod5, the integro-differential equation for the evolution of the particle mass distribution is approximated by a set of coupled first order differential equations. To this end, the particle distribution function is replaced by a number of discrete monodisperse fractions. The CORRAL-2 has an essentially empirical basis (processes not explicitely modelled, but their net effects accounted for). The physical processes taken into account in the codes are shown finally

  16. Increasing severity of damage caused by floods in the Spanish Mediterranean coast (1960-2014), climate change or vulnerability?

    Science.gov (United States)

    Perez, Alfredo; Gil, Salvador; Lopez, Francisco; Barriendos, Mariano

    2016-04-01

    In recent decades, there has been an increase in physical and economic losses (WMO, CRED and UCL, 2014) that raises serious concerns in society. Climate change projections may explain the rise in flood losses; however, these shouldn't be considered yet (Bouwer, 2011). According to IPCC (2014), there is low confidence in anthropogenic climate change affecting the frequency and magnitude of fluvial floods on a global scale. In other words, this increase in flood events is not completely related to the higher frequency of heavy rainfall. To illustrate the aforementioned, a spatial example can be seen in the study area. In the Spanish Mediterranean coast, we see an increase in economic losses within the last 50 years due to flood events (Gil et al., 2014). It seems that the socio-economic growth and the rise of housing construction (Gaja, 2008) have led to an increase in vulnerability and exposure which are mainly responsible for those losses and the increase in severity of flood events (Pérez et al., 2015). Furthermore, this situation will probably become more precarious if some climate forecasts are met [IPCC, 2014; AEMET, 2015], and if the economic model fails to adopt efficient adaptive measures. Therefore, it is interesting to focus attention on social factors either within the present or future scenario in order to minimise the potential consequences and improve the adaptation. The main objective of this work focuses on the study of the evolution of the severity of the floods in the Spanish Mediterranean coast for the period (1960-2015). To do that, a statistical analysis of the data base [Gil et al., 2014; extended to the entire Spanish Mediterranean coast (MEDIFLOOD)] and a multiscale mapping (local, provincial and regional level) of the frequency of these events will take place in order to make comparisons and show spatiotemporal patterns according to the severity events evolution. Preliminary results show some interesting statistically significant

  17. Effects of biomarkers of oxidative stress damage on prevalence and severity of visual disability among black Central Africans.

    Science.gov (United States)

    Longo-Mbenza, B; Muaka, M Mvitu; Yokobo, E Cibanda; Phemba, I Longo; Mokondjimobe, E; Gombet, T; Ndembe, D Kibokela; Mona, D Tulomba; Masamba, S Wayiza

    2012-01-01

    Because of the demographic transition, lifestyle changes, urbanization, and nutrition transition, Central Africans are at higher risk of ocular diseases associated with oxidative stress and visual disability. This study aimed to estimate the normal values of oxidant status defined by oxidized low-density lipoprotein (Ox-LDL), 8-Isoprostane and 8-hydroxy-deoxyguanosine (8-OHdG) and to determine their pathogenic role in the prevalence and the severity of visual disability among these black Africans. This was a cross-sectional study, run in a case-control study randomly selected from Kinshasa province, DR Congo. The study included 150 type 2 diabetes mellitus (T2DM) patients (cases) matched for sex and age to 50 healthy non diabetic controls. Logistic regression models were used to identify independent determinants of visual disability. The presence rates were 8.5% for blindness, 20.5% for visual impairment and 29% for visual disability including blindness and visual impairment. After adjusted for taro leaves intake, red beans intake, T2DM, aging, waist circumference, and systolic blood pressure, we identified low education level (OR=3.3 95%CI 1.5-7.2; p=0.003), rural-urban migration (OR=2.6 95% CI 1.2-5.6; p=0.017), and high Ox-LDL (OR=2.3 95% CI 1.1-4.7; p=0.029) as the important independent determinants of visual disability. After adjusted for education, intake of red beans, intake of taro leaves, triglycerides, and T2DM, we identified no intake of safou fruit (OR=50.7 95% CI 15.2-168.5; pvisual disability. After adjusted for education level, no intake of red beans, no intake of Taro leaves, triglycerides, and T2DM, we identified no intake of Safou fruit (OR=43.1 95% CI 13.7-135.4; pvisual disability. Visual disability remains a public health problem in Central Africa. Antioxidant supplement, fruit intake, nutrition education, control of migration, and blocking of oxidative stress are crucial steps for delayed development of vision loss.

  18. High-Dose Polymerized Hemoglobin Fails to Alleviate Cardiac Ischemia/Reperfusion Injury due to Induction of Oxidative Damage in Coronary Artery.

    Science.gov (United States)

    Yang, Qian; Wu, Wei; Li, Qian; Chen, Chan; Zhou, Ronghua; Qiu, Yanhua; Luo, Ming; Tan, Zhaoxia; Li, Shen; Chen, Gang; Zhou, Wentao; Liu, Jiaxin; Yang, Chengmin; Liu, Jin; Li, Tao

    2015-01-01

    Objective. Ischemia/reperfusion (I/R) injury is an unavoidable event for patients in cardiac surgery under cardiopulmonary bypass (CPB). This study was designed to investigate whether glutaraldehyde-polymerized human placenta hemoglobin (PolyPHb), a hemoglobin-based oxygen carrier (HBOC), can protect heart against CPB-induced I/R injury or not and to elucidate the underlying mechanism. Methods and Results. A standard dog CPB model with 2-hour cardiac arrest and 2-hour reperfusion was established. The results demonstrated that a low-dose PolyPHb (0.1%, w/v) provided a significant protection on the I/R heart, whereas the high-dose PolyPHb (3%, w/v) did not exhibit cardioprotective effect, as evidenced by the impaired cardiac function, decreased myocardial oxygen utilization, and elevated enzymes release and pathological changes. Further study indicated that exposure of isolated coronary arteries or human umbilical vein endothelial cells (HUVECs) to a high-dose PolyPHb caused impaired endothelium-dependent relaxation, which was companied with increased reactive oxygen species (ROS) production, reduced superoxide dismutase (SOD) activity, and elevated malonaldehyde (MDA) formation. Consistent with the increased oxidative stress, the NAD(P)H oxidase activity and subunits expression, including gp91(phox), p47(phox), p67(phox), and Nox1, were greatly upregulated. Conclusion. The high-dose PolyPHb fails to protect heart from CPB-induced I/R injury, which was due to overproduction of NAD(P)H oxidase-induced ROS and resultant endothelial dysfunction.

  19. High-Dose Polymerized Hemoglobin Fails to Alleviate Cardiac Ischemia/Reperfusion Injury due to Induction of Oxidative Damage in Coronary Artery

    Directory of Open Access Journals (Sweden)

    Qian Yang

    2015-01-01

    Full Text Available Objective. Ischemia/reperfusion (I/R injury is an unavoidable event for patients in cardiac surgery under cardiopulmonary bypass (CPB. This study was designed to investigate whether glutaraldehyde-polymerized human placenta hemoglobin (PolyPHb, a hemoglobin-based oxygen carrier (HBOC, can protect heart against CPB-induced I/R injury or not and to elucidate the underlying mechanism. Methods and Results. A standard dog CPB model with 2-hour cardiac arrest and 2-hour reperfusion was established. The results demonstrated that a low-dose PolyPHb (0.1%, w/v provided a significant protection on the I/R heart, whereas the high-dose PolyPHb (3%, w/v did not exhibit cardioprotective effect, as evidenced by the impaired cardiac function, decreased myocardial oxygen utilization, and elevated enzymes release and pathological changes. Further study indicated that exposure of isolated coronary arteries or human umbilical vein endothelial cells (HUVECs to a high-dose PolyPHb caused impaired endothelium-dependent relaxation, which was companied with increased reactive oxygen species (ROS production, reduced superoxide dismutase (SOD activity, and elevated malonaldehyde (MDA formation. Consistent with the increased oxidative stress, the NAD(PH oxidase activity and subunits expression, including gp91phox, p47phox, p67phox, and Nox1, were greatly upregulated. Conclusion. The high-dose PolyPHb fails to protect heart from CPB-induced I/R injury, which was due to overproduction of NAD(PH oxidase-induced ROS and resultant endothelial dysfunction.

  20. Comparative study of the antioxidant properties of monocarbonyl curcumin analogues C66 and B2BrBC in isoproteranol induced cardiac damage.

    Science.gov (United States)

    Hadzi-Petrushev, Nikola; Bogdanov, Jane; Krajoska, Jovanka; Ilievska, Jovana; Bogdanova-Popov, Biljana; Gjorgievska, Elizabeta; Mitrokhin, Vadim; Sopi, Ramadan; Gagov, Hristo; Kamkin, Andre; Mladenov, Mitko

    2018-03-15

    To test the antioxidant properties of the newly synthesized (2E,6E)-2,6-bis(2-bromobenzylidene)cyclohexanone (B2BrBC) in parallel with C66 in rats with cardiac hypertrophy. The protective effects of both C66 and B2BrBC against oxidative stress in rats with cardiac hypertrophy, was studied by evaluating the activity of antioxidant enzymes, the relationship between the ratio of the activities of the antioxidant enzymes R = SOD/(GPx + CAT) and levels of thiols and lipid peroxidation in the heart. In order to gain better understanding of the antioxidant properties of the studied compounds, computational methods were utilized. The properties of selected structurally related derivatives were obtained on optimized geometries for ground states, using semi-empirical PM3 quantum mechanical calculations. The ratio R shows disequilibrium in rats with induced hypertrophy (p antioxidant. The obtained results indicated that the antioxidant ability of B2BrBC is positively associated with the catalytic SOD and GPx activities expressed through preserved t-SH levels. It seems plausible that for a compound to exhibit antioxidant activity, as most of the 2,6-bis(benzylidene)cyclohexanones do, they should be good electron donors. Understanding the relationship between cardiac hypertrophy induced oxidative injuries and supporters of endogenous reparatory machinery will help in establishing the beneficial role of adequate antioxidant supplementation. In this study reliable data on the preventive effects of newly synthesized symmetric monocarbonyl curcumin analogue B2BrBC and its role in the prevention of oxidative injuries on three levels (enzymatic, protein and lipid), in the heart hypertrophic onset, were obtained. Copyright © 2018 Elsevier Inc. All rights reserved.

  1. Chemical and structural composition study through transmission and reflection electron microscopy and X-ray microanalysis of damaged duramater cardiac valves

    International Nuclear Information System (INIS)

    Verginelli, G.; Didio, L.J.A.; Puig, L.B.; Allen, D.J.; Highinson, G.H.; Zerbini, E.J.

    1982-01-01

    Ten malfunctioning durameter aortic prosthesis, excised surgically after 44 to 54 months of implantation were studied through transmission and reflection electron microscopy and X-ray microanalysis. Duramater extracted at necropsy but not used for valve prosthesis and duramater aortic prosthesis not implanted in patients were used as controls. It was concluded that homologous duramater valves present subcellular changes following implantation, with degenerating and proliferating areas which could correspond either to normal adaptation or consequence of degeneration - rebuilding which begins with implantation; it is also emphazised the need for ultramicroscopic studies in evaluating biological tissues and establishing its applicability in cardiac surgery. (M.A.C.) [pt

  2. Severe isolated tricuspid insufficiency due to tricuspid papillary muscle rupture after a fall from a horse: treatment with port access minimally invasive cardiac surgery.

    Science.gov (United States)

    Öz, Kürsad; Mayeran, Yousef; Van Praet, Frank; Codens, Jose; Vanerman, Hugo

    2014-04-01

    We report on the successful treatment of tricuspid valve insufficiency due to blunt chest injury using port-access minimally invasive cardiac surgery. The optimal surgical treatment of traumatic valvular insufficiency is discussed, including a brief review of the relevant literature.

  3. Delayed contrast-enhanced MRI: use in myocardial viability assessment and other cardiac pathology

    International Nuclear Information System (INIS)

    Bogaert, J.; Dymarkowski, S.

    2005-01-01

    As in other organs, tissue characterization is important for many cardiac diseases. For example, in ischemic heart disease, differentiation between reversibly and irreversibly damaged myocardium in patients with a prior myocardial infarction is crucial in determining disease severity, functional recovery and patient outcome. With the recent advent of the single inversion-recovery contrast-enhanced magnetic resonance imaging (MRI) sequence (delayed contrast-enhanced MRI), contrast between normal and abnormal tissues could be significantly enhanced compared with the conventional cardiac MRI sequences, enabling even subtle abnormalities to be visualized. Together with other advances in cardiac MRI (e.g. functional imaging, coronary artery imaging), MRI has become one of the preferred non-invasive modalities to study cardiac diseases. In this paper an overview of the versatility of delayed contrast-enhanced MRI for investigating cardiac diseases is given. (orig.)

  4. Validation of maternal cardiac output assessed by transthoracic echocardiography against pulmonary artery catheterization in severely ill pregnant women: prospective comparative study and systematic review.

    Science.gov (United States)

    Cornette, J; Laker, S; Jeffery, B; Lombaard, H; Alberts, A; Rizopoulos, D; Roos-Hesselink, J W; Pattinson, R C

    2017-01-01

    Most severe pregnancy complications are characterized by profound hemodynamic disturbances, thus there is a need for validated hemodynamic monitoring systems for pregnant women. Pulmonary artery catheterization (PAC) using thermodilution is the clinical gold standard for the measurement of cardiac output (CO), however this reference method is rarely performed owing to its invasive nature. Transthoracic echocardiography (TTE) allows non-invasive determination of CO. We aimed to validate TTE against PAC for the determination of CO in severely ill pregnant women. This study consisted of a meta-analysis combining data from a prospective study and a systematic review. The prospective arm was conducted in Pretoria, South Africa, in 2003. Women with severe pregnancy complications requiring invasive monitoring with PAC according to contemporary guidelines were included. TTE was performed within 15 min of PAC and the investigator was blinded to the PAC measurements. Comparative measurements were extracted from similar studies retrieved from a systematic review of the literature and added to a database. Simultaneous CO measurements by TTE and PAC were compared. Agreement between methods was assessed using Bland-Altman statistics and intraclass correlation coefficients (ICC). Thirty-four comparative measurements were included in the meta-analysis. Mean CO values obtained by PAC and TTE were 7.39 L/min and 7.18 L/min, respectively. The bias was 0.21 L/min with lower and upper limits of agreement of -1.18 L/min and 1.60 L/min, percentage error was 19.1%, and ICC between the two methods was 0.94. CO measurements by TTE show excellent agreement with those obtained by PAC in pregnant women. Given its non-invasive nature and availability, TTE could be considered as a reference for the validation of other CO techniques in pregnant women. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. Las complicaciones del embarazo más graves se caracterizan por trastornos hemodin

  5. Cardiac rehabilitation

    Science.gov (United States)

    ... rehab; Heart failure - cardiac rehab References Anderson L, Taylor RS. Cardiac rehabilitation for people with heart disease: ... of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed ...

  6. Lesiones torácicas graves y el enfoque del control de daños Severe thoracic lesions and the damage control approach

    Directory of Open Access Journals (Sweden)

    Mario Miguel Morales Wong

    2008-03-01

    Full Text Available En los últimos años se han desarrollado nuevas estrategias para el tratamiento del trauma grave con lesiones exanguinantes o sin ellas, pero son estas últimas las que más requieren un cambio de la forma de actuar en aras de mejorar la supervivencia. Tales estrategias quirúrgicas se han denominado cirugía de control de daños, que en esencia evita complicaciones como la tríada letal de acidosis, hipotermia y coagulopatía. A diferencia del control de daños en el abdomen, existen lesiones torácicas que requieren una reparación inicial durante el acto quirúrgico, pero pueden hallarse otras cuya reparación puede ser secundaria. El método de control de daños en las lesiones torácicas debe llevarse a cabo con procedimientos que sean técnicamente rápidos y simples, para postergar el tratamiento definitivo de las lesiones que no requieran una reparación inmediata en pacientes in extremisNew strategies have been developed in the last years to treat severe trauma with exsanguinating lesions or without them. The latter demand more changes in the way of acting in order to improve survival. Such surgical strategies have been called damage control surgery that in essence prevent complications such as the lethal triad of acidosis, hypothermia and coagulopathy. Unlike the control of abdomen damage, there are thoracic lesions requiring an initial repair during surgery, but there may be found others, whose repair is secondary. The damage control method in the thoracic lesions should be conducted with technically fast and simple procedures to postpone the definitive treatment of the lesions that do not require an immediate repair in patients in extremis

  7. Unstandardized treatment of electroencephalographic status epilepticus does not improve outcome of comatose patients after cardiac arrest

    NARCIS (Netherlands)

    Hofmeijer, Jeannette; Cloostermans, M.C.; Beishuizen, A.; van Putten, Michel Johannes Antonius Maria

    2014-01-01

    Objective: Electroencephalographic status epilepticus occurs in 9–35% of comatose patients after cardiac arrest. Mortality is 90–100%. It is unclear whether (some) seizure patterns represent a condition in which anti-epileptic treatment may improve outcome, or severe ischemic damage, in which

  8. Duration of Untreated Cardiac Arrest and Clinical Relevance of Animal Experiments: The Relationship Between the "No-Flow" Duration and the Severity of Post-Cardiac Arrest Syndrome in a Porcine Model.

    Science.gov (United States)

    Babini, Giovanni; Grassi, Luigi; Russo, Ilaria; Novelli, Deborah; Boccardo, Antonio; Luciani, Anita; Fumagalli, Francesca; Staszewsky, Lidia; Fiordaliso, Fabio; De Maglie, Marcella; Salio, Monica; Zani, Davide D; Letizia, Teresa; Masson, Serge; Luini, Mario V; Pravettoni, Davide; Scanziani, Eugenio; Latini, Roberto; Ristagno, Giuseppe

    2018-02-01

    The study investigated the effect of untreated cardiac arrest (CA), that is, "no-flow" time, on postresuscitation myocardial and neurological injury, and survival in a pig model to identify an optimal duration that adequately reflects the most frequent clinical scenario. An established model of myocardial infarction followed by CA and cardiopulmonary resuscitation was used. Twenty-two pigs were subjected to three no-flow durations: short (8-10 min), intermediate (12-13 min), and long (14-15 min). Left ventricular ejection fraction (LVEF) was assessed together with thermodilution cardiac output (CO) and high sensitivity cardiac troponin T (hs-cTnT). Neurological impairment was evaluated by neurological scores, serum neuron specific enolase (NSE), and histopathology. More than 60% of animals survived when the duration of CA was ≤13 min, compared to only 20% for a duration ≥14 min. Neuronal degeneration and neurological scores showed a trend toward a worse recovery for longer no-flow durations. No animals achieved a good neurological recovery for a no-flow ≥14 min, in comparison to a 56% for a duration ≤13 min (P = 0.043). Serum NSE levels significantly correlated with the no-flow duration (r = 0.892). Longer durations of CA were characterized by lower LVEF and CO compared to shorter durations (P flow time, the higher was the number of defibrillations delivered (P = 0.043). The defibrillations delivered significantly correlated with LVEF and plasma hs-cTnT. Longer no-flow durations caused greater postresuscitation myocardial and neurological dysfunction and reduced survival. An untreated CA of 12-13 min may be an optimal choice for a clinically relevant model.

  9. [Arm Motor Function Recovery during Rehabilitation with the Use of Hand Exoskeleton Controlled by Brain-Computer Interface: a Patient with Severe Brain Damage].

    Science.gov (United States)

    Biryukova, E V; Pavlova, O G; Kurganskaya, M E; Bobrov, P D; Turbina, L G; Frolov, A A; Davydov, V I; Sil'tchenko, A V; Mokienko, O A

    2016-01-01

    We studied the dynamics of motor function recovery in a patient with severe brain damage in the course of neurorehabilitation using hand exoskeleton controlled by brain-computer interface. For estimating the motor function of paretic arm, we used the biomechanical analysis of movements registered during the course of rehabilitation. After 15 weekly sessions of hand exoskeleton control, the following results were obtained: a) the velocity profile of goal-directed movements of paretic hand became bell-shaped, b) the patient began to extend and abduct the hand which was flexed and adducted in the beginning of rehabilitation, and c) the patient began to supinate the forearm which was pronated in the beginning of rehabilitation. The first result is an evidence of the general improvement of the quality of motor control, while the second and third results prove that the spasticity of paretic arm has decreased.

  10. The dynamics of fibroblasts/ECM in neonatal cardiac injury

    OpenAIRE

    Pinto, Vasco Miguel Sampaio, 1991-

    2014-01-01

    Tese de mestrado. Biologia (Biologia Evolutiva e do Desenvolvimento). Universidade de Lisboa, Faculdade de Ciências, 2014 Cardiac diseases remain the major cause of morbidity and mortality worldwide. This is the ground for an increasing number of studies on the characterization of the heart’s response to injury and on the development of new therapies to functionally restore the damaged myocardium. Recently, several reports show that the mammalian heart, when injured in a shortperiod after ...

  11. Cardiac sympathetic innervation assessed with (123)I-MIBG retains prognostic utility in diabetic patients with severe left ventricular dysfunction evaluated for primary prevention implantable cardioverter-defibrillator.

    Science.gov (United States)

    García-González, P; Fabregat-Andrés, Ó; Cozar-Santiago, P; Sánchez-Jurado, R; Estornell-Erill, J; Valle-Muñoz, A; Quesada-Dorador, A; Payá-Serrano, R; Ferrer-Rebolleda, J; Ridocci-Soriano, F

    2016-01-01

    Scintigraphy with iodine-123-metaiodobenzylguanidine ((123)I-MIBG) is a non-invasive tool for the assessment of cardiac sympathetic innervation (CSI) that has proven to be an independent predictor of survival. Recent studies have shown that diabetic patients with heart failure (HF) have a higher deterioration in CSI. It is unknown if (123)I-MIBG has the same predictive value for diabetic and non-diabetic patients with advanced HF. An analysis is performed to determine whether CSI with (123)I-MIBG retains prognostic utility in diabetic patients with HF, evaluated for a primary prevention implantable cardioverter-defibrillator (ICD). Seventy-eight consecutive HF patients (48 diabetic) evaluated for primary prevention ICD implantation were prospectively enrolled and underwent (123)I-MIBG to assess CSI (heart-to-mediastinum ratio - HMR). A Cox proportional hazards multivariate analysis was used to determine the influence of (123)I-MIBG images for prediction of cardiac events in both diabetic and non-diabetic patients. The primary end-point was a composite of arrhythmic event, cardiac death, or admission due to HF. During a mean follow-up of 19.5 [9.3-29.3] months, the primary end-point occurred in 24 (31%) patients. Late HMR was significantly lower in diabetic patients (1.30 vs. 1.41, p=0.014). Late HMR≤1.30 was an independent predictor of cardiac events in diabetic (hazard ratio 4.53; p=0.012) and non-diabetic patients (hazard ratio 12.31; p=0.023). Diabetic patients with HF evaluated for primary prevention ICD show a higher deterioration in CSI than non-diabetics; nevertheless (123)I-MIBG imaging retained prognostic utility for both diabetic and non-diabetic patients. Copyright © 2015 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

  12. No post-no core approach to restore severely damaged posterior teeth: An up to 10-year retrospective study of documented endocrown cases.

    Science.gov (United States)

    Belleflamme, Marcia M; Geerts, Sabine O; Louwette, Marie M; Grenade, Charlotte F; Vanheusden, Alain J; Mainjot, Amélie K

    2017-08-01

    The objectives of the present study were to (1) retrospectively evaluate documented cases of ceramic and composite endocrowns performed using immediate dentin sealing (IDS); (2) correlate failures with clinical parameters such as tooth preparation characteristics and occlusal parameters. 99 documented cases of endocrowns were evaluated after a mean observation period of 44.7±34.6months. A classification of restorations was established in function of the level of damage of residual tooth tissues after preparation, from 1 to 3. Evaluation was performed according to FDI criteria and endodontic outcomes were analyzed. Occlusal risk factors were examined and fractographic analysis was performed in case of fracture. 48.4% of patients were shown to present occlusal risk factors. 75.8% of restorations were Class 3 endocrowns. 56.6% were performed on molars, 41.4% on premolars and 2.0% on canines. 84.8% were performed in lithium-disilicate glass-ceramic and 12.1% in Polymer-Infiltrated Ceramic Network (PICN) material. The survival and success rates of endocrowns were 99.0% and 89.9% respectively, while the 10-year Kaplan-Meier estimated survival and success rates were 98.8% and 54.9% respectively. Ten failures were detected: periodontal disease (n=3), endocrown debonding (n=2), minor chipping (n=2), caries recurrence (n=2) and major fractures (n=1). Due to the reduced amount of failures, no statistical correlation could be established with clinical parameters. Endocrowns were shown to constitute a reliable approach to restore severely damaged molars and premolars, even in the presence of extensive coronal tissue loss or occlusal risk factors, such as bruxism or unfavorable occlusal relationships. Practitioners should consider the endocrown instead of the post and core approach to restore severely damaged non-vital posterior teeth. This minimally invasive solution reduces the risk of catastrophic failures and is easily performed. The use of IDS procedure and lithium

  13. Cardiac ventriculography

    International Nuclear Information System (INIS)

    Hillis, L.D.; Grossman, W.

    1986-01-01

    Cardiac ventriculography has been used extensively to define the anatomy of the ventricles and related structures in patients with congenital, valvular, coronary, and cardiomyopathic heart disease. Specifically, left ventriculography may provide valuable information about global and segmental left ventricular function, mitral valvular incompetence, and the presence, location, and severity of a number of other abnormalities, including ventricular septal defect and hypertrophic cardiomyopathy. As a result, it should be a routine part of catheterization in patients being evaluated for coronary artery disease, aortic or mitral valvular disease, unexplained left ventricular failure, or congenital heart disease. Similarly, right ventriculography may provide information about global and segmental right ventricular function and can be especially helpful in patients with congenital heart disease

  14. Post cardiac injury syndrome

    DEFF Research Database (Denmark)

    Nielsen, S L; Nielsen, F E

    1991-01-01

    The post-pericardiotomy syndrome is a symptom complex which is similar in many respects to the post-myocardial infarction syndrome and these are summarized under the diagnosis of the Post Cardiac Injury Syndrome (PCIS). This condition, which is observed most frequently after open heart surgery, i...... on the coronary vessels, with cardiac tamponade and chronic pericardial exudate. In the lighter cases, PCIS may be treated with NSAID and, in the more severe cases, with systemic glucocorticoid which has a prompt effect....

  15. Quantitative MRI shows cerebral microstructural damage in hemolytic-uremic syndrome patients with severe neurological symptoms but no changes in conventional MRI

    Energy Technology Data Exchange (ETDEWEB)

    Weissenborn, Karin; Worthmann, Hans; Heeren, Meike [Hannover Medical School, Clinic for Neurology, Hannover (Germany); Bueltmann, Eva; Donnerstag, Frank; Giesemann, Anja M.; Goetz, Friedrich; Lanfermann, Heinrich; Ding, Xiao-Qi [Hannover Medical School, Institute of Diagnostic and Interventional Neuroradiology, Hannover (Germany); Kielstein, Jan; Schwarz, Anke [Hannover Medical School, Clinic for Nephrology and Hypertension, Hannover (Germany)

    2013-07-15

    Severe neurological symptoms in Shiga toxin-producing Escherichia coli infection associated hemolytic-uremic syndrome (STEC-HUS) are often accompanied by none or only mild alterations of cerebral magnetic resonance imaging (MRI). This study aims to analyze if quantitative MRI is able to reveal cerebral pathological alterations invisible for conventional MRI. In nine patients with STEC-HUS associated severe neurological symptoms but inconspicuous cerebral MRI findings maps of the parameters T2 relaxation time, relative proton density (PD), apparent diffusion coefficient (ADC), and fractional anisotropy (FA) were generated. Quantitative values of these parameters were measured at the basal ganglia, thalamus, and white matter of the frontal and parietal lobe and compared to those of nine age- and sex-matched controls. Significant T2 prolongation (p < 0.01) was found in the basal ganglia of all patients compared to controls. PD and ADC were not significantly altered. A significant reduction of FA in patients was seen at caput nuclei caudati (p < 0.01). Prolonged T2 relaxation time indicates cerebral microstructural damages in these patients despite their inconspicuous MRI findings. T2 relaxometry could be used as a complementary tool for the assessment of metabolic-toxic brain syndromes. (orig.)

  16. Corticospinal tract damage in patients with severe diffuse axonal injury in a chronic stage on diffusion tensor magnetic resonance imaging and motor evoked potential

    International Nuclear Information System (INIS)

    Yasokawa, Yu-to; Nakayama, Noriyuki; Iwama, Toru; Okumura, Ayumi; Shinoda, Jun; Miwa, Kazuhiro

    2005-01-01

    The aim of this study is to evaluate the disturbed motor function of the corticospinal tract (CST) of diffuse axonal injury (DAI) using diffusion tensor magnetic resonance (DTMR) imaging and motor evoked potential (MEP) examination, and to analyze these comparatively. Forty-three patients (86 sides of the CST) with severe DAI in a chronic stage underwent DTMR imaging and MEP examination using transcranial magnetic stimulation. Fractional anisotrophy (FA) values of 6 regions of interests (ROIs) in the CST were measured on FA map obtained from DTMR imaging. The lowest FA value among the FA values of the 6 ROIs in each of the CSTs was defined as the minimum FA value. And the lowest magnetic stimulation strength that could derive MEP was defined as the minimum threshold of MEP. The mean minimum FA value of the CSTs in which MEP could not be obtained even by the maximum strength of magnetic stimulation (the MEP (-) group) was significantly lower than that of the CSTs in which MEP could be obtained (the MEP (+) group). In the MEP (+) group, the minimum FA value decreased with the increase of the minimum threshold of MEP with a significant correlation. These results demonstrate that physiological motor dysfunction disclosed on MEP is significantly correlated with morphological damage of the CST observed on DTMR imaging in patients with DAI in a chronic stage. DTMR imaging is strongly suggested to be helpful to evaluate disturbed motor function and to infer its severity in DAI. (author)

  17. Usefulness of severe cardiac sympathetic dysfunction to predict the occurrence of rapid atrial fibrillation in patients with Wolff-Parkinson-White syndrome.

    Science.gov (United States)

    Akutsu, Yasushi; Kaneko, Kyouichi; Kodama, Yusuke; Li, Hui-Ling; Asano, Taku; Suyama, Jumpei; Tanno, Kaoru; Namiki, Atsuo; Shinozuka, Akira; Gokan, Takehiko; Kobayashi, Youichi

    2013-09-01

    Atrial fibrillation (AF) can be a potentially life-threatening arrhythmia when it conducts rapidly through the accessory pathway, which was not predicted by the noninvasive method. We evaluated the cardiac sympathetic activity for predicting the occurrence of AF in patients with Wolff-Parkinson-White (WPW) syndrome. Iodine-123 metaiodobenzylguanidine scintigraphy was performed under stable sinus rhythm conditions at rest syndrome than in the normal control group, and in the 15 patients with AF induced during EPS than in the 30 patients without AF (p syndrome. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. The imaging research of myocardial damage in Duchenne muscular dystrophy

    International Nuclear Information System (INIS)

    Fu Peng; Wei Lingge; Hu Jing; Huang Jianmin; Liu Xiaomei

    2011-01-01

    It is common that Duchenne muscular dystrophy (DMD) patients can suffer from cardiac damage, which performed variously. Cardiac damage in DMD often be paid no attention in early stage,since the clinical symptoms is slight. With the decline of cardiac function, the quality of life, treatment and rehabilitation training of patients will be affected significantly. Furthermore, the progress of the disease will be speeded up and the difficulty of treatment will be increased. Therefore, there will be important significance in delaying the progression of cardiac damage and prolonging the life of patients by the early diagnosis and intervention treatment of cardiac damage in DMD. For the convenience of the clinician to choose suitable imaging methods, to improve the cardiac damage in patients of DMD, imaging researches which are applied to the DMD cardiac damage are reviewed. (authors)

  19. The effect of short-term coenzyme Q10 supplementation and pre-cooling strategy on cardiac damage markers in elite swimmers.

    Science.gov (United States)

    Emami, Ali; Tofighi, Asghar; Asri-Rezaei, Siamak; Bazargani-Gilani, Behnaz

    2018-02-01

    Strenuous physical exercise and hyperthermia may paradoxically induce oxidative stress and adverse effects on myocardial function. The purpose of this study was to investigate the effect of 14-d coenzyme Q10 (CoQ10) supplementation and pre-cooling on serum creatine kinase-MB (CK-MB), cardiac Troponin I (cTnI), myoglobin (Mb), lactate dehydrogenase (LD), total antioxidant capacity (TAC), lipid peroxidation (LPO) and CoQ10 concentration in elite swimmers. In total, thirty-six healthy males (mean age 17 (sd 1) years) were randomly selected and divided into four groups of supplementation, supplementation with pre-cooling, pre-cooling and control. During an eighteen-session protocol in the morning and evening, subjects attended speed and endurance swimming training sessions for 5 km in each session. Blood sampling was done before (two stages) and after (two stages) administration of CoQ10 and pre-cooling. ANCOVA and repeated measurement tests with Bonferroni post hoc test were used for the statistical analysis of the data. There was no significant statistical difference among groups for the levels of CK-MB, cTnI, Mb, LD, TAC, LPO and CoQ10 at the presampling (stages 1 and 2) (P>0·05). However, pre-cooling and control groups show a significant increase in the levels of CK-MB, cTnI, Mb, LD and LPO compared with the supplementation and supplementation with pre-cooling groups in the post-sampling (stages 1 and 2) (Pcompetition phase. Meanwhile, the pre-cooling strategy individually has no desired effect on the levels of CK-MB, cTnI, Mb, LD, LPO, TAC and CoQ10.

  20. IgA anti-Actin antibodies in children with celiac disease: comparison of immunofluorescence with Elisa assay in predicting severe intestinal damage

    Directory of Open Access Journals (Sweden)

    Mora Stefano

    2010-03-01

    Full Text Available Abstract Background Previous studies have demonstrated that the presence of serum IgA antibodies against actin filaments (AAA in patients with celiac disease (CD is strongly associated with mucosal damage and severe degrees of villous atrophy. The aims of the present study were (1 to verify the effectiveness of IgA-AAA in newly diagnosed CD patients in a clinical setting (2 to compare the immunofluorescence assay with ELISA assay; (3 to compare the correlation of our IgA anti-tissue transglutaminase antibodies (tTG-Ab class with mucosal intestinal lesions. Methods 90 patients underwent endoscopy and multiple biopsies for suspected CD on the basis of symptoms, in presence of positive tTG-Ab tests. Twenty biopsied and 25 not-biopsied subjects with negative tTG-Ab were tested as control groups. IgA-AAA assays were performed by indirect immunofluorescence using rat epithelial intestinal cells, and by ELISA with a commercial kit. tTG-Ab assay was a radio-binding assay. Intestinal specimens were collected by upper endoscopy and the histological study was done according to the Marsh's classification modified by Oberhuber (M/O. Auto-antibodies assays and histological evaluation have been performed blindly by skilled operators. Results CD diagnosis was confirmed in 82 patients (type I M/O in 2 patients, IIIA in 18 patients, IIIB in 29 patients and IIIC in 33 patients. Two patients with type 1 lesion in presence of positive tTG-Ab and abdominal complaints, started a gluten free diet. The rate of IgA-AAA positivity (sensitivity by IFI and ELISA in histologically proven celiac disease patients, were 5.5% and 25% patients in IIIA, 27.5% and 34.4% patients in IIIB, 78.8% and 75% in IIIC patients, respectively. Patients with normal or nearly normal mucosa, regardless of tTG-Ab status, presented negative IgA-AAA IFI assay. On the other hand, 1 patient with normal mucosa but positive tTG-Ab, also presented positive IgA-AAA ELISA. All healthy non biopsied

  1. Stem Cells for Cardiac Regeneration by Cell Therapy and Myocardial Tissue Engineering

    Science.gov (United States)

    Wu, Jun; Zeng, Faquan; Weisel, Richard D.; Li, Ren-Ke

    Congestive heart failure, which often occurs progressively following a myocardial infarction, is characterized by impaired myocardial perfusion, ventricular dilatation, and cardiac dysfunction. Novel treatments are required to reverse these effects - especially in older patients whose endogenous regenerative responses to currently available therapies are limited by age. This review explores the current state of research for two related approaches to cardiac regeneration: cell therapy and tissue engineering. First, to evaluate cell therapy, we review the effectiveness of various cell types for their ability to limit ventricular dilatation and promote functional recovery following implantation into a damaged heart. Next, to assess tissue engineering, we discuss the characteristics of several biomaterials for their potential to physically support the infarcted myocardium and promote implanted cell survival following cardiac injury. Finally, looking ahead, we present recent findings suggesting that hybrid constructs combining a biomaterial with stem and supporting cells may be the most effective approaches to cardiac regeneration.

  2. Ethical and practical considerations concerning perimortem sperm procurement in a severe neurologically damaged patient and the apparent discrepancy in validation of proxy consent in various postmortem procedures.

    Science.gov (United States)

    Epker, J L; de Groot, Y J; Kompanje, E J O

    2012-06-01

    Although sperm procurement and preservation has been become commonplace in situations in which infertility can be easily foreseen, peri- or postmortem sperm procurement for reproductive use in unexpected coma or death is not generally accepted. There are no laws and regulations for this kind of intervention in all countries and they may also differ from country to country. Intensive care specialists can be confronted with a request for peri- or postmortem sperm procurement, while not being aware of the country-specific provisions. A young male patient who suffered 17 L blood loss and half an hour of cardiopulmonary resuscitation was admitted to a university hospital for an ill-understood unstoppable abdominal bleed. After rapid deterioration of the neurological situation, due to severe post-anoxic damage, the decision was made to withdraw life-sustaining treatment. At that moment the partner of the patient asked for perimortem sperm procurement, which was denied, on the basis of the ethical reasoning that consent of the man involved was lacking. Retrospectively the decision was right according to Dutch regulations; however, with more time for elaborate ethical reasoning, the decision outcome, without the awareness of an existing prohibition, also could have been different. Guidelines and laws for peri- or postmortem sperm procurement differ from country to country, so any intensive care specialist should have knowledge from the latest legislation for this specific subject in his/her country. An overview is provided. A decision based on ethical reasoning may appear satisfying, but can unfortunately be in full contrast with the existing laws.

  3. Metabolic cardiac imaging in severe coronary disease: assessment of viability with iodine-123-iodophenylpentadecanoic acid and multicrystal gamma camera, and correlation with biopsy.

    Science.gov (United States)

    Murray, G; Schad, N; Ladd, W; Allie, D; vander Zwagg, R; Avet, P; Rockett, J

    1992-07-01

    Fifteen patients with coronary disease and resting left ventricular ejection fractions of less than or equal to 0.35 underwent resting metabolic cardiac imaging utilizing 1 mCi [123I]iodophenylpentadecanoic acid (IPPA) intravenously and a multicrystal gamma camera. Parametric images of regional rates of IPPA clearance and accumulation were generated. Forty-two vascular territories (22 infarcted) were evaluated by metabolic imaging as well as transmural myocardial biopsy. Despite resting akinesis or dyskinesis in 20/22 (91%) infarcted territories, 16/22 (73%) of these territories were metabolically viable. Transmural myocardial biopsies in all patients (43 sites, 42 vascular territories) during coronary bypass surgery confirmed IPPA results in 39/43 patients (91%). When compared to biopsy, scan sensitivity for viability was 33/36 (92%) with a specificity of 6/7 (86%). Eighty percent of bypassed, infarcted but IPPA viable segments demonstrated improved regional systolic wall motion postoperatively as assessed by exercise radionuclide angiography. We conclude resting IPPA imaging identifies viable myocardium, thereby providing a safe, cost-effective technique for myocardial viability assessment.

  4. Assessment of cardiac sympathetic nerve integrity with positron emission tomography

    International Nuclear Information System (INIS)

    Raffel, David M.; Wieland, Donald M.

    2001-01-01

    The autonomic nervous system plays a critical role in the regulation of cardiac function. Abnormalities of cardiac innervation have been implicated in the pathophysiology of many heart diseases, including sudden cardiac death and congestive heart failure. In an effort to provide clinicians with the ability to regionally map cardiac innervation, several radiotracers for imaging cardiac sympathetic neurons have been developed. This paper reviews the development of neuronal imaging agents and discusses their emerging role in the noninvasive assessment of cardiac sympathetic innervation

  5. Cardiac Ochronosis

    Science.gov (United States)

    Erek, Ersin; Casselman, Filip P.A.; Vanermen, Hugo

    2004-01-01

    We report the case of 67-year-old woman who underwent aortic valve replacement and mitral valve repair due to ochronotic valvular disease (alkaptonuria), which was diagnosed incidentally during cardiac surgery. PMID:15745303

  6. Cardiac catheterization

    Science.gov (United States)

    ... tests. However, it is very safe when done by an experienced team. The risks include: Cardiac tamponade Heart attack Injury to a coronary artery Irregular heartbeat Low blood pressure Reaction to the contrast dye Stroke Possible complications ...

  7. Quantification of myocardial perfusion using cardiac magnetic resonance imaging correlates significantly to rubidium-82 positron emission tomography in patients with severe coronary artery disease: A preliminary study

    International Nuclear Information System (INIS)

    Qayyum, Abbas A.; Hasbak, Philip; Larsson, Henrik B.W.; Christensen, Thomas E.; Ghotbi, Adam A.; Mathiasen, Anders B.

    2014-01-01

    Introduction: Aim was to compare absolute myocardial perfusion using cardiac magnetic resonance imaging (CMRI) based on Tikhonov's procedure of deconvolution and rubidium-82 positron emission tomography (Rb-82 PET). Materials and methods: Fourteen patients with coronary artery stenosis underwent rest and adenosine stress imaging by 1.5-Tesla MR Scanner and a mCT/PET 64-slice Scanner. CMRI were analyzed based on Tikhonov's procedure of deconvolution without specifying an explicit compartment model using our own software. PET images were analyzed using standard clinical software. CMRI and PET data was compared with Spearman's rho and Bland–Altman analysis. Results: CMRI results were strongly and significantly correlated with PET results for the absolute global myocardial perfusion differences (r = 0.805, p = 0.001) and for global myocardial perfusion reserve (MPR) (r = 0.886, p < 0.001). At vessel territorial level, CMRI results were also significantly correlated with absolute PET myocardial perfusion differences (r = 0.737, p < 0.001) and MPR (r = 0.818, p < 0.001). Each vessel territory had similar strong correlation for absolute myocardial perfusion differences (right coronary artery (RCA): r = 0.787, p = 0.001; left anterior descending artery (LAD): r = 0.796, p = 0.001; left circumflex artery (LCX): r = 0.880, p < 0.001) and for MPR (RCA: r = 0.895, p < 0.001; LAD: r = 0.886, p < 0.001; LCX: r = 0.886, p < 0.001). Conclusion: On a global and vessel territorial basis, CMRI-measured absolute myocardial perfusion differences and MPR were strongly and significantly correlated with the Rb-82 PET findings

  8. Quantification of myocardial perfusion using cardiac magnetic resonance imaging correlates significantly to rubidium-82 positron emission tomography in patients with severe coronary artery disease: A preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Qayyum, Abbas A., E-mail: abbas.ali.qayyum@regionh.dk [Department of Cardiology and Cardiac Catheterization Laboratory 2014, The Heart Centre, Rigshospitalet, University Hospital of Copenhagen and Faculty of Health Sciences, Copenhagen University, Blegdamsvej 9, 2100 Copenhagen (Denmark); Hasbak, Philip, E-mail: philip.hasbak@regionh.dk [Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University Hospital of Copenhagen and Faculty of Health Sciences, Copenhagen University, Blegdamsvej 9, 2100 Copenhagen (Denmark); Larsson, Henrik B.W., E-mail: henrik.larsson@regionh.dk [Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University Hospital of Copenhagen and Faculty of Health Sciences, Copenhagen University, Blegdamsvej 9, 2100 Copenhagen (Denmark); Functional Imaging Unit, Diagnostic Department, Glostrup Hospital, University Hospital of Copenhagen and Faculty of Health Sciences, Copenhagen University, Ndr. Ringvej 57, 2600 Copenhagen (Denmark); Christensen, Thomas E., E-mail: thomas.emil.christensen@regionh.dk [Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University Hospital of Copenhagen and Faculty of Health Sciences, Copenhagen University, Blegdamsvej 9, 2100 Copenhagen (Denmark); Ghotbi, Adam A., E-mail: adam.ali.ghotbi@regionh.dk [Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University Hospital of Copenhagen and Faculty of Health Sciences, Copenhagen University, Blegdamsvej 9, 2100 Copenhagen (Denmark); Mathiasen, Anders B., E-mail: anders.b.mathiasen@gmail.com [Department of Cardiology and Cardiac Catheterization Laboratory 2014, The Heart Centre, Rigshospitalet, University Hospital of Copenhagen and Faculty of Health Sciences, Copenhagen University, Blegdamsvej 9, 2100 Copenhagen (Denmark); and others

    2014-07-15

    Introduction: Aim was to compare absolute myocardial perfusion using cardiac magnetic resonance imaging (CMRI) based on Tikhonov's procedure of deconvolution and rubidium-82 positron emission tomography (Rb-82 PET). Materials and methods: Fourteen patients with coronary artery stenosis underwent rest and adenosine stress imaging by 1.5-Tesla MR Scanner and a mCT/PET 64-slice Scanner. CMRI were analyzed based on Tikhonov's procedure of deconvolution without specifying an explicit compartment model using our own software. PET images were analyzed using standard clinical software. CMRI and PET data was compared with Spearman's rho and Bland–Altman analysis. Results: CMRI results were strongly and significantly correlated with PET results for the absolute global myocardial perfusion differences (r = 0.805, p = 0.001) and for global myocardial perfusion reserve (MPR) (r = 0.886, p < 0.001). At vessel territorial level, CMRI results were also significantly correlated with absolute PET myocardial perfusion differences (r = 0.737, p < 0.001) and MPR (r = 0.818, p < 0.001). Each vessel territory had similar strong correlation for absolute myocardial perfusion differences (right coronary artery (RCA): r = 0.787, p = 0.001; left anterior descending artery (LAD): r = 0.796, p = 0.001; left circumflex artery (LCX): r = 0.880, p < 0.001) and for MPR (RCA: r = 0.895, p < 0.001; LAD: r = 0.886, p < 0.001; LCX: r = 0.886, p < 0.001). Conclusion: On a global and vessel territorial basis, CMRI-measured absolute myocardial perfusion differences and MPR were strongly and significantly correlated with the Rb-82 PET findings.

  9. Nuclear cardiac

    International Nuclear Information System (INIS)

    Slutsky, R.; Ashburn, W.L.

    1982-01-01

    The relationship between nuclear medicine and cardiology has continued to produce a surfeit of interesting, illuminating, and important reports involving the analysis of cardiac function, perfusion, and metabolism. To simplify the presentation, this review is broken down into three major subheadings: analysis of myocardial perfusion; imaging of the recent myocardial infarction; and the evaluation of myocardial function. There appears to be an increasingly important relationship between cardiology, particularly cardiac physiology, and nuclear imaging techniques

  10. RELATION BETWEEN PREECLAMPSIA AND CARDIAC ENZYMES

    Directory of Open Access Journals (Sweden)

    Rubina Aziz

    2010-12-01

    Full Text Available Abstract    INTRODUCTION: Preeclampsia affects about 5-10% of all pregnancies and is a major cause of maternal, fetal and neonatal mortality and morbidity. The cardiovascular system undergoes a host of changes in association with development of preeclampsia. LDH is a useful biochemical marker that reflects the severity of the occurrence of preeclampsia.    METHOD AND MATERIALS: One hundred pregnant women were selected for this study, 50 normal pregnant women as controls and 50 preeclamptic women as the study group.  Cardiac enzymes (serum LDH, serum AST, serum CK and serum CKMB of these women were analyzed.    RESULTS: Mean Serum LDH and mean serum AST concentrations were significantly higher in preeclamptic patients compared to normal pregnant women (348.34 ± 59.17 vs. 255.92 ± 43.26, P < 0.01 and (34.32 ± 10.37 vs. 22.06 ± 5.10, P < 0.01 respectively.     CONCLUSION: LDH and AST may be increased due to liver damage. This endothelial vascular damage is the main cause in the occurrence of preeclampsia. Higher levels of LDH and AST are very useful markers to identify the occurrence of preeclampsia.      Keywords: LDH, Preeclampsia, AST, Cardiac Enzymes.

  11. Estimated airborne release of plutonium from Westinghouse Cheswick site as a result of postulated damage from severe wind and seismic hazard

    International Nuclear Information System (INIS)

    Mishima, J.; Schwendiman, L.C.; Ayer, J.E.

    1979-06-01

    The potential airborne releases of plutonium (source terms) from postulated damage sustained by the Westinghouse Plutonium Fuel Development Laboratories at the Cheswick site in Pennsylvania as a result of various levels of wind and seismic hazard are estimated. The source terms are based on damage scenarios originated by other specialists and range up to 260 mph for wind hazard and in excess of 0.39 g ground acceleration for seismic hazard. The approaches and factors used to estimate the source terms (inventories of dispersible materials at risk, damage levels and ratios, fractional airborne releases of dispersible materials under stress, atmosphere exchange rates, and source term ranges) are discussed. Source term estimates range from less than 10 -7 g plutonium to greater than 130 g plutonium over a four-day period

  12. Insect damage and powdery mildew severity in soybean cultivars and lines Danos de insetos e severidade de oídio em cultivares e linhagens de soja

    Directory of Open Access Journals (Sweden)

    André Luiz Lourenção

    2004-12-01

    Full Text Available The use of soybean cultivars resistant to insects and diseases reduces the application of pesticides, decreasing production costs and promoting a sustainable agriculture. The damage of stink bugs and defoliators and the severity of powdery mildew (Microsphaera diffusa in soybean of three maturity groups were evaluated under field conditions, at Tarumã and Ribeirão Preto, State of São Paulo, Brazil. Three experiments, one for each group, were carried out in the 1999/2000 and 2000/2001 growing seasons. In 1999/2000, the disease occurred in Tarumã; in that year, infestation of chrysomelids (Cerotoma sp. and Colaspis sp. was observed in Ribeirão Preto. Low infestations of stink bugs occurred in both years and locations, but in Tarumã, at the stage of plant maturation, the insect population exceeded the economic injury level. The severity of powdery mildew was evaluated using a scale varying from 1 (no symptom to 5 (more than 50% of leaves with symptoms. Chrysomelid injuries were estimated by the percentage of leaf area removed, and stink bug damage was evaluated by the percentage of leaf retention (LRP and yield. Within the early maturity group (110 days, IAC 94-2675 showed good yield levels, low LRP, and resistance to powdery mildew. In the genotypes of the 120-day maturity group, IAC 94-5, IAC 94-1172, IAC 94-1017, IAC 94-133, and IAC 94-745 presented good yield; the last two behaved as resistant to the disease. With regard to the genotypes of the 135-day maturity group, IAC 93-1564 and IAC 94-2939 showed good yield, low LRP, and resistance to powdery mildew.A utilização de cultivares de soja resistentes a pragas e doenças reduz a aplicação de pesticidas, diminuindo custos de produção e favorecendo uma agricultura sustentável. Assim, avaliaram-se os danos causados por percevejos e coleópteros crisomelídeos e a severidade de oídio (Microsphaera diffusa em cultivares e linhagens de soja de ciclos precoce, semiprecoce e médio, em

  13. Edaravone, a Free Radical Scavenger, Mitigates Both Gray and White Matter Damages after Global Cerebral Ischemia in Rats

    Science.gov (United States)

    Kubo, Kozue; Nakao, Shinichi; Jomura, Sachiko; Sakamoto, Sachiyo; Miyamoto, Etsuko; Xu, Yan; Tomimoto, Hidekazu; Inada, Takefumi; Shingu, Koh

    2012-01-01

    Recent studies have shown that similar to cerebral gray matter (mainly composed of neuronal perikarya), white matter (composed of axons and glias) is vulnerable to ischemia. Edaravone, a free radical scavenger, has neuroprotective effects against focal cerebral ischemia even in humans. In this study, we investigated the time course and the severity of both gray and white matter damage following global cerebral ischemia by cardiac arrest, and examined whether edaravone protected the gray and the white matter. Male Sprague-Dawley rats were used. Global cerebral ischemia was induced by 5 minutes of cardiac arrest and resuscitation (CAR). Edaravone, 3 mg/kg, was administered intravenously either immediately or 60 minutes after CAR. The morphological damage was assessed by cresyl violet staining. The microtubule-associated protein 2 (a maker of neuronal perikarya and dendrites), the β amyloid precursor protein (the accumulation of which is a maker of axonal damage), and the ionized calcium binding adaptor molecule 1 (a marker of microglia) were stained for immunohistochemical analysis. Significant neuronal perikaryal damage and marked microglial activation were observed in the hippocampal CA1 region with little axonal damage one week after CAR. Two weeks after CAR, the perikaryal damage and microglial activation were unchanged, but obvious axonal damage occurred. Administration of edaravone 60 minutes after CAR significantly mitigated the perikaryal damage, the axonal damage, and the microglial activation. Our results show that axonal damage develops slower than perikaryal damage and that edaravone can protect both gray and white matter after CAR in rats. PMID:19410562

  14. Efficacy of 670 nm Light Therapy to Protect against Photoreceptor Cell Death Is Dependent on the Severity of Damage

    Directory of Open Access Journals (Sweden)

    Joshua A. Chu-Tan

    2016-01-01

    Full Text Available Photobiomodulation at a wavelength of 670 nm has been shown to be effective in preventing photoreceptor cell death in the retina. We treated Sprague-Dawley (SD rats with varying doses of 670 nm light (9; 18; 36; 90 J/cm2 before exposing them to different intensities of damaging white light (750; 1000; 1500 lux. 670 nm light exhibited a biphasic response in its amelioration of cell death in light-induced degeneration in vivo. Lower light damage intensities required lower doses of 670 nm light to reduce TUNEL cell death. At higher damage intensities, the highest dose of 670 nm light showed protection. In vitro, the Seahorse XFe96 Extracellular Flux Analyzer revealed that 670 nm light directly influences mitochondrial metabolism by increasing the spare respiratory capacity of mitochondria in 661 W photoreceptor-like cells in light damaged conditions. Our findings further support the use of 670 nm light as an effective treatment against retinal degeneration as well as shedding light on the mechanism of protection through the increase of the mitochondrial spare respiratory capacity.

  15. Cardiac CT

    International Nuclear Information System (INIS)

    Dewey, Marc

    2011-01-01

    Computed tomography of the heart has become a highly accurate diagnostic modality that is attracting increasing attention. This extensively illustrated book aims to assist the reader in integrating cardiac CT into daily clinical practice, while also reviewing its current technical status and applications. Clear guidance is provided on the performance and interpretation of imaging using the latest technology, which offers greater coverage, better spatial resolution, and faster imaging. The specific features of scanners from all four main vendors, including those that have only recently become available, are presented. Among the wide range of applications and issues to be discussed are coronary artery bypass grafts, stents, plaques, and anomalies, cardiac valves, congenital and acquired heart disease, and radiation exposure. Upcoming clinical uses of cardiac CT, such as plaque imaging and functional assessment, are also explored. (orig.)

  16. Cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Dewey, Marc [Charite - Universitaetsmedizin Berlin (Germany). Inst. fuer Radiologie

    2011-07-01

    Computed tomography of the heart has become a highly accurate diagnostic modality that is attracting increasing attention. This extensively illustrated book aims to assist the reader in integrating cardiac CT into daily clinical practice, while also reviewing its current technical status and applications. Clear guidance is provided on the performance and interpretation of imaging using the latest technology, which offers greater coverage, better spatial resolution, and faster imaging. The specific features of scanners from all four main vendors, including those that have only recently become available, are presented. Among the wide range of applications and issues to be discussed are coronary artery bypass grafts, stents, plaques, and anomalies, cardiac valves, congenital and acquired heart disease, and radiation exposure. Upcoming clinical uses of cardiac CT, such as plaque imaging and functional assessment, are also explored. (orig.)

  17. Cardiac echinococcosis

    Directory of Open Access Journals (Sweden)

    Ivanović-Krstić Branislava A.

    2002-01-01

    Full Text Available Cardiac hydatid disease is rare. We report on an uncommon hydatid cyst localized in the right ventricular wall, right atrial wall tricuspid valve left atrium and pericard. A 33-year-old woman was treated for cough, fever and chest pain. Cardiac echocardiograpic examination revealed a round tumor (5.8 x 4 cm in the right ventricular free wall and two smaller cysts behind that tumor. There were cysts in right atrial wall and tricuspidal valve as well. Serologic tests for hydatidosis were positive. Computed tomography finding was consistent with diagnosis of hydatid cyst in lungs and right hylar part. Surgical treatment was rejected due to great risk of cardiac perforation. Medical treatment with albendazole was unsuccessful and the patient died due to systemic hydatid involvement of the lungs, liver and central nervous system.

  18. Cardiac changes in anorexia nervosa.

    Science.gov (United States)

    Spaulding-Barclay, Michael A; Stern, Jessica; Mehler, Philip S

    2016-04-01

    Introduction Anorexia nervosa is an eating disorder, which is associated with many different medical complications as a result of the weight loss and malnutrition that characterise this illness. It has the highest mortality rate of any psychiatric disorder. A large portion of deaths are attributable to the cardiac abnormalities that ensue as a result of the malnutrition associated with anorexia nervosa. In this review, the cardiac complications of anorexia nervosa will be discussed. A comprehensive literature review on cardiac changes in anorexia nervosa was carried out. There are structural, functional, and rhythm-type changes that occur in patients with anorexia nervosa. These become progressively significant as ongoing weight loss occurs. Cardiac changes are inherent to anorexia nervosa and they become more life-threatening and serious as the anorexia nervosa becomes increasingly severe. Weight restoration and attention to these cardiac changes are crucial for a successful treatment outcome.

  19. 8-Oxoguanine DNA glycosylase 1 (ogg1) maintains the function of cardiac progenitor cells during heart formation in zebrafish

    Energy Technology Data Exchange (ETDEWEB)

    Yan, Lifeng [State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing 210029 (China); Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 210029 (China); Zhou, Yong [Key Laboratory of Stem Cell Biology, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and Shanghai Jiao Tong University School of Medicine, Shanghai 200025 (China); Yu, Shanhe [Shanghai Institute of Hematology, RuiJin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200025 (China); Ji, Guixiang [Nanjing Institute of Environmental Sciences/Key Laboratory of Pesticide Environmental Assessment and Pollution Control, Ministry of Environmental Protection, Nanjing 210042 (China); Wang, Lei [Key Laboratory of Stem Cell Biology, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and Shanghai Jiao Tong University School of Medicine, Shanghai 200025 (China); Liu, Wei [State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing 210029 (China); Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 210029 (China); Gu, Aihua, E-mail: aihuagu@njmu.edu.cn [State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing 210029 (China); Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 210029 (China)

    2013-11-15

    Genomic damage may devastate the potential of progenitor cells and consequently impair early organogenesis. We found that ogg1, a key enzyme initiating the base-excision repair, was enriched in the embryonic heart in zebrafish. So far, little is known about DNA repair in cardiogenesis. Here, we addressed the critical role of ogg1 in cardiogenesis for the first time. ogg1 mainly expressed in the anterior lateral plate mesoderm (ALPM), the primary heart tube, and subsequently the embryonic myocardium by in situ hybridisation. Loss of ogg1 resulted in severe cardiac morphogenesis and functional abnormalities, including the short heart length, arrhythmia, decreased cardiomyocytes and nkx2.5{sup +} cardiac progenitor cells. Moreover, the increased apoptosis and repressed proliferation of progenitor cells caused by ogg1 deficiency might contribute to the heart phenotype. The microarray analysis showed that the expression of genes involved in embryonic heart tube morphogenesis and heart structure were significantly changed due to the lack of ogg1. Among those, foxh1 is an important partner of ogg1 in the cardiac development in response to DNA damage. Our work demonstrates the requirement of ogg1 in cardiac progenitors and heart development in zebrafish. These findings may be helpful for understanding the aetiology of congenital cardiac deficits. - Highlights: • A key DNA repair enzyme ogg1 is expressed in the embryonic heart in zebrafish. • We found that ogg1 is essential for normal cardiac morphogenesis in zebrafish. • The production of embryonic cardiomyocytes requires appropriate ogg1 expression. • Ogg1 critically regulated proliferation of cardiac progenitor cells in zebrafish. • foxh1 is a partner of ogg1 in the cardiac development in response to DNA damage.

  20. Cardiac and metabolic changes in long-term high fructose-fat fed rats with severe obesity and extensive intramyocardial lipid accumulation

    DEFF Research Database (Denmark)

    Axelsen, Lene N; Lademann, Jacob B; Petersen, Jørgen S

    2010-01-01

    Metabolic syndrome and obesity-related diseases are affecting more and more people in the Western world. The basis for an effective treatment of these patients is a better understanding of the underlying pathophysiology. Here, we characterize fructose- and fat-fed rats (FFFRs) as a new animal model....... FFFRs developed severe obesity, decreased glucose tolerance, increased serum insulin and triglyceride levels, and an initial increased fasting glucose, which returned to control levels after 24 wk of feeding. The diet had no effect on blood pressure but decreased hepatic PEPCK levels. FFFRs showed...

  1. Estimated airborne release of plutonium from Atomics International's Nuclear Materials Development Facility in the Santa Susana site, California, as a result of postulated damage from severe wind and earthquake hazard

    International Nuclear Information System (INIS)

    Mishima, J.; Ayer, J.E.

    1981-09-01

    The potential mass of airborne releases of plutonium (source term) that could result from wind and seismic damage is estimated for the Atomics International Company's Nuclear Materials Development Facility (NMDF) at the Santa Susana site in California. The postulated source terms will be useful as the basis for estimating the potential dose to the maximum exposed individual by inhalation and to the total population living within a prescribed radius of the site. The respirable fraction of airborne particles is thus the principal concern. The estimated source terms are based on the damage ratio, and the potential airborne releases if all enclosures suffer particular levels of damage. In an attempt to provide a realistic range of potential source terms that include most of the normal processing conditions, a best estimate bounded by upper and lower limits is provided. The range of source terms is calculated by combining a high best estimate and a low damage ratio, based on a fraction of enclosures suffering crush or perforation, with the airborne release from enclosures based upon an upper limit, average, and lower limit inventory of dispersible materials at risk. Two throughput levels are considered. The factors used to evaluate the fractional airborne release of materials and the exchange rates between enclosed and exterior atmospheres are discussed. The postulated damage and source terms are discussed for wind and earthquake hazard scenarios in order of their increasing severity

  2. Limited effects of exogenous glucose during severe hypoxia and a lack of hypoxia-stimulated glucose uptake in isolated rainbow trout cardiac muscle

    Science.gov (United States)

    Becker, Tracy A.; DellaValle, Brian; Gesser, Hans; Rodnick, Kenneth J.

    2013-01-01

    SUMMARY We examined whether exogenous glucose affects contractile performance of electrically paced ventricle strips from rainbow trout under conditions known to alter cardiomyocyte performance, ion regulation and energy demands. Physiological levels of d-glucose did not influence twitch force development for aerobic preparations (1) paced at 0.5 or 1.1 Hz, (2) at 15 or 23°C, (3) receiving adrenergic stimulation or (4) during reoxygenation with or without adrenaline after severe hypoxia. Contractile responses to ryanodine, an inhibitor of Ca2+ release from the sarcoplasmic reticulum, were also not affected by exogenous glucose. However, glucose did attenuate the fall in twitch force during severe hypoxia. Glucose uptake was assayed in non-contracting ventricle strips using 2-[3H] deoxy-d-glucose (2-DG) under aerobic and hypoxic conditions, at different incubation temperatures and with different inhibitors. Based upon a lack of saturation of 2-DG uptake and incomplete inhibition of uptake by cytochalasin B and d-glucose, 2-DG uptake was mediated by a combination of facilitated transport and simple diffusion. Hypoxia stimulated lactate efflux sixfold to sevenfold with glucose present, but did not increase 2-DG uptake or reduce lactate efflux in the presence of cytochalasin B. Increasing temperature (14 to 24°C) also did not increase 2-DG uptake, but decreasing temperature (14 to 4°C) reduced 2-DG uptake by 45%. In conclusion, exogenous glucose improves mechanical performance under hypoxia but not under any of the aerobic conditions applied. The extracellular concentration of glucose and cold temperature appear to determine and limit cardiomyocyte glucose uptake, respectively, and together may help define a metabolic strategy that relies predominantly on intracellular energy stores. PMID:23685969

  3. Cardiac Pacemakers

    International Nuclear Information System (INIS)

    Fiandra, O.; Espasandin, W.; Fiandra, H.

    1984-01-01

    A complete survey of physiological biophysical,clinical and engineering aspects of cardiac facing,including the history and an assessment of possible future developments.Among the topics studied are: pacemakers, energy search, heart stimulating with pacemakers ,mathematical aspects of the electric cardio stimulation chronic, pacemaker implants,proceeding,treatment and control

  4. Simvastatin induces apoptosis by a Rho-dependent mechanism in cultured cardiac fibroblasts and myofibroblasts

    International Nuclear Information System (INIS)

    Copaja, Miguel; Venegas, Daniel; Aranguiz, Pablo; Canales, Jimena; Vivar, Raul; Catalan, Mabel; Olmedo, Ivonne; Rodriguez, Andrea E.; Chiong, Mario; Leyton, Lisette; Lavandero, Sergio; Diaz-Araya, Guillermo

    2011-01-01

    Several clinical trials have shown the beneficial effects of statins in the prevention of coronary heart disease. Additionally, statins promote apoptosis in vascular smooth muscle cells, in renal tubular epithelial cells and also in a variety of cell lines; yet, the effects of statins on cardiac fibroblast and myofibroblast, primarily responsible for cardiac tissue healing are almost unknown. Here, we investigated the effects of simvastatin on cardiac fibroblast and myofibroblast viability and studied the molecular cell death mechanism triggered by simvastatin in both cell types. Methods: Rat neonatal cardiac fibroblasts and myofibroblasts were treated with simvastatin (0.1-10 μM) up to 72 h. Cell viability and apoptosis were evaluated by trypan blue exclusion method and by flow cytometry, respectively. Caspase-3 activation and Rho protein levels and activity were also determined by Western blot and pull-down assay, respectively. Results: Simvastatin induces caspase-dependent apoptosis of cardiac fibroblasts and myofibroblasts in a concentration- and time-dependent manner, with greater effects on fibroblasts than myofibroblasts. These effects were prevented by mevalonate, farnesylpyrophosphate and geranylgeranylpyrophosphate, but not squalene. These last results suggest that apoptosis was dependent on small GTPases of the Rho family rather than Ras. Conclusion: Simvastatin triggered apoptosis of cardiac fibroblasts and myofibroblasts by a mechanism independent of cholesterol synthesis, but dependent of isoprenilation of Rho protein. Additionally, cardiac fibroblasts were more susceptible to simvastatin-induced apoptosis than cardiac myofibroblasts. Thus simvastatin could avoid adverse cardiac remodeling leading to a less fibrotic repair of the damaged tissues. - Research Highlights: → Simvastatin decreases CF and CMF viability independent of cholesterol synthesis. → Simvastatin induces CF and CMF apoptosis in a caspase-dependent manner being CMF more resistant

  5. Direct Cardiac Reprogramming: Advances in Cardiac Regeneration

    Directory of Open Access Journals (Sweden)

    Olivia Chen

    2015-01-01

    Full Text Available Heart disease is one of the lead causes of death worldwide. Many forms of heart disease, including myocardial infarction and pressure-loading cardiomyopathies, result in irreversible cardiomyocyte death. Activated fibroblasts respond to cardiac injury by forming scar tissue, but ultimately this response fails to restore cardiac function. Unfortunately, the human heart has little regenerative ability and long-term outcomes following acute coronary events often include chronic and end-stage heart failure. Building upon years of research aimed at restoring functional cardiomyocytes, recent advances have been made in the direct reprogramming of fibroblasts toward a cardiomyocyte cell fate both in vitro and in vivo. Several experiments show functional improvements in mouse models of myocardial infarction following in situ generation of cardiomyocyte-like cells from endogenous fibroblasts. Though many of these studies are in an early stage, this nascent technology holds promise for future applications in regenerative medicine. In this review, we discuss the history, progress, methods, challenges, and future directions of direct cardiac reprogramming.

  6. Calcification remodeling index characterized by cardiac CT as A novel parameter to predict the use of rotational atherectomy for coronary intervention of lesions with moderate to severe calcification

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Meng Meng; Li, Yue Hua; Li, Wen Bin; Lu, Zhi Gang; Wei, Meng; Zhang, Jia Yin [Shanghai Jiao Tong University Affiliated Sixth People' s Hospital, Shanghai (China)

    2017-09-15

    To assess the feasibility of calcification characterization by coronary computed tomography angiography (CCTA) to predict the use of rotational atherectomy (RA) for coronary intervention of lesions with moderate to severe calcification. Patients with calcified lesions treated by percutaneous coronary intervention (PCI) who underwent both CCTA and invasive coronary angiography were retrospectively included in this study. Calcification remodeling index was calculated as the ratio of the smallest vessel cross-sectional area of the lesion to the proximal reference luminal area. Other parameters such as calcium volume, regional Agatston score, calcification length, and involved calcium arc quadrant were also recorded. A total of 223 patients with 241 calcified lesions were finally included. Lesions with RA tended to have larger calcium volume, higher regional Agatston score, more involved calcium arc quadrants, and significantly smaller calcification remodeling index than lesions without RA. Receiver operating characteristic curve analysis revealed that the best cutoff value of calcification remodeling index was 0.84 (area under curve = 0.847, p < 0.001). Calcification remodeling index ≤ 0.84 was the strongest independent predictor (odds ratio: 251.47, p < 0.001) for using RA. Calcification remodeling index was significantly correlated with the incidence of using RA to aid PCI. Calcification remodeling index ≤ 0.84 was the strongest independent predictor for using RA prior to stent implantation.

  7. Calcification remodeling index characterized by cardiac CT as A novel parameter to predict the use of rotational atherectomy for coronary intervention of lesions with moderate to severe calcification

    International Nuclear Information System (INIS)

    Yu, Meng Meng; Li, Yue Hua; Li, Wen Bin; Lu, Zhi Gang; Wei, Meng; Zhang, Jia Yin

    2017-01-01

    To assess the feasibility of calcification characterization by coronary computed tomography angiography (CCTA) to predict the use of rotational atherectomy (RA) for coronary intervention of lesions with moderate to severe calcification. Patients with calcified lesions treated by percutaneous coronary intervention (PCI) who underwent both CCTA and invasive coronary angiography were retrospectively included in this study. Calcification remodeling index was calculated as the ratio of the smallest vessel cross-sectional area of the lesion to the proximal reference luminal area. Other parameters such as calcium volume, regional Agatston score, calcification length, and involved calcium arc quadrant were also recorded. A total of 223 patients with 241 calcified lesions were finally included. Lesions with RA tended to have larger calcium volume, higher regional Agatston score, more involved calcium arc quadrants, and significantly smaller calcification remodeling index than lesions without RA. Receiver operating characteristic curve analysis revealed that the best cutoff value of calcification remodeling index was 0.84 (area under curve = 0.847, p < 0.001). Calcification remodeling index ≤ 0.84 was the strongest independent predictor (odds ratio: 251.47, p < 0.001) for using RA. Calcification remodeling index was significantly correlated with the incidence of using RA to aid PCI. Calcification remodeling index ≤ 0.84 was the strongest independent predictor for using RA prior to stent implantation.

  8. Calcification Remodeling Index Characterized by Cardiac CT as a Novel Parameter to Predict the Use of Rotational Atherectomy for Coronary Intervention of Lesions with Moderate to Severe Calcification

    Science.gov (United States)

    Yu, Mengmeng; Li, Yuehua; Li, Wenbin; Lu, Zhigang; Wei, Meng

    2017-01-01

    Objective To assess the feasibility of calcification characterization by coronary computed tomography angiography (CCTA) to predict the use of rotational atherectomy (RA) for coronary intervention of lesions with moderate to severe calcification. Materials and Methods Patients with calcified lesions treated by percutaneous coronary intervention (PCI) who underwent both CCTA and invasive coronary angiography were retrospectively included in this study. Calcification remodeling index was calculated as the ratio of the smallest vessel cross-sectional area of the lesion to the proximal reference luminal area. Other parameters such as calcium volume, regional Agatston score, calcification length, and involved calcium arc quadrant were also recorded. Results A total of 223 patients with 241 calcified lesions were finally included. Lesions with RA tended to have larger calcium volume, higher regional Agatston score, more involved calcium arc quadrants, and significantly smaller calcification remodeling index than lesions without RA. Receiver operating characteristic curve analysis revealed that the best cutoff value of calcification remodeling index was 0.84 (area under curve = 0.847, p < 0.001). Calcification remodeling index ≤ 0.84 was the strongest independent predictor (odds ratio: 251.47, p < 0.001) for using RA. Conclusion Calcification remodeling index was significantly correlated with the incidence of using RA to aid PCI. Calcification remodeling index ≤ 0.84 was the strongest independent predictor for using RA prior to stent implantation. PMID:28860893

  9. Studies on DNA damage: discordant responses of rate of DNA disentanglement (viscosimetrically evaluated) and alkaline elution rate, obtained for several compounds. Possible explanations of the discrepancies.

    Science.gov (United States)

    Parodi, S; Balbi, C; Abelmoschi, M L; Pala, M; Russo, P; Santi, L

    1983-12-01

    Alkaline elution is a well-known method for detecting DNA damage. Recently we have developed a viscosimetric method that is even more sensitive than alkaline elution. Here we report that the two methods, although apparently both revealing alkaline DNA fragmentation, can give dramatically different results for a significant series of compounds. We suspect that alkaline elution might reveal not only DNA fragmentation but also the extent of disentanglement of chromatin structure, whereas this DNA disentanglement rate, when evaluated viscosimetrically , is more strictly correlated with the initiation of DNA unwinding.

  10. Protective effects of several plant polyphenols against chromosomal damage induced in vivo by X-rays. Comparative study versus diosmin and rutin

    Energy Technology Data Exchange (ETDEWEB)

    Alcaraz, M; Rosa, B [Radiology and Physical Medicine Department of Furfural Espanol S.A., Murcia (Spain); Castillo, J; Benavente-Garcia, O; Lorente, J [Research and Development Department of Furfural Espanol S.A., Murcia (Spain); Vicente, V [Pathology Department of Furfural Espanol S.A., Murcia (Spain); Canteras, M [Biostatistical Department, Faculty of Medicine, University of Murcia, Murcia (Spain)

    2001-03-01

    Protective effects of grape (Vitis vinifera) seed (GSE), Citrus spp. fruits (CE) and olive (Olea europaea L.) leaf (OL) extracts, the flavonoids diosmin and rutin, widely used as pharmaceuticals, and dimethylsulphoxide (DMSO) against chromosomal damage induced by X-rays were determined by using the micronucleus test for anticlastogenic activity. The reduction of the frequency of micronucleated polychromatic erythrocytes (MnPCEs) in bone marrow of mouse exposed to X-rays was examined. The most effective compounds were, in order: GSE {approx} CE > rutin {approx} DMSO {approx} OL > diosmin. These results suggest a correlation between the antioxidant and anticlastogenic activity of these polyphenolic extracts. (author)

  11. Protective effects of several plant polyphenols against chromosomal damage induced in vivo by X-rays. Comparative study versus diosmin and rutin

    International Nuclear Information System (INIS)

    Alcaraz, M.; Rosa, B.; Castillo, J.; Benavente-Garcia, O.; Lorente, J.; Vicente, V.; Canteras, M.

    2001-01-01

    Protective effects of grape (Vitis vinifera) seed (GSE), Citrus spp. fruits (CE) and olive (Olea europaea L.) leaf (OL) extracts, the flavonoids diosmin and rutin, widely used as pharmaceuticals, and dimethylsulphoxide (DMSO) against chromosomal damage induced by X-rays were determined by using the micronucleus test for anticlastogenic activity. The reduction of the frequency of micronucleated polychromatic erythrocytes (MnPCEs) in bone marrow of mouse exposed to X-rays was examined. The most effective compounds were, in order: GSE ∼ CE > rutin ∼ DMSO ∼ OL > diosmin. These results suggest a correlation between the antioxidant and anticlastogenic activity of these polyphenolic extracts. (author)

  12. Halogenated anaesthetics and cardiac protection in cardiac and non-cardiac anaesthesia

    Directory of Open Access Journals (Sweden)

    Landoni Giovanni

    2009-01-01

    Full Text Available Volatile anaesthetic agents have direct protective properties against ischemic myocardial damage. The implementation of these properties during clinical anaesthesia can provide an additional tool in the treatment or prevention, or both, of ischemic cardiac dysfunction in the perioperative period. A recent meta-analysis showed that desflurane and sevoflurane reduce postoperative mortality and incidence of myocardial infarction following cardiac surgery, with significant advantages in terms of postoperative cardiac troponin release, need for inotrope support, time on mechanical ventilation, intensive care unit and overall hospital stay. Multicentre, randomised clinical trials had previously demonstrated that the use of desflurane can reduce the postoperative release of cardiac troponin I, the need for inotropic support, and the number of patients requiring prolonged hospitalisation following coronary artery bypass graft surgery either with and without cardiopulmonary bypass. The American College of Cardiology/American Heart Association Guidelines recommend volatile anaesthetic agents during non-cardiac surgery for the maintenance of general anaesthesia in patients at risk for myocardial infarction. Nonetheless, e vidence in non-coronary surgical settings is contradictory and will be reviewed in this paper together with the mechanisms of cardiac protection by volatile agents.

  13. N-terminal pro-brain natriuretic peptide and cardiac troponin I for the prognostic utility in elderly patients with severe sepsis or septic shock in intensive care unit: A retrospective study.

    Science.gov (United States)

    Cheng, Hui; Fan, Wei-Ze; Wang, Sheng-Chi; Liu, Zhao-Hui; Zang, Hui-Ling; Wang, Li-Zhong; Liu, Hong-Juan; Shen, Xiao-Hui; Liang, Shao-Qing

    2015-06-01

    Using biomarkers to predict mortality in patient with severe sepsis or septic shock is of importance, as these patients frequently have high mortality and unsatisfied outcome. N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) play extremely important roles in prognostic value in the mortality of severe sepsis and septic shock. The present study was retrospectively designed to evaluate the predicting mortality of NT-proBNP and cTnI in elderly patients with severe sepsis or septic shock administered in the intensive care unit (ICU) and also to evaluate whether the predicting ability of Acute Physiology and Chronic Health Evaluation II (APACHE-II) score or C-reactive protein (CRP) was increased in combination with the biomarkers. A cohort of 430 patients (aged ≥65 years) with severe sepsis or septic shock admitted to our ICU between October 2011 and December 2013 was included in the study. Patient data including clinical, laboratory, and survival and mortality were collected. All patients were examined with NT-proBNP, cTnI, CRP, and APACHE-II score and were categorized as the survived and deceased groups according to the outcome 30 days after ICU treatment. The levels of NT-proBNP and cTnI (P pro-brain natriuretic peptide and cTnI were superior to CRP in predicting mortality. The predicting ability of APACHE-II score was improved only when combined with NT-proBNP and cTnI. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Damage analysis: damage function development and application

    International Nuclear Information System (INIS)

    Simons, R.L.; Odette, G.R.

    1975-01-01

    The derivation and application of damage functions, including recent developments for the U.S. LMFBR and CTR programs, is reviewed. A primary application of damage functions is in predicting component life expectancies; i.e., the fluence required in a service spectrum to attain a specified design property change. An important part of the analysis is the estimation of the uncertainty in such fluence limit predictions. The status of standardizing the procedures for the derivation and application of damage functions is discussed. Improvements in several areas of damage function development are needed before standardization can be completed. These include increasing the quantity and quality of the data used in the analysis, determining the limitations of the analysis due to the presence of multiple damage mechanisms, and finally, testing of damage function predictions against data obtained from material surveillance programs in operating thermal and fast reactors. 23 references. (auth)

  15. Estimated airborne release of plutonium from the 102 Building at the General Electric Vallecitos Nuclear Center, Vallecitos, California, as a result of postulated damage from severe wind and earthquake hazard

    International Nuclear Information System (INIS)

    Mishima, J.; Ayer, J.E.; Hays, I.D.

    1980-12-01

    This report estimates the potential airborne releases of plutonium as a consequence of various severities of earthquake and wind hazard postulated for the 102 Building at the General Electric Vallecitos Nuclear Center in California. The releases are based on damage scenarios developed by other specialists. The hazard severities presented range up to a nominal velocity of 230 mph for wind hazard and are in excess of 0.8 g linear acceleration for earthquakes. The consequences of thrust faulting are considered. The approaches and factors used to estimate the releases are discussed. Release estimates range from 0.003 to 3 g Pu

  16. Cardiac ablation

    Directory of Open Access Journals (Sweden)

    Kelly Ratheal

    2016-01-01

    Full Text Available Cardiac ablation is a procedure that uses either radiofrequency or cryothermal energy to destroy cells in the heart to terminate and/or prevent arrhythmias. The indications for cardiac catheter ablation include refractory, symptomatic arrhythmias, with more specific guidelines for atrial fibrillation in particular. The ablation procedure itself involves mapping the arrhythmia and destruction of the aberrant pathway in an effort to permanently prevent the arrhythmia. There are many types of arrhythmias, and they require individualized approaches to ablation based on their innately different electrical pathways. Ablation of arrhythmias, such as Wolff-Parkinson-White syndrome, AV nodal reentrant tachycardia, and atrial-fibrillation, is discussed in this review. Ablation has a high success rate overall and minimal complication rates, leading to improved quality of life in many patients.

  17. Living cardiac patch: the elixir for cardiac regeneration.

    Science.gov (United States)

    Lakshmanan, Rajesh; Krishnan, Uma Maheswari; Sethuraman, Swaminathan

    2012-12-01

    A thorough understanding of the cellular and muscle fiber orientation in left ventricular cardiac tissue is of paramount importance for the generation of artificial cardiac patches to treat the ischemic myocardium. The major challenge faced during cardiac patch engineering is to choose a perfect combination of three entities; cells, scaffolds and signaling molecules comprising the tissue engineering triad for repair and regeneration. This review provides an overview of various scaffold materials, their mechanical properties and fabrication methods utilized in cardiac patch engineering. Stem cell therapies in clinical trials and the commercially available cardiac patch materials were summarized in an attempt to provide a recent perspective in the treatment of heart failure. Various tissue engineering strategies employed thus far to construct viable thick cardiac patches is schematically illustrated. Though many strategies have been proposed for fabrication of various cardiac scaffold materials, the stage and severity of the disease condition demands the incorporation of additional cues in a suitable scaffold material. The scaffold may be nanofibrous patch, hydrogel or custom designed films. Integration of stem cells and biomolecular cues along with the scaffold may provide the right microenvironment for the repair of unhealthy left ventricular tissue as well as promote its regeneration.

  18. Cardiac function in acute hypothyroidism

    International Nuclear Information System (INIS)

    Donaghue, K.; Hales, I.; Allwright, S.; Cooper, R.; Edwards, A.; Grant, S.; Morrow, A.; Wilmshurst, E.; Royal North Shore Hospital, Sydney

    1985-01-01

    It has been established that chronic hypothyroidism may affect cardiac function by several mechanisms. It is not known how long the patient has to be hypothyroid for cardiac involvement to develop. This study was undertaken to assess the effect of a short period of hypothyroidism (10 days) on cardiac function. Nine patients who had had total tyroidectomy, had received ablative radioiodine for thyroid cancer and were euthyroid on replacement therapy were studied while both euthyroid and hypothyroid. Cardiac assessment was performed by X-ray, ECG, echocardiography and gated blood-pool scans. After 10 days of hypothyroidisms, the left-ventricular ejection fraction failed to rise after exercise in 4 of the 9 patients studied, which was significant (P<0.002). No significant changes in cardiac size or function at rest were detected. This functional abnormality in the absence of any demonstrable change in cardiac size and the absence of pericardial effussion with normal basal function suggest that short periods of hypothyroidism may reduce cardiac reserve, mostly because of alterations in metabolic function. (orig.)

  19. The total right/left-volume index: a new and simplified cardiac magnetic resonance measure to evaluate the severity of Ebstein anomaly of the tricuspid valve: a comparison with heart failure markers from various modalities.

    Science.gov (United States)

    Hösch, Olga; Sohns, Jan Martin; Nguyen, Thuy-Trang; Lauerer, Peter; Rosenberg, Christina; Kowallick, Johannes Tammo; Kutty, Shelby; Unterberg, Christina; Schuster, Andreas; Faßhauer, Martin; Staab, Wieland; Paul, Thomas; Lotz, Joachim; Steinmetz, Michael

    2014-07-01

    The classification of clinical severity of Ebstein anomaly still remains a challenge. The aim of this study was to focus on the interaction of the pathologically altered right heart with the anatomically-supposedly-normal left heart and to derive from cardiac magnetic resonance (CMR) a simple imaging measure for the clinical severity of Ebstein anomaly. Twenty-five patients at a mean age of 26±14 years with unrepaired Ebstein anomaly were examined in a prospective study. Disease severity was classified using CMR volumes and functional measurements in comparison with heart failure markers from clinical data, ECG, laboratory and cardiopulmonary exercise testing, and echocardiography. All examinations were completed within 24 hours. A total right/left-volume index was defined from end-diastolic volume measurements in CMR: total right/left-volume index=(RA+aRV+fRV)/(LA+LV). Mean total right/left-volume index was 2.6±1.7 (normal values: 1.1±0.1). This new total right/left-volume index correlated with almost all clinically used biomarkers of heart failure: brain natriuretic peptide (r=0.691; P=0.0003), QRS (r=0.432; P=0.039), peak oxygen consumption/kg (r=-0.479; P=0.024), ventilatory response to carbon dioxide production at anaerobic threshold (r=0.426; P=0.048), the severity of tricuspid regurgitation (r=0.692; P=0.009), tricuspid valve offset (r=0.583; P=0.004), and tricuspid annular plane systolic excursion (r=0.554; P=0.006). Previously described severity indices ([RA+aRV]/[fRV+LA+LV]) and fRV/LV end-diastolic volume corresponded only to some parameters. In patients with Ebstein anomaly, the easily acquired index of right-sided to left-sided heart volumes from CMR correlated well with established heart failure markers. Our data suggest that the total right/left-volume index should be used as a new and simplified CMR measure, allowing more accurate assessment of disease severity than previously described scoring systems. © 2014 American Heart Association, Inc.

  20. The usefulness of the nuclear cardiology in the cellular implant in patients with severe myocardial damage; La utilidad de la cardiologia nuclear en el implante celular en pacientes con dano miocardico severo

    Energy Technology Data Exchange (ETDEWEB)

    Omelas A, M.; Arguero S, R.; Garrido G, M.H.; Rodriguez C, A.; Careaga, G.; Castano G, R.; Nambo, M.J.; Pascual P, J.; Ortega R, A.; Gaxiola A, A.; Magana S, J.A.; Estrada A, H.; Equipo de Tecnicos en Medicina Nuclear [Centro Medico Nacional Siglo XXI IMSS Hospital de Cardiologia-Servicio de Medicina Nuclear Mexico DF (Mexico)

    2005-07-01

    The recent therapeutic advances as the cellular implant as well as those different protocols of image acquisition in the field of the Nuclear Cardiology its have allowed that the patient with severe myocardial damage and without some possibility of revascularization is benefited with these advances. Doubtless the Tl-201 par excellence has an important paper for standardize the more appropriate therapeutic behavior for the heart attack patient; reason by this investigation protocol was developed. The objective of the study was to identify the heart attack regions without viable tissue with SPECT in patient with important myocardial damage without some possibility of traditional revascularization; for the 'Stem cell' cellular implantation therapy. The methodology it was carried out by a study of myocardial perfusion in 10 patients with important myocardial damage previous cellular implants, with PICANUC/ SPECT methodology and using a software (Emory Tool Box) for the image processing validated by the University of Emory Atlanta GA; and using as tracer the Tl - 201 to identify the heart attack regions without presence of viable tissue with an analysis model of 17 segments standardized for the left ventricle; qualifying this way the myocardial perfusion in: 0 (normal), 1 (light), 2 (moderate), 3 (severe), 4 (absent) and x (bad technique). The conclusions were that the SPECT study with PICANUC methodology with Tl-201 is safe and effective for the precise localization for the cellular implantation via direct intra myocardial. (Author)

  1. A severity rating system for evaluating stand-level balsam woolly adelgid (Hemiptera: Adelgidae) damage in two Abies species in western North America

    Science.gov (United States)

    Kathryn H. Hrinkevich; Robert A. Progar; David C. Shaw

    2016-01-01

    Severity rating systems are fundamental to understanding the impacts of disturbance agents in forest stands. The balsam woolly adelgid (BWA), Adelges piceae (Ratzeburg) (Hemiptera: Adelgidae), is an invasive forest pest in North America that infests and causes mortality in true fir, Abies spp. There is currently no single...

  2. Metoclopramide-induced cardiac arrest

    Directory of Open Access Journals (Sweden)

    Martha M. Rumore

    2011-11-01

    Full Text Available The authors report a case of cardiac arrest in a patient receiving intravenous (IV metoclopramide and review the pertinent literature. A 62-year-old morbidly obese female admitted for a gastric sleeve procedure, developed cardiac arrest within one minute of receiving metoclopramide 10 mg via slow intravenous (IV injection. Bradycardia at 4 beats/min immediately appeared, progressing rapidly to asystole. Chest compressions restored vital function. Electrocardiogram (ECG revealed ST depression indicative of myocardial injury. Following intubation, the patient was transferred to the intensive care unit. Various cardiac dysrrhythmias including supraventricular tachycardia (SVT associated with hypertension and atrial fibrillation occurred. Following IV esmolol and metoprolol, the patient reverted to normal sinus rhythm. Repeat ECGs revealed ST depression resolution without pre-admission changes. Metoclopramide is a non-specific dopamine receptor antagonist. Seven cases of cardiac arrest and one of sinus arrest with metoclopramide were found in the literature. The metoclopramide prescribing information does not list precautions or adverse drug reactions (ADRs related to cardiac arrest. The reaction is not dose related but may relate to the IV administration route. Coronary artery disease was the sole risk factor identified. According to Naranjo, the association was possible. Other reports of cardiac arrest, severe bradycardia, and SVT were reviewed. In one case, five separate IV doses of 10 mg metoclopramide were immediately followed by asystole repeatedly. The mechanism(s underlying metoclopramide’s cardiac arrest-inducing effects is unknown. Structural similarities to procainamide may play a role. In view of eight previous cases of cardiac arrest from metoclopramide having been reported, further elucidation of this ADR and patient monitoring is needed. Our report should alert clinicians to monitor patients and remain diligent in surveillance and

  3. Cardiac cone-beam CT

    International Nuclear Information System (INIS)

    Manzke, Robert

    2005-01-01

    This doctoral thesis addresses imaging of the heart with retrospectively gated helical cone-beam computed tomography (CT). A thorough review of the CT reconstruction literature is presented in combination with a historic overview of cardiac CT imaging and a brief introduction to other cardiac imaging modalities. The thesis includes a comprehensive chapter about the theory of CT reconstruction, familiarizing the reader with the problem of cone-beam reconstruction. The anatomic and dynamic properties of the heart are outlined and techniques to derive the gating information are reviewed. With the extended cardiac reconstruction (ECR) framework, a new approach is presented for the heart-rate-adaptive gated helical cardiac cone-beam CT reconstruction. Reconstruction assessment criteria such as the temporal resolution, the homogeneity in terms of the cardiac phase, and the smoothness at cycle-to-cycle transitions are developed. Several reconstruction optimization approaches are described: An approach for the heart-rate-adaptive optimization of the temporal resolution is presented. Streak artifacts at cycle-to-cycle transitions can be minimized by using an improved cardiac weighting scheme. The optimal quiescent cardiac phase for the reconstruction can be determined automatically with the motion map technique. Results for all optimization procedures applied to ECR are presented and discussed based on patient and phantom data. The ECR algorithm is analyzed for larger detector arrays of future cone-beam systems throughout an extensive simulation study based on a four-dimensional cardiac CT phantom. The results of the scientific work are summarized and an outlook proposing future directions is given. The presented thesis is available for public download at www.cardiac-ct.net

  4. Mechanostimulation Protocols for Cardiac Tissue Engineering

    Directory of Open Access Journals (Sweden)

    Marco Govoni

    2013-01-01

    Full Text Available Owing to the inability of self-replacement by a damaged myocardium, alternative strategies to heart transplantation have been explored within the last decades and cardiac tissue engineering/regenerative medicine is among the present challenges in biomedical research. Hopefully, several studies witness the constant extension of the toolbox available to engineer a fully functional, contractile, and robust cardiac tissue using different combinations of cells, template bioscaffolds, and biophysical stimuli obtained by the use of specific bioreactors. Mechanical forces influence the growth and shape of every tissue in our body generating changes in intracellular biochemistry and gene expression. That is why bioreactors play a central role in the task of regenerating a complex tissue such as the myocardium. In the last fifteen years a large number of dynamic culture devices have been developed and many results have been collected. The aim of this brief review is to resume in a single streamlined paper the state of the art in this field.

  5. Fetal cardiac assessment

    International Nuclear Information System (INIS)

    Greene, K.R.

    1983-01-01

    The better understanding of fetal cardiovascular physiology coupled with improved technology for non-invasive study of the fetus now enable much more detailed assessment of fetal cardiac status than by heart rate alone. Even the latter, relatively simple, measurement contains much more information than was previously realized. It is also increasingly clear that no single measurement will provide the answer to all clinical dilemmas either on cardiac function or the welfare of the fetus as a whole. There are obvious clinical advantages in measuring several variables from one signal and the measurement of heart rate, heart rate variation and waveform from the ECG in labour is a potentially useful combination. Systolic time intervals or flow measurements could easily be added or used separately by combining real-time and Doppler ultrasound probes

  6. Cardiac nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    Gerson, M.C.

    1987-01-01

    The book begins with a review of the radionuclide methods available for evaluating cardiac perfusion and function. The authors discuss planar and tomographic thallium myocardial imaging, first-pass and equilibrium radionuclide angiography, and imaging with infarct-avid tracers. Several common but more specialized procedures are then reviewed: nonogemetric measurement of left ventricular volume, phase (Fourier) analysis, stroke volume ratio, right ventricular function, and diastolic function. A separate chapter is devoted to drug interventions and in particular the use of radionuclide ventriculography to monitor doxorubicin toxicity and therapy of congestive heart failure. The subsequent chapters provide a comprehensive guide to test selection, accuracy, and results in acute myocardial infarction, in postmyocardial infarction, in chronic coronary artery disease, before and after medical or surgical revascularization, in valvular heart disease, in cardiomyopathies, and in cardiac trauma.

  7. Cardiac nuclear medicine

    International Nuclear Information System (INIS)

    Gerson, M.C.

    1987-01-01

    The book begins with a review of the radionuclide methods available for evaluating cardiac perfusion and function. The authors discuss planar and tomographic thallium myocardial imaging, first-pass and equilibrium radionuclide angiography, and imaging with infarct-avid tracers. Several common but more specialized procedures are then reviewed: nonogemetric measurement of left ventricular volume, phase (Fourier) analysis, stroke volume ratio, right ventricular function, and diastolic function. A separate chapter is devoted to drug interventions and in particular the use of radionuclide ventriculography to monitor doxorubicin toxicity and therapy of congestive heart failure. The subsequent chapters provide a comprehensive guide to test selection, accuracy, and results in acute myocardial infarction, in postmyocardial infarction, in chronic coronary artery disease, before and after medical or surgical revascularization, in valvular heart disease, in cardiomyopathies, and in cardiac trauma

  8. The effect of malaria and anti-malarial drugs on skeletal and cardiac muscles.

    Science.gov (United States)

    Marrelli, Mauro Toledo; Brotto, Marco

    2016-11-02

    Malaria remains one of the most important infectious diseases in the world, being a significant public health problem associated with poverty and it is one of the main obstacles to the economy of an endemic country. Among the several complications, the effects of malaria seem to target the skeletal muscle system, leading to symptoms, such as muscle aches, muscle contractures, muscle fatigue, muscle pain, and muscle weakness. Malaria cause also parasitic coronary artery occlusion. This article reviews the current knowledge regarding the effect of malaria disease and the anti-malarial drugs on skeletal and cardiac muscles. Research articles and case report publications that addressed aspects that are important for understanding the involvement of malaria parasites and anti-malarial therapies affecting skeletal and cardiac muscles were analysed and their findings summarized. Sequestration of red blood cells, increased levels of serum creatine kinase and reduced muscle content of essential contractile proteins are some of the potential biomarkers of the damage levels of skeletal and cardiac muscles. These biomarkers might be useful for prevention of complications and determining the effectiveness of interventions designed to protect cardiac and skeletal muscles from malaria-induced damage.

  9. Cardiac hybrid imaging

    Energy Technology Data Exchange (ETDEWEB)

    Gaemperli, Oliver [University Hospital Zurich, Cardiac Imaging, Zurich (Switzerland); University Hospital Zurich, Nuclear Cardiology, Cardiovascular Center, Zurich (Switzerland); Kaufmann, Philipp A. [University Hospital Zurich, Cardiac Imaging, Zurich (Switzerland); Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland)

    2014-05-15

    Hybrid cardiac single photon emission computed tomography (SPECT)/CT imaging allows combined assessment of anatomical and functional aspects of cardiac disease. In coronary artery disease (CAD), hybrid SPECT/CT imaging allows detection of coronary artery stenosis and myocardial perfusion abnormalities. The clinical value of hybrid imaging has been documented in several subsets of patients. In selected groups of patients, hybrid imaging improves the diagnostic accuracy to detect CAD compared to the single imaging techniques. Additionally, this approach facilitates functional interrogation of coronary stenoses and guidance with regard to revascularization procedures. Moreover, the anatomical information obtained from CT coronary angiography or coronary artery calcium scores (CACS) adds prognostic information over perfusion data from SPECT. The use of cardiac hybrid imaging has been favoured by the dissemination of dedicated hybrid systems and the release of dedicated image fusion software, which allow simple patient throughput for hybrid SPECT/CT studies. Further technological improvements such as more efficient detector technology to allow for low-radiation protocols, ultra-fast image acquisition and improved low-noise image reconstruction algorithms will be instrumental to further promote hybrid SPECT/CT in research and clinical practice. (orig.)

  10. Analysis of the kinetic behaviour of iodine and caesium isotopes in the primary circuit of LWR's during severe fuel damage accidents

    International Nuclear Information System (INIS)

    Alonso, A.; Fernandez, S.; Buron, J.M.; Lopez, J.V.

    1991-01-01

    This State of the Art report deals with the chemical behaviour of caesium and iodine in the primary system, focusing particularly on kinetic chemical aspects. In case of a postulated severe accident in a nuclear reactor, cesium and iodine fission products are among the major contributors to health harm because of their high volatility and radiotoxicity. The extent of the release of such fission products to the environment depends on the effectiveness of transport through different structures in the reactor coolant system and within the reactor building. The release from fuel has been briefly studied; only those aspects concerning to iodine and caesium chemical forms when released have been reviewed; nevertheless the emphasis has been put on the transport of such elements and their species through the primary system. Some thermochemical equilibrium studies, applied to primary circuit conditions in LWR's, have been analyzed. The revision of the few kinetic studies existing on this matter has shown that kinetic behaviour of iodine and caesium isotopes in the primary circuit is an aspect poorly studied, despite the fact that kinetic aspects could have great importance on the chemical species formed under certain conditions. Other phenomena affecting iodine and caesium transport, besides chemical reactions, such as interactions with surfaces, aerosols or other chemical species have also been examined from available information on diverse experiments

  11. Minor myocardial damage is a prevalent condition in patients with acute heart failure syndromes and preserved systolic function with long-term prognostic implications: a report from the CIAST-HF (Collaborative Italo-Argentinean Study on cardiac Troponin T in Heart Failure) study.

    Science.gov (United States)

    Perna, Eduardo R; Aspromonte, Nadia; Cimbaro Canella, Juan P; Di Tano, Giuseppe; Macin, Stella M; Feola, Mauro; Coronel, María L; Milani, Loredano; Parras, Jorge I; Milli, Massimo; García, Edgar H; Valle, Roberto

    2012-11-01

    Half of patients with acute heart failure syndromes (AHFS) have preserved left ventricular ejection fraction (PLVEF). In this setting, the role of minor myocardial damage (MMD), as identified by cardiac troponin T (cTnT), remains to be established. To evaluate the prevalence and long-term prognostic significance of cTnT elevations in patients with AHFS and PLVEF. This retrospective, multicenter, collaborative study included 500 patients hospitalized for AHFS with PLVEF (ejection fraction ≥40%) between October 2000 and December 2006. Blood samples were collected within 12 hours after admission and were assayed for cTnT. MMD was defined as a cTnT value of ≥0.020 ng/mL. Mean age was 73 ± 12 years, 47% were female, 38% had an ischemic etiology, and New York Heart Association (NYHA) class was 2.2 ± 0.7. Mean cTnT value was 0.149 ± 0.484 ng/mL, and cTnT was directly correlated with serum creatinine (Spearman's Rho = 0.35, P < .001) and NYHA class (0.25, P < .001). MMD was diagnosed in 220 patients (44%). Patients with MMD showed lower left ventricular ejection fraction (P < .05), higher serum creatinine (P < .001), higher prevalence of ischemic etiology and diabetes mellitus, a worse NYHA class (P < .001), and higher natriuretic peptide levels (P < .001) as compared with patients without MMD. At 6-month follow-up, overall event-free survival was 55% and 75% in patients with and without MMD (P < .001), respectively. On multivariate Cox regression analysis, only NYHA class (HR = 1.50; P = .002) and MMD (HR = 1.81; P = .001) were identified as predictors of events. Increased cTnT levels were detected in approximately 50% of patients with AHFS with preserved systolic function, and were found to correlate with clinical measures of disease severity. The presence of MMD was associated with a worse long-term outcome, lending support to cTnT-based risk stratification in the setting of AHFS. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Cardiac abnormalities after subarachnoid hemorrhage

    NARCIS (Netherlands)

    Bilt, I.A.C. van der

    2016-01-01

    Aneurysmal subarachnoid hemorrhage(aSAH) is a devastating neurological disease. During the course of the aSAH several neurological and medical complications may occur. Cardiac abnormalities after aSAH are observed often and resemble stress cardiomyopathy or Tako-tsubo cardiomyopathy(Broken Heart

  13. [Acute cardiac failure in pheochromocytoma.

    DEFF Research Database (Denmark)

    Jønler, Morten; Munk, Kim

    2008-01-01

    Pheochromocytoma (P) is an endocrine catecholamine-secreting tumor. Classical symptoms like hypertension, attacks of sweating, palpitations, headache and palor are related to catecholamine discharge. We provide a case of P in a 71 year-old man presenting with acute cardiac failure, severe reduction...

  14. Cardiac Aging - Benefits of Exercise, Nrf2 Activation and Antioxidant Signaling.

    Science.gov (United States)

    Narasimhan, Madhusudhanan; Rajasekaran, Namakkal-Soorappan

    2017-01-01

    Cardiovascular dysfunction and heart failure associated with aging not only impairs the cardiac function but also the quality of life eventually decreasing the life expectancy of the elderly. Notably, cardiac tissue can prematurely age under certain conditions such as genetic mutation, persistent redox stress and overload, aberrant molecular signaling, DNA damage, telomere attrition, and other pathological insults. While cardiovascular-related morbidity and mortality is on the rise and remains a global health threat, there has been only little to moderate improvements in its medical management. This is due to the fact that the lifestyle changes to molecular mechanisms underlying age-related myocardial structure and functional remodeling are multifactorial and intricately operate at different levels. Along these lines, the intrinsic redox mechanisms and oxidative stress (OS) are widely studied in the myocardium. The accumulation of reactive oxygen species (ROS) with age and the resultant oxidative damage has been shown to increase the susceptibility of the myocardium to multiple complications such as atherosclerosis, hypertension, ischemic heart disease, cardiac myopathy, and heart failure. There has been growing interest in trying to enhance the mechanisms that neutralize the ROS and curtailing OS as a possible anti-aging intervention and as a treatment for age-related disorders. Natural defense system to fight against OS involves a master transcription factor named nuclear erythroid-2-p45-related factor-2 (Nrf2) that regulates several antioxidant genes. Compelling evidence exists on the Nrf2 gain of function through pharmacological interventions in counteracting the oxidative damage and affords cytoprotection in several organs including but not limited to lung, liver, kidney, brain, etc. Nevertheless, thus far, only a few studies have described the potential role of Nrf2 and its non-pharmacological induction in cardiac aging. This chapter explores the effects of

  15. Estimated airborne release of radionuclides from the Battelle Memorial Institute Columbus Laboratories JN-1b building at the West Jefferson site as a result of postulated damage from severe wind and earthquake hazard

    International Nuclear Information System (INIS)

    Mishima, J.; Ayer, J.E.

    1981-11-01

    The potential airborne releases of radionuclides (source terms) that could result from wind and earthquake dmage are estimated for the Battelle Memorial Institute Columbus Laboratories JN-1b Building at the West Jefferson site in Ohio. The estimated source terms are based on the damage to barriers containing the radionuclides, the inventory of radionuclides at risk, and the fraction of the inventory made airborne as a result of the loss of containment. In an attempt to provide a realistic range of potential source terms that include most of the normal operating conditions, a best estimate bounded by upper and lower limits is calculated by combining the upper-bound, best-estimate, and lower-bound inventories-at-risk with an airborne release factor (upper-bound, best-estimate, and lower-bound if possible) for the situation. The factors used to evaluate the fractional airborne release of materials and the exchange rates between enclosed and exterior atmospheres are discussed. The postulated damage and source terms are discussed for wind and earthquake hazard scenarios in order of their increasing severity

  16. Evaluation of potential severe accidents during low power and shutdown operations at Surry, Unit 1: Analysis of core damage frequency from internal events during mid-loop operations, Appendices A--D. Volume 2, Part 2

    International Nuclear Information System (INIS)

    Chu, T.L.; Musicki, Z.; Kohut, P.

    1994-06-01

    During 1989, the Nuclear Regulatory Commission (NRC) initiated an extensive program to carefully examine the Potential risks during low Power and shutdown operations. The program includes two parallel projects being performed by Brookhaven National Laboratory (BNL) and Sandia National Laboratories (SNL). Two plants, Surry (pressurized water reactor) and Grand Gulf (boiling water reactor), were selected as the Plants to be studied. The objectives of the program are to assess the risks of severe accidents initiated during plant operational states other than full power operation and to compare the estimated core damage frequencies, important accident sequences and other qualitative and quantitative results with those accidents initiated during full power operation as assessed in NUREG-1150. The objective of this report is to document the approach utilized in the Surry plant and discuss the results obtained. A parallel report for the Grand Gulf plant is prepared by SNL. This study shows that the core-damage frequency during mid-loop operation at the Surry plant is comparable to that of power operation. We recognize that there is very large uncertainty in the human error probabilities in this study. This study identified that only a few procedures are available for mitigating accidents that may occur during shutdown. Procedures written specifically for shutdown accidents would be useful. This document, Volume 2, Pt. 2 provides appendices A through D of this report

  17. Evaluation of potential severe accidents during low power and shutdown operations at Surry, Unit 1: Analysis of core damage frequency from internal events during mid-loop operations, Main report (Chapters 7--12). Volume 2, Part 1B

    International Nuclear Information System (INIS)

    Chu, T.L.; Musicki, Z.; Kohut, P.

    1994-06-01

    During 1989, the Nuclear Regulatory Commission (NRC) initiated an extensive program to carefully examine the potential risks during low power and shutdown operations. The program includes two parallel projects being performed by Brookhaven National Laboratory (BNL) and Sandia National Laboratories (SNL). Two plants, Surry (pressurized water reactor) and Grand Gulf (boiling water reactor), were selected as the plants to be studied. The objectives of the program are to assess the risks of severe accidents initiated during plant operational states other than full power operation and to compare the estimated core damage frequencies, important accident sequences and other qualitative and quantitative results with those accidents initiated during full power operation as assessed in NUREG-1150. The objective of this report is to document the approach utilized in the Surry plant and discuss the results obtained. A parallel report for the Grand Gulf plant is prepared by SNL. This study shows that the core-damage frequency during mid-loop operation at the Surry plant is comparable to that of power operation. We recognize that there is very large uncertainty in the human error probabilities in this study. This study identified that only a few procedures are available for mitigating accidents that may occur during shutdown. Procedures written specific shutdown accidents would be useful

  18. Evaluation of potential severe accidents during low power and shutdown operations at Surry, Unit 1: Analysis of core damage frequency from internal fires during mid-loop operations. Volume 3, Part 1, Main report

    International Nuclear Information System (INIS)

    Musicki, Z.; Chu, T.L.; Yang, J.; Ho, V.; Hou, Y.M.; Lin, J.; Siu, N.

    1994-07-01

    During l989, the Nuclear Regulatory Commission (NRC) initiated an extensive program to carefully examine the potential risks during low power and shutdown operations. The program includes two parallel projects being performed by Brookhaven National Laboratory (BNL) and Sandia National Laboratories (SNL). Two plants, Surry (pressurized water reactor) and Grand Gulf (boiling water reactor), were selected as the plants to be studied. The objectives of the program are to assess the risks of severe accidents initiated during plant operational states other than fun power operation and to compare the estimated core damage frequencies, important accident sequences and other qualitative and quantitative results with those accidents initiated during full power operation as assessed in NUREG-1150. The objective of this report is to document the approach utilized in ' the Surry plant and discuss the results obtained. A parallel report for the Grand Gulf plant is prepared by SNL. This study shows that the core-damage frequency during mid-loop operation at the Surry plant is comparable to that of power operation. We recognize that there is very large uncertainty in the human error probabilities in this study. This study identified that only a few. procedures are available for mitigating accidents that may occur during shutdown. Procedures written specifically for shutdown accidents would be useful

  19. Evaluation of potential severe accidents during low power and shutdown operations at Surry, Unit 1: Analysis of core damage frequency from internal events during mid-loop operations, Appendices E (Sections E.1--E.8). Volume 2, Part 3A

    International Nuclear Information System (INIS)

    Chu, T.L.; Musicki, Z.; Kohut, P.

    1994-06-01

    During 1989, the Nuclear Regulatory Commission (NRC) initiated an extensive program to carefully examine the potential risks during low power and shutdown operations. The program includes two parallel projects being performed by Brookhaven National Laboratory (BNL) and Sandia National Laboratories (SNL). Two plants, Surry (pressurized water reactor) and Grand Gulf (boiling water reactor), were selected as the plants to be studied. The objectives of the program are to assess the risks of severe accidents initiated during plant operational states other than full power operation and to compare the estimated core damage frequencies, important accident sequences and other qualitative and quantitative results with those accidents initiated during full power operation as assessed in NUREG-1150. The objective of this report is to document the approach utilized in the Surry plant and discuss the results obtained. A parallel report for the Grand Gulf plant is prepared by SNL. This study shows that the core-damage frequency during mid-loop operation at the Surry plant is comparable to that of power operation. The authors recognize that there is very large uncertainty in the human error probabilities in this study. This study identified that only a few procedures are available for mitigating accidents that may occur during shutdown. Procedures written specifically for shutdown accidents would be useful

  20. Evaluation of potential severe accidents during low power and shutdown operations at Surry, Unit 1: Analysis of core damage frequency from internal events during mid-loop operations, Main report (Chapters 1--6). Volume 2, Part 1A

    International Nuclear Information System (INIS)

    Chu, T.L.; Musicki, Z.; Kohut, P.

    1992-06-01

    During 1989, the Nuclear Regulatory Commission (NRC) initiated an extensive program to carefully examine the potential risks during low power and shutdown operations. The program includes two parallel projects being performed by Brookhaven National Laboratory (BNL) and Sandia National Laboratories (SNL). Two plants, Surry (pressurized water reactor) and Grand Gulf (boiling water reactor), were selected as the plants to be studied. The objectives of the program are to assess the risks of severe accidents initiated during plant operational states other than full power operation and to compare the estimated core damage frequencies, important accident sequences and other qualitative and quantitative results with those accidents initiated during full power operation as assessed in NUREG-1150. The objective of this report is to document the approach utilized in the Surry plant and discuss the results obtained. A parallel report for the Grand Gulf plant is prepared by SNL. This study shows that the core-damage frequency during mid-loop operation at the Surry plant is comparable to that of power operation. We recognize that there is very large uncertainty in the human error probabilities in this study. This study identified that only a few procedures are available for mitigating accidents that may occur during shutdown written specifically for shutdown accidents would be useful. This document presents Chapters 1--6 of the report

  1. Evaluation of potential severe accidents during low power and shutdown operations at Surry, Unit 1: Analysis of core damage frequency from internal events during mid-loop operations, Appendices A--D. Volume 2, Part 2

    Energy Technology Data Exchange (ETDEWEB)

    Chu, T.L.; Musicki, Z.; Kohut, P. [Brookhaven National Lab., Upton, NY (United States)] [and others

    1994-06-01

    During 1989, the Nuclear Regulatory Commission (NRC) initiated an extensive program to carefully examine the Potential risks during low Power and shutdown operations. The program includes two parallel projects being performed by Brookhaven National Laboratory (BNL) and Sandia National Laboratories (SNL). Two plants, Surry (pressurized water reactor) and Grand Gulf (boiling water reactor), were selected as the Plants to be studied. The objectives of the program are to assess the risks of severe accidents initiated during plant operational states other than full power operation and to compare the estimated core damage frequencies, important accident sequences and other qualitative and quantitative results with those accidents initiated during full power operation as assessed in NUREG-1150. The objective of this report is to document the approach utilized in the Surry plant and discuss the results obtained. A parallel report for the Grand Gulf plant is prepared by SNL. This study shows that the core-damage frequency during mid-loop operation at the Surry plant is comparable to that of power operation. We recognize that there is very large uncertainty in the human error probabilities in this study. This study identified that only a few procedures are available for mitigating accidents that may occur during shutdown. Procedures written specifically for shutdown accidents would be useful. This document, Volume 2, Pt. 2 provides appendices A through D of this report.

  2. DNA damage and polyploidization.

    Science.gov (United States)

    Chow, Jeremy; Poon, Randy Y C

    2010-01-01

    A growing body of evidence indicates that polyploidization triggers chromosomal instability and contributes to tumorigenesis. DNA damage is increasingly being recognized for its roles in promoting polyploidization. Although elegant mechanisms known as the DNA damage checkpoints are responsible for halting the cell cycle after DNA damage, agents that uncouple the checkpoints can induce unscheduled entry into mitosis. Likewise, defects of the checkpoints in several disorders permit mitotic entry even in the presence of DNA damage. Forcing cells with damaged DNA into mitosis causes severe chromosome segregation defects, including lagging chromosomes, chromosomal fragments and chromosomal bridges. The presence of these lesions in the cleavage plane is believed to abort cytokinesis. It is postulated that if cytokinesis failure is coupled with defects of the p53-dependent postmitotic checkpoint pathway, cells can enter S phase and become polyploids. Progress in the past several years has unraveled some of the underlying principles of these pathways and underscored the important role of DNA damage in polyploidization. Furthermore, polyploidization per se may also be an important determinant of sensitivity to DNA damage, thereby may offer an opportunity for novel therapies.

  3. Containment loading during severe core damage accidents

    International Nuclear Information System (INIS)

    Fermandjian, J.; Evrard, J.M.; Cenerino, C.; Berthion, Y.; Carvallo, G.

    1984-11-01

    The objective of the article is to study the influence of the state of the reactor cavity (dry or flooded) and of the corium coolability on the thermal-hydraulics in the containment in the case of an accident sequence involving core melting and subsequent containment basemat erosion, in a 900 MWe PWR unit. Calculations are performed by using the JERICHO thermal hydraulics code

  4. USNRC severe core damage assessment program

    Energy Technology Data Exchange (ETDEWEB)

    Hanson, J E [EG and G Idaho, Inc., Idaho Falls (USA); Johnston, W V; Kelber, C N [Nuclear Regulatory Commission, Washington, DC (USA)

    1981-01-01

    The accident at the Three Mile Island nuclear power station has significantly altered the perception of the importance of beyond-design-basis accidents in licensing and safety reviews of light-water reactors in the USA. Increased consideration will be given by the United States Nuclear Regulatory Commission to low-probability, high-risk core melt accidents in future licensing proceedings. To this end, the USNRC is mounting experimental and analytic methods development programs to provide the technical basis for future LWR design and licensing criteria related to class-9 accidents. The scope, objectives, and content of five major new programs addressing safety and licensing issues for beyond-design-basis accidents are reviewed and the rationale and logic for formulation of the programs is discussed.

  5. Evaluation of potential severe accidents during low power and shutdown operations at Surry, Unit 1: Analysis of core damage frequency from internal events during mid-loop operations. Appendix E (Sections E.9-E.16), Volume 2, Part 3B

    Energy Technology Data Exchange (ETDEWEB)

    Chu, T.L.; Musicki, Z.; Kohut, P.; Yang, J.; Bozoki, G.; Hsu, C.J.; Diamond, D.J.; Wong, S.M. [Brookhaven National Lab., Upton, NY (United States); Bley, D.; Johnson, D. [PLG Inc., Newport Beach, CA (United States)] [and others

    1994-06-01

    Traditionally, probabilistic risk assessments (PRA) of severe accidents in nuclear power plants have considered initiating events potentially occurring only during full power operation. Some previous screening analyses that were performed for other modes of operation suggested that risks during those modes were small relative to full power operation. However, more recent studies and operational experience have implied that accidents during low power and shutdown could be significant contributors to risk. Two plants, Surry (pressurized water reactor) and Grand Gulf (boiling water reactor), were selected as the plants to be studied. The objectives of the program are to assess the risks of severe accidents initiated during plant operational states other than full power operation and to compare the estimated core damage frequencies, important accident sequences and other qualitative and quantitative results with those accidents initiated during full power operation as assessed in NUREG-1150. The scope of the program includes that of a level-3 PRA. In phase 2, mid-loop operation was selected as the plant configuration to be analyzed based on the results of the phase 1 study. The objective of the phase 2 study is to perform a detailed analysis of the potential accident scenarios that may occur during mid-loop operation, and compare the results with those of NUREG-1150. The scope of the level-1 study includes plant damage state analysis, and uncertainty analysis. Volume 1 summarizes the results of the study. Internal events analysis is documented in Volume 2. It also contains an appendix that documents the part of the phase 1 study that has to do with POSs other than mid-loop operation. Internal fire and internal flood analyses are documented in Volumes 3 and 4. A separate study on seismic analysis, documented in Volume 5, was performed for the NRC by Future Resources Associates, Inc. Volume 6 documents the accident progression, source terms, and consequence analysis.

  6. Evaluation of potential severe accidents during low power and shutdown operations at Surry, Unit-1: Analysis of core damage frequency from internal events during mid-loop operations. Appendix I, Volume 2, Part 5

    Energy Technology Data Exchange (ETDEWEB)

    Chu, T.L.; Musicki, Z.; Kohut, P.; Yang, J.; Bozoki, G.; Hsu, C.J.; Diamond, D.J. [Brookhaven National Lab., Upton, NY (United States); Bley, D.; Johnson, D. [PLG Inc., Newport Beach, CA (United States); Holmes, B. [AEA Technology, Dorset (United Kingdom)] [and others

    1994-06-01

    Traditionally, probabilistic risk assessments (PRA) of severe accidents in nuclear power plants have considered initiating events potentially occurring only during full power operation. Some previous screening analyses that were performed for other modes of operation suggested that risks during those modes were small relative to full power operation. However, more recent studies and operational experience have implied that accidents during low power and shutdown could be significant contributors to risk. During 1989, the Nuclear Regulatory Commission (NRC) initiated an extensive program to carefully examine the potential risks during low power and shutdown operations. The program includes two parallel projects being performed by Brookhaven National Lab. (BNL) and Sandia National Labs. (SNL). Two plants, Surry (pressurized water reactor) and Grand Gulf (boiling water reactor), were selected as the plants to be studied. The objectives of the program are to assess the risks of severe accidents initiated during plant operational states other than full power operation and to compare the estimated core damage frequencies, important accident sequences and other qualitative and quantitative results with those accidents initiated during full power operation as assessed in NUREG-1150. The objective of this volume of the report is to document the approach utilized in the level-1 internal events PRA for the Surry plant, and discuss the results obtained. A phased approach was used in the level-1 program. In phase 1, which was completed in Fall 1991, a coarse screening analysis examining accidents initiated by internal events (including internal fire and flood) was performed for all plant operational states (POSs). The objective of the phase 1 study was to identify potential vulnerable plant configurations, to characterize (on a high, medium, or low basis) the potential core damage accident scenarios, and to provide a foundation for a detailed phase 2 analysis.

  7. Behaviour of a VVER-1000 fuel element with boron carbide/steel absorber tested under severe fuel damage conditions in the CORA facility (Results of experiment CORA-W2)

    International Nuclear Information System (INIS)

    Hagen, S.; Hofmann, P.; Noack, V.; Schanz, G.; Schumacher, G.; Sepold, L.

    1994-10-01

    The 'Severe Fuel Damage' (SFD) experiments of the Kernforschungszentrum Karlsruhe (KfK), Federal Republic of Germany, were carried out in the out-of-pile facility 'CORA' as part of the international Severe Fuel Damage (SFD) research. The experimental program was set up to provide information on the failure mechanisms of Light Water Reactor (LWR) fuel elements in a temperature range from 1200 C to 2000 C and in few cases up to 2400 C. Between 1987 and 1992 a total of 17 CORA experiments with two different bundle configurations, i.e. PWR (Pressurized Water Reactor) and BWR (Boiling Water Reactor) bundles were performed. These assemblies represented 'Western-type' fuel elements with the pertinent materials for fuel, cladding, grid spacer, and absorber rod. At the end of the experimental program two VVER-1000 specific tests were run in the CORA facility with identical objectives but with genuine VVER-type materials. The experiments, designated CORA-W1 and CORA-W2 were conducted on February 18, 1993 and April 21, 1993, respectively. Test bundle CORA-W1 was without absorber material whereas CORA-W2 contained one absorber rod (boron carbide/steel). As in the earlier CORA tests the test bundles were subjected to temperature transients of a slow heatup rate in a steam environment. The transient phases of the tests were initiated with a temperature ramp rate of 1 K/s. With these conditions a so-called small-break LOCA was simulated. The temperature escalation due to the exothermal zircon/niobium-steam reaction started at about 1200 C, leading the bundles to maximum temperatures of approximately 1900 C. The thermal response of bundle CORA-W2 is comparable to that of CORA-W1. In test CORA-W2, however, the temperature front moved faster from the top to the bottom compared to test CORA-W1 [de

  8. Evaluation of potential severe accidents during low power and shutdown operations at Surry, Unit-1: Analysis of core damage frequency from internal events during mid-loop operations. Appendices F-H, Volume 2, Part 4

    International Nuclear Information System (INIS)

    Chu, T.L.; Musicki, Z.; Kohut, P.; Yang, J.; Bozoki, G.; Hsu, C.J.; Diamond, D.J.; Bley, D.; Johnson, D.; Holmes, B.

    1994-06-01

    Traditionally, probabilistic risk assessments (PRA) of severe accidents in nuclear power plants have considered initiating events potentially occurring only during full power operation. Some previous screening analyses that were performed for other modes of operation suggested that risks during those modes were small relative to full power operation. However, more recent studies and operational experience have implied that accidents during low power and shutdown could be significant contributors to risk. Two plants, Surry (pressurized water reactor) and Grand Gulf (boiling water reactor), were selected as the plants to be studied. The objectives of the program are to assess the risks of severe accidents initiated during plant operational states other than full power operation and to compare the estimated core damage frequencies, important accident sequences and other qualitative and quantitative results with those accidents initiated during full power operation as assessed in NUREG-1150. The scope of the program includes that of a level-3 PRA. In phase 2, mid-loop operation was selected as the plant configuration to be analyzed based on the results of the phase 1 study. The objective of the phase 2 study is to perform a detailed analysis of the potential accident scenarios that may occur during mid-loop operation, and compare the results with those of NUREG-1150. The scope of the level-1 study includes plant damage state analysis, and uncertainty analysis. Volume 1 summarizes the results of the study. Internal events analysis is documented in Volume 2. It also contains an appendix that documents the part of the phase 1 study that has to do with POSs other than mid-loop operation. Internal fire and internal flood analyses are documented in Volumes 3 and 4. A separate study on seismic analysis, documented in Volume 5, was performed for the NRC by Future Resources Associates, Inc. Volume 6 documents the accident progression, source terms, and consequence analysis

  9. Evaluation of potential severe accidents during low power and shutdown operations at Surry, Unit 1: Analysis of core damage frequency from internal events during mid-loop operations. Appendix E (Sections E.9-E.16), Volume 2, Part 3B

    International Nuclear Information System (INIS)

    Chu, T.L.; Musicki, Z.; Kohut, P.; Yang, J.; Bozoki, G.; Hsu, C.J.; Diamond, D.J.; Wong, S.M.; Bley, D.; Johnson, D.

    1994-06-01

    Traditionally, probabilistic risk assessments (PRA) of severe accidents in nuclear power plants have considered initiating events potentially occurring only during full power operation. Some previous screening analyses that were performed for other modes of operation suggested that risks during those modes were small relative to full power operation. However, more recent studies and operational experience have implied that accidents during low power and shutdown could be significant contributors to risk. Two plants, Surry (pressurized water reactor) and Grand Gulf (boiling water reactor), were selected as the plants to be studied. The objectives of the program are to assess the risks of severe accidents initiated during plant operational states other than full power operation and to compare the estimated core damage frequencies, important accident sequences and other qualitative and quantitative results with those accidents initiated during full power operation as assessed in NUREG-1150. The scope of the program includes that of a level-3 PRA. In phase 2, mid-loop operation was selected as the plant configuration to be analyzed based on the results of the phase 1 study. The objective of the phase 2 study is to perform a detailed analysis of the potential accident scenarios that may occur during mid-loop operation, and compare the results with those of NUREG-1150. The scope of the level-1 study includes plant damage state analysis, and uncertainty analysis. Volume 1 summarizes the results of the study. Internal events analysis is documented in Volume 2. It also contains an appendix that documents the part of the phase 1 study that has to do with POSs other than mid-loop operation. Internal fire and internal flood analyses are documented in Volumes 3 and 4. A separate study on seismic analysis, documented in Volume 5, was performed for the NRC by Future Resources Associates, Inc. Volume 6 documents the accident progression, source terms, and consequence analysis

  10. Evaluation of potential severe accidents during low power and shutdown operations at Surry, Unit-1: Analysis of core damage frequency from internal events during mid-loop operations. Appendix I, Volume 2, Part 5

    International Nuclear Information System (INIS)

    Chu, T.L.; Musicki, Z.; Kohut, P.; Yang, J.; Bozoki, G.; Hsu, C.J.; Diamond, D.J.; Bley, D.; Johnson, D.; Holmes, B.

    1994-06-01

    Traditionally, probabilistic risk assessments (PRA) of severe accidents in nuclear power plants have considered initiating events potentially occurring only during full power operation. Some previous screening analyses that were performed for other modes of operation suggested that risks during those modes were small relative to full power operation. However, more recent studies and operational experience have implied that accidents during low power and shutdown could be significant contributors to risk. During 1989, the Nuclear Regulatory Commission (NRC) initiated an extensive program to carefully examine the potential risks during low power and shutdown operations. The program includes two parallel projects being performed by Brookhaven National Lab. (BNL) and Sandia National Labs. (SNL). Two plants, Surry (pressurized water reactor) and Grand Gulf (boiling water reactor), were selected as the plants to be studied. The objectives of the program are to assess the risks of severe accidents initiated during plant operational states other than full power operation and to compare the estimated core damage frequencies, important accident sequences and other qualitative and quantitative results with those accidents initiated during full power operation as assessed in NUREG-1150. The objective of this volume of the report is to document the approach utilized in the level-1 internal events PRA for the Surry plant, and discuss the results obtained. A phased approach was used in the level-1 program. In phase 1, which was completed in Fall 1991, a coarse screening analysis examining accidents initiated by internal events (including internal fire and flood) was performed for all plant operational states (POSs). The objective of the phase 1 study was to identify potential vulnerable plant configurations, to characterize (on a high, medium, or low basis) the potential core damage accident scenarios, and to provide a foundation for a detailed phase 2 analysis

  11. Sudden visual loss after cardiac resynchronization therapy device implantation.

    Science.gov (United States)

    De Vitis, Luigi A; Marchese, Alessandro; Giuffrè, Chiara; Carnevali, Adriano; Querques, Lea; Tomasso, Livia; Baldin, Giovanni; Maestranzi, Gisella; Lattanzio, Rosangela; Querques, Giuseppe; Bandello, Francesco

    2017-03-10

    To report a case of sudden decrease in visual acuity possibly due to a cardiogenic embolism in a patient who underwent cardiac resynchronization therapy (CRT) device implantation. A 62-year-old man with severe left ventricular systolic dysfunction and a left bundle branch block was referred to our department because of a sudden decrease in visual acuity. Nine days earlier, he had undergone cardiac transapical implantation of a CRT device, which was followed, 2 days later, by an inflammatory reaction. The patient underwent several general and ophthalmologic examinations, including multimodal imaging. At presentation, right eye (RE) best-corrected visual acuity (BCVA) was counting fingers and RE pupil was hyporeactive. Fundus examination revealed white-centered hemorrhagic dots suggestive of Roth spots. Fluorescein angiography showed delay in vascular perfusion during early stage, late hyperfluorescence of the macula and optic disk, and peripheral perivascular leakage. The first visual field test showed complete loss of vision RE and a normal left eye. Due to suspected giant cell arteritis, temporal artery biopsy was performed. Thirty minutes after the procedure, an ischemic stroke with right hemisyndrome and aphasia occurred. The RE BCVA worsened to hands motion. Four months later, RE BCVA did not improve, despite improvement in fluorescein angiography inflammatory sign. We report a possible cardiogenic embolism secondary to undiagnosed infective endocarditis causing monocular visual loss after CRT device implantation. It remains unclear how the embolus caused severe functional damage without altering the retinal anatomical structure.

  12. Cardiac Function Remains Impaired Despite Reversible Cardiac Remodeling after Acute Experimental Viral Myocarditis

    Directory of Open Access Journals (Sweden)

    Peter Moritz Becher

    2017-01-01

    Full Text Available Background. Infection with Coxsackievirus B3 induces myocarditis. We aimed to compare the acute and chronic phases of viral myocarditis to identify the immediate effects of cardiac inflammation as well as the long-term effects after resolved inflammation on cardiac fibrosis and consequently on cardiac function. Material and Methods. We infected C57BL/6J mice with Coxsackievirus B3 and determined the hemodynamic function 7 as well as 28 days after infection. Subsequently, we analyzed viral burden and viral replication in the cardiac tissue as well as the expression of cytokines and matrix proteins. Furthermore, cardiac fibroblasts were infected with virus to investigate if viral infection alone induces profibrotic signaling. Results. Severe cardiac inflammation was determined and cardiac fibrosis was consistently colocalized with inflammation during the acute phase of myocarditis. Declined cardiac inflammation but no significantly improved hemodynamic function was observed 28 days after infection. Interestingly, cardiac fibrosis declined to basal levels as well. Both cardiac inflammation and fibrosis were reversible, whereas the hemodynamic function remains impaired after healed viral myocarditis in C57BL/6J mice.

  13. Squalene Modulates Radiation-Induced Structural, Ultrastructural And Biochemical Changes In Cardiac Muscles Of Male Albino Rats

    International Nuclear Information System (INIS)

    REZK, R.G.; YACOUB, S.F.; ABDEL AZIZ, N.

    2009-01-01

    The failing heart represents an enormous clinical problem and is a major cause of death throughout the world. Hyperlipidemia and oxidative stress have been shown to contribute to heart failure. Squalene is a remarkable bioactive substance that belongs to a class of antioxidants called isoprenoids, which neutralize the harmful effect of excessive free radicals production in the body.The present study was designed to determine the possible protective effect of squalene against oxidative cardiac muscle damage induced by gamma irradiation.Rats were treated daily by gavage with 0.4 ml/kg squalene for 42 days before whole body gamma irradiation at a dose of 4 Gy and continued until animals were sacrificed 3 days post irradiation.Histological examination of cardiac muscles sections by using light and electron microscopes showed that exposure of rats to ionizing radiation has provoked a severe architecture damage such as necrotic nuclei, nuclei located at the periphery, alteration in chromatin distribution, ruptured cell and mitochondrial membranes, cristae of mitochondria disappeared, sticking mitochondria and ruptured myofibers. Structural and ultra-structural changes were associated with severe oxidative stress. Significant increase of lipid peroxidation products (malondialdehyde) (MDA) along with reduction in the activity of the antioxidant enzymes; superoxide dismutase (SOD) and catalse (CAT), and glutathione content (GSH), were recorded.Treatment of rats with squalene has significantly attenuated the radiation-induced oxidative damage and histopathological changes in cardiac muscle which was substantiated by a significant amelioration in the activity of plasma lactate dehydrogenase (LDH), creatine phosphokinase (CPK) and aspartate transaminase (AST). Furthermore, administration of squalene to rats has adjusted the radiation-induced increase in plasma triglycerides (TG), total cholesterol (TC) and low density lipoprotein-cholesterol (LDL-C). Based on these results, it

  14. Cardiac fluid dynamics meets deformation imaging.

    Science.gov (United States)

    Dal Ferro, Matteo; Stolfo, Davide; De Paris, Valerio; Lesizza, Pierluigi; Korcova, Renata; Collia, Dario; Tonti, Giovanni; Sinagra, Gianfranco; Pedrizzetti, Gianni

    2018-02-20

    Cardiac function is about creating and sustaining blood in motion. This is achieved through a proper sequence of myocardial deformation whose final goal is that of creating flow. Deformation imaging provided valuable contributions to understanding cardiac mechanics; more recently, several studies evidenced the existence of an intimate relationship between cardiac function and intra-ventricular fluid dynamics. This paper summarizes the recent advances in cardiac flow evaluations, highlighting its relationship with heart wall mechanics assessed through the newest techniques of deformation imaging and finally providing an opinion of the most promising clinical perspectives of this emerging field. It will be shown how fluid dynamics can integrate volumetric and deformation assessments to provide a further level of knowledge of cardiac mechanics.

  15. Cardiac-specific overexpression of catalase attenuates lipopolysaccharide-induced myocardial contractile dysfunction: role of autophagy.

    Science.gov (United States)

    Turdi, Subat; Han, Xuefeng; Huff, Anna F; Roe, Nathan D; Hu, Nan; Gao, Feng; Ren, Jun

    2012-09-15

    Lipopolysaccharide (LPS) from gram-negative bacteria is a major initiator of sepsis, leading to cardiovascular collapse. Accumulating evidence has indicated a role of reactive oxygen species (ROS) in cardiovascular complications in sepsis. This study was designed to examine the effect of cardiac-specific overexpression of catalase in LPS-induced cardiac contractile dysfunction and the underlying mechanism(s) with a focus on autophagy. Catalase transgenic and wild-type FVB mice were challenged with LPS (6 mg/kg) and cardiac function was evaluated. Levels of oxidative stress, autophagy, apoptosis, and protein damage were examined using fluorescence microscopy, Western blot, TUNEL assay, caspase-3 activity, and carbonyl formation. A Kaplan-Meier curve was constructed for survival after LPS treatment. Our results revealed a lower mortality in catalase mice compared with FVB mice after LPS challenge. LPS injection led to depressed cardiac contractile capacity as evidenced by echocardiography and cardiomyocyte contractile function, the effect of which was ablated by catalase overexpression. LPS treatment induced elevated TNF-α level, autophagy, apoptosis (TUNEL, caspase-3 activation, cleaved caspase-3), production of ROS and O(2)(-), and protein carbonyl formation, the effects of which were significantly attenuated by catalase overexpression. Electron microscopy revealed focal myocardial damage characterized by mitochondrial injury after LPS treatment, which was less severe in catalase mice. Interestingly, LPS-induced cardiomyocyte contractile dysfunction was prevented by the antioxidant N-acetylcysteine and the autophagy inhibitor 3-methyladenine. Taken together, our data revealed that catalase protects against LPS-induced cardiac dysfunction and mortality, which may be associated with inhibition of oxidative stress and autophagy. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Cardiac-Specific Overexpression of Catalase Attenuates Lipopolysaccharide-Induced Myocardial Contractile Dysfunction: Role of Autophagy

    Science.gov (United States)

    Turdi, Subat; Han, Xuefeng; Huff, Anna F.; Roe, Nathan D.; Hu, Nan; Gao, Feng; Ren, Jun

    2012-01-01

    Lipopolysaccharide (LPS) from Gram-negative bacteria is a major initiator of sepsis, leading to cardiovascular collapse. Accumulating evidence has indicated a role of reactive oxygen species (ROS) in cardiovascular complication in sepsis. This study was designed to examine the effect of cardiac-specific overexpression of catalase in LPS-induced cardiac contractile dysfunction and the underlying mechanism(s) with a focus on autophagy. Catalase transgenic and wild-type FVB mice were challenged with LPS (6 mg/kg) and cardiac function was evaluated. Levels of oxidative stress, autophagy, apoptosis and protein damage were examined using fluorescence microscopy, Western blot, TUNEL assay, caspase-3 activity and carbonyl formation. Kaplan-Meier curve was constructed for survival following LPS treatment. Our results revealed a lower mortality in catalase mice compared with FVB mice following LPS challenge. LPS injection led to depressed cardiac contractile capacity as evidenced by echocardiography and cardiomyocyte contractile function, the effect of which was ablated by catalase overexpression. LPS treatment induced elevated TNF-α level, autophagy, apoptosis (TUNEL, caspase-3 activation, cleaved caspase-3), production of ROS and O2−, and protein carbonyl formation, the effects of which were significantly attenuated by catalase overexpression. Electron microscopy revealed focal myocardial damage characterized by mitochondrial injury following LPS treatment, which was less severe in catalase mice. Interestingly, LPS-induced cardiomyocyte contractile dysfunction was prevented by antioxidant NAC and the autophagy inhibitor 3-methyladenine. Taken together, our data revealed that catalase protects against LPS-induced cardiac dysfunction and mortality, which may be associated with inhibition of oxidative stress and autophagy. PMID:22902401

  17. External cardiac compression may be harmful in some scenarios of pulseless electrical activity.

    Science.gov (United States)

    Hogan, T S

    2012-10-01

    Pulseless electrical activity occurs when organised or semi-organised electrical activity of the heart persists but the product of systemic vascular resistance and the increase in systemic arterial flow generated by the ejection of the left venticular stroke volume is not sufficient to produce a clinically detectable pulse. Pulseless electrical activity encompasses a very heterogeneous variety of severe circulatory shock states ranging in severity from pseudo-cardiac arrest to effective cardiac arrest. Outcomes of cardiopulmonary resuscitation for pulseless electrical activity are generally poor. Impairment of cardiac filling is the limiting factor to cardiac output in many scenarios of pulseless electrical activity, including extreme vasodilatory shock states. There is no evidence that external cardiac compression can increase cardiac output when impaired cardiac filling is the limiting factor to cardiac output. If impaired cardiac filling is the limiting factor to cardiac output and the heart is effectively ejecting all the blood returning to it, then external cardiac compression can only increase cardiac output if it increases venous return and cardiac filling. Repeated cardiac compression asynchronous with the patient's cardiac cycle and raised mean intrathoracic pressure due to chest compression can be expected to reduce rather than to increase cardiac filling and therefore to reduce rather than to increase cardiac output in such circumstances. The hypothesis is proposed that the performance of external cardiac compression will have zero or negative effect on cardiac output in pulseless electrical activity when impaired cardiac filling is the limiting factor to cardiac output. External cardiac compression may be both directly and indirectly harmful to significant sub-groups of patients with pulseless electrical activity. We have neither evidence nor theory to provide comfort that external cardiac compression is not harmful in many scenarios of pulseless

  18. External cardiac compression may be harmful in some scenarios of pulseless electrical activity.

    LENUS (Irish Health Repository)

    Hogan, T S

    2012-10-01

    Pulseless electrical activity occurs when organised or semi-organised electrical activity of the heart persists but the product of systemic vascular resistance and the increase in systemic arterial flow generated by the ejection of the left venticular stroke volume is not sufficient to produce a clinically detectable pulse. Pulseless electrical activity encompasses a very heterogeneous variety of severe circulatory shock states ranging in severity from pseudo-cardiac arrest to effective cardiac arrest. Outcomes of cardiopulmonary resuscitation for pulseless electrical activity are generally poor. Impairment of cardiac filling is the limiting factor to cardiac output in many scenarios of pulseless electrical activity, including extreme vasodilatory shock states. There is no evidence that external cardiac compression can increase cardiac output when impaired cardiac filling is the limiting factor to cardiac output. If impaired cardiac filling is the limiting factor to cardiac output and the heart is effectively ejecting all the blood returning to it, then external cardiac compression can only increase cardiac output if it increases venous return and cardiac filling. Repeated cardiac compression asynchronous with the patient\\'s cardiac cycle and raised mean intrathoracic pressure due to chest compression can be expected to reduce rather than to increase cardiac filling and therefore to reduce rather than to increase cardiac output in such circumstances. The hypothesis is proposed that the performance of external cardiac compression will have zero or negative effect on cardiac output in pulseless electrical activity when impaired cardiac filling is the limiting factor to cardiac output. External cardiac compression may be both directly and indirectly harmful to significant sub-groups of patients with pulseless electrical activity. We have neither evidence nor theory to provide comfort that external cardiac compression is not harmful in many scenarios of pulseless

  19. Diffuse infiltrative cardiac tuberculosis

    International Nuclear Information System (INIS)

    Gulati, Gurpreet S; Kothari, Shyam S

    2011-01-01

    We present the cardiac magnetic resonance images of an unusual form of cardiac tuberculosis. Nodular masses in a sheet-like distribution were seen to infiltrate the outer myocardium and pericardium along most of the cardiac chambers. The lesions showed significant resolution on antitubercular therapy

  20. Biomimetic material strategies for cardiac tissue engineering

    International Nuclear Information System (INIS)

    Prabhakaran, Molamma P.; Venugopal, J.; Kai, Dan; Ramakrishna, Seeram

    2011-01-01

    Cardiovascular disease precedes many serious complications including myocardial infarction (MI) and it remains a major problem for the global community. Adult mammalian heart has limited ability to regenerate and compensate for the loss of cardiomyocytes. Restoration of cardiac function by replacement of diseased myocardium with functional cardiomyocytes is an intriguing strategy because it offers a potential cure for MI. Biomaterials are fabricated in nanometer scale dimensions by combining the chemical, biological, mechanical and electrical aspects of material for potential tissue engineering (TE) applications. Synthetic polymers offer advantageous in their ability to tailor the mechanical properties, and natural polymers offer cell recognition sites necessary for cell, adhesion and proliferation. Cardiac tissue engineering (TE) aim for the development of a bioengineered construct that can provide physical support to the damaged cardiac tissue by replacing certain functions of the damaged extracellular matrix and prevent adverse cardiac remodeling and dysfunction after MI. Electrospun nanofibers are applied as heart muscle patches, while hydrogels serve as a platform for controlled delivery of growth factors, prevent mechanical complications and assist in cell recruitment. This article reviews the applications of different natural and synthetic polymeric materials utilized as cardiac patches, injectables or 3D constructs for cardiac TE. Smart organization of nanoscale assemblies with synergistic approaches of utilizing nanofibers and hydrogels could further advance the field of cardiac tissue engineering. Rapid innovations in biomedical engineering and cell biology will bring about new insights in the development of optimal scaffolds and methods to create tissue constructs with relevant contractile properties and electrical integration to replace or substitute the diseased myocardium.

  1. Biomimetic material strategies for cardiac tissue engineering

    Energy Technology Data Exchange (ETDEWEB)

    Prabhakaran, Molamma P., E-mail: nnimpp@nus.edu.sg [Health Care and Energy Materials Laboratory, Nanoscience and Nanotechnology Initiative, Faculty of Engineering, National University of Singapore, 2 Engineering Drive 3, Singapore 117576 (Singapore); Venugopal, J. [Health Care and Energy Materials Laboratory, Nanoscience and Nanotechnology Initiative, Faculty of Engineering, National University of Singapore, 2 Engineering Drive 3, Singapore 117576 (Singapore); Kai, Dan [NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore (Singapore); Ramakrishna, Seeram [Health Care and Energy Materials Laboratory, Nanoscience and Nanotechnology Initiative, Faculty of Engineering, National University of Singapore, 2 Engineering Drive 3, Singapore 117576 (Singapore)

    2011-04-08

    Cardiovascular disease precedes many serious complications including myocardial infarction (MI) and it remains a major problem for the global community. Adult mammalian heart has limited ability to regenerate and compensate for the loss of cardiomyocytes. Restoration of cardiac function by replacement of diseased myocardium with functional cardiomyocytes is an intriguing strategy because it offers a potential cure for MI. Biomaterials are fabricated in nanometer scale dimensions by combining the chemical, biological, mechanical and electrical aspects of material for potential tissue engineering (TE) applications. Synthetic polymers offer advantageous in their ability to tailor the mechanical properties, and natural polymers offer cell recognition sites necessary for cell, adhesion and proliferation. Cardiac tissue engineering (TE) aim for the development of a bioengineered construct that can provide physical support to the damaged cardiac tissue by replacing certain functions of the damaged extracellular matrix and prevent adverse cardiac remodeling and dysfunction after MI. Electrospun nanofibers are applied as heart muscle patches, while hydrogels serve as a platform for controlled delivery of growth factors, prevent mechanical complications and assist in cell recruitment. This article reviews the applications of different natural and synthetic polymeric materials utilized as cardiac patches, injectables or 3D constructs for cardiac TE. Smart organization of nanoscale assemblies with synergistic approaches of utilizing nanofibers and hydrogels could further advance the field of cardiac tissue engineering. Rapid innovations in biomedical engineering and cell biology will bring about new insights in the development of optimal scaffolds and methods to create tissue constructs with relevant contractile properties and electrical integration to replace or substitute the diseased myocardium.

  2. [Economic damage caused by lowered prices in the agro-food sector in areas contaminated by radioactive materials leaked from the nuclear power plant severely damaged by the 2011 Great East Japan Earthquake--consideration from the viewpoints of epidemiology, economics and social psychology].

    Science.gov (United States)

    Sugita, Minoru; Miyakawa, Michiko

    2013-01-01

    Large amounts of radioactive materials were leaked into the environment from the Fukushima Daiichi Nuclear Power Plant (FDNPP) of the Tokyo Electric Power Company, which was severely damaged by the 2011 Tohoku Region Pacific Coast Earthquake and accompanying tsunami. Economic damage due to lowered prices and supplies of food products produced in the areas contaminated by the radioactive materials leaked from the damaged FDNPP to the agro-food sector in the affected areas is notable. In Japanese, this is known as fuhyo higai. In this study, we investigated fuhyo higai from the viewpoints of epidemiology, economics, and social psychology in an effort to seek solutions. Information was obtained from articles in print and on the Internet. Fuhyo higai, or economic damage of the agro-food sector, which is the main industry in the contaminated areas, is serious because it is difficult to reassure the general population regarding food safety. This fuhyo higai does not derive solely from rumor. It has been reported that improving the science literacy of the general population is important as a countermeasure against fuhyo higai, but this may not be effective because of the human social structure and behavior of people who seek subjective safety. Almost all radiological laboratory results of samples of food produced in the contaminated areas were below detectable limits. Very high values were rarely detected. In general, information about the dose-response relationship is obtained under the assumption that there may be error in the response but not in the dose. The rare cases of extremely high radiological values of food samples from the contaminated areas may correspond to large errors in dose. However, it is difficult to deny a high-dose risk. The reported information on the dose-response relationship obtained under the assumption that there is no error in dose is not sufficient. Thus, response, i.e., health risk, cannot be correctly estimated. This leads the general

  3. Twinkle overexpression prevents cardiac rupture after myocardial infarction by alleviating impaired mitochondrial biogenesis.

    Science.gov (United States)

    Inoue, Takahiro; Ikeda, Masataka; Ide, Tomomi; Fujino, Takeo; Matsuo, Yuka; Arai, Shinobu; Saku, Keita; Sunagawa, Kenji

    2016-09-01

    Cardiac rupture is a fatal complication after myocardial infarction (MI). However, the detailed mechanism underlying cardiac rupture after MI remains to be fully elucidated. In this study, we investigated the role of mitochondrial DNA (mtDNA) and mitochondria in the pathophysiology of cardiac rupture by analyzing Twinkle helicase overexpression mice (TW mice). Twinkle overexpression increased mtDNA copy number approximately twofold and ameliorated ischemic cardiomyopathy at day 28 after MI. Notably, Twinkle overexpression markedly prevented cardiac rupture and improved post-MI survival, accompanied by the suppression of MMP-2 and MMP-9 in the MI border area at day 5 after MI when cardiac rupture frequently occurs. Additionally, these cardioprotective effects of Twinkle overexpression were abolished in transgenic mice overexpressing mutant Twinkle with an in-frame duplication of amino acids 353-365, which resulted in no increases in mtDNA copy number. Furthermore, although apoptosis and oxidative stress were induced and mitochondria were damaged in the border area, these injuries were improved in TW mice. Further analysis revealed that mitochondrial biogenesis, including mtDNA copy number, transcription, and translation, was severely impaired in the border area at day 5 In contrast, Twinkle overexpression maintained mtDNA copy number and restored the impaired transcription and translation of mtDNA in the border area. These results demonstrated that Twinkle overexpression alleviated impaired mitochondrial biogenesis in the border area through maintained mtDNA copy number and thereby prevented cardiac rupture accompanied by the reduction of apoptosis and oxidative stress, and suppression of MMP activity. Copyright © 2016 the American Physiological Society.

  4. Brain-Heart Interaction: Cardiac Complications After Stroke.

    Science.gov (United States)

    Chen, Zhili; Venkat, Poornima; Seyfried, Don; Chopp, Michael; Yan, Tao; Chen, Jieli

    2017-08-04

    Neurocardiology is an emerging specialty that addresses the interaction between the brain and the heart, that is, the effects of cardiac injury on the brain and the effects of brain injury on the heart. This review article focuses on cardiac dysfunction in the setting of stroke such as ischemic stroke, brain hemorrhage, and subarachnoid hemorrhage. The majority of post-stroke deaths are attributed to neurological damage, and cardiovascular complications are the second leading cause of post-stroke mortality. Accumulating clinical and experimental evidence suggests a causal relationship between brain damage and heart dysfunction. Thus, it is important to determine whether cardiac dysfunction is triggered by stroke, is an unrelated complication, or is the underlying cause of stroke. Stroke-induced cardiac damage may lead to fatality or potentially lifelong cardiac problems (such as heart failure), or to mild and recoverable damage such as neurogenic stress cardiomyopathy and Takotsubo cardiomyopathy. The role of location and lateralization of brain lesions after stroke in brain-heart interaction; clinical biomarkers and manifestations of cardiac complications; and underlying mechanisms of brain-heart interaction after stroke, such as the hypothalamic-pituitary-adrenal axis; catecholamine surge; sympathetic and parasympathetic regulation; microvesicles; microRNAs; gut microbiome, immunoresponse, and systemic inflammation, are discussed. © 2017 American Heart Association, Inc.

  5. Sudden Cardiac Death

    DEFF Research Database (Denmark)

    Risgaard, Bjarke; Winkel, Bo Gregers; Jabbari, Reza

    2017-01-01

    Objectives This study sought to describe the use of pharmacotherapy in a nationwide cohort of young patients with sudden cardiac death (SCD). Background Several drugs have been associated with an increased risk of SCD and sudden arrhythmic death syndrome (SADS). It remains unclear how...... pharmacotherapy may contribute to the overall burden of SCD in the general population. Methods This was a nationwide study that included all deaths that occurred between 2000 and 2009 and between 2007 and 2009 in people age 1 to 35 years and 36 to 49 years, respectively. Two physicians identified all SCDs through...... review of death certificates. Autopsy reports were collected. Pharmacotherapy prescribed within 90 days before SCD was identified in the Danish Registry of Medicinal Product Statistics. Results We identified 1,363 SCDs; median age was 38 years (interquartile range: 29 to 45 years), and 72% (n = 975) were men...

  6. Cardiac potassium channel subtypes

    DEFF Research Database (Denmark)

    Schmitt, Nicole; Grunnet, Morten; Olesen, Søren-Peter

    2014-01-01

    About 10 distinct potassium channels in the heart are involved in shaping the action potential. Some of the K(+) channels are primarily responsible for early repolarization, whereas others drive late repolarization and still others are open throughout the cardiac cycle. Three main K(+) channels...... drive the late repolarization of the ventricle with some redundancy, and in atria this repolarization reserve is supplemented by the fairly atrial-specific KV1.5, Kir3, KCa, and K2P channels. The role of the latter two subtypes in atria is currently being clarified, and several findings indicate...... that they could constitute targets for new pharmacological treatment of atrial fibrillation. The interplay between the different K(+) channel subtypes in both atria and ventricle is dynamic, and a significant up- and downregulation occurs in disease states such as atrial fibrillation or heart failure...

  7. Scandinavian clinical practice guidelines for therapeutic hypothermia and post-resuscitation care after cardiac arrest

    DEFF Research Database (Denmark)

    Castrén, M; Silfvast, T; Rubertsson, S

    2009-01-01

    BACKGROUND AND AIM: Sudden cardiac arrest survivors suffer from ischaemic brain injury that may lead to poor neurological outcome and death. The reperfusion injury that occurs is associated with damaging biochemical reactions, which are suppressed by mild therapeutic hypothermia (MTH). In several...... of Anaesthesiology and Intensive Care Medicine (SSAI). METHODS: Relevant studies were identified after two consensus meetings of the SSAI Task Force on Therapeutic Hypothermia (SSAITFTH) and via literature search of the Cochrane Central Register of Controlled Trials and Medline. Evidence was assessed and consensus...

  8. Toll-like receptor 9 mediated responses in cardiac fibroblasts.

    Directory of Open Access Journals (Sweden)

    Ingrid Kristine Ohm

    Full Text Available Altered cardiac Toll-like receptor 9 (TLR9 signaling is important in several experimental cardiovascular disorders. These studies have predominantly focused on cardiac myocytes or the heart as a whole. Cardiac fibroblasts have recently been attributed increasing significance in mediating inflammatory signaling. However, putative TLR9-signaling through cardiac fibroblasts remains non-investigated. Thus, our aim was to explore TLR9-signaling in cardiac fibroblasts and investigate the consequence of such receptor activity on classical cardiac fibroblast cellular functions. Cultivated murine cardiac fibroblasts were stimulated with different TLR9 agonists (CpG A, B and C and assayed for the secretion of inflammatory cytokines (tumor necrosis factor α [TNFα], CXCL2 and interferon α/β. Expression of functional cardiac fibroblast TLR9 was proven as stimulation with CpG B and -C caused significant CXCL2 and TNFα-release. These responses were TLR9-specific as complete inhibition of receptor-stimulated responses was achieved by co-treatment with a TLR9-antagonist (ODN 2088 or chloroquine diphosphate. TLR9-stimulated responses were also found more potent in cardiac fibroblasts when compared with classical innate immune cells. Stimulation of cardiac fibroblasts TLR9 was also found to attenuate migration and proliferation, but did not influence myofibroblast differentiation in vitro. Finally, results from in vivo TLR9-stimulation with subsequent fractionation of specific cardiac cell-types (cardiac myocytes, CD45+ cells, CD31+ cells and cardiac fibroblast-enriched cell-fractions corroborated our in vitro data and provided evidence of differentiated cell-specific cardiac responses. Thus, we conclude that cardiac fibroblast may constitute a significant TLR9 responder cell within the myocardium and, further, that such receptor activity may impact important cardiac fibroblast cellular functions.

  9. Videodensitometry in rats with pulmonary damage due to microembolism

    Energy Technology Data Exchange (ETDEWEB)

    Wegenius, G.; Wegener, T.; Ruhn, G.; Saldeen, T.; Erikson, U.

    Serial pulmonary angiography with videodensitometry was performed in 18 rats with pulmonary damage caused by administration of a fibrinolysis inhibitor, tranexamic acid (200 mg/kg body weight injected intraperitoneally) and bovine thrombin (500 NIH/kg body weight injected into the right femoral vein). The mean transit time (MTT) was calculated from videodensitometry, the observed area of interest consisting of approximately one-third of the right lung, including both central and peripheral parts. The impact of the pulmonary damage was analysed by morphologic methods and correlated to MTT. Although a pressure rise presumably occurred in the pulmonary circulation, no change in MTT was found after induction of pulmonary damage, indicating opening of actual and potential anastomoses between pulmonary arterioles and venules to serve as by-pass portions and as a safety-valve mechanism for the capillary bed and the right heart, respectively. Another explanation to unchanged MTT may be opening of resting capillary beds. Two rats with very severe pulmonary damage showed prolonged MTT. These rats may have suffered from cardiac failure.

  10. Videodensitometry in rats with pulmonary damage due to microembolism

    International Nuclear Information System (INIS)

    Wegenius, G.; Wegener, T.; Ruhn, G.; Saldeen, T.; Erikson, U.

    1985-01-01

    Serial pulmonary angiography with videodensitometry was performed in 18 rats with pulmonary damage caused by administration of a fibrinolysis inhibitor, tranexamic acid (200 mg/kg body weight injected intraperitoneally) and bovine thrombin (500 NIH/kg body weight injected into the right femoral vein). The mean transit time (MTT) was calculated from videodensitometry, the observed area of interest consisting of approximately one-third of the right lung, including both central and peripheral parts. The impact of the pulmonary damage was analysed by morphologic methods and correlated to MTT. Although a pressure rise presumably occurred in the pulmonary circulation, no change in MTT was found after induction of pulmonary damage, indicating opening of actual and potential anastomoses between pulmonary arterioles and venules to serve as by-pass portions and as a safety-valve mechanism for the capillary bed and the right heart, respectively. Another explanation to unchanged MTT may be opening of resting capillary beds. Two rats with very severe pulmonary damage showed prolonged MTT. These rats may have suffered from cardiac failure. (orig.)

  11. Stimulating endogenous cardiac regeneration

    Directory of Open Access Journals (Sweden)

    Amanda eFinan

    2015-09-01

    Full Text Available The healthy adult heart has a low turnover of cardiac myocytes. The renewal capacity, however, is augmented after cardiac injury. Participants in cardiac regeneration include cardiac myocytes themselves, cardiac progenitor cells, and peripheral stem cells, particularly from the bone marrow compartment. Cardiac progenitor cells and bone marrow stem cells are augmented after cardiac injury, migrate to the myocardium, and support regeneration. Depletion studies of these populations have demonstrated their necessary role in cardiac repair. However, the potential of these cells to completely regenerate the heart is limited. Efforts are now being focused on ways to augment these natural pathways to improve cardiac healing, primarily after ischemic injury but in other cardiac pathologies as well. Cell and gene therapy or pharmacological interventions are proposed mechanisms. Cell therapy has demonstrated modest results and has passed into clinical trials. However, the beneficial effects of cell therapy have primarily been their ability to produce paracrine effects on the cardiac tissue and recruit endogenous stem cell populations as opposed to direct cardiac regeneration. Gene therapy efforts have focused on prolonging or reactivating natural signaling pathways. Positive results have been demonstrated to activate the endogenous stem cell populations and are currently being tested in clinical trials. A potential new avenue may be to refine pharmacological treatments that are currently in place in the clinic. Evidence is mounting that drugs such as statins or beta blockers may alter endogenous stem cell activity. Understanding the effects of these drugs on stem cell repair while keeping in mind their primary function may strike a balance in myocardial healing. To maximize endogenous cardiac regeneration,a combination of these approaches couldameliorate the overall repair process to incorporate the participation ofmultiple cell players.

  12. Radiation damage

    CERN Document Server

    Heijne, Erik H M; CERN. Geneva

    1998-01-01

    a) Radiation damage in organic materials. This series of lectures will give an overview of radiation effects on materials and components frequently used in accelerator engineering and experiments. Basic degradation phenomena will be presented for organic materials with comprehensive damage threshold doses for commonly used rubbers, thermoplastics, thermosets and composite materials. Some indications will be given for glass, scintillators and optical fibres. b) Radiation effects in semiconductor materials and devices. The major part of the time will be devoted to treat radiation effects in semiconductor sensors and the associated electronics, in particular displacement damage, interface and single event phenomena. Evaluation methods and practical aspects will be shown. Strategies will be developed for the survival of the materials under the expected environmental conditions of the LHC machine and detectors. I will describe profound revolution in our understanding of black holes and their relation to quantum me...

  13. {sup 123}I-MIBG imaging detects cardiac involvement and predicts cardiac events in Churg-Strauss syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Horiguchi, Yoriko; Morita, Yukiko [National Hospital Organization Sagamihara National Hospital, Department of Cardiology, Sagamihara City, Kanagawa (Japan); Tsurikisawa, Naomi; Akiyama, Kazuo [National Hospital Organization Sagamihara National Hospital, Clinical Research Centre for Allergy and Rheumatology, Sagamihara City, Kanagawa (Japan)

    2011-02-15

    In Churg-Strauss syndrome (CSS) it is important to detect cardiac involvement, which predicts poor prognosis. This study evaluated whether {sup 123}I-metaiodobenzylguanidine (MIBG) scintigraphy could detect cardiac damage and predict cardiac events in CSS. {sup 123}I-MIBG scintigraphy was performed in 28 patients with CSS, 12 of whom had cardiac involvement. The early and delayed heart to mediastinum ratio (early H/M and delayed H/M) and washout rate were calculated by using {sup 123}I-MIBG scintigraphy and compared with those in control subjects. Early H/M and delayed H/M were significantly lower and the washout rate was significantly higher in patients with cardiac involvement than in those without and in controls (early H/M, p = 0.0024, p = 0.0001; delayed H/M, p = 0.0002, p = 0.0001; washout rate, p = 0.0012, p = 0.0052 vs those without and vs controls, respectively). Accuracy for detecting cardiac involvement was 86% for delayed H/M and washout rate and 79% for early H/M and B-type natriuretic peptide (BNP). Kaplan-Meier analysis showed significantly lower cardiac event-free rates in patients with early H/M {<=} 2.18 and BNP > 21.8 pg/ml than those with early H/M > 2.18 and BNP {<=} 21.8 pg/ml (log-rank test p = 0.006). Cardiac sympathetic nerve function was damaged in CSS patients with cardiac involvement. {sup 123}I-MIBG scintigraphy was useful in detecting cardiac involvement and in predicting cardiac events. (orig.)

  14. 123I-MIBG imaging detects cardiac involvement and predicts cardiac events in Churg-Strauss syndrome

    International Nuclear Information System (INIS)

    Horiguchi, Yoriko; Morita, Yukiko; Tsurikisawa, Naomi; Akiyama, Kazuo

    2011-01-01

    In Churg-Strauss syndrome (CSS) it is important to detect cardiac involvement, which predicts poor prognosis. This study evaluated whether 123 I-metaiodobenzylguanidine (MIBG) scintigraphy could detect cardiac damage and predict cardiac events in CSS. 123 I-MIBG scintigraphy was performed in 28 patients with CSS, 12 of whom had cardiac involvement. The early and delayed heart to mediastinum ratio (early H/M and delayed H/M) and washout rate were calculated by using 123 I-MIBG scintigraphy and compared with those in control subjects. Early H/M and delayed H/M were significantly lower and the washout rate was significantly higher in patients with cardiac involvement than in those without and in controls (early H/M, p = 0.0024, p = 0.0001; delayed H/M, p = 0.0002, p = 0.0001; washout rate, p = 0.0012, p = 0.0052 vs those without and vs controls, respectively). Accuracy for detecting cardiac involvement was 86% for delayed H/M and washout rate and 79% for early H/M and B-type natriuretic peptide (BNP). Kaplan-Meier analysis showed significantly lower cardiac event-free rates in patients with early H/M ≤ 2.18 and BNP > 21.8 pg/ml than those with early H/M > 2.18 and BNP ≤ 21.8 pg/ml (log-rank test p = 0.006). Cardiac sympathetic nerve function was damaged in CSS patients with cardiac involvement. 123 I-MIBG scintigraphy was useful in detecting cardiac involvement and in predicting cardiac events. (orig.)

  15. Assessing quality in cardiac surgery

    Directory of Open Access Journals (Sweden)

    Samer A.M. Nashef

    2005-07-01

    Full Text Available There is a the strong temporal, if not causal, link between the intervention and the outcome in cardiac surgery and therefore a link becomes established between operative mortality and the measurement of surgical performance. In Britain the law stipulates that data collected by any public body or using public funds must be made freely available. Tools and mechanisms we devise and develop are likely to form the models on which the quality of care is assessed in other surgical and perhaps medical specialties. Measuring professional performance should be done by the profession. To measure risk there are a number of scores as crude mortality is not enough. A very important benefit of assessing the risk of death is to use this knowledge in the determination of the indication to operate. The second benefit is in the assessment of the quality of care as risk prediction gives a standard against performance of hospitals and surgeons. Peer review and “naming and shaming” are two mechanisms to monitor quality. There are two potentially damaging outcomes from the publication of results in a league-table form: the first is the damage to the hospital; the second is to refuse to operate on high-risk patients. There is a real need for quality monitoring in medicine in general and in cardiac surgery in particular. Good quality surgical work requires robust knowledge of three crucial variables: activity, risk prediction and performance. In Europe, the three major specialist societies have agreed to establish the European Cardiovascular and Thoracic Surgery Institute of Accreditation (ECTSIA. Performance monitoring is soon to become imperative. If we surgeons are not on board, we shall have no control on its final destination, and the consequences may be equally damaging to us and to our patients.

  16. Mathematical Models of Cardiac Pacemaking Function

    Science.gov (United States)

    Li, Pan; Lines, Glenn T.; Maleckar, Mary M.; Tveito, Aslak

    2013-10-01

    Over the past half century, there has been intense and fruitful interaction between experimental and computational investigations of cardiac function. This interaction has, for example, led to deep understanding of cardiac excitation-contraction coupling; how it works, as well as how it fails. However, many lines of inquiry remain unresolved, among them the initiation of each heartbeat. The sinoatrial node, a cluster of specialized pacemaking cells in the right atrium of the heart, spontaneously generates an electro-chemical wave that spreads through the atria and through the cardiac conduction system to the ventricles, initiating the contraction of cardiac muscle essential for pumping blood to the body. Despite the fundamental importance of this primary pacemaker, this process is still not fully understood, and ionic mechanisms underlying cardiac pacemaking function are currently under heated debate. Several mathematical models of sinoatrial node cell membrane electrophysiology have been constructed as based on different experimental data sets and hypotheses. As could be expected, these differing models offer diverse predictions about cardiac pacemaking activities. This paper aims to present the current state of debate over the origins of the pacemaking function of the sinoatrial node. Here, we will specifically review the state-of-the-art of cardiac pacemaker modeling, with a special emphasis on current discrepancies, limitations, and future challenges.

  17. Mathematical Models of Cardiac Pacemaking Function

    Directory of Open Access Journals (Sweden)

    Pan eLi

    2013-10-01

    Full Text Available Over the past half century, there has been intense and fruitful interaction between experimental and computational investigations of cardiac function. This interaction has, for example, led to deep understanding of cardiac excitation-contraction coupling; how it works, as well as how it fails. However, many lines of inquiry remain unresolved, among them the initiation of each heartbeat. The sinoatrial node, a cluster of specialized pacemaking cells in the right atrium of the heart, spontaneously generates an electro-chemical wave that spreads through the atria and through the cardiac conduction system to the ventricles, initiating the contraction of cardiac muscle essential for pumping blood to the body. Despite the fundamental importance of this primary pacemaker, this process is still not fully understood, and ionic mechanisms underlying cardiac pacemaking function are currently under heated debate. Several mathematical models of sinoatrial node cell membrane electrophysiology have been constructed as based on different experimental data sets and hypotheses. As could be expected, these differing models offer diverse predictions about cardiac pacemaking activities. This paper aims to present the current state of debate over the origins of the pacemaking function of the sinoatrial node. Here, we will specifically review the state-of-the-art of cardiac pacemaker modeling, with a special emphasis on current discrepancies, limitations, and future challenges.

  18. Tort Damages

    NARCIS (Netherlands)

    L.T. Visscher (Louis)

    2008-01-01

    textabstractAbstract: In this Chapter, I provide an overview of Law and Economics literature regarding tort damages. Where necessary, attention is also spent to rules of tort liability. Both types of rules provide behavioral incentives to both injurers and victims, with respect to their level of

  19. Marketing cardiac CT programs.

    Science.gov (United States)

    Scott, Jason

    2010-01-01

    There are two components of cardiac CT discussed in this article: coronary artery calcium scoring (CACS) and coronary computed tomography angiography (CCTA).The distinctive advantages of each CT examination are outlined. In order to ensure a successful cardiac CT program, it is imperative that imaging facilities market their cardiac CT practices effectively in order to gain a competitive advantage in this valuable market share. If patients receive quality care by competent individuals, they are more likely to recommend the facility's cardiac CT program. Satisfied patients will also be more willing to come back for any further testing.

  20. Mutations in calmodulin cause ventricular tachycardia and sudden cardiac death

    DEFF Research Database (Denmark)

    Nyegaard, Mette; Overgaard, Michael Toft; Sondergaard, M.T.

    2012-01-01

    a substantial part of sudden cardiac deaths in young individuals. Mutations in RYR2, encoding the cardiac sarcoplasmic calcium channel, have been identified as causative in approximately half of all dominantly inherited CPVT cases. Applying a genome-wide linkage analysis in a large Swedish family with a severe......Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a devastating inherited disorder characterized by episodic syncope and/or sudden cardiac arrest during exercise or acute emotion in individuals without structural cardiac abnormalities. Although rare, CPVT is suspected to cause...... calmodulin-binding-domain peptide at low calcium concentrations. We conclude that calmodulin mutations can cause severe cardiac arrhythmia and that the calmodulin genes are candidates for genetic screening of individual cases and families with idiopathic ventricular tachycardia and unexplained sudden cardiac...

  1. Remote Monitoring of the Heart Condition of Athletes by Measuring the Cardiac Action Potential Propagation Time Using a Wireless Sensor Network

    Directory of Open Access Journals (Sweden)

    Amang Sudarsono

    2016-04-01

    Full Text Available Highly performing athletes are susceptible to cardiac damage of several kinds which may be irreversible. The monitoring of heart rate and ECG waveforms from such subjects by wireless sensor networks has been reported in health and sports care documents. However, a more decisive parameter for instant to instant changes would be the time of Cardiac Action Potential Propagation. This time, which can be between 15-20 ms would shoot suddenly in acute stress in highly performing athletes for short durations. Repeated incidents of such rising values will tend to cause irreversible damage to the heart. We developed the technique of measuring this time and reporting it through a wireless sensor network to monitoring station.

  2. Cardiac sympathetic neuronal imaging using PET

    International Nuclear Information System (INIS)

    Lautamaeki, Riikka; Tipre, Dnyanesh; Bengel, Frank M.

    2007-01-01

    Balance of the autonomic nervous system is essential for adequate cardiac performance, and alterations seem to play a key role in the development and progression of various cardiac diseases. PET imaging of the cardiac autonomic nervous system has advanced extensively in recent years, and multiple pre- and postsynaptic tracers have been introduced. The high spatial and temporal resolution of PET enables noninvasive quantification of neurophysiologic processes at the tissue level. Ligands for catecholamine receptors, along with radiolabeled catecholamines and catecholamine analogs, have been applied to determine involvement of sympathetic dysinnervation at different stages of heart diseases such as ischemia, heart failure, and arrhythmia. This review summarizes the recent findings in neurocardiological PET imaging. Experimental studies with several radioligands and clinical findings in cardiac dysautonomias are discussed. (orig.)

  3. Cirugía de control de daños: alternativa quirúrgica eficaz para el trauma hepático grave Damage control surgery: efficacious surgical alternative for severe hepatic

    Directory of Open Access Journals (Sweden)

    Darwin Aníbal Iñaguazo Sánchez

    2007-06-01

    Full Text Available El trauma hepático se halla con mayor frecuencia en un individuo politraumatizado con alteraciones hemodinámicas y contusiones intraabdominales. Corresponden a lesiones penetrantes 80 % y 20 %, a trauma cerrado. Aproximadamente 3 % de estos pacientes acuden a los servicios de emergencias en shock hipovolémico grave. La mortalidad por trauma hepático ha disminuido considerablemente, lo que refleja no solo los avances en la atención médica prehospitalaria, sino también la adquisición de nuevas habilidades y técnicas quirúrgicas por parte de los cirujanos. La cirugía de control de daños es una alternativa quirúrgica que se utiliza actualmente en el paciente traumatizado grave. Presentamos una revisión actualizada de la literatura y hacemos énfasis en la actitud y los procedimientos quirúrgicos empleados en el manejo del trauma hepático grave, con descripción específica del taponamiento hepático (packing. El éxito de este tratamiento guarda relación con la decisión rápida y oportuna de su ejecución por el cirujano de traumaHepatic trauma is more frequently found in multitrauma individuals with hemodynamics disorders and abdominal contusions. It is present in 80% of penetrating injures and 20% of closed trauma. Approximately 3% of these patients are seen at emergency room services when they are in serious hypovolemic shock. Hepatic trauma mortality rate has substantially lowered, which shows not only the advances in pre-hospital medical care but also the learning of new abilities and surgical techniques by surgeons. Damage control surgery is a surgical choice that is being used at present to manage the severely traumatized patient. We presented an updated literature review, making emphasis on attitudes and surgical procedures in the management of severe hepatic trauma and giving a specific description of hepatic packing. The sucess of this treatment is linked to a quick and prompt decision by trauma surgeon to perform this

  4. Pre-transplantation specification of stem cells to cardiac lineage for regeneration of cardiac tissue.

    Science.gov (United States)

    Mayorga, Maritza; Finan, Amanda; Penn, Marc

    2009-03-01

    Myocardial infarction (MI) is a lead cause of mortality in the Western world. Treatment of acute MI is focused on restoration of antegrade flow which inhibits further tissue loss, but does not restore function to damaged tissue. Chronic therapy for injured myocardial tissue involves medical therapy that attempts to minimize pathologic remodeling of the heart. End stage therapy for chronic heart failure (CHF) involves inotropic therapy to increase surviving cardiac myocyte function or mechanical augmentation of cardiac performance. Not until the point of heart transplantation, a limited resource at best, does therapy focus on the fundamental problem of needing to replace injured tissue with new contractile tissue. In this setting, the potential for stem cell therapy has garnered significant interest for its potential to regenerate or create new contractile cardiac tissue. While to date adult stem cell therapy in clinical trials has suggested potential benefit, there is waning belief that the approaches used to date lead to regeneration of cardiac tissue. As the literature has better defined the pathways involved in cardiac differentiation, preclinical studies have suggested that stem cell pretreatment to direct stem cell differentiation prior to stem cell transplantation may be a more efficacious strategy for inducing cardiac regeneration. Here we review the available literature on pre-transplantation conditioning of stem cells in an attempt to better understand stem cell behavior and their readiness in cell-based therapy for myocardial regeneration.

  5. Resuscitation after prolonged cardiac arrest: role of cardiopulmonary bypass and systemic hyperkalemia.

    Science.gov (United States)

    Liakopoulos, Oliver J; Allen, Bradley S; Buckberg, Gerald D; Hristov, Nikola; Tan, Zhongtuo; Villablanca, J Pablo; Trummer, Georg

    2010-06-01

    The purpose of this study was to determine (1) the role of emergency cardiopulmonary bypass (CPB) after prolonged cardiac arrest and failed cardiopulmonary resuscitation, and (2) the use of systemic hyperkalemia during CPB to convert intractable ventricular fibrillation (VF). Thirty-one pigs (34 +/- 2 kg) underwent 15 minutes of cardiac arrest after induced VF, followed by 10 minutes of cardiopulmonary resuscitation-advanced life support. Peripheral CPB was used if cardiopulmonary resuscitation failed to restore stable circulation. Damage was assessed by evaluating hemodynamics, biochemical variables (creatine kinase-MB, neuron-specific enolase), neurologic deficit score, and brain magnetic resonance imaging. Cardiopulmonary resuscitation alone was successful in only 19% (6 of 31 pigs). Cardiopulmonary bypass was initiated in 81% of animals (25 of 31 pigs) either for hypotension (5 of 25 pigs) or intractable VF (20 of 25 pigs). Defibrillation was successful in 7 of 20 animals during the first 10 minutes after initiating CPB. Ventricular fibrillation persisted more than 10 minutes in 13 of 20 pigs, and animals were treated either with repeated defibrillation (6 of 13 pigs) or with a potassium bolus (7 of 13 pigs) to induce transient cardiac arrest. Overall survival at 24 hours was 84% with cardiopulmonary resuscitation (100% of pigs with hypotension; 71% in CPB-VF < 10 minutes). Despite CPB, fatal myocardial failure occurred after VF duration of more than 10 minutes in all pigs treated with electrical defibrillation, whereas hyperkalemia allowed 100% cardioversion and 86% survival. Biochemical variables remained elevated in all groups. Similarly, severe brain injury was present in all animals as confirmed by neurologic deficit score (197 +/- 10) and magnetic resonance imaging. Emergency CPB after prolonged cardiac arrest improves survival and allows systemic hyperkalemia to convert intractable VF, but fails to reduce neurologic damage. 2010 The Society of Thoracic

  6. The relationship between clinical stage, prognosis and myocardial damage in patients with Duchenne-type muscular dystrophy. Five-year follow-up study

    International Nuclear Information System (INIS)

    Naruse, Hitoshi; Miyagi, Junko; Arii, Tohru; Ohyanagi, Mitsumasa; Iwasaki, Tadaaki; Jinnai, Kenji

    2004-01-01

    The evaluation of myocardial damage by [ 123 I]15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid (BMIPP) imaging, which represents free fatty acid metabolism, has not been reported in patients with Duchenne-type muscular dystrophy (DMD). To date, the relationship between clinical stage, prognosis and myocardial damage has not been evaluated by radionuclear cardiac imaging. The main goal of this study was to elucidate the relationship of quantitative indices of myocardial damage obtained by radionuclear cardiac imaging ([ 201 Tl] and [ 123 I]BMIPP) to clinical stage and incidence of severe cardiac events in patients with Duchenne-type muscular dystrophy (DMD). The study population consisted of 28 male patients with DMD. The average age at the beginning of observation was 19.1±7.4 yrs. Nuclear tomographic imaging was performed using [ 201 Tl] and [ 123 I]BMIPP. The mid-ventricular short axial slices were classified into four anatomical regions, and the normalized count data in these areas (TL, BM) were obtained. The endpoint was the occurrence of heart failure during the follow up period. Thirteen cases of heart failure occurred during the 5-year follow-up period, including three cases with cardiac death due to congestive heart failure. Clinical staging correlated directly with TL (p=0.0118) and BM (p=0.0401) in the whole left ventricle. In regional TL analysis, an association was observed only in the septum (p=0.0151), and in the anterior (p=0.0361) region. The only discrepancy between the tracer parameters (TL-BM) in the septum was observed with the radionuclear cardiac values, which exhibited a relationship with cardiac events (p=0.0124). This discordance, TL 201 Tl] in this area was representative of the clinical stage, and TL-BM correlated well with the prognosis. (author)

  7. Clinical application of cardiac SPECT

    International Nuclear Information System (INIS)

    Nishimura, Shigeyuki

    1999-01-01

    Single-photon emission computed tomography (SPECT) has replaced planar imaging techniques for myocardial scintigraphy. Thallium-201 was the dominant agent employed for myocardial perfusion imaging. Today new technetium-99m labelled radionuclides have been used as excellent alternatives to 201 Tl for detection of coronary artery disease, prognostification, and even assessment of myocardial viability. Pharmacologic stress imaging using either dipyridamole, adenosine or dobutamine is a substitute for exercise stress. Accurate determination of myocardial viability is vitally important for clinical decision making for patients with LV dysfunction who will most benefit from revascularization. Stunned and hibernated myocardium may result in profound regional LTV dysfunction in absence of necrosis. The various approach such as stress-redistribution-reinjection imaging, rest-redistribution imaging and stress-redistribution-24 hours delayed imaging has been utilized to assess myocardial viability with 201 Tl. Quantitative assessment of 99m Tc MIBI uptake reflect the degree of viability. 123 I-Metaiodobenzylguanidine (MIBG), an analog of norepinephrine, has been used for scintigraphic assessment of regional cardiac adrenergic innervation. Cardiac sympathetic denervation, assessed by 123 I-MIBG, due to ischemia in non-Q myocardial infarction and unstable angina has been shown. Quantitative cardiac MIBG scintigram was shown to have prognostic value in patients with severe congestive heart failure. 23 I-BMIPP (ρ-methyl-iodophenyl pentadecanoic acid) has been used to assess myocardial fatty acid utilization. BMIPP has the memory function of ischemia in unstable angina, since decreased BMIPP uptake persists several days after ischemic episode. Nuclear cardiology in Japan has experienced an expansion in the techniques including use of new radionuclides, 99m Tc perfusion agents, 123 I-MIBG and 23 I-BMIPP and in associated clinical application to the various cardiac diseases

  8. Safety in cardiac surgery

    NARCIS (Netherlands)

    Siregar, S.

    2013-01-01

    The monitoring of safety in cardiac surgery is a complex process, which involves many clinical, practical, methodological and statistical issues. The objective of this thesis was to measure and to compare safety in cardiac surgery in The Netherlands using the Netherlands Association for

  9. Cardiac Catheterization (For Kids)

    Science.gov (United States)

    ... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body Works ... Educators Search English Español Cardiac Catheterization KidsHealth / For Kids / Cardiac Catheterization What's in this article? What Is ...

  10. Sudden cardiac death

    Directory of Open Access Journals (Sweden)

    Neeraj Parakh

    2015-01-01

    Full Text Available Sudden cardiac death is one of the most common cause of mortality worldwide. Despite significant advances in the medical science, there is little improvement in the sudden cardiac death related mortality. Coronary artery disease is the most common etiology behind sudden cardiac death, in the above 40 years population. Even in the apparently healthy population, there is a small percentage of patients dying from sudden cardiac death. Given the large denominator, this small percentage contributes to the largest burden of sudden cardiac death. Identification of this at risk group among the apparently healthy individual is a great challenge for the medical fraternity. This article looks into the causes and methods of preventing SCD and at some of the Indian data. Details of Brugada syndrome, Long QT syndrome, Genetics of SCD are discussed. Recent guidelines on many of these causes are summarised.

  11. CARDIAC LYMPHOMA IN DOG

    Directory of Open Access Journals (Sweden)

    G. D. Cruz

    2016-11-01

    Full Text Available Lymphoma is a lymphoid tumor that originates in hematopoietic organs such as lymph node, spleen or liver. In dogs, the overall prevalence of cardiac tumors was estimated to be only 0.19% based on the results of the survey of a large database, and lymphomas accounts for approximately 2% of all cardiac tumors. In general, the involvement of the myocardium is rarely described in canine lymphoma. Currently, there is no evidence of a viral association with primary cardiac lymphoma in dogs, but other types of immunosuppression may contribute to abnormal events, such as involvement primary cardiac. The aim of this study was to analyze a case of sudden death of a bitch, SRD, aged 10, who had the final diagnosis of cardiac lymphoma.

  12. Mathematical cardiac electrophysiology

    CERN Document Server

    Colli Franzone, Piero; Scacchi, Simone

    2014-01-01

    This book covers the main mathematical and numerical models in computational electrocardiology, ranging from microscopic membrane models of cardiac ionic channels to macroscopic bidomain, monodomain, eikonal models and cardiac source representations. These advanced multiscale and nonlinear models describe the cardiac bioelectrical activity from the cell level to the body surface and are employed in both the direct and inverse problems of electrocardiology. The book also covers advanced numerical techniques needed to efficiently carry out large-scale cardiac simulations, including time and space discretizations, decoupling and operator splitting techniques, parallel finite element solvers. These techniques are employed in 3D cardiac simulations illustrating the excitation mechanisms, the anisotropic effects on excitation and repolarization wavefronts, the morphology of electrograms in normal and pathological tissue and some reentry phenomena. The overall aim of the book is to present rigorously the mathematica...

  13. Biomaterials for cardiac regeneration

    CERN Document Server

    Ruel, Marc

    2015-01-01

    This book offers readers a comprehensive biomaterials-based approach to achieving clinically successful, functionally integrated vasculogenesis and myogenesis in the heart. Coverage is multidisciplinary, including the role of extracellular matrices in cardiac development, whole-heart tissue engineering, imaging the mechanisms and effects of biomaterial-based cardiac regeneration, and autologous bioengineered heart valves. Bringing current knowledge together into a single volume, this book provides a compendium to students and new researchers in the field and constitutes a platform to allow for future developments and collaborative approaches in biomaterials-based regenerative medicine, even beyond cardiac applications. This book also: Provides a valuable overview of the engineering of biomaterials for cardiac regeneration, including coverage of combined biomaterials and stem cells, as well as extracellular matrices Presents readers with multidisciplinary coverage of biomaterials for cardiac repair, including ...

  14. Acquired valvar disease and cardiac tumours

    International Nuclear Information System (INIS)

    Ruttley, M.

    1985-01-01

    Investigation must determine the severity of the valve fault or faults, the effect on cardiac function and the significance of any associated cardiac disease in order that surgical referral can be made when appropriate with knowledge of operative risk and prognosis; radiology plays an important part in this. Radiological features will depend on the valve or valves affected, the type and severity of the haemodynamic disturbance and its time scale of development and duration. They may be modified by embolism or infection and there may be specific radiological manifestations of the underlying disease

  15. Evaluation of potential severe accidents during low power and shutdown operations at Surry, Unit 1: Analysis of core damage frequency from internal floods during mid-loop operations. Volume 4

    International Nuclear Information System (INIS)

    Kohut, P.

    1994-07-01

    The major objective of the Surry internal flood analysis was to provide an improved understanding of the core damage scenarios arising from internal flood-related events. The mean core damage frequency of the Surry plant due to internal flood events during mid-loop operations is 4.8E-06 per year, and the 5th and 95th percentiles are 2.2E-07 and 1.8E-05 per year, respectively. Some limited sensitivity calculations were performed on three plant improvement options. The most significant result involves modifications of intake-level structure on the canal, which reduced core damage frequency contribution from floods in mid-loop by about 75%

  16. Diabetic cardiac autonomic dysfunction. Parasympathetic versus sympathetic

    International Nuclear Information System (INIS)

    Uehara, Akihiko; Kurata, Chinori; Sugi, Toshihiko; Mikami, Tadashi; Shouda, Sakae

    1999-01-01

    Diabetic cardiac autonomic dysfunction often causes lethal arrhythmia and sudden cardiac death. 123 I-Metaiodobenzylguanidine (MIBG) can evaluate cardiac sympathetic dysfunction, and analysis of heart rate variability (HRV) can reflect cardiac parasympathetic activity. We examined whether cardiac parasympathetic dysfunction assessed by HRV may correlate with sympathetic dysfunction assessed by MIBG in diabetic patients. In 24-hour electrocardiography, we analyzed 4 HRV parameters: high-frequency power (HF), HF in the early morning (EMHF), rMSSD and pNN50. MIBG planar images and SPECT were obtained 15 minutes (early) and 150 minutes (late) after injection and the heart washout rate was calculated. The defect score in 9 left ventricular regions was scored on a 4 point scale (0=normal - 3=severe defect). In 20 selected diabetic patients without congestive heart failure, coronary artery disease and renal failure, parasympathetic HRV parameters had a negative correlation with the sum of defect scores (DS) in the late images (R=-0.47 to -0.59, p<0.05) and some parameters had a negative correlation with the washout rate (R=-0.50 to -0.55, p<0.05). In a total of 64 diabetic patients also, these parameters had a negative correlation with late DS (R=-0.28 to -0.35, p<0.05) and early DS (R=-0.27 to -0.32, p<0.05). The progress of diabetic cardiac parasympathetic dysfunction may parallel the sympathetic one. (author)

  17. Regulation of cardiac expression of the diabetic marker microRNA miR-29.

    Directory of Open Access Journals (Sweden)

    Nicholas Arnold

    Full Text Available Diabetes mellitus (DM is an independent risk factor for heart disease and its underlying mechanisms are unclear. Increased expression of diabetic marker miR-29 family miRNAs (miR-29a, b and c that suppress the pro-survival protein Myeloid Cell Leukemia 1(MCL-1 is reported in pancreatic β-cells in Type 1 DM. Whether an up-regulation of miR-29 family miRNAs and suppression of MCL-1 (dysregulation of miR-29-MCL-1 axis occurs in diabetic heart is not known. This study tested the hypothesis that insulin regulates cardiac miR-29-MCL-1 axis and its dysregulation correlates with DM progression. In vitro studies with mouse cardiomyocyte HL-1 cells showed that insulin suppressed the expression of miR-29a, b and c and increased MCL-1 mRNA. Conversely, Rapamycin (Rap, a drug implicated in the new onset DM, increased the expression of miR-29a, b and c and suppressed MCL-1 and this effect was reversed by transfection with miR-29 inhibitors. Rap inhibited mammalian target of rapamycin complex 1 (mTORC1 signaling in HL-1 cells. Moreover, inhibition of either mTORC1 substrate S6K1 by PF-4708671, or eIF4E-induced translation by 4E1RCat suppressed MCL-1. We used Zucker diabetic fatty (ZDF rat, a rodent model for DM, to test whether dysregulation of cardiac miR-29-MCL-1 axis correlates with DM progression. 11-week old ZDF rats exhibited significantly increased body weight, plasma glucose, insulin, cholesterol, triglycerides, body fat, heart weight, and decreased lean muscle mass compared to age-matched lean rats. Rap treatment (1.2 mg/kg/day, from 9-weeks to 15-weeks significantly reduced plasma insulin, body weight and heart weight, and severely dysregulated cardiac miR-29-MCL1 axis in ZDF rats. Importantly, dysregulation of cardiac miR-29-MCL-1 axis in ZDF rat heart correlated with cardiac structural damage (disorganization or loss of myofibril bundles. We conclude that insulin and mTORC1 regulate cardiac miR-29-MCL-1 axis and its dysregulation caused by reduced

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

    Science.gov (United States)

    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.

  19. Developmental origin and lineage plasticity of endogenous cardiac stem cells

    Science.gov (United States)

    Santini, Maria Paola; Forte, Elvira; Harvey, Richard P.; Kovacic, Jason C.

    2016-01-01

    Over the past two decades, several populations of cardiac stem cells have been described in the adult mammalian heart. For the most part, however, their lineage origins and in vivo functions remain largely unexplored. This Review summarizes what is known about different populations of embryonic and adult cardiac stem cells, including KIT+, PDGFRα+, ISL1+ and SCA1+ cells, side population cells, cardiospheres and epicardial cells. We discuss their developmental origins and defining characteristics, and consider their possible contribution to heart organogenesis and regeneration. We also summarize the origin and plasticity of cardiac fibroblasts and circulating endothelial progenitor cells, and consider what role these cells have in contributing to cardiac repair. PMID:27095490

  20. Baseline cardiac troponin t levels are elevated in subjects with untreated diabetes mellitus

    DEFF Research Database (Denmark)

    Pareek, M; Nielsen, M L; Leósdóttir, M

    2015-01-01

    Objective: Cardiac troponins are biomarkers of myocardial injury and serve both diagnostic and prognostic purposes. Even mild elevations represent subclinical myocardial damage in the general population. The objective of this study was to investigate the relationship between glucometabolic status...

  1. Serum cardiac troponin I in acute stroke is related to serum cortisol and TNF-alpha

    DEFF Research Database (Denmark)

    Christensen, Hanne Krarup; Johannesen, Helle Hjorth; Christensen, Anders Fogh

    2004-01-01

    Serum cardiac troponin I (cTnI) is a specific marker of myocardial injury related to in-patient fatality and cardiac injury in acute stroke. We investigated whether cTnI in acute stroke is related to serum cortisol, acute inflammatory response, and insular damage. We also investigated whether c...

  2. QTc-prolonging drugs and hospitalizations for cardiac arrhythmias

    NARCIS (Netherlands)

    De Bruin, ML; Hoes, AW; Leufkens, HGM

    2003-01-01

    Cardiac arrhythmia as an adverse effect of noncardiac drugs has been an issue of growing importance during the past few years. In this population-based study, we evaluated the risk for serious cardiac arrhythmias during the use of several noncardiac QTc-prolonging drugs in day-to-day practice, and

  3. Evaluation of potential severe accidents during low power and shutdown operations at Grand Gulf, Unit 1: Analysis of core damage frequency from internally induced flooding events for Plant Operational State 5 during a refueling outage. Volume 4

    International Nuclear Information System (INIS)

    Dandini, V.; Staple, B.; Kirk, H.; Whitehead, D.; Forester, J.

    1994-07-01

    An estimate of the contribution of internal flooding to the mean core damage frequency at the Grand Gulf Nuclear Station was calculated for Plant Operational State 5 during a refueling outage. Pursuant to this objective, flood zones and sources were identified and flood volumes were calculated. Equipment necessary for the maintenance of plant safety was identified and its vulnerability to flooding was determined. Event trees and fault trees were modified or developed as required, and PRA quantification was performed using the IRRAS code. The mean core damage frequency estimate for GGNS during POS 5 was found to be 2.3 E-8 per year

  4. [Cardiac rehabilitation: current status and future challenges].

    Science.gov (United States)

    Hahmann, H W

    2012-02-01

    The goal of cardiac rehabilitation is to support heart patients using a multidisciplinary team in order to obtain the best possible physical and mental health and achieve long-term social reintegration. In addition to improving physical fitness, cardiac rehabilitation restores self-confidence, thus better equipping patients to deal with mental illness and improving their social reintegration ("participation"). Once the causes of disease have been identified and treated as effectively as possible, drug and lifestyle changes form the focus of cardiac rehabilitation measures. In particular diseases, rehabilitation offers the opportunity for targeted educational courses for diabetics or drug dose escalation, as well as special training for heart failure patients. A nationwide network of outpatient heart groups is available for targeted follow-up. Cardiac patients predominantly rehabilitated in follow-up rehabilitation are older and have greater morbidity than in the past; moreover, they generally come out of acute clinical care earlier and are discharged from hospital more quickly. The proportion of severely ill and multimorbid patients presents a diagnostic and therapeutic challenge in cardiac rehabilitation, although cardiac rehabilitation was not initially conceived for this patient group. The benefit of cardiac rehabilitation has been a well documented reduction in morbidity and mortality. However, hurdles remain, partly due to the patients themselves, partly due to the health insurers. Some insurance providers still refuse rehabilitation for non-ST-segment elevation infarction. In principle rehabilitation can be carried out in an inpatient or an outpatient setting. Specific allocation criteria have not yet been established, but the structure and process quality of outpatient rehabilitation should correspond to that of the inpatient setting. The choice between the two settings should be based on pragmatic criteria. Both settings should be possible for an individual

  5. Severe accident phenomena

    International Nuclear Information System (INIS)

    Jokiniemi, J.; Kilpi, K.; Lindholm, I.; Maekynen, J.; Pekkarinen, E.; Sairanen, R.; Silde, A.

    1995-02-01

    Severe accidents are nuclear reactor accidents in which the reactor core is substantially damaged. The report describes severe reactor accident phenomena and their significance for the safety of nuclear power plants. A comprehensive set of phenomena ranging from accident initiation to containment behaviour and containment integrity questions are covered. The report is based on expertise gained in the severe accident assessment projects conducted at the Technical Research Centre of Finland (VTT). (49 refs., 32 figs., 12 tabs.)

  6. Cardiac rhabdomyoma associated with tuberosclerosis complex in a newborn

    Directory of Open Access Journals (Sweden)

    Birgin Torer

    2016-03-01

    Full Text Available Cardiac rhabdomyomas are the most comman cardiac tumors in children. They are hamartomatous benign tumors composed of myocytes. They often presents as multiple lesions involving the ventricular cavities. Rhabdomyomas are usually detected in utero by fetal echocardiography. Although patients with cardiac rhabdomyomas are generally asymptomatic these tumors may cause heart failure, severe arrhyhmias and sudden death. Cardiac rhabdomyomas are often associated with tuberosclerosis and they may be the earliest manifestation of tuberosclerosis. Here, we report a newborn infant with antenatally detected cardiac rhabdomyomas associated with tuberosclerosis and we want to emphasize that other diagnostic features of tuberosclerosis should be evaluated in patients with cardiac rhabdomyomas. [Cukurova Med J 2016; 41(0.100: 56-59

  7. Disruption of Ah Receptor Signaling during Mouse Development Leads to Abnormal Cardiac Structure and Function in the Adult.

    Directory of Open Access Journals (Sweden)

    Vinicius S Carreira

    Full Text Available The Developmental Origins of Health and Disease (DOHaD Theory proposes that the environment encountered during fetal life and infancy permanently shapes tissue physiology and homeostasis such that damage resulting from maternal stress, poor nutrition or exposure to environmental agents may be at the heart of adult onset disease. Interference with endogenous developmental functions of the aryl hydrocarbon receptor (AHR, either by gene ablation or by exposure in utero to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD, a potent AHR ligand, causes structural, molecular and functional cardiac abnormalities and altered heart physiology in mouse embryos. To test if embryonic effects progress into an adult phenotype, we investigated whether Ahr ablation or TCDD exposure in utero resulted in cardiac abnormalities in adult mice long after removal of the agent. Ten-months old adult Ahr-/- and in utero TCDD-exposed Ahr+/+ mice showed sexually dimorphic abnormal cardiovascular phenotypes characterized by echocardiographic findings of hypertrophy, ventricular dilation and increased heart weight, resting heart rate and systolic and mean blood pressure, and decreased exercise tolerance. Underlying these effects, genes in signaling networks related to cardiac hypertrophy and mitochondrial function were differentially expressed. Cardiac dysfunction in mouse embryos resulting from AHR signaling disruption seems to progress into abnormal cardiac structure and function that predispose adults to cardiac disease, but while embryonic dysfunction is equally robust in males and females, the adult abnormalities are more prevalent in females, with the highest severity in Ahr-/- females. The findings reported here underscore the conclusion that AHR signaling in the developing heart is one potential target of environmental factors associated with cardiovascular disease.

  8. Cardiac output during exercise

    DEFF Research Database (Denmark)

    Siebenmann, C; Rasmussen, P.; Sørensen, H.

    2015-01-01

    Several techniques assessing cardiac output (Q) during exercise are available. The extent to which the measurements obtained from each respective technique compares to one another, however, is unclear. We quantified Q simultaneously using four methods: the Fick method with blood obtained from...... the right atrium (Q(Fick-M)), Innocor (inert gas rebreathing; Q(Inn)), Physioflow (impedance cardiography; Q(Phys)), and Nexfin (pulse contour analysis; Q(Pulse)) in 12 male subjects during incremental cycling exercise to exhaustion in normoxia and hypoxia (FiO2  = 12%). While all four methods reported...... a progressive increase in Q with exercise intensity, the slopes of the Q/oxygen uptake (VO2) relationship differed by up to 50% between methods in both normoxia [4.9 ± 0.3, 3.9 ± 0.2, 6.0 ± 0.4, 4.8 ± 0.2 L/min per L/min (mean ± SE) for Q(Fick-M), Q(Inn), QP hys and Q(Pulse), respectively; P = 0...

  9. Extracorporeal life support in pediatric cardiac patients

    Directory of Open Access Journals (Sweden)

    Matteo Di NARDO

    2016-10-01

    Full Text Available Extracorporeal Life Support (ECLS is a valuable tool in the management of neonates and older children with severe cardiac or respiratory failure. In this review, we focus on ECLS when used for neonatal and pediatric cardiac disease. Strict selection of patients and timely deployment are necessary to optimize outcomes. Although every attempt should be made to deploy ECLS urgently rather than emergently, extracorporeal cardiopulmonary resuscitation (ECPR is being increasingly used and reasonable survival rates have been achieved after initiation of ECLS during active compressions of the chest following in-hospital cardiac arrest. Contraindications to ECLS are falling over time, although lethal chromosomal abnormalities, severe irreversible brain injury, and extremely low gestational age and weight (<32 weeks gestation or <1.5 kg remain firm contraindications.

  10. Cardiac-specific overexpression of aldehyde dehydrogenase 2 exacerbates cardiac remodeling in response to pressure overload

    Directory of Open Access Journals (Sweden)

    Sujith Dassanayaka

    2018-07-01

    Full Text Available Pathological cardiac remodeling during heart failure is associated with higher levels of lipid peroxidation products and lower abundance of several aldehyde detoxification enzymes, including aldehyde dehydrogenase 2 (ALDH2. An emerging idea that could explain these findings concerns the role of electrophilic species in redox signaling, which may be important for adaptive responses to stress or injury. The purpose of this study was to determine whether genetically increasing ALDH2 activity affects pressure overload-induced cardiac dysfunction. Mice subjected to transverse aortic constriction (TAC for 12 weeks developed myocardial hypertrophy and cardiac dysfunction, which were associated with diminished ALDH2 expression and activity. Cardiac-specific expression of the human ALDH2 gene in mice augmented myocardial ALDH2 activity but did not improve cardiac function in response to pressure overload. After 12 weeks of TAC, ALDH2 transgenic mice had larger hearts than their wild-type littermates and lower capillary density. These findings show that overexpression of ALDH2 augments the hypertrophic response to pressure overload and imply that downregulation of ALDH2 may be an adaptive response to certain forms of cardiac pathology. Keywords: Heart failure, Hypertrophy, Oxidative stress, Aldehydes, Cardiac remodeling, Hormesis

  11. Comprehensive cardiac rehabilitation

    DEFF Research Database (Denmark)

    Kruse, Marie; Hochstrasser, Stefan; Zwisler, Ann-Dorthe O

    2006-01-01

    OBJECTIVES: The costs of comprehensive cardiac rehabilitation are established and compared to the corresponding costs of usual care. The effect on health-related quality of life is analyzed. METHODS: An unprecedented and very detailed cost assessment was carried out, as no guidelines existed...... and may be as high as euro 1.877. CONCLUSIONS: Comprehensive cardiac rehabilitation is more costly than usual care, and the higher costs are not outweighed by a quality of life gain. Comprehensive cardiac rehabilitation is, therefore, not cost-effective....

  12. Dual energy cardiac CT.

    Science.gov (United States)

    Carrascosa, Patricia; Deviggiano, Alejandro; Rodriguez-Granillo, Gastón

    2017-06-01

    Conventional single energy CT suffers from technical limitations related to the polychromatic nature of X-rays. Dual energy cardiac CT (DECT) shows promise to attenuate and even overcome some of these limitations, and might broaden the scope of patients eligible for cardiac CT towards the inclusion of higher risk patients. This might be achieved as a result of both safety (contrast reduction) and physiopathological (myocardial perfusion and characterization) issues. In this article, we will review the main clinical cardiac applications of DECT, that can be summarized in two core aspects: coronary artery evaluation, and myocardial evaluation.

  13. Cardiac Response to Chronic Intermittent Hypoxia with a Transition from Adaptation to Maladaptation: The Role of Hydrogen Peroxide

    Directory of Open Access Journals (Sweden)

    Xia Yin

    2012-01-01

    Full Text Available Obstructive sleep apnea (OSA is a highly prevalent respiratory disorder of sleep, and associated with chronic intermittent hypoxia (CIH. Experimental evidence indicates that CIH is a unique physiological state with potentially “adaptive” and “maladaptive” consequences for cardio-respiratory homeostasis. CIH is also a critical element accounting for most of cardiovascular complications of OSA. Cardiac response to CIH is time-dependent, showing a transition from cardiac compensative (such as hypertrophy to decompensating changes (such as failure. CIH-provoked mild and transient oxidative stress can induce adaptation, but severe and persistent oxidative stress may provoke maladaptation. Hydrogen peroxide as one of major reactive oxygen species plays an important role in the transition of adaptive to maladaptive response to OSA-associated CIH. This may account for the fact that although oxidative stress has been recognized as a driver of cardiac disease progression, clinical interventions with antioxidants have had little or no impact on heart disease and progression. Here we focus on the role of hydrogen peroxide in CIH and OSA, trying to outline the potential of antioxidative therapy in preventing CIH-induced cardiac damage.

  14. Impact of metabolic, hemodynamic and inflammatory factors on target organ damage in healthy subjects

    DEFF Research Database (Denmark)

    Blicher, M.; Kruger, R.; Olesen, Thomas Bastholm

    2015-01-01

    Objective: We wanted to test the impact of metabolic, hemodynamic and inflammatory factors on target organ damage (TOD) defined as cardiac hypertrophy, atherosclerosis, arterioclerosis and microvascular damage. Design and method: In a population based cohort study of 2115 healthy subjects (1049...... associated to hypertrophy, arteriosclerosis and microvascular damage in healthy subjects....

  15. Irradiation damage

    Energy Technology Data Exchange (ETDEWEB)

    Howe, L.M

    2000-07-01

    There is considerable interest in irradiation effects in intermetallic compounds from both the applied and fundamental aspects. Initially, this interest was associated mainly with nuclear reactor programs but it now extends to the fields of ion-beam modification of metals, behaviour of amorphous materials, ion-beam processing of electronic materials, and ion-beam simulations of various kinds. The field of irradiation damage in intermetallic compounds is rapidly expanding, and no attempt will be made in this chapter to cover all of the various aspects. Instead, attention will be focused on some specific areas and, hopefully, through these, some insight will be given into the physical processes involved, the present state of our knowledge, and the challenge of obtaining more comprehensive understanding in the future. The specific areas that will be covered are: point defects in intermetallic compounds; irradiation-enhanced ordering and irradiation-induced disordering of ordered alloys; irradiation-induced amorphization.

  16. Irradiation damage

    International Nuclear Information System (INIS)

    Howe, L.M.

    2000-01-01

    There is considerable interest in irradiation effects in intermetallic compounds from both the applied and fundamental aspects. Initially, this interest was associated mainly with nuclear reactor programs but it now extends to the fields of ion-beam modification of metals, behaviour of amorphous materials, ion-beam processing of electronic materials, and ion-beam simulations of various kinds. The field of irradiation damage in intermetallic compounds is rapidly expanding, and no attempt will be made in this chapter to cover all of the various aspects. Instead, attention will be focused on some specific areas and, hopefully, through these, some insight will be given into the physical processes involved, the present state of our knowledge, and the challenge of obtaining more comprehensive understanding in the future. The specific areas that will be covered are: point defects in intermetallic compounds; irradiation-enhanced ordering and irradiation-induced disordering of ordered alloys; irradiation-induced amorphization

  17. [Cardiac safety of electroconvulsive therapy in an elderly patient--a case report].

    Science.gov (United States)

    Karakuła-Juchnowicz, Hanna; Próchnicki, Michał; Kiciński, Paweł; Olajossy, Marcin; Pelczarska-Jamroga, Agnieszka; Dzikowski, Michał; Jaroszyński, Andrzej

    2015-10-01

    Since electroconvulsive therapy (ECT) was introduced as treatment for psychiatric disorders in 1938, it has remained one of the most effective therapeutic methods. ECT is often used as a "treatment of last resort" when other methods fail, and a life-saving procedure in acute clinical states when a rapid therapeutic effect is needed. Mortality associated with ECT is lower, compared to the treatment with tricyclic antidepressants, and comparable to that observed in so-called minor surgery. In the literature, cases of effective and safe electroconvulsive therapy have been described in patients of advanced age, with a burden of many somatic disorders. However, cases of acute cardiac episodes have also been reported during ECT. The qualification of patients for ECT and the selection of a group of patients at the highest risk of cardiovascular complications remains a serious clinical problem. An assessment of the predictive value of parameters of standard electrocardiogram (ECG), which is a simple, cheap and easily available procedure, deserves special attention. This paper reports a case of a 74-year-old male patient treated with ECT for a severe depressive episode, in the context of cardiologic safety. Both every single ECT session and the full course were assessed to examine their impact on levels of troponin T, which is a basic marker of cardiac damage, and selected ECG parameters (QTc, QRS). In the presented case ECT demonstrated its high general and cardiac safety with no negative effect on cardiac troponin (TnT) levels, corrected QT interval (QTc) duration, or other measured ECG parameters despite initially increased troponin levels, the patient's advanced age, the burden of a severe somatic disease and its treatment (anticancer therapy). © 2015 MEDPRESS.

  18. Antimyosin imaging in cardiac transplant rejection

    International Nuclear Information System (INIS)

    Johnson, L.L.; Cannon, P.J.

    1991-01-01

    Fab fragments of antibodies specific for cardiac myosin have been labeled with indium-111 and injected intravenously into animals and into patients with heart transplants. The antibodies, developed by Khaw, Haber, and co-workers, localize in cardiac myocytes that have been damaged irreversibly by ischemia, myocarditis, or the rejection process. After clearance of the labeled antibody from the cardiac blood pool, planar imaging or single photon emission computed tomography is performed. Scintigrams reveal the uptake of the labeled antimyosin in areas of myocardium undergoing transplant rejection. In animal studies, the degree of antimyosin uptake appears to correlate significantly with the degree of rejection assessed at necropsy. In patients, the correlation between scans and pathologic findings from endomyocardial biopsy is not as good, possibly because of sampling error in the endomyocardial biopsy technique. The scan results at 1 year correlate with either late complications (positive) or benign course (negative). Current limitations of the method include slow blood clearance, long half-life of indium-111, and hepatic uptake. Overcoming these limitations represents a direction for current research. It is possible that from these efforts a noninvasive approach to the diagnosis and evaluation of cardiac transplantation may evolve that will decrease the number of endomyocardial biopsies required to evaluate rejection. This would be particularly useful in infants and children. 31 references

  19. Cardiac Catheterization (For Parents)

    Science.gov (United States)

    ... cases, the doctor might call for a cardiac magnetic resonance imaging (MRI) scan or a CAT scan . ... first couple of days. This means no heavy lifting (more than 10 pounds) and no sports. After ...

  20. Cardiac Catheterization (For Teens)

    Science.gov (United States)

    ... doctor may also call for a cardiac MRI (magnetic resonance imaging) scan or a CT (computerized tomography) ... first couple of days. This means no heavy lifting (nothing over 10 pounds) and no sports. After ...

  1. [Anomalous origin of the left coronary artery from the pulmonary trunk with myocardial infarction and severe left ventricular dysfunction in infancy--assessment of myocardial damage using SPECT studies with 201TlCl and 123I-BMIPP].

    Science.gov (United States)

    Miyamoto, T; Horigome, H; Sato, H; Yamada, M; Inai, K; Takeda, T; Ishikawa, N; Hoshino, H; Itai, Y

    1996-02-01

    A 4-month-old male infant with Bland-White-Garland (BWG) syndrome complicated myocardial infarction was reported. Signs included tachypnea, coughing, and failure to thrive. However, there was no sign of myocardial infarction. A chest radiograph revealed cardiomegaly (CTR = 65%) and electrocardiogram showed abnormal Q waves in I, aVL, V6 leads. Cardiac catheterization and angiography revealed marked dilatation of left ventricle (end-diastolic volume = 384 ml/m2) and extremely depressed ejection fraction (16%), confirming the diagnosis of BWG syndrome. A 201TlCl-myocardial SPECT demonstrated apical defect and hypoperfusion in the anterolateral, inferoposterior walls, whereas 123I-beta-methyl-p-iodophenylpentadecanoic-acid (123I-BMIPP) SPECT showed a wider defect area. SPECT studies with 201TlCl and 123I-BMIPP, are useful to assess myocardial viability more accurately in BWG syndrome.

  2. Autonomic cardiac innervation

    Science.gov (United States)

    Hasan, Wohaib

    2013-01-01

    Autonomic cardiac neurons have a common origin in the neural crest but undergo distinct developmental differentiation as they mature toward their adult phenotype. Progenitor cells respond to repulsive cues during migration, followed by differentiation cues from paracrine sources that promote neurochemistry and differentiation. When autonomic axons start to innervate cardiac tissue, neurotrophic factors from vascular tissue are essential for maintenance of neurons before they reach their targets, upon which target-derived trophic factors take over final maturation, synaptic strength and postnatal survival. Although target-derived neurotrophins have a central role to play in development, alternative sources of neurotrophins may also modulate innervation. Both developing and adult sympathetic neurons express proNGF, and adult parasympathetic cardiac ganglion neurons also synthesize and release NGF. The physiological function of these “non-classical” cardiac sources of neurotrophins remains to be determined, especially in relation to autocrine/paracrine sustenance during development.   Cardiac autonomic nerves are closely spatially associated in cardiac plexuses, ganglia and pacemaker regions and so are sensitive to release of neurotransmitter, neuropeptides and trophic factors from adjacent nerves. As such, in many cardiac pathologies, it is an imbalance within the two arms of the autonomic system that is critical for disease progression. Although this crosstalk between sympathetic and parasympathetic nerves has been well established for adult nerves, it is unclear whether a degree of paracrine regulation occurs across the autonomic limbs during development. Aberrant nerve remodeling is a common occurrence in many adult cardiovascular pathologies, and the mechanisms regulating outgrowth or denervation are disparate. However, autonomic neurons display considerable plasticity in this regard with neurotrophins and inflammatory cytokines having a central regulatory

  3. Cardiac imaging in adults

    International Nuclear Information System (INIS)

    Jaffe, C.C.

    1987-01-01

    This book approaches adult cardiac disease from the correlative imaging perspective. It includes chest X-rays and angiographs, 2-dimensional echocardiograms with explanatory diagrams for clarity, plus details on digital radiology, nuclear medicine techniques, CT and MRI. It also covers the normal heart, valvular heart disease, myocardial disease, pericardial disease, bacterial endocarditis, aortic aneurysm, cardiac tumors, and congenital heart disease of the adult. It points out those aspects where one imaging technique has significant superiority

  4. Cardiac imaging in adults

    Energy Technology Data Exchange (ETDEWEB)

    Jaffe, C.C.

    1987-01-01

    This book approaches adult cardiac disease from the correlative imaging perspective. It includes chest X-rays and angiographs, 2-dimensional echocardiograms with explanatory diagrams for clarity, plus details on digital radiology, nuclear medicine techniques, CT and MRI. It also covers the normal heart, valvular heart disease, myocardial disease, pericardial disease, bacterial endocarditis, aortic aneurysm, cardiac tumors, and congenital heart disease of the adult. It points out those aspects where one imaging technique has significant superiority.

  5. Awareness in cardiac anesthesia.

    LENUS (Irish Health Repository)

    Serfontein, Leon

    2010-02-01

    Cardiac surgery represents a sub-group of patients at significantly increased risk of intraoperative awareness. Relatively few recent publications have targeted the topic of awareness in this group. The aim of this review is to identify areas of awareness research that may equally be extrapolated to cardiac anesthesia in the attempt to increase understanding of the nature and significance of this scenario and how to reduce it.

  6. Effects of Caloric Restriction on Cardiac Oxidative Stress and Mitochondrial Bioenergetics: Potential Role of Cardiac Sirtuins

    Directory of Open Access Journals (Sweden)

    Ken Shinmura

    2013-01-01

    Full Text Available The biology of aging has not been fully clarified, but the free radical theory of aging is one of the strongest aging theories proposed to date. The free radical theory has been expanded to the oxidative stress theory, in which mitochondria play a central role in the development of the aging process because of their critical roles in bioenergetics, oxidant production, and regulation of cell death. A decline in cardiac mitochondrial function associated with the accumulation of oxidative damage might be responsible, at least in part, for the decline in cardiac performance with age. In contrast, lifelong caloric restriction can attenuate functional decline with age, delay the onset of morbidity, and extend lifespan in various species. The effect of caloric restriction appears to be related to a reduction in cellular damage induced by reactive oxygen species. There is increasing evidence that sirtuins play an essential role in the reduction of mitochondrial oxidative stress during caloric restriction. We speculate that cardiac sirtuins attenuate the accumulation of oxidative damage associated with age by modifying specific mitochondrial proteins posttranscriptionally. Therefore, the distinct role of each sirtuin in the heart subjected to caloric restriction should be clarified to translate sirtuin biology into clinical practice.

  7. Cardiac involvement in patients with Becker muscular dystrophy: new diagnostic and pathophysiological insights by a CMR approach

    Directory of Open Access Journals (Sweden)

    Thiene Gaetano

    2008-11-01

    Full Text Available Abstract Background Becker-Kiener muscular dystrophy (BMD represents an X-linked genetic disease associated with myocardial involvement potentially resulting in dilated cardiomyopathy (DCM. Early diagnosis of cardiac involvement may permit earlier institution of heart failure treatment and extend life span in these patients. Both echocardiography and nuclear imaging methods are capable of detecting later stages of cardiac involvement characterised by wall motion abnormalities. Cardiovascular magnetic resonance (CMR has the potential to detect cardiac involvement by depicting early scar formation that may appear before onset of wall motion abnormalities. Methods In a prospective two-center-study, 15 male patients with BMD (median age 37 years; range 11 years to 56 years underwent comprehensive neurological and cardiac evaluations including physical examination, echocardiography and CMR. A 16-segment model was applied for evaluation of regional wall motion abnormalities (rWMA. The CMR study included late gadolinium enhancement (LGE imaging with quantification of myocardial damage. Results Abnormal echocardiographic results were found in eight of 15 (53.3% patients with all of them demonstrating reduced left ventricular ejection fraction (LVEF and rWMA. CMR revealed abnormal findings in 12 of 15 (80.0% patients (p = 0.04 with 10 (66.6% having reduced LVEF (p = 0.16 and 9 (64.3% demonstrating rWMA (p = 0.38. Myocardial damage as assessed by LGE-imaging was detected in 11 of 15 (73.3% patients with a median myocardial damage extent of 13.0% (range 0 to 38.0%, an age-related increase and a typical subepicardial distribution pattern in the inferolateral wall. Ten patients (66.7% were in need of medical heart failure therapy based on CMR results. However, only 4 patients (26.7% were already taking medication based on clinical criteria (p = 0.009. Conclusion Cardiac involvement in patients with BMD is underdiagnosed by echocardiographic methods resulting

  8. Evaluation of potential severe accidents during low power and shutdown operations at Grand Gulf, Unit 1: Analysis of core damage frequency from internal fire events for Plant Operational State 5 during a refueling outage. Volume 3

    International Nuclear Information System (INIS)

    Lambright, J.; Yakle, J.

    1994-07-01

    This report, Volume 3, presents the details of the analysis of core damage frequency due to fire during shutdown Plant Operational State 5 at the Grand Gulf Nuclear Station. Insights from previous fire analyses (Peach Bottom, Surry, LaSalle) were used to the greatest extent possible in this analysis. The fire analysis was fully integrated utilizing the same event trees and fault trees that were used in the internal events analysis. In assessing shutdown risk due to fire at Grand Gulf, a detailed screening was performed which included the following elements: (a) Computer-aided vital area analysis; (b) Plant inspections; (c) Credit for automatic fire protection systems; (d) Recovery of random failures; (e) Detailed fire propagation modeling. This screening process revealed that all plant areas had a negligible (<1.0E-8 per year) contribution to fire-induced core damage frequency

  9. Imaging in blunt cardiac injury: Computed tomographic findings in cardiac contusion and associated injuries.

    Science.gov (United States)

    Hammer, Mark M; Raptis, Demetrios A; Cummings, Kristopher W; Mellnick, Vincent M; Bhalla, Sanjeev; Schuerer, Douglas J; Raptis, Constantine A

    2016-05-01

    Blunt cardiac injury (BCI) may manifest as cardiac contusion or, more rarely, as pericardial or myocardial rupture. Computed tomography (CT) is performed in the vast majority of blunt trauma patients, but the imaging features of cardiac contusion are not well described. To evaluate CT findings and associated injuries in patients with clinically diagnosed BCI. We identified 42 patients with blunt cardiac injury from our institution's electronic medical record. Clinical parameters, echocardiography results, and laboratory tests were recorded. Two blinded reviewers analyzed chest CTs performed in these patients for myocardial hypoenhancement and associated injuries. CT findings of severe thoracic trauma are commonly present in patients with severe BCI; 82% of patients with ECG, cardiac enzyme, and echocardiographic evidence of BCI had abnormalities of the heart or pericardium on CT; 73% had anterior rib fractures, and 64% had pulmonary contusions. Sternal fractures were only seen in 36% of such patients. However, myocardial hypoenhancement on CT is poorly sensitive for those patients with cardiac contusion: 0% of right ventricular contusions and 22% of left ventricular contusions seen on echocardiography were identified on CT. CT signs of severe thoracic trauma are frequently present in patients with severe BCI and should be regarded as indirect evidence of potential BCI. Direct CT findings of myocardial contusion, i.e. myocardial hypoenhancement, are poorly sensitive and should not be used as a screening tool. However, some left ventricular contusions can be seen on CT, and these patients could undergo echocardiography or cardiac MRI to evaluate for wall motion abnormalities. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Cardiac pacemaker battery discharge after external electrical cardioversion for broad QRS Complex Tachycardia.

    Science.gov (United States)

    Annamaria, Martino; Andrea, Scapigliati; Michela, Casella; Tommaso, Sanna; Gemma, Pelargonio; Antonio, Dello Russo; Roberto, Zamparelli; Stefano, De Paulis; Fulvio, Bellocci; Rocco, Schiavello

    2008-08-01

    External electrical cardioversion or defibrillation may be necessary in patients with implanted cardiac pacemaker (PM) or implantable cardioverter defibrillator (ICD). Sudden discharge of high electrical energy employed in direct current (DC) transthoracic countershock may damage the PM/ICD system resulting in a series of possible device malfunctions. For this reason, when defibrillation or cardioversion must be attempted in a patient with a PM or ICD, some precautions should be taken, particularly in PM dependent patients, in order to prevent damage to the device. We report the case of a 76-year-old woman with a dual chamber PM implanted in the right subclavicular region, who received two consecutive transthoracic DC shocks to treat haemodynamically unstable broad QRS complex tachycardia after cardiac surgery performed with a standard sternotomic approach. Because of the sternal wound and thoracic drainage tubes together with the severe clinical compromise, the anterior paddle was positioned near the pulse generator. At the following PM test, a complete battery discharge was detected.

  11. Diving bradycardia: a mechanism of defence against hypoxic damage.

    Science.gov (United States)

    Alboni, Paolo; Alboni, Marco; Gianfranchi, Lorella

    2011-06-01

    A feature of all air-breathing vertebrates, diving bradycardia is triggered by apnoea and accentuated by immersion of the face or whole body in cold water. Very little is known about the afferents of diving bradycardia, whereas the efferent part of the reflex circuit is constituted by the cardiac vagal fibres. Diving bradycardia is associated with vasoconstriction of selected vascular beds and a reduction in cardiac output. The diving response appears to be more pronounced in mammals than in birds. In humans, the bradycardic response to diving varies greatly from person to person; the reduction in heart rate generally ranges from 15 to 40%, but a small proportion of healthy individuals can develop bradycardia below 20 beats/min. During prolonged dives, bradycardia becomes more pronounced because of activation of the peripheral chemoreceptors by a reduction in the arterial partial pressure of oxygen (O2), responsible for slowing of heart rate. The vasoconstriction is associated with a redistribution of the blood flow, which saves O2 for the O2-sensitive organs, such as the heart and brain. The results of several investigations carried out both in animals and in humans show that the diving response has an O2-conserving effect, both during exercise and at rest, thus lengthening the time to the onset of serious hypoxic damage. The diving response can therefore be regarded as an important defence mechanism for the organism.

  12. [Cardiac myopathy due to overt hypothyroidism].

    Science.gov (United States)

    Harbeck, B; Berndt, M J; Lehnert, H

    2014-03-01

    A 51-year-old man presented with progressive tiredness, proximal muscle weakness, hair loss and weight gain for months. The patient showed mild pretibial myxedema and dry skin. Laboratory findings revealed strongly elevated cardiac enzymes as well as marked hypothyroidism. The electrocardiogram, echocardiography, abdominal sonography and chest X-ray were unremarkable. Thyroid ultrasound demonstrated features of Hashimoto thyroiditis. The findings supported the diagnosis of an overt hypothyroidism with myxedema and rhabdomyolysis. After starting levothyroxine and volume substitution laboratory parameters and clinical condition slowly normalized. Severe overt hypothyroidism may rarely present primarily as myopathy with myositis and cardiac involvement. © Georg Thieme Verlag KG Stuttgart · New York.

  13. Damaged Skylab

    Science.gov (United States)

    1973-01-01

    The Saturn V vehicle, carrying the unmarned orbital workshop for the Skylab-1 mission, lifted off successfully and all systems performed normally. Sixty-three seconds into the flight, engineers in the operation support and control center saw an unexpected telemetry indication that signalled that damages occurred on one solar array and the micrometeoroid shield during the launch. The micrometeoroid shield, a thin protective cylinder surrounding the workshop protecting it from tiny space particles and the sun's scorching heat, ripped loose from its position around the workshop. This caused the loss of one solar wing and jammed the other. Still unoccupied, the Skylab was stricken with the loss of the heat shield and sunlight beat mercilessly on the lab's sensitive skin. Internal temperatures soared, rendering the station uninhabitable, threatening foods, medicines, films, and experiments. This image, taken during a fly-around inspection by the Skylab-2 crew, shows a crippled Skylab in orbit. The crew found their home in space to be in serious shape; the heat shield gone, one solar wing gone, and the other jammed. The Marshall Space Flight Center (MSFC) developed, tested, rehearsed, and approved three repair options. These options included a parasol sunshade and a twin-pole sunshade to restore the temperature inside the workshop, and a set of metal cutting tools to free the jammed solar panel.

  14. Structural damage

    International Nuclear Information System (INIS)

    Gray, R.E.; Bruhn, R.W.

    1992-01-01

    Virtually all structures show some signs of distress due to deterioration of the building components, to changed loads, or to changed support conditions. Changed support conditions result from ground movements. In mining regions many cases of structural distress are attributed to mining without considering alternative causes. This is particularly true of coal mining since it occurs under extensive areas. Coal mining is estimated to have already undermined more than eight million acres and may eventually undermine 40 million acres in the United States. Other nonmetal and metal underground mines impact much smaller areas. Although it is sometimes difficult, even with careful study, to identify the actual cause of damage, persons responsible for underground coal mining should at least be aware of possible causes of building stress other than mine subsidence. This paper presents information on distress to structures and briefly reviews a number of causes of ground movements other than subsidence: Mass movements, dissolution, erosion, frost action, shrinking and swelling, yield into excavations and compressibility

  15. Radiation damage prediction system using damage function

    International Nuclear Information System (INIS)

    Tanaka, Yoshihisa; Mori, Seiji

    1979-01-01

    The irradiation damage analysis system using a damage function was investigated. This irradiation damage analysis system consists of the following three processes, the unfolding of a damage function, the calculation of the neutron flux spectrum of the object of damage analysis and the estimation of irradiation effect of the object of damage analysis. The damage function is calculated by applying the SAND-2 code. The ANISN and DOT3, 5 codes are used to calculate neutron flux. The neutron radiation and the allowable time of reactor operation can be estimated based on these calculations of the damage function and neutron flux. The flow diagram of the process of analyzing irradiation damage by a damage function and the flow diagram of SAND-2 code are presented, and the analytical code for estimating damage, which is determined with a damage function and a neutron spectrum, is explained. The application of the irradiation damage analysis system using a damage function was carried out to the core support structure of a fast breeder reactor for the damage estimation and the uncertainty evaluation. The fundamental analytical conditions and the analytical model for this work are presented, then the irradiation data for SUS304, the initial estimated values of a damage function, the error analysis for a damage function and the analytical results are explained concerning the computation of a damage function for 10% total elongation. Concerning the damage estimation of FBR core support structure, the standard and lower limiting values of damage, the permissible neutron flux and the allowable years of reactor operation are presented and were evaluated. (Nakai, Y.)

  16. Anthracycline-induced cardiomyopathy: favourable effects of cardiac resynchronization therapy

    DEFF Research Database (Denmark)

    Ahlehoff, Ole; Galløe, Anders M; Hansen, Peter R

    2010-01-01

    We report a case of severe refractory congestive heart failure after anthracycline chemotherapy in a patient with a narrow QRS interval on the electrocardiogram and echocardiographic evidence of left ventricular dyssynchrony, where cardiac resynchronization therapy resulted in normalization of left...

  17. Clinical skills: cardiac rhythm recognition and monitoring.

    Science.gov (United States)

    Sharman, Joanna

    With technological advances, changes in provision of healthcare services and increasing pressure on critical care services, ward patients' severity of illness is ever increasing. As such, nurses need to develop their skills and knowledge to care for their client group. Competency in cardiac rhythm monitoring is beneficial to identify changes in cardiac status, assess response to treatment, diagnosis and post-surgical monitoring. This paper describes the basic anatomy and physiology of the heart and its conduction system, and explains a simple and easy to remember process of analysing cardiac rhythms (Resuscitation Council UK, 2000) that can be used in first-line assessment to assist healthcare practitioners in providing care to their patients.

  18. Hemodilution, kidney dysfunction and cardiac surgery

    Directory of Open Access Journals (Sweden)

    Fabio Papa Taniguchi

    2009-03-01

    Full Text Available Hemodilution has been used in cardiac surgery to reduce blood viscosity and peripheral vascular resistance, decrease the need for blood transfusions, attenuate the risk of transfusions and diminish systemic inflammatory response syndrome and hospital costs. The lowest hematocrit level during cardiopulmonary bypass has been stated as 20%. However, severe hemodilution in cardiopulmonary bypass for patients undergoing cardiac surgery has been recognized as a risk factor for hospital deaths and reduced long-term survival. The introduction of normothermia restarted the debate about the lowest acceptable hematocrit during cardiopulmonary bypass. The objective of this review is to evaluate hemodilution during cardiac surgery as a risk factor for the development of post-operative acute renal failure.

  19. Succinct history of Greek cardiac surgery.

    Science.gov (United States)

    Apostolakis, Efstratios; Koletsis, Efstratios; Dougenis, Dimitrios

    2008-01-01

    The development and evolution of Greek Cardiac Surgery (GCS) has followed the international cardiothoracic surgery after the invention of cardiopulmonary bypass machine by John Gibbon in 1953. Chronologically, the development of GCS could be divided in four periods: (a) the first or essay period (1950-1960) characterized by the lack of organization, the experimentation and hesitation from the surgeons' side, and the reluctance from the patients' side to have an operation in Greece. (b) The second or stabilization period (1960-1970) is the period during which several separate cardiovascular departments were organized and performed the first valve replacement in 1964. (c) The third or "strengthening" period (1970-1985), during which Greek surgeons were trained abroad and adopted new methods and techniques of surgical therapy. The first operations of coronary artery bypass grafting and aortic aneurysm were performed (1973-1975). Various purely Cardiothoracic Centers were founded in Athens and Thessalonica and cardiac surgery became a routine operation. However, these centers were numerically not enough to cover the demand of patients in need of cardiac surgery. (d) The fourth or maturity period (1985 till today). It is characterized by the creation of private cardiac surgery departments and the gradual establishment of new university centers at the periphery, which along with the Onassis Cardiac Center, eliminated any need for patients to leave the country.

  20. Biomarkers for cardiac cachexia: reality or utopia.

    Science.gov (United States)

    Martins, Telma; Vitorino, Rui; Amado, Francisco; Duarte, José Alberto; Ferreira, Rita

    2014-09-25

    Cardiac cachexia is a serious complication of chronic heart failure, characterized by significant weight loss and body wasting. Chronic heart failure-related muscle wasting results from a chronic imbalance in the activation of anabolic or catabolic pathways, caused by a series of immunological, metabolic, and neurohormonal processes. In spite of the high morbidity and mortality associated to this condition, there is no universally accepted definition or specific biomarkers for cardiac cachexia, which makes its diagnosis and treatment difficult. Several hormonal, inflammatory and oxidative stress molecules have been proposed as serological markers of prognosis in cardiac cachexia but with doubtful success. As individual biomarkers may have limited sensitivity and specificity, multimarker strategies involving mediators of the biological processes modulated by cardiac cachexia will strongly contribute for the diagnosis and management of the disease, as well as for the establishment of new therapeutic targets. An integrated analysis of the biomarkers proposed so far for cardiac cachexia is made in the present review, highlighting the biological processes to which they are related. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. Progress study of the cardiac damage in Duchenne muscular dystrophy

    Directory of Open Access Journals (Sweden)

    ZHANG Yao

    2013-05-01

    Full Text Available Duchenne muscular dystrophy (DMD is a fatal muscular disease with rapid progression in children. Most patients die of respiratory and circulatory failure before the age of 20 if there is no systematic treatment. Now the heart problem in this disease has become increasingly prominent, and is thought to be closely associated with certain dystrophin exon deletion. We would like to review the epidemiology, relevance of dystrophin, pathogenesis, clinical manifestations and pathological features, as well as early prevention and treatment of DMD.

  2. Neutron induced radiation damage

    International Nuclear Information System (INIS)

    Williams, M.M.R.

    1977-01-01

    We derive a general expression for the number of displaced atoms of type j caused by a primary knock-on of type i. The Kinchin-Pease model is used, but considerably generalised to allow for realistic atomic potentials. Two cases are considered in detail: the single particle problem causing a cascade and the neutron initiated problem which leads to multiple subcascades. Numerical results have been obtained for a variety of scattering laws. An important conclusion is that neutron initiated damage is much more severe than atom-initiated damage and leads to the number of displaced atoms being a factor of (A+1) 2 /4A larger than the single primary knock-on theory predicts. A is the ratio of the atomic mass to the neutron mass. The importance of this result to the theory of neutron sputtering is explained. (orig.) [de

  3. Evaluation of potential severe accidents during low power and shutdown operations at Grand Gulf, Unit 1. Volume 5: Analysis of core damage frequency from seismic events for plant operational state 5 during a refueling outage

    International Nuclear Information System (INIS)

    Budnitz, R.J.; Davis, P.R.; Ravindra, M.K.; Tong, W.H.

    1994-08-01

    In 1989 the US Nuclear Regulatory Commission (NRC) initiated an extensive program to examine carefully the potential risks during low-power and shutdown operations. The program included two parallel projects, one at Sandia National Laboratories studying a boiling water reactor (Grand Gulf), and the other at Brookhaven National Laboratory studying a pressurized water reactor (Surry Unit 1). Both the Sandia and Brookhaven projects have examined only accidents initiated by internal plant faults---so-called ''internal initiators.'' This project, which has explored the likelihood of seismic-initiated core damage accidents during refueling outage conditions, is complementary to the internal-initiator analyses at Brookhaven and Sandia. This report covers the seismic analysis at Grand Gulf. All of the many systems modeling assumptions, component non-seismic failure rates, and human effort rates that were used in the internal-initiator study at Grand Gulf have been adopted here, so that the results of the study can be as comparable as possible. Both the Sandia study and this study examine only one shutdown plant operating state (POS) at Grand Gulf, namely POS 5 representing cold shutdown during a refueling outage. This analysis has been limited to work analogous to a level-1 seismic PRA, in which estimates have been developed for the core-damage frequency from seismic events during POS 5. The results of the analysis are that the core-damage frequency for earthquake-initiated accidents during refueling outages in POS 5 is found to be quite low in absolute terms, less than 10 -7 /year

  4. Evaluation of potential severe accidents during low power and shutdown operations at Surry, Unit 1. Volume 5: Analysis of core damage frequency from seismic events during mid-loop operations

    International Nuclear Information System (INIS)

    Budnitz, R.J.; Davis, P.R.; Ravindra, M.K.; Tong, W.H.

    1994-08-01

    In 1989 the US Nuclear Regulatory Commission (NRC) initiated an extensive program to examine carefully the potential risks during low-power and shutdown operations. The program included two parallel projects, one at Brookhaven National Laboratory studying a pressurized water reactor (Surry Unit 1) and the other at Sandia National Laboratories studying a boiling water reactor (Grand Gulf). Both the Brookhaven and Sandia projects have examined only accidents initiated by internal plant faults--so-called ''internal initiators.'' This project, which has explored the likelihood of seismic-initiated core damage accidents during refueling shutdown conditions, is complementary to the internal-initiator analyses at Brookhaven and Sandia. This report covers the seismic analysis at Surry Unit 1. All of the many systems modeling assumptions, component non-seismic failure rates, and human error rates that were used in the internal-initiator study at Surry have been adopted here, so that the results of the two studies can be as comparable as possible. Both the Brookhaven study and this study examine only two shutdown plant operating states (POSs) during refueling outages at Surry, called POS 6 and POS 10, which represent mid-loop operation before and after refueling, respectively. This analysis has been limited to work analogous to a level-1 seismic PRA, in which estimates have been developed for the core-damage frequency from seismic events during POSs 6 and 10. The results of the analysis are that the core-damage frequency of earthquake-initiated accidents during refueling outages in POS 6 and POS 10 is found to be low in absolute terms, less than 10 -6 /year

  5. Evaluation of potential severe accidents during low power and shutdown operations at Grand Gulf, Unit 1. Analysis of core damage frequency from internal events for plant operational state 5 during a refueling outage. Internal events appendices K to M

    International Nuclear Information System (INIS)

    Forester, J.; Yakle, J.; Walsh, B.; Darby, J.; Whitehead, D.; Staple, B.; Brown, T.

    1994-07-01

    This report provides supporting documentation for various tasks associated with the performance of the probabilistic risk assessment for Plant Operational State 5 (approximately Cold Shutdown as defined by Grand Gulf Technical Specifications) during a refueling outage at Grand Gulf, Unit 1 as documented in Volume 2, Part 1 of NUREG/CR-6143. The report contains the following appendices: K - HEP Locator Files; L - Supporting Information for the Plant Damage State Analysis; M - Summary of Results from the Coarse Screening Analysis - Phase 1A

  6. Cardiac radiology: centenary review.

    Science.gov (United States)

    de Roos, Albert; Higgins, Charles B

    2014-11-01

    During the past century, cardiac imaging technologies have revolutionized the diagnosis and treatment of acquired and congenital heart disease. Many important contributions to the field of cardiac imaging were initially reported in Radiology. The field developed from the early stages of cardiac imaging, including the use of coronary x-ray angiography and roentgen kymography, to nowadays the widely used echocardiographic, nuclear medicine, cardiac computed tomographic (CT), and magnetic resonance (MR) applications. It is surprising how many of these techniques were not recognized for their potential during their early inception. Some techniques were described in the literature but required many years to enter the clinical arena and presently continue to expand in terms of clinical application. The application of various CT and MR contrast agents for the diagnosis of myocardial ischemia is a case in point, as the utility of contrast agents continues to expand the noninvasive characterization of myocardium. The history of cardiac imaging has included a continuous process of advances in our understanding of the anatomy and physiology of the cardiovascular system, along with advances in imaging technology that continue to the present day.

  7. Engineered Biomaterials to Enhance Stem Cell-Based Cardiac Tissue Engineering and Therapy.

    Science.gov (United States)

    Hasan, Anwarul; Waters, Renae; Roula, Boustany; Dana, Rahbani; Yara, Seif; Alexandre, Toubia; Paul, Arghya

    2016-07-01

    Cardiovascular disease is a leading cause of death worldwide. Since adult cardiac cells are limited in their proliferation, cardiac tissue with dead or damaged cardiac cells downstream of the occluded vessel does not regenerate after myocardial infarction. The cardiac tissue is then replaced with nonfunctional fibrotic scar tissue rather than new cardiac cells, which leaves the heart weak. The limited proliferation ability of host cardiac cells has motivated investigators to research the potential cardiac regenerative ability of stem cells. Considerable progress has been made in this endeavor. However, the optimum type of stem cells along with the most suitable matrix-material and cellular microenvironmental cues are yet to be identified or agreed upon. This review presents an overview of various types of biofunctional materials and biomaterial matrices, which in combination with stem cells, have shown promises for cardiac tissue replacement and reinforcement. Engineered biomaterials also have applications in cardiac tissue engineering, in which tissue constructs are developed in vitro by combining stem cells and biomaterial scaffolds for drug screening or eventual implantation. This review highlights the benefits of using biomaterials in conjunction with stem cells to repair damaged myocardium and give a brief description of the properties of these biomaterials that make them such valuable tools to the field. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  8. UCP3 Ablation Exacerbates High-Salt Induced Cardiac Hypertrophy and Cardiac Dysfunction

    Directory of Open Access Journals (Sweden)

    Hongmei Lang

    2018-04-01

    Full Text Available Background/Aims: Excessive salt intake and left ventricular hypertrophy (LVH are both critical for the development of hypertension and heart failure. The uncoupling protein 3 (UCP3 plays a cardio-protective role in early heart failure development. However, the potential role for UCP3 in salt intake and LVH is unclear. Methods: UCP3-/- and C57BL/6 mice were placed on either a normal-salt (NS, 0.5% or a high-salt (HS, 8% diet for 24 weeks. The cardiac function, endurance capacity, energy expenditure, and mitochondrial functional capacity were measured in each group. Results: Elevated blood pressure was only observed in HS-fed UCP3-/- mice. High salt induced cardiac hypertrophy and dysfunction were observed in both C57BL/6 and UCP3-/- mice. However, the cardiac lesions were more profound in HS-fed UCP3-/- mice. Furthermore, HS-fed UCP3-/-mice experienced more severe mitochondrial respiratory dysfunction compared with HS-fed C57BL/6 mice, represented by the decreased volume of oxygen consumption and heat production at the whole-body level. Conclusion: UCP3 protein was involved in the incidence of high-salt induced hypertension and the progression of cardiac dysfunction in the early stages of heart failure. UCP3 ablation exacerbated high-salt-induced cardiac hypertrophy and cardiac dysfunction.

  9. Isolated Cardiac Hydatid Cyst

    International Nuclear Information System (INIS)

    Shakil, U.; Rehman, A. U.; Shahid, R.

    2015-01-01

    Hydatid cyst disease is common in our part of the world. Cardiac hydatid cyst is its rare manifestation. We report this case of 48-year male having isolated cardiac hydatid cyst, incidentally found on computed tomography. This patient presented in medical OPD of Combined Military Hospital, Lahore with one month history of mild retrosternal discomfort. His general physical and systemic examinations as well as ECG were unremarkable. Chest X-ray showed an enlarged cardiac shadow with mildly irregular left heart border. Contrast enhanced CT scan of the chest showed a large well defined multiloculated non-enhancing cystic lesion with multiple daughter cysts involving wall of left ventricle and overlying pericardium. Serology for echinococcus confirmed the diagnosis of hydatid cyst. Patient was offered the surgical treatment but he opted for medical treatment only. Albendezol was prescribed. His follow-up echocardiography after one month showed no significant decrease in size of the cyst. (author)

  10. Pediatric cardiac postoperative care

    Directory of Open Access Journals (Sweden)

    Auler Jr. José Otávio Costa

    2002-01-01

    Full Text Available The Heart Institute of the University of São Paulo, Medical School is a referral center for the treatment of congenital heart diseases of neonates and infants. In the recent years, the excellent surgical results obtained in our institution may be in part due to modern anesthetic care and to postoperative care based on well-structured protocols. The purpose of this article is to review unique aspects of neonate cardiovascular physiology, the impact of extracorporeal circulation on postoperative evolution, and the prescription for pharmacological support of acute cardiac dysfunction based on our cardiac unit protocols. The main causes of low cardiac output after surgical correction of heart congenital disease are reviewed, and methods of treatment and support are proposed as derived from the relevant literature and our protocols.

  11. Risk of nuclear damage

    International Nuclear Information System (INIS)

    Kienzl, K.

    1997-01-01

    , the Act on Third party Liability for Damages from Nuclear Incidents of the year 1964 being the most important piece of legislation. She underlined that the Austrian nuclear liability law does in no way come up to the potential damage inherent to nuclear installations. This could be simply illustrated by the fact that in the event of a nuclear incident liability is limited to ATS 500 million and operators of nuclear installations are granted generous privileges limiting their liability, such as establishing a maximum amount of liability coverage even in the case of damage arising from gross negligence, or limited liability to provide compensation for any personal injury or any loss of, or damage to, property. The Austrian liability law does not consider the potential danger originating from foreign nuclear installations and hence does not cover damage resulting therefrom. As a response to the Chernobyl disaster the Standing Committee on Nuclear Liability of the IAEO has since 1989 been trying to improve compensation for victims from nuclear incidents as laid down in existing nuclear liability conventions. As a consequence, the Vienna Convention was revised to include a guaranteed liability coverage of 150 million SDRs (US $ 216 million). Another outcome of the negotiations was the Supplementary Funding Convention under which - in addition to the insurance coverage - per nuclear incident the Installation state has to ensure the availability of 300 million SDRs, the Contracting Parties are to make available another 300 million SDR on the basis of joint and several liability, half of the amount being earmarked for compensation of transboundary damage. (author)

  12. [Cardiac involvement in Churg-Strauss syndrome].

    Science.gov (United States)

    Brucato, Antonio; Maestroni, Silvia; Masciocco, Gabriella; Ammirati, Enrico; Bonacina, Edgardo; Pedrotti, Patrizia

    2015-09-01

    agents, particularly cyclophosphamide in case of myocardial inflammation. Thus, early diagnosis of cardiac involvement and subsequent therapy may prevent progression of cardiac disease. At present, the role of troponin and brain natriuretic peptide in monitoring and therapy remains unclear. Orthotopic heart transplantation is feasible in case of severe disease, even if the experience is limited in -EGPA, and optimal post-transplantation immunosuppressive strategy has yet to be defined.

  13. Roles of PDE1 in Pathological Cardiac Remodeling and Dysfunction.

    Science.gov (United States)

    Chen, Si; Knight, Walter E; Yan, Chen

    2018-04-23

    Pathological cardiac hypertrophy and dysfunction is a response to various stress stimuli and can result in reduced cardiac output and heart failure. Cyclic nucleotide signaling regulates several cardiac functions including contractility, remodeling, and fibrosis. Cyclic nucleotide phosphodiesterases (PDEs), by catalyzing the hydrolysis of cyclic nucleotides, are critical in the homeostasis of intracellular cyclic nucleotide signaling and hold great therapeutic potential as drug targets. Recent studies have revealed that the inhibition of the PDE family member PDE1 plays a protective role in pathological cardiac remodeling and dysfunction by the modulation of distinct cyclic nucleotide signaling pathways. This review summarizes recent key findings regarding the roles of PDE1 in the cardiac system that can lead to a better understanding of its therapeutic potential.

  14. [Cardiac sarcoidosis: diagnostics, treatment and follow-up].

    Science.gov (United States)

    Dudziak, Maria; Jankowska, Hanna; Dorniak, Karolina

    2018-03-27

    Sarcoidosis is a generalised granulomatous disorder of unknown aetiology. Cardiac involvement may affect conduction system, myocardium, valvular apparatus and pericardium. Clinical spectrum ranges from asymptomatic involvement to sudden cardiac death. Patients with biopsy-proven extracardiac sarcoidosis should be screened for cardiac involvement (standard ECG, 24-hour Holter ECG, echocardiography) and in case of any abnormalities found on these tests, more advanced diagnostic methods should be used. Steroid treatment is still the mainstay of therapy in cardiac sarcoidosis. Several immunosuppresive agents are also effective and used in different combinations with steroids, as well as heart failure treatment (including ACE inhibitors, angiotensin receptor blockers, beta-blockers and diuretics). Advanced heart block requires pacemaker implantation, and implantable cardioverterdefibrillator is an effective treatment in primary and secondary prophylaxis of sudden cardiac death. Heart transplantation is considered in advanced, drug-resistant heart failure or incessant ventricular arrhythmias unresponsive to other forms of therapy. © 2018 MEDPRESS.

  15. Quantitative cardiac computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Thelen, M.; Dueber, C.; Wolff, P.; Erbel, R.; Hoffmann, T.

    1985-06-01

    The scope and limitations of quantitative cardiac CT have been evaluated in a series of experimental and clinical studies. The left ventricular muscle mass was estimated by computed tomography in 19 dogs (using volumetric methods, measurements in two axes and planes and reference volume). There was good correlation with anatomical findings. The enddiastolic volume of the left ventricle was estimated in 22 patients with cardiomyopathies; using angiography as a reference, CT led to systematic under-estimation. It is also shown that ECG-triggered magnetic resonance tomography results in improved visualisation and may be expected to improve measurements of cardiac morphology.

  16. Cardiac output measurement

    Directory of Open Access Journals (Sweden)

    Andreja Möller Petrun

    2014-02-01

    Full Text Available In recent years, developments in the measuring of cardiac output and other haemodynamic variables are focused on the so-called minimally invasive methods. The aim of these methods is to simplify the management of high-risk and haemodynamically unstable patients. Due to the need of invasive approach and the possibility of serious complications the use of pulmonary artery catheter has decreased. This article describes the methods for measuring cardiac output, which are based on volume measurement (Fick method, indicator dilution method, pulse wave analysis, Doppler effect, and electrical bioimpedance.

  17. Current Pharmacological Advances in the Treatment of Cardiac Arrest

    Directory of Open Access Journals (Sweden)

    Andry Papastylianou

    2012-01-01

    Full Text Available Cardiac arrest is defined as the sudden cessation of spontaneous ventilation and circulation. Within 15 seconds of cardiac arrest, the patient loses consciousness, electroencephalogram becomes flat after 30 seconds, pupils dilate fully after 60 seconds, and cerebral damage takes place within 90–300 seconds. It is essential to act immediately as irreversible damage can occur in a short time. Cardiopulmonary resuscitation (CPR is an attempt to restore spontaneous circulation through a broad range of interventions which are early defibrillation, high-quality and uninterrupted chest compressions, advanced airway interventions, and pharmacological interventions. Drugs should be considered only after initial shocks have been delivered (when indicated and chest compressions and ventilation have been started. During cardiopulmonary resuscitation, no specific drug therapy has been shown to improve survival to hospital discharge after cardiac arrest, and only few drugs have a proven benefit for short-term survival. This paper reviews current pharmacological treatment of cardiac arrest. There are three groups of drugs relevant to the management of cardiac arrest: vasopressors, antiarrhythmics, and other drugs such as sodium bicarbonate, calcium, magnesium, atropine, fibrinolytic drugs, and corticosteroids.

  18. Serum cardiac troponin I and cardiac troponin T concentrations in dogs with gastric dilatation-volvulus.

    Science.gov (United States)

    Schober, Karsten E; Cornand, Corinna; Kirbach, Babett; Aupperle, Heike; Oechtering, Gerhard

    2002-08-01

    To determine whether serum concentrations of cardiac troponin I (cTnI) and cardiac troponin T (cTnT) are increased in dogs with gastric dilatationvolvulus (GDV) and whether concentrations correlate with severity of ECG abnormalities or outcome. Prospective case series. 85 dogs with GDV. Serum cTnl and cTnT concentrations were measured 12 to 24, 48, 72, and 96 hours after surgery. Dogs were grouped on the basis of severity of ECG abnormalities and outcome. cTnl and cTnT were detected in serum from 74 (87%) and 43 (51%) dogs, respectively. Concentrations were significantly different among groups when dogs were grouped on the basis of severity of ECG abnormalities (none or mild vs moderate vs severe). Dogs that died (n = 16) had significantly higher serum cTnI (24.9 ng/ml) and cTnT (0.18 ng/ml) concentrations than did dogs that survived (2.05 and dogs with high serum cardiac troponin concentrations. Results indicate that concentrations of cTnI and cTnT suggestive of myocardial cell injury can commonly be found in serum from dogs with GDV and that serum cardiac troponin concentrations are associated with severity of ECG abnormalities and outcome.

  19. Chapter 6: Fire damage of wood structures

    Science.gov (United States)

    B. Kukay; R.H. White; F. Woeste

    2012-01-01

    Depending on the severity, fire damage can compromise the structural integrity of wood structures such as buildings or residences. Fire damage of wood structures can incorporate several models that address (1) the type, cause, and spread of the fire, (2) the thermal gradients and fire-resistance ratings, and (3) the residual load capacity (Figure 6.1). If there is a...

  20. Relationship between cardiac 123I-Metaiodobenzylguanidine imaging and the transcardiac gradient of neurohumoral factors in patients with dilated cardiomyopathy

    International Nuclear Information System (INIS)

    Matsui, Toshiki; Tsutamoto, Takayoshi; Kinoshita, Masahiko

    2001-01-01

    Cardiac sympathetic nervous function is altered in congestive heart failure (CHF) and the uptake and washout rate of cardiac 123 I-metaiodobenzylguanidine (MIBG) are useful markers for evaluating the severity of it. To assess what parameters predict decreased uptake or increased washout rate of MIBG, the concentrations of neurohumoral factor in both the aorta (Ao) and coronary sinus (CS) were measured, as well as hemodynamic parameters by catheterization, in patients with dilated cardiomyopathy (DCM). MIBG imaging was performed within 1 week of cardiac catheterization. Regarding MIBG parameters, the correlation with the transcardiac gradient of norepinephrine (NE), brain natriuretic peptide (BNP) and hemodynamics was investigated. Stepwise multivariate regression analysis was used to determine which variables closely correlated with cardiac MIBG parameters. There was a significant increase in the NE level between the Ao (446 pg/ml) and the CS (727 pg/ml). According to stepwise multivariate regression analysis, the heart/mediastinum (H/M) ratio independently correlated with the transcardiac gradient of BNP (r=-0.480, p<0.01), and the washout rate independently correlated with the transcardiac gradient of NE (r=0.481, p<0.01). These findings indicate that the H/M ratio may reflect the transcardiac gradient of BNP, which implies the degree of left ventricular dysfunction and/or damage and the washout rate may reflect altered cardiac sympathetic nerve terminal in DCM patients with CHF, suggesting that both the H/M ratio and washout rate provide important information about the failing ventricle. (author)

  1. The LP-FP-2 severe fuel damage scenario and discussion of the relative influence of the transient and reflood phases in affecting the final condition of the bundle

    International Nuclear Information System (INIS)

    Modro, S.M.; Carboneau, M.L.

    1990-01-01

    The purpose of this paper is to review the evidence from the OECD LP-FP-2 experiment that a high temperature excursion occurred within the center fuel module (CFM) during the reflood portion of the test, was caused by rapid metal-water reaction. It is shown that this reflood scenario explains many perplexing observations from the experiment, in particular, the small amount of fission products and hydrogen transported to the blowdown suppression tank (BST) as compared with the larger quantities trapped within the primary coolant system (PCS). The timing and destruction of the CFM upper tie plate, as well as the transport of fuel debris to the top of this plate, are also explained. In general, all measurements, observations, and analyses of the LP-FP-2 data indicate that most of the CFM damage occurred during a relatively short period of time coincident with the reflood portion of the experiment. 4 refs., 6 figs

  2. Anisotropic creep damage in the framework of continuum damage mechanics

    International Nuclear Information System (INIS)

    Caboche, J.L.

    1983-01-01

    For some years, various works have shown the possibility of applying continuum mechanics to model the evolution of the damage variable, initially introduced by Kachanov. Of interest here are the complex problems posed by the anisotropy which affects both the elastic behaviour and the viscoplastic one, and also the rupture phenomenon. The main concepts of the Continuum Damage Mechanics are briefly reviewed together with some classical ways to introduce anisotropy of damage in the particular case of proportional loadings. Based on previous works, two generalizations are presented and discussed, which use different kinds of tensors to describe the anisotropy of creep damage: - The first one, by Murakami and Ohno introduces a second rank damage tensor and a net stress tensor through a net area definition. The effective stress-strain behaviour is then obtained by a fourth rank tensor. - The second theory, by the author, uses one effective stress tensor only, defined in terms of the macroscopic strain behaviour, through a fourth-order non-symmetrical damage tensor. The two theories are compared at several levels: difference and similarities are pointed out for the damage evolution during tensile creep as well as for anisotropy effects. The possibilities are discussed and compared on the basis of some existing experimental results, which leads to a partial validation of the two approaches. (orig.)

  3. Cardiac cell damage in hypertrophic cardiomyopathy evaluated by beta-methyl-branched fatty acid analogue, iodine-123-15-(p-iodophenyl)-3-(R,S)-methylpen-tadecanoic acid (BMIPP) myocardial fatty-acid imaging and late gadolinium-enhanced contrast magnetic resonance imaging. Usefulness of combining the two techniques

    International Nuclear Information System (INIS)

    Kawade, Masafumi; Teraoka, Kunihiko; Hirano, Masaharu; Igarashi, Yuko; Yamada, Masao; Chikamori, Taishiro; Takazawa, Kenji; Yamashina, Akira

    2011-01-01

    Late gadolinium-enhanced (LGE) magnetic resonance imaging (MRI) has been found to be a highly valuable imaging modality for myocardial characterization in cases of hypertrophic cardiomyopathy (HCM). In addition, abnormalities of BMIPP uptake have also been recognized in HCM. In this study, we hypothesized that abnormalities of fatty acid uptake and metabolism may be detected before fibrosis can be recognized on cardiovascular MRI in patients with HCM. Twenty-four patients with HCM were examined by both BMIPP myocardial fatty acid imaging and LGE MRI, and the results of the two imaging methods were compared. BMIPP uptake abnormalities were recognized in 23 of the 24 HCM patients (95.8%) and 126 out of the 408 segments (30.9%) examined, and were most frequently located in the interventricular septum and anterior wall of the left ventricle, the inferior wall and apex of the heart. Areas of LGE were recognized in 18 of the 24 HCM patients (75%) and 50 of the 408 segments (12.2%) examined, and were most frequently located in the interventricular septum of the left ventricle. Double-positive results of both BMIPP uptake abnormalities and LGE were recognized in 18 of the 24 cases (75.0%) and 45 of the 408 segments (11.0%) examined. Double-positive results were noted most frequently in the interventricular septum of the left ventricle and the anterior wall. The areas showing BMIPP uptake abnormalities were more extensive than those showing LGE on MRI. In addition, the positivity rate for BMIPP uptake abnormalities in areas showing LGE on MRI was considerably higher than that of LGE positivity in areas positive for BMIPP uptake abnormalities. These results are not contradictory to our hypothesis. Therefore, differences between the examination methods in terms of the extent and positivity rate in cases of HCM may be related to the stage of progression of the cardiac muscle cell damage in cases of HCM. Thus, the use of both examinations together might be useful in the

  4. Damage Models for Soft Tissues: A Survey.

    Science.gov (United States)

    Li, Wenguang

    Damage to soft tissues in the human body has been investigated for applications in healthcare, sports, and biomedical engineering. This paper reviews and classifies damage models for soft tissues to summarize achievements, identify new directions, and facilitate finite element analysis. The main ideas of damage modeling methods are illustrated and interpreted. A few key issues related to damage models, such as experimental data curve-fitting, computational effort, connection between damage and fractures/cracks, damage model applications, and fracture/crack extension simulation, are discussed. Several new challenges in the field are identified and outlined. This review can be useful for developing more advanced damage models and extending damage modeling methods to a variety of soft tissues.

  5. Economic and biological costs of cardiac imaging

    Directory of Open Access Journals (Sweden)

    Picano Eugenio

    2005-05-01

    Full Text Available Abstract Medical imaging market consists of several billion tests per year worldwide. Out of these, at least one third are cardiovascular procedures. Keeping in mind that each test represents a cost, often a risk, and a diagnostic hypothesis, we can agree that every unnecessary and unjustifiable test is one test too many. Small individual costs, risks, and wastes multiplied by billions of examinations per year represent an important population, society and environmental burden. Unfortunately, the appropriateness of cardiac imaging is extra-ordinarily low and there is little awareness in patients and physicians of differential costs, radiological doses, and long term risks of different imaging modalities. For a resting cardiac imaging test, being the average cost (not charges of an echocardiogram equal to 1 (as a cost comparator, the cost of a CT is 3.1x, of a SPECT 3.27x, of a Cardiovascular Magnetic Resonance imaging 5.51x, of a PET 14.03x, and of a right and left heart catheterization 19.96x. For stress cardiac imaging, compared with the treadmill exercise test equal to 1 (as a cost comparator, the cost of stress echocardiography is 2.1x and of a stress SPECT scintigraphy is 5.7x. Biohazards and downstream long-term costs linked to radiation-induced oncogenesis should also be considered. The radiation exposure is absent in echo and magnetic resonance, and corresponds to 500 chest x rays for a sestamibi cardiac stress scan and to 1150 chest x rays for a thallium scan. The corresponding extra-risk in a lifetime of fatal cancer is 1 in 2000 exposed patients for a sestamibi stress and 1 in 1000 for a thallium scan. Increased awareness of economic, biologic, and environmental costs of cardiac imaging will hopefully lead to greater appropriateness, wisdom and prudence from both the prescriber and the practitioner. In this way, the sustainability of cardiac imaging will eventually improve.

  6. Neonatal cardiac emergencies

    African Journals Online (AJOL)

    flow) or require intervention (surgical or catheter) within the first ... Cardiac. History. Risk factors, e.g. meconium-stained liquor, prematurity, ... 'snowman' sign for supracardiac total anomalous pulmonary venous drainage (TAPVD), cardiomegaly with plethora for ... central cyanosis and on auscultation you hear no murmurs.

  7. Comparative cardiac imaging

    International Nuclear Information System (INIS)

    Brundage, B.H.

    1990-01-01

    This book is designed to compare all major cardiac imaging techniques. All major imaging techniques - including conventional angiography, digital angiography, echocardiography and Doppler imaging, conventional radioisotope techniques, computed tomography, and magnetic resonance imaging - are covered in this text as they apply to the major cardiovascular disorders. There is brief coverage of positron emission tomography and an extensive presentation of ultrafast computed tomography

  8. Advanced Cardiac Life Support.

    Science.gov (United States)

    Kirkwood Community Coll., Cedar Rapids, IA.

    This document contains materials for an advanced college course in cardiac life support developed for the State of Iowa. The course syllabus lists the course title, hours, number, description, prerequisites, learning activities, instructional units, required text, six references, evaluation criteria, course objectives by units, course…

  9. Cardiac Pacemakers; Marcapasos Cardiacos

    Energy Technology Data Exchange (ETDEWEB)

    Fiandra, O [Universidad de la Republica, Facultad de Maedicina, Departamento de Cardiologia, Montevideo(Uruguay); Espasandin, W [Universidad de la Republica, Facultad de Medicina, Departamento de Cirugia Cardiaca, Montevideo (Uruguay); Fiandra, H [Instituto Nacional de Cirugia Cardiaca, Departamento de Hemodinamia y Marcapasos, Montevideo (Uruguay); and others

    1984-07-01

    A complete survey of physiological biophysical,clinical and engineering aspects of cardiac facing,including the history and an assessment of possible future developments.Among the topics studied are: pacemakers, energy search, heart stimulating with pacemakers ,mathematical aspects of the electric cardio stimulation chronic, pacemaker implants,proceeding,treatment and control.

  10. Nonexercise cardiac stress testing

    International Nuclear Information System (INIS)

    Vacek, J.L.; Baldwin, T.

    1989-01-01

    Many patients who require evaluation for coronary artery disease are unable to undergo exercise stress testing because of physiologic or psychological limitations. Drs Vacek and Baldwin describe three alternative methods for assessment of cardiac function in these patients, all of which have high levels of diagnostic sensitivity and specificity. 23 references

  11. Cardiac magnetic resonance imaging

    African Journals Online (AJOL)

    2011-03-06

    Mar 6, 2011 ... Cardiac magnetic resonance imaging. Cardiovascular magnetic resonance imaging is becoming a routine diagnostic technique. BRUCE s sPOTTiswOOdE, PhD. MRC/UCT Medical Imaging Research Unit, University of Cape Town, and Division of Radiology, Stellenbosch University. Bruce Spottiswoode ...

  12. DNA Damage Signals and Space Radiation Risk

    Science.gov (United States)

    Cucinotta, Francis A.

    2011-01-01

    Space radiation is comprised of high-energy and charge (HZE) nuclei and protons. The initial DNA damage from HZE nuclei is qualitatively different from X-rays or gamma rays due to the clustering of damage sites which increases their complexity. Clustering of DNA damage occurs on several scales. First there is clustering of single strand breaks (SSB), double strand breaks (DSB), and base damage within a few to several hundred base pairs (bp). A second form of damage clustering occurs on the scale of a few kbp where several DSB?s may be induced by single HZE nuclei. These forms of damage