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Sample records for spontaneous sma dissection

  1. Spontaneous Dissection of the Superior Mesenteric Artery

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    Sheldon, Patrick J.; Esther, James B.; Sheldon, Elana L.; Sparks, Steven R.; Brophy, David P.; Oglevie, Steven B.

    2001-01-01

    Spontaneous dissection of the superior mesenteric artery (SMA) is a rare occurrence, especially when not associated with aortic dissection. Currently, only 28 cases appear to have been reported. Due to the scarcity of cases in the literature, the natural history of isolated, spontaneous SMA dissection is unclear. CT has been reported to be useful for the initial diagnosis of SMA dissection [2-5]. We present two recent cases of spontaneous SMA dissection in which enhanced spiral CT was instrumental in following the disease process and guiding clinical decision making

  2. Bilateral spontaneous carotid artery dissection.

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    Townend, Bradley Scott; Traves, Laura; Crimmins, Denis

    2005-06-01

    Bilateral internal carotid artery dissections have been reported, but spontaneous bilateral dissections are rare. Internal carotid artery dissection can present with a spectrum of symptoms ranging from headache to completed stroke. Two cases of spontaneous bilateral carotid artery dissection are presented, one with headache and minimal symptoms and the other with a stroke syndrome. No cause could be found in either case, making the dissections completely spontaneous. Bilateral internal carotid artery dissection (ICAD) should be considered in young patients with unexplained head and neck pain with or without focal neurological symptoms and signs. The increasing availability of imaging would sustain the higher index of suspicion.

  3. Spontaneous isolated celiac artery dissection

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    Tuba Cimilli Ozturk

    2011-01-01

    Full Text Available Dyspepsia with mild, stabbing epigastric discomfort without history of trauma is a very common symptom that emergency physicians see in their daily practice. Vascular emergencies, mostly the aortic dissection and aneurysm, are always described in the differential diagnosis with persistent symptoms. Isolated celiac artery dissection occurring spontaneously is a very rare diagnosis. The involvement of branch vessels is generally observed and patients show various clinical signs and symptoms according to the involved branch vessel. Here we are presenting a case with spontaneous isolated celiac artery dissection, without any branch vessel involvement or visceral damage, detected by computed tomography scans taken on admission.

  4. Clinical features of ten cases of isolated spontaneous dissection of the superior mesenteric artery

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    Kozuki, Akihito; Shinozaki, Hiroharu; Takasato, Fumika; Kobayashi, Kenji; Kase, Kenichi

    2009-01-01

    Isolated spontaneous dissection of the superior mesenteric artery (SMA) is a comparatively rare disease, and symptoms vary from acute to chronic abdominal pain to no symptoms. However, it is difficult to diagnose; there is no consensus about medical treatment and the long-term consequences. Isolated spontaneous dissection of the SMA was believed to be a rare disease that required conventional surgery for treatment; however reports of SMA dissection have increased with the progression of diagnostic imaging, and surgery may not always be required. We reviewed 10 cases of isolated spontaneous dissection of the SMA that we experienced between January 1998 and December 2008. We performed conservative medical treatment with anticoagulants in 5 cases, advised bed rest in 4 cases, and performed endovascular treatment in 1 case. None of the cases needed surgery for treatment. There were 3 cases that required continuous administration of long-term anticoagulants or antiplatelet agents. There were no recurrences in a 4-year average observation period. (author)

  5. Spontaneous healing of spontaneous coronary artery dissection.

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    Almafragi, Amar; Convens, Carl; Heuvel, Paul Van Den

    2010-01-01

    Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome and sudden cardiac death. It should be suspected in every healthy young woman without cardiac risk factors, especially during the peripartum or postpartum periods. It is important to check for a history of drug abuse, collagen vascular disease or blunt trauma of the chest. Coronary angiography is essential for diagnosis and early management. We wonder whether thrombolysis might aggravate coronary dissection. All types of treatment (medical therapy, percutaneous intervention or surgery) improve the prognosis without affecting survival times if used appropriately according to the clinical stability and the angiographic features of the involved coronary arteries. Prompt recognition and targeted treatment improve outcomes. We report a case of SCAD in a young female free of traditional cardiovascular risk factors, who presented six hours after thrombolysis for ST elevation myocardial infarction. Coronary angiography showed a dissection of the left anterior descending and immediate branch. She had successful coronary artery bypass grafting, with complete healing of left anterior descending dissection.

  6. Spontaneous left main coronary artery dissection

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    Alptug Tokatli

    2016-03-01

    Full Text Available Spontaneous coronary artery dissection (SCAD is a very rare clinical condition. Physiopathology of SCAD is still mostly unclear. Clinical presentation of SCAD ranges from atypical symptoms to sudden cardiac death. The diagnosis of dissection is generally made by using conventional coronary angiography. Invasive or conservative treatment is reasonable.

  7. Spontaneous Cervical Artery Dissection: The Borgess Classification

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    Firas eAl-Ali

    2013-09-01

    Full Text Available ABSTRACTBackground and Purpose: The pathogenesis of spontaneous cervical artery dissections (sCAD and its best medical treatment are debated. This may be due to a lack of clear classification of sCAD. We propose the new Borgess classification of sCAD, based on the presence or absence of intimal tear as depicted on imaging studies and effect on blood flow. Materials and Methods: This is a single-center investigator-initiated registry on consecutive patients treated for sCAD. In the Borgess classification, type I dissections have intact intima and type II dissections have an intimal tear. Results: Forty-four patients and 52 dissected arteries were found. Forty-nine of 52 dissections (93% were treated with dual anti-platelet therapy. Twenty-one of 52 dissections were type I; 31 were type II. Type I dissections were more likely to present with ischemic symptoms (stroke, TIA (p=0.001. More type I dissections occurred in the vertebral artery, while more type II dissections occurred in the internal carotid artery (p

  8. [Spontaneous renal artery dissection: a case report].

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    Maehana, Takeshi; Nishida, Sachiyo; Shindo, Tetsuya; Miyamoto, Shintaro; Muranaka, Takashi; Suzuki, Kazuhiro; Yanase, Masahiro

    2008-01-01

    A 65-year-old female was admitted to our hospital complaining of left upper abdominal pain. Although the symptom improved with observation, serum creatinine rose to 2.0 mg/dl. Slight atrophy of the left kidney was seen on abdominal plain computed tomography. In order to examine the possibility of renal infarction from thrombosis with angiography, we consulted the department of cardiovascular medicine. Even though we did not detect thrombosis with left renal angiography or intravascular ultrasound, there was a dissection finding localized at the left renal artery. Based on this finding, we made a diagnosis of spontaneous renal artery dissection and performed stent placement. Spontaneous renal artery dissection is extremely rare and the frequency of occurrence is reported to be less than 0.05%. Recently, however the frequency of detection has risen with the development of clinical imaging. We must keep in mind that the condition has the possibility of leading to renal blood circulation disorders.

  9. Spontaneous Coronary Artery Dissection and Pregnancy.

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    Naderi, Sahar

    2017-09-01

    Spontaneous coronary artery dissection (SCAD) is a non-atherosclerotic, non-traumatic cause of coronary artery dissection. SCAD is the most common cause of myocardial infarction in pregnancy or the postpartum period and results in significant cardiovascular morbidity and mortality in the pregnant population. It is important to consider pregnancy-associated spontaneous coronary artery dissection (PASCAD) high on the differential for a pregnant woman who presents with symptoms consistent with acute coronary syndrome. Management of these patients requires a thoughtful, multidisciplinary approach, with consideration of conservative management if possible. Counseling regarding future pregnancies is also critical and requires compassionate care. Given our limited understanding of SCAD, including PASCAD, more data and research are needed to help guide diagnosis, management, and determination of prognosis.

  10. Spontaneous aortic dissecting hematoma in two dogs.

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    Boulineau, Theresa Marie; Andrews-Jones, Lydia; Van Alstine, William

    2005-09-01

    This report describes 2 cases of spontaneous aortic dissecting hematoma in young Border Collie and Border Collie crossbred dogs. Histology was performed in one of the cases involving an unusual splitting of the elastin present within the wall of the aorta, consistent with elastin dysplasia as described in Marfan syndrome in humans. The first case involved a young purebred Border Collie that died suddenly and the second case involved a Border Collie crossbred dog that died after a 1-month history of seizures. Gross lesions included pericardial tamponade with dissection of the ascending aorta in the former case and thoracic cavity hemorrhage, mediastinal hematoma, and aortic dissection in the latter. Histologic lesions in the case of the Border Collie crossbred dog included a dissecting hematoma of the ascending aorta with elastin dysplasia and right axillary arterial intimal proliferation.

  11. Management of spontaneous isolated dissection of the superior mesenteric artery: Case report and literature review

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    Takara Hiroaki

    2011-05-01

    Full Text Available Abstract Background and method The aim of this study was to assess retrospectively the clinical presentation, management and outcome of three patients with isolated SMA dissection encountered at Okinawa Prefectural Chubu Hospital, Japan from 2005 to 2006, along with a review of the literature. We follow up the patient's clinical symptoms and the image by using enhanced dynamic CT at 1 week, 1 or 2 months, 6 months, and yearly after onset. Case presentation We present three patients with acute abdominal pain due to spontaneous dissection of the superior mesenteric artery (SMA, who were treated by surgical revascularization or conservative management. Two patients underwent surgery because of signs or symptoms of intestinal ischemia and one patient elected conservative management. The SMA was repaired by bypass graft in two cases, and in one of these, the graft was occluded because of prominent native flow from the SMA. All patients were symptom free and there was no evidence of disease recurrence after a median follow-up of 4.3 years. Conclusion Although the indications for surgery are still controversial, we should proceed with exploratory laparotomy if the patient has acute symptoms with suspicion of mesenteric ischemia. A non-operative approach for SMA dissection requires close follow-up abdominal CT, with a focus on the clinical signs of mesenteric ischemia and the vascular supply of the SMA, including collateral flow from the celiac artery and inferior mesenteric artery.

  12. Spontaneous Coronary Artery Dissection Associated With Pregnancy.

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    Tweet, Marysia S; Hayes, Sharonne N; Codsi, Elisabeth; Gulati, Rajiv; Rose, Carl H; Best, Patricia J M

    2017-07-25

    Spontaneous coronary artery dissection (SCAD) is the most common cause of pregnancy-associated myocardial infarction and remains poorly characterized. This study sought to assess presentation, clinical factors, and outcomes of pregnancy-associated spontaneous coronary artery dissection (P-SCAD) compared with spontaneous coronary artery dissection not associated with pregnancy (NP-SCAD). A Mayo Clinic registry was established in 2010 to include comprehensive retrospective and prospective SCAD data. Records were reviewed to identify women who were pregnant or ≤12 weeks postpartum at time of SCAD. Complete records were available for 323 women; 54 women met criteria for P-SCAD (4 during pregnancy) and they were compared with 269 women with NP-SCAD. Most events occurred within the first month postpartum (35 of 50). Compared with NP-SCAD, P-SCAD patients more frequently presented with ST-segment elevation myocardial infarction (57% vs. 36%; p = 0.009), left main or multivessel SCAD (24% vs. 5%; p vs. 14%; p = 0.0027, respectively), and left ventricular function ≤35% (26% vs. 10%; p = 0.0071). Among women with imaging of other vascular territories, P-SCAD was less likely with a diagnosis of fibromuscular dysplasia and extracoronary vascular abnormalities (42% vs. 64%; p = 0.047; and 46% vs. 77%; p = 0.0032, respectively). Compared with U.S. birth data, women with P-SCAD were more often multiparous (p = 0.0167), had a history of infertility therapies (p = 0.0004), and had pre-eclampsia (p = 0.001). On long-term follow-up (median 2.3 years) recurrent SCAD occurred in 51 patients, with no difference in the Kaplan Meier 5-year recurrence rates (10% vs. 23%; p = 0.18). P-SCAD patients had more acute presentations and high-risk features than women with NP-SCAD did. The highest frequency of P-SCAD occurred during the first postpartum month and P-SCAD patients less often had extracoronary vascular abnormalities. Hormonal, hemodynamic variations, and yet

  13. Spontaneous Coronary Artery Dissection: Diagnosis and Management.

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    Yeo, Ilhwan; Feldman, Dmitriy N; Kim, Luke K

    2018-03-17

    Spontaneous coronary artery dissection (SCAD) is a non-iatrogenic and non-traumatic separation of the coronary arterial wall. While SCAD represents an important cause of myocardial infarction, optimal diagnostic and therapeutic options remain challenging. We sought to review recent studies and provide an update on diagnosis and management of SCAD. Coronary angiography is the first-line diagnostic modality for SCAD, with three angiographic features commonly observed in SCAD: type 1 (pathognomonic angiographic appearance with contrast staining of the arterial wall), type 2 (long coronary stenosis), and type 3 (focal tubular stenosis). In addition, adjunctive intracoronary imaging can aid in identifying coronary dissections. Conservative management with beta-blockers and aspirin remains the mainstay of therapy. However, patients with high-risk features and recurrent symptoms may require revascularization. Several techniques have been reported, such as long stents to seal the entire length of the dissection, stepwise stenting starting at the distal edge followed by proximal edge stenting, use of bioabsorbable stents, and cutting balloon angioplasty. Furthermore, cardiac rehabilitation appears to be safe and offers significant benefits for patients with SCAD. Coronary angiographic classification contributed to the increased recognition of SCAD in recent years. Selecting the most suitable and appropriate therapy based on accurate diagnosis is the cornerstone of management in SCAD. Further studies are needed to establish optimal treatment of SCAD depending on anatomical and/or clinical features.

  14. [Spontaneous coronary artery dissection (SCAD): about 2 cases].

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    Elkasimi, Abdelouahab; Elouazzani, Ghizlane; Hbali, Anas; Ismaili, Nabila; Elouafi, Nouha

    2017-01-01

    Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS); its prevalence is estimated to be less than 3%. It is defined as a separation within the coronary arterial wall secondary to intramural bleeding with or without intimal tear, creating a false channel. It mainly affects young subjects, mainly women, without coronary atherosclerosis or risk factors for atherosclerosis. However, the occurrence of spontaneous dissection due to atheromatous disease is possible. We here report 2 cases of spontaneous coronary dissection, in order to discuss its pathogenesis, factors favoring its occurrence, its clinical presentation and its therapeutic management.

  15. Current management of spontaneous coronary artery dissection.

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    Bastante, Teresa; Cuesta, Javier; García-Guimaraes, Marcos; Rivero, Fernando; Maruri, Ramon; Adlan, David; Alfonso, Fernando

    2017-08-01

    Spontaneous coronary artery dissection (SCAD) remains an infrequent and elusive clinical entity of unknown etiology. However, our knowledge of SCAD has been significantly enriched in recent years. Large and prospective contemporary series have increased the interest in this disease with fewer patients misdiagnosed and a growing number of cases recognized in daily clinical practice. Classically, SCAD was thought to present mainly in young women without traditional atherosclerotic risk factors but, actually, most patients are middle-aged and are not free from coronary risk factors. A high number of associated conditions have been reported. Of these, fibromuscular dysplasia emerges as a major association with intriguing pathophysiological implications. Areas covered: This review aims to present a contemporary update on SCAD. We concentrate on the clinical scenario, related conditions, practical management and treatment strategies. Expert commentary: Recognition of SCAD is currently much more frequent and accurate as a result of increased clinical awareness and the widespread use of intravascular imaging techniques. Hopefully, in the near future an improvement in the management of SCAD patients will come not only from empirical evidence but also from dedicated clinical trials.

  16. Acute spontaneous isolated dissection of abdominal aorta

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    Ali Akbar beigi

    2009-09-01

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    • Aortic dissection occurs when the layers of the aorta separate as a result of extra luminal cavity of blood through an intimal tear. Dissection limited to the abdominal aorta is rare. Unfortunately, the appropriate management of dissecting aneurysm of abdominal aorta is not documented yet. A 43 years old man was admitted to Al-zahra hospital in Isfahan with sudden onset of periumbilical abdominal pain. CT scan confirmed infrarenal dissection of abdominal aorta. Performing laparotomy, aorta was repaired using bifurcate collagen-coated Dacron graft. Surgical intervention with synthetic graft is recommended in patients with dissecting aortic aneurysm of infrarenal segments where the extent of dissection is limited and accessible.
    • Keywords: Aneurysm, Aortic dissection, Aortic aneurysm abdominal surgery.

  17. Spontaneous carotid artery dissection causing a juvenile cerebral infarction

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    Trattnig, S.; Huebsch, P.; Schindler, E.

    1988-11-01

    The case of a 19-year-old patient is presented who was admitted with aphasia and hemiparesis due to basal ganglia infarction as a result of spontaneous dissection of the internal carotid artery. The difficulties in diagnosing this disease with CT and MRI in the acute stage are demonstrated. Angiography is still imperative in order to ascertain that a carotid dissection has occurred.

  18. Spontaneous carotid artery dissection causing a juvenile cerebral infarction

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    Trattnig, S.; Huebsch, P.; Schindler, E.

    1988-01-01

    The case of a 19-year-old patient is presented who was admitted with aphasia and hemiparesis due to basal ganglia infarction as a result of spontaneous dissection of the internal carotid artery. The difficulties in diagnosing this disease with CT and MRI in the acute stage are demonstrated. Angiography is still imperative in order to ascertain that a carotid dissection has occurred. (orig.) [de

  19. Spontaneous coronary artery dissection: complete angiographic resolution without stenting

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    Alexandre Abizaid

    2007-09-01

    Full Text Available A case of spontaneous coronary artery dissection in a 49-year-oldwoman is presented. She did not present the classical cardiovascular riskfactors. Etiology and treatment are discussed. She underwent primarypercutaneous coronary intervention of the left anterior descendingartery with no stenting and had complete angiographic resolution.

  20. Spontaneous coronary artery dissection. Case report and literature review

    DEFF Research Database (Denmark)

    Elming, H; Køber, L

    1999-01-01

    to patient characteristics, patient treatment, and prognosis. Primary spontaneous coronary artery dissection is a rare condition but one that must be considered when young people, especially post partum women, present an acute ischaemic syndrome. Thrombolytic therapy may be a two-edged sword and therefore...

  1. Spontaneous coronary artery dissection associated with apical hypertrophic cardiomyopathy

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    Tuncer, M.; Gumrukcuoglu, H.A.; Ekim, H.; Gunes, Y.; Simsek, H.

    2010-01-01

    Apical hypertrophic cardiomyopathy (HCM) is a relatively uncommon inherited disease. Spontaneous coronary artery dissection (SCAD) is also uncommonly observed, which often occurs in pregnant or post partum women but is rare in men. This report describes a 38 years old man with apical hypertrophic cardiomyopathy who developed SCAD leading to acute inferior myocardial infarction. After emergent appendectomy operation at another hospital, he was immediately transferred to the Cardiology Department of our hospital due to acute myocardial infarction. He emergently underwent coronary angiography which showed a long dissection involving the right coronary. He underwent an emergent CABG with cardiopulmonary bypass. Postoperative recovery was uneventful and he was discharged. According to our knowledge, no case of spontaneous coronary artery dissection associated with apical hypertrophic cardiomyopathy unrelated to postpartum period or oral contraceptive use has been reported so far. (author)

  2. Spontaneous vertebral dissection: Clinical, conventional angiographic, CT, and MR findings

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    Provenzale, J.M.; Morgenlander, J.C. [Duke Univ. Medical Center, Durham, NC (United States); Gress, D. [Univ. of California, San Francisco, CA (United States)

    1996-03-01

    The purpose of this study was to determine if typical clinical and neuroradiologic patterns exist in patients with spontaneous vertebral artery (VA) dissection. The medical records and neuroradiologic examinations of 14 patients with spontaneous VA dissection were reviewed. The medical records were examined to exclude patients with a history of trauma and to record evidence of a nontratimatic precipitating event ({open_quotes}trivial trauma{close_quotes}) and presence of possible risk factors such as hypertension. All patients under-went conventional angiography, 13 either CT or MRI (II both CT and MRI), and 3 MRA. Conventional arteriograrris were evaluated for dissection site, evidence of fibromuscular dysplasia, luminal stenosis or occlusion, and pseudoaneurysm formation, CT examinations for the presence of infarction or subarachnoid hemorrhage, MR examinations for the presence of infarction or arterial signal abnormality, and MR angiograms for abnormality of the arterial signal column. Seven patients had precipitating events within 24 h of onset of symptoms that may have been causative of dissection and five had hypertension. At catheter angiography, two patients had dissections in two arteries (both VAs in one patient, VA and internal carotid artery in one patient), giving a total of 15 VAs with dissection. Dissection sites included V1 in four patients, V2 in one patient, V3 in three patients, V4 in six patients, and both V3 and V4 in one patient. Luminal stenosis was present in 13 VAs, occlusion in 2, pseudoaneurysm in 1, and evidence of fibromuscular dysplasia in 1. Posterior circulation infarcts were found on CT or MR in five patients. Subarachnoid hemorrhage was found on CT in two patients and by lumbar puncture alone in two patients. Abnormal periarterial signal on MRI was seen in three patients. MRA demonstrated absent VA signal in one patient, pseudoaneurysm in one, and a false-negative examination in one.

  3. Conservative treatment of spontaneous and isolated dissection of mesenteric arteries.

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    Amabile, Philippe; Ouaïssi, Mehdi; Cohen, Serge; Piquet, Philippe

    2009-01-01

    Isolated and spontaneous dissection of mesenteric arteries is a rare entity; a little more than 50 cases have been reported in medical literature. There is no therapeutic consensus concerning this type of lesion. In this study, we report the results of our treatment based on a conservative approach. This retrospective study concerns eight patients with dissection of the celiac trunk and/or of the upper mesenteric artery (UMA) who were treated between 2002 and 2006. Because these patients were not presenting with acute intestinal ischemia diagnosed by clinical examination or paraclinical tests (medical imaging/biology) or with vital complications, they were treated with an efficient anticoagulation (heparin followed by anti-vitamin K) for 3 to 6 months. Endovascular or surgical treatment was used as the first option in patients with obvious intestinal ischemia or likely to have an arterial rupture, and also when medical treatment had failed. Clinical and radiological follow-up was at 1 month, 3 months, 6 months, and 1 year and then every year. Seven men and one woman (mean age, 48.2; age range, 38-53 years) were treated. Six patients presented with isolated dissection (celiac trunk=4, UMA=2). One patient had a celiac trunk and a UMA dissection and one had a celiac trunk and a UMA dissection along with a dissection of his two renal arteries. On entering the hospital, a patient was operated on for mesenteric ischemia related to a stenosis of the upper mesenteric artery (upper aortomesenteric bypass); a covered stent was implanted in the celiac trunk of another patient presenting with a contained rupture. Both patients were successfully treated. Six patients were medically treated. One of them required an aortohepatic bypass to treat an aneurysmal evolution of the celiac trunk revealed by a computed tomography scan obtained 1 month after the symptoms had begun. In one patient, the dissection remained stable on imaging. Four patients were cured, with a mean 20.1-month

  4. Spontaneous coronary artery dissection, challenges of diagnosis and management.

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    Ahmed, Mohamed A; Hamra, Mardi; Ali, Mohamed; Abdullah, Abdullah S; Arnous, Samer; Kiernan, Thomas J

    2017-11-01

    Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute coronary syndrome in young patients. No clear factors exist to predict the natural history of the disease and the prognosis of the condition. Furthermore, current management practice of SCAD is based mainly on retrospective data and case series and clear management guidelines are lacking. In this article, we present a series of cases of patients with SCAD and we will discuss the different clinical presentations, the diagnostic approaches and the options of management of this cohort of patients. Our aim is to outline the challenges of diagnosis and management of this interesting and serious pathology.

  5. Spontaneous coronary artery dissections: Four cases and literature review

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    Necmettin Çolak

    2009-01-01

    Full Text Available Spontaneous coronary artery dissection(SCAD is a very rare cause of acute coronary syndrome. SCAD can cause stable angina, unstable angina, acute myocardial infarction, cardiogenic shock and sudden cardiac death. Predisposing factors include atherosclerosis, the peripar-tum period, structural and inflammatory conditions affect-ing the arterial wall. The diagnosis is usually made by coronary angiography. The clinical presentation is similar to the atherosclerotic coronary artery disease. Prompt diagnosis and treatment of patients improves survival. Therapeutic options include medical therapy, percutane-ous coronary intervention and surgery. The four cases were presented an discussed with review of the pertinent literature.

  6. Spontaneous coronary artery dissection: challenges of coronary computed tomography angiography.

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    Eleid, Mackram F; Tweet, Marysia S; Young, Phillip M; Williamson, Eric; Hayes, Sharonne N; Gulati, Rajiv

    2017-01-01

    There is limited understanding of the role of cardiac computed tomography angiography (CCTA) for assessment of patients with spontaneous coronary artery dissection (SCAD). In this report we describe the diagnostic utility of CCTA in three young women presenting with signs and symptoms of myocardial ischemia who were eventually diagnosed with SCAD. None of the women had traditional atherosclerotic risk factors. SCAD was not initially identified on CCTA in any of the three women, but was visualized during retrospective analysis in two patients after invasive coronary angiography. In two patients follow-up CCTA imaging was used successfully for subsequent management. In patients presenting with signs or symptoms of acute coronary syndrome, SCAD may be missed or not detectable on CCTA. A negative CCTA should not exclude a diagnosis of SCAD, and invasive coronary angiography should be considered for further evaluation.

  7. Multivessel Spontaneous Coronary Artery Dissection in an Unlikely Patient

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    Waqas Jehangir

    2015-01-01

    Full Text Available When approaching the symptom of acute onset chest pain in a previously healthy 26-year-old male, anchoring heuristic presents a challenge to healthcare workers. This diagnostic error is the healthcare professional’s tendency to rely on a previous diagnosis, and, in situations where a set of symptoms might mask a rare and deadly condition, this error can prove fatal for the patient. One such condition, Spontaneous Coronary Artery Dissection (SCAD, is an uncommon and malefic presentation of coronary artery disease that can lead to myocardial infarction and sudden death. We present a case of SCAD in an otherwise healthy 26 year-old male who had been experiencing chest pain during and after sports activity. In the young, athletic male with SCAD, the danger of diagnostic error was a reality due to the broad symptomatology and the betraying demographics.

  8. Spontaneous Coronary Artery Dissection: A Rare Manifestation of Alport Syndrome

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    Sethi, Prince; Steffen, Kelly; Jonsson, Orvar; Petrasko, Marian

    2017-01-01

    Alport syndrome (AS) is a genetic disorder due to inheritance of genetic mutations which lead to production of abnormal type IV collagen. AS has been associated with renal, auditory, and ocular diseases due to the presence of abnormal alpha chains of type IV collagen in the glomerulus, cochlea, cornea, lens, and retina. The resulting disorder includes hereditary nephritis, corneal opacities, anterior lenticonus, fleck retinopathy, temporal retinal thinning, and sensorineural deafness. Aortic and aortic valve pathologies have been described as extrarenal manifestations of AS in multiple case reports. One case report described intramural hematoma of the coronary artery. We report the first case of true spontaneous coronary artery dissection (SCAD) with an intimal flap as a very rare manifestation of AS. The patient is a 36-year-old female with history of AS with chronic kidney disease, hypertension, and obesity who presented to the emergency room with acute onset of substernal chest pain radiating to her neck and arms. Troponin was elevated, and ECG showed transient 1 mm ST-segment elevation in the inferior leads. Subsequent coronary angiography revealed localized dissection of the left circumflex artery. Percutaneous coronary angioplasty was performed and her symptoms improved. This case illustrates that SCAD may be a manifestation of AS patients with chest pain. PMID:28884028

  9. Spontaneous Coronary Artery Dissection: A Rare Manifestation of Alport Syndrome

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    Amornpol Anuwatworn

    2017-01-01

    Full Text Available Alport syndrome (AS is a genetic disorder due to inheritance of genetic mutations which lead to production of abnormal type IV collagen. AS has been associated with renal, auditory, and ocular diseases due to the presence of abnormal alpha chains of type IV collagen in the glomerulus, cochlea, cornea, lens, and retina. The resulting disorder includes hereditary nephritis, corneal opacities, anterior lenticonus, fleck retinopathy, temporal retinal thinning, and sensorineural deafness. Aortic and aortic valve pathologies have been described as extrarenal manifestations of AS in multiple case reports. One case report described intramural hematoma of the coronary artery. We report the first case of true spontaneous coronary artery dissection (SCAD with an intimal flap as a very rare manifestation of AS. The patient is a 36-year-old female with history of AS with chronic kidney disease, hypertension, and obesity who presented to the emergency room with acute onset of substernal chest pain radiating to her neck and arms. Troponin was elevated, and ECG showed transient 1 mm ST-segment elevation in the inferior leads. Subsequent coronary angiography revealed localized dissection of the left circumflex artery. Percutaneous coronary angioplasty was performed and her symptoms improved. This case illustrates that SCAD may be a manifestation of AS patients with chest pain.

  10. Changes in left ventricular function after spontaneous coronary artery dissection.

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    Franco, Christopher; Starovoytov, Andrew; Heydari, Milad; Mancini, G B John; Aymong, Eve; Saw, Jacqueline

    2017-03-01

    Spontaneous healing of spontaneous coronary artery dissection (SCAD) and left ventricular ejection fraction (LVEF) recovery is frequently observed clinically. However, LVEF on presentation and follow-up imaging has not been described. We hypothesize that LV dysfunction improves at follow-up after initial SCAD presentation. We included patients with nonatherosclerotic SCAD prospectively followed at Vancouver General Hospital, who had baseline assessment of LVEF and wall-motion abnormality (WMA) during their index presentation. A subset of these patients had repeat assessment of their ventricular function at follow-up. We compared the baseline LVEF and WMA with follow-up assessments and correlated to long-term cardiovascular outcomes. We included 277 SCAD patients who had baseline ventricular assessment performed. The average age was 52.4 ± 9.4 years, and 90.3% were female. All presented with myocardial infarction (24.2% STEMI, 75.8% NSTEMI). At baseline, the mean LVEF was 55.6% ± 9.1% and 72/277 (26.0%) had LVEF 50 µg/L (OR: 1.02, P = 0.005), and SCAD involvement of the LAD (OR: 2.5, P = 0.002) were independent predictors of baseline LVEF SCAD cohort, the majority of patients presented with WMA and had relatively normal LVEF. Over half had subsequent normalization of WMA and LVEF on follow-up assessment. © 2017 Wiley Periodicals, Inc.

  11. Extracranial vertebral artery rupture likely secondary to "cupping therapy" superimposed on spontaneous dissection.

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    Choi, Jae Young; Huh, Chae Wook; Choi, Chang Hwa; Lee, Jae Il

    2016-12-01

    The extracranial vertebral artery (VA) is vulnerable to dissection and the V3 segment is the most common location for dissection. Dissection accounts for about 2% of all ischemic strokes and can occur after trauma or chiropractic neck maneuvers. We report an extremely rare case of spontaneous extracranial VA dissection presenting with posterior neck hematoma aggravated after cupping therapy, a treatment in traditional Oriental medicine. We treated the patient successfully by endovascular treatment without any complication. © The Author(s) 2016.

  12. Spontaneous coronary artery dissection: a case series and literature review

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    Nelson A. Telles Garcia

    2014-09-01

    Full Text Available Spontaneous coronary artery dissection (SCAD is a rare and often lethal cause of acute coronary syndrome, which typically affects young women and otherwise healthy individuals. SCAD can be diagnosed in patients undergoing coronary angiography and can be underestimated. Special techniques such as optical coherence tomography (OCT and intravascular ultrasound should be used when there is suspicion of the condition. In the majority of cases, the left anterior descending (LAD artery is involved; however, a few cases of the right coronary artery (RCA involvement have been reported. This article describes three cases of SCAD in women of different ages, all presenting with chest pain. Coronary angiography in conjunction with OCT was used for diagnosis in two of the cases. One of the patients had involvement of the proximal RCA and underwent percutaneous coronary intervention, whereas the other two patients had mid-LAD disease and were treated conservatively with medical therapy. Presently, there are no specific guidelines for the treatment of SCAD, and therapy is individualized according to extent and severity of the condition.

  13. Emergency Department Presentation of Patients with Spontaneous Coronary Artery Dissection.

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    Lindor, Rachel A; Tweet, Marysia S; Goyal, Kiran A; Lohse, Christine M; Gulati, Rajiv; Hayes, Sharonne N; Sadosty, Annie T

    2017-03-01

    Spontaneous coronary artery dissection (SCAD) is an infrequently recognized but potentially fatal cause of acute coronary syndrome (ACS) that disproportionately affects women. Little is currently known about how patients with SCAD initially present. We sought to describe patients who presented to the emergency department (ED) with symptoms of SCAD to improve providers' awareness and recognition of this condition. We performed a retrospective medical record review of all patients who presented to the ED of a single academic medical center from January 1, 2002 through October 31, 2015 and were subsequently diagnosed with SCAD by angiography. These patients were identified by International Classification of Diseases, Ninth Revision codes and a Boolean search of the diagnosis field of the medical record. Data regarding patients' presentations and course were abstracted by two independent reviewers. We identified 20 episodes of SCAD involving 19 patients, all of whom were female. The majority of patients had 0-1 conventional cardiovascular disease risk factors. Most patients had chest pain (85%), initial electrocardiograms without evidence of ischemia (85%), and elevated initial troponin (72%). The most common diagnosis in providers' differential was acute coronary syndrome (ACS). Patients with SCAD present with similar symptoms compared to patients with ACS caused by atherosclerotic disease, but have different risk profiles. Providers should consider SCAD in patients presenting with symptoms concerning for ACS, especially in younger female patients without traditional cardiovascular disease risk factors, as their risk may be significantly underestimated with commonly used ACS risk-stratifiers. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Rapid Healing of a Spontaneous Coronary Artery Dissection Detected by Computed Tomography Angiography.

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    Sakai, Koyu; Kobayashi, Yohei; Shirai, Shinichi; Ando, Kenji

    2018-03-20

    Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome and little is known about characteristics, treatment, and follow-up of patients with SCAD. Computed tomography angiography (CTA) plays an important role in the diagnosis and management of SCAD. Herein, we describe a case of a patient with SCAD who underwent successful conservative management, and in whom CTA was able to detect rapid healing of the dissection, 4.5 hours post-dissection.

  15. A lesson from intravascular imaging: insights for recognizing a spontaneous coronary artery dissection.

    Science.gov (United States)

    Buccheri, Dario; Milazzo, Diego; Geraci, Salvatore; Vaccaro, Giovanni; Caramanno, Giuseppe

    2017-12-01

    Spontaneous coronary artery dissection (SCAD) is still today an underdiagnosed disease due to the absence of angiographic hallmarks in more than 70% of cases. In several cases, an intravascular imaging is a sole tool for recognizing a dissection. Particularly, optical coherence tomography analysis (OCT) could represent the gold standard technique of easy interpretation and prompt diagnosis. Here we present a rare case of multivessel spontaneous coronary artery disease (SCAD) with atypical collateral circulation.

  16. Safety and efficacy of drug eluting stents in patients with spontaneous coronary artery dissection

    NARCIS (Netherlands)

    Conrotto, Federico; D'Ascenzo, Fabrizio; Cerrato, Enrico; Fernández-Ortiz, Antonio; Gonzalo, Nieves; Macaya, Fernando; Tamburino, Corrado; Barbanti, Marco; van Lavieren, Martijn; Piek, Jan J.; Applegate, Robert J.; Latib, Azeem; Spinnler, Maria Teresa; Marzullo, Raffaella; Iannaccone, Mario; Pavani, Marco; Crimi, Gabriele; Fattori, Rossella; Chinaglia, Alessandra; Presbitero, Patrizia; Varbella, Ferdinando; Gaita, Fiorenzo; Escaned, Javier

    2017-01-01

    Aims: Given the different pathogenesis, use of drug eluting stent (DES) in patients with Spontaneous Coronary Artery Dissection SCAD may delay the healing of the dissected vessel. Aim of our studywas to compare the safety and the efficacy of DES vs. bare metal stent (BMS) in a cohort of patients who

  17. Improvement and Aggravation of Spontaneous Unruptured Vertebral Artery Dissection

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    Tomoya Shibahara

    2017-10-01

    Full Text Available Background: Intracranial vertebral artery dissection (VAD is a well-recognized cause of stroke in young and middle-aged individuals, especially in Asian populations. However, a long-term natural course remains unclear. We investigated the long-term time course of VAD using imaging findings to examine the rate and predisposing factors for improvement. Methods: We registered 56 consecutive patients (40 males; mean age, 51.8 ± 10.7 years with acute spontaneous VAD and retrospectively investigated neuroimaging and clinical course within 1 month and at 3 months ± 2 weeks, 6 months ± 2 weeks, and 12 months ± 2 weeks after onset to ascertain predisposing factors and time course for improvement. Results: The most common presenting symptoms were headache and/or posterior neck pain, seen in 41 patients (73%. Magnetic resonance imaging showed brainstem and/or cerebellum infarction in only 32 patients (57%. Of the 56 VADs, 16 (28% presented with pearl and string sign, 5 (9% with pearl sign, 15 (27% with string sign, and 20 (36% with occlusion sign. VAD occurred on the dominant side in 20 patients and on the nondominant side in the other 36 patients. The pearl and string sign was more frequently noted on the dominant side than on the nondominant side (50 vs. 17%, p = 0.008. On the other hand, occlusion occurred more often on the nondominant side than on the dominant side (47 vs. 15%, p = 0.016. Furthermore, the pearl and string sign was more frequently seen in the improvement group (41 vs. 15%, p = 0.028, whereas the occlusion sign was evident more frequently in the nonimprovement group (21 vs. 52%, p = 0.015. Follow-up neuroimaging evaluation was performed at 1 and 3 months in 91% each, and at 6 and 12 months in 82% each. VAD aggravation was identified within 1 month after onset in 14%, while VAD improvement was seen in 14, 38, 50, and 52% at each period, mainly within 6 months after onset. Older patients and current smoking were negatively associated

  18. Clinical presentation of patients with spontaneous coronary artery dissection.

    Science.gov (United States)

    Luong, Christina; Starovoytov, Andrew; Heydari, Milad; Sedlak, Tara; Aymong, Eve; Saw, Jacqueline

    2017-06-01

    Spontaneous coronary artery dissection (SCAD) is an infrequent but important cause of myocardial infarction (MI) especially in younger women. However, the clinical presentation and the acuity of symptoms prompting invasive management in SCAD patients have not been described. Understanding these presenting features may improve SCAD diagnosis and management. We reviewed SCAD patients who were prospectively followed at the Vancouver General Hospital SCAD Clinic. Their presenting symptoms and unstable features were obtained from detailed clinical histories and hospital admission documentation. Baseline characteristics, predisposing and precipitating conditions, angiographic findings, management strategies, in-hospital, and long-term events were recorded prospectively. We included 196 SCAD patients who had complete documentation of their presenting symptoms. The majority were women (178/196; 90.8%) and all presented with MI (24.0% STEMI). The most frequent presenting symptom was chest discomfort, reported by 96%. Other symptoms included arm pain (49.5%), neck pain (22.1%), nausea or vomiting (23.4%), diaphoresis (20.9%), dyspnea (19.3%), and back pain (12.2%). Ventricular tachycardia/fibrillation occurred in 8.1% (16/196), with 1.0% having cardiac arrest. The time from symptom onset to hospital presentation was 1.1 ± 3.0 days. NSTEMI patients had longer delay for coronary angiography compared with STEMI (2.0 ± 2.5 days vs. 0.8 ± 1.7 days, P = 0.002). Overall, 34.2% had unstable symptoms upon arrival for coronary angiography. Those with unstable symptoms were more likely to undergo repeat angiography (65.7% vs. 50.4%, P = 0.049), and repeat or unplanned revascularization (14.9% vs. 5.4%, P = 0.033) during acute hospitalization. Chest discomfort was the most frequent presenting symptom with SCAD and one-third had unstable symptoms prompting urgent invasive angiography. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  19. Spontaneous Coronary Artery Dissection: Clinical Outcomes and Risk of Recurrence.

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    Saw, Jacqueline; Humphries, Karin; Aymong, Eve; Sedlak, Tara; Prakash, Roshan; Starovoytov, Andrew; Mancini, G B John

    2017-08-29

    Spontaneous coronary artery dissection (SCAD) is underdiagnosed and an important cause of myocardial infarction (MI), especially in young women. Long-term cardiovascular outcomes, including recurrent SCAD, are inadequately reported. This study sought to describe the acute and long-term cardiovascular outcomes and assess the predictors of recurrent SCAD. Nonatherosclerotic SCAD patients were prospectively followed at Vancouver General Hospital systematically to ascertain baseline, predisposing and precipitating stressors, angiographic features, revascularization, use of medication, and in-hospital and long-term cardiovascular events. Clinical predictors for recurrent de novo SCAD were tested using univariate and multivariate Cox regression models. The authors prospectively followed 327 SCAD patients. Average age was 52.5 ± 9.6 years, and 90.5% were women (56.9% postmenopausal). All presented with MI; 25.7% had ST-segment elevation MI, 74.3% had non-ST-segment elevation MI, and 8.9% had ventricular tachycardia/ventricular fibrillation. Precipitating emotional stressors were reported in 48.3% and physical stressors in 28.1%. Fibromuscular dysplasia was present in 62.7%, connective tissue disorder in 4.9%, and systemic inflammatory disease in 11.9%. The majority (83.1%) were initially treated medically, with only 16.5% or 2.2% undergoing in-hospital percutaneous coronary intervention or coronary artery bypass graft surgery, respectively. The majority of SCAD patients were taking aspirin and beta-blocker therapy at discharge and at follow-up. Median hospital stay was 3.0 days, and the overall major adverse event rate was 7.3%. Median long-term follow-up was 3.1 years, and overall major adverse cardiac event rate was 19.9% (death rate: 1.2%; recurrent MI: 16.8%; stroke/transient ischemic attack: 1.2%; revascularization: 5.8%). Recurrent SCAD occurred in 10.4% of patients. In multivariate modeling, only hypertension increased (hazard ratio: 2.46; p = 0.011) and

  20. Isolated spontaneous dissection of the celiac trunk in a patient with bicuspid aortic valve

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    Abdel-Rauf Zeina

    2010-05-01

    Full Text Available Abdel-Rauf Zeina1, Alicia Nachtigal1, Anton Troitsa2, Gil Admon2, Nina Avshovich31Department of Radiology, 2Department of Surgery A, 3Department of Internal Medicine C, Hillel Yaffe Medical Center, Hadera, Israel. Hillel Yaffe Medical Center is affiliated with the Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, IsraelAbstract: Isolated spontaneous dissection of celiac trunk is a rare entity. The spontaneous dissection of the visceral artery occurs without aortic dissection. The most consistent presenting symptom is acute onset abdominal pain. Complications consist of ischemia, aneurysm formation, and rupture. We report an exceptional case of an isolated spontaneous dissection of the celiac trunk which occurred in a 49 year old male with a previously undiagnosed bicuspid aortic valve (BAV. We also describe the classical appearance in different imaging modalities with a particular emphasis on multidetector computed tomography, and discuss the clinical manifestation and its relationship to BAV.Keywords: celiac trunk dissection, isolated spontaneous dissection, CT angiography, bicuspid aortic valve, MRA

  1. Spontaneous intracranial arterial dissection in the young: diagnosis by CT angiography

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    Given Curtis A

    2006-04-01

    Full Text Available Abstract Background Spontaneous carotid artery dissections have been rarely reported in children. Diagnosis has traditionally been confirmed by catheter arteriography. More recently diagnosis has been made by magnetic resonance imaging and magnetic resonance angiography; however the sensitivity of these techniques has yet to be determined. The authors are unaware of reports of carotid dissection confirmed by dynamic computed tomography (computerized tomographic arteriography in the young. Case presentation We recently evaluated a fourteen year-old male following the development of transient neurologic symptoms. There was no antecedent illness or trauma. Dynamic computed tomography revealed an intracranial dissection involving the supraclinoid segment of the left internal carotid artery (confirmed by catheter arteriography. Studies for vasculitis, pro-thrombotic states, and defects of collagen were negative. Conclusion Spontaneous carotid artery dissection is a potential cause of transient neurological symptoms and ischemic stroke in the pediatric population. Dynamic computed tomography appears to be a reliable diagnostic tool which can lead to early diagnosis.

  2. Successful Treatment of Isolated Spontaneous Superior Mesenteric Artery Dissection with Stent Placement

    International Nuclear Information System (INIS)

    Yoon, Young-Won; Choi, Donghoon; Cho, Seung-Yun; Lee, Do Yun

    2003-01-01

    Isolated dissection of superior mesenteric artery is a rare condition and is usually treated surgically. We treated a patient with severe abdominal pain who was angiographically confirmed to have superior mesenteric artery thrombosis associated with isolated spontaneous dissection. He was treated initially by thrombolysis and oral anticoagulation, but recurrent symptoms developed with radiologic evidence of disease progression. We performed superior mesenteric artery stenting and recovery was uneventful

  3. A Case of Spontaneous Isolated Celiac Artery Dissection with Pseudoaneurysm Formation.

    Science.gov (United States)

    Kim, John; Moree, Lamar H; Muehlberger, Michael J

    2017-08-27

    Spontaneous isolated celiac artery dissection is a rare disease and patients without evidence of significant complications often resolve with medical therapy alone; however, the extension of the dissection can lead to more serious complications including aneurysmal dilatation, complete occlusion, and rupture of a visceral artery. In these patients, optimal management has not yet been clearly defined and treatment primarily depends on clinical presentation and lesions identified on imaging studies. This case report demonstrates the conservative management of spontaneous celiac artery dissection. A 49-year-old male presented to our emergency department with acute and persistent abdominal pain. A contrast-enhanced computed tomogram (CT) of abdomen showed a pseudoaneurysm involving the ostium of the celiac artery with focal dissection, with no evidence of thrombosis or infarction to the visceral organs. Ultrasound studies demonstrated a prominent but patent celiac artery with adequate distal perfusion. Therefore, conservative medical management with antiplatelet therapy was initiated in our patient. Follow-up repeat ultrasound three weeks following discharge showed no evidence of dissection flap, stenosis, thrombosis or increase in the size of the aneurysm. This case report demonstrates that conservative medical management with antiplatelet therapy can be sufficient in treating spontaneous isolated celiac artery dissection with pseudoaneurysm formation. We suggest endovascular or surgical intervention should be reserved for patients who present with hemodynamic instability, or other serious complications, such as aneurysm rupture or visceral infarction.

  4. Self-limiting Spontaneous Isolated Celiac Artery Dissection: A Case Report

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    A.D. Morzycki

    Full Text Available : Introduction: Isolated dissection of the celiac artery is rare, with less then 100 cases reported to date. Although some patients present with epigastric pain and tenderness, many cases are asymptomatic and found incidentally on CT. The appropriate management of isolated celiac artery dissections is unclear. This report illustrates an observational approach to a symptomatic case of isolated celiac artery dissection. Report: A 55-year-old Caucassian male presented to the emergency department with epigastric pain. His Initial CT revealed possible celiac artery dissection with associated intramural hematoma. Due to continued pain, a subsequent CTA was ordered. This scan showed progression of the intramural hematoma to near occlusion of the hepatic artery. Despite this, there were no signs of ischemic hepatitis as indicated by normal levels of liver transaminases. There was also no evidence to suggest propagation of the dissection or pseudo-aneurysm formation. We therefore choose a conservative and observational approach to this isolated celiac artery dissection. His dissection was managed with ASA and metoprolol, and he was discharged after 1 week of observation. 3 week follow-up CTA showed spontaneous resolution of the intramural hematoma and improved patency of the hepatic artery. There was no change at 3 months follow-up. Conclusion: This case highlights that an observational approach to cases of isolated celiac artery dissection may be indicated if there is no evident end organ disease or malperfusion. Keywords: Celiac artery, Dissection, Management

  5. Endovascular stent graft for treatment of complicated spontaneous dissection of celiac artery: Report of two cases

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    Kang, Ung Rae; Lee, Young Hwan [Dept. of Diagnostic Radiology, Catholic University of Daegu School of Medicine, Daegu (Korea, Republic of); Kim, Young Hwan [Dept. of Diagnostic Radiology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2013-06-15

    We report 2 cases of complicated spontaneous dissection of the celiac artery, which were successfully treated by a stent graft. The first patient was a 47-year-old man who presented with acute abdominal pain. CT scan showed ruptured saccular aneurysm with surrounding retroperitoneal hematoma. The second patient was a 57-year-old man with progressive dissecting aneurysm. Endovascular stent graft was placed in the celiac trunk to control bleeding, and to prevent rupture in each patient. Follow-up CT scans showed complete obliteration of a dissecting aneurysm.

  6. Characteristics of extension and de novo recurrent spontaneous coronary artery dissection.

    Science.gov (United States)

    Main, Anthony; Prakash, Roshan; Starovoytov, Andrew; Sabbaghan, Amir; Aymong, Eve; Mancini, G B John; Saw, Jacqueline

    2017-12-08

    Spontaneous coronary artery dissection (SCAD) is an under-recognised and important cause of myocardial infarction in young women. Recurrent SCAD is frequent but poorly understood. We aimed to explore the clinical and angiographic characteristics, and outcomes of recurrent SCAD. Patients with SCAD extension or recurrence prospectively followed at Vancouver General Hospital were included in this retrospective study. SCAD diagnosis was confirmed by two experienced cardiologists. Detailed medical history, baseline demographics, angiographic results, and clinical details of index SCAD and recurrent events were recorded. SCAD extension was defined as angiographic extension of a previously dissected coronary segment, and de novo recurrent SCAD was defined as new spontaneous dissection. We identified 43 patients with SCAD recurrence with mean age 48.9±8.4 years; 38/43 were women, and 32/43 had fibromuscular dysplasia. Nine patients had SCAD extension at median time of five (1-19) days, while 34 patients had de novo recurrent SCAD at median time of 1,487 (107- 6,461) days after the index SCAD event. All SCAD extension patients had worsening of the index dissected segment, with 5/9 involving extension to adjacent segments, while all de novo recurrent SCAD patients had new dissections affecting coronary segments distinct from the index dissection. De novo recurrent SCAD invariably affected new segments distinct from previously dissected segments.

  7. [Spontaneous coronary artery dissection: An exceptional cause of acute coronary syndrome].

    Science.gov (United States)

    Yao, H; Ekou, A; N'Djessan, J J; Zoumenou, A; Angoran, I; N'Guetta, R

    2018-02-01

    Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndrome (ACS) or sudden death, which typically affects young women. We reported two cases of black Africans patients, aged 56 and 52 years old, who presented to Abidjan Heart Institute for ACS. Coronary angiography showed spontaneous dissection of the right coronary artery in the first case, and dissection of the distal left anterior descending artery in the second. A conservative approach was preferred. Both patients received antiplatelet agents, beta-blockers, angiotensin converting enzyme inhibitors and statins, with a favorable in-hospital course. These cases highlight SCAD as a possible cause of ACS. Implementation of interventional cardiology in Sub-Saharan Africa will help identify this uncommon cause of ACS. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  8. Postpartum Sudden Cardiac Death After Spontaneous Coronary Artery Dissection in a Patient With Fibromuscular Dysplasia.

    Science.gov (United States)

    Shoja, Tannaz; Basman, Craig; Jain, Suresh; Mangla, Aditya; Lasic, Zoran

    2017-12-01

    Spontaneous coronary artery dissection (SCAD) is a rare entity that can cause acute myocardial infarction and sudden cardiac death (SCD) which often goes unrecognized. We report a case of SCAD in a young postpartum female who presented with sudden cardiac arrest. The patient was managed medically and found to have fibromuscular dysplasia (FMD). After being stabilized in the critical care unit, coronary angiography was performed which showed dissection of the left main artery, intramural hematoma, and the culprit lesion. Further investigation showed dissection of the left vertebral artery which was all consistent with a diagnosis of FMD. The patient was followed as an outpatient and a repeated coronary angiography demonstrated healed dissection site. In conclusion, this case exemplifies that prompt diagnosis along with medical management without the need of coronary artery bypass graft, and percutaneous coronary intervention can improve survival in SCAD.

  9. Multiple Spontaneous Intracranial-Extracranial Arterial Dissections in a Patient with Osteogenesis Imperfecta

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    Mehmet Kolukısa

    2017-01-01

    Full Text Available A 40-year-old male with osteogenesis imperfecta (OI was admitted to the hospital with an acute right monoparesis. Diffusion-weighted MRI showed infarction in the territory of the left anterior cerebral artery (ACA and in the left posterior cerebral artery (PCA. In his vascular imaging, occlusion of the left vertebral artery (VA starting from V2 segment was consistent with dissection and pseudoaneurysm in the right ACA. We presented this case because of the presence of spontaneous and simultaneous occurrence of both intracranial and extracranial arterial dissections in OI.

  10. Spontaneous circumferential esophageal dissection in a young man with eosinophilic esophagitis.

    Science.gov (United States)

    Quiroga, Jorge; Prim, José María G; Moldes, Milagros; Ledo, Ramiro

    2009-12-01

    Spontaneous esophageal dissection is a rare condition that may happen in patients with eosinophilic esophagitis. Conservative management is an important therapeutic option to be considered. We describe an unusual case of a young man with eosinophilic esophagitis who presented complaining of acute retrosternal pain, fever and vomiting. After a thorough evaluation including CT-scan and esophagogram, circumferential esophageal dissection and mediastinal abscess without visible perforation was observed. Abscess resolution and oral nutrition reintroduction was achieved with non-surgical management. Corticoid therapy was initiated for esophagitis treatment.

  11. Spontaneous dissection of the arterial duct during continuous infusion of prostaglandin E1 in a neonate with aortic arch interruption.

    Science.gov (United States)

    Inoue, Nao; Yasukochi, Satoshi; Takigiku, Kiyohiro; Matsui, Hikoro; Takei, Kohta; Nakano, Yusuke; Otagiri, Tessyu; Hashida, Yuichiro; Ogiso, Yoshifumi; Maekawa, Yoshiyuki; Umezu, Kentaro; Sakamoto, Takahiko; Harada, Yorikazu

    2013-12-01

    We report a 3-day-old boy with double outlet of the right ventricle and interruption of the aortic arch who developed spontaneous dissection of the arterial duct (DA) despite use of continuous infusion of lipo-prostaglandin E1 (PGE1). Transthoracic echocardiography demonstrated the spontaneous dissecting aneurysm of DA, which was confirmed by histology at the modified Norwood procedure done at age of 18 days. This is the first report of spontaneous dissection of DA in a neonate receiving PGE1, suggesting a new closing mechanism of DA.

  12. Succesful treatment of spontaneous dissection of the coronary artery by primary percutaneous coronary intervention

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    Yüksel Çavuşoğlu

    2011-09-01

    Full Text Available Spontaneous coronary artery dissection (SCAD is a rare cause of acute myocardial infarction. The disease is usually seen in young-middle aged women and leads to sudden death in the majority of cases. In survived patients, diagnosis of SCAD has been made with coronary anjiography. Involvement of left main coronary artery (LMCA is very unusual. We describe on a case of SCAD involving the LMCA in a young woman presenting with an acute myocardial infarction and cardiogenic shock status. There were no risk factors for coronary artery disease and no evidence of atherosclerosis on angiography. Coronary angiography revealed dissection of the LMCA that extended into the anterior descending and circumflex coronary arteries. The dissection was successfully treated with primary coronary artery stenting. The patient was discharged without complication. There was no problem in the first evaluation at the end of the first of the month. J Clin Exp Invest 2011; 2 (3: 299-303.

  13. The link between spontaneous coronary artery dissection and takotsubo cardiomyopathy: analysis of the published cases.

    Science.gov (United States)

    Buccheri, Dario; Zambelli, Giulia

    2017-12-01

    Spontaneous coronary artery dissection (SCAD) and takotsubo cardiomyopathy (TTS) are two non-atherosclerotic causes of myocardial infarction. They share several common features. Firstly, they have a predilection for the female gender and, in both, the exact mechanism has yet to be fully established. Both they could be responsible for an acute coronary syndrome. Hence, we want to do further consideration based on pathophysiology, literature review, and cases presented affected by both entities up today.

  14. Spontaneous dissection of the celiac artery in the young: a case report and systematic review of the literature.

    Science.gov (United States)

    Tana, Marco; Tana, Claudio; Schiavone, Cosima; Verdiani, Valerio; Palermo, Carlo; Alessandri, Massimo; Giamberardino, Maria Adele; Montagnani, Andrea

    2017-12-01

    The spontaneous isolated celiac artery dissection (siCAD) represents a challenging cause of abdominal pain and complete information regarding incidence, etiology and risk factors in the young is still lacking. In this study, we report a case of siCAD occurred in a young woman and we systematically searched for information on siCADs in literature databases. PubMed/Embase and Cochrane were searched for, using the following terms: Isolated celiac trunk dissection, isolated celiac artery dissection, celiac artery dissection, celiac trunk dissection, spontaneous isolated visceral artery dissection, spontaneous isolated dissection of visceral arteries, isolated celiac artery dissection in the young, isolated celiac trunk dissection in the young. Patients were included if they were younger than 50 years, if they had a spontaneous etiology and a selective involvement of the celiac artery (with or without involvement of its branches). 180 studies were found, and 18 remained after screening. Twenty-one patients (male = 19, female = 2) with siCADs were included. Mean age was 44.71 ± 3.61 years. Hypertension was the most prevalent comorbidity. All patients presented with abdominal pain, more often located in the epigastrium (n = 11). Almost all patients underwent CT to confirm the diagnosis. A conservative treatment was adopted in 13 patients while an invasive approach was adopted in 8 patients (endovascular approach in 7). siCADs represent a rare but important cause of vascular dissection in the young. Uncomplicated cases can be safely treated with conservative strategies. The surgical or endovascular repair is indicated when dissections complicate or symptoms persist despite an adequate conservative treatment.

  15. Clinical features of 10 patients with spontaneous cervical internal carotid artery dissection

    International Nuclear Information System (INIS)

    Nagoya, Harumitsu; Takeda, Hidetaka; Dembo, Tomohisa; Kato, Yuzi; Deguchi, Ichiro; Fukuoka, Takuya; Maruyama, Hazime; Horiuchi, Yohsuke; Tanahashi, Norio

    2011-01-01

    We clinically investigated 10 patients with spontaneous cervical internal carotid artery dissections (age range 36-70, mean 52±12 years; 8 male and 2 female) who were admitted to our university hospital between August 2002 and 2009. Cervical internal carotid artery dissection was diagnosed using findings from MRI, MR angiography (MRA), 3D-CTA, cerebral angiography, and carotid artery ultrasonography according to the diagnostic criteria of brain artery dissociation defined by the brain artery dissociation working group of the Strategies Against Stroke Study for Young Adults in Japan. The initial symptoms were stroke in eight patients, only neck pain in another, and no symptoms in the last. Four patients (40%) had neck pain or headache at onset. Five of the 10 patients had radiological improvements within three months after onset. The outcomes at three months were relatively good, with seven and three patients scoring 1 and 2, respectively, on the modified Rankin Scale. Disease did not recur in any patients during an average of 17.2 months of follow up. Spontaneous cervical internal carotid artery dissection is not rare in Japan. This condition should be considered when patients present with internal carotid artery occlusion or stenosis. (author)

  16. Spontaneous coronary artery dissection causing acute coronary syndrome in a young patient without risk factors

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    Parag Chevli

    2014-09-01

    Full Text Available Spontaneous coronary artery dissection (SCAD is a rare cause of acute myocardial infarction that is more common in younger patients (under age 50 and in women. Although the etiology is not known, some predisposing conditions to SCAD are well known and include Marfan syndrome, pregnancy and peripartum state, drug abuse, and some anatomical abnormalities of the coronary arteries such as aneurysms and severe kinking. We describe a case of SCAD in a young woman who presented with sudden onset of chest pain and was admitted for the treatment of acute coronary syndrome. The coronary angiography showed dissection of the left anterior descending artery. The patient underwent successful percutaneous transluminal coronary angioplasty and stent placement.

  17. Spontaneous Coronary Artery Dissection: An Under-recognized Cause of Acute Coronary Syndromes.

    Science.gov (United States)

    Al Naabi, Hanan; Al Lawati, Hatim

    2017-07-01

    Spontaneous coronary artery dissection (SCAD) is a rare condition that is often underdiagnosed given limitations of conventional cineangiography. In addition to the diagnostic challenge, the condition poses a major therapeutic dilemma given paucity of literature to guide management. We report the case of a 55-year-old woman, who presented with acute coronary syndrome. Coronary angiography at the time of the index hospitalization revealed type 2 SCAD. She was managed conservatively. Repeat coronary angiography three months later showed complete resolution of the previously noted dissection. Because of the high association between SCAD and fibromuscular dysplasia (FMD), a cross-sectional imaging was performed in this case, which ruled out underlying FMD. The patient has been followed longitudinally since her index event and has had no reported recurrences.

  18. Spontaneous Coronary Artery Dissection: An Under-recognized Cause of Acute Coronary Syndromes

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    Hanan Al Naabi

    2017-07-01

    Full Text Available Spontaneous coronary artery dissection (SCAD is a rare condition that is often underdiagnosed given limitations of conventional cineangiography. In addition to the diagnostic challenge, the condition poses a major therapeutic dilemma given paucity of literature to guide management. We report the case of a 55-year-old woman, who presented with acute coronary syndrome. Coronary angiography at the time of the index hospitalization revealed type 2 SCAD. She was managed conservatively. Repeat coronary angiography three months later showed complete resolution of the previously noted dissection. Because of the high association between SCAD and fibromuscular dysplasia (FMD, a cross-sectional imaging was performed in this case, which ruled out underlying FMD. The patient has been followed longitudinally since her index event and has had no reported recurrences.

  19. Spontaneous Renal Artery Dissection in a Patient with Neurofibromatosis Type I

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    Nicolas W. Shammas

    2016-01-01

    Full Text Available We present a case of spontaneous renal artery dissection (SRAD in a 28-year-old female with history of neurofibromatosis type I (NF-1 treated successfully with endovascular stenting. The clinical presentation, diagnostic testing, and treatment options are discussed. An endovascular approach with stenting was successfully performed after failure of medical treatment with subcutaneous low molecular weight heparin. Patient’s blood pressure and symptoms improved significantly. This may be the first reported case of SRAD in a patient with NF-1 successfully treated with endovascular stenting.

  20. Spontaneous coronary artery dissection and takotsubo syndrome: The chicken or the egg causality dilemma.

    Science.gov (United States)

    Y-Hassan, Shams; Themudo, Raquel; Maret, Eva

    2017-06-01

    Acute coronary syndrome (ACS) including spontaneous coronary artery dissection (SCAD) has been reported to trigger its own clinical twin takotsubo syndrome (TS). The pathogenetic association between SCAD and TS remains to be elucidated. The two diseases afflict predominantly women and both conditions may be triggered by an emotional stress factor and an unusual extreme physical exercise. Herein, we describe a case of 54-year-old woman presenting with ACS caused by an obtuso-marginal SCAD. Concurrently, the patient had typical clinical features and course of mid-apical pattern of TS. The causal link between the two conditions is discussed. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  1. Spontaneous Coronary Artery Dissection: A Review of Pathogenesis, Presentations, Treatment, and Outcomes.

    Science.gov (United States)

    Afzal, Aasim; Sarmast, Syed; Choi, James W; McCullough, Peter A; Schussler, Jeffrey M

    2017-01-01

    Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndromes and sudden cardiac death. The epidemiology, pathogenesis, and optimal approaches to diagnosis and management are poorly understood. Additionally, SCAD as a syndrome is commonly under-recognized and its prognosis is not well studied. Guidelines on management of SCAD have not yet been established. We present three cases of SCAD that varied in their clinical presentation and describe the different management strategies utilized. This is followed by a review of the clinical features, epidemiology, prognosis, and potential treatment strategies for patients presenting with SCAD.

  2. [A rare case of spontaneous coronary artery dissection after emotional stress in a postmenopausal woman].

    Science.gov (United States)

    DU, Yuan; Han, Ke; Bai, Ling; Liu, Ping

    2017-08-20

    Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction. While its etiology and pathogenesis remain not fully understood, SCAD occurs most frequently in patients at a young age and of a female gender. We report a case of SCAD in a 52-year-old healthy postmenopausal woman who developed acute myocardial infarction and subsequent ventricular aneurysm after emotional stress. This case may provide valuable insight into this rare disease and highlights the importance of psychological factors as contributing factors of SCAD in postmenopausal women with acute onset of chest pain.

  3. Use of a Three-Stent Technique for a Case of Spontaneous Coronary Artery Dissection.

    Science.gov (United States)

    Dashwood, Alexander M; Saw, Jacqueline; Dhillon, Priyanka; Murdoch, Dale

    2017-06-01

    A 78-year-old woman presented with acute inferior ST-segment-elevation myocardial infarction and complete heart block. Angiography revealed spontaneous coronary artery dissection (SCAD) of her right coronary artery. Given her ongoing instability, we proceeded to primary coronary intervention. A strategy of sealing the distal lesion edge followed by the proximal edge containing the intramural hematoma before placing a final stent to the midsegment was decided on (3-stent strategy). Our case represents the second such "sequential stent-sandwiching" report and provides a strategy for percutaneous coronary intervention in hemodynamically unstable patients with SCAD. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  4. A Case of Spontaneous Coronary Artery Dissection Complicated by Free Wall Rupture.

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    Alzayer, Hussain; Bossard, Matthias; Ahsan, Shoeb; Tsang, Michael; Whitlock, Richard; Sheth, Tej

    2017-12-01

    Spontaneous coronary artery dissection (SCAD) is an unusual and underdiagnosed cause of nonatherosclerotic acute coronary syndrome (ACS). Patients might present in various ways including chest pain, ST-elevation ACS, ventricular arrhythmia, and sudden cardiac death. In a few reports, it manifested initially as cardiac tamponade. The association of SCAD with free wall rupture is extremely rare. We present a unique case of a 70-year-old woman who initially presented with non-ST elevation ACS and was found to have SCAD on angiography, which was subsequently complicated by cardiac tamponade with free wall rupture. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  5. Spontaneous Coronary Artery Dissection: Insights From Histology and Optical Coherence Tomography.

    Science.gov (United States)

    Krishnan, Sandeep K; Zhu, Alex; Larson, Brent; Henry, Timothy D; Dohad, Suhail

    2017-01-01

    Spontaneous coronary artery dissection (SCAD) is a well-known but infrequent cause of acute coronary syndrome (ACS), and often goes unrecognized. Although management of SCAD is, at times, controversial, when a patient presents with ACS, percutaneous coronary intervention (PCI) is frequently necessary. We present a patient with ST-segment elevation myocardial infarction (STEMI) with SCAD that illustrates two important points: use of intracoronary optical coherence tomography to guide PCI, and histologic assessment to provide a unique insight into the etiology of SCAD. Following the case, we briefly review the important aspects of the pathophysiology, epidemiology, diagnosis, and interventional management of SCAD.

  6. Acute Coronary Syndrome Due to Spontaneous Coronary Artery Dissection in a Middle-Aged Man

    Directory of Open Access Journals (Sweden)

    Davran Cicek

    2014-08-01

    Full Text Available True spontaneous coronary artery dissection (SCAD is an extremely rare but important cause of acute coronary syndrome, with only about 200 cases reported in the literature. Diagnosis is often made at autopsy. Risk factors include oral contraceptive use, atherosclerotic disease and the peripartum period. SCAD should be considered when a healthy young patient presents with the onset of acute myocardial ischemic syndrome. A timely diagnosis and intervention are mandatory as SCAD can cause sudden death. We present a case of SCAD with an uncommon clinical presentation of acute coronary syndrome and without identifiable risk factors, and successfully treated with non-invasive (medical therapy.

  7. The Diagnosis of Spontaneous Coronary Artery Dissection by Optical Coherence Tomography.

    Science.gov (United States)

    Kanda, Takahiro; Tawarahara, Kei; Matsukura, Gaku; Matsunari, Masayoshi; Takabayashi, Rumi; Tamura, Jun; Ozeki, Mariko; Ukigai, Hiroshi

    2018-02-15

    Spontaneous coronary artery dissection (SCAD) is rare, but it frequently presents as acute myocardial infarction. It is frequently fatal and most cases are diagnosed at autopsy. We herein present the case of a 65-year-old woman with ST-elevation and myocardial infarction due to SCAD. Optical coherence tomography (OCT) helped us to confirm the diagnosis. The information on the intravascular morphology provided by OCT imaging is much more detailed in comparison to that provided by coronary angiography (CAG) and intravascular ultrasound (IVUS).

  8. Medical and Interventional Therapy for Spontaneous Vertebral Artery Dissection in the Craniocervical Segment

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    Guiyun Zhang

    2017-01-01

    Full Text Available Background and Purpose. Spontaneous vertebral artery dissection (SVAD is an important reason for posterior-circulation-ischemic stroke in the young and middle-aged population. Although some previous reports reveal a favorable outcome with conservative therapy, it is still controversial in the treatment of SVAD in some specific patients. Herein, we present our 10 years of clinical experience for SVAD at this location. Material and Methods. 20 patients with 20 SVADs in V2 and V3 segments were retrospectively studied. Clinical manifestations and imageology materials were collected and analyzed. All the patients underwent anticoagulation except for one patient because of contraindication. 14 patients underwent Wingspan stents implantation with general anesthesia. Results. In our sample, ischemia (infarction or transient ischemic attack, TIA was found in all the patients. Angiographic stenosis and dissection aneurysm were the most common findings in the segments mentioned above. 19 of the patients (95% got the excellent imageological and clinical outcomes. Conclusions. According to our experience in this group, although anticoagulation is effective in vertebral artery dissection, interventional therapy for SVADs in V2 and/or V3 segments is preferred in some specific patients. Stent with higher radial supporting and flexibility, such as Wingspan stent, is suggested.

  9. Successful treatment of long spontaneous coronary dissection with medical management: Not to intervene

    Directory of Open Access Journals (Sweden)

    Hatem Ari

    2013-12-01

    Full Text Available Spontaneous coronary artery dissection (SCAD is an uncommon cause of acute coronary syndrome (ACS and optimal therapy has not been well-defined. We present a case of long SCAD with complete healing due to medical management. A 47-year-old woman presented to emergency department because of sudden onset of typical chest pain. Electrocardiogram (ECG showed minimal ST-segment elevation in leads V1–V4. Coronary angiography showed a long spiral dissection extending from the middle segment to the distal segment of the left anterior descending artery and TIMI flow grade three. We decided to follow-up with medical management and have control angiography unless hemodynamic instability and chest pain emerged. Control angiography displayed complete healing of dissect segment after six months. SCAD should be considered, especially in women who present with an ACS without a history of cardiovascular disease and risk factor. This report offers the idea that medical management can be a choice even if in the long segment SCAD setting.

  10. Spontaneous Coronary Artery Dissection in a Male Patient with Takayasu’s Arteritis and Antiphospholipid Antibody Syndrome

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    Demet Menekşe Gerede

    2013-01-01

    Full Text Available We present a case of a 34-year-old male who presented to the emergency ward with fever and abdominal pain. The diagnosis of Takayasu’s arteritis and also antiphospholipid syndrome was made during an imaging workup of deep-vein thrombosis. A spontaneous coronary artery dissection was revealed in coronary CT angiography requested for chest pain and dyspnea. The patient was treated medically and discharged on close followup. The concurrence of spontaneous coronary artery dissection with antiphospholipid syndrome and Takayasu’s arteritis has not been reported in the previous literature. The possibility of a spontaneous coronary artery dissection should be considered in patients presenting with both diseases.

  11. Spontaneous Coronary Dissection: “Live Flash” Optical Coherence Tomography Guided Angioplasty

    Science.gov (United States)

    Bento, Angela Pimenta; Fernandes, Renato Gil dos Santos Pinto; Neves, David Cintra Henriques Silva; Patrício, Lino Manuel Ribeiro; de Aguiar, José Eduardo Chambel

    2016-01-01

    Optical Coherence tomography (OCT) is a light-based imaging modality which shows tremendous potential in the setting of coronary imaging. Spontaneous coronary artery dissection (SCAD) is an infrequent cause of acute coronary syndrome (ACS). The diagnosis of SCAD is made mainly with invasive coronary angiography, although adjunctive imaging modalities such as computed tomography angiography, IVUS, and OCT may increase the diagnostic yield. The authors describe a clinical case of a young woman admitted with the diagnosis of ACS. The ACS was caused by SCAD detected in the coronary angiography and the angioplasty was guided by OCT. OCT use in the setting of SCAD has been already described and the true innovation in this case was this unique use of OCT. The guidance of angioplasty with live and short images was very useful as it allowed clearly identifying the position of the guidewires at any given moment without the use of prohibitive amounts of contrast. PMID:26989520

  12. Spontaneous Coronary Dissection: “Live Flash” Optical Coherence Tomography Guided Angioplasty

    Directory of Open Access Journals (Sweden)

    Angela Pimenta Bento

    2016-01-01

    Full Text Available Optical Coherence tomography (OCT is a light-based imaging modality which shows tremendous potential in the setting of coronary imaging. Spontaneous coronary artery dissection (SCAD is an infrequent cause of acute coronary syndrome (ACS. The diagnosis of SCAD is made mainly with invasive coronary angiography, although adjunctive imaging modalities such as computed tomography angiography, IVUS, and OCT may increase the diagnostic yield. The authors describe a clinical case of a young woman admitted with the diagnosis of ACS. The ACS was caused by SCAD detected in the coronary angiography and the angioplasty was guided by OCT. OCT use in the setting of SCAD has been already described and the true innovation in this case was this unique use of OCT. The guidance of angioplasty with live and short images was very useful as it allowed clearly identifying the position of the guidewires at any given moment without the use of prohibitive amounts of contrast.

  13. The role of Intravascular Ultrasound in the management of spontaneous coronary artery dissection

    Directory of Open Access Journals (Sweden)

    Karamitsos Theodoros D

    2008-05-01

    Full Text Available Abstract Primary or spontaneous coronary artery dissection (SCAD is an unusual but increasingly recognized cause of acute myocardial ischemia and sudden cardiac death. Typically, SCAD presents in younger patients without conventional risk factors for coronary artery disease. It occurs more commonly in women than in men, and frequently during pregnancy or the postpartum period. Its pathophysiology is poorly understood, and there is considerable controversy regarding the optimal management of patients with SCAD-related myocardial ischemia. Therapeutic approaches include conservative medical therapy, coronary artery bypass graft surgery and percutaneous coronary intervention (PCI. We present four cases of SCAD to illustrate specific aspects of the presentation and management of this condition, with particular reference to the importance of intravascular ultrasound (IVUS to aid diagnosis and guide subsequent PCI.

  14. Sudden Death from Spontaneous Coronary Artery Dissection due to Polyarteritis Nodosa.

    Science.gov (United States)

    Munguti, Cyrus M; Ndunda, Paul M; Muutu, Tabitha M

    2017-10-02

    Spontaneous coronary artery dissection (SCAD) is an emerging and rare cause of acute coronary syndrome and sudden cardiac death. While it was previously reported among young females with fibromuscular dysplasia, new literature indicates that this condition could occur in older populations. Polyarteritis nodosa (PAN) causes systemic necrotizing vasculitis which typically affects small to medium-sized muscular arteries and could affect the coronary arteries. A few case reports of PAN causing acute coronary artery disease have been reported in the literature. We report a case of a 62-year-old lady who presented with abdominal pain and died abruptly during her stay; she was found to have PAN-associated SCAD on autopsy.

  15. Pregnancy-associated spontaneous coronary artery dissection: insights from a case series of 13 patients.

    Science.gov (United States)

    Cade, Jamil R; Szarf, Gilberto; de Siqueira, Maria Eduarda M; Chaves, Áurea; Andréa, Júlio C M; Figueira, Hélio R; Gomes, Manuel M; Freitas, Bárbara P; Filgueiras Medeiros, Juliana; Dos Santos, Márcio Ricardo; Fiorotto, Walter B; Daige, Augusto; Gonçalves, Rosaly; Cantarelli, Marcelo; Alves, Cláudia Maria Rodrigues; Echenique, Leandro; de Brito, Fábio S; Perin, Marco A; Born, Daniel; Hecht, Harvey; Caixeta, Adriano

    2017-01-01

    We sought to present a series of 13 pregnancy-associated spontaneous coronary artery dissection (P-SCAD), their angiographic and multimodal imaging findings, acute phase treatment, and outcomes. Between 2005 and 2015, 13 cases of P-SCAD were collected from a database of 11 tertiary hospitals. The mean age was 33.8 ± 3.7 years; most patients had no risk factors for coronary artery disease, and the majority were multiparous. P-SCAD occurred during the puerperium in 12 patients with a median time of 10 days. Only one patient presented with P-SCAD in the 37th week of pregnancy, and she was the only patient who died in this series. Six patients (46%) presented with ST-segment elevation acute myocardial infarction (STEMI), six (46%) presented with non-STEMI, and one presented with unstable angina; one-third of women had cardiogenic shock. In 12 patients, the dissection involved the left anterior descending or circumflex artery, and it extended to the left main coronary artery in 6 patients. Intravascular ultrasound or optical coherence tomography helped to confirm diagnosis and guide treatment in 46% of cases. Seven women were managed clinically; percutaneous coronary intervention was performed in five cases, and coronary artery bypass grafting was performed in one patient. In these 13 cases of P-SCAD, clinical presentation commonly included acute myocardial infarction and cardiogenic shock. Multivessel dissections and involvement of the left coronary artery and left main coronary artery were highly prevalent. Clinicians must be aware of angiographic appearances of P-SCAD for prompt diagnosis and management in these high-risk patients. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

  16. High-resolution MR imaging of periarterial edema associated with biological inflammation in spontaneous carotid dissection

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    Naggara, Olivier; Marsico, Rodolpho; Meder, Jean-Francois; Oppenheim, Catherine [Paris-Descartes University, Department of Neuroradiology, Paris (France); Touze, Emmanuel; Mas, Jean-Louis [Paris-Descartes University, Department of Neurology, Paris (France); Leclerc, Xavier; Pruvo, Jean-Pierre [University Hospital Roger Salengro, Department of Neuroradiology, Lille (France); Nguyen, Thanh [Boston University Medical Center, Department of Neurology, Neurosurgery, and Radiology, Boston, MA (United States)

    2009-09-15

    It has been suggested that spontaneous cervical carotid artery dissection (sCAD) may result from arterial inflammation. Periarterial edema (PAE), occasionally described in the vicinity of the mural hematoma in patients with sCAD, may support this hypothesis. Using cervical high-resolution magnetic resonance imaging, three readers, blinded to the mechanism of carotid artery dissection, searched for PAE, defined as periarterial T2-hyperintensity and T1-hypointensity, in 29 consecutive CAD patients categorized as spontaneous CAD (sCAD, n = 18) or traumatic CAD (tCAD, n = 11; i.e., major head or neck trauma within 2 weeks before the clinical onset). The relationships between PAE, inflammatory biological markers, history of infection and CAD mechanism were explored. Multiple CADs (n = 8) were found only in sCAD patients. Compared with tCAD, patients with sCAD were more likely to have a recent history of infection (OR = 12.5 [{sub 95%}CI = 1.3-119], p = 0.03), PAE (83% vs. 27%; OR = 13.3 [{sub 95%}CI = 2.2-82.0], p = 0.005) and to have elevated CRP (OR = 6.1 [{sub 95%}CI = 1.2-32.1], p = 0.0002) or ESR (OR = 8.8 [{sub 95%}CI = 1.5-50.1], p = 0.002) values. Interobserver agreement was 0.84 or higher for PAE identification. sCAD was associated with PAE and biological inflammation. Our results support the hypothesis of an underlying arterial inflammation in sCAD. (orig.)

  17. High-resolution MR imaging of periarterial edema associated with biological inflammation in spontaneous carotid dissection

    International Nuclear Information System (INIS)

    Naggara, Olivier; Marsico, Rodolpho; Meder, Jean-Francois; Oppenheim, Catherine; Touze, Emmanuel; Mas, Jean-Louis; Leclerc, Xavier; Pruvo, Jean-Pierre; Nguyen, Thanh

    2009-01-01

    It has been suggested that spontaneous cervical carotid artery dissection (sCAD) may result from arterial inflammation. Periarterial edema (PAE), occasionally described in the vicinity of the mural hematoma in patients with sCAD, may support this hypothesis. Using cervical high-resolution magnetic resonance imaging, three readers, blinded to the mechanism of carotid artery dissection, searched for PAE, defined as periarterial T2-hyperintensity and T1-hypointensity, in 29 consecutive CAD patients categorized as spontaneous CAD (sCAD, n = 18) or traumatic CAD (tCAD, n = 11; i.e., major head or neck trauma within 2 weeks before the clinical onset). The relationships between PAE, inflammatory biological markers, history of infection and CAD mechanism were explored. Multiple CADs (n = 8) were found only in sCAD patients. Compared with tCAD, patients with sCAD were more likely to have a recent history of infection (OR = 12.5 [ 95% CI = 1.3-119], p = 0.03), PAE (83% vs. 27%; OR = 13.3 [ 95% CI = 2.2-82.0], p = 0.005) and to have elevated CRP (OR = 6.1 [ 95% CI = 1.2-32.1], p = 0.0002) or ESR (OR = 8.8 [ 95% CI = 1.5-50.1], p = 0.002) values. Interobserver agreement was 0.84 or higher for PAE identification. sCAD was associated with PAE and biological inflammation. Our results support the hypothesis of an underlying arterial inflammation in sCAD. (orig.)

  18. Spontaneous coronary artery dissection after intense weightlifting UCSF Fresno Department of Cardiology.

    Science.gov (United States)

    El-Sherief, Karim; Rashidian, Ali; Srikanth, Sundararajan

    2011-08-01

    Spontaneous coronary artery dissection (SCAD) is a rare cause of chest pain and cardiomyopathy. This phenomenon usually occurs during the peripartum period. SCAD associated with exercise and heavy weight lifting is even rarer and has been reported in less than 10 cases in the literature. We describe a case of SCAD associated with heavy weight lifting and exercise in a 29-year-old male who presented with exertional chest pain. The patient subsequently underwent a cardiac catheterization that showed a left ventricular ejection fraction of 40% and a dissection in the left anterior descending (LAD) coronary artery after the first diagonal/septal branch with extension to the distal LAD that wrapped around the apex. He was effectively managed with the combination of medical therapy followed by a few days later with stenting. In summary, diagnosis and treatment of this rare phenomenon is a challenge, but early diagnosis and appropriate management can lead to a successful outcome. Copyright © 2011 Wiley-Liss, Inc.

  19. Spontaneous coronary artery dissection (SCAD): The underdiagnosed cardiac condition that plagues women.

    Science.gov (United States)

    Lebrun, Sandrine; Bond, Rachel M

    2017-12-11

    Coronary heart disease (CHD) continues to be understudied, underdiagnosed, and undertreated in women. Gender and age bias complicate the evaluation of women with acute coronary syndrome (ACS). As a result, conditions like spontaneous coronary artery dissection (SCAD) are often missed. SCAD is an infrequent yet important cause of myocardial infarction (MI) with a predilection for young to middle aged women. The condition is thought to be under-reported, likely a result of both low index of suspicion as well as an unfamiliarity with SCAD's angiographic variants. Recently, the European Society of Cardiology (ESC) detailed an assessment pathway for patients with myocardial infarction with non-obstructive coronary arteries (MINOCA), a subset of which includes patients with SCAD. The pathway highlights the role of cardiac magnetic resonance (CMR) in addition to intracoronary imaging for increased diagnostic yield. Early and proper diagnosis is crucial in SCAD given the potential for sudden cardiac death, as well as the increased risk for future cardiac events including recurrent dissection. In addition, SCAD has frequently been associated with underlying connective tissue disease and/or arteriopathy, most commonly fibromuscular dysplasia (FMD), which requires careful screening. The lack of consensus on investigation or treatment highlights the need for increased awareness and further research to better understand this challenging entity. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Spontaneous coronary artery dissection and takotsubo syndrome: An often overlooked association; review.

    Science.gov (United States)

    Y-Hassan, Shams

    2018-02-08

    Spontaneous coronary artery dissection (SCAD) and takotsubo syndrome (TS) are two cardiovascular syndromes with predilection for women. Both conditions may be preceded by an emotional stress or, for the affected individual, an unusual severe physical exercise. "Restitution ad integrum" occurs in most cases suffering from SCAD or TS with complete angiographic resolution of the dissected vessel and left ventricular dysfunction respectively. Recently, many cases, which were initially diagnosed as TS because of typical left ventricular ballooning pattern showed to have SCAD, have been reported; these cases were deemed to be "SCAD misdiagnosed as TS". The left ventricular wall motion abnormality has been attributed to the ischemia caused by SCAD-affected coronary vessel especially in the left anterior descending artery (LAD) with "wrap-around course". However, the left ventricular ballooning pattern have occurred in patients with SCAD in non-long-wrap-around LAD and SCAD in other coronary branches where coronary ischemia on its own cannot explain the left ventricular ballooning. In this review, sufficient data supporting the evidence for the possibility of coexistence of SCAD and TS is provided. Misdiagnosis of the association of the two conditions may result in mismanagement of the patient with undesirable consequences. Furthermore, the causal links between SCAD and TS is discussed. Copyright © 2018. Published by Elsevier Inc.

  1. The location of origin of spontaneous extracranial internal carotid artery dissection is adjacent to the skull base

    International Nuclear Information System (INIS)

    Downer, Jonathon; Briggs, Eliza; Wrigley, Peter; Nadarajah, Mahendra; McAuliffe, William

    2014-01-01

    The traditional view is that spontaneous extracranial internal carotid artery (ICA) dissection (CAD) extends cranially from an intimal tear located just beyond the carotid bulb. This paper demonstrates that CAD originates in and primarily involves a more distal segment of the artery. A retrospective study of 54 dissected ICAs in 50 consecutive patients with spontaneous or traumatic CAD was undertaken. The site of the dissection, presence of ICA redundancy, rate of acute or delayed ischaemic stroke and vessel remodelling were determined. Of the 51 dissections that occurred spontaneously or after indirect trauma, 25/51 (49.0%) were solely in the distal third of the artery, and 49/51 (96.1%) involved the distal two-thirds. Only 2/51 (3.9%) originated in the proximal third. ICA redundancy was seen in 27/36 (75%) of patients with spontaneous CAD, compared with only 1/11 (9.1%) of those with CAD due to indirect trauma (P = 0.0002). Acute stroke occurred in 10/12 (83.3%) of patients with ICA occlusion secondary to CAD and in 14/38 (36.8%) with non-occlusive CAD (P = 0.0074). Where follow-up was available, only 2/32 (6.3%) patients had a stroke after diagnosis, and 19/33 (57.6%) ICAs recanalised or remodelled. CAD occurring spontaneously or due to indirect trauma most frequently involves the distal extracranial ICA. Spontaneous CAD is associated with vessel redundancy, and the risk of acute stroke is greatest with occlusive CAD. The prognosis is good with treatment, with a low rate of recurrent stroke and a high rate of vessel remodelling.

  2. Safety and efficacy of drug eluting stents in patients with spontaneous coronary artery dissection.

    Science.gov (United States)

    Conrotto, Federico; D'Ascenzo, Fabrizio; Cerrato, Enrico; Fernández-Ortiz, Antonio; Gonzalo, Nieves; Macaya, Fernando; Tamburino, Corrado; Barbanti, Marco; van Lavieren, Martijn; Piek, Jan J; Applegate, Robert J; Latib, Azeem; Spinnler, Maria Teresa; Marzullo, Raffaella; Iannaccone, Mario; Pavani, Marco; Crimi, Gabriele; Fattori, Rossella; Chinaglia, Alessandra; Presbitero, Patrizia; Varbella, Ferdinando; Gaita, Fiorenzo; Escaned, Javier

    2017-07-01

    Given the different pathogenesis, use of drug eluting stent (DES) in patients with Spontaneous Coronary Artery Dissection SCAD may delay the healing of the dissected vessel. Aim of our study was to compare the safety and the efficacy of DES vs. bare metal stent (BMS) in a cohort of patients who underwent stenting for SCAD. Consecutive patients with SCAD between January 1995 and August 2014 were retrospectively identified in 12 centers and included. Major Adverse Cardiac Events (MACE) was the primary end point. A total of 238 SCAD patients were identified: of them 108 patients underwent PCI with DES or BMS. Overall 24 patients (22.2%) suffered an intra-procedural complication without any differences between the 2 groups. At median follow-up of 1201days (Inter Quartile Range 541-2760), incidence of the primary endpoint showed a trend towards less events in the DES-treated patients (38.7% vs. 25.9% p=0.14) mainly driven by the benefit of DES in terms of TVR (17.6% vs. 4%, p=0.08), mortality (16.8% vs. 9.3%, p=0.4), and MI rate (16% vs. 8.4%, p=0.33). STEMI at presentation (HR 6.4, CI 95% 1.29-31.9, p=0.02) but not kind of stent (HR 0.97, CI 95% 0.2-4.7, p=0.9) emerged as independently related to prognosis at multivariable analysis. In SCAD patients use of DES seems to be as safe as BMS with trend of better efficacy in the long term. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. The spectrum of spontaneous coronary artery dissection: illustrated review of the literature.

    Science.gov (United States)

    Vandamme, Marian; De Backer, Julie; De Backer, Tine; Drieghe, Benny; Devos, Daniel; Gevaert, Sofie

    2017-12-01

    Spontaneous coronary artery dissection or SCAD is a rare and challenging disease that is increasingly diagnosed. It is characterized by a non-traumatic, non-iatrogenic separation of the coronary artery wall and occurs predominantly in young and middle-aged women without traditional cardiovascular risk factors. SCAD is often associated with predisposing conditions such as the peripartum period, systemic inflammatory disease and heritable connective tissue disease. More recently, independent investigators have demonstrated an important association with fibromuscular dysplasia. Extreme emotional or physical stress as well as intense hormonal therapy or drug abuse have been pointed out as precipitating factors. The diagnosis of SCAD can be challenging and starts with clinical suspicion. Advanced imaging techniques such as intravascular ultrasound and optical coherence tomography are useful for the differentiation from atherosclerotic disease and are increasingly used for this indication. The proposed treatment in the acute setting is based on findings from single-centre retrospective series: in stable patients with a TIMI-flow ≥2 a conservative management is proposed because of the high risk of procedural failure and complications as well as a high probability of spontaneous healing. Long-term treatment is comparable to that in non-SCAD acute coronary syndromes (ACS) but dual antiplatelet therapy should only be started in case of stenting and should be kept as short as possible in patients with vascular Ehlers-Danlos syndrome. Prognosis seems to be better compared to non-SCAD ACS but there is a reasonable risk of recurrence. In this review, we discuss the current knowledge of SCAD and provide a clinical pathway for the diagnosis, management and work-up of SCAD patients.

  4. Fibromuscular Dysplasia Leading to Spontaneous Coronary Artery Dissection with Sudden Cardiac Arrest

    Directory of Open Access Journals (Sweden)

    Ata Bajwa

    2015-01-01

    Full Text Available A 30-year-old previously healthy female, who was six-week postpartum, experienced sudden collapse and tonic-clonic seizure. Emergency medicine services arrived at the scene and the patient was found to be in ventricular fibrillation. Advanced cardiovascular life support (ACLS was initiated with return of spontaneous circulation. Afterwards, her initial EKG showed atrial fibrillation with rapid ventricular rate, ST elevation in leads II, III, and aVF, and ST depression in V2–V4. She was transferred to a tertiary care hospital where emergent angiogram was performed revealing obstruction of blood flow in the proximal and mid right coronary artery (RCA. A hazy and irregularly contoured appearance of the RCA was consistent with diagnosis of fibromuscular dysplasia. Subsequently, intravascular ultrasonogram (IVUS was performed which confirmed the diagnosis of RCA dissection. Successful revascularization of the RCA was performed using two bare mental stents. After a complicated course in hospital, she was discharged in stable condition and did very well overall.

  5. Prognosis of spontaneous coronary artery dissection treated by percutaneous coronary intervention with optical coherence tomography.

    Science.gov (United States)

    Nishiguchi, Tsuyoshi; Tanaka, Atsushi; Taruya, Akira; Ozaki, Yuichi; Nakai, Mai; Teraguchi, Ikuko; Ota, Shingo; Kuroi, Akio; Kameyama, Takeyoshi; Yamano, Takashi; Yamaguchi, Tomoyuki; Matsuo, Yoshiki; Ino, Yasushi; Kubo, Takashi; Hozumi, Takeshi; Akasaka, Takashi

    2017-12-01

    Although about half of patients with spontaneous coronary artery dissection (SCAD) face ongoing necrosis, conservative therapy is recommended due to a high complication rate in angiography-guided percutaneous coronary intervention (PCI). The aim of this study was to investigate clinical outcomes of SCAD treated by optical coherence tomography (OCT)-guided PCI. This study consisted of consecutive 306 patients with acute coronary syndrome (ACS) who underwent OCT-guided PCI. Based on the culprit lesion morphology by OCT, patients were assigned to four groups: a SCAD group, a plaque rupture (PR) group, a calcified nodule (CN) group, and an undetermined etiology (UE) group. Successful PCI was defined as thrombolysis in myocardial infarction flow grade 3 in final angiography without any complications. Primary endpoint was defined as occurrence rate of major adverse cardiac events (MACE) including cardiac death, myocardial infarction, and unstable angina pectoris. OCT revealed 12 SCADs, 149 PRs, 16 CNs, and 129 UEs, respectively. No significant difference was observed in the success rate of PCI (SCAD 91.7%, PR 85.2%, CN 81.2%, UE 86.8%, p=0.88), while wire repositioning was needed in 2 SCAD cases (pSCAD were favorable, as well as those for other ACS etiologies. OCT-guided PCI could become a therapeutic option for SCAD compromised with ongoing necrosis. Copyright © 2017 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  6. Heavy Lifting Causing Spontaneous Coronary Artery Dissection with Anterior Myocardial Infarction in a 54-Year-Old Woman

    Science.gov (United States)

    Papadopoulos, Kyriacos; Azina, Chara

    2016-01-01

    Spontaneous coronary artery dissection in association with strenuous exercise and weightlifting is rather sparsely described in the medical literature. Diagnosis and treatment of this rare condition is a challenge, but prompt recognition and appropriate early choice of angioplasty or surgery can lead to a good outcome. We report the case of a postmenopausal 54-year-old woman who presented with anterior myocardial infarction caused by spontaneous dissection of the left anterior descending coronary artery after she had lifted a heavy weight while gardening. The patient was treated successfully by means of angioplasty and the implantation of 3 drug-eluting stents. In addition to presenting the patient's case, we review the topical medical literature. PMID:27127443

  7. Clinical Significance of Intraluminal Contrast Enhancement in Patients with Spontaneous Cervical Artery Dissection: A Black-Blood MRI Study.

    Science.gov (United States)

    Coppenrath, Eva; Lenz, Olga; Sommer, Nora; Lummel, Nina; Linn, Jennifer; Treitl, Karla; Bamberg, Fabian; Reiser, Maximilian; Pfefferkorn, Thomas; Saam, Tobias

    2017-07-01

    Purpose  Recent studies have suggested that intraluminal thrombi show contrast enhancement on carotid black-blood T1w MRI. The aim of this study was to evaluate the significance of intraluminal contrast enhancement (iCE) regarding symptom status in patients with spontaneous cervical artery dissection (sCAD). Methods  33 consecutive patients (19 men) with sCAD received a brain MRI (DIFF, T2w, T2*w, FLAIR) and a multi-sequence 3T-MRI with fat-saturated high-resolution black-blood T1w-sequences pre- and post-contrast, contrast-enhanced MR angiography and TOF images of carotid and vertebral arteries. Presence/absence of iCE, vessel occlusion and vessel wall hematoma (hyperintense in T1w pre-contrast) were analysed by two radiologists in consensus decision. Results  44 of 132 analysed vessels had a vessel wall hematoma, consistent with sCAD. In 17 of 44 dissected vessels an acute ischemic stroke was found. 16 of 17 (94.1 %) vessels ipsilateral to ischemic stroke demonstrated iCE, compared to 9 of 44 (20.4 %) dissected vessels without stroke (PsCAD. Key points   · Intraluminal contrast enhancement is associated with cerebral ischemia in corresponding vessel territories in patients with cervical artery dissection.. · Our results suggest that intraluminal contrast enhancement represents intraluminal thrombus formation.. · Black-blood imaging might be useful to identify those patients with cervical artery dissection at higher risk for initial or recurrent stroke.. Citation Format · Coppenrath E, Lenz O, Sommer N et al. Clinical Significance of Intraluminal Contrast Enhancement in Patients with Spontaneous Cervical Artery Dissection: A Black-Blood MRI Study. Fortschr Röntgenstr 2017; 189: 624 - 631. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Resolution of spontaneous coronary artery dissection within 3 weeks detected by computed tomography angiography and intravascular ultrasound.

    Science.gov (United States)

    Tsutsui, Hiroshi; Chino, Chiharu; Komatsu, Miho; Sakai, Takahiro; Aizawa, Kazunori; Owa, Mafumi

    2017-01-01

    A 62-year-old woman was admitted with chest pain lasting about 3 h. Spontaneous coronary artery dissection (SCAD) was detected in the left anterior descending artery (LAD) by intravascular ultrasound (IVUS). Sixteen days after onset, follow-up computed tomography angiography was performed and revealed shrinkage of the false lumen of the SCAD. On hospital day 22, IVUS image confirmed that the SCAD in the LAD was completely healed. This case shows the possibility of rapid healing of SCAD.

  9. First reported case of magnesium-made bioresorbable scaffold to treat spontaneous left anterior descending coronary artery dissection.

    Science.gov (United States)

    Quadri, Giorgio; Tomassini, Francesco; Cerrato, Enrico; Varbella, Ferdinando

    2017-11-01

    Spontaneous coronary artery dissection (SCAD) is a rare cause of Acute Coronary Syndrome. Although its treatment is still debated, use of Bioreasorbable Scaffold was recently advocated as an attractive option in this setting. We report the first case, to our knowledge, of a new magnesium-made Bioresorbable Scaffold implantation in a young woman presenting with Non-ST- Elevation Myocardial Infarction and a rapid worsening SCAD. © 2017 Wiley Periodicals, Inc.

  10. La dissection spontanée des artères coronaires: à propos de 2 cas ...

    African Journals Online (AJOL)

    La dissection spontanée des artères coronaires (DSAC) est une cause rare du syndrome coronarien aigu (SAC); sa prévalence est de moins de 3%. Elle se définit par une séparation au sein de la paroi artérielle coronaire secondaire à une hémorragie intra murale, avec ou sans déchirure de l'intima, créant un faux chenal.

  11. Characteristics and diagnostic pitfalls of spontaneous visceral artery dissection in the emergency department.

    Science.gov (United States)

    Nonami, Suguru; Nakanishi, Taizo; Tanizaki, Shinsuke; Matsumoto, Takashi; Sera, Makoto; Maeda, Shigenobu; Ishida, Hiroshi

    2016-06-01

    Spontaneous visceral artery dissection (VAD) is a rare disease that mainly occurs in the superior mesenteric artery and celiac artery. However, VAD has been detected more frequently in the past several years because of the increasing use of computed tomography (CT) for the evaluation of abdominal symptoms. A prompt diagnosis and referral to a specialist should be made, because VAD occasionally causes critical bowel ischemia. However, there is no well-established management approach. We performed a retrospective analysis to evaluate the characteristics and prognoses of patients diagnosed with VAD. We retrospectively examined data on patients who visited the Emergency Department (ED) at Fukui Prefectural Hospital, and were diagnosed with VAD using enhanced CT scanning from April 2004 to March 2015. All data were collected from the hospital's electronic medical records. We analyzed the clinical characteristics, comorbidity, risk factors, imaging findings, and treatment of patients. Fifty-six patients were identified (superior mesenteric artery: 40 patients, celiac artery: 16 patients). The median age of the patients was 54 years (range, 32-86 years) and 89.3% were men. The majority of the patients complained of abdominal pain (37 patients, 66%). Thirty-nine of the patients (69.6%) were hospitalized. All hospitalized patients received conservative treatment initially. Three patients received endovascular therapy, and 2 patients received surgery. No fatal cases were observed. Twenty-eight patients presented with ED at their initial visit, and 8 cases (29%) were undiagnosed on their initial visit by emergency physicians, though enhanced CT scans were obtained. Patients with VAD often present with sudden onset abdominal pain. Most patients were managed successfully with conservative treatment. No fatal cases were observed; however, some cases were missed, even with an enhanced CT scan. It is necessary to include VAD among the differential diagnoses of acute abdominal pain

  12. Spontaneous coronary artery dissection: A retrospective analysis of 19,676 coronary angiograms

    Directory of Open Access Journals (Sweden)

    Dinesha Basavanna

    2017-01-01

    Full Text Available Aim: Spontaneous coronary artery dissection (SCAD is a rare cause of angina, myocardial infarction (MI, and sudden cardiac death (SCD and may frequently manifest as acute coronary syndrome (ACS. The diagnosis of SCAD relies on angiographic visualization of a radiolucent intimal flap. Therapeutic options include medical therapy, percutaneous coronary interventions, and bypass surgery. The aim of this study is to analyze the clinical profile, inhospital outcomes, management, and follow-up of patients with angiographic SCAD. Methods: About 19,676 diagnostic coronary angiograms (CAGs were reviewed retrospectively during a 2-year period; 64 patients had SCAD and were included in the study. Complete medical histories before and during the event as well as treatment regimens were obtained from patients' hospital files. Results: A total of 64 cases of SCAD were considered for the study within an age range of 25–70 years. Fifty-eight patients presented with ACS, two patients presented with unstable angina, one patient presented with rheumatic mitral stenosis in atrial fibrillation, one patient presented with non-ST-elevation myocardial infarction, one patient with dilated cardiomyopathy with left ventricular dysfunction, and one patient with effort. Out of 64 patients, four patients died and the average hospital stay is 3–5 days. Conclusion: SCAD occurs in 0.32% of patients undergoing CAG for evaluation of coronary artery disease. Majority of SCAD occurs in men. The left coronary artery is most commonly affected. The inhospital outcomes are good. Most of the patients with SCAD have good prognosis following optimal medical therapy.

  13. A major pain in the … Back and epigastrium: an unusual case of spontaneous celiac artery dissection

    Directory of Open Access Journals (Sweden)

    Kumkum Sarkar Patel

    2014-11-01

    Full Text Available A 60-year-old woman with mitral valve prolapse, chronic low back pain, and a 30-pack year smoking history presented for a second admission of poorly controlled mid-back pain 10 days after her first admission. She had concomitant epigastric pain, sharp/burning in quality, radiating to the right side and to the mid-back, not associated with food nor improving with pain medications. She denied nausea, vomiting, diarrhea, constipation, dark stools, or blood per rectum. Our purpose was to determine the cause of the patient's epigastric pain. Physical examination revealed epigastric and mid-back tenderness on palpation. Labs were normal except for a hemoglobin drop from 14 to 12.1 g/dL over 2 days. Abdominal ultrasound and subsequent esophagogastroduodenoscopy were normal. Contrast-enhanced abdominal computed tomographic (CT scan revealed the development of a spontaneous celiac artery dissection as the cause of the epigastric pain. The patient was observed without stenting and subsequent CT angiography 4 days later did not reveal worsening of the dissection. She was discharged on aspirin and clopidogrel with outpatient follow-up. Thus far, less than 100 cases of isolated spontaneous celiac artery dissections have been reported. The advent of CT scans and magnetic resonance imaging has increasingly enabled its detection. Risk factors may include hypertension, arteriosclerosis, smoking, and cystic medial necrosis. There is a 5:1 male to female ratio with an average presenting age of 55. Management of dissections may include surgical repair, endovascular stenting, and selective embolization. Limited dissections can be managed conservatively with anti-platelet and/or anticoagulation agents and strict blood pressure control, as done in our patient.

  14. Does thrombolytic therapy harm or help in ST elevation myocardial infarction (STEMI caused by the spontaneous coronary dissection?

    Directory of Open Access Journals (Sweden)

    Jović Zoran

    2015-01-01

    Full Text Available Introduction. Spontaneous coronary artery dissection (SCAD is a very rare disease with poor prognosis. It mainly affects young women free of risk factors for coronary artery disease (CAD and women during the peripartum period. The prognosis for myocardial infarction caused by SCAD is poor, management is often difficult and guidelines still missing. Case report. We presented a woman with acute myocardial infarction of anterior wall of the left ventricle, caused by spontaneous dissection of medial segment of the left anterior descending coronary artery. We treated the patient with thrombolytic therapy and performed coronary angiography after that. Finally we decided to do nothing more. Two years later we performed coronary angiography again and founded the coronary artery normal. We also analyzed 19 cases publiched from 1996 to 2012 when coronary artery dissection had been treated with thrombolytic agent. Analysis revealed only one case of 19, with complication after treating SCAD with thrombolysis. Conclusion. Sometimes, regarding myocardial infarction in young women with no risk factors for CAD, especially in young women in peripartum, we should think about SCAD. The presented case, like eight others, demonstrates that good clinical outcomes can be achieved with thrombolysis. In spite of all this, we still need more data to verify that thrombolysis does not have to harm the therapy for SCAD. For the time being thrombolytic therapy could be an option.

  15. Managing practical issues with percutaneous treatment of spontaneous coronary artery dissection in the cardiac catheterization laboratory: An interesting case report

    Directory of Open Access Journals (Sweden)

    T G Varghese

    2017-01-01

    Full Text Available Spontaneous coronary artery dissection (SCAD is a rare condition and uncommon cause of acute coronary syndrome which is associated with high acute phase mortality with an estimated prevalence of approximately 0.7%. SCAD is known to occur more commonly in young women during pregnancy or postpartum period, and in most cases, it involves a single coronary artery. It has also been reported in patients with atherosclerosis. SCAD is generally treated by percutaneous intervention and stenting. While stenting a segment of the right coronary artery (RCA with dissection, opening the balloon in the false lumen or placing a stent in the false plane can lead to abrupt closure of the RCA leading to on table catastrophe, thereby confirming that we are in the true lumen is of pivotal importance. Simple maneuvers to prevent this error can be lifesaving. In this article, we have presented a few practical measures to deal with this dilemma in the background of a patient who was found to have spontaneous spiral dissection of the RCA while being evaluated for angina.

  16. Pregnancy-associated spontaneous coronary artery dissection (PASCAD): An etiology for chest pain in the young peripartum patient.

    Science.gov (United States)

    Lee, Richard; Carr, David

    2018-02-22

    Cardiac emergencies in pregnancy and the postpartum period are rare but often life-threatening. An emergency physician's differential diagnosis for chest pain in the peripartum patient often includes serious etiologies such as pulmonary embolism or myocardial infarction (MI). A lesser-known but important consideration on the differential for MI is that of a spontaneous coronary artery dissection (SCAD). SCAD is defined as an intramural hematoma within the coronary artery that compresses the true lumen. Expansion by increased pressures may lead to subsequent myocardial ischemia and infarction. This condition is the most common cause of pregnancy-associated MI and is reported as the cause of MI in 24% to 35% of all women younger than 50 years. This condition is predominately seen in young healthy females with no traditional risk factors for coronary artery or cardiac disease, and typically in the postpartum period. SCAD in the peripartum period is defined as pregnancy-associated spontaneous coronary artery dissection (PASCAD). Abnormal ECG changes, elevated troponins, and regional wall motional abnormalities on echocardiography are all diagnostic findings of SCAD, which can be ultimately confirmed with coronary angiography. Failure to immediately address this condition can lead to acute heart failure, cardiogenic shock, and death. Thrombolytic treatment may be harmful and is not recommended, and percutaneous coronary intervention can result in the iatrogenic propagation of further coronary dissection. As a result, the management for suspected SCAD involves emphasis on urgent transfer and urgent coronary artery angiography to determine appropriate treatment modalities.

  17. Spontaneous cervical artery dissection is accompanied by a hypercoagulable state and simultaneous inflammatory condition.

    Science.gov (United States)

    Pelz, Johann Otto; Harms, Kristian; Metze, Michael; Michalski, Dominik

    2018-02-01

    Spontaneous cervical artery dissections (sCAD) are often preceded by infections. However, existing data about inflammatory parameters remained inconsistent. Remarkably, concurrent information about the coagulation system, whose affection seems also reasonable to cause ischaemic events, are still lacking in sCAD patients. Thus, this study explores the association between the inflammatory and coagulation system in patients with sCAD. The parameters leukocyte and thrombocyte count, C-reactive protein, fibrinogen, D-dimer, activated partial thromboplastin time (aPTT) and prothrombin time were extracted from hospital-based medical records of patients (n = 60) with sCAD and compared with those of a control group (n = 97) from a prospective observational stroke study. Univariate analyses were added by multiple regression analyses. As compared with the control group, patients with sCAD had an increased leucocyte count (9.2 ± 3.2 vs. 7.9 ± 2.2 × 10 9 /l; p = 0.003), an increased thrombocyte count (252 ± 52 vs. 229 ± 64 × 10 9 /l; p = 0.021), a shortened aPTT 28.0 ± 3.5 vs. 29.9 ± 3.6 s; p = 0.001) and decreased D-dimer values (0.44 ± 0.29 vs. 0.76 ± 0.73 mg/l; p = 0.002). However, in multiple regression analyses adjusted for age, sex, initial stroke severity, arterial hypertension, diabetes mellitus and smoking only the shortened aPTT remained statistically significant (p = 0.045) between groups, while differences on leucocyte count (p = 0.087), thrombocyte count (p = 0.234) and D-dimer (p = 0.321) failed statistical significance. We found evidence for a hypercoagulable state in patients with sCAD as indicated by a shortened aPTT, which was associated with a trend to an increased leucocyte count at the same time. Our findings first strengthen the hypothesis that inflammation critically impacts on the occurrence of sCAD, and second linked this condition with a marked affection of the coagulation system.

  18. Repeated Loss of Consciousness in a Young Woman: A Suspicious SMAD3 Mutation Underlying Spontaneous Coronary Artery Dissection.

    Science.gov (United States)

    Garcia-Bermúdez, Míriam; Moustafa, Abdel-Hakim; Barrós-Membrilla, Antonio; Tizón-Marcos, Helena

    2017-02-01

    Spontaneous coronary artery dissection (SCAD) is an infrequent cause of acute coronary syndrome and is often underdiagnosed. Intramural hematoma is the most frequent angiographic presentation and is a challenging diagnosis that may require intravascular imaging techniques to confirm it and guide treatment. It affects mostly young women without coronary risk factors and is usually associated with fibromuscular dysplasia. SCAD has an underlying disease in 80% of patients. A SMAD3 mutation has been linked to aneurysm-osteoarthritis syndrome and has been identified as a cause of familial thoracic aortic aneurysm and dissection. The first reported case, to our knowledge, of a SMAD3 mutation underlying SCAD is described here. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  19. Spontaneous Coronary Artery Dissection in a Woman with a Past Medical History of Subarachnoid Hemorrhage: A Case Report.

    Science.gov (United States)

    Bardon, Jean; Picard, Fabien; Barbou, Franck; Varenne, Olivier; Vivien, Benoît

    2017-01-01

    Spontaneous coronary artery dissection (SCAD) is an uncommon disease. We report the case of a 50 year-old woman with a past medical history of aneurysmal subarachnoid hemorrhage, presenting with acute chest pain and diffuse ST segment elevation on ECG. Coronary angiogram revealed a SCAD of the left anterior descending coronary artery. The association between cerebral aneurysms and SCAD should trigger providers concern for fibromuscular dysplasia. We hereby report on a rare and atypical case involving the relationship between fibromuscular dysplasia and SCAD.

  20. Non-atherosclerotic spontaneous coronary artery dissection revascularized by intravascular ultrasonography-guided fenestration with cutting balloon angioplasty.

    Science.gov (United States)

    Ito, Tsuyoshi; Shintani, Yasuhiro; Ichihashi, Taku; Fujita, Hiroshi; Ohte, Nobuyuki

    2017-07-01

    A 46-year-old woman was referred to our hospital due to chest pain. Twelve-lead electrocardiogram revealed ST-segment elevation suggesting acute myocardial infarction. Emergent coronary angiography showed diffuse narrowing and occlusion in the middle to distal left anterior descending artery (LAD). To investigate the cause of occlusion, an intravascular ultrasound (IVUS) examination was performed and we diagnosed spontaneous coronary artery dissection (SCAD) as the cause of occlusion. After a cutting balloon was dilated at the distal LAD, coronary flow recovered. IVUS-guided angioplasty with cutting balloon could be a choice of treatment in SCAD patients who need revascularization.

  1. IVUS and OCT guided primary percutaneous coronary intervention for spontaneous coronary artery dissection with bioresorbable vascular scaffolds

    Energy Technology Data Exchange (ETDEWEB)

    Mahmood, Muhammad Muzaffar; Austin, David, E-mail: david.austin@stees.nhs.uk

    2017-01-15

    Summary: Spontaneous coronary artery dissection (SCAD) is an uncommon but important cause of acute coronary syndrome. The diagnosis of SCAD by an angiogram alone can be challenging and the increasing use of intracoronary imaging has proven an invaluable diagnostic adjunct in this regard. The appropriate initial management of SCAD has been a matter of significant debate. Owing to frequent spontaneous healing of coronary dissection and a higher risk of complications with percutaneous coronary intervention (PCI) in the setting of SCAD, a default approach of mechanical revascularization is not recommended. However in the presence of vessel occlusion and on-going myocardial infarction PCI is mandated. Bioresorbable vascular scaffolds (BVS) offer potential advantages over the conventional stents in the setting of SCAD. We describe a state-of-the-art approach to the acute treatment of SCAD causing STEMI, utilizing intravascular ultrasound (IVUS), optical coherence tomography (OCT) and BVS and discuss management strategies for the modern era. - Highlights: • SCAD is an infrequent but important cause of acute coronary syndrome. • Intracoronary imaging is a useful adjunct in the diagnosis of SCAD. • Revascularization is recommended in the presence on-going myocardial infarction. • BVS may be considered preferable to conventional stents in the setting of SCAD.

  2. Dissecting Dissection.

    Science.gov (United States)

    AV Magazine, 1996

    1996-01-01

    This journal features articles covering various aspects of dissection. "Biology--The Study of Life" (George Russell) offers students experiments that do not require using invasive procedures. "Animal Cruelty--Behind the Scenes" (Zoe Weil) describes sources of laboratory animals. "Doing without Dissection" (Juliana…

  3. Treatment of Cervical Internal Carotid Artery Spontaneous Dissection with Pseudoaneurysm and Unilateral Lower Cranial Nerves Palsy by Two Silk Flow Diverters

    Energy Technology Data Exchange (ETDEWEB)

    Zelenak, Kamil, E-mail: zelenak@unm.sk [University Hospital, Department of Radiology (Slovakia); Zelenakova, Jana [University Hospital, Department of Neurology (Slovakia); DeRiggo, Julius [University Hospital, Department of Neurosurgery (Slovakia); Kurca, Egon; Kantorova, Ema [University Hospital, Department of Neurology (Slovakia); Polacek, Hubert [University Hospital, Department of Radiology (Slovakia)

    2013-08-01

    Internal carotid artery (ICA) lesions in the parapharyngeal space (a dissection and a pseudoaneurysm) may present as isolated lower cranial nerves (IX, X, XI, and XII) palsy (Collet-Sicard syndrome). Some arteriopathies such as fibromuscular dysplasia and tortuosity make a vessel predisposed to dissection. Extreme vessel tortuosity makes the treatment by a stent graft impossible. Two Silk stents were used in a 46 year-old man with left lower cranial nerves (IX-XII) palsy for the treatment of left ICA spontaneous dissection with pseudoaneurysm. A follow-up angiogram 5 months later confirmed pseudoaneurysm thrombosis and patency of the left ICA. The patient recovered completely from the deficits.

  4. Spontaneous healing of cervical pseudoaneurysm in vertebral artery dissection under anticoagulant therapy

    Energy Technology Data Exchange (ETDEWEB)

    Sommer, A.; Neff, W.; Schwartz, A. [Department of Neurology, Klinikum Mannheim, Medical Faculty, University of Heidelberg, Theodor-Kutzer-Ufer 1, D-68132 Mannheim (Germany)

    1998-04-01

    We report a 41-year-old woman with embolic stroke of the mid-pons attributed to embolism from vertebral artery dissection. Angiography revealed an occluded artery on one side and an incidental pseudoaneurysm of the midcervical portion of the vertebral artery on the other. After 3 months of warfarin therapy control angiography showed complete occlusion of the pseudoaneurysm. We discuss therapeutic choices and review the literature. (orig.) With 4 figs., 8 refs.

  5. Dissecção espontânea da aorta abdominal infrarrenal Spontaneous dissection of the infrarenal aorta

    Directory of Open Access Journals (Sweden)

    Otacílio de Camargo Junior

    2012-09-01

    Full Text Available A rotura da camada íntima que marca o início da dissecção aórtica se origina na maioria dos casos na aorta torácica, sendo rara a dissecção espontânea da aorta abdominal infra-renal. As três principais causas são: iatrogênica, traumática ou espontânea. A dor abdominal e a isquemia de membros são os sintomas mais comuns e um número significativo de pacientes e´ assintomatico. O diagnóstico tem sido feito através de métodos de imagem como ultrassonografia, tomografia computadorizada, ressonância nuclear magnética e angiografia aliados ao alto índice de suspeição. Relatamos os casos de duas pacientes que apresentaram dissecção de aorta abdominal infrarrenal com quadro de dor abdominal súbita, sem sinais de irritação peritoneal com pulsos presentes e simétricos ao exame físico que deram entrada no pronto socorro do Hospital e Maternidade Celso Pierro da PUC Campinas e que foram tratadas pela equipe de Cirurgia Vascular. As duas pacientes no momento do exame apresentavam-se hipertensas e ao ultrassom apresentavam alteração da conformidade da aorta abdominal que foram tratada s cirurgicamente. Uma paciente foi tratada cirurgicamente submetida a endarterectomia da placa dissecada da aorta abdominal infrarrenal de 2,2 cm de diâmetro e 2,0 cm de extensão. A outra paciente foi submetida a revascularização da aorta abdominal bi-iliaca com prótese de Dacron 16 × 8 mm por apresentar disseccao da aorta abdominal distal. As duas pacientes apresentaram boa evolução pos-operatoria tendo alta hospitalar em bom estado geral.The rupture of the intimal layer marks the beginning of the aortic dissection, which usually happens in the thoracic aorta. The spontaneous dissection of the infrarenal aorta is rare. The main causes are: iatrogenic, traumatic and spontaneous. Abdominal pain and limb ischemia are the commonest symptoms, and some patients are asymptomatics. The diagnosis is made by ultrasound, computed tomography

  6. Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement From the American Heart Association.

    Science.gov (United States)

    Hayes, Sharonne N; Kim, Esther S H; Saw, Jacqueline; Adlam, David; Arslanian-Engoren, Cynthia; Economy, Katherine E; Ganesh, Santhi K; Gulati, Rajiv; Lindsay, Mark E; Mieres, Jennifer H; Naderi, Sahar; Shah, Svati; Thaler, David E; Tweet, Marysia S; Wood, Malissa J

    2018-02-22

    Spontaneous coronary artery dissection (SCAD) has emerged as an important cause of acute coronary syndrome, myocardial infarction, and sudden death, particularly among young women and individuals with few conventional atherosclerotic risk factors. Patient-initiated research has spurred increased awareness of SCAD, and improved diagnostic capabilities and findings from large case series have led to changes in approaches to initial and long-term management and increasing evidence that SCAD not only is more common than previously believed but also must be evaluated and treated differently from atherosclerotic myocardial infarction. High rates of recurrent SCAD; its association with female sex, pregnancy, and physical and emotional stress triggers; and concurrent systemic arteriopathies, particularly fibromuscular dysplasia, highlight the differences in clinical characteristics of SCAD compared with atherosclerotic disease. Recent insights into the causes of, clinical course of, treatment options for, outcomes of, and associated conditions of SCAD and the many persistent knowledge gaps are presented. © 2018 American Heart Association, Inc.

  7. Spontaneous dissections of the anterior cerebral artery: a meta-analysis of the literature and three recent cases

    Energy Technology Data Exchange (ETDEWEB)

    Hensler, Johannes; Jensen-Kondering, Ulf; Jansen, Olav [University Hospital Schleswig-Holstein (UKSH), Department of Radiology and Neuroradiology, Kiel (Germany); Ulmer, Stephan [Medical Radiological Institute, Neuroradiology, Zurich (Switzerland)

    2016-10-15

    Spontaneous dissections of intracranial arteries are rare, but important causes of stroke, especially in younger patients. Dissections of the anterior cerebral artery (ACA) have been reported only very rarely in the European and North American populations but might be more prevalent than previously thought. This paper describes the presenting pattern of the disease, the clinical and imaging findings, as well as endovascular therapeutical options with respect to a meta-analysis of cases reported in the literature. Additionally, own observations in three recent representative cases are discussed. Overall, 80 cases from recent literature were included to the meta-analysis. The median age was 51 (35-82) years. Ischemia alone was described in 58 cases (73 %), subarachnoid hemorrhage (SAH) in 8 cases (10 %), and a combination of both in 14 cases (17 %). Radiological diagnosis including use of thin-layered 3T-MRI vessel wall imaging with black blood technique was verified by double lumen, by a string sign or string and pearl sign, or by a vessel wall hematoma in 23 (32 %), 62 (89 %), and 14 (20 %) cases, respectively. Interventional or surgical treatment was performed in 7 cases. A good clinical recovery was achieved in 77 % of cases. Dissections of the ACA mostly cause ischemia, but can cause SAH or a combination of both in a relatively young population. Detailed neuroradiological diagnosis including 3T-MRI vessel wall imaging is required as a double lumen, isolated stenosis due to vessel wall hematoma, or the secondary development of a pseudoaneurysm might occur. Interventional therapy is the primary therapy for these vascular complications. (orig.)

  8. Spontaneous Coronary Artery Dissection: Angiographic Follow-Up and Long-Term Clinical Outcome in a Predominantly Medically Treated Population.

    Science.gov (United States)

    Rogowski, Sebastian; Maeder, Micha T; Weilenmann, Daniel; Haager, Philipp K; Ammann, Peter; Rohner, Franziska; Joerg, Lucas; Rickli, Hans

    2017-01-01

    We sought to assess the angiographic and long-term clinical outcomes in a predominantly medically treated population with spontaneous coronary artery dissection (SCAD). There are little data on the angiographic and long-term outcome in patients with SCAD. We studied 64 patients with SCAD (mean age 53 years, 94% females, three peripartum) with acute coronary syndrome who were treated using coronary bypass grafting (n = 1), percutaneous coronary intervention (n = 7), or medical therapy (n = 56). A repeat angiogram was performed in 40/64 (63%) patients. The median clinical follow-up was 4.5 years. Five (8%) patients had a major cardiac event. One patient with peripartum left main SCAD and cardiogenic shock died during PCI. One patient with conservatively treated SCAD of the posterior descending artery suffered out-of-hospital cardiac arrest 16 days after the initial angiogram but survived. Three patients experienced a second SCAD in another vessel 3.7, 4.7, and 7.9 years after the index event while the initial dissection had healed. Thirty medically treated patients underwent a scheduled repeat angiogram showing healing of the dissection in all but one patient. After a median follow-up of 4.5 (1.8-8.4) years, all 63 patients surviving the index event were alive and free of symptoms suggestive of myocardial ischemia. In general, the long-term outcome of patients with SCAD is excellent, and medical therapy can be safely applied in the majority of patients. However, SCAD can be a life-threatening and sometimes catastrophic event, and some patients experience early or late complications including SCAD of another vessel. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  9. Spontaneous dissections of the anterior cerebral artery: a meta-analysis of the literature and three recent cases

    International Nuclear Information System (INIS)

    Hensler, Johannes; Jensen-Kondering, Ulf; Jansen, Olav; Ulmer, Stephan

    2016-01-01

    Spontaneous dissections of intracranial arteries are rare, but important causes of stroke, especially in younger patients. Dissections of the anterior cerebral artery (ACA) have been reported only very rarely in the European and North American populations but might be more prevalent than previously thought. This paper describes the presenting pattern of the disease, the clinical and imaging findings, as well as endovascular therapeutical options with respect to a meta-analysis of cases reported in the literature. Additionally, own observations in three recent representative cases are discussed. Overall, 80 cases from recent literature were included to the meta-analysis. The median age was 51 (35-82) years. Ischemia alone was described in 58 cases (73 %), subarachnoid hemorrhage (SAH) in 8 cases (10 %), and a combination of both in 14 cases (17 %). Radiological diagnosis including use of thin-layered 3T-MRI vessel wall imaging with black blood technique was verified by double lumen, by a string sign or string and pearl sign, or by a vessel wall hematoma in 23 (32 %), 62 (89 %), and 14 (20 %) cases, respectively. Interventional or surgical treatment was performed in 7 cases. A good clinical recovery was achieved in 77 % of cases. Dissections of the ACA mostly cause ischemia, but can cause SAH or a combination of both in a relatively young population. Detailed neuroradiological diagnosis including 3T-MRI vessel wall imaging is required as a double lumen, isolated stenosis due to vessel wall hematoma, or the secondary development of a pseudoaneurysm might occur. Interventional therapy is the primary therapy for these vascular complications. (orig.)

  10. Clinical significance of intraluminal contrast enhancement in patients with spontaneous cervical artery dissection. A black-blood MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Coppenrath, Eva; Lenz, Olga; Sommer, Nora; Treitl, Karla; Reiser, Maximilian [Munich Univ. (Germany). Inst. of Clinical Radiology; Lummel, Nina [Univ. Hospital Klinikum rechts der Isar Munich, Munich (Germany). Inst. of Neuroradiology and Interventional Neuroradiology; Linn, Jennifer [Univ. Hospital Dresden (Germany). Inst. of Neuroradiology; Bamberg, Fabian [Tuebingen Univ. (Germany). Diagnostical and Interventional Radiology; Pfefferkorn, Thomas [Munich Univ. (Germany). Interdisciplinary Stroke Center Munich; Saam, Tobias [Radiology Center Rosenheim (Germany)

    2017-07-15

    Recent studies have suggested that intraluminal thrombi show contrast enhancement on carotid black-blood T1w MRI. The aim of this study was to evaluate the significance of intraluminal contrast enhancement (iCE) regarding symptom status in patients with spontaneous cervical artery dissection (sCAD). 33 consecutive patients (19 men) with sCAD received a brain MRI (DIFF, T2w, T2{sup *}w, FLAIR) and a multi-sequence 3T-MRI with fat-saturated high-resolution black-blood T1w-sequences pre- and post-contrast, contrast-enhanced MR angiography and TOF images of carotid and vertebral arteries. Presence/absence of iCE, vessel occlusion and vessel wall hematoma (hyperintense in T1w pre-contrast) were analysed by two radiologists in consensus decision. 44 of 132 analysed vessels had a vessel wall hematoma, consistent with sCAD. In 17 of 44 dissected vessels an acute ischemic stroke was found. 16 of 17 (94.1 %) vessels ipsilateral to ischemic stroke demonstrated iCE, compared to 9 of 44 (20.4 %) dissected vessels without stroke (P< 0.001). The presence/absence of iCE resulted in a sensitivity, specificity, positive and negative predictive value and accuracy for ischemic stroke of 0.94, 0.67, 0.64, 0.95, and 0.77, respectively, and an odds ratio of 32.0. iCE, which is suggestive of intraluminal thrombus formation, is strongly correlated with ischemic symptoms in patients with sCAD.

  11. An Unusual Case of Spontaneous Left Main Coronary Dissection in A Young Pregnant Woman Treated with Percutaneous Intervention

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    Jayme Ferro

    2017-12-01

    Full Text Available Spontaneous coronary artery dissection (SCAD is the spontaneous separation of the coronary artery wall, not iatrogenic or related to trauma. SCAD is an uncommon disease in which the left main coronary involvement is rare. SCAD is commonly nonatherosclerotic, according to predisposing factors (fibromuscular dysplasia, female gender, pregnancy, ecc and precipating factors (intense exercise/emotional stress, vigorous Valsalva type activities, abuse of recreational drugs, ecc. Diagnosis of SCAD is first based on clinical grounds and then confirmed with imaging. Access to different imaging techniques, in particular coronary angiography (CA and intravascular ultrasound (IVUS, is crucial to recognize and manage SCAD in acute care settings. We report an unusual case of high risk acute coronary syndrome due to the left main coronary dissection in a 33 year-old pregnant woman at 19th week of gestation. According to coronary angiography and clinical unstable conditions, LM was successfully treated with a provisional stenting technique. Intra-procedural IVUS was helpful to obtain good stent apposition and confirm the underlying intramural hematoma. Before invasive strategy, the cooperation of the heart team was crucial because we not only considered some protocols to reduce radiation and contrast agent exposure, but also planned a follow up in order to organize the delivery and minimize potential stress conditions and bleeding risk to the fetus. SCAD should not be underestimated when associated to ACS and pregnancy: urgent coronary angiography and bail-out adjunctive imaging are crucial. Improvements in materials and techniques together with a protocol for radiation/contrast media exposure and for antithrombotics drugs administration could make percutaneous interventions feasible and safe in these scenarios.

  12. Bilateral spontaneous internal carotid artery dissection managed with endovascular stenting – A case report

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    Manoj Kumar Agarwala

    2016-09-01

    We describe a patient with ischemic stroke from spontaneous bilateral ICAD with completely occluded left ICA. Having failed medical therapy with antiplatelets and anticoagulants due to extensive loss of carotid vascular supply, he was managed successfully with endovascular stenting with good neurological recovery.

  13. Primary spontaneous coronary dissectİon in a young male and the role of intravascular ultrasonography for diagnosis and treatment

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    Sadık Volkan Emren

    2015-09-01

    Full Text Available Primary spontaneous coronary artery dissection (SCAD is a rare cause of acute coronary syndrome and is observed especially during gestation or the postpartum period of young healthy female patients. SCAD is much more rarely seen in young male patients. A 32 year-old male was admitted to our clinic with a typical anginal complaint that had begun after a verbal discussion in a family environment. The patient was hospitalized with a diagnosis of acute myocardial infarction without ST elevation. During coronary angiography, a lesion seen as a dissection in the proximal region of the left anterior descending artery (LAD, 30% stenosis in the circumflex artery and plaque in the right coronary artery were observed. In the LAD osteal region, a dissection flap and intimal rupture was observed at the 12:00–2:00 o'clock position using intravascular ultrasonography (IVUS. Our case was very young and had no atherosclerotic risk factors except for a history of smoking. It was suggested that intense emotional stress was the triggering factor for coronary dissection. The gold standard imaging method for spontaneous coronary dissection is coronary angiography. Recently, imaging methods like IVUS have made important contributions to the diagnosis of dissections that cannot be detected by coronary angiography. Treatment must be individual since there is no standard protocol. Medical therapy, percutaneous coronary intervention and coronary artery bypass surgery are the main treatment options.

  14. Spontaneous Coronary Artery Dissection Associated With Ascending Aortic Dystrophy: A Tear for Fear.

    Science.gov (United States)

    Amabile, Nicolas; Lansac, Emmanuel; Caussin, Christophe

    2015-08-01

    A 36-year-old man with a recent history of surgery for an aortic valve ascending aortic aneurysm was admitted for non-ST-elevation myocardial infarction. Cardiac magnetic resonance imaging showed a limited necrotic lesion in the anterior wall. Coronary angiography showed no significant stenosis, but a mild distal dynamic tortuosity was seen on the left anterior descending artery. Optical coherence tomography analysis confirmed the absence of any significant atherosclerotic infiltration but revealed the presence of a localized short arterial dissection within the kinked zone. The patient was managed with a conservative medical approach. The subsequent evolution was uneventful. Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  15. Spontaneous Dissection of the Renal Artery in Vascular Ehlers-Danlos Syndrome

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    Filipa Pereira

    2015-01-01

    Full Text Available Ehlers-Danlos syndrome (EDS is a rare heterogeneous group of connective tissue disorders. The vascular type (vEDS is an autosomal dominant disorder caused by heterozygous mutations in the COL3A1 gene predisposing to premature arterial, intestinal, or uterine rupture. We report a case of a 38-year-old woman with a recent diagnosis of vEDS admitted in the Emergency Department with a suspicion of a pyelonephritis that evolved to a cardiopulmonary arrest. A fatal retroperitoneal hematoma related with a haemorrhagic dissection of the right renal artery was found after emergency surgery. This case highlights the need to be aware of the particular characteristics of vEDS, such as a severe vascular complication that can lead to a fatal outcome.

  16. Chronic dissection of the superior mesenteric artery: case report

    International Nuclear Information System (INIS)

    Common, A.A.; Pressacco, J.

    1999-01-01

    Acute dissection of the thoracic aorta is a well-recognized, often fatal condition that frequently extends to involve the abdominal aorta and iliac vessels. The ostia of the renal and mesenteric vessels may be compromised, and the resulting visceral ischemia may necessitate surgical intervention. However, visceral perfusion may be restored if blood flow from true to false lumen is re-established or if the false lumen is obliterated, either spontaneously or by surgical or interventional techniques. Isolated dissections of mesenteric, renal, and carotid vessels are rarely reported. These may be spontaneous, related to high blood pressure and underlying disease of the vessel wall, or caused by abdominal trauma or medical intervention, including angiographic procedures. They are usually associated with pain and other signs and symptoms of ischemia in the appropriate territory. We present a case of chronic superior mesenteric artery (SMA) dissection, an incidental angiographic finding, in an asymptomatic patient being evaluated for resection of an abdominal aortic aneurysm (AAA). (author)

  17. Chronic dissection of the superior mesenteric artery: case report

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    Common, A.A.; Pressacco, J. [Univ. of Toronto, St. Michael' s Hospital, Dept. of Medical Imaging, Toronto, Ontario (Canada)

    1999-02-01

    Acute dissection of the thoracic aorta is a well-recognized, often fatal condition that frequently extends to involve the abdominal aorta and iliac vessels. The ostia of the renal and mesenteric vessels may be compromised, and the resulting visceral ischemia may necessitate surgical intervention. However, visceral perfusion may be restored if blood flow from true to false lumen is re-established or if the false lumen is obliterated, either spontaneously or by surgical or interventional techniques. Isolated dissections of mesenteric, renal, and carotid vessels are rarely reported. These may be spontaneous, related to high blood pressure and underlying disease of the vessel wall, or caused by abdominal trauma or medical intervention, including angiographic procedures. They are usually associated with pain and other signs and symptoms of ischemia in the appropriate territory. We present a case of chronic superior mesenteric artery (SMA) dissection, an incidental angiographic finding, in an asymptomatic patient being evaluated for resection of an abdominal aortic aneurysm (AAA). (author)

  18. Different patients, different outcomes: A case-control study of spontaneous coronary artery dissection versus acute coronary syndrome.

    Science.gov (United States)

    Adams, Heath; Paratz, Elizabeth; Somaratne, Jithendra; Layland, Jamie; Burns, Andrew; Palmer, Sonny; MacIsaac, Andrew; Whitbourn, Robert

    2018-02-01

    There is progressive interest worldwide in spontaneous coronary artery dissection (SCAD). To identify a SCAD cohort and compare risk factors, presentation, and management outcomes compared to acute coronary syndrome (ACS) matched controls. Retrospective analysis was performed from 2000 to 2015. Clinical data included a neuropsychiatric history, with management and clinical outcomes assessed at 12 months. Patients were matched on a 1:3 case-control basis according to type of ACS. Twenty-two SCAD patients were matched to 66 controls by ACS type (ST-elevation myocardial infarction 45%, Non-ST-elevation myocardial infarction 41%, unstable angina 14%). The SCAD group were more likely female (77.3% vs 19.7%, P SCAD patients had a high prevalence of anxiety, depression or previous neuropsychiatric history (52.4% SCAD vs 1.5% ACS, P SCAD patients (13.6% SCAD vs 83.3% ACS, P SCAD vs 27.3% ACS P = NS). SCAD affects young females with a paucity of cardiovascular risk factors. The major risk factor for SCAD was a history of anxiety, depression, or neuropsychiatric illness. A conservative approach to SCAD revascularization led to similar MACCE when compared to ACS controls undergoing guideline revascularization at 12 months. © 2017, Wiley Periodicals, Inc.

  19. A case of spontaneous coronary artery dissection presenting with acute anterior wall myocardial infarction in a young adult male - an increasingly recognized rare disease.

    Science.gov (United States)

    Taha, Mohamed; Latt, Htun; Al-Khafaji, Jaafar; Ali, Mohamed; Seher, Richard

    2018-01-01

    Background : Spontaneous coronary artery dissection (SCAD) is increasingly recognized as an important cause of myocardial infarction and sudden death. Although some correlations have been noted in relation to aetiology, no direct causes have been identified in a large number of patients. Most of the patients are women in peripartum period or of childbearing age, with few if any risk factors for coronary heart disease. In men, however, risk factors for atherosclerosis are more prevalent in cases of SCAD Case report : We report a case of a 43-years-old healthy male, with no known risk factors, who presented with ischemic chest pain and elevated troponin levels. He underwent an emergent percutaneous transluminal coronary angiography which revealed a total occlusion of the left anterior descending artery at its origin with an evidence of spontaneous dissection as the cause of the occlusion, which was subsequently treated with placement of a drug-eluting stent and thrombectomy from the distal occluded portion. This case highlights the importance of including spontaneous coronary artery dissection as a cause of ischemic cardiac insults and illustrates the approach to treatment. Conclusion : Internists should have a low threshold of clinical suspicion for SCAD especially in a young patient with no known risk factors and should know the importance of emergency in management.

  20. Medical treatment or revascularisation as the best approach for spontaneous coronary artery dissection: A systematic review and meta-analysis.

    Science.gov (United States)

    Martins, José Luís; Afreixo, Vera; Santos, Luís; Costa, Marco; Santos, José; Gonçalves, Lino

    2017-04-01

    Patients presenting with spontaneous coronary artery dissection (SCAD) may receive either conservative medical management or a revascularisation strategy. There is still a lack of consensus with respect to the best treatment approach for SCAD. We sought to determine whether outcomes differ between the first-line treatment approaches (conservative versus revascularisation) in patients with SCAD. We searched Medline, EMBASE and the Cochrane Library for studies published from January 1990 to November 2016 that compared first-line treatments for patients with SCAD. We conducted a pooled risk ratio meta-analysis for four main outcomes: mortality, myocardial infarction (MI), SCAD recurrence and target vessel revascularisation (TVR). We identified 11 non-randomised studies that included a total of 631 patients. A pooled meta-analysis showed no significant difference between conservative management and revascularisation approaches in mortality (risk difference [RD] = 0.01; 95% confidence interval [CI] = -0.01 to 0.04; I 2 = 0%; p = 1), MI (RD = -0.01; 95% CI = -0.04 to 0.03; I 2 = 0%; p = 0.5) or SCAD recurrence (RD = -0.01; 95% CI = -0.06 to 0.05; I 2 = 0%; p = 0.74). Revascularisation as an initial first-line approach was associated with an estimated additional risk of TVR of 6.3% (RD = 0.06; 95% CI = 0.01-0.11; I 2 = 0%; p = 0.96). The results demonstrate an increased risk of TVR when revascularisation was used as the initial first-line treatment approach. The treatment decision must be individualised and be based on both clinical and angiographic factors, but conservative therapy should prevail in most cases.

  1. Spontaneous Coronary Artery Dissection as a Cause of Acute Myocardial Infarction in Young Female Population: A Single-center Study.

    Science.gov (United States)

    Meng, Pei-Na; Xu, Chen; You, Wei; Wu, Zhi-Ming; Xie, Du-Jiang; Zhang, Hang; Pan, Chang; Ye, Fei

    2017-07-05

    Spontaneous coronary artery dissection (SCAD) is a nonatherosclerotic but a rare and extremely dangerous clinical entity, it has a high prevalence in young female population with acute myocardial infarction (AMI). The previous reports were restricted to other countries' population, but rare in China. Hence, this study aimed to focus on the characteristics of SCAD as a cause of young female AMI population in Jiangsu, China. This study enrolled young female AMI patients aged ≤50 years who underwent coronary angiography (CAG) and intracoronary imaging in our center between January 2013 and December 2016. Their clinical presentations, risk factors, and CAG characteristics were analyzed. A total of 60 young female AMI (SCAD in young female AMI population was 35% (21/60), the prevalence of coronary atherosclerostic heart disease was 65% (39/60). In the SCAD group, 43% (9/21) presented with non-ST-elevation myocardial infarction (NSTEMI) and the remainder presenting as STEMI. SCAD usually occurred in a single vessel (20/21, 95%), especially in left anterior descending artery (14/21, 67%). Eighteen patients (18/21, 86%) underwent conservative treatment, whereas the remaining three patients (3/21, 14%) underwent percutaneous coronary intervention. Regarding the angiographic results of SCAD lesions, intramural hematoma was discriminated in 95% (20/21), and Type I imaging was observed in 5% (1/21), Type II was observed in 67% (14/21), and Type III was 29% (6/21). The average stenosis in the group was 76.9% ± 20.6%, and the mean lesion length was 36.6 ± 8.6 mm. SCAD has a high prevalence in young female AMI population in Jiangsu, China. Discriminating the cause of AMI in young female population is very important.

  2. Spinal Muscular Atrophy (SMA)

    Science.gov (United States)

    ... of SMA can survive long into adulthood, and academic and workplace achievements are common. Type 4 SMA (adult-onset SMA) ... 5s. These “extra” SMN2 genes can lessen the impact of a flaw in both SMN1 genes. ... helpful products and devices, social and family issues, and much more. Other MDA ...

  3. [A dissecting aneurysm of the posterior inferior cerebellar artery was reduced spontaneously during conservative therapy: case report].

    Science.gov (United States)

    Wakamoto, Hirooki; Orii, Maaya; Miyazaki, Hiromichi; Ishiyama, Naomi

    2002-04-01

    We report here a case of a patient with a dissecting aneurysm of the anterior medullary segment of the posterior inferior cerebellar artery (PICA) which presented with Wallenberg's syndrome. A 32-year-male presented with an unusual case of Wallenberg's syndrome due to a dissecting aneurysm of the PICA manifesting as a sensation of heaviness in the occipital region and vertigo. The occipital symptoms persisted and vertigo and vomiting developed after 6 days. Numbness developed on the left side of the patient's face, and hyperalgesia on the right side of the body. The diagnosis of Wallenberg's syndrome was based on the above findings. MRI revealed infarction of the lateral aspect of the medulla oblongata and MR angiography revealed dilatation in the proximal portion of the left PICA. Digital subtraction angiography revealed that the left vertebral artery was essentially normal, but there was a spindle-shaped dilatation in the proximal portion of the left PICA. We carried out conservative therapy at the patient's request and 3D-CTA revealed that the dissecting aneurysm was markedly reduced in size seven months after the onset. Dissecting aneurysms of the intracranial posterior circulation have been shown to be less uncommon than previously thought. However, those involving the PICA without involvement of the vertebral artery at all are extremely rare. The natural history of the dissecting PICA aneurysm was unknown, and the indication for surgical treatment of such aneurysms remains controversial. Management options are conservative treatment, open surgical treatment including wrapping, trapping, and resection with reconstruction, but almost all of the patients underwent radical treatment to prevent rupture of the aneurysm. However we had no knowledge of the risk of rupture of a PICA dissecting aneurysm presenting with ischemic symptoms. We have reviewed the well-documented 15 cases of dissecting aneurysms of the PICA reported in the literature and we discuss the

  4. Brainstem ischemic stroke without permanent sequelae during the course of spontaneous internal carotid artery dissection – case report

    International Nuclear Information System (INIS)

    Nesteruk, Tomasz; Nesteruk, Marta; Bulik-Pasińska, Marta; Boroszko, Dariusz; Ostrowska, Monika

    2012-01-01

    Internal carotid artery dissection (ICAD) is a frequent cause of a stroke in young patients. Risk factors which can lead to dissection include neck injury and diseases of the inner wall of the artery. Common symptoms in ICAD are cervical pain and headache, Horner’s syndrome, paralysis of the cranial nerves and subsequently cerebral and retinal ischemia. MR angiography in TOF technique and brain MRI in T1- and T2-weighted images, FLAIR and DWI sequences are the method of choice in patients with ICAD but contrast-enhanced multislice computed tomography remains the fastest and the most available diagnostic method. A 39-year old woman, previously healthy, presented to the Hospital Emergency Department because of increasing neck pain on the right side and difficulty in swallowing. The neurological examination revealed: drooping of the right eyelid with narrow palpebral fissure, dysarthria, anisocoria (narrower pupil on the right side), unilateral hypoesthesia on the left side, weak palatal and pharyngeal reflexes on both sides, paresthesia within the left half of the body. Seven days before, the patient felt a sudden, severe neck pain radiating to the temporal apophysis. CT angiography revealed a defect in contrast filling within the left internal carotid artery and right vertebral artery. MRI of the head with MR angiography showed internal carotid artery dissection on the left side and dissection of the right vertebral artery and no ischemic changes within the brain. CT and MR angiography are methods characterized by high sensitivity in detecting dissection of the cervical arteries

  5. Spontaneous coronary artery dissection presenting as an ischaemic stroke in a middle-aged man with anti-cardiolipin antibodies: a case report

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    Lim F

    2010-03-01

    Full Text Available Abstract Introduction Cerebrovascular disease is a major cause of mortality and morbidity worldwide. Ischemic stroke is the most common manifestation, encompassing a wide variety of causative mechanisms. We present the case of a middle-aged male patient with spontaneous coronary artery dissection in the presence of anti-cardiolipin antibodies, leading to left ventricular thrombus and presenting with stroke. Case presentation A 56-year-old Caucasian man presented with dysarthria and right-sided weakness. There was a history of chest pain with autonomic symptoms four days earlier. Examination revealed right-sided hemiparesis. Electrocardiogram showed sinus rhythm with anterior Q waves. Magnetic resonance imaging of the brain showed large left parietal and smaller multiple cerebral infarcts. Echocardiogram showed anterior wall and apical akinesis with a large mural thrombus. Anti-cardiolipin antibodies immunoglobulin G and immunoglobulin M were strongly positive. Coronary angiography showed dissection of the mid left anterior descending artery with normal flow down the distal vessel. He was treated conservatively with anticoagulation and secondary prevention. He was in good health when seen in clinic four months later. Conclusion We highlight the importance of a comprehensive approach at obtaining the correct diagnosis, input of different specialities and the fact that the presence of anti-cardiolipin antibodies is associated with coronary artery dissection in a middle-aged male patient whose presentation was stroke.

  6. Spontaneous left main coronary artery dissection complicated by pseudoaneurysm formation in pregnancy: role of CT coronary angiography

    Directory of Open Access Journals (Sweden)

    Weintraub Nealw F

    2009-04-01

    Full Text Available Abstract We report a case of a 26-year-old female, who presented at 34 weeks of an uncomplicated pregnancy with an acute ST elevation anterior wall myocardial infarction. Cardiac catheterization suggested a left main coronary artery dissection with pseudoaneurysm formation. The patient's course was complicated by congestive heart failure. She was initially managed conservatively by a multidisciplinary team including heart failure specialists, obstetricians, and cardiovascular surgeons. 4 days after admission, her LMC was imaged by dual-source 64 slice Cardiac computed tomography, coronary dissection was identified extending to the lumen, and the presence of pseudoaneurysm was confirmed. She underwent subsequently a staged procedure, which included placement of an intra-aortic balloon pump, cesarean section, and coronary artery bypass grafting. This case illustrates the utility of coronary artery CT imaging to assess the complexity and stability of coronary artery dissections, thereby helping to determine the need for, and timing of revascularization procedures.

  7. MRI with fat suppression improves visualization of arterial wall hematoma in spontaneous dissection of the internal carotid artery; MRT mit Fettsuppression zur Darstellung des Wandhaematoms bei spontaner Dissektion der A. carotis interna

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    Fiebach, J.; Knauth, M.; Jansen, O. [Heidelberg Univ. (Germany). Abt. fuer Neuroradiologie; Brandt, T. [Heidelberg Univ. (Germany). Abt. fuer Neurologie

    1999-10-01

    Purpose: Comparison of different MR-examination techniques for the diagnosis of acute spontaneous internal carotid artery dissection. Patients and methods: 13 patients (age range 23-59 years) with symptomatic spontaneous dissection of the internal carotid artery were examined. The MRI protocol contained a transverse spin echo sequence, a time-of-flight MR-angiography and a coronal fat suppressed T{sub 1}-weighted sequence. The earliest examination was performed three days after symptom onset. Follow-up extended up to 30 months. We compared the three different sequences to find out the one that demonstrated the hematoma best. Results: MR-angiography shows a narrowing of the vessel diameter in early examinations. During the subacute stage methemoglobin can obscure this finding. From the third day on fat suppressed T{sub 1}-weighted images showed a hyperintense hematoma that strongly contrasted to the surrounding fatty tissue. Fat suppressed images showed a hyperintense hematoma up to 10 months after symptom onset while MRA and spin echo sequences did not. Conclusions: Fat suppressed T{sub 1}-weighted images are superior in showing vessel wall hematoma and should thus be used in the standard MR-protocol for spontaneous internal carotid artery dissection. (orig.) [German] Zielsetzung: Untersuchung zur Wertigkeit einer fettsupprimierten T{sub 1}-gewichteten Sequenz in der MR-Diagnostik bei spontanen Dissektionen der extrakraniellen Arteria carotis interna. Material und Methoden: 13 Patienten im Alter von 23-59 Jahren mit symptomatischer spontaner Karotisdissektion wurden mit transversalen T{sub 2}-gewichteten SE-Sequenzen, MR-Angiographie (TOF) und koronaren fettsupprimierenden T{sub 1}-gewichteten Sequenzen untersucht. Die frueheste MR-Untersuchung fand 3 Tage nach Symptombeginn, die letzte Verlaufsuntersuchung nach 30 Monaten statt. Bestimmt wurde, welche der drei Sequenzen das Wandhaematom bei Dissektion am deutlichsten erfasst. Ergebnisse: In der Fruehphase der

  8. The subpetrous carotid wall hematoma. A sign of spontaneous dissection of the internal carotid artery on non-enhanced computed tomography. A retrospective study

    International Nuclear Information System (INIS)

    Jensen-Kondering, U.; Univ. Hospital Schleswig-Holstein, Kiel; Huhndorf, M.; Madjidyar, J.; Jansen, O.

    2015-01-01

    Spontaneous dissection of the internal carotid artery (CAD) is an increasingly recognized cause for stroke especially in young and middle-aged patients. We hypothesized that non-enhanced cranial computed tomography (NECCT) can visualize the subpetrous carotid wall hematoma and thus enable identification of patients with CAD. We retrospectively reviewed patients with confirmed CAD (n=21) and a control group with ischemic symptoms but without CAD (n=42) who received NECCT at admission. Two independent neuroradiologists rated the presence and shape of SPH, density and diameter of the subpetrous internal carotid artery. Additionally, we correlated the shape of the subpetrous carotid wall hematoma with the grade of stenosis on subsequent angiographic imaging. The subpetrous carotid wall hematoma was present in 14 of 21 patients (Cohen's k = 0.67). Mean diameter was 6.95 ± 1.05 mm in dissected vessels and 5.71 ± 1.52 mm in the contralateral vessel (p<0.05). Mean difference in vessel density was 15.05 ± 8.01 HU (p<0.01). Median grade of stenosis was significantly higher in patients with a full moon- shaped (n=11) than crescent-shaped (n=3) subpetrous carotid wall hematoma (21% vs. 80%, p<0.05). Two-thirds of patients with CAD were correctly identified on NECCT. The extracranial carotid artery should be evaluated in patients with symptoms of cerebral ischemia.

  9. The subpetrous carotid wall hematoma. A sign of spontaneous dissection of the internal carotid artery on non-enhanced computed tomography. A retrospective study

    Energy Technology Data Exchange (ETDEWEB)

    Jensen-Kondering, U. [Univ. Hospital Schleswig-Holstein, Kiel (Germany). Dept. of Radiology and Neuroradiology; Univ. Hospital Schleswig-Holstein, Kiel (Germany). Dept. of Neurology; Huhndorf, M.; Madjidyar, J.; Jansen, O. [Univ. Hospital Schleswig-Holstein, Kiel (Germany). Dept. of Radiology and Neuroradiology

    2015-03-15

    Spontaneous dissection of the internal carotid artery (CAD) is an increasingly recognized cause for stroke especially in young and middle-aged patients. We hypothesized that non-enhanced cranial computed tomography (NECCT) can visualize the subpetrous carotid wall hematoma and thus enable identification of patients with CAD. We retrospectively reviewed patients with confirmed CAD (n=21) and a control group with ischemic symptoms but without CAD (n=42) who received NECCT at admission. Two independent neuroradiologists rated the presence and shape of SPH, density and diameter of the subpetrous internal carotid artery. Additionally, we correlated the shape of the subpetrous carotid wall hematoma with the grade of stenosis on subsequent angiographic imaging. The subpetrous carotid wall hematoma was present in 14 of 21 patients (Cohen's k = 0.67). Mean diameter was 6.95 ± 1.05 mm in dissected vessels and 5.71 ± 1.52 mm in the contralateral vessel (p<0.05). Mean difference in vessel density was 15.05 ± 8.01 HU (p<0.01). Median grade of stenosis was significantly higher in patients with a full moon- shaped (n=11) than crescent-shaped (n=3) subpetrous carotid wall hematoma (21% vs. 80%, p<0.05). Two-thirds of patients with CAD were correctly identified on NECCT. The extracranial carotid artery should be evaluated in patients with symptoms of cerebral ischemia.

  10. Age determination of vessel wall hematoma in spontaneous cervical artery dissection: A multi-sequence 3T Cardiovascular Magnetic resonance study

    Directory of Open Access Journals (Sweden)

    Habs Maximilian

    2011-11-01

    Full Text Available Abstract Background Previously proposed classifications for carotid plaque and cerebral parenchymal hemorrhages are used to estimate the age of hematoma according to its signal intensities on T1w and T2w MR images. Using these classifications, we systematically investigated the value of cardiovascular magnetic resonance (CMR in determining the age of vessel wall hematoma (VWH in patients with spontaneous cervical artery dissection (sCAD. Methods 35 consecutive patients (mean age 43.6 ± 9.8 years with sCAD received a cervical multi-sequence 3T CMR with fat-saturated black-blood T1w-, T2w- and TOF images. Age of sCAD was defined as time between onset of symptoms (stroke, TIA or Horner's syndrome and the CMR scan. VWH were categorized into hyperacute, acute, early subacute, late subacute and chronic based on their signal intensities on T1w- and T2w images. Results The mean age of sCAD was 2.0, 5.8, 15.7 and 58.7 days in patients with acute, early subacute, late subacute and chronic VWH as classified by CMR (p Conclusions Signal intensities of VWH in sCAD vary over time and multi-sequence CMR can help to determine the age of an arterial dissection. Furthermore, findings of this study suggest that the time course of carotid hematomas differs from that of cerebral hematomas.

  11. Progressed Multivessel Spontaneous Coronary Artery Dissection That Naturally Healed in a Male Patient with Non-ST Segment Elevation Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Tatsuo Haraki

    2016-01-01

    Full Text Available Spontaneous coronary artery dissection (SCAD is a rare condition that may have a serious outcome because of acute coronary syndrome. The condition especially affects young women. We evaluated a middle-aged male patient with a non-ST segment elevation myocardial infarction caused by multivessel SCAD. The SCAD had occurred in the distal right coronary artery (RCA, the mid left anterior descending artery (LAD, and the distal LAD at the same time. His culprit lesion was in the distal RCA, but the SCAD had progressed more proximally within the RCA 12 days later with no clinical symptoms. We treated the mid LAD with implantation of a drug-eluting stent on admission and the SCAD had not progressed 12 days later. Moreover, the SCAD in the distal RCA and distal LAD healed spontaneously 12 days later. He had no recurrent attack, and all SCAD lesions of the RCA and LAD had completely healed 6 months later. Given that SCAD appears in various forms over the clinical course, a strategy of intervention needs careful consideration.

  12. Dissection of Chromosome 18 Blood Pressure and Salt-Sensitivity Quantitative Trait Loci in the Spontaneously Hypertensive Rat

    Czech Academy of Sciences Publication Activity Database

    Johnson, M.D.; He, L.; Herman, D.; Wakimoto, H.; Wallace, C. A.; Zídek, Václav; Mlejnek, Petr; Musilová, Alena; Šimáková, Miroslava; Vorlíček, Jaroslav; Křen, Vladimír; Vyklický, O.; Qi, N.R.; Wang, J.; Seidman, Ch. E.; Seidman, J.; Kurtz, T. W.; Aitman, T. J.; Pravenec, Michal

    2009-01-01

    Roč. 54, č. 3 (2009), s. 639-645 ISSN 0194-911X R&D Projects: GA MŠk(CZ) 1M0520; GA MŠk(CZ) 1P05ME791; GA ČR(CZ) GA301/08/0166 Grant - others:EC(XE) LSHG-CT-2005-019015; Howard Hughes Medical Institute(US) HHMI 55005624; Transatlantic network of excellence(US) Foundation Leducq Institutional research plan: CEZ:AV0Z50110509 Keywords : spontaneously hypertensive rat * salt sensitivity * gene Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 6.614, year: 2009

  13. Carotid dissections

    Energy Technology Data Exchange (ETDEWEB)

    Mueller-Forell, W.; Rothacher, G.; Kraemer, G.

    1989-09-01

    In younger patients, the clinical symptoms of sudden unilateral headache and facial pain, often combined with Horner syndrome and the cerebrovascular symptoms of TIAs or stroke, should indicate the diagnosis of spontaneous carotid dissection. Angiographic findings can verify this diagnosis, showing various signs of eccentric, narrowing stenosis, false lumen, pseudoaneurysms, or complete occlusion. In addition to noninvasive Doppler ultrasonography, B-mode and Duplex investigations, although more or less nonspecific, give some indications of the diagnosis; modern imaging techniques, especially MRI, can image the intramural hematoma directly. As the hematoma is the source of the intracranial emboli, the therapy of choice in this rarely diagnosed disease should be anticoagulation. (orig.).

  14. Natural course and outcomes of spontaneous isolated celiac artery dissection according to morphological findings on computed tomography angiography: STROBE compliant article.

    Science.gov (United States)

    Kim, Bohyun; Lee, Byung Soo; Kwak, Hyun Kyu; Kang, Hyuncheol; Ahn, Jung Hwan

    2018-02-01

    We aimed to identify natural course and optimal management of spontaneous isolated celiac artery dissection (SICAD) according to morphologic classification determined on computed tomography angiography (CTA), and to investigate the association between symptoms and morphological classification of SICAD.This retrospective observational study included 21 consecutive patients with SICAD from January 2012 to April 2017. Demographic data, clinical features, treatment modalities, follow-up results, and CTA findings including morphologic classification, dissection length, and relative diameter of the true lumen (TLRD) were reviewed. Changes in follow-up CTA were recorded and compared to prior studies to reveal natural course of the disease.The serial changes of SICAD on follow-up CTA according to morphologic classifications were as follows; type I (5/5, no interval change), type IIa (1/1, no interval change), type IIb (1/1, partial remodeling), type IIIa (1/4, complete remodeling; 1/4, partial remodeling; 1/4, no interval change; 1/4, deterioration), type IIIb (4/6, no interval change; 2/6, partial remodeling), and type IV (2/2, no interval change). Thirteen (61.9%) symptomatic and 8 (38.1%) asymptomatic patients were all treated with conservative management with or without antiplatelet and/or anticoagulation therapies. Symptomatic group (SG) more commonly had type IIb, IIIa, IIIb, and IV than asymptomatic group (AG) (SG; 11 patients, AG; 1 patient, P = .002). TLRD in AG was larger than that in SG (SG: 40.5 ± 24.1%, AG: 61.7 ± 7.0%, P = .045).SICAD might be treated by conservative management in stable patients irrespective of the morphologic classification except for with type IV (dissecting aneurysm) and extension of celiac branch who may need an early intervention. Types IIb, IIIa, IIIb, and IV are TLRD are associated with patients' symptoms. Further studies on extended natural course of SICAD with a larger number of subjects are needed to draw a strong

  15. Comparative Life Cycle Assessment between Warm SMA and Conventional SMA

    Science.gov (United States)

    2011-09-01

    This report presents the comparative life cycle assessment (LCA) between warm stone mastic asphalt (SMA) and conventional : SMA. Specifically, the study evaluated and compared the life cycle environmental and economic performances of two mixtures: a ...

  16. How and when to suspect spontaneous coronary artery dissection: novel insights from a single-centre series on prevalence and angiographic appearance.

    Science.gov (United States)

    Motreff, Pascal; Malcles, Guilhem; Combaret, Nicolas; Barber-Chamoux, Nicolas; Bouajila, Sara; Pereira, Bruno; Amonchot, Aimé; Citron, Bernard; Lusson, Jean-René; Eschalier, Romain; Souteyrand, Géraud

    2017-04-07

    Spontaneous coronary artery dissection (SCAD) is an underdiagnosed entity of acute coronary syndrome (ACS). Its prevalence remains unclear due to a challenging diagnosis, particularly in instances of intramural haematoma without intimal rupture. In the present study, we aimed to: 1) estimate the prevalence of SCAD among acute coronary syndrome (ACS) patients managed in a French coronary care centre, 2) demonstrate the value of specific angiographic signs for diagnosing SCAD, and 3) confirm the incremental value of intracoronary imaging in ambiguous cases. From 1999 to 2014, 55 cases of SCAD (all women, mean age 50.1 years) were diagnosed. Ignoring age, 51 (92.7%) had ≤2 cardiovascular risk factors. Thirty-six were diagnosed prospectively during the latter period (2012-2014). Among these, SCAD accounted for 35.7% of ACS (20/56) in women SCAD were identified: 1) absence of atheroma on other coronary arteries, 2) radiolucent flap(s), 3) contrast dye staining of the arterial wall, 4) starting and/or ending of the angiographic ambiguity on a side branch, 5) long narrowing of lumen calibre: smooth and linear, or stenosis of varying severity mimicking a "stick insect" or "radish" aspect. Three of the above five signs were present in 51 (92.7%) cases. Optical computed tomography (OCT) was performed in 19 cases with no complication. All explored arteries had evidence of intramural haematoma and/or intimomedial membrane separation. An intimal rupture was observed in 10 (52.6%) patients. The diseased segment initiated or ended on a side branch in 14 (73.7%) patients. SCAD accounts for approximately one third of ACS in young women with ≤1 CRF. The combination of specific angiographic signs and OCT imaging facilitates the diagnosis of ambiguous cases without intimal rupture.

  17. Acute myocardial infarction due to spontaneous, localized, acute dissection of the sinus of Valsalva detected by intravascular ultrasound and electrocardiogram-gated computed tomography.

    Science.gov (United States)

    Ichihashi, Taku; Ito, Tsuyoshi; Murai, Shunsuke; Ikehara, Noriyuki; Fujita, Hiroshi; Suda, Hisao; Ohte, Nobuyuki

    2016-09-01

    A 58-year-old man was referred to our hospital because of chest pain. The 12-lead electrocardiogram (ECG) revealed ST-segment elevation in II, III, and a Vf with advanced heart block. Transthoracic echocardiography demonstrated aortic root dilatation at the sinus of Valsalva, moderate aortic regurgitation, and decreased wall motion in the inferior part of the left ventricle. Non-ECG-gated enhanced computed tomography (CT) did not reveal an aortic dissection. The patient underwent emergent coronary angiography, which revealed a severely narrowed ostium of the right coronary artery (RCA). Percutaneous coronary intervention (PCI) was performed under intravascular ultrasound (IVUS) guidance. IVUS images demonstrated an intimal flap extending from the aortic wall to the proximal RCA, suggesting that a periaortic hematoma in the false lumen compressed the ostium of the RCA, leading to acute myocardial infarction. To recover hemodynamic stability, the RCA ostium was stented. Subsequent ECG-gated enhanced CT clearly depicted the entry point and extension of the dissection localized within the sinus of Valsalva. The dissection likely involved the left main coronary artery and an emergent Bentall procedure was performed. Intraoperative findings confirmed an intimal tear and extension of the dissection. Thus, ECG-gated CT can clearly depict the entry site and extension of a dissection occurring in the localized area that cannot be detected by conventional CT.

  18. Dissecção espontânea do tronco celíaco: qual a melhor abordagem terapêutica? Spontaneous dissection of the celiac trunk: what is the best therapeutic approach?

    Directory of Open Access Journals (Sweden)

    Francisco Leonardo Galastri

    2013-03-01

    Full Text Available A dissecção espontânea das artérias viscerais é um evento relativamente raro. Dor abdominal súbita no epigástrio é o sintoma mais frequentemente manifestado pelos pacientes. O avanço das técnicas de exames de imagem possibilitou o diagnóstico deste evento com maior facilidade, aumentando a incidência das dissecções das artérias viscerais. O tratamento clínico conservador, a revascularização cirúrgica, e a terapia endovascular são as três possíveis opções terapêuticas. Neste artigo, relatamos os casos de dois pacientes com dissecção espontânea do tronco celíaco conduzidos de formas diversas, de acordo com a apresentação clínica e exames de imagem, além de realizar uma revisão bibliográfica sobre esta doença.Spontaneous dissection of visceral arteries is a quite rare event. Sudden abdominal pain in the epigastrium is the most frequent symptom. Advances in imaging techniques have made it easier to establish the diagnosis of this event, increasing the incidence of dissections of visceral arteries. Conservative medical treatment, surgical revascularization, and endovascular therapy are the three treatment options available. We report two cases of patients with spontaneous dissection of the celiac trunk that received different treatments based on clinical presentation and imaging studies. We also conducted a literature review on this disease.

  19. Aortic dissection

    Science.gov (United States)

    ... made in the chest or abdomen. Endovascular aortic repair. This surgery is done without any major surgical ... needed. If the heart arteries are involved, a coronary bypass is also performed. Outlook ... aneurysm - dissecting; Chest pain - aortic dissection; Thoracic aortic aneurysm - ...

  20. Stent implantation and vascular healing of a spontaneous coronary artery dissection assessed by optical coherence tomography in a patient with acute coronary syndrome

    DEFF Research Database (Denmark)

    Hansen, Kirstine Nørregaard; Antonsen, Lisbeth; Jensen, Lisette Okkels

    2018-01-01

    A 60-year old woman with non-ST-segment elevation myocardial infarction, underwent coronary angiogram combined with optical coherence tomography (OCT) revealing a long dissection in the right coronary artery. The patient experienced peri-procedural chest pain, the electrocardiogram showed ST...

  1. SMA DOE Student Fellowship Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Steel Manufacturers Association

    2004-12-24

    Steel companies in many areas of the country have found it increasingly difficult to attract talented recent graduates of college and university engineering and applied science programs to the Electric Arc Furnace iron & steel industry. College student involvement in co-operative programs at steel companies can attract needed talent to the industry. Additionally, certain R & D needs identified in the Steel Industry Technology Roadmap are addressed as co-operative program activities. The Steel Manufacturers Association (''SMA'') therefore established a co-operative education program for selected college students who have completed the first or second year of a four or five-year college program, to be recognized as SMA Co-Operative Fellows, in regard to their summer and fall semester projects with SMA's member companies.

  2. Vascular type Ehlers-Danlos Syndrome with fatal spontaneous rupture of a right common iliac artery dissection: case report and review of literature.

    Science.gov (United States)

    Abayazeed, Aly; Hayman, Emily; Moghadamfalahi, Mana; Cain, Darren

    2014-02-01

    Vascular Ehlers-Danlos Syndrome (previously Ehlers-Danlos IV) is a rare autosomal dominant collagen vascular disorder caused by a 2q31 COL3A1 gene mutation encoding pro-alpha1 chain of type III collagen (in contrast to classic Ehlers-Danlos, caused by a COL5A1 mutation). The vascular type accounts for less than 4% of all Ehlers-Danlos cases and usually has a poor prognosis due to life threatening vascular ruptures and difficult, frequently unsuccessful surgical and vascular interventions. In 70% of cases, vascular rupture or dissection, gastrointestinal perforation, or organ rupture is a presenting sign. We present a case of genetically proven vascular Ehlers-Danlos with fatal recurrent retroperitoneal hemorrhages secondary to a ruptured right common iliac artery dissection in a 30-year-old male. This case highlights the need to suspect collagen vascular disorders when a young adult presents with unexplained retroperitoneal hemorrhage, even without family history of such diseases.

  3. Traumatic cervical artery dissection.

    Science.gov (United States)

    Nedeltchev, Krassen; Baumgartner, Ralf W

    2005-01-01

    Traumatic cervical artery dissection (TCAD) is a complication of severe blunt head or neck trauma, the main cause being motor vehicle accidents. TCAD are increasingly recognized, and incidences of up to 0.86% for internal carotid and 0.53% for traumatic vertebral artery dissections (TVAD) among blunt trauma victims are reported. Diagnostic evaluation for TCAD is mandatory in the presence of (1) hemorrhage of potential arterial origin originating from the nose, ears, mouth, or a wound; (2) expanding cervical hematoma; (3) cervical bruit in a patient >50 years of age; (4) evidence of acute infarct at brain imaging; (5) unexplained central or lateralizing neurological deficit or transient ischemic attack, or (6) Horner syndrome, neck or head pain. In addition, a number of centers screen asymptomatic patients with blunt trauma for TCAD. Catheter angiography is the standard of reference for diagnosis of TCAD. Color duplex ultrasound, computed tomographic, and magnetic resonance angiography are noninvasive screening alternatives, but each method has its diagnostic limitations compared to catheter angiography. Anticoagulants and antiplatelet drugs may prevent ischemic stroke, but bleeding from traumatized tissues may offset the benefits of antithrombotic treatment. Endovascular therapy of dissected vessels, thrombarterectomy, direct suture of intimal tears, and extracranial-intracranial bypass should be considered in exceptional cases. Neurological outcome is probably worse in TCAD compared to spontaneous CAD, although it is unclear whether this is due to dissection-induced ischemic stroke or associated traumatic lesions.

  4. Aortic Dissection

    Science.gov (United States)

    ... Follow a low-salt diet with plenty of fruits, vegetables and whole grains and exercise regularly. Wear a seat belt. This reduces the risk of traumatic injury to your chest area. Work with your doctor. If you have a family history of aortic dissection, a connective tissue disorder or ...

  5. Fatigue crack behavior on a Cu-Zn-Al SMA

    Directory of Open Access Journals (Sweden)

    V. Di Cocco

    2014-10-01

    Full Text Available In recent years, mechanical property of many SMA has improved in order to introduce these alloys in specific field of industry. Main examples of these alloys are the NiTi, Cu-Zn-Al and Cu-Al-Ni which are used in many fields of engineering such as aerospace or mechanical systems. Cu-Zn-Al alloys are characterized by good shape memory properties due to a bcc disordered structure stable at high temperature called β-phase, which is able to change by means of a reversible transition to a B2 structure after appropriate cooling, and reversible transition from B2 secondary to DO3 order, under other types of cooling. In β-Cu-Zn-Al shape memory alloys, the martensitic transformation is not in equilibrium at room temperature. It is therefore often necessary to obtain the martensitic structure, using a thermal treatment at high temperature followed by quenching. The martensitic phases can be either thermally-induced spontaneous transformation, or stressinduced, or cooling, or stressing the β- phase. Direct quenching from high temperatures to the martensite phase is the most effective because of the non-diffusive character of the transformation. The martensite inherits the atomic order from the β-phase. Precipitation of many kinds of intermetallic phases is the main problem of treatment on cu-based shape memory alloy. For instance, a precipitation of α-phase occurs in many low aluminum copper based SMA alloy and presence of α-phase implies a strong degradation of shape recovery. However, Cu-Zn-Al SMA alloys characterized by aluminum contents less than 5% cover a good cold machining and cost is lower than traditional NiTi SMA alloys. In order to improve the SMA performance, it is always necessary to identify the microstructural changing in mechanical and thermal conditions, using X-Ray analyses. In this work a Cu-Zn-Al SMA alloy obtained in laboratory has been microstructurally and metallographically characterized by means of X-Ray diffraction and Light

  6. Trends of Incidence, Clinical Presentation, and In-Hospital Mortality Among Women With Acute Myocardial Infarction With or Without Spontaneous Coronary Artery Dissection: A Population-Based Analysis.

    Science.gov (United States)

    Mahmoud, Ahmed N; Taduru, Siva Sagar; Mentias, Amgad; Mahtta, Dhruv; Barakat, Amr F; Saad, Marwan; Elgendy, Akram Y; Mojadidi, Mohammad K; Omer, Mohamed; Abuzaid, Ahmed; Agarwal, Nayan; Elgendy, Islam Y; Anderson, R David; Saw, Jacqueline

    2018-01-08

    The authors sought to determine the clinical characteristics and in-hospital survival of women presenting with acute myocardial infarction (AMI) and spontaneous coronary artery dissection (SCAD). The clinical presentation and in-hospital survival of women with AMI and SCAD remains unclear. The National Inpatient Sample (2009 to 2014) was queried for all women with a primary diagnosis of AMI and concomitant SCAD. Iatrogenic coronary dissection was excluded. The main outcome was in-hospital mortality. Propensity score matching and multivariable logistic regression analyses were performed. Among 752,352 eligible women with AMI, 7,347 had a SCAD diagnosis. Women with SCAD were younger (61.7 vs. 67.1 years of age) with less comorbidity. SCAD was associated with higher incidence of in-hospital mortality (6.8% vs. 3.4%). In SCAD patients, a decrease in in-hospital mortality was evident with time (11.4% in 2009 vs. 5.0% in 2014) and concurred with less percutaneous coronary intervention (PCI) (82.5% vs. 69.1%). Propensity score yielded 7,332 SCAD and 14,352 patients without SCAD. The odds ratio (OR) of in-hospital mortality remained higher with SCAD after propensity matching (OR: 1.87, 95% confidence interval [CI]: 1.65 to 2.11) and on multivariable regression analyses (OR: 2.41, 95% CI: 2.07 to 2.80). PCI was associated with higher mortality in SCAD patients presenting with non-ST-segment elevation myocardial infarction (OR: 2.01; 95% CI: 1.00 to 4.47), but not with STEMI (OR: 0.62; 95% CI: 0.41 to 0.96). Women presenting with AMI and SCAD appear to be at higher risk of in-hospital mortality. Lower rates of PCI were associated with improved survival, with evidence of worse outcomes when PCI was performed for SCAD in the setting of non with ST-segment elevation myocardial infarction. Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  7. Dissecção espontânea cervical carotídea e verbal: estudo de 48 pacientes Spontaneous cervical carotid and vertebral arteries dissection: study of 48 patients

    Directory of Open Access Journals (Sweden)

    Cynthia Resende Campos

    2004-06-01

    Full Text Available OBJETIVO: Dada a ausência de estudos de séries brasileiras de pacientes com dissecção arterial cervical espontânea, com o objetivo de descrever os fatores de risco, sintomas precedentes, manifestações clínicas, resultados da investigação, tratamento e evolução. MÉTODO: realizamos a análise retrospectiva dos prontuários e laudos radiológicos [angiografia digital(AD, ressonância magnética(RM e ângio-ressonância(ARM] dos pacientes com esse diagnóstico atendidos no Serviço de Neurologia do HC/USP entre 1997 e 2003. RESULTADOS: 48 pacientes (24 homens, média de idade 37,9 anos; 26 pacientes com dissecção carotídea (DC unilateral, 15 com vertebral (DV unilateral e 7 com multiarterial, todos com déficits neurológicos. Os principais fatores de risco para doença vascular foram hipertensão arterial, tabagismo e dislipidemia. Mais de 80% apresentaram pelo menos um sintoma precedente, na maioria cefaléia têmporo-parietal. Cervicalgia foi referida por 44% dos pacientes com DV e por 3,4% dos com DC. O tempo médio entre o primeiro sintoma e o déficit foi 5,4 dias para as DC e 13,5 para as DV. AD foi o principal método diagnóstico (93%, associado a RM e ARM em 42% dos casos. Em 3 pacientes a RM cervical com supressão de gordura foi isoladamente suficiente. 75% dos pacientes receberam anticoagulação. Dois pacientes fizeram trombólise endovenosa sem complicações. A evolução foi boa, exceto por dois óbitos (DC bilateral. CONCLUSÃO: Os resultados são semelhantes aos da literatura, exceto pela baixa freqüência de cervicalgia nos casos de DC e pelo predomínio de cefaléia têmporo-parietal nas dissecções arteriais cervicais. Fatores de risco para doença vascular isquêmica foram frequentes.OBJETIVE: To report a Brazilian series of spontaneous cervical arterial dissections, risk factors, warning symptoms, clinical manifestations, diagnostic tests, treatment and prognosis. METHOD: We performed the retrospective

  8. Design of shape memory alloy (SMA) actuators

    CERN Document Server

    Rao, Ashwin; Reddy, J N

    2015-01-01

    This short monograph presents an analysis and design methodology for shape memory alloy (SMA) components such as wires, beams, and springs for different applications. The solid-solid, diffusionless phase transformations in thermally responsive SMA allows them to demonstrate unique characteristics like superelasticity and shape memory effects. The combined sensing and actuating capabilities of such materials allows them to provide a system level response by combining multiple functions in a single material system. In SMA, the combined mechanical and thermal loading effects influence the functionality of such materials. The aim of this book is to make the analysis of these materials accessible to designers by developing a "strength of materials" approach to the analysis and design of such SMA components inspired from their various applications with a review of various factors influencing the design process for such materials.

  9. Nutcracker and SMA syndromes: What is the normal SMA angle in children?

    International Nuclear Information System (INIS)

    Arthurs, O.J.; Mehta, U.; Set, P.A.K.

    2012-01-01

    Objective: The nutcracker and superior mesenteric artery (SMA) syndromes are rare conditions where the left renal vein or duodenum may be compressed by an unusually acute angle between the SMA and aorta, although the normal angle in children is unknown. We measured the SMA angle to define the normal range in children. Methods: We retrospectively measured SMA angles, left renal vein (LRV) distance, and duodenal distance (DD) in 205 consecutive pediatric abdominal CT. Total and visceral intra-abdominal fat at the level of the umbilicus were also assessed. Results: Mean SMA angle was 45.6 ± 19.6° (range 10.6–112.9°), mean LRV distance was 8.6 ± 3.9 mm (range 2.0–28.6 mm) and mean DD was 11.3 ± 4.8 mm (range 3.6–35.3 mm). There was a significant but weak correlation between %visceral fat volume (%VF) and SMA angle (R = 0.30; p < 0.001), LRV distance (R = 0.37, p < 0.001) and DD (R = 0.32; p < 0.001). Conclusion: There is a wide range of SMA angle, LRV and DD in normal children, which correlated weakly with visceral fat volume. Using a definition of SMA angle <25° would diagnose 9.3% of asymptomatic children with nutcracker syndrome, and using a DD definition of <8 mm would diagnose 20% with SMA compression. Our findings suggest exercising caution when attributing these rare syndromes to an absolute SMA angle.

  10. Nutcracker and SMA syndromes: What is the normal SMA angle in children?

    Energy Technology Data Exchange (ETDEWEB)

    Arthurs, O.J., E-mail: oja20@owenarthurs.co.uk [Department of Radiology, Box 219, Addenbrooke' s Hospital, Cambridge University Teaching Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ (United Kingdom); Mehta, U. [Department of Radiology, Box 219, Addenbrooke' s Hospital, Cambridge University Teaching Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ (United Kingdom); Set, P.A.K., E-mail: p.set@addenbrookes.nhs.uk [Department of Radiology, Box 219, Addenbrooke' s Hospital, Cambridge University Teaching Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ (United Kingdom)

    2012-08-15

    Objective: The nutcracker and superior mesenteric artery (SMA) syndromes are rare conditions where the left renal vein or duodenum may be compressed by an unusually acute angle between the SMA and aorta, although the normal angle in children is unknown. We measured the SMA angle to define the normal range in children. Methods: We retrospectively measured SMA angles, left renal vein (LRV) distance, and duodenal distance (DD) in 205 consecutive pediatric abdominal CT. Total and visceral intra-abdominal fat at the level of the umbilicus were also assessed. Results: Mean SMA angle was 45.6 {+-} 19.6 Degree-Sign (range 10.6-112.9 Degree-Sign ), mean LRV distance was 8.6 {+-} 3.9 mm (range 2.0-28.6 mm) and mean DD was 11.3 {+-} 4.8 mm (range 3.6-35.3 mm). There was a significant but weak correlation between %visceral fat volume (%VF) and SMA angle (R = 0.30; p < 0.001), LRV distance (R = 0.37, p < 0.001) and DD (R = 0.32; p < 0.001). Conclusion: There is a wide range of SMA angle, LRV and DD in normal children, which correlated weakly with visceral fat volume. Using a definition of SMA angle <25 Degree-Sign would diagnose 9.3% of asymptomatic children with nutcracker syndrome, and using a DD definition of <8 mm would diagnose 20% with SMA compression. Our findings suggest exercising caution when attributing these rare syndromes to an absolute SMA angle.

  11. Cervical artery dissection following a turbulent flight.

    LENUS (Irish Health Repository)

    Quinn, Colin

    2012-01-31

    BACKGROUND: Cervical artery dissection is a common cause of stroke in young patients without vascular risk factors and may affect the carotid or vertebral arteries. The risk of spontaneous dissection is higher in those with genetic predisposing factors while other cases may be precipitated by an event involving head or neck movement or associated with direct neck trauma. CASE REPORT: We present the case of a previously well young woman with a history of migraine who developed internal carotid artery dissection following a turbulent short-haul commercial flight while restrained using a seatbelt. DISCUSSION: We propose that repetitive flexion-hyperextension neck movements encountered during the flight were the most likely precipitant of carotid artery dissection in this case and review the therapeutic options available.

  12. Characteristics Analysis and Testing of SMA Spring Actuator

    Directory of Open Access Journals (Sweden)

    Jianzuo Ma

    2013-01-01

    Full Text Available The biasing form two-way shape memory alloy (SMA actuator composed of SMA spring and steel spring is analyzed. Based on the force equilibrium equation, the relationship between load capacity of SMA spring and geometric parameters is established. In order to obtain the characteristics of SMA spring actuator, the output force and output displacement of SMA spring under different temperatures are analyzed by the theoretical model and the experimental method. Based on the shape memory effect of SMA, the relationship of the SMA spring actuator's output displacement with the temperature, the stress and strain, the material parameters, and the size parameters is established. The results indicate that the trend of theoretical results is basically consistent with the experimental data. The output displacement of SMA spring actuator is increased with the increasing temperature.

  13. KESULITAN PEMECAHAN MASALAH FISIKA PADA SISWA SMA

    Directory of Open Access Journals (Sweden)

    Rismatul Azizah

    2015-12-01

    Full Text Available Telah dilakukan penelitian untuk mengidentifikasi kesulitan pemecahan masalah fisika pada siswa SMA. Penelitian ini menggunakan metode survey dengan menyebarkan angket. Responden terdiri dari 120 siswa yang berasal dari 3 sekolah yaitu, SMA Negeri 1 Bangil, SMA Negeri 8 Malang, dan SMA YADIKA Bangil. Dilakukan pula wawancara pada beberapa guru dan siswa. Berdasarkan hasil penyebaran angket, diperoleh 26% siswa mengalami kesulitan pada materi Suhu dan Kalor, 25% Optik, 21% Fluida Statik, 17% Elastisitas dan Hukum Hooke, dan 11% Kinematika. Kesulitan tersebut salah satunya disebabkan pembelajaran bagi siswa yang kurang maksimal dalam bentuk hands on activity. Sebanyak 88% siswa mengatakan bahwa pembelajaran fisika yang sering dialami adalah dengan metode ceramah. Siswa mengalami kesulitan belajar fisika dalam menyelesaikan permasalahan pada soal sebesar 32%, kesulitan memahami konsep dan rumus 26%, kesulitan menggunakan persamaan atau rumus dalam soal 18%, kesulitan menganalisis grafik dan gambar 17%, dan kesulitan menyimpulkan materi yang telah dipelajari 7%. Kesulitan tersebut terlihat ketika siswa memecahkan permasalahan pada soal kinematika serta suhu dan kalor. Diperoleh dari hasil angket, bahwa 76% siswa mengalami kesulitan dalam memecahkan permasalahan pada soal dengan alasan lupa atau tidak paham, sebesar 19% siswa kurang memahami solusi pemecahan masalah pada soal, dan hanya sebesar 5% siswa mampu memecahkan permasalahan pada soal.

  14. Dissecting Classroom Ethics.

    Science.gov (United States)

    Allchin, Douglas

    1991-01-01

    Described are activities that lead to values clarification. Issues such as dissection, bioengineering, birth control, medical resources, and death are discussed. Included is a student questionnaire on the subject of dissection and the use of animals in laboratories. (KR)

  15. The Problems of Dissection.

    Science.gov (United States)

    Davis, Pat

    1997-01-01

    Describes some problems of classroom dissection including the cruelty that animals destined for the laboratory suffer. Discusses the multilevel approach that the National Anti-Vivisection Society (NAVS) has developed to address the problems of animal dissection such as offering a dissection hotline, exhibiting at science teacher conferences, and…

  16. BISMAC control using SMA resistance feedback

    Science.gov (United States)

    Villanueva, Alex; Priya, Shashank

    2010-04-01

    Recently, bio-inspired shape memory alloy composite (BISMAC) actuators have been shown to be promising for the design of medusae rowing propulsion. BISMAC actuators were able to recreate bell deformation of Aurelia aurita by controlling shape memory alloy (SMA) deformation that allowed matching the contraction-relaxation deformation profile. In this study, we improve upon the control system and demonstrate feedback control using SMA wire resistance to decrease contraction time and power consumption. The controller requires the knowledge of threshold resistance and safe current inputs which were determined experimentally. The overheating effect of SMA wires was analyzed for BioMetal Fiber (BMF) and Flexinol 100 μm diameter wires revealing an increase in resistance as the wires overheated. The controller was first characterized on a SMA wire with bias spring system for a BMF 100 using Ihi = 0.5 A and Ilow = 0.2 A, where hi corresponds to peak current for fast actuation and low corresponds to the safe current which prevents overheating and maintains desired deformation. A contraction of 4.59% was achieved in 0.06 s using the controller and the deformation was maintained for 2 s at low current. The BISMAC actuator was operated using the controller with Ihi = 1.1 A and Ilow = 0.65 A achieving a 67% decrease in contraction time compared to using a constant driving current of Ilow = 0.2 A and a 60% decrease in energy consumption compared to using constant Ihi = 0.5 A while still exceeding the contraction requirements of the Aurelia aurita.

  17. MRI and MR angiography of vertebral artery dissection

    Energy Technology Data Exchange (ETDEWEB)

    Mascalchi, M. [Cattedra di Radiologia, Universita di Pisa (Italy); Bianchi, M.C. [Servizio di Neuroradiologia, Ospedale S. Chiara, Pisa (Italy); Mangiafico, S. [Servizio di Neuroradiologia, Ospedale di Careggi, Firenze (Italy); Ferrito, G. [Servizio di Neuroradiologia, Ospedali Riuniti, Livorno (Italy); Puglioli, M. [Servizio di Neuroradiologia, Ospedale S. Chiara, Pisa (Italy); Marin, E. [Servizio di Radiologia, Ospedale S. M. Nuova, Firenze (Italy); Mugnai, S. [Clinica Neurologica, Universita di Firenze (Italy); Canapicchi, R. [Servizio di Neuroradiologia, Ospedale S. Chiara, Pisa (Italy); Quilici, N. [Servizio di Neuroradiologia, Ospedali Riuniti, Livorno (Italy); Inzitari, D. [Clinica Neurologica, Universita di Firenze (Italy)

    1997-05-01

    A review of 4,500 angiograms yielded 11 patients with dissection of the vertebral arteries who had MRI and (in 4 patients) MR angiography (MRA) in the acute phase of stroke. One patient with incidental discovery at arteriography of asymptomatic vertebral artery dissection and two patients with acute strokes with MRI and MRA findings consistent with vertebral artery dissection were included. Dissection occurred after neck trauma or chiropractic manipulation in 4 patients and was spontaneous in 10. Dissection involved the extracranial vertebral artery in 9 patients, the extra-intracranial junction in 1, and the intracranial artery in 4. MRI demonstrated infarcts in the brain stem, cerebellum, thalamus or temporo-occipital regions in 7 patients with extra- or extra-intracranial dissections and a solitary lateral medullary infarct in 4 patients (3 with intracranial and 1 with extra-intracranial dissection). In 2 patients no brain abnormality related to vertebral artery dissection was found and in one MRI did not show subarachnoid haemorrhage revealed by CT. Intramural dissecting haematoma appeared as crescentic or rounded high signal on T1-weighted images in 10 patients examined 3-20 days after the onset of symptoms. The abnormal vessel stood out in the low signal cerebrospinal fluid in intracranial dissections, whereas it was more difficult to detect in extracranial dissections because of the intermediate-to-high signal of the normal perivascular structures and slow flow proximal and distal to the dissection. In two patients examined within 36 h of the onset, mural thickening was of intermediate signal intensity on T1-weighted images and high signal on spin-density and T2-weighted images. MRA showed abrupt stenosis in 2 patients and disappearance of flow signal at and distal to the dissection in 5. Follow-up arteriography, MRI or MRA showed findings consistent with occlusion of the dissected vessel in 6 of 8 patients. (orig.). With 7 figs., 3 tabs.

  18. Profil Antisipasi Siswa SMA Dalam Memecahkan Masalah Integral

    Directory of Open Access Journals (Sweden)

    Erfan Yudianto

    2015-06-01

    Full Text Available Penelitian ini dilatarbelakangi oleh sulitnya siswa dalam menyelesaikan masalah integral khusunya luas daerah. Banyak siswa hanya menyelesaikan masalah integral hanya berdasarkan rumus yang sudah disediakan. Siswa jarang mengaitkan konsep-konsep yang saling terkait, dalam hal ini konsep integral subpokokbahasan luas daerah.Tujuan penelitian ini untuk mendeskripsikan Profil antisipasi siswa SMA dalam memecahkan masalah integral. Hasil penelitian ini dapat dimanfaatkan oleh guru untuk membantu siswa mengaitkan konsep-konsep yang belum terkait.  Penelitian ini menggunakan metode tes dan wawancara. Tes berupa  tes kemampuan matematika yang diberikan kepada siswa, sehingga diperoleh siswa berkemampuan tinggi dan wawancara diberikan kepada siswa yang bersangkutan untuk menggali dan melihat jaringan konsep yang dimiliki siswa dalam menyelesaikan masalah integral. Subjek dalam penelitian ini termasuk dalam antisipasi terinternasilsasi dikarenakan siswa secara spontan menerapkan rumus integral tanpa menganalisis soal yang diberikan.This research is motivated by the difficulty of students in solving integral problems especially the area. Many students just completed the integral problems just based on a formula that has been provided. Students rarely associate the concepts are interrelated, in this case the integral concept of the area. The purpose of this study was to describe the profile anticipation of high school students in problem solving integrals. The results could be used by teachers to help students link the concepts are not related. This study uses tests and interviews. The tests such as math skills test given to students, in order to obtain a high ability students and interviews given to the student to explore and see the network concept of the students in problem solving integrals. Subjects in this study are included in anticipation terinternasilsasi because students spontaneously apply the integral formula without analyzing the questions

  19. REPRESENTASI VISUAL BUKU BIOLOGI SMA PADA MATERI KINGDOM PLANTAE

    OpenAIRE

    Asep Mulyani

    2014-01-01

    Penelitian ini berjudul “Representasi Visual Buku Biologi SMA pada Materi Kingdom Plantae”. Penelitian ini bertujuan untuk mengetahui representasi visual yang terdapat pada buku teks biologi SMA. Pendekatan penelitian yang digunakan dalam penelitian ini adalah deskriptif. Sampel dalam penelitian ini adalah tujuh buku biologi SMA kelas X. Instrument yang digunakan dalam penelitian ini yaitu lembar observasi dalam bentuk checklist untuk mengidentifikasi representasi visual yang terdapat pada bu...

  20. Optical coherence tomography assessment of incidence, morphological characteristics, and spontaneous healing course of edge dissections following percutaneous coronary intervention with stent implantation in patients with non-ST segment elevation myocardial infarction

    DEFF Research Database (Denmark)

    Antonsen, L.; Thayssen, P.; Hansen, H. S.

    2016-01-01

    in a non-ST segment elevation myocardial infarction (NSTEMI) patient-population. Methods: Acute vessel wall injury at the 5-mm stent adjacent distal and proximal reference segments was assessed by post-procedure OCT and intravascular ultrasound (IVUS) in n = 97 NSTEMI-patients (n = 97 lesions). Six months...... on concomitant IVUS-analysis. Morphologically, there was a significant difference in plaque type present at ED-edges vs. non-ED-edges when assessed with OCT; (1) lipid-rich and calcified plaques: 80.9% vs. 57.0%, (2) fibrous plaques: 17.0% vs. 26.7%, and (3) normal coronary vessels: 2.1% vs. 16.3%, p ....01. Plaqueburden, assessed by IVUS, was substantially larger at ED-containing borders: 54.5 +/- 10.0% vs. 43.7 +/- 11.6%, p = 0.01. Three dissections (8.6%) were incompletely healed at 6-month OCT follow-up. None of the EDs caused cardiac events during the 6-month follow-up, however, 1 ED-patient had target lesion...

  1. Influence of SMA reinforcement on the impact resistance of GFRP ...

    Indian Academy of Sciences (India)

    Plain glass fibre-reinforced polymeric (GFRP) laminates and GFRP reinforced with randomly oriented short strips of shape memory alloy (SMA) were prepared by hand lay-up method. The SMA strip reinforcement was placed at 0.75 × thickness of the laminate with weight fractions of 2, 4 and 6%. The specimens were ...

  2. Influence of SMA reinforcement on the impact resistance of GFRP ...

    Indian Academy of Sciences (India)

    short strips of shape memory alloy (SMA) were prepared by hand lay-up method. The SMA strip reinforcement was placed at ... GFRP laminates; shape memory alloy; low velocity impact; impact resistance; SEM. 1. Introduction. Composite materials offer ..... C. Thus, a working environment arround the critical temperature will ...

  3. EVALUASI STRATEGI BERSAING SMA KRISTEN 1 SALATIGA

    Directory of Open Access Journals (Sweden)

    Eclesia Tehupeiory

    2015-06-01

    Full Text Available This study aims to evaluate the competitive strategies of SMA Kristen 1 Salatiga. The type of this study was a qualitative evaluation, through data collection by means of interviews, questionnaires, observation and documentation study. Data obtained and analyzed by an evaluation component based on Rumelt (2000 were consistency, consonance, advantage and feasibility. The results showed that: (1 Consistency evaluation of competitive strategy applied by SMA Kristen 1 Salatiga has shown consistency with the goals, values and policies of the school. (2 Consonance evaluation of competitive strategy has demonstrated suitability with the needs of society, while for competition with other schools, the school programs such as Peduli Kasih program, Sekolah Lima Hari, moving class, SMUQI Radio and multimedia extracurricular namely cinematography and photography are not appropriate. (3 Advantage evaluation of competitive strategy in the school programs such as Peduli Kasih, moving class, and Sekolah Lima Hari do not excel the resources, skills and superior positions. Other programs such as multimedia Extracurricular namely photography and cinematography is not superior to the superior position. Meanwhile, special programs such as the education expo, parenting day, career day and the Field Trip program through Live In and outdoor study do not excel in superior skills. (4 Feasibility evaluation shows that multimedia extracurricular programs have not showed the feasibility of the physical resources which involves computer supporting facilities and Wi-Fi. Suggestion to school in order to maintain the consistency that was owned, suitability to the needs of society as well as pay attention to competition with other schools also enhance the achievement of advantage and checking of IT facilities.

  4. Spontaneous pneumothorax

    Directory of Open Access Journals (Sweden)

    Davari R

    1996-07-01

    Full Text Available A case with bilateral spontaneous pneumothorax was presented. Etiology, mechanism, and treatment were discussed on the review of literature. Spontaneous Pneumothorax is a clinical entity resulting from a sudden non traumatic rupture of the lung. Biach reported in 1880 that 78% of 916 patients with spontaneous pneumothorax had tuberculosis. Kjergaard emphasized 1932 the primary importance of subpleural bleb disease. Currently the clinical spectrum of spontaneous pneumothorax seems to have entered a third era with the recognition of the interstitial lung disease and AIDS as a significant etiology. Standard treatment is including: observation, thoracocentesis, tube thoracostomy. Chemical pleurodesis, bullectomy or wedge resection of lung with pleural abrasion and occasionally pleurectomy. Little information has been reported regarding the efficacy of such treatment in spontaneous pneumothorax secondary to non bleb disease

  5. Genomic dissection and prioritizing of candidate genes of QTL for ...

    Indian Academy of Sciences (India)

    Genomic dissection and prioritizing of candidate genes of QTL for regulating spontaneous arthritis on chromosome 1 in mice deficient for interleukin-1 receptor ... People's Republic of China; Department of Orthopaedic Surgery, Campbell Clinic and Pathology, University of Tennessee Health Science Center, Memphis, TN ...

  6. Epidemiology, pathophysiology, diagnosis, and management of intracranial artery dissection

    NARCIS (Netherlands)

    Debette, Stéphanie; Compter, A; Labeyrie, Marc Antoine; Uyttenboogaart, Maarten; Metso, Tina M.; Majersik, Jennifer J.; Goeggel-Simonetti, Barbara; Engelter, Stefan T.; Pezzini, Alessandro; Bijlenga, Philippe; Southerland, Andrew M.; Naggara, Olivier; Béjot, Yannick; Cole, John W.; Ducros, Anne; Giacalone, Giacomo; Schilling, Sabrina; Reiner, Peggy; Sarikaya, Hakan; Specken-Welleweerd, Jantien; Kappelle, L. Jaap; de Borst, Gert Jan; Bonati, Leo H.; Jung, Simon; Thijs, Vincent; Martin, Juan J.; Brandt, Tobias; Grond-Ginsbach, Caspar; Kloss, Manja; Mizutani, Tohru; Minematsu, Kazuo; Meschia, James F.; Pereira, Vitor M.; Bersano, Anna; Touzé, Emmanuel; Lyrer, Philippe A.; Leys, Didier; Chabriat, Hugues; Markus, Hugh S.; Worrall, Bradford B.; Chabrier, Stéphane; Baumgartner, Ralph; Stapf, Christian; Tatlisumak, Turgut; Arnold, Marcel; Bousser, Marie Germaine

    2015-01-01

    Spontaneous intracranial artery dissection is an uncommon and probably underdiagnosed cause of stroke that is defined by the occurrence of a haematoma in the wall of an intracranial artery. Patients can present with headache, ischaemic stroke, subarachnoid haemorrhage, or symptoms associated with

  7. Epidemiology, pathophysiology, diagnosis, and management of intracranial artery dissection

    NARCIS (Netherlands)

    Debette, Stephanie; Compter, Annette; Labeyrie, Marc-Antoine; Uyttenboogaart, Maarten; Metso, Tina M.; Majersik, Jennifer J.; Goeggel-Simonetti, Barbara; Engelter, Stefan T.; Pezzini, Alessandro; Bijlenga, Philippe; Southerland, Andrew M.; Naggara, Olivier; Bejot, Yannick; Cole, John W.; Ducros, Anne; Giacalone, Giacomo; Schilling, Sabrina; Reiner, Peggy; Sarikaya, Hakan; Welleweerd, Janna C.; Kappelle, L. Jaap; de Borst, Gert Jan; Bonati, Leo H.; Jung, Simon; Thijs, Vincent; Martin, Juan J.; Brandt, Tobias; Grand-Ginsbach, Caspar; Kloss, Manja; Mizutani, Tohru; Minematsu, Kazuo; Meschia, James F.; Pereira, Vitor M.; Bersano, Anna; Touze, Emmanuel; Lyrer, Philippe A.; Leys, Didier; Chabriat, Hugues; Markus, Hugh S.; Worrall, Bradford B.; Chabrier, Stephane; Baumgartner, Ralph; Stapf, Christian; Tatlisumak, Turgut; Arnold, Marcel; Bousser, Marie-Germaine

    Spontaneous intracranial artery dissection is an uncommon and probably underdiagnosed cause of stroke that is defined by the occurrence of a haematoma in the wall of an intracranial artery. Patients can present with headache, ischaemic stroke, subarachnoid haemorrhage, or symptoms associated with

  8. Genomic dissection and prioritizing of candidate genes of QTL

    Indian Academy of Sciences (India)

    Genomic dissection and prioritizing of candidate genes of QTL for regulating spontaneous arthritis on chromosome 1 in mice deficient for interleukin-1 receptor antagonist. Yanhong Cao Jifei Zhang Yan Jiao Jian Yan Feng Jiao Xiaoyun Liu Robert W. Williams Karen A. Hasty John M. Stuart Weikuan Gu. Research Article ...

  9. Genomic dissection and prioritizing of candidate genes of QTL for ...

    Indian Academy of Sciences (India)

    Genomic dissection and prioritizing of candidate genes of QTL for regulating spontaneous arthritis on chromosome 1 in mice deficient for interleukin-1 receptor antagonist. Yanhong Cao, Jifei Zhang, Yan Jiao, Jian Yan, Feng Jiao, XiaoYun Liu, Robert W. Williams, Karen A. Hasty,. John M. Stuart and Weikuan Gu. J. Genet.

  10. Relationship between input power and power density of SMA spring

    Science.gov (United States)

    Park, Cheol Hoon; Ham, Sang Yong; Son, Young Su

    2016-04-01

    The important required characteristics of an artificial muscle for a human arm-like manipulator are high strain and high power density. From this viewpoint, an SMA (shape memory alloy) spring is a good candidate for the actuator of a robotic manipulator that utilizes an artificial muscle. In this study, the maximum power density of an SMA spring was evaluated with respect to the input power. The spring samples were fabricated from SMA wires of different diameters ranging between 0.1 and 0.3 mm. For each diameter, two types of wires with different transition temperatures were used. The relationship between the transition temperature and maximum power density was also evaluated. Each SMA spring was stretched downward by an attached weight and the temperature was increased through the application of an electric current. The displacement, velocity, and temperature of the SMA spring were measured by laser displacement sensors and a thermocouple. Based on the experimental data, it was determined that the maximum power densities of the different SMA springs ranged between 1,300 and 5,500 W/kg. This confirmed the applicability of an SMA spring to human arm-like robotic manipulators. The results of this study can be used as reference for design.

  11. Isolated vagus nerve paralysis associated with internal carotid artery dissection.

    Science.gov (United States)

    Nakagawa, Hideki; Kusuyama, Toshiyuki; Ogawa, Kaoru

    2014-02-01

    Dysphagia and hoarseness caused by laryngopharyngeal paralysis associated with internal carotid artery (ICA) dissection is rare. We reported a case which recovered spontaneously. A 57-year old man visited our hospital complaining of dysphagia and hoarseness lasting for two weeks. Paralysis of right vocal fold and rotational movement of the posterior pharyngeal wall toward the left side during swallowing were observed. Magnetic resonance imaging was performed under diagnosis of isolated right vagus nerve paralysis, and dissection of the right ICA was revealed. He was treated conservatively, and both of laryngopharyngeal movement and the ICA dissection were improved completely. There is a possibility that laryngeal paralysis caused by ICA dissection has been misdiagnosed as an idiopathic paralysis. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  12. An analytical study on the bending of prismatic SMA beams

    International Nuclear Information System (INIS)

    Ostadrahimi, Alireza; Arghavani, Jamal; Poorasadion, Saeid

    2015-01-01

    In this study, an analytical solution is presented for pure bending of shape memory alloy (SMA) beams with symmetric cross section as well as symmetric behavior in tension and compression. To this end, a three-dimensional constitutive equation is reduced to one-dimensional form and employed to study the bending response of SMA beams at high (pseudo-elasticity) and low (shape memory effect) temperatures. An analytical expression for bending stress as well as polynomial approximation for shear stress and deflection are obtained. Derived equations for bending are employed to analyze an SMA beam with rectangular cross section and results are compared with those of the finite element method. The results of this work show good agreement when compared with experimental data and finite element results. Furthermore, the existence of several zero-stress fibers during unloading of SMA beams at low temperature is demonstrated. (paper)

  13. Neurorehabilitation in stroke produced by vertebral artery dissection: case presentation

    Directory of Open Access Journals (Sweden)

    Stanescu Ioana

    2018-02-01

    Full Text Available Arterial dissections are a common cause of stroke in the young (mean age 44 to 46 years. Primary lesion is a tear of the arterial intima, which promotes platelet aggregation, thrombus formation, which further produced vessel stenosis / occlusion, distal embolism or vessel wall rupture. Vertebral artery (VA dissection appear most commonly in extracranial segments V2 and V3, and could be spontaneous (with underlying predispositions or triggered by various traumatisms. Clinicaly, VA dissection produces an ischemic stroke or transient ischemic attack , preceded by local symptoms such as neck pain or headache. The diagnosis is confirmed by neurovascular imaging. Treatment of symptomatic VA dissections respect indications of treatment in ischemic strokes. Prognosis is mostly favorable in extracranial dissections. We present the case of a left VA dissection in V2 segment, produced by physical effort (swimming, which causes 2 ischemic lesions, one in the territory of the left posterior cerebral artery and the other in the territory of the left posterolateral chorroidal artery. Patient’s treatment included antiplatelet agents, statines, and an adapted physical rehabilitation program. At three months he showed significant clinical improvement with regain of autonomy and partial recanalisation at angio-MRI of the V2 segment of the dissected artery.

  14. Damper-controlled switch for SMA motion smoothing

    Science.gov (United States)

    Aguayo, Clover; Utter, Brent; Luntz, Jonathan; Gonzalez, Richard; Brei, Diann; Johnson, Nancy L.; Alexander, Paul W.

    2014-04-01

    While the use of SMA-actuated devices continues to grow in many industries, current device limitations pose a challenge to successful adoption for certain classes of applications. SMA-actuated devices typically demonstrate motion with non-constant velocity due to the non-linear thermo-mechanically coupled behavior of SMA material transformation, and motion sensitivity to external factors such as voltage and load. This variation in motion can lead to the perception of poor device quality, limiting SMA-actuated devices to applications hidden from the sight of the product user, or requiring them to be augmented with higher cost controls to improve the motion quality. Therefore, a need exists for simple, passive, low-cost device technologies that enable the designer to prescribe desired motion characteristics with relative insensitivity to fluctuation in operating conditions. This paper presents a Damper Controlled Switch (DCS) mechanism that delivers constant velocity and relative insensitivity to operating conditions when combined with a standard SMA wire actuator. The DCS includes a damper that acts against a spring to open a switch when the velocity exceeds a tunable threshold. To validate the ability of the DCS to provide the desired motion quality, experiments were conducted comparing the normal motion of the SMA actuator to the motion produced when the same actuator was fitted with a DCS prototype. The addition of the DCS produced nearly constant actuator velocity, performing significantly better than the SMA actuator alone. The tunability of the DCS was demonstrated producing a wide range of attainable constant velocities. Finally, a set of experiments explored the DCS's sensitivity to voltage and load, indicating a low sensitivity to a wide range of operating parameters for which the operating limits were identified. The DCS represents a simple, compact technology based on passive, low-cost components, providing a very practical solution that will enable

  15. Evaluasi terhadap Sekolah Khusus Olahragawan Smp/sma Ragunan Jakarta

    OpenAIRE

    Sofyan Hanif, Achmad

    2011-01-01

    An Evaluation of Special Schools for Athletes (SMP/SMA Ragunan Jakarta). This evaluation study aims to obtain information about the implementation of the training program by the special schools for athletes (SMP/SMA Ragu- nan), academic and sports achievements, recruitment, motivation, social system, communication, information, and services for the students. The sample consisted of 121 students, specially recruited by the Ministry of Youths and Sports, and 16 coaches/assistants randomly sel...

  16. Optical Coherence Tomography Guided Approach to Postpartum Coronary Artery Dissection: A Case Report

    Directory of Open Access Journals (Sweden)

    Francesco Soriano

    2016-01-01

    Full Text Available Postpartum spontaneous coronary dissection (SCAD is a rare and dramatic complication of pregnancy. SCAD is a separation of the coronary artery wall by intramural hematoma which can occur by a spontaneous intramedial hemorrhage with or without intimal rupture. Diagnosis and treatment can be difficult from a clinical and an angiographic point of view.

  17. Cervicocephalic Arterial Dissection

    Directory of Open Access Journals (Sweden)

    Marzie Abotorabi

    2017-02-01

    Full Text Available Cervicocephalic arterial dissection is not a common disease (2.5 % of total brain infarction and its pathogenesis is still not fully understood. However, it seems that it is multifactorial And rarely seen in the postpartum priod. A 40-year-old female patient who referred to emergency department because she experienced right lower limb Paresis 10 days following the delivery and her Paresis was progressed within 72 hours. She has no history of DM ,HTN, preeclampsia and  underlying cerebrovascular disease On evaluations, Brain MRI revealed multiple infarction in the left MCA territory . ECG, TTE ,coagulation and rheumatologic tests were normal. leftextracranial carotid artery dissection was found in the cervical MRA. The likelihood of postpartum dissection is rare , But it could be due to vasculardamage associated with the Valsalva maneuver during labor ; hemodynamic and hormonal changes due to pregnancyare also involved.

  18. Fabrication and testing of SMA composite beam with shape control

    Science.gov (United States)

    Noolvi, Basavaraj; S, Raja; Nagaraj, Shanmukha; Mudradi, Varada Raj

    2017-07-01

    Smart materials are the advanced materials that have characteristics of sensing and actuation in response to the external stimuli like pressure, heat or electric charge etc. These materials can be integrated in to any structure to make it smart. From the different types of smart materials available, Shape Memory Alloy (SMA) is found to be more useful in designing new applications, which can offer more actuating speed, reduce the overall weight of the structure. The unique property of SMA is the ability to remember and recover from large strains of upto 8% without permanent deformation. Embedding the SMA wire/sheet in fiber-epoxy/flexible resin systems has many potential applications in Aerospace, Automobile, Medical, Robotics and various other fields. In this work the design, fabrication, and testing of smart SMA composite beam has been carried out. Two types of epoxy based resin systems namely LY 5210 resin system and EPOLAM 2063 resin system are used in fabricating the SMA composite specimens. An appropriate mould is designed and fabricated to retain the pre-strain of SMA wire during high temperature post curing of composite specimens. The specimens are fabricated using vacuum bag technique.

  19. Internal carotid artery dissection following chiropractic treatment in a pregnant woman with Systemic Lupus Erythematosus

    Directory of Open Access Journals (Sweden)

    Morton Adam

    2012-12-01

    Full Text Available Abstract A case of internal carotid artery dissection in a pregnant woman with Systemic Lupus Erythematosus (SLE immediately following chiropractic treatment is presented. The literature regarding complications of neck manipulation during pregnancy, spontaneous dissection of craniocervical arteries in pregnancy and the postpartum period, and dissection of craniocervical arteries in SLE are reviewed. To the best of the author’s knowledge, this is the first case of carotid artery dissection following chiropractic treatment in a pregnant woman published in the literature.

  20. Parametric binary dissection

    Science.gov (United States)

    Bokhari, Shahid H.; Crockett, Thomas W.; Nicol, David M.

    1993-01-01

    Binary dissection is widely used to partition non-uniform domains over parallel computers. This algorithm does not consider the perimeter, surface area, or aspect ratio of the regions being generated and can yield decompositions that have poor communication to computation ratio. Parametric Binary Dissection (PBD) is a new algorithm in which each cut is chosen to minimize load + lambda x(shape). In a 2 (or 3) dimensional problem, load is the amount of computation to be performed in a subregion and shape could refer to the perimeter (respectively surface) of that subregion. Shape is a measure of communication overhead and the parameter permits us to trade off load imbalance against communication overhead. When A is zero, the algorithm reduces to plain binary dissection. This algorithm can be used to partition graphs embedded in 2 or 3-d. Load is the number of nodes in a subregion, shape the number of edges that leave that subregion, and lambda the ratio of time to communicate over an edge to the time to compute at a node. An algorithm is presented that finds the depth d parametric dissection of an embedded graph with n vertices and e edges in O(max(n log n, de)) time, which is an improvement over the O(dn log n) time of plain binary dissection. Parallel versions of this algorithm are also presented; the best of these requires O((n/p) log(sup 3)p) time on a p processor hypercube, assuming graphs of bounded degree. How PBD is applied to 3-d unstructured meshes and yields partitions that are better than those obtained by plain dissection is described. Its application to the color image quantization problem is also discussed, in which samples in a high-resolution color space are mapped onto a lower resolution space in a way that minimizes the color error.

  1. Vertebral artery dissection associated with viral meningitis

    Directory of Open Access Journals (Sweden)

    Pan Xudong

    2012-08-01

    Full Text Available Abstract Background Vertebral artery dissection (VAD is often associated with trauma or occurs spontaneously, inevitably causing some neurological deficits. Even though acute infection can be related to the development of spontaneous VAD (sVAD, VAD associated with viral meningitis has never been reported in the literature. Case presentation A 42-year-old man with fever, sore throat, and runny nose developed sudden onset of occipital headache, vertigo, transient confusion, diplopia, and ataxia. Brain stem encephalitis was diagnosed initially because the cerebrospinal fluid (CSF study showed inflammatory changes. However, subsequent diffusion-weighted (DWI magnetic resonance imaging of his brain demonstrated left lateral medullary infarction, and the digital subtraction angiography (DSA confirmed VAD involving left V4 segment of the artery. Consequently, the patient was diagnosed as VAD accompanied by viral meningitis. Conclusion This case suggests that viral meningitis might lead to inflammatory injury of the vertebral arterial wall, even sVAD with multiple neurological symptoms.

  2. Posttraumatic abdominal aortic dissection

    International Nuclear Information System (INIS)

    Hahmann, M.; Richter, G.M.; Kauffmann, G.W.; Schuhmacher, H.; Allenberg, J.R.

    2001-01-01

    Dissections due to deceleration trauma are rarely limited to the infradiaphragmal aorta (only 2-3%) and are usually lethal. Here we report the unusual course of an abdominal aortic dissection with aneurysmatic enlargement of the false lumen. Based on diagnostic imaging, a therapeutic stent application was planed in order to close the entry and to prevent rupture. During the intervention sondation of the false lumen revealed that the left renal artery had a reentry. Due to the complexity of the entry - reentry situation of the left renal artery the intervention was not possible, and the patient had to undergo vascular surgery. (orig.) [de

  3. Virtual reality haptic dissection.

    Science.gov (United States)

    Erolin, Caroline; Wilkinson, Caroline; Soames, Roger

    2011-12-01

    This project aims to create a three-dimensional digital model of the human hand and wrist which can be virtually 'dissected' through a haptic interface. Tissue properties will be added to the various anatomical structures to replicate a realistic look and feel. The project will explore the role of the medical artist, and investigate cross-discipline collaborations in the field of virtual anatomy. The software will be used to train anatomy students in dissection skills, before experience on a real cadaver. The effectiveness of the software will be evaluated and assessed both quantitatively as well as qualitatively.

  4. Imaging in aortic dissection

    International Nuclear Information System (INIS)

    Yu-Qing Liu, M.D.

    1995-01-01

    Aortic dissection (AD) is a catastrophic aortic disease. Imaging techniques play an invaluable role in the diagnostic evaluation and management of patients with AD. Major signs of AD with different imaging modalities are described in this article with a pertinent discussion on guidelines for the optimized approach of imaging study (13 refs.)

  5. Mastectomy using ultrasonic dissection

    DEFF Research Database (Denmark)

    Galatius, Hanne; Okholm, Mette; Hoffmann, Jack

    2003-01-01

    on seroma formation and other complications: 59 patients with operable breast cancer underwent modified radical mastectomy, performed in 30 of them with an Ultracision Harmonic scalpel and in 29 with scissors and electrocautery. In all cases a standard level II axillary dissection was performed...

  6. Intracranial artery dissection

    NARCIS (Netherlands)

    Sikkema, T.; Uyttenboogaart, Maarten; Eshghi, O.; De Keyser, J.; Brouns, R.; van Dijk, J.M.C.; Luijckx, G. J.

    The aim of this narrative review is to evaluate the pathogenesis, clinical features, diagnosis, treatment and prognosis of intracranial artery dissection (IAD). IAD is a rare and often unrecognized cause of stroke or subarachnoid haemorrhage (SAH), especially in young adults. Two types of IAD can be

  7. A Geometric Dissection Problem

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 7; Issue 7. A Geometric Dissection Problem. M N Deshpande. Think It Over Volume 7 Issue 7 July 2002 pp 91-91. Fulltext. Click here to view fulltext PDF. Permanent link: https://www.ias.ac.in/article/fulltext/reso/007/07/0091-0091. Author Affiliations.

  8. The effectiveness of styrene-maleic acid (SMA) copolymers for solubilisation of integral membrane proteins from SMA-accessible and SMA-resistant membranes.

    Science.gov (United States)

    Swainsbury, David J K; Scheidelaar, Stefan; Foster, Nicholas; van Grondelle, Rienk; Killian, J Antoinette; Jones, Michael R

    2017-10-01

    Solubilisation of biological lipid bilayer membranes for analysis of their protein complement has traditionally been carried out using detergents, but there is increasing interest in the use of amphiphilic copolymers such as styrene maleic acid (SMA) for the solubilisation, purification and characterisation of integral membrane proteins in the form of protein/lipid nanodiscs. Here we survey the effectiveness of various commercially-available formulations of the SMA copolymer in solubilising Rhodobacter sphaeroides reaction centres (RCs) from photosynthetic membranes. We find that formulations of SMA with a 2:1 or 3:1 ratio of styrene to maleic acid are almost as effective as detergent in solubilising RCs, with the best solubilisation by short chain variants (membranes was uniformly low, but could be increased through a variety of treatments to increase the lipid:protein ratio. However, proteins isolated from such membranes comprised clusters of complexes in small membrane patches rather than individual proteins. We conclude that short-chain 2:1 and 3:1 formulations of SMA are the most effective in solubilising integral membrane proteins, but that solubilisation efficiencies are strongly influenced by the size of the target protein and the density of packing of proteins in the membrane. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  9. Achieving dynamic switchable filter based on a transmutable metasurface using SMA

    Science.gov (United States)

    Chen, Xin; Gao, Jinsong; Kang, Bonan

    2017-09-01

    We propose a switchable filter composed of transmutable array using shape memory alloys (SMA). It could exhibit a temperature induced morphology change spontaneously like the biological excitability, acting as a shutter that allows the incident energy to be selectively transmitted or reflected with in excess of 12dB isolation at the certain frequencies for both polarizations. Equivalent circuit models describe the operational principle qualitatively and the switching effect is underpinned by the full-wave analysis. A further physical mechanism is shown by contrasting the distributions of electric field and surface current on the surface at the same frequency for the two working modes. The experimental results consist with the theoretical simulations, indicating that the metasurface could serve as one innovative solution for manipulating the electromagnetic waves and enlighten the next generation of advanced electromagnetic materials with more freedom in the processes of design and manufacturing.

  10. Achieving dynamic switchable filter based on a transmutable metasurface using SMA

    Directory of Open Access Journals (Sweden)

    Xin Chen

    2017-09-01

    Full Text Available We propose a switchable filter composed of transmutable array using shape memory alloys (SMA. It could exhibit a temperature induced morphology change spontaneously like the biological excitability, acting as a shutter that allows the incident energy to be selectively transmitted or reflected with in excess of 12dB isolation at the certain frequencies for both polarizations. Equivalent circuit models describe the operational principle qualitatively and the switching effect is underpinned by the full-wave analysis. A further physical mechanism is shown by contrasting the distributions of electric field and surface current on the surface at the same frequency for the two working modes. The experimental results consist with the theoretical simulations, indicating that the metasurface could serve as one innovative solution for manipulating the electromagnetic waves and enlighten the next generation of advanced electromagnetic materials with more freedom in the processes of design and manufacturing.

  11. Simultaneous Idiopathic Dissections of the Coronary and Superior Mesenteric Arteries

    Science.gov (United States)

    Nishi, Masato; Sueta, Daisuke; Miyazaki, Takashi; Sakamoto, Kenji; Yamamoto, Eiichiro; Izumiya, Yasuhiro; Tsujita, Kenichi; Kojima, Sunao; Kaikita, Koichi; Ikeda, Osamu; Yamashita, Yasuyuki; Hokimoto, Seiji

    2017-01-01

    A 49-year-old man complained of sudden upper abdominal pain but was not given a definitive diagnosis. The day after he was discharged, he noticed left chest pain. An in-depth electrocardiogram indicated acute myocardial infarction, and emergent coronary angiography revealed 99% stenosis of his left coronary artery. An intravascular ultrasound revealed spontaneous coronary artery dissection (SCAD), and the lesion was successfully stented. In an atherosclerosis screening, superior mesenteric artery dissection (SMAD) was confirmed, after which the lesion was successfully stented. This case suggests that SCAD and SMAD might have similar pathological backgrounds. PMID:28566599

  12. Spontaneous deregulation

    NARCIS (Netherlands)

    Edelman, Benjamin; Geradin, Damien

    Platform businesses such as Airbnb and Uber have risen to success partly by sidestepping laws and regulations that encumber their traditional competitors. Such rule flouting is what the authors call “spontaneous private deregulation,” and it’s happening in a growing number of industries. The authors

  13. SMA-MAP: a plasma protein panel for spinal muscular atrophy.

    Directory of Open Access Journals (Sweden)

    Dione T Kobayashi

    Full Text Available Spinal Muscular Atrophy (SMA presents challenges in (i monitoring disease activity and predicting progression, (ii designing trials that allow rapid assessment of candidate therapies, and (iii understanding molecular causes and consequences of the disease. Validated biomarkers of SMA motor and non-motor function would offer utility in addressing these challenges. Our objectives were (i to discover additional markers from the Biomarkers for SMA (BforSMA study using an immunoassay platform, and (ii to validate the putative biomarkers in an independent cohort of SMA patients collected from a multi-site natural history study (NHS.BforSMA study plasma samples (N = 129 were analyzed by immunoassay to identify new analytes correlating to SMA motor function. These immunoassays included the strongest candidate biomarkers identified previously by chromatography. We selected 35 biomarkers to validate in an independent cohort SMA type 1, 2, and 3 samples (N = 158 from an SMA NHS. The putative biomarkers were tested for association to multiple motor scales and to pulmonary function, neurophysiology, strength, and quality of life measures. We implemented a Tobit model to predict SMA motor function scores.12 of the 35 putative SMA biomarkers were significantly associated (p<0.05 with motor function, with a 13(th analyte being nearly significant. Several other analytes associated with non-motor SMA outcome measures. From these 35 biomarkers, 27 analytes were selected for inclusion in a commercial panel (SMA-MAP for association with motor and other functional measures.Discovery and validation using independent cohorts yielded a set of SMA biomarkers significantly associated with motor function and other measures of SMA disease activity. A commercial SMA-MAP biomarker panel was generated for further testing in other SMA collections and interventional trials. Future work includes evaluating the panel in other neuromuscular diseases, for pharmacodynamic

  14. REPRESENTASI VISUAL BUKU BIOLOGI SMA PADA MATERI KINGDOM PLANTAE

    Directory of Open Access Journals (Sweden)

    Asep Mulyani

    2014-06-01

    Full Text Available Penelitian ini berjudul “Representasi Visual Buku Biologi SMA pada Materi Kingdom Plantae”. Penelitian ini bertujuan untuk mengetahui representasi visual yang terdapat pada buku teks biologi SMA. Pendekatan penelitian yang digunakan dalam penelitian ini adalah deskriptif. Sampel dalam penelitian ini adalah tujuh buku biologi SMA kelas X. Instrument yang digunakan dalam penelitian ini yaitu lembar observasi dalam bentuk checklist untuk mengidentifikasi representasi visual yang terdapat pada buku biologi. Data yang telah didapatkan dideskripsikan berdasarkan tipe-tipe representasi visual. Hasil penelitian menunjukan, jenis representasi visual dalam bentuk gambar menunjukan tingkat yang paling banyak digunakan dibandingkan dengan diagram. Hubungan antara representasi visual dengan isi materi banyak yang bermakna. Hubungan representasi visual dengan realitas menunjukan hubungan yang realistis. Representasi visual yang terdapat dalam buku biologi mayoritas berfungsi dalam memberikan contoh. Kesimpulan yang didapatkan dalam penelitian ini menunjukan kalau representasi visual dalam buku biologi mempunyai peranan yang penting. Kata Kunci: Representasi visual, Buku teks, gambar, diagram.

  15. Spontaneous coronary artery dissection: Case series and review of literature

    Directory of Open Access Journals (Sweden)

    Satyavan Sharma

    2016-07-01

    Implications and practice: The awareness of SCAD is important for all clinicians involved in STEMI care. A prompt suspicion can avoid administration of thrombolytic therapy. Early coronary angiography will provide an accurate diagnosis and help in deciding appropriate therapy. Percutaneous intervention can be challenging.

  16. Spontaneous coronary artery dissection. Case report and literature review

    DEFF Research Database (Denmark)

    Elming, H; Køber, L

    1999-01-01

    descending artery (LAD). Her condition stabilized during treatment with intravenous heparin, aspirin, nitrates, beta-blockers, digoxin, ACE inhibitor and anticoagulants. At discharge she had no symptoms of heart failure. One hundred and forty one cases from the literature are reviewed with special reference...

  17. Laying the foundation stone of CERN Building SMA18

    CERN Multimedia

    Patrice Loiez

    1999-01-01

    Photo 10 : Le Directeur general du CERN, Luciano Maiani inaugure avec le President du Conseil general de l'Ain, M. Jean Pepin, la 1ere pierre du futur batiment SMA 18 a Prevessin-Moens. Photo 14 : Discours du President du Conseil general de l'Ain, M. Jean Pepin lors de la pose de la 1ere pierre au futur batiment SMA 18. Photo 15 : CERN director-general L. Maiani speaks at the official ceremony to lay the foundation stone of a new CERN building.

  18. Pemanfaatan Informasi Olahraga di Media Massa Cetak oleh Guru Pendidikan Jasmani dan Kesehatan dalam Pembelajaran Pendidikan Jasmani dan Kesehatan di SMA 5, SMA 6, SMA 11 Semarang

    Directory of Open Access Journals (Sweden)

    Muhaimin Muhaimin

    2011-01-01

    Full Text Available Utilization of information in mass media print by master of physical education and health in physical education and health in SMA 5, SMA 6, SMA 11 Semarang. The presence of print media is now a community needs. That's because, the print media presents a variety of information including information of actual politics, culture, economy, crime, entertainment, and sports. Basically, sports information in the print media have educational value and can add insight to a reading of new knowledge. The study produced these findings: (1 third physical education and health teacher at school who becomes the object research have made use of sports information in the print media to support the success of teaching and learning process, (2 the type of information they use to support the success of learning teaching is a form of news, articles about health, (3 form of utilization is appropriate to set clipping and through direct delivery of the material in the field while providing practice in the field. This method is considered more effective because all students can immediately practice, (4 sports information in the print media meets the needs of teachers and physical health education in supporting the learning process.

  19. Aplikasi Sistem Pembayaran Administrasi Kesiswaan Di SMA Ya BAKII Kesugihan

    Directory of Open Access Journals (Sweden)

    Novi Ika Atikah

    2011-11-01

    Full Text Available Sekolah sebagai salah satu bentuk organisasi memerlukan pengolahan administrasi yang efektif dan efisien, yaitu berorientasi pada tujuan penggunaan semua sumber daya serta mekanisme pengelolaan sekolah. Salah satu fungsi administrasi sekolah adalah pengelolaan data pembayaran administrasi kesiswaan. Yang terjadi di SMA Ya BAKII Kesugihan yang masih menggunakan sistem manual dalam pengelolaan data pembayaran. Dengan memanfaatkan software komputer kita dapat mengelola data-data pembayaran administrasi kesiswaan dengan lebih mudah.  Dalam kegiatan ini mencakup bagaimana perancangan program basis data tentang pengelolaan data pembayaran sekolah di SMA Ya BAKII Kesugihan dengan menggunakan software Visual Basic 6.0 dan MySQL Server 5.1. Hasil dari perancangan dan pembuatan Aplikasi Sistem Pembayaran Administrasi Kesiswaan di SMA Ya BAKII Kesugihan adalah untuk mengoptimalisasikan pengolahan data pembayaran administrasi kesiswaan. Aplikasi ini dapat menghasilkan laporan-laporan yang dapat digunakan oleh bagian Tata Usaha lain yang berkaitan dengan administrasi kesiswaan. Berdasarkan hasil kegiatan di atas, pihak Sekolah disarankan dapat meningkatkan kualitas dan pengelolaan sekolah terutama bagian pembayaran administrasi kesiswaan di SMA Ya BAKII Kesugihan.

  20. Influence of SMA reinforcement on the impact resistance of GFRP ...

    Indian Academy of Sciences (India)

    stand the impact damage characteristics when SMA wires are embedded into composite laminates. Further structures are also subjected to severe environment conditions such as high temperature. The study of impact response of com- posite materials subjected to environmental conditions other than ambient is more ...

  1. Vertebral artery dissection in young adults. Case report and review of the literature

    International Nuclear Information System (INIS)

    Chicu, Cristina; Pascal, Oleg; Cicala, Alexandra; Dimitras, Stela; Feodorovici, Angela; Arion, Marian

    2011-01-01

    Vertebral artery dissection is a important cause of stroke in young patients. It may be spontaneous or traumatic and can lead to various clinical symptoms. We describe a case of 38-year-old man, with no preceding trauma or apparent inciting event, presented with the acute onset of imbalance, dysarthria, left-sided paraesthesias, headache, dysphagia, and dysmetria. Workup revealed a right vertebral artery dissection, ischemic stroke in the vertebrobasilar system, bulbar syndrome, right hemiparesis and cerebellar disorders. (authors)

  2. Dynamics study of free volume properties of SMA/SMMA blends by PAL method

    International Nuclear Information System (INIS)

    Jiang, Z.Y.; Jiang, X.Q.; Huang, Y.J.; Lin, J.; Li, S.M.; Li, S.Z.; Hsia, Y.F.

    2006-01-01

    Miscibility of poly(styrene-co-maleic anhydride) (containing 7 wt% maleic anhydride)/poly(styrene-co-methyl methacrylate) (containing 40 wt% styrene) blends were previously studied. It was obtained that SMA70 (containing 70 wt% of SMA in SMA/SMMA blends) is miscible in molecular level but SMA20 is not. In this paper, the two blends selected were used to investigate the temperature dependence of free volume parameters. It showed there are different deviations of free volume parameters in SMA20 and SMA70, and it was interesting that temperature dependence of ortho-positronium lifetime τ 3 of the SMA20 mixture exhibits two breaks in the range temperature from 90 deg. C to 120 deg. C, which revealed that the mixture has two glass transition ranges. Also, ortho-positronium lifetime τ 3 of the SMA20 mixture is nearly constant in the temperature range from 130 deg. C to 160 deg. C. These indicated that SMA20 blend is phase-separated in room temperature and become miscible above 130 deg. C, which may be due to steric hindrance effect of phenyl rings of SMMA and SMA. From the deviation of o-Ps lifetimes of SMA70, the single glass transition temperature of SMA70 blend was shown. Combining the previous study, it was further concluded that PAL method seems to be a powerful method to detect in situ phase behavior of immiscible polymer blends and glass transition of miscible polymer blends

  3. The Role of the Supplementary Motor Region in Overt Reading: Evidence for Differential Processing in SMA-Proper and Pre-SMA as a Function of Task Demands.

    Science.gov (United States)

    Cummine, Jacqueline; Hanif, Wahab; Dymouriak-Tymashov, Inna; Anchuri, Kavya; Chiu, Stephanie; Boliek, Carol A

    2017-09-01

    A differentiation in function between the pre-SMA (i.e., cognitive load) and the SMA-proper (i.e., motor execution) has been described (Zhang et al., Cereb Cortex 22:99-111, 2012). These differential SMA functions may be influential in overt reading tasks. The present study examined the relationships between various segments of the SMA and overt reading through the modulation of task demands in an effort to explore the complexity of the print-to-speech network. Skilled reading adults (N = 15) took part in five overt reading tasks: pure regular word reading, pure exception word reading, mixed regular word and exception word reading, go/no-go reading with nonword foils and go/no-go reading with pseudohomophone foils. Five regions of interest that spanned the pre-SMA to the SMA-proper were isolated. Behaviour-function relationships were tested to examine the associations between performance (response time) and brain activity (percent signal change). Further, the coherence between feedforward (SMA) and feedback (supramarginal gyrus) regions were explored to further refine the print-to-speech network. We found that the pre-SMA was related to cognitively demanding tasks (go/no-go with pseudohomophones), whereas the SMA-proper was related to an automatized task (pure regular words). Notably, only those tasks that required information from the feedback system (i.e., mixed word lists, go/no-go tasks) showed connections between SMA regions and the supramarginal gyrus, which is in line with the role of feedback and feedforward systems in the print-to-speech network. Together, these results support the notion that the pre-SMA and SMA-proper are sensitive to reading tasks that differentially invoke higher cognitive resources (mixed word lists, go/no-go) versus automatized articulation (pure lists), respectively. We discuss our findings in the context of print-to-speech neural networks.

  4. Columbia SMA Project: A Randomized, Control Trial of the Effects of Exercise on Motor Function and Strength in Patients with Spinal Muscular Atrophy (SMA)

    Science.gov (United States)

    2012-06-01

    patients with spinal muscular atrophy (SMA). SMA causes significant disability, and there is no effective drug treatment. Maximizing function, endurance...REPORTABLE OUTCOMES: An abstract entitled "Falls and Spinal Muscular Atrophy (SMA): Exploring Cause and Prevention" was presented at the...Rubenstein LZ, Josephson KR. The epidemiology of falls and syncope . Clin Geriatr Med 2002;18:141-158. Wang HY, Yang YH, Jong YJ. Evaluation of muscle

  5. Paediatric dissecting posterior cerebral aneurysms: report of two cases and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Vilela, Pedro; Goulao, Augusto [Garcia de Orta Hospital, Neuroradiology Department, Almada (Portugal)

    2006-08-15

    Intracranial aneurysms in the paediatric population are uncommon, accounting for 2% to 6% of all aneurysms, and spontaneous arterial dissection is rarely reported as the cause of aneurysms in children, especially in the posterior cerebral artery. Two cases of paediatric spontaneous posterior cerebral artery dissecting aneurysms are reported, one in a 33-month-old male child presenting with aneurysmal rupture and subarachnoid haemorrhage and the other in a 9-year-old boy with an unruptured aneurysm. The first child was successfully treated by endovascular parent vessel occlusion without neurological deficit and in the second a spontaneous thrombosis of the aneurysm and its parent artery occurred associated with hydrocephalus and a favourable outcome. Dissecting aneurysms are dynamic lesions with variable and unpredictable evolution and close follow-up and/or early treatment is warranted. Spontaneous arterial dissection is a rare, probably still under-recognized, cause of intracranial aneurysms that may be responsible for a significant number of aneurysms and spontaneous aneurysmal thromboses in children. (orig.)

  6. Evaluasi Program Musyawarah Guru Mata Pelajaran (MGMP Biologi SMA

    Directory of Open Access Journals (Sweden)

    Ani Uslimah

    2006-06-01

    Full Text Available Penelirian ini bertujuan mengevaluasi program MGMP Biologi SMA di Kabupaten Bantul, yang meKputi: (1 relevansi program dengan kebutuhan peserta, (2 karaktenstikpeserta, (3 materi program, (4 ketersediaan sarana penunjang kegiatan, (5 sistem pengelolaan program, (6 pardsipasi peserta, (7 kualitas pelaksanaan pro­gram, (8 manfeat program bagi guru, (9 keterampilan mengajar guru Biologi setelah mengikud program, dan (10 faktor penghambat maupun penunjang program. Penelirian ini merupakan penelirian evaluasi dengan menggunakan model evaluasi QPP (Context, Input, Process, Product dari Stufflebeam. Subjek penelirian meliputi 20 peserta MGMP Biologi periode 2003/2004,260 siswa SMA kelas X di Kabupaten Bantul, pengelola program kegiatan yang terdiri dari pengurus MGMP, Ketua Musyawarah Kerja Kepala Sekolah (MKKS, dan Pengelola Sanggar Kegiatan. Pengumpulan data dilakukan dengan kuesioner, observasi, dan wawancata terstruktur. Data kuanritatif diolah secara deskripdf dengan batuan program SPSS 11.0for Windows. Penentuan validitas instrumen dilakukan terhadap validitas isi dan konstruk menggunakan analisis faktor. Penentuan reliabilitas mengguna-kan rumus Alpha. Hasil penelirian menunjukkan: (1 program MGMP Biologi relevan dengan kebutuhan peserta; (2 75% peserta adalah guru SMA Negeri, 25% guru SMA Swasta, dan 75% PNS, 25% guru bantu/GTT; (3 ringkat relevansi materi pro­gram MGMP dalam kategon ringgi sebesar 70%; (4 ketersediaan satana penunjang dalam katagori kurang baik sebesar 50%; (5 kesiapan pengelola program maupun peserta dalam katagori baik, (6 ringkat pardsipasi peserta dalam kategon baik (75% - 80%; (7 kualitas pelaksanaan program dalam katagori baik sebesar 70%, dan secara fungsional pelaksana program adalah pengurus beserta anggota MGMP itu sendiri; (8 manfaat program kegiatan MGMP bagi guru Biologi dalam katagori baik sebesar 60%; (9 menurut persepsi siswa, secara umum ringkat keterampilan mengajar guru Biologi setelah mengikuri MGMP dalam

  7. Pelaksanaan Pendidikan Agama di SMA Katolik Soverdi Kabupaten Badung Bali

    OpenAIRE

    Taruna, Mulyani Mudis

    2010-01-01

    This research was conducted at SMA Catholic Soverdi under umbrella ofCatholic foundation in Badung district Bali Province. Focuses of this study are,implementation of religious education was seen from the aspects of curriculumimplementation, influencing factors of curriculum implementation. Thisis a qualitative research. Finding of the research depicts that developmentof the religious education’s curriculum uses curriculum set by ministry ofeducation. This affects in developing of atmosphere ...

  8. Analisis Implementasi Penjaminan Mutu di SMA Negeri 3 Kota Jambi

    OpenAIRE

    Simarmata, Jonner

    2015-01-01

    Today education is considered as an investment. Hence, parents are very selective in choosing schools for their children. In response with this public attitude, our government i.e. Ministry of Education has issued Regulation No 63 Year 2009 on education quality assurance system to show its high commitment to improving quality of education. This research aims at investigating how education quality assurance system is implemented in SMA N 3 Kota Jambi. The method applied is descriptive-qualitat...

  9. A network micromechanics model of thermomechanical behaviors of SMA polycrystals

    Czech Academy of Sciences Publication Activity Database

    Novák, Václav; Šittner, Petr

    2004-01-01

    Roč. 50, - (2004), s. 199-206 ISSN 1359-6462 R&D Projects: GA AV ČR IAA1048107; GA ČR GA106/01/0396 Institutional research plan: CEZ:AV0Z1010914 Keywords : shape memory alloys (SMA) * martensitic phase transformation * micromechanics modeling * neutron diffraction * texture Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 2.112, year: 2004

  10. Pengembangan Program Macromedia Flash 8 untuk Pembelajaran Fisika di SMA

    Directory of Open Access Journals (Sweden)

    Wiji Susilowati

    2007-12-01

    Full Text Available Tujuan penelitian adalah membuat dan mengevaluasi media pembelajaran fisika SMA menggunakan program Macromedia Flash 8. Subjek coba pada penelitian ini berjumlah 40 orang yang terdiri dari 10 siswa untuk uji coba instrumen penelitian, 10 siswa untuk ujicoba kelompok kecdl, dan 20 siswa untuk uji coba lapangan. Pengumpulan data dilakukan dengan mengguna­kan kuesioner dan tes fisika (pre-test dan post-test. Evaluasi terhadap program ditinjau dari aspek pembelajaran dan aspek media. Kritik dan saran digunakan untuk memperbaiki program. Hasil penelitian menunjukkan bahwa program Macromedia Flash 8 untuk pembelajaran fisika di SMA: (1 dirancang sesuai dengan prinsip-prinsip desain pembelajaran, (2 terbukti mampu menaikkan skor rerata tes fisika siswa sebesar 55,42%, (3 memiliki efisiensi waktu yang tinggi, (4 ditinjau dari aspek media Hinilai cukup bagus/menarik (dinilai/dikategorikan sedang oleh siswa, (5 ditinjau dari aspek pembelajaran secara keseluruhan program ini dinilai tinggi/jelas dimengerti oleh siswa, (6 ditinjau dari aspek media dinilai menarik (bagus/kategori tinggi oleh guru fisika, dan (7 ditinjau dari aspek pembelajaran juga dinilai menarik (bagus/kategori tinggi oleh guru fisika. Kata kunci: media pembelajaran fisika diSMA.

  11. Passive base isolation with superelastic nitinol SMA helical springs

    International Nuclear Information System (INIS)

    Huang, Bin; Zhang, Haiyang; Wang, Han; Song, Gangbing

    2014-01-01

    Seismic isolation of structures such as multi-story buildings, nuclear reactors, bridges, and liquid storage tanks should be designed to preserve structural integrity. By implementing seismic isolation technology, the deformation of superstructures can be dramatically reduced, consequently helping to protect their safety as well. In this paper, an innovative type of passive base isolation system, which is mainly composed of superelastic nitinol SMA helical springs, is developed. In order to verify the effectiveness of the proposed system, a two-story experimental steel frame model is constructed, and two superelastic SMA helical springs are thermo-mechanically built in the laboratory. To describe the nonlinear mechanical properties of the superelastic SMA helical springs under reciprocating load, a phenomenological model is presented in terms of a series of tensile tests. Afterwards, a numerical model of the two-story frame with the suggested isolation system is set up to simulate the response of the isolated frame subjected to an earthquake. Both the experimental and the numerical simulation results indicate that the proposed base isolation system can remarkably suppress structural vibrations and has improved isolation effects when compared with a steel spring isolation system. Due to the capabilities of energy dissipation as well as fully re-centering, it is very applicable to utilize the suggested isolation system in base isolated structures to resist earthquakes. (paper)

  12. Low power consumption mini rotary actuator with SMA wires

    Science.gov (United States)

    Manfredi, Luigi; Huan, Yu; Cuschieri, Alfred

    2017-11-01

    Shape memory alloys (SMAs) are smart materials widely used as actuators for their high power to weight ratio despite their well-known low energy efficiency and limited mechanical bandwidth. For robotic applications, SMAs exhibit limitations due to high power consumption and limited stroke, varying from 4% to 7% of the total length. Hysteresis, during the contraction and extension cycle, requires a complex control algorithm. On the positive side, the small size and low weight are eminently suited for the design of mini actuators for robotic platforms. This paper describes the design and construction of a light weight and low power consuming mini rotary actuator with on-board contact-less position and force sensors. The design is specifically intended to reduce (i) energy consumption, (ii) dimensions of the sensory system, and (iii) provide a simple control without any need for SMA characterisation. The torque produced is controlled by on-board force sensors. Experiments were performed to investigate the energy consumption and performance (step and sinusoidal angle profiles with a frequency varying from 0.5 to 10 Hz and maximal amplitude of {15}\\circ ). We describe a transient capacitor effect related to the SMA wires during the sinusoidal profile when the active SMA wire is powered and the antagonist one switched-off, resulting in a transient current time varying from 300 to 400 ms.

  13. SMA bellows as reversible thermal sensors/actuators

    International Nuclear Information System (INIS)

    Damanpack, A R; Bodaghi, M; Liao, W H

    2015-01-01

    In this paper, the feasibility of reversible bellows made of shape memory alloys (SMAs) in sensory and actuated applications to transfer pressure and/or temperature into a linear motion is investigated. An analytical three-dimensional model is developed to simulate key features of SMAs including martensitic transformation, reorientation of martensite variants, the shape memory effect, and pseudo-elasticity. Axisymmetric two-dimensional theory of thermo-inelasticity based on the non-linear Green–Lagrange strain tensor is employed to derive the equilibrium equations. A finite element method along with an iterative incremental elastic-predictor–inelastic-corrector procedure is developed to solve the governing equations with both material and geometrical non-linearities. The feasibility of reversible SMA bellows in transferring pressure and/or temperature into a linear motion is numerically demonstrated. In this respect, the effects of geometric parameters, magnitude of thermo-mechanical loadings and end conditions on the performances of SMA bellows are evaluated and discussed in depth. This study provides pertinent results toward an efficient and reliable design of reversible thermally-driven SMA bellows. (paper)

  14. KEEFEKTIFAN TEKNIK RELAKSASI UNTUK MENURUNKAN STRES AKADEMIK SISWA SMA

    Directory of Open Access Journals (Sweden)

    Suyono Suyono

    2016-08-01

    Full Text Available Abstract: This study aims at examining the effectiveness of relaxation techniques to release students’stress and tension regarding academic within Senior High School Assádah in Gresik City. This study employed quasi-experiment design using one group pretest-posttest model. The data of this study were obtained through academic stress inventory to attain a depiction of stress level encountered by the subject. The subjects of this study were seven students of Tenth Graders in SMA Assaadah Bungah Gresik who experienced low to average stress regarding exam preparation. The data were, then, analyzed by using Wilcoxon Statistic Analysis. The result of the study indicated that relaxation technique could lower and release the level of students stress in exam preparation. Key Words: relaxation technique, student academic stress   Abstrak: Penelitian ini bertujuan untuk  menguji keefektifan teknik relaksasi untuk menurunkan stres akademik siswa SMA Ass’adah di Kota Gresik dengan menggunakan rancangan kuasi eksperimen dengan model “one group pretest posttest design. Pengumpulan data dengan menggunakan inventori stres akademik tujuannya untuk memperoleh gambaran tingkat stres akademik pada subjek penelitian. Subjek penelitian adalah siswa yang mengalami stres akademik sedang dan rendah  dalam menghadapi ujian berjumlah 7 orang siswa pada kelas X SMA Assaadah Bungah Gresik. Teknik analisis data dengan menggunakanan analisis statistic Wilcoxon. Hasil penelitian menunjukkan adanya penurunan tingkat stres akademik menjelang ujian sesudah subjek mendapatkan layanan dengan teknik  relaksasi. Kata kunci: Teknik relaksasi, stres akademik siswa

  15. SMA actuator for tab-assisted control surface application

    Science.gov (United States)

    Nguyen, Thang D.; Gowing, Scott; Bochinski, David; Carpenter, Bernie F.

    1999-07-01

    This study, started in late 1997, evaluates the concept of tab-assisted control (TAC), and the use of shape memory alloy (SMA) actuator in that connection. Under the TAC concept, a small tab, typically 10 percent of the mean chord of the entire control surface structure, is appended to the trailing edge of the primary control surface, or flap. This small tab vastly enhances the versatility of the control surface system. Depending on the orientation of the tab with respect to the flap and the amount of tab deflection, this tab may be used to modify lift and torque, actuate the flap, or provide precision control; if the tab is aligned with the flap, TAC reverts itself to the conventional configuration. Despite its many benefits, TAC faces one practical challenge in implementation. Due to the particular TAC configuration, the actuating system for the tab must be compact enough to fit in the limited real estate available within the flap. This makes SMA actuator a promising contender for TAC implementation. This paper presents some of the experimental result relevant to the design of the SMA actuator and addresses implementation issues such as power usage, life cycle, frequency response, and reliability.

  16. Spontaneous rupture of the middle colic artery resulting in delayed ...

    African Journals Online (AJOL)

    mission for three days after delivery due to raised blood pressure which was controlled using antihypertensives. The baby weighed 3.8 kg with good Apgar score. ... Osamu C, Hiroshi K, Makoto S, Soichiro Y, Hiroyuki. K, Yasumasa K, Hiroyasu M. Spontaneous rupture of. Dissecting Aneurysm of the Middle colic Artery. Tokai.

  17. Cine MRI of dissecting aneurysm

    International Nuclear Information System (INIS)

    Takaki, Hajime

    1991-01-01

    Cine MRI was performed in 25 cases of aortic dissection and comparative study among cine MRI, spin-echo static MRI, contrast-enhanced CT and intravenous digital subtraction angiography (IVDSA) was made. Cine MRI accurately detected aortic dissection. It was most accurate among various diagnostic methods in demonstration of entry site of dissection. Take-off of renal artery and its relation to true and false channels was also accurately demonstrated by cine MRI. The above results suggest that cine MRI can be an important diagnostic modality with almost equal diagnostic quality to those of conventional angiography. However, further technical improvement to shorten the imaging time seems necessary to replace angiography. (author)

  18. Caenorhabditis elegans SMA-10/LRIG is a conserved transmembrane protein that enhances bone morphogenetic protein signaling.

    Directory of Open Access Journals (Sweden)

    Tina L Gumienny

    2010-05-01

    Full Text Available Bone morphogenetic protein (BMP pathways control an array of developmental and homeostatic events, and must themselves be exquisitely controlled. Here, we identify Caenorhabditis elegans SMA-10 as a positive extracellular regulator of BMP-like receptor signaling. SMA-10 acts genetically in a BMP-like (Sma/Mab pathway between the ligand DBL-1 and its receptors SMA-6 and DAF-4. We cloned sma-10 and show that it has fifteen leucine-rich repeats and three immunoglobulin-like domains, hallmarks of an LRIG subfamily of transmembrane proteins. SMA-10 is required in the hypodermis, where the core Sma/Mab signaling components function. We demonstrate functional conservation of LRIGs by rescuing sma-10(lf animals with the Drosophila ortholog lambik, showing that SMA-10 physically binds the DBL-1 receptors SMA-6 and DAF-4 and enhances signaling in vitro. This interaction is evolutionarily conserved, evidenced by LRIG1 binding to vertebrate receptors. We propose a new role for LRIG family members: the positive regulation of BMP signaling by binding both Type I and Type II receptors.

  19. Fatigue of NiTi SMA-pulley system using Taguchi and ANOVA

    Science.gov (United States)

    Mohd Jani, Jaronie; Leary, Martin; Subic, Aleksandar

    2016-05-01

    Shape memory alloy (SMA) actuators can be integrated with a pulley system to provide mechanical advantage and to reduce packaging space; however, there appears to be no formal investigation of the effect of a pulley system on SMA structural or functional fatigue. In this work, cyclic testing was conducted on nickel-titanium (NiTi) SMA actuators on a pulley system and a control experiment (without pulley). Both structural and functional fatigues were monitored until fracture, or a maximum of 1E5 cycles were achieved for each experimental condition. The Taguchi method and analysis of the variance (ANOVA) were used to optimise the SMA-pulley system configurations. In general, one-way ANOVA at the 95% confidence level showed no significant difference between the structural or functional fatigue of SMA-pulley actuators and SMA actuators without pulley. Within the sample of SMA-pulley actuators, the effect of activation duration had the greatest significance for both structural and functional fatigue, and the pulley configuration (angle of wrap and sheave diameter) had a greater statistical significance than load magnitude for functional fatigue. This work identified that structural and functional fatigue performance of SMA-pulley systems is optimised by maximising sheave diameter and using an intermediate wrap-angle, with minimal load and activation duration. However, these parameters may not be compatible with commercial imperatives. A test was completed for a commercially optimal SMA-pulley configuration. This novel observation will be applicable to many areas of SMA-pulley system applications development.

  20. Confinement of NORMAL- AND HIGH-STRENGTH CONCRETE by Shape Memory Alloy (SMA) Spirals

    Science.gov (United States)

    Gholampour, A.; Ozbakkaloglu, T.

    2018-01-01

    This paper presents the results of an experimental study on the axial compressive behaviour of normal- and high-strength concrete (NSC and HSC) confined by shape memory alloy (SMA) spirals. A spiral pitch space of 36 and 20 mm was used for SMA confinement of NSC and HSC columns, respectively. The confining pressure was applied on the concrete cylinders by SMA spirals that were prestrained at 0, 5.5, and 9.5%. The compression test results on the SMA-confined specimens indicate that the prestrain level of SMA significantly affects the axial compressive behaviour of both NSC and HSC. An increase in the level of prestrain leads to an increase in the peak axial stress and corresponding strain of SMA-confined concrete.

  1. PENDEKATAN PENDIDIKAN MULTIKULTURAL PADA MATA PELAJARAN SOSIOLOGI SMA KELAS XI

    Directory of Open Access Journals (Sweden)

    Akbar Wahyu Riyadi

    2013-04-01

    Full Text Available Tujuan penelitian ini adalah untuk menggambarkan penggunaan pendekatan pendidikan multikultural pada pelajaran Sosiologi SMA kelas XI. Penelitian ini merupakan penelitian kualitatif yang dilakukan di SMAN 4 Purworejo. Data dikumpulkan melalui metode pengamatan dan wawancara dengan guru Sosiologi SMAN 4 Purworejo. Hasil penelitian menunjukkan bahwa karakteristik Pendekatan Pendidikan multikultural yang dilakukan oleh guru sosiologi SMA menekankan pada tiga bentuk: optimalisasi peran rasionalitas bagi siswa, praktek dan pembiasaan perbedaan pendapat. Pendekatan ini tepat dilakukan dalam kegiatan pembelajaran pada materi kelompok sosial dalam masyarakat multikultural. Kendala dalam pelaksanaan pendekatan multikultural di SMA adalah, alokasi waktu pertemuan, konsentrasi siswa dalam menerima materi pelajaran yang berhubungan dengan multikultural, keterbatasan media pembelajaran yang digunakan saat pembelajaran serta minat siswa dalam belajar. Hal ini membuat guru bekerja ekstra untuk membuat variasi dalam pembelajaran agar kegiatan belajar mengajar dapat berhasil dengan baik.The objective of this article is to describe the use of multicultural education approach to the study of sociology for senior high school student class XI. This study is a qualitative study conducted in SMAN 4 Purworejo. Data were collected through a method of observation and interviews with teachers of Sociology. The results show that the characteristics of a multicultural approach to education implemented by high school sociology include three forms: teacher’s emphasis on the optimization of students’ rationality, practice and dissent habituation. This approach is appropriate for the learning activities on material of social groups in multicultural societies. Constraints in the implementation of a multicultural approach in high school include time allocation, student’s concentration, the limitations of instructional media used during the learning process

  2. PENGARUH MODEL EXPERIENTIAL LEARNING TERHADAP KEMAMPUAN BERPIKIR SISWA SMA

    Directory of Open Access Journals (Sweden)

    Mar’atus Sholihah

    2016-11-01

    Full Text Available The purpose of this study was to determine the effect of Experiential Learning models developed by Kolb's theory of the critical thinking skills of high school students. This study uses a quasi experiment conducted in SMA Assa'adah Gresik. The population of students of class X IS second semester of academic year 2015/2016. Samples are 2 classes that are homogeneous. Methods of data collection using test questions and the ability to think critically using observation sheet. Data were analyzed by comparing the average acquisition value of critical thinking skills with experimental class control class. Average value of the critical thinking skills using model Experiential Learning higher at 80.9 while the control class is 71.2. Based on the average it can be concluded that the learning model of Experiential Learning can improve students' critical thinking skills. This study is expected to provide information on the application and benefits of the model Experiential Learning in teaching geography and make it more meaningful for students. Tujuan dari penelitian ini adalah mengetahui pengaruh model Experiential Learning yang dikembangkan oleh teori Kolb terhadap kemampuan berpikir kritis siswa SMA. Penelitian ini menggunakan metode quasi experimen yang dilakukan di SMA Assa’adah Gresik. Populasi siswa kelas X IS semester genap tahun pelajaran 2015/2016. Sampel yang digunakan sebanyak 2 kelas yang bersifat homogen. Metode pengumpulan data menggunakan soal tes kemampuan berpikir kritis serta menggunakan lembar observasi. Data yang diperoleh kemudian dianalisis dengan membandingkan rata-rata perolehan nilai kemampuan berpikir kritis kelas kontrol dengan kelas eksperimen. Nilai rata rata kemampuan berpikir kritis yang menggunakan model pembelajaran Experiential Learning lebih tinggi, yaitu sebesar 80,9, sedangkan kelas kontrol sebesar 71,2. Berdasarkan nilai rata-rata tersebut dapat disimpulkan bahwa model pembelajaran Experiential Learning dapat

  3. KONTRIBUSI KONSELOR DALAM MEMBENTUK KARAKTER PESERTA DIDIK SMA

    Directory of Open Access Journals (Sweden)

    Agung Slamet Kusmanto

    2015-11-01

    Full Text Available Pengembangan model Pendidikan Holistik Berbasis Karakter, yang memfokuskan pada pembentukan seluruh aspek dimensi manusia, sehingga dapat menjadi manusia yang berkarakter. Kurikulum Holistik Berbasis Karakter ini disusun berdasarkan Kurikulum Berbasis Kompetensi (KBK dan diterapkan dengan menggunakan pendekatan Student Active Learning, Integrated Learning, Developmentally Appropriate Practices, Contextual Learning, Collaborative Learning, dan Multiple Intelligences yang semuanya dapat menciptakan suasana belajar yang efektif dan menyenangkan, serta dapat mengembangkan seluruh aspek dimensi manusia secara holistik. Maka diperlukan peran yang sangat besar dari guru pembimbing (konselor SMA dalam mengembangkan potensi peserta didiknya dalam mengembangkan potensinya dan membentuk karakter individu itu sendiri dan memberikan warna positif dalam suasana pembelajaran.

  4. NASA Keynote at the 2015 Trilateral SMA Conference, Frascati, Italy

    Science.gov (United States)

    Groen, Frank

    2015-01-01

    The purpose of this presentation is to illustrate some new directions within NASA's safety and mission function in response to changes in missions, technology, and practices. The presentation lists last year's highlights from NASA's human and robotic spaceflight missions, and discusses anticipated highlights for the coming year taken from existing Agency presentations. It will highlight changes to NASA's mission and the way NASA does business, as described in the 2014 strategic plan. It will then discuss how these changes pose challenges to trusted SMA practices, and provide some examples of initiatives NASA is taking action to address these challenges.

  5. Hubungan Antara Minat Siswa Dan Hasil Belajar Bahasa Inggris Mereka Di SMA Negeri Ujungbatu

    OpenAIRE

    Mulyani, Sri Dewi; ', Mahdum; Delfi, Syofia

    2017-01-01

    This study is aimed to find out the correlation between students' interest and their English learning achievement at SMA Negeri Ujungbatu. The problem needs to be discussed in this research is: is there any correlation between students' interest and their English learning achievement at SMA Negeri Ujungbatu. The population of this research was the first grade students of SMA Negeri Ujungbatu which was 527 students. The writer used random sampling technique to choose the sample. There were 263...

  6. TANGGAPAN GENERASI MUDA TERHADAP VLOG PRESIDEN JOKOWI (STUDI KHALAYAK SISWA SMA DI KOTA MAKASSAR)

    OpenAIRE

    -

    2017-01-01

    ABSTRAK MUFLISHA SETYAFAJRINI, E31113320. Tanggapan Generasi Muda Terhadap Vlog Presiden Jokowi (Studi Khalayak Siswa SMA di Kota Makassar). (Dibimbing oleh Muh Nadjib and Tuti Bahfiarti) Skripsi : Program S-1 Universitas Hasanuddin. Skripsi ini bertujuan : (1) Untuk mengethaui tanggapan siswa SMA di Kota Makassar terhadap vlog Presiden Jokowi. (2) Untuk mengetahui citra yang terbentuk dari vlog Presiden Jokowi terhadap siswa SMA di Kota Makassar. Penelitian ini dilakukan selama kura...

  7. KESANTUNAN TUTURAN DIREKTIF DALAM INTERAKSI PEMBELAJARAN DI SMA

    Directory of Open Access Journals (Sweden)

    Mardiyah Putri Astuti

    2017-03-01

    Full Text Available Politeness speech in learning interactions in the classroom tend to be effected through a directive speech. Assessment of form directive speech made by using a guide to the theory and analysis based on speech act theory directive Bach and Harnish. This study aims to determine the form of politeness directive in an interaction study in SMA 1 Batu. Forms directive speech in learning interactions are marked with (1 directive requests, (2 directive question, (3 directive command, (4 The prohibition directive, (5 directive licensing, and (6 the directive advice. The results of the analysis of the forms of speech directive shows that teachers do politeness predominantly through commands, prohibitions, permissions, and advice, while the shape of the directive utterances made by teachers and students to consider cultural aspects. Kesantunan tuturan dalam interaksi pembelajaran di dalam kelas cenderung dilakukan melalui bentuk tuturan direktif. Pengkajian terhadap bentuk tuturan direktif dilakukan dengan mengggunakan teori dan panduan analisis berdasarkan teori tindak tutur direktif Bach dan Harnish. Penelitian ini bertujuan untuk mengetahui bentuk kesantunan direktif dalam interaksi pembelajaran di SMA 1 Batu. Bentuk tuturan direktif dalam interaksi pembelajaran ditandai dengan (1 direktif permintaan, (2 direktif pertanyaan, (3 direktif perintah, (4 direktif larangan, (5 direktif pemberian izin, dan (6 direktif nasihat. Hasil analisis mengenai bentuk tuturan direktif menunjukkan bahwa guru melakukan kesantunan secara dominan melalui perintah, larangan, izin, dan nasihat, sedangkan bentuk tuturan direktif dilakukan oleh guru dan siswa dengan mempertimbangkan aspek budaya.

  8. Shape Memory Alloy (SMA)-Based Launch Lock

    Science.gov (United States)

    Badescu, Mircea; Bao, Xiaoqi; Bar-Cohen, Yoseph

    2014-01-01

    Most NASA missions require the use of a launch lock for securing moving components during the launch or securing the payload before release. A launch lock is a device used to prevent unwanted motion and secure the controlled components. The current launch locks are based on pyrotechnic, electro mechanically or NiTi driven pin pullers and they are mostly one time use mechanisms that are usually bulky and involve a relatively high mass. Generally, the use of piezoelectric actuation provides high precession nanometer accuracy but it relies on friction to generate displacement. During launch, the generated vibrations can release the normal force between the actuator components allowing shaft's free motion which could result in damage to the actuated structures or instruments. This problem is common to other linear actuators that consist of a ball screw mechanism. The authors are exploring the development of a novel launch lock mechanism that is activated by a shape memory alloy (SMA) material ring, a rigid element and an SMA ring holding flexure. The proposed design and analytical model will be described and discussed in this paper.

  9. A Novel SMA-based Concept for Airfoil Structural Morphing

    Science.gov (United States)

    Barbarino, S.; Pecora, R.; Lecce, L.; Concilio, A.; Ameduri, S.; Calvi, E.

    2009-08-01

    The adaptive structures concept is of great interest in the aerospace field because of the several benefits which can be accomplished in the fields including noise reduction, load alleviation, weight reduction, etc., at a level in which they can be considered as compulsory in the design of future aircraft. Improvements in terms of the aerodynamic efficiency, aeroelastic behavior, stability, and manoeuvrability performance have already been proved through many international studies in the past. In the family of the Smart Materials, Shape Memory Alloys (SMA) seem to be a suitable solution for many static applications. Their high structural integrability in conjunction with actuation capabilities and a favorable performance per weight ratio, allows the development of original architectures. In this study, a morphing wing trailing edge concept is presented; morphing ability was introduced with the aim of replacing a conventional flap device. A compliant rib structure was designed, based on SMA actuators exhibiting structural potential (bearing external aerodynamic loads). Numerical results, achieved through a FE approach, are presented in terms of trailing edge induced displacement and morphed shape.

  10. Modeling of SMA superelastic behavior with nonlocal approach

    Science.gov (United States)

    Duval, Arnaud; Haboussi, Mohamed; Zineb, Tarak Ben

    Due to their thermomechanical properties (high mechanical work/volume ratio), shape memory alloys (SMA) are particularly interesting to be adopted in the design of micro-sensors and micro-actuators. Thus, various constitutive models have been developed and implemented in finite element codes in order to design such applications. If these 'local' models are well adapted to describe the behavior of the bulk material, they fail to satisfactorily describe phenomena such as transformation localization or size effects observed in small samples. A gradient constitutive model is presented in order to describe the localization of phase transformation in SMA structures. To achieve this development restricted to superelasticity, a non local variable (martensite volume fraction) is defined at a material point as the weighted average over the entire material domain of the local transformation variable. Using Taylor expansions, the non local definition is substituted by a gradient based equation, introducing a material length parameter which controls the size of the localization zone. The gradient and mechanical equilibrium constitutive equations have been numerically integrated by using the finite element method. Two kinds of finite elements have been developed (1D truss and 2D quadrilateral) and implemented in Abaqus®via a UEL subroutine. Several simulations have been performed which exhibit the localization phenomena of phase transformation in structures undergoing mechanical loading.

  11. Design optimization and uncertainty analysis of SMA morphing structures

    International Nuclear Information System (INIS)

    Oehler, S D; Hartl, D J; Lopez, R; Malak, R J; Lagoudas, D C

    2012-01-01

    The continuing implementation of shape memory alloys (SMAs) as lightweight solid-state actuators in morphing structures has now motivated research into finding optimized designs for use in aerospace control systems. This work proposes methods that use iterative analysis techniques to determine optimized designs for morphing aerostructures and consider the impact of uncertainty in model variables on the solution. A combination of commercially available and custom coded tools is utilized. ModelCenter, a suite of optimization algorithms and simulation process management tools, is coupled with the Abaqus finite element analysis suite and a custom SMA constitutive model to assess morphing structure designs in an automated fashion. The chosen case study involves determining the optimized configuration of a morphing aerostructure assembly that includes SMA flexures. This is accomplished by altering design inputs representing the placement of active components to minimize a specified cost function. An uncertainty analysis is also conducted using design of experiment methods to determine the sensitivity of the solution to a set of uncertainty variables. This second study demonstrates the effective use of Monte Carlo techniques to simulate the variance of model variables representing the inherent uncertainty in component fabrication processes. This paper outlines the modeling tools used to execute each case study, details the procedures for constructing the optimization problem and uncertainty analysis, and highlights the results from both studies. (paper)

  12. Isolated celiac trunk aneurysm dissection: A rare entity

    Directory of Open Access Journals (Sweden)

    Esteban-Zubero, Eduardo

    2017-04-01

    Full Text Available Spontaneous and isolated celiac artery dissection is a rare clinical disease. It is the fourth cause of abdominal aneurysms behind those that occur in the splenic, hepatic, and superior mesenteric arteries. It is important to suspect the diagnosis of this entity whose clinical symptoms are unspecific. We report the case of a 60 year-old male treated in our hospital because of this illness, and present a review of this pathology, specially focused on the diagnosis and the different treatments available.

  13. Selective Neuromuscular Denervation in Taiwanese Severe SMA Mouse Can Be Reversed by Morpholino Antisense Oligonucleotides.

    Directory of Open Access Journals (Sweden)

    Te-Lin Lin

    Full Text Available Spinal muscular atrophy (SMA is an autosomal recessive motor neuron disease caused by deficiency of the survival of motor neuron (SMN protein, which leads to synaptic defects and spinal motor neuron death. Neuromuscular junction (NMJ abnormalities have been found to be involved in SMA pathogenesis in the SMNΔ7 SMA mouse model. However, whether similar NMJ pathological findings present in another commonly used mouse model, the Taiwanese SMA mouse, has not been fully investigated. To examine the NMJs of the Taiwanese severe SMA mouse model (Smn-/-; SMN2tg/0, which is characterized by severe phenotype and death before postnatal day (P 9, we investigated 25 axial and appendicular muscles from P1 to P9. We labelled the muscles with anti-neurofilament and anti-synaptophysin antibodies for nerve terminals and α-bungarotoxin for acetylcholine receptors (AChRs. We found that severe NMJ denervation (<50% fully innervated endplates selectively occurred in the flexor digitorum brevis 2 and 3 (FDB-2/3 muscles from P5, and an increased percentage of fully denervated endplates correlated with SMA progression. Furthermore, synaptophysin signals were absent at the endplate compared to control littermate mice, suggesting that vesicle transport might only be affected at the end stage. Subsequently, we treated the Taiwanese severe SMA mice with morpholino (MO antisense oligonucleotides (80 μg/g via subcutaneous injection at P0. We found that MO significantly reversed the NMJ denervation in FDB-2/3 muscles and extended the survival of Taiwanese severe SMA mice. We conclude that early NMJ denervation in the FDB-2/3 muscles of Taiwanese severe SMA mice can be reversed by MO treatment. The FDB-2/3 muscles of Taiwanese severe SMA mice provide a very sensitive platform for assessing the effectiveness of drug treatments in SMA preclinical studies.

  14. Endoluminal treatment of aortic dissection

    Energy Technology Data Exchange (ETDEWEB)

    Chavan, Ajay; Lotz, Joachim; Galanski, Michael [Department of Diagnostic Radiology, Hannover Medical School, Carl Neuberg Strasse 1, 30625, Hannover (Germany); Oelert, Frank; Haverich, Axel; Karck, Matthias [Department of Thoracic and Cardiovascular Surgery, Hannover Medical School, Carl Neuberg Strasse 1, 30625, Hannover (Germany)

    2003-11-01

    Aortic dissection is most often a catastrophic medical emergency which, if untreated, can be potentially fatal. The intention of therapy in patients with aortic dissection is to prevent aortic rupture or aneurysm formation as well as to relieve branch vessel ischaemia. Patients with aortic dissection are often poor candidates for anaesthesia and surgery and the surgical procedure itself is challenging requiring thoracotomy, aortic cross clamping, blood transfusion as well as prolonged hospital stay in some cases. Operative mortality is especially high in patients with critical mesenteric or renal ischaemia. The past decade has experienced the emergence of a number of interventional radiological or minimally invasive techniques which have significantly improved the management of patients with aortic dissection. These include stent grafting for entry site closure to prevent aneurysmatic widening of the false lumen as well as percutaneous techniques such as balloon fenestration of the intimal flap and aortic true lumen stenting to alleviate branch vessel ischaemia. False lumen thrombosis following entry closure with stent grafts has been observed in 86-100% of patients, whereas percutaneous interventions are able to effectively relieve organ ischaemia in approximately 90% of the cases. In the years to come, it is to be expected that these endoluminal techniques will become the method of choice for treating most type-B dissections and will assist in significantly reducing the number of open surgical procedures required for type-A dissections. The intention of this article is to provide an overview of the current status of these endoluminal techniques based on our own experience as well as on a review of the relevant literature. (orig.)

  15. Endoluminal treatment of aortic dissection

    International Nuclear Information System (INIS)

    Chavan, Ajay; Lotz, Joachim; Galanski, Michael; Oelert, Frank; Haverich, Axel; Karck, Matthias

    2003-01-01

    Aortic dissection is most often a catastrophic medical emergency which, if untreated, can be potentially fatal. The intention of therapy in patients with aortic dissection is to prevent aortic rupture or aneurysm formation as well as to relieve branch vessel ischaemia. Patients with aortic dissection are often poor candidates for anaesthesia and surgery and the surgical procedure itself is challenging requiring thoracotomy, aortic cross clamping, blood transfusion as well as prolonged hospital stay in some cases. Operative mortality is especially high in patients with critical mesenteric or renal ischaemia. The past decade has experienced the emergence of a number of interventional radiological or minimally invasive techniques which have significantly improved the management of patients with aortic dissection. These include stent grafting for entry site closure to prevent aneurysmatic widening of the false lumen as well as percutaneous techniques such as balloon fenestration of the intimal flap and aortic true lumen stenting to alleviate branch vessel ischaemia. False lumen thrombosis following entry closure with stent grafts has been observed in 86-100% of patients, whereas percutaneous interventions are able to effectively relieve organ ischaemia in approximately 90% of the cases. In the years to come, it is to be expected that these endoluminal techniques will become the method of choice for treating most type-B dissections and will assist in significantly reducing the number of open surgical procedures required for type-A dissections. The intention of this article is to provide an overview of the current status of these endoluminal techniques based on our own experience as well as on a review of the relevant literature. (orig.)

  16. Virtual reality haptic human dissection.

    Science.gov (United States)

    Needham, Caroline; Wilkinson, Caroline; Soames, Roger

    2011-01-01

    This project aims to create a three-dimensional digital model of the human hand and wrist which can be virtually 'dissected' through a haptic interface. Tissue properties will be added to the various anatomical structures to replicate a realistic look and feel. The project will explore the role of the medical artist and investigate the cross-discipline collaborations required in the field of virtual anatomy. The software will be used to train anatomy students in dissection skills before experience on a real cadaver. The effectiveness of the software will be evaluated and assessed both quantitatively as well as qualitatively.

  17. Dissection and preparation of viscera for plastination

    OpenAIRE

    Creus Tacies, Xavier

    2014-01-01

    Póster 1- Get a better understanding of the sistem coronary dissection, one of the most important from the point of anatomical and functional aspects. 2- Learn the plastination technique applying on a previously dissected equine heart.

  18. Intracranial hypertension following neck dissection

    NARCIS (Netherlands)

    de Vries, W. A.; Balm, A. J.; Tiwari, R. M.

    1986-01-01

    A 51-year-old man developed prolonged papilloedema as a result of increased cerebrospinal fluid pressure following staged bilateral radical neck dissection. The patient recovered completely with no further specific therapy. Although the prognosis for vision is usually good in patients with

  19. Animal Rights Activism Threatens Dissection.

    Science.gov (United States)

    Holden, Constance

    1990-01-01

    Discussed is the movement against the use of dissections in science laboratories. Examples of protests across the United States are included. Compared is the plight of using animals in a biology classroom and the demise of the teaching of evolution in some areas. (KR)

  20. Modified Brinson model as an equivalent one-dimensional constitutive equation of SMA spring

    Science.gov (United States)

    Ryu, Junghyun; Ahn, Sungmin; Koh, Je-sung; Cho, Kyu-Jin; Cho, Maenghyo

    2011-04-01

    Shape Memory Alloy (SMA) spring has great potential as a component of compact actuating system. Trade-off between recovery force and deformation range due to phase transformation is possible through the control of spring design parameters such as spring diameter. Deformation behavior of SMA spring is complicated function in three-dimensional space because its behavior is a combination of torsion, bending and stretching action. Therefore, three dimensional analysis of SMA spring is the most accurate simulation procedure. In this paper, modified one-dimensional Brinson model for SMA spring is proposed for more efficient and accurate simulation. In addition, numerical simulation of SMA spring is validated by comparing it with the results of experiment.

  1. Kelompok Sebaya dan Perilaku Makan Menyimpang Remaja SMA di Jakarta

    Directory of Open Access Journals (Sweden)

    Rizky Ibrahim Isra

    2017-02-01

    Full Text Available                                                                          AbstrakTulisan ini membahas hubungan tekanan kelompok sebaya (peer group terhadap gejala perilaku makan menyimpang pada remaja SMA di Jakarta. Banyak studi lain yang mengkaji hal serupa, namun kajian yang membahas permasalahan perilaku makan menyimpang secara sosiologis masih sangat minim. Ketika studi lain hanya memfokuskan pada jenis kelamin perempuan saja, dalam tulisan ini jenis kelamin (laki-laki dan perempuan digunakan sebagai variabel kontrol. Studi sebelumnya yang hanya berfokus pada perempuan memiliki kelemahan karena kelompok sebaya tidak hanya memengaruhi perilaku remaja perempuan, tetapi juga memengaruhi laki-laki. Oleh karena itu, penulis berargumen bahwa kelompok sebaya dapat memengaruhi munculnya gejala perilaku makan menyimpang pada remaja SMA di Jakarta, baik pada laki-laki maupun perempuan. Tulisan ini merupakan hasil studi yang menggunakan metode kuantitatif dengan teknik pengambilan sampel secara acak bertingkat (stratified random sampling sebanyak 235 siswa salah satu SMA negeri di Jakarta. Tulisan ini mengungkapkan bahwa terdapat hubungan antara tekanan kelompok sebaya terhadap gejala perilaku makan menyimpang pada remaja SMA di Jakarta, di mana laki-laki lebih terpengaruh oleh pesan (message dari kelompok sebayanya, sedangkan perempuan lebih kuat terpengaruh oleh interaksi dan likeability.                                                                      AbstractThis article discusses the correlation between peer group pressure and eating disorder behavior symptoms in Jakarta Senior High School students. Many of studies talk about it, but the discussion about eating disorder behavior on sociology was rarely found. In this article, gender was used as a control variable while many of studies only focused on the

  2. Application of SMA technology to auxiliary functions in appliances

    Science.gov (United States)

    Johnson, Bart; Brei, Diann E.; Patera, John

    2002-07-01

    Traditionally smart material actuation has been reserved for high technology industries such as space and aerospace; however, as the field matures more and more instances are found in low-cost, high production areas. This paper describes one such instance - the application of shape memory alloys to auxiliary functions in appliances. This investigation focused on lid locks for washing machines because it is representative of several other applications found in appliances including valves, dispensers, locks, brakes, etc. Several competing concepts for SMA actuated lid locks are discussed including simple analytical design models and experimental characterization of proof-of-concept prototypes. A comparison of these designs based on performance (force, response times), energy (power requirements) and economic metrics is given. From this study, a final concept was developed based upon the best attributes of the different concepts. The resulting proof-of-concept prototype demonstrated improved performance over the current state with a potential for cost reduction.

  3. Pengembangan Modul Pembelajaran Fisika SMA Terintegrasi Penanggulangan Bencana Tanah Longsor

    Directory of Open Access Journals (Sweden)

    Widya Wati

    2015-04-01

    Full Text Available Wilayah Indonesia secara geologis dilalui oleh dua jalur pegunungan muda dunia yaitu Pegunungan Mediterania di sebelah barat dan Pegunungan Sirkum Pasifik di sebelah timur menyebabkan Indonesia banyak memiliki gunung api yang aktif dan rawan terjadi bencana. Oleh sebab itu diperlukan edukasi mitigasi bencana alam sejak dini. Edukasi mitigasi bencana alam dapat dilakukan dengan menintegrasikannya dalam pembelajaran. Penelitian ini bertujuan mengembangkan modul pembelajaran fisika yang terintegrasi penanggulangan bencana alam. Penelitian ini adalah penelitian pengembangan dengan menggunakan model 4D. Tahapan yang dilakukan adalah define, design, dan develop. Pada tahap define dilakukan analisis kurikulum, analisis konsep dan analisis mitigasi bencana alam. Pada tahap design  dilakukan perancangan modul pembelajaran fisika. Tahap develop dilakukan pengembangan modul pembelajaran fisika SMA yang terintegrasi penanggulangan bencana alam tanah longsor. Hasil penelitian menghasilkan modul pembelajaran fisika yang dirancang untuk penanggulangan benaca alam tanah longsor. Kata Kunci: modul pembelajaran fisika, penanggulangan bencana, tanah longsor

  4. [Modern treatment of type B dissections

    DEFF Research Database (Denmark)

    Klitfod, L.; Baekgaard, N.; Just, S.

    2008-01-01

    Rapid classification is essential in the management of aortic dissections, as Type A dissections require surgery, while the optimal treatment of Type B dissections is controversial. Medical treatment with antihypertensive medication and analgesics has so far been the main treatment of uncomplicated...... Type B dissections, while surgery has been reserved for complications and persistent pain in spite of medical treatment. Endovascular techniques are less invasive than open repair and show promising early results Udgivelsesdato: 2008/9/8...

  5. KONSUMSI SUPLEMEN ATLET REMAJA DI SMA RAGUNAN JAKARTA

    Directory of Open Access Journals (Sweden)

    Muhammad Q Aliyyan Wijaya

    2015-05-01

    Full Text Available ABSTRACTThe objective of this study was to investigate consumption of supplement among Ragunan High School Jakarta athletes. The cross sectional study was done with total subjects were 79 students of Ragunan high school who were willing to join the study and they were at school when the study was conducted. There was 92.4% athletes consumed supplement in last one year. All athletes from light and heavy sport category were found consumed supplement. The most popular supplement were vitamin, mineral, and phytonutrition in tablet form. There was 89.0% athletes consumed supplement everyday. Moreover, the main reason for supplementation was to meet a nutrition requirement. The source of information about food supplement was mostly from coach advisor. More than half of athletes got supplement for free from any sources. There was a significant correlation between category of sport and number of supplement used (p<0.05.Keywords: adolescent, athlete, high school, supplementABSTRAKTujuan penelitian adalah menggambarkan konsumsi suplemen pada atlet remaja di SMA Ragunan Jakarta. Desain penelitian ini menggunakan cross sectional dengan total subjek sebanyak 79 siswa SMA Ragunan yang bersedia mengikuti penelitian dan berada di sekolah saat penelitian dilakukan. Sebanyak 92,4% atlet mengaku mengonsumsi suplemen dalam satu tahun terakhir. Atlet dari kategori olahraga ringan dan berat sekali semuanya mengonsumsi suplemen. Suplemen vitamin, mineral, dan fitonutrisi dalam bentuk tablet merupakan jenis dan bentuk suplemen yang paling banyak dikonsumsi. Sebanyak 89,0% dari atlet mengonsumsi suplemen setiap hari. Alasan utama atlet mengonsumsi suplemen adalah untuk memenuhi kebutuhan gizi. Pelatih merupakan sumber infomasi tentang suplemen yang paling banyak dipilih oleh atlet. Lebih dari 50,0% atlet mendapatkan suplemen dengan cara diberi. Kategori olahraga dan jumlah suplemen yang dikonsumsi menunjukkan hubungan positif signifikan (p<0,05.Kata kunci: atlet, remaja

  6. CHARACTER EDUCATION IN ISLAMIC BOARDING SCHOOL- BASED SMA AMANAH

    Directory of Open Access Journals (Sweden)

    Nana Herdiana Abdurrahman

    2016-06-01

    Full Text Available This paper aims to describe findings of the study in pesantren-based SMA Amanah covering: 1 the principal policy in developing character education, 2 the methods used in developing character education, 3 students’ characteristics as the result of the character education process, 4 the problems encountered in the implementation of character education and the efforts made in addressing the implementation of character education at the school. This study applied qualitative method using descriptive technique. The data were collected through observation, interviews, and documentation. The findings of study showed that: 1 the principal’s policy in developing character education was carried out by implementing government policies in line with the school’s vision, mission, and programs; 2 the methods used in the process of character education were through role-modelling, assignments and nurturing, habituation, training programs, and  students’ participation in various types of activities, as well as the application of rewards and punishments; 3 the student's characteristics resulted from the character  education process were piousness and devotion as well as being able to apply their knowledge and piety in everyday life; 4 problems encountered in the implementation of character education  were different values and norms students brought from home; imbalance of facilities compared to the number of students; as well as teachers’ readiness to actually implement the new program, which  was character education. Meanwhile the efforts made to overcome those problems were namely developing personal, family, neighborhood or community characters, and making commitment of all related parties/stakeholdres of SMA Amanah.

  7. Revised Hammersmith Scale for spinal muscular atrophy: A SMA specific clinical outcome assessment tool.

    Directory of Open Access Journals (Sweden)

    Danielle Ramsey

    Full Text Available Recent translational research developments in Spinal Muscular Atrophy (SMA, outcome measure design and demands from regulatory authorities require that clinical outcome assessments are 'fit for purpose'. An international collaboration (SMA REACH UK, Italian SMA Network and PNCRN USA undertook an iterative process to address discontinuity in the recorded performance of the Hammersmith Functional Motor Scale Expanded and developed a revised functional scale using Rasch analysis, traditional psychometric techniques and the application of clinical sensibility via expert panels. Specifically, we intended to develop a psychometrically and clinically robust functional clinician rated outcome measure to assess physical abilities in weak SMA type 2 through to strong ambulant SMA type 3 patients. The final scale, the Revised Hammersmith Scale (RHS for SMA, consisting of 36 items and two timed tests, was piloted in 138 patients with type 2 and 3 SMA in an observational cross-sectional multi-centre study across the three national networks. Rasch analysis demonstrated very good fit of all 36 items to the construct of motor performance, good reliability with a high Person Separation Index PSI 0.98, logical and hierarchical scoring in 27/36 items and excellent targeting with minimal ceiling. The RHS differentiated between clinically different groups: SMA type, World Health Organisation (WHO categories, ambulatory status, and SMA type combined with ambulatory status (all p < 0.001. Construct and concurrent validity was also confirmed with a strong significant positive correlation with the WHO motor milestones rs = 0.860, p < 0.001. We conclude that the RHS is a psychometrically sound and versatile clinical outcome assessment to test the broad range of physical abilities of patients with type 2 and 3 SMA. Further longitudinal testing of the scale with regards change in scores over 6 and 12 months are required prior to its adoption in clinical trials.

  8. Spontaneous pneumothorax in weightlifters.

    Science.gov (United States)

    Marnejon, T; Sarac, S; Cropp, A J

    1995-06-01

    Spontaneous pneumothorax is infrequently caused by strenuous exertion. To our knowledge there has only been one case of spontaneous pneumothorax associated with weightlifting reported in the medical literature. We describe three consecutive cases of spontaneous pneumothorax associated with weightlifting. We postulate that spontaneous pneumothorax in these patients may be secondary to improper breathing techniques. It is important that physicians and weight trainers be aware of the association between weight lifting and spontaneous pneumothorax and assure that proper instruction is given to athletes who work with weights.

  9. [Spinal accessory nerve and lymphatic neck dissection].

    Science.gov (United States)

    Pinsolle, V; Michelet, V; Majoufre, C; Caix, P; Siberchicot, F; Pinsolle, J

    1997-09-01

    Radical neck dissection was the golden standard of treatment for cervical nodes in head and neck tumors. From the seventies, the preservation of the spinal accessory nerve has become increasingly popular in order to improve the functional result of the neck dissections. The aim of this study was to assess the degree of functional disability associated with each type of neck dissection and the value of anatomical references for dissection of the spinal accessory nerve. One hundred twenty seven patients were evaluated 1 month and 1 year after radical, functional or supraomohyoid neck dissection with a questionnaire and a physical examination. Anatomical measurements of the spinal accessory nerve were performed in 20 patients. We found considerable or severe shoulder dysfunction in 7%, 34% and 51% respectively of patients in whom supraomohyoid, functional and radical neck dissections were performed. Furthermore 49% of patients having undergone a radical neck dissection had little or no symptoms. Sacrifice of the spinal accessory nerve in radical neck dissection may lead to shoulder dysfunction. A functional disability may also be associated, although in a less extent, with any neck dissection in which the spinal accessory nerve is dissected and placed in traction. There is a large variation in the degree of functional disability and pain in patients with similar neck dissections. The course of the spinal accessory nerve in the neck makes it particularly vulnerable to injury during the dissection near the sternocleidomastoid muscle and in the posterior cervical triangle.

  10. Spontaneous Hemothorax in Neurofibromatosis Treated with Percutaneous Embolization

    International Nuclear Information System (INIS)

    Arai, Kazunori; Sanada, Junichiro; Kurozumi, Akiko; Watanabe, Toshio; Matsui, Osamu

    2007-01-01

    We evaluated the effectiveness of transcatheter arterial coil embolization therapy for the treatment of spontaneous hemothorax followed by aneurysm rupture in neurofibromatosis patients. Three patients were treated for massive hemothorax caused by arterial lesions associated with neurofibromatosis. Bleeding episodes were secondary to ascending cervical artery aneurysm and dissection of vertebral artery in 1 patient, and intercostal artery aneurysm with or without arteriovenous fistula in 2 patients. Patients were treated by transarterial coil embolization combined with chest drainage. In 1 patient, the ruptured ascending cervical artery aneurysm was well embolized but, shortly after the embolization, fatal hemorrhage induced by dissection of the vertebral artery occurred and the patient died. In the other 2 patients, the ruptured intercostal artery aneurysm was well embolized and they were successfully treated and discharged. Transcatheter arterial coil embolization therapy is an effective method for the treatment of spontaneous hemothorax followed by aneurysm rupture in neurofibromatosis patients

  11. Analysis and Evaluation of the Dynamic Performance of SMA Actuators for Prosthetic Hand Design

    Science.gov (United States)

    O'Toole, Kevin T.; McGrath, Mark M.; Coyle, Eugene

    2009-08-01

    It is widely acknowledged within the biomedical engineering community that shape memory alloys (SMAs) exhibit great potential for application in the actuation of upper limb prosthesis designs. These lightweight actuators are particularly suitable for prosthetic hand solutions. A four-fingered, 12 degree-of-freedom prosthetic hand has been developed featuring SMA bundle actuators embedded within the palmar structure. Joule heating of the SMA bundle actuators generates sufficient torque at the fingers to allow a wide range of everyday tasks to be carried out. Transient characterization of SMA bundles has shown that performance/response during heating and cooling differs substantially. Natural convection is insufficient to provide for adequate cooling during elongation of the actuators. An experimental test-bed has been developed to facilitate analysis of the heat transfer characteristics of the appropriately sized SMA bundle actuators for use within the prosthetic hand design. Various modes of heat sinking are evaluated so that the most effective wire-cooling solution can be ascertained. SMA bundles of varying size will be used so that a generalized model of the SMA displacement performance under natural and forced cooling conditions can be obtained. The optimum cooling solution will be implemented onto the mechanical hand framework in future work. These results, coupled with phenomenological models of SMA behavior, will be used in the development of an effective control strategy for this application in future work.

  12. Monotonic and cyclic bond behavior of confined concrete using NiTiNb SMA wires

    International Nuclear Information System (INIS)

    Choi, Eunsoo; Chung, Young-Soo; Kim, Yeon-Wook; Kim, Joo-Woo

    2011-01-01

    This study conducts bond tests of reinforced concrete confined by shape memory alloy (SMA) wires which provide active and passive confinement of concrete. This study uses NiTiNb SMA which usually shows wide temperature hysteresis; this is a good advantage for the application of shape memory effects. The aims of this study are to investigate the behavior of SMA wire under residual stress and the performance of SMA wire jackets in improving bond behavior through monotonic-loading tests. This study also conducts cyclic bond tests and analyzes cyclic bond behavior. The use of SMA wire jackets transfers the bond failure from splitting to pull-out mode and satisfactorily increases bond strength and ductile behavior. The active confinement provided by the SMA plays a major role in providing external pressure on the concrete because the developed passive confinement is much smaller than the active confinement. For cyclic behavior, slip and circumferential strain are recovered more with larger bond stress. This recovery of slip and circumferential strain are mainly due to the external pressure of the SMA wires since cracked concrete cannot provide any elastic recovery

  13. [Pregnancy and coronary artery dissection].

    Science.gov (United States)

    Martínez-Quintana, Efrén; Rodríguez-González, Fayna

    2015-01-01

    Acute myocardial infarction during pregnancy is associated with high maternal and fetal mortality. Coronary atherosclerosis is the most common cause due to an increase in the age of the patients and the association with cardiovascular risk factors such as smoking, hypertension, diabetes mellitus, preeclampsia, and the existence of family history of coronary disease. However, thrombosis, coronary dissection or coronary vasospasms are other causes that may justify it. We report the case of a 33 weeks pregnant first-time mother, without cardiovascular risk factors, who presented an acute coronary event in the context of atherosclerotic disease and coronary dissection after percutaneous coronary intervention. Copyright © 2014 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.

  14. An interactive anatomy dissection DVD

    OpenAIRE

    Al-Sabah, Fadel YS

    2013-01-01

    Anatomy remains the cornerstone of medical education. Human anatomy has not changed, yet our understanding of the topic and the methods by which we teach anatomy continue to evolve. At present lectures, tutorials and human cadaveric dissection in the anatomy room remain central to anatomical education in the Republic of Ireland and throughout many parts of the world. With the emergence of new technologies, new teaching methods can be explored. In-house and on-line teaching of Radiology and...

  15. Dissection of Saccharomyces cerevisiae asci.

    Science.gov (United States)

    Morin, Audrey; Moores, Adrian W; Sacher, Michael

    2009-05-19

    Yeast is a highly tractable model system that is used to study many different cellular processes. The common laboratory strain Saccharomyces cerevisiae exists in either a haploid or diploid state. The ability to combine alleles from two haploids and the ability to introduce modifications to the genome requires the production and dissection of asci. Asci production from haploid cells begins with the mating of two yeast haploid strains with compatible mating types to produce a diploid strain. This can be accomplished in a number of ways either on solid medium or in liquid. It is advantageous to select for the diploids in medium that selectively promotes their growth compared to either of the haploid strains. The diploids are then allowed to sporulate on nutrient-poor medium to form asci, a bundle of four haploid daughter cells resulting from meiotic reproduction of the diploid. A mixture of vegetative cells and asci is then treated with the enzyme zymolyase to digest away the membrane sac surrounding the ascospores of the asci. Using micromanipulation with a microneedle under a dissection microscope one can pick up individual asci and separate and relocate the four ascopores. Dissected asci are grown for several days and tested for the markers or alleles of interest by replica plating onto appropriate selective media.

  16. Percutaneous Thrombin Injection to Complete SMA Pseudoaneurysm Exclusion After Failing of Endograft Placement

    International Nuclear Information System (INIS)

    Szopinski, Piotr; Ciostek, Piotr; Pleban, Eliza; Iwanowski, Jaroslaw; Krol, Malgorzata Serafin-; Marianowska, Agnieszka; Noszczyk, Wojciech

    2005-01-01

    Visceral aneurysms are potentially life-threatening vascular lesions. Superior mesenteric artery (SMA) pseudoaneurysms are a rare but well-recognized complication of chronic pancreatitis. Open surgical repair of such an aneurysm, especially in patients after previous surgical treatment, might be dangerous and risky. Stent graft implantation makes SMA pseudoaneurysm exclusion possible and therefore avoids a major abdominal operation. Percutaneous direct thrombin injection is also one of the methods of treating aneurysms in this area. We report a first case of percutaneous ultrasound-guided thrombin injection to complete SMA pseudoaneurysm exclusion after an unsuccessful endograft placement. Six-month follow-up did not demonstrate any signs of aneurysm recurrence

  17. EVALUASI DAN STRATEGI PENGEMBANGAN SMA INDONESISCH NERDERLANDSCHE SCHOOL (INS KAYUTANAM

    Directory of Open Access Journals (Sweden)

    David David

    2016-06-01

    Full Text Available Penelitian ini bertujuan untuk: (1 mengevaluasi SMA INS Kayutanam dan (2 menyusuan strategi pengembangan SMA INS Kayutanam berdasarkan hasil evaluasi tersebut. Pendekatan yang digunakan dalam penelitian ini adalah kuantitatif dan kualitatif. Sumber data dalam penelitian ini adalah 50 siswa kelas X dan XI, satu kepala sekolah, empat wakil kepala sekolah, 30 guru, dua pembina asrama dan dua orang dari pemerintahan. Hasil penelitian dibagi dalam dua kelompok yaitu hasil evaluasi dan strategi pengembangan. Berdasarkan hasil evaluasi ditemukan bahwa ada beberapa komponen yang perlu perbaikan yaitu kurikulum, kompetensi pendidik dan tenaga kependidikan, fasilitas, peran serta masyarakat, dana dan organisasi. Strategi pengembangan terdiri dari: (1 perumusan kurikulum terintegrasi yang memuat tujuan dan sasaran pendidikan yang diprakarsai oleh Sjafei; (2 perumusan metode mengajar yang sesuai dengan tujuan dan sasaran pendidikan yang diprakasai Sjafei; (3 pengelolaan aset produktif dengan pemanfaatan modal sosial; (4 pemanfaatan basis alumni; (5 membangun kerja sama dengan instansi terkait seperti sekolah lain, pemerintah daerah, dan pihak swasta. Kata kunci: evaluasi, strategi pengembangan   THE EVALUATION AND THE STRATEGY FOR DEVELOPING INDONESISCH NEDERLANDSCHE SCHOOL (INS KAYUTANAM SENIOR HIGH SCHOOL Abstract The study was to: (1 evaluate the development of INS Kayutanam Senior High School; and (2 design the strategy to develop INS Kayutanam Senior High School based on the results of the evaluation. The approach used of in the study was quantitative and qualitative. The data source in the study was 50 students from the X grade and the XI grade, one principal, four vice principals, 30 teachers, two dormitory advisors and two government representatives. The results of the study were divided into two groups namely the evaluation results and the development strategies. Based on the results of the study, the researcher found that there were several

  18. Visceral hybrid reconstruction of thoracoabdominal aortic aneurysm after open repair of type a aortic dissection by the Bentall procedure with the elephant trunk technique: A case report

    Directory of Open Access Journals (Sweden)

    Marjanović Ivan

    2014-01-01

    Full Text Available Introduction. Reconstruction of chronic type B dissection and thoracoabdominal aortic aneurysm (TAAA remaining after the emergency reconstruction of the ascending thoracic aorta and aortic arch for acute type A dissection represents one of the major surgical challenges. Complications of chronic type B dissection are aneurysmal formation and rupture of an aortic aneurysm with a high mortality rate. We presented a case of visceral hybrid reconstruction of TAAA secondary to chronic dissection type B after the Bentall procedure with the elephant trunk technique due to acute type A aortic dissection in a high-risk patient. Case report. A 62 year-old woman was admitted to our institution for reconstruction of Crawford type I TAAA secondary to chronic dissection. The patient had had an acute type A aortic dissection 3 years before and undergone reconstruction by the Bentall procedure with the elephant trunk technique with valve replacement. On admission the patient had coronary artery disease (myocardial infarction, two times in the past 3 years, congestive heart disease with ejection fraction of 25% and chronic obstructive pulmonary disease. On computed tomography (CT of the aorta TAAA was revealed with a maximum diameter of 93 mm in the descending thoracic aorta secondary to chronic dissection. All the visceral arteries originated from the true lumen with exception of the celiac artery (CA, and the end of chronic dissection was below the origin of the superior mesenteric artery (SMA. The patient was operated on using surgical visceral reconstruction of the SMA, CA and the right renal artery (RRA as the first procedure. Postoperative course was without complications. Endovascular TAAA reconstruction was performed as the second procedure one month later, when the elephant trunk was used as the proximal landing zone for the endograft, and distal landing zone was the level of origin of the RRA. Postoperatively, the patient had no neurological deficit and

  19. Kondisi Stres Akademik Siswa SMA Negeri di Kota Padang

    Directory of Open Access Journals (Sweden)

    Taufik Taufik

    2014-01-01

    Full Text Available This research conduct base from increasing the National Examination standards from recent years, and overload student’s learning activity in Senior High School (SMA. These conditions as triggers stress students, from a long time, its influence on their learning. Based that, the research is to identify level of student academic stress, and differences base gender, and school location. This research use Cluster Random Sampling. Samples are grouped into 3 (three, that’s school is located in downtown, midtown and the Suburbs. Research findings show that there are 15% of student’s stress academic at low levels of, 71,8% experiencing stress academic at medium level, and 13.2% of students experiencing stress academic at high level. There was no significant difference between the academic stress Student SMAN in Padang by location and gender. These research findings can then be an important basic need for guidance and counseling services in order to decrease the level of stress of academic students in Padang city, so that they can learn by making every effort that is optimal.

  20. Klasifikasi dan Klastering Penjurusan Siswa SMA Negeri 3 Boyolali

    Directory of Open Access Journals (Sweden)

    Yusuf Sulistyo Nugroho

    2015-12-01

    Full Text Available SMA N 3 Boyolali merupakan salah satu sekolah menengah di kota Boyolali yang saat ini telah memiliki 2 jurusan yaitu IPA dan IPS. Penjurusan siswa ini dapat mengarahkan peserta didik agar lebih fokus dalam mengembangkan kemampuan diri dan minat yang dimiliki. Pemilihan jurusan yang tidak tepat bisa sangat merugikan siswa terhadap minat dan karir mereka di masa mendatang. Dengan penjurusan tersebut diharapkan dapat memaksimalkan potensi, bakat atau talenta individu, sehingga dapat memaksimalkan nilai akademisnya. Berdasarkan latar belakang tersebut, maka dengan menerapkan teknik data mining diharapkan dapat membantu siswa untuk menentukan jurusan yang tepat sesuai dengan kriteria yang ditetapkan. Adapaun teknik data mining yang digunakan dalam penentuan jurusan ini menggunakan 3 buah metode yaitu Algoritma C4.5, Naive Bayes dan Algoritma K-Means. Sedangkan atribut yang digunakan terdiri dari Gender, Minat, Rata-rata nilai IPA, Rata-rata nilai IPS, nilai Psikotest IPA, nilai Psikotest IPS, Asal Sekolah dan Jurusan. Analisis dilakukan dengan bantuan aplikasi RapidMiner 5 untuk mengetahui nilai-nilai perbandingan terhadap metode yang digunakan. Hasil penelitian menggunakan perbandingan 3 metode menunjukkan bahwa berdasarkan nilai precision, metode naive bayes lebih baik dibandingkan dengan metode yang lain dengan nilai 77,51%. Sedangkan berdasarkan nilai recall dan accuracy, decision tree lebih baik dibandingkan dengan metode yang lain dengan nilai recall sebesar 90,80% dan nilai accuracy sebesar 79,14%. Variabel yang paling berpengaruh dalam menentukan penjurusan yaitu rata-rata nilai IPA sehingga perlu dijadikan pertimbangan bagi pihak sekolah untuk menentukan jurusan siswa.

  1. Specific methanogenic activity (SMA of industrial sludge from the aerobic and anaerobic biological treatment

    Directory of Open Access Journals (Sweden)

    Danieli Schneiders

    2013-08-01

    Full Text Available In this study, specific methanogenic activity (SMA tests were performed on textile sludge and food industry sludge. The textile sludge from an activated sludge was collected at the entrance of the secondary biologic clarifier and the food sludge was collected in a UASB reactor. Once collected, the sludges were characterized and tested for SMA. It was found that the microrganisms present in the food sludge had SMA of 0.17 gCOD-CH4 gSSV.d-1 and 337.05 mL of methane production, while the microrganisms of the textile sludge presented 0.10 gCOD-CH4 gSSV.d-1 of SMA and 3.04 mL of methane production. Therefore, the food sludge was more suitable to be used as a starting inoculum in UASB.

  2. Optimal design of damping layers in SMA/GFRP laminated hybrid composites

    Science.gov (United States)

    Haghdoust, P.; Cinquemani, S.; Lo Conte, A.; Lecis, N.

    2017-10-01

    This work describes the optimization of the shape profiles for shape memory alloys (SMA) sheets in hybrid layered composite structures, i.e. slender beams or thinner plates, designed for the passive attenuation of flexural vibrations. The paper starts with the description of the material and architecture of the investigated hybrid layered composite. An analytical method, for evaluating the energy dissipation inside a vibrating cantilever beam is developed. The analytical solution is then followed by a shape profile optimization of the inserts, using a genetic algorithm to minimize the SMA material layer usage, while maintaining target level of structural damping. Delamination problem at SMA/glass fiber reinforced polymer interface is discussed. At the end, the proposed methodology has been applied to study the hybridization of a wind turbine layered structure blade with SMA material, in order to increase its passive damping.

  3. Klasifikasi Kecamatan Berdasarkan Nilai Akhir SMA/MA di Kabupaten Aceh Selatan Menggunakan Analisis Diskriminan

    Directory of Open Access Journals (Sweden)

    Fitriana A.R.

    2015-11-01

    Full Text Available Analisis diskriminan merupakan bagian dari analisis peubah ganda. Analisis diskriminan digunakan untuk memodelkan variabel tak bebas yang bersifat kualitatif dengan variabel bebas yang bersifat kuantitatif. Pada penelitian ini, analisis diskriminan lebih dari dua kelompok diterapkan pada data nilai akhir SMA/MA di Kabupaten Aceh Selatan yang bertujuan untuk mendapatkan model untuk pengklasifikasian kecamatan. Pengklasifikasian ini bertujuan untuk melihat perbedaan kualitas siswa SMA/MA yang berada di masing-masing kecamatan Kabupaten Aceh Selatan berdasarkan data nilai akhir. Variabel tak bebas yang digunakan berupa klasifikasi kecamatan berdasarkan rata-rata jumlah nilai akhir SMA/MA yang berada di masing-masing kecamatan yang dibentuk dengan K-Means Cluster. Sedangkan variabel bebas yang digunakan adalah data rata-rata nilai akhir SMA/MA untuk setiap mata pelajaran yang diujiankan pada masing-masing jurusan setiap kecamatan. Model yang didapatkan adalah dua model diskriminan untuk jurusan IPA dan IPS.

  4. Persepsi Siswa Terhadap Pembelajaran Guru Pendidikan Jasmani Di SMA Muhammadiyah Kediri

    Directory of Open Access Journals (Sweden)

    Hendra Mashuri

    2017-05-01

    Full Text Available Tujuan yang ingin dicapai dalam penelitian ini adalah untuk memperoleh informasi tentang persepsi siswa terhadap pembelajaran guru pendidikan jasmani di SMA Muhammadiyah Kediri. Rumusan masalah dalam penelitian ini adalah bagaimana persepsi siswa terhadap pembelajaran guru pendidikan jasmani di SMA Muhammadiyah Kediri? Jenis penelitian ini adalah penelitian survei. Populasi yang digunakan adalah seluruh siswa SMA Muhammadiyah Kediri, sampel yang diambil berjumlah 60 siswa yang terdiri dari 20 siswa dari masing-masing kelas. Instrumen yang digunakan adalah angket dan dokumentasi. Teknik analisis data menggunakan persentase. Hasil penelitian menunjukkan bahwa persepsi siswa terhadap proses pembelajaran SMA Muhammadiyah Kediri mendapatkan skor 3115 atau rata-rata jawaban siswa 51,917 dengan persentase sebesar 74% dan masuk dalam kategori “Baik”. Dengan demikian dapat dikatakan bahwa persepsi siswa terhadap pembelajaran guru pendidikan jasmani adalah baik.

  5. PENGEMBANGAN KINERJA GURU MELALUI PENELITIAN TINDAKAN KELAS PADA SMA NEGERI DI KOTA PALOPO

    Directory of Open Access Journals (Sweden)

    Hilal Muhammad

    2015-12-01

    Tujuan penelitian ini adalah untuk mengungkap: (1 pelaksanaan pengembangan kinerja guru melalui PTK pada SMA Negeri di Kota Palopo; dan (2 hambatan da-lam pelaksanaan pengembangan kinerja guru melalui PTK pada SMA Negeri di Kota Palopo. Jenis penelitian adalah penelitian lapangan yang kajiannya bersifat kualitatif-verifikatif. Pendekatan yang digunakan adalah pendekatan fenomeno-logi. Metode pengumpulan data yang digunakan dalam penelitian ini adalah wawancara, observasi, dan dokumentasi. Hasil penelitian ini menunjukkan dua hal. Pertama, pengembangan kinerja guru melalui PTK pada SMA Negeri di Kota Palopo belum berjalan optimal dan baru sebatas memenuhi kebutuhan persyarat-an kenaikan pangkat. Potensi guru belum dimanfaatkan melalui pemberdayaan, khususnya penelitian tindakan kelas. Kedua, hambatan dalam pelaksanaan pe-ngembangan kinerja guru melalui PTK pada SMA Negeri di Kota Palopo adalah keterbatasan waktu, dana, sumber referensi kurang, lingkungan tidak kondusif, dan motivasi kurang. Selain itu, sebagian guru juga masih mengalami kesulitan dalam melakukan dan menyusun laporan hasil PTK.

  6. PERANGKAT PENGEMBANGAN DIRI UNTUK MENINGKATKAN KOMPETENSI GURU DAN PENGEMBANGAN KEPRIBADIAN SISWA SMA

    Directory of Open Access Journals (Sweden)

    Wenny Hulukati

    2014-06-01

    Abstrak: Perangkat Pengembangan Diri untuk Meningkatkan Kompetensi Guru dan Pengembangan Kepribadian Siswa SMA. Penelitian ini bertujuan mengembangkan perangkat pengembangan diri untuk meningkatkan kompetensi guru dan pengembangan kepribadian siswa SMA. Kegiatan penelitian ini diawali dengan studi pendahuluan yang berkaitan dengan kompentensi guru pembimbing dalam melaksanakan pelayanan bimbingan dan konseling dan kecenderungan kepribadian siswa SMA. Langkah berikutnya adalah mendesain dan mengembangkan draf, dan diakhiri dengan kegiatan uji keefektifan produk. Dari kegiatan penelitian pengembangan ini telah dihasilkan produk pengembangan yang valid dan handal yang meliputi panduan guru, panduan siswa, dan panduan penilaian. Berdasarkan hasil uji keefektifan terhadap produk pengembangan diperoleh informasi bahwa perangkat panduan pengembangan diri efektif diguna­kan untuk meningkatkan kompetensi guru pembimbing dalam melaksanakan pelayanan bimbingan dan konseling dan pengembangan kepribadian siswa SMA.

  7. Spontaneous uterine rupture

    African Journals Online (AJOL)

    ABSTRACT. Rupture of a gravid uterus is a surgical emergency. Predisposing factors include a scarred uterus. Spontaneous rupture of an unscarred uterus during pregnancy is a rare occurrence. We hereby present the case of a spontaneous complete uterine rupture at a gestational age of 34 weeks in a 35 year old patient ...

  8. Spontaneous intracranial hypotension.

    LENUS (Irish Health Repository)

    Fullam, L

    2012-01-31

    INTRODUCTION: Spontaneous\\/primary intracranial hypotension is characterised by orthostatic headache and is associated with characteristic magnetic resonance imaging findings. CASE REPORT: We present a case report of a patient with typical symptoms and classical radiological images. DISCUSSION: Spontaneous intracranial hypotension is an under-recognised cause of headache and can be diagnosed by history of typical orthostatic headache and findings on MRI brain.

  9. Investigations on Vibration Characteristics of Sma Embedded Horizontal Axis Wind Turbine Blade

    Science.gov (United States)

    Jagadeesh, V.; Yuvaraja, M.; Chandhru, A.; Viswanathan, P.; Senthil kumar, M.

    2018-02-01

    Vibration induced in wind turbine blade is a solemn problem as it reduces the life of the blade and also it can create critical vibration onto the tower, which may cause serious damage to the tower. The aim of this paper is to investigate the vibration characteristics of the prototype horizontal axis wind turbine blade. Shape memory alloys (SMA), with its variable physical properties, provides an alternative actuating mechanism. Heating an SMA causes a change in the elastic modulus of the material and hence SMAs are used as a damping material. A prototype blade with S1223 profile has been manufactured and the natural frequency is found. The natural frequency is found by incorporating the single SMA wire of 0.5mm diameter over the surface of the blade for a length of 240 mm. Similarly, number of SMA wires over the blade is increased up to 3 and the natural frequency is found. Frequency responses showed that the embedment of SMA over the blade’s surface will increase the natural frequency and reduce the amplitude of vibration. This is because of super elastic nature of SMA. In this paper, when SMA wire of 0.5 mm diameter and of length of 720 mm is embedded on the blade, an increase in the natural frequency by 6.3% and reducing the amplitude by 64.8%. Results of the experimental modal and harmonic indicates the effectiveness of SMA as a passive vibration absorber and that it has potential as a modest and high-performance method for controlling vibration of the blade.

  10. Pengaruh Minat Pada Lagu Bahasa Inggris Terhadap Kemahiran Mendengarkan Siswa Di SMA Kristen Irene Manado

    OpenAIRE

    ANGMALISANG, HELEN YULIANA

    2013-01-01

    This skripsi is entitled “Pengaruh Minat pada Lagu Bahasa Inggris terhadap Kemahiran Mendengarkan Siswa di SMA Kristen Irene Manado”. The objective of this research is to analyze in what extent the interest in English songs have an effect on students' listening skills in SMA Kristen Irene Manado. This research is based on the theory of Slameto (2010) stating that learning is more successful when dealing with interest of students. In conducting this study, the writer uses quantitative approach...

  11. Experimental characterization of self-sensing SMA actuators under controlled convective cooling

    International Nuclear Information System (INIS)

    Lewis, N; York, A; Seelecke, S

    2013-01-01

    Shape memory alloy (SMA) wires are attractive for actuation systems due to their high energy density, light weight and silent operation. In addition, they feature self-sensing capabilities by relating electrical resistance measurements to strain changes. In real world applications SMAs typically operate in non-ambient air and it is imperative to understand an actuator’s behavior under varying convective cooling conditions, especially for smaller diameter wires, where convective effects are amplified. This paper shows that the multi-functionality of SMA actuators can be further extended by related heating power to convective air speed. It investigates the relationship between the normalized excess power needed and corresponding airspeed under controlled, laminar airflow patterns in a small-scale wind tunnel. For each experiment, airflow through the wind tunnel, strain in the SMA wire, and power supplied to the SMA wire were controlled, while the stress and resistance of the wire were measured. The ability to understand and predict an SMA wire’s behavior under various external airflows will aid in the design and understanding of future SMA actuated structures, such as micro-air vehicles, and shows that SMAs can function as self-sensing actuators and airspeed sensors. (paper)

  12. Physical therapy services received by individuals with spinal muscular atrophy (SMA).

    Science.gov (United States)

    Dunaway, Sally; Montes, Jacqueline; McDermott, Michael P; Martens, William; Neisen, Annie; Glanzman, Allan M; Pasternak, Amy; Riley, Susan; Sproule, Douglas; Chiriboga, Claudia; Finkel, Richard; Tennekoon, Gihan; Darras, Basil; De Vivo, Darryl; Pandya, Shree

    2016-01-01

    The consensus statement for standard of care in SMA recommends multidisciplinary medical care including physical therapy (PT) services. To date there are no reports regarding the implementation of these recommendations and the type of care or services received by individuals with SMA. The purpose of this study is to describe the PT services received by individuals with SMA. Interviews were conducted with patients or their caregivers at the Pediatric Neuromuscular Clinical Research (PNCR) Network sites from October 2011 to September 2012. Questions included information about clinical status of the patient, sociodemographic profile of the patient or caregiver, and PT services received in the past year, including the setting, frequency, duration and type of PT, and therapies administered by caregivers. Eighty-six percent of 105 participants reported receiving PT services, some in multiple settings: 62% in the neuromuscular clinic, 38% at school, 34% at home, and 13% in an outpatient clinic. Greater frequency of PT services received was associated with younger age and inability to walk, but not SMA type. This is the first multicenter study documenting PT services received by patients with SMA. Further research is needed to better understand the impact of PT services on the natural history of SMA.

  13. Experimental and numerical study on hysteretic performance of SMA spring-friction bearings

    Science.gov (United States)

    Zhuang, Peng; Xue, Suduo; Nie, Pan; Wang, Wenting

    2016-12-01

    This paper presents an experimental and numerical study to investigate the hysteretic performance of a new type of isolator consisting of shape memory alloy springs and friction bearing called an SMA spring-friction bearing (SFB). The SFB is a sliding-type isolator with SMA devices used for the seismic protection of engineering structures. The principle of operation of the isolation bearing is introduced. In order to explore the possibility of applying SMA elements in passive seismic control devices, large diameter superelastic tension/compression NiTi SMA helical springs used in the SFB isolator were developed. Mechanical experiments of the SMA helical spring were carried out to understand its superelastic characteristics. After that, a series of quasi-static tests on a single SFB isolator prototype were conducted to measure its force-displacement relationships for different loading conditions and study the corresponding variation law of its mechanical performance. The experimental results demonstrate that the SFB exhibits full hysteretic curves, excellent energy dissipation capacity, and moderate recentering ability. Finally, a theoretical model capable of emulating the hysteretic behavior of the SMA-based isolator was then established and implemented in MATLAB software. The comparison of the numerical results with the experimental results shows the efficacy of the proposed model for simulating the response of the SFB.

  14. KONTRIBUSI KEMAMPUAN MEMAHAMI CERPEN TERHADAP KETERAMPILAN MENULIS CERPEN SISWA KELAS XI SMA NEGERI 4 PADANG

    Directory of Open Access Journals (Sweden)

    risa yulisna

    2016-10-01

     siswa jarang membaca karya sastra termasuk karya sastra cerpen. Keempat, kemampuan memahami bacaan siswa masih rendah. Kelima, kemampuan memahami cerpen siswa rendah. Siswa mengalami kesulitan dalam menentukan dan memahami unsur-unsur cerpen. Penelitian ini bertujuan untuk mendeskripsikan kemampuan memahami cerpen siswa kelas XI SMA Negeri 4 Padang dan keterampilan menulis cerpen siswa kelas XI SMA Negeri 4 Padang, serta kontribusi kemampuan memahami cerpen terhadap keterampilan menulis cerpen siswa kelas XI SMA Negeri 4 Padang. Subjek penelitian ini adalah siswa kelas XI SMA Negeri 4 Padang dengan sampel berjumlah 30 orang. Penelitian ini adalah kuantitatif dengan metode deskriptif. Data penelitian diperoleh melalui dua jenis tes yaitu tes objektif dan tes unjuk kerja. Tes objektif digunakan untuk mengumpulkan data memahami bacaan cerpen sedangkan tes unjuk kerja digunakan untuk mengumpulkan data kemampuan menulis cerpen. Berdasarkan hasil analisis data dan pembahasan disimpulkan hal-hal berikut. Pertama, kemampuan memahami cerpen siswa kelas XI SMA Negeri 4 Padang pada kualifikasi lebih dari cukup (75,33. Kedua, kemampuan menulis cerpen siswa kelas XI SMA Negeri 4 Padang berada pada kualifikasi cukup (63,33. Ketiga, terdapat kontribusi yang signifikan antara kemampuan memahami cerpen terhadap keterampilan menulis cerpen sebesar 61%.

  15. Selective vulnerability of spinal and cortical motor neuron subpopulations in delta7 SMA mice.

    Science.gov (United States)

    d'Errico, Paolo; Boido, Marina; Piras, Antonio; Valsecchi, Valeria; De Amicis, Elena; Locatelli, Denise; Capra, Silvia; Vagni, Francesco; Vercelli, Alessandro; Battaglia, Giorgio

    2013-01-01

    Loss of the survival motor neuron gene (SMN1) is responsible for spinal muscular atrophy (SMA), the most common inherited cause of infant mortality. Even though the SMA phenotype is traditionally considered as related to spinal motor neuron loss, it remains debated whether the specific targeting of motor neurons could represent the best therapeutic option for the disease. We here investigated, using stereological quantification methods, the spinal cord and cerebral motor cortex of ∆7 SMA mice during development, to verify extent and selectivity of motor neuron loss. We found progressive post-natal loss of spinal motor neurons, already at pre-symptomatic stages, and a higher vulnerability of motor neurons innervating proximal and axial muscles. Larger motor neurons decreased in the course of disease, either for selective loss or specific developmental impairment. We also found a selective reduction of layer V pyramidal neurons associated with layer V gliosis in the cerebral motor cortex. Our data indicate that in the ∆7 SMA model SMN loss is critical for the spinal cord, particularly for specific motor neuron pools. Neuronal loss, however, is not selective for lower motor neurons. These data further suggest that SMA pathogenesis is likely more complex than previously anticipated. The better knowledge of SMA models might be instrumental in shaping better therapeutic options for affected patients.

  16. SMA Foils for MEMS: From Material Properties to the Engineering of Microdevices

    Science.gov (United States)

    Kohl, Manfred; Ossmer, Hinnerk; Gueltig, Marcel; Megnin, Christof

    2017-12-01

    In the early nineties, microelectromechanical systems (MEMS) technology has been still in its infancy. As silicon (Si) is not a transducer material, it was clear at the very beginning that mechanically active materials had to be introduced to MEMS in order to enable functional microdevices with actuation capability beyond electrostatics. At that time, shape memory alloys (SMAs) have been available in bulk form, mainly as SMA wires and SMA plates. On the macro scale, these materials show highest work densities compared to other actuation principles in the order of 107 J/m3, which stimulated research on the integration of SMA to MEMS. Subsequently, two approaches for producing planar materials have been initiated (1) magnetron sputtering of SMA thin films and (2) the integration of rolled SMA foils, which both turned out to be very successful creating a paradigm change in microactuation technology. The following review covers important milestones of the research and development of SMA foil-based microactuators including materials characterization, design engineering, technology, and demonstrator development as well as first commercial products.

  17. Evaluation of Educator & Student Use of & Attitudes toward Dissection & Dissection Alternatives

    Science.gov (United States)

    Osenkowski, Pamela; Green, Che; Tjaden, Anne; Cunniff, Peggy

    2015-01-01

    Animal dissection has been routinely practiced in American biology classrooms for decades. With technological advancements, more states adopting student choice measures, and increased awareness about ethical concerns surrounding dissection, many useful dissection alternatives have been developed. To understand the current use of animal dissection…

  18. Probabilistic fiber tracking of the language and motor white matter pathways of the supplementary motor area (SMA) in patients with brain tumors.

    Science.gov (United States)

    Jenabi, Mehrnaz; Peck, Kyung K; Young, Robert J; Brennan, Nicole; Holodny, Andrei I

    2014-12-01

    Accurate localization of anatomically and functionally separate SMA tracts is important to improve planning prior to neurosurgery. Using fMRI and probabilistic DTI techniques, we assessed the connectivity between the frontal language area (Broca's area) and the rostral pre-SMA (language SMA) and caudal SMA proper (motor SMA). Twenty brain tumor patients completed motor and language fMRI paradigms and DTI. Peaks of functional activity in the language SMA, motor SMA and Broca's area were used to define seed regions for probabilistic tractography. fMRI and probabilistic tractography identified separate and unique pathways connecting the SMA to Broca's area - the language SMA pathway and the motor SMA pathway. For all subjects, the language SMA pathway had a larger number of voxels (PProbabilistic tractography can identify unique white matter tracts that connect language SMA and motor SMA to Broca's area. The language SMA is more significantly connected to Broca's area than is the motor subdivision of the SMA proper. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  19. The design, hysteresis modeling and control of a novel SMA-fishing-line actuator

    Science.gov (United States)

    Xiang, Chaoqun; Yang, Hui; Sun, Zhiyong; Xue, Bangcan; Hao, Lina; Asadur Rahoman, M. D.; Davis, Steve

    2017-03-01

    Fishing line can be combined with shape memory alloy (SMA) to form novel artificial muscle actuators which have low cost, are lightweight and soft. They can be applied in bionic, wearable and rehabilitation robots, and can reduce system weight and cost, increase power-to-weight ratio and offer safer physical human-robot interaction. However, these actuators possess several disadvantages, for example fishing line based actuators possess low strength and are complex to drive, and SMA possesses a low percentage contraction and has high hysteresis. This paper presents a novel artificial actuator (known as an SMA-fishing-line) made of fishing line and SMA twisted then coiled together, which can be driven directly by an electrical voltage. Its output force can reach 2.65 N at 7.4 V drive voltage, and the percentage contraction at 4 V driven voltage with a 3 N load is 7.53%. An antagonistic bionic joint driven by the novel SMA-fishing-line actuators is presented, and based on an extended unparallel Prandtl-Ishlinskii (EUPI) model, its hysteresis behavior is established, and the error ratio of the EUPI model is determined to be 6.3%. A Joule heat model of the SMA-fishing-line is also presented, and the maximum error of the established model is 0.510 mm. Based on this accurate hysteresis model, a composite PID controller consisting of PID and an integral inverse (I-I) compensator is proposed and its performance is compared with a traditional PID controller through simulations and experimentation. These results show that the composite PID controller possesses higher control precision than basic PID, and is feasible for implementation in an SMA-fishing-line driven antagonistic bionic joint.

  20. Aortic Dissection Type A in Alpine Skiers

    Directory of Open Access Journals (Sweden)

    Thomas Schachner

    2013-01-01

    Full Text Available Patients and Methods. 140 patients with aortic dissection type A were admitted for cardiac surgery. Seventy-seven patients experienced their dissection in the winter season (from November to April. We analyzed cases of ascending aortic dissection associated with alpine skiing. Results. In 17 patients we found skiing-related aortic dissections. Skiers were taller (180 (172–200 cm versus 175 (157–191 cm, and heavier (90 (68–125 kg versus 80 (45–110 kg, than nonskiers. An extension of aortic dissection into the aortic arch, the descending thoracic aorta, and the abdominal aorta was found in 91%, 74%, and 69%, respectively, with no significant difference between skiers and nonskiers. Skiers experienced RCA ostium dissection requiring CABG in 17.6% while this was true for 5% of nonskiers (. Hospital mortality of skiers was 6% versus 13% in nonskiers (. The skiers live at an altitude of 170 (0–853 m.a.s.l. and experience their dissection at 1602 (1185–3105; m.a.s.l. In 82% symptom start was during recreational skiing without any trauma. Conclusion. Skiing associated aortic dissection type A is usually nontraumatic. The persons affected live at low altitudes and practice an outdoor sport at unusual high altitude at cold temperatures. Postoperative outcome is good.

  1. Aortic Dissection Type A in Alpine Skiers

    Science.gov (United States)

    Schachner, Thomas; Fischler, Nikolaus; Dumfarth, Julia; Bonaros, Nikolaos; Krapf, Christoph; Schobersberger, Wolfgang; Grimm, Michael

    2013-01-01

    Patients and Methods. 140 patients with aortic dissection type A were admitted for cardiac surgery. Seventy-seven patients experienced their dissection in the winter season (from November to April). We analyzed cases of ascending aortic dissection associated with alpine skiing. Results. In 17 patients we found skiing-related aortic dissections. Skiers were taller (180 (172–200) cm versus 175 (157–191) cm, P = 0.008) and heavier (90 (68–125) kg versus 80 (45–110) kg, P = 0.002) than nonskiers. An extension of aortic dissection into the aortic arch, the descending thoracic aorta, and the abdominal aorta was found in 91%, 74%, and 69%, respectively, with no significant difference between skiers and nonskiers. Skiers experienced RCA ostium dissection requiring CABG in 17.6% while this was true for 5% of nonskiers (P = 0.086). Hospital mortality of skiers was 6% versus 13% in nonskiers (P = 0.399). The skiers live at an altitude of 170 (0–853) m.a.s.l. and experience their dissection at 1602 (1185–3105; P < 0.001) m.a.s.l. In 82% symptom start was during recreational skiing without any trauma. Conclusion. Skiing associated aortic dissection type A is usually nontraumatic. The persons affected live at low altitudes and practice an outdoor sport at unusual high altitude at cold temperatures. Postoperative outcome is good. PMID:23971024

  2. Quick Dissection of the Segmental Bronchi

    Science.gov (United States)

    Nakajima, Yuji

    2010-01-01

    Knowledge of the three-dimensional anatomy of the bronchopulmonary segments is essential for respiratory medicine. This report describes a quick guide for dissecting the segmental bronchi in formaldehyde-fixed human material. All segmental bronchi are easy to dissect, and thus, this exercise will help medical students to better understand the…

  3. Medical Students' Attitudinal Changes towards Cadaver Dissection ...

    African Journals Online (AJOL)

    Smell of the cadaver and eye irritation as a result of the chemicals in it were the major aspects identified as making the dissecting room stressful. The result also showed that almost all (99%) considered cadaver dissection had very important educational value for anatomy learning. Conclusion: In the majority of the students ...

  4. Nodal yield in selective neck dissection

    DEFF Research Database (Denmark)

    Norling, Rikke; Therkildsen, Marianne H; Bradley, Patrick J

    2013-01-01

    The total lymph node yield in neck dissection is highly variable and depends on anatomical, surgical and pathological parameters. A minimum yield of six lymph nodes for a selective neck dissection (SND) as recommended in guidelines lies in the lower range of the reported clinical nodal yields...

  5. Postoperative hypertension following radical neck dissection

    Directory of Open Access Journals (Sweden)

    Smita Prakash

    2012-01-01

    Full Text Available Baroreflex failure results in wide excursions of blood pressure and heart rate. We report two cases that developed severe postoperative hypertension after radical neck dissection. Carotid sinus denervation during neck dissection may be the cause of the reflex hypertension once general anesthesia-induced vasodilatation has ended.

  6. Beyond Dissection: Innovative Tools for Biology Education.

    Science.gov (United States)

    Larson, Sandra, Ed.

    This catalog lists resources available for classroom use in teaching about anatomy and physiology which are alternatives to dissection. The entries are provided under three main categories: (1) Whole Animal Dissection/Vivisection; (2) Animal Organ or System Anatomy and Physiology; and (3) Other, including animal behavior, biotechnology,…

  7. Spontaneous Esophageal Injury: Esophageal Intramural Hematoma

    Directory of Open Access Journals (Sweden)

    Yu-Hui Chiu

    2009-09-01

    Full Text Available Acute chest pain can indicate a life-threatening condition and it is important for physicians to diagnose and treat it as a matter of urgency. We report 1 rare case of esophageal intramural hematoma (IMH that presented with chest pain at the emergency department and which was initially clinically suspected to be due to aortic dissection. The case was diagnosed preoperatively by multidetector computed tomography. Esophageal IMH may represent an intermediate stage between Mallory-Weiss tear (mucosal and Boerhaave's syndrome (transmural. Multidetector computed tomography is a useful noninvasive imaging modality for accurate diagnosis of these spontaneous intramural and transmural ruptures of the esophagus, and aids in the differential diagnosis of aortic and other mediastinal diseases with acute chest pain.

  8. Quality of life after planned neck dissection

    International Nuclear Information System (INIS)

    Iwae, Shigemichi; Hirayama, Yuji; Komatsu, Hirokazu

    2009-01-01

    We evaluated the effect of planned neck dissection (PND) after concurrent chemoradiotherapy (CCRT) on quality of life (QOL) by using a self-administered neck dissection questionnaire and an arm abduction test. Subjects are fourteen patients who had undergone CCRT followed by planned selective neck dissection for the treatment of mesopharyngeal and hypopharyngeal cancer. The findings of the survey were compared with thirty-two patients who had undergone CCRT alone. Patients without PND had better scores on measures of pain, constriction, numbness and appearance of the neck, but had no advantage about arm abduction. After PND, the patients who had dissected dominant hand side had lower satisfaction compared with those who had dissected non-dominant hand side. (author)

  9. Decreased Motor Neuron Support by SMA Astrocytes due to Diminished MCP1 Secretion.

    Science.gov (United States)

    Martin, Jasmin E; Nguyen, TrangKimberly T; Grunseich, Christopher; Nofziger, Jonathan H; Lee, Philip R; Fields, Douglas; Fischbeck, Kenneth H; Foran, Emily

    2017-05-24

    Spinal muscular atrophy (SMA) is an autosomal-recessive disorder characterized by severe, often fatal muscle weakness due to loss of motor neurons. SMA patients have deletions and other mutations of the survival of motor neuron 1 ( SMN1 ) gene, resulting in decreased SMN protein. Astrocytes are the primary support cells of the CNS and are responsible for glutamate clearance, metabolic support, response to injury, and regulation of signal transmission. Astrocytes have been implicated in SMA as in in other neurodegenerative disorders. Astrocyte-specific rescue of SMN protein levels has been shown to mitigate disease manifestations in mice. However, the mechanism by which SMN deficiency in astrocytes may contribute to SMA is unclear and what aspect of astrocyte activity is lacking is unknown. Therefore, it is worthwhile to identify defects in SMN-deficient astrocytes that compromise normal function. We show here that SMA astrocyte cultures derived from mouse spinal cord of both sexes are deficient in supporting both WT and SMN-deficient motor neurons derived from male, female, and mixed-sex sources and that this deficiency may be mitigated with secreted factors. In particular, SMN-deficient astrocytes have decreased levels of monocyte chemoactive protein 1 (MCP1) secretion compared with controls and MCP1 restoration stimulates outgrowth of neurites from cultured motor neurons. Correction of MCP1 deficiency may thus be a new therapeutic approach to SMA. SIGNIFICANCE STATEMENT Spinal muscular atrophy (SMA) is caused by the loss of motor neurons, but astrocyte dysfunction also contributes to the disease in mouse models. Monocyte chemoactive protein 1 (MCP1) has been shown to be neuroprotective and is released by astrocytes. Here, we report that MCP1 levels are decreased in SMA mice and that replacement of deficient MCP1 increases differentiation and neurite length of WT and SMN-deficient motor-neuron-like cells in cell culture. This study reveals a novel aspect of

  10. An improved tuned mass damper (SMA-TMD) assisted by a shape memory alloy spring

    International Nuclear Information System (INIS)

    Mishra, Sudib K; Gur, Sourav; Chakraborty, Subrata

    2013-01-01

    The tuned mass damper (TMD) is a well acclaimed passive control device for vibration control of structures. However, the requirement of a higher mass ratio restricts its applicability for seismic vibration control of civil engineering structures. Improving the performance of TMDs has been attempted by supplementing them with nonlinear restoring devices. In this regard, the ability of shape memory alloy (SMA) in dissipating energy through a hysteretic phase transformation of its microstructure triggered by cyclic loading is notable. An improved version of TMD assisted by a nonlinear shape memory alloy (SMA) spring, referred as SMA-TMD, is studied here for seismic vibration mitigation. Extensive numerical simulations are conducted based on nonlinear random vibration analysis via stochastic linearization of the nonlinear force–deformation hysteresis of the SMA. A design optimization based on minimizing the root mean square displacement of the main structure is also carried out to postulate the optimal design parameters for the proposed system. The viability of the optimal design is verified with respect to its performance under recorded earthquake motions. Significant improvements of the control efficiency and a reduction of the TMD displacement at a much reduced mass ratio are shown to be achieved in the proposed SMA-TMD over those in the linear TMD. (paper)

  11. PEMBELAJARAN THINK-PAIR-SHARE, KETERAMPILAN METAKOGNITIF, DAN HASIL BELAJAR KOGNITIF SISWA SMA

    Directory of Open Access Journals (Sweden)

    Sri Amnah S.

    2012-05-01

    Full Text Available Abstract: Think-Pair-Share Learning, Meta-cognitive Skills and Cognitive Learning Outcomes. The study investigates the effects of meta-cognitive skills based Think-Pair-Share cooperative learning on meta-cognitive skills and cognitive learning outcomes of 11th grade students of Senior High Schools in Pekanbaru. The sample consists of 11th grade students of SMA 9 as an experiment group and 11th grade students SMA 10 as a control group. Based on analyzing the data using ANCOVA, the results show that there is a signifi­cant difference in meta-cognitive skills and cognitive learning outcomes of the students in the experimental and the control groups, and there is no significant difference between students who have high and low academic levels in their meta-cognitive skills and cognitive learning outcomes. Abstrak: Pembelajaran Think-Pair-Share, Keterampilan Metakognitif, dan Hasil Belajar Kognitif Siswa SMA. Penelitian ini bertujuan mengukur pengaruh pembela­jaran koperatif Think-Pair-Share terha­dap keterampilan metakognitif dan hasil belajar kognitif siswa SMA. Sampel dipilih secara acak dari popu­lasi 13 SMA di Pekanbaru. Dengan menggunakan ANAKOVA, hasilnya menunjukkan bahwa terdapat per­bedaan yang nyata keterampilan metakognitif dan hasil belajar kognitif siswa di kelompok eksperimental dan kelompok control, dan tidak ada perbedaan yang nyata antara siswa berkemampuan akademik tinggi dan akademik rendah pada keterampilan metakognitif dan hasil belajar kognitifnya.

  12. Prestressing effect of cold-drawn short NiTi SMA fibres in steel reinforced mortar beams

    Science.gov (United States)

    Choi, Eunsoo; Kim, Dong Joo; Hwang, Jin-Ha; Kim, Woo Jin

    2016-08-01

    This study investigated the prestressing effect of cold-drawn short NiTi shape memory alloy (SMA) fibres in steel reinforced mortar beams. The SMA fibres were mixed with 1.5% volume content in a mortar matrix with the compressive strength of 50 MPa. The SMA fibres had an average length of 34 mm, and they were manufactured with a dog-bone shape: the diameters of the end- and middle-parts were 1.024 and 1.0 mm, respectively. Twenty mortar beams with the dimensions of 40 mm × 40 mm × 160 mm (B × H × L) were prepared. Two types of tests were conducted. One was to investigate the prestressing effect of the SMA fibres, and the beams with the SMA fibres were heated at the bottom. The other was to assess the bending behaviour of the beams prestressed by the SMA fibres. The SMA fibres induced upward deflection and cracking at the top surface by heating at the bottom; thus, they achieved an obvious prestressing effect. The beams that were prestressed by the SMA fibres did not show a significant difference in bending behaviour from that of the SMA fibre reinforced beams that were not subjected to heating. Stress analysis of the beams indicated that the prestressing effect decreased in relation to the cooling temperature.

  13. Perceptions of cadaveric dissection in anatomy teaching.

    Science.gov (United States)

    Naz, Saima; Nazir, Ghazala; Iram, Samia; Mohammad, Malik; Umair; Qari, Iftikhar Hussain; Mohammad, Shaheen

    2011-01-01

    Anatomy professors world over are lamenting about medical students' lack of interest in dissections and its diminishing utilisation in medical studies. The objective of our study was to find out the reasons why some of the Pakistani medical students were avoiding dissections. We conducted this study in 5 medical colleges of Pakistan from Dec 2010-Oct 2011. Questionnaires were prepared and administered to more than 500 Pakistani medical students, at least 6 months after their first cadaver dissecting session. Mostly 1st and 2nd year medical students participated in this study. Around 43% students have actually performed dissections in some form, whereas around 57% had never touched the cadaver. Further evaluation of these results revealed that out of 57% of students, 45% avoided dissection due to bad smell of formaldehyde, 37% due to moral/ethical grounds, 22% due to low motivation and respect of human body, 19.4% due to anxiety, 18.6% due to religious reason, 16% due to fear, asthma and emotional reaction, 9.4% due to toxic chemical, 8.6% due to laziness and 7% due to nightmares. In spite of availability of required number of cadavers in all 5 medical colleges and a clear realisation amongst the students that dissecting cadaver is an effective way of learning anatomy; majority of students were not very keen and had therefore not performed dissection even once.

  14. UPAYA PENINGKATAN KARAKTER SISWA SMA DALAM PERMAINAN BOLA BASKET MELALUI MODEL TPSR

    Directory of Open Access Journals (Sweden)

    Titis Nurina

    2014-04-01

    Full Text Available Pembelajaran pendidikan jasmani dalam model TPSR lebih menekankan pada kondisi siswa dan pendekatannya juga berorientasi kepada aktualisasi diri dan rekonstruksi sosial siswa di dalam pembelajaran permainan bola basket. Penelitian ini bertujuan untuk meningkatkan karakter tanggung jawab, kerja sama, dan percaya diri siswa putri kelas XI IPS 2 SMA Muhammadiyah 3 Yogyakarta dengan model TPSR dalam pembelajaran permainan bola basket. Penelitian ini menggunakan metode penelitian tindakan kelas yang dilaksanakan dalam dua siklus. Subjek dalam penelitian adalah seluruh siswa putri kelas XI IPS 2 SMA Muhammadiyah 3 yang berjumlah sembilan siswa. Analisis data menggunakan analisis diskriptif, kualitatif, dan kuantitatif. Hasil penelitian menunjukkan bahwa model pembelajaran TPSR dapat meningkatkan karakter tanggung jawab dan kerja sama dalam pembel-ajaran permainan bola basket yang berdampak pada kepercayaan diri siswa putri kelas XI IPS 2 SMA Muhammadiyah 3 Yogyakarta yang dapat dilihat dari peningkatan nilai keterampilan psikomotor, kognitif, dan afektif siswa. Kata Kunci: TPSR, karakter, permainan bola basket

  15. Natural Heat-Sinking Control Method for High-Speed Actuation of the SMA

    Directory of Open Access Journals (Sweden)

    Tamio Arai

    2008-11-01

    Full Text Available This paper describes two methodologies for increasing the actuation speed of the shape memory alloy (SMA actuator in ambient environment. The first method involves the implementation of a simple, light-weight heat sink, which consists only of a combination of an outer metal tube with the silicone grease, but able to cool the heated alloy effectively. The second method describes a high current pulse actuation that actuates the alloy fastly using pulses in the milliseconds order. We hypothesize that a fast actuation of the SMA results in small increase in temperature, due to energy transformation from heat energy to the kinetic energy in the SMA. This new heating method revolutionizes the actuation of the alloy for a significantly faster response.

  16. Pengembangan dan Pelaksanaan Kurikulum Pendidikan Agama Pada SMA di Bawah Yayasan Keagamaan

    Directory of Open Access Journals (Sweden)

    Wahab Wahab

    2011-06-01

    Full Text Available The purpose of this study is to investigate the development and the implementationof  religious education curriculum developed by senior high schools  (SMA under religious foundations. This is a case study of SMA Muhammadiyah I Palangkaraya. Research design applied in this study is Stufflebeam’s  CIPP (Context, Input, Process, Product. The results how:1 SMA Muhammadiyah I Palangkaraya develops not only curriculum designed by Ministry  of National Education but also local religious education one (curriculum developed by the foundation of Muhammadiyah; the way the school develops  the curriculum can also be considered as especial because it provides its nonmuslims  students facilities for learning their religious teachings, 2 some supporting factors are the participation of the foundation, the principal, and the school committee in the curriculum implementation, and 3 the obstacle of the curriculum implementation is the absence of a particular place such as laboratory for religious education.

  17. Development of SMA Actuated Morphing Airfoil for Wind Turbine Load Alleviation

    Science.gov (United States)

    Karakalas, A.; Machairas, T.; Solomou, A.; Riziotis, V.; Saravanos, D.

    Wind turbine rotor upscaling has entered a range of rotor diameters where the blade structure cannot sustain the increased aerodynamic loads without novel load alleviation concepts. Research on load alleviation using morphing blade sections is presented. Antagonistic shape memory alloy (SMA) actuators are implemented to deflect the section trailing edge (TE) to target shapes and target time-series relating TE movement with changes in lift coefficient. Challenges encountered by the complex thermomechanical response of morphing section and the enhancement of SMA transient response to achieve frequencies meaningful for aerodynamic load alleviation are addressed. Using a recently developed finite element for SMA actuators [1], actuator configurations are considered for fast cooling and heating cycles. Numerical results quantify the attained ranges of TE angle movement, the moving time period and the developed stresses. Estimations of the attained variations of lift coefficient vs. time are also presented to assess the performance of the morphing section.

  18. PENGEMBANGAN MEDIA PEMBELAJARAN PENDIDIKAN JASMANI OLAHRAGA DAN KESEHATAN BERBASIS KOMPUTER UNTUK SMA

    Directory of Open Access Journals (Sweden)

    Suci Cahyati

    2014-04-01

    Full Text Available Penelitian ini bertujuan untuk menghasilkan produk berupa CD pembelajaran pendidikan jasmani olahraga dan kesehatan berbasis komputer untuk SMA yang valid dan efektif. Penelitian ini menggunakan metode Research and Development (R&D. Media yang dikembangkan memuat materi tentang HIV/AIDS. Pengembangan media pembelajaran ini menggunakan software Adobe Flash Cs3 Professional. Media yang telah dikembangkan melalui dua tahap penelitiannya itu validasi ahli dan uji coba lapangan. Berdasarkan validasi ahli dan uji coba lapangan hasil penelitian menunjukkan produk termasuk kriteria “Sangat baik” dengan rerata skor 4,25. Hasil tes siswa mengalami peningkatan dari rerata skor pretest 5,53 dan rerata skor posttest 7,56. Berdasarkan hasil tes tersebut dapat disimpulkan bahwa media pembelajaran pendidikan jasmani olahraga dan kesehatan efektif digunakan dalam pembelajaran di SMA. Kata kunci: Pengembangan media, penjasorkes, SMA

  19. Nonlinear Dynamic Characteristics and Optimal Control of SMA Composite Wings Subjected to Stochastic Excitation

    Directory of Open Access Journals (Sweden)

    Zhi-Wen Zhu

    2015-01-01

    Full Text Available A kind of high-aspect-ratio shape memory alloy (SMA composite wing is proposed to reduce the wing’s fluttering. The nonlinear dynamic characteristics and optimal control of the SMA composite wings subjected to in-plane stochastic excitation are investigated where the great bending under the flight loads is considered. The stochastic stability of the system is analyzed, and the system’s response is obtained. The conditions of stochastic Hopf bifurcation are determined, and the probability density of the first-passage time is obtained. Finally, the optimal control strategy is proposed. Numerical simulation shows that the stability of the system varies with bifurcation parameters, and stochastic Hopf bifurcation appears in the process; the reliability of the system is improved through optimal control, and the first-passage time is delayed. Finally, the effects of the control strategy are proved by experiments. The results of this paper are helpful for engineering applications of SMA.

  20. Pemodelan Enterprise Architecture Sistem Informasi Akademik SMA PL Don Bosko Semarang Dengan Framework Zachman

    Directory of Open Access Journals (Sweden)

    Maria Alfonsa Chintia Dea Prananingrum

    2017-05-01

    Full Text Available Abstrak SMA PL Don Bosko Semarang belum dapat memanfaatkan teknologi komputer secara optimal karena masih menggunakan cara manual dalam pengelolaan berbagai macam data akademik sehingga memberikan masalah seperti lambatnya dalam pembuatan laporan yang menyulitkan kepala sekolah dalam pengambilan keputusan. Oleh sebab itu, SMA PL Don Bosko Semarang membutuhkan Sistem Informasi Akademik untuk memberikan kemudahan dalam mengelola berbagai macam data akademik secara terintegrasi serta memberikan layanan yang lebih baik kepada siswanya. Sebuah model architecture enterprise Sistem Informasi Akademik dibutuhkan agar meminimalisir kegagalan ketika menerapkan sistem tersebut sekaligus dapat berjalan sesuai kebutuhan di SMA PL Don Bosko Semarang. Metode analisis dalam penelitian ini menggunakan Framework Zachman yang memberikan pondasi dalam membantu menyediakan struktur dasar organisasi sehingga dapat mendukung perancangan dan pengembangan sistem informasi suatu organisasi. Hasil dari penelitian ini berupa blueprint (cetak biru pemodelan Sistem Informasi Akademik. Kata kunci— sistem informasi akademik, architecture enterprise, framework zachman, bluprint

  1. PENGEMBANGAN CD PEMBELAJARAN INTERAKTIF KIMIA SMA BERBASIS INTERTEKSTUALITAS SEBAGAI ALTERNATIF MODEL PEMBELAJARAN

    Directory of Open Access Journals (Sweden)

    Mr Sjaeful Anwar

    2011-10-01

    Full Text Available Studi aplikasi model pembelajaran intertekstual menggunakan CD pembelajaran telah dilakukan di 3 SMA, yaitu SMA A, SMA B dan SMA C selama bulan Mei 2010. Pemilihan tiga sekolah ini diharapkan dapat mewakili sekolah dengan kualitas rendah sampai kualitas tinggi. Selama proses ujicoba pembelajaran berlangsung, siswa dapat mengikuti secara aktif dengan memberikan respon yang baik. Dari tampilan-tampilan yang diberikan, siswa bisa memahami konsep-konsep pada materi hidrolisis garam dengan baik meskipun terkadang tampilan tersebut harus diberikan secara bolak-balik untuk dapat mempertautkan ketiga level representasi. Secara umum, siswa merespon dengan baik terhadap implementasi strategi pembelajaran intertekstual ini karena merasa tertarik dengan proses pembelajaran yang dilakukan dan memudahkan untuk memahami konsep-konsep yang diberikan secara sistematis dan selalu menghubungkan dengan konsep-konsep yang sudah dipelajari. Tanggapan guru terhadap implementasi strategi pembelajaran intertekstual ini memberikan pandangan yang positif, hal tersebut dikarenakan dengan proses pembelajaran yang dilakukan dapat memudahkan guru untuk menyampaikan materi hidrolisis garam yang disusun secara sistematis melalui pertautan ketiga level representasi dan dikemas dalam bentuk multimedia sehingga konsep-konsep yang disampaikan dapat diterima oleh siswa dengan utuh dan mudah. Aplikasi model pembelajaran intertekstual pada materi hidrolisis garam ternyata mampu meningkatkan penguasaan konsep-konsep pada materi tersebut. Peningkatan penguasaan konsep siswa terhadap materi hidrolisis garam diperoleh berdasarkan perhitungan nilai N-gain, secara keseluruhan diperoleh nilai N-gain sebesar 0,67 yang berarti implementasi strategi pembelajaran intertekstual pada materi hidrolisis garam ini dapat meningkatkan penguasaan konsep dengan kriteria tinggi. Hal ini didukung juga data model mental siswa untuk proses pelarutan berbagai garam. Model ini ternyata juga dapat meningkatkan

  2. Constitutive modeling of SMA SMP multifunctional high performance smart adaptive shape memory composite

    International Nuclear Information System (INIS)

    Jarali, Chetan S; Raja, S; Upadhya, A R

    2010-01-01

    Materials design involving the thermomechanical constitutive modeling of shape memory alloy (SMA) and shape memory polymer (SMP) composites is a key topic in the development of smart adaptive shape memory composites (SASMC). In this work, a constitutive model for SASMC is developed. First, a one-dimensional SMA model, which can simulate the pseudoelastic (PE) and shape memory effects (SME) is presented. Subsequently, a one-dimensional SMP model able to reproduce the SME is addressed. Both SMA and SMP models are based on a single internal state variable, namely the martensite fraction and the frozen fraction, which can be expressed as a function of temperature. A consistent form of the analytical solution for the SMP model is obtained using the fourth-order Runge–Kutta method. Finally, the SASMC constitutive model is proposed, following two analytical homogenization approaches. One approach is based on an equivalent inclusion method and the other approach is the rule of mixtures. The SMA and SMP constitutive models are validated independently with experimental results. However, the validation of the composite model is performed using the two homogenization approaches and a close agreement in results is observed. Results regarding the isothermal and thermomechanical stress–strain responses are analyzed as a function of SMA volume fraction. Further, it is concluded that the proposed composite model is able to reproduce consistently the overall composite response by taking into consideration not only the phase transformations, variable modulus and transformation stresses in SMA but also the variable modulus, the evolution of stored strain and thermal strain in the SMP

  3. Simulación basada en SMA de sistemas originalmente representados con EDO

    OpenAIRE

    Ekaitz Zulueta Guerrero; Asier Gonzáez Gonzáez; Jose Manuel Lopez-Guede; Isidro Calvo Gordillo

    2011-01-01

    [ES] En este trabajo se expone una metodología para modelar un sistema Multi-Agente (SMA), para que sea equivalente a un sistema de Ecuaciones Diferenciales Ordinarias (EDO), mediante un esquema basado en el método de Monte Carlo. Se muestra que el SMA puede describir con mayor riqueza modelos de sistemas dinámicos con variables cuantificadas discretas. Estos sistemas son muy acordes con los sistemas biológicos y fisiológicos, como el modelado de poblaciones o el modelado de enfermedades epid...

  4. MENINGKATKAN KEMAMPUAN BERPIKIR KREATIF MATEMATIS SISWA SMA MELALUI PEMBELAJARAN OPEN ENDED PADA MATERI SPLDV

    Directory of Open Access Journals (Sweden)

    Firdaus Firdaus

    2016-02-01

    Penelitian ini bertujuan untuk mendeskripsikan kemampuan berpikir kreatif matematis siswa SMA melalui pembelajaran open ended problem materi SPLDV. Jenis penelitian ini, yaitu deskriptif kualitatif. Subjeknya adalah siswa kelas X.2 SMA Negeri 1 Woja Dompu. Tahap pembelajaran dalam penelitian ini adalah (1 Orientasi, (2 pembekalan materi, (3 penyajian dan pengerjaan soal open ended, (4 presentasi, (5 kesimpulan. Kemampuan berpikir kreatif matematis siswa meliputi: (a fluency, kemampuan siswa lancar dalam memberikan jawaban benar, (b flexibility, kemampuan siswa dalam menggunakan berbagai cara penyelesaian masalah, (c novelty, kemampuan siswa dalam memberikan jawaban yang baru dan berbeda dengan siswa lain. Penelitian ini hasilnya, bahwa siswa mempunyai kemampuan berpikir kreatif matematis.

  5. Spontaneous Atraumatic Mediastinal Hemorrhage

    Directory of Open Access Journals (Sweden)

    Morkos Iskander BSc, BMBS, MRCS, PGCertMedEd

    2013-04-01

    Full Text Available Spontaneous atraumatic mediastinal hematomas are rare. We present a case of a previously fit and well middle-aged lady who presented with acute breathlessness and an increasing neck swelling and spontaneous neck bruising. On plain chest radiograph, widening of the mediastinum was noted. The bruising was later confirmed to be secondary to mediastinal hematoma. This life-threatening diagnostic conundrum was managed conservatively with a multidisciplinary team approach involving upper gastrointestinal and thoracic surgeons, gastroenterologists, radiologists, intensivists, and hematologists along with a variety of diagnostic modalities. A review of literature is also presented to help surgeons manage such challenging and complicated cases.

  6. Animal Rights Groups Target High School Dissection.

    Science.gov (United States)

    Trotter, Andrew

    1992-01-01

    Two groups leading the charge against dissection are People for the Ethical Treatment of Animals (PETA) and the Student Action Corps for Animals (SACA). Protests by student and community members remain the movement's strongest weapon. (MLF)

  7. Dissecting aortic aneurysm in maintenance hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Ounissi M

    2009-01-01

    Full Text Available The dissecting aortic aneurysm (DAA is a rare pathology that may result in fatal outcome. We report follow up of three cases of DAA patients undergoing maintenance hemo-dialysis who were managed conservatively.

  8. CT diagnosis of acute aortic dissection

    International Nuclear Information System (INIS)

    Ogawa, Noriko; Kobayashi, Takeshi

    1989-01-01

    Sixteen (47.5%) of 35 patients with acute aortic dissection showed a non-opacified crescent in the aorta on an initial contrast CT. Seven of these 16 patients underwent cineangiography soon after the initial CT, and in all 7 patients, neither an intimal tear nor an intimal flap was obtained. All but one of above 16 patients were followed by CT. Mean duration of follow-up was 9.6 months. In 10 of 15 patients with non-opacified false lumen, the false lumen remained non-opacified until the last examination. Moreover, in 6 of these 10 patients, the false lumen shrunk, and in the other 3, it disappeared completely on follow-up CT. On the other hand, in remaining 5 of these 15 patients who were initially diagnosed to have non-opacified false lumen, the false lumen became opacified and enlarged in size on follow-up CT performed in the first 14 weeks. Moreover, in 4 of these 5 patients, the false lumen became opacified in the only first 6 weeks. No matter how intensive care should be paid at least for the first 6 weeks, it seems that patients with aortic dissection which have non-opacified false lumen had good prognosis in comparison to patients with ordinary aortic dissections which have opacified false lumen. We believe aortic dissection with non-opacified false lumen may consist of two type of aortic dissection, one has no intimal tear, the other has some intimal tears and a thrombosed false lumen. In conclusion, CT is the most useful modality in diagnosing acute aortic dissection. The reasons are the incidence of acute aortic dissection with non-opacified false lumen was high, patients with non-opacified false lumen had good prognosis, and it was difficult to diagnose aortic dissection with non-opacified false lumen by conventional cineangiography and/or DSA. (author)

  9. Visualizing Science Dissections in 3D: Contextualizing Student Responses to Multidimensional Learning Materials in Science Dissections

    Science.gov (United States)

    Walker, Robin Annette

    A series of dissection tasks was developed in this mixed-methods study of student self-explanations of their learning using actual and virtual multidimensional science dissections and visuo-spatial instruction. Thirty-five seventh-grade students from a science classroom (N = 20 Female/15 Male, Age =13 years) were assigned to three dissection environments instructing them to: (a) construct static paper designs of frogs, (b) perform active dissections with formaldehyde specimens, and (c) engage with interactive 3D frog visualizations and virtual simulations. This multi-methods analysis of student engagement with anchored dissection materials found learning gains on labeling exercises and lab assessments among most students. Data revealed that students who correctly utilized multimedia text and diagrams, individually and collaboratively, manipulated 3D tools more effectively and were better able to self-explain and complete their dissection work. Student questionnaire responses corroborated that they preferred learning how to dissect a frog using 3D multimedia instruction. The data were used to discuss the impact of 3D technologies, programs, and activities on student learning, spatial reasoning, and their interest in science. Implications were drawn regarding how to best integrate 3D visualizations into science curricula as innovative learning options for students, as instructional alternatives for teachers, and as mandated dissection choices for those who object to physical dissections in schools.

  10. Neurofunctionally dissecting the reading system in children.

    Science.gov (United States)

    Liebig, Johanna; Froehlich, Eva; Morawetz, Carmen; Braun, Mario; Jacobs, Arthur M; Heekeren, Hauke R; Ziegler, Johannes C

    2017-10-01

    The reading system can be broken down into four basic subcomponents in charge of prelexical, orthographic, phonological, and lexico-semantic processes. These processes need to jointly work together to become a fluent and efficient reader. Using functional magnetic resonance imaging (fMRI), we systematically analyzed differences in neural activation patterns of these four basic subcomponents in children (N=41, 9-13 years) using tasks specifically tapping each component (letter identification, orthographic decision, phonological decision, and semantic categorization). Regions of interest (ROI) were selected based on a meta-analysis of child reading and included the left ventral occipito-temporal cortex (vOT), left posterior parietal cortex (PPC), left inferior frontal gyrus (IFG), and bilateral supplementary motor area (SMA). Compared to a visual baseline task, enhanced activation in vOT and IFG was observed for all tasks with very little differences between tasks. Activity in the dorsal PPC system was confined to prelexical and phonological processing. Activity in the SMA was found in orthographic, phonological, and lexico-semantic tasks. Our results are consistent with the idea of an early engagement of the vOT accompanied by executive control functions in the frontal system, including the bilateral SMA. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. Spontaneous Appendicocutaneous Fistula I

    African Journals Online (AJOL)

    M T0k0de* MB, BS and. Dr 0. A. AWOj0bi+ FMCS (Nig). ABSTRACT. Ruptured appendicitis is not a common cause of spontaneous enterocutaneous fistula. A case of ruptured retrocaecal appendicitis presenting as an enterocutaneous fistula in a Nigerian woman is presented. The literature on this disorder is also reviewed.

  12. [Spontaneous bacterial peritonitis].

    Science.gov (United States)

    Strauss, Edna; Caly, Wanda Regina

    2003-01-01

    Spontaneous bacterial peritonitis occurs in 30% of patients with ascites due to cirrhosis leading to high morbidity and mortality rates. The pathogenesis of spontaneous bacterial peritonitis is related to altered host defenses observed in end-stage liver disease, overgrowth of microorganisms, and bacterial translocation from the intestinal lumen to mesenteric lymph nodes. Clinical manifestations vary from severe to slight or absent, demanding analysis of the ascitic fluid. The diagnosis is confirmed by a number of neutrophils over 250/mm3 associated or not to bacterial growth in culture of an ascites sample. Enterobacteriae prevail and Escherichia coli has been the most frequent bacterium reported. Mortality rates decreased markedly in the last two decades due to early diagnosis and prompt antibiotic treatment. Third generation intravenous cephalosporins are effective in 70% to 95% of the cases. Recurrence of spontaneous bacterial peritonitis is common and can be prevented by the continuous use of oral norfloxacin. The development of bacterial resistance demands the search for new options in the prophylaxis of spontaneous bacterial peritonitis; probiotics are a promising new approach, but deserve further evaluation. Short-term antibiotic prophylaxis is recommended for patients with cirrhosis and ascites shortly after an acute episode of gastrointestinal bleeding.

  13. Spontaneous Grammar Explanations.

    Science.gov (United States)

    Tjoo, Hong Sing; Lewis, Marilyn

    1998-01-01

    Describes one New Zealand university language teacher's reflection on her own grammar explanations to university-level students of Bahasa Indonesian. Examines form-focused instruction through the teacher's spontaneous answers to students' questions about the form of the language they are studying. The teacher's experiences show that it takes time…

  14. EDITORIAL SPONTANEOUS BACTERIAL PERITONITIS ...

    African Journals Online (AJOL)

    hi-tech

    Spontaneous bacterial peritonitis (SBP) frequent]y occurs in patients with liver cirrhosis and ascites. It is defined as an infection of previously sterile ascitic fluid without any demonstrable intrabdominal source of infection. It is now internationally agreed that a polymorphonuclear (PMN) cell count in the ascitic fluid of over 250 ...

  15. Spontaneous dimensional reduction?

    Science.gov (United States)

    Carlip, Steven

    2012-10-01

    Over the past few years, evidence has begun to accumulate suggesting that spacetime may undergo a "spontaneous dimensional reduction" to two dimensions near the Planck scale. I review some of this evidence, and discuss the (still very speculative) proposal that the underlying mechanism may be related to short-distance focusing of light rays by quantum fluctuations.

  16. Recurrent post-partum coronary artery dissection

    Directory of Open Access Journals (Sweden)

    Resnic Frederic S

    2010-10-01

    Full Text Available Abstract Coronary artery dissection is a rare but well-described cause for myocardial infarction during the post-partum period. Dissection of multiple coronary arteries is even less frequent. Here we present a case of recurrent post-partum coronary artery dissections. This unusual presentation poses unique problems for management. A 35 year-old female, gravida 3 para 2, presented with myocardial infarction 9 weeks and 3 days post-partum. Cardiac catheterization demonstrated left anterior descending (LAD dissection but an otherwise normal coronary anatomy. The lesion was treated with four everolimus eluting stents. Initially the patient made an unremarkable recovery until ventricular fibrillation arrest occurred on the following day. Unsynchronized cardioversion restored a normal sinus rhythm and repeat catheterization revealed new right coronary artery (RCA dissection. A wire was passed distally, but it was unclear whether this was through the true or false lumen and no stents could be placed. However, improvement of distal RCA perfusion was noted on angiogram. Despite failure of interventional therapy the patient was therefore treated conservatively. Early operation after myocardial infarction has a significantly elevated risk of mortality and the initial dissection had occurred within 24 hours. This strategy proved successful as follow-up transthoracic echocardiography after four months demonstrated a preserved left ventricular ejection fraction of 55-60% without regional wall motion abnormalities. The patient remained asymptomatic from a cardiac point of view.

  17. Magnetic resonance diagnosis of aortic dissection

    International Nuclear Information System (INIS)

    Mukohara, Nobuhiko; Yoshida, Yutaka; Nakamura, Kazuo

    1986-01-01

    Magnetic resonance imaging (MRI) was performed in thirty-one patients with aortic dissection to evaluate its usefulness in diagnosing the site of communicating orifice between the true and false lumens and the presence of retrograde dissection. 1. MRI revealed the site of the entry as a defect in the intimal flap in the images of 12 of 15 patients (80 %). 2. The site of the communicating orifice between the true and false lumens in the abdominal aorta could be determined in six of eight patients (75 %). 3. MRI diagnosis of retrograde dissection was successful in three patients. 4. Cross-sectional analysis of the abdominal aorta based on the location of the true lumen revealed that the celiac and superior mesenteric arteries tended to arise from the true lumen when the latter was situated in the anterior part of the abdominal aorta. The right and left renal arteries arose from the true lumen when it was positioned anterolaterally. In conclusion, MRI was a useful diagnostic method for aortic dissection, especially for determining the site of entry in the thoracic aorta. The changes in signal intensity in the false lumen provided useful information for locating the communicating orifice between the true and false lumens and for diagnosis of retrograde dissection. Cross-sectional analysis of dissection in the abdominal aorta was useful for predicting the branching of the main arteries from the true or false lumen. (author)

  18. Phenotypic and genotypic studies of ALS cases in ALS-SMA families.

    Science.gov (United States)

    Corcia, Philippe; Vourc'h, Patrick; Blasco, Helene; Couratier, Philippe; Dangoumau, Audrey; Bellance, Remi; Desnuelle, Claude; Viader, Fausto; Pautot, Vivien; Millecamps, Stephanie; Bakkouche, Salah; Salachas, FranÇois; Andres, Christian R; Meininger, Vincent; Camu, William

    2018-03-01

    Amyotrophic lateral sclerosis (ALS) and spinal muscular atrophy (SMA) are the most frequent motor neuron disorders in adulthood and infancy, respectively. There is a growing literature supporting common pathophysiological patterns between those disorders. One important clinical issue for that is the co-occurrence of both diseases within a family. To collect families in which ALS and SMA patients co-exist and describe the phenotype and the genotype of ALS patients. Nine families with co-occurrence of SMA and ALS have been gathered over the last 15 years. Epidemiological, phenotype and genetic status were collected. Out of the nine families, six corresponded to the criteria of familial ALS (FALS). Clinical data were available for 11 patients out of the 15 ALS cases. Mean age of onset was 58.5 years, site of onset was lower limbs in nine cases (81.8%), median duration was 22 months. Four ALS patients carried a mutation: three mutations in SOD1 gene (G147N in two cases and one with E121G) and one repeat expansion in the C9ORF72 gene. Three patients had abnormal SMN1 copy numbers. While the high proportion of familial history of ALS cases in these ALS-SMA pedigrees could have suggested that these familial clusters of the two most frequent MND rely on a genetic background, we failed to exclude that this occurred by chance.

  19. Superelastic SMA U-shaped dampers with self-centering functions

    Science.gov (United States)

    Wang, Bin; Zhu, Songye

    2018-05-01

    As high-performance metallic materials, shape memory alloys (SMAs) have been investigated increasingly by the earthquake engineering community in recent years, because of their remarkable self-centering (SC) and energy-dissipating capabilities. This paper systematically presents an experimental study on a novel superelastic SMA U-shaped damper (SMA-UD) with SC function under cyclic loading. The mechanical properties, including strength, SC ability, and energy-dissipating capability with varying loading amplitudes and strain rates are evaluated. Test results show that excellent and stable flag-shaped hysteresis loops are exhibited in multiple loading cycles. Strain rate has a negligible effect on the cyclic behavior of the SMA-UD within the dynamic frequency range of typical interest in earthquake engineering. Furthermore, a numerical investigation is performed to understand the mechanical behavior of the SMA-UD. The numerical model is calibrated against the experimental results with reasonable accuracy. Then, the stress–strain states with different phase transformations are also discussed.

  20. Recovery and residual stress of SMA wires and applications for concrete structures

    International Nuclear Information System (INIS)

    Choi, Eunsoo; Cho, Sung-Chul; Park, Taehyo; Hu, Jong Wan; Chung, Young-Soo

    2010-01-01

    In general, NiTi shape memory alloys are used for applications in civil structures. NiTi SMAs show good superelasticity and shape memory effect properties. However, for application of the shape memory effect, it is desirable for SMAs to show a wide temperature hysteresis, especially for civil structures which are exposed to severe environmental conditions. NiTiNb SMAs, in general, show a wider temperature hysteresis than NiTi SMAs and are more applicable for civil structures. This study examines the temperature hysteresis of NiTiNb and NiTi SMAs, and their recovery and residual stress are investigated. In addition, the tensile behaviors of SMA wires under residual stress are evaluated. This study explains the possible applications for concrete structures with the shape memory effect and illustrates two experimental results of concrete cylinders and reinforced concrete columns. For both tests, SMA wires of NiTiNb and NiTi are used to confine concrete using residual stress. The SMA wire jackets on the concrete cylinders increase the peak strength and the ductility compared to the plain concrete cylinders. In addition, the SMA wire jackets on reinforced concrete columns increase the ductility greatly without flexural strength degradation

  1. PELAKSANAAN PROGRAM BOARDING SCHOOL DALAM PEMBINAAN MORAL SISWA DI SMA TARUNA INDONESIA PALEMBANG

    Directory of Open Access Journals (Sweden)

    Hendriyenti H

    2014-12-01

    Full Text Available AbstractIndonesia nowadays faces some moral issues in teenagers scope or adult scope such as the use of drugs, violence, rascality, abortion, persecution, gambling, prostitution, and so on. Those problems are very danger for the country. Therefore, moral education is very important in this situation. The study was done at SMA Taruna Indonesia Palembang by the tittle: “the Implementation of boarding School Program for Students Moral education at SMA Taruna Indonesia Palembang”.Based on the result of the stuy, it was found that the implementation of boarding school program to educate students’moral at SMA Taruna Indonesia Palembang was applied throug dicipline implementation program and religion education program. Those two programs were applied by preventive and currative treatment. Moreover, there were some factors which support students’ moral education at SMA Taruna Indonesia Palembang such as students motivation, advisors dedication, 24 hours education and guidance, good coordination between advisors, teachers, securities, and other staff, and far location of boarding school from city center. As long as the teenager is an unstable period, there weremany difficulties in educate them. Finally,it is hoped that school stakeholders could improve the school management so that those difficulties could be solved and moral education could be applied.  Keywords: boarding school, morality building

  2. Survival in SMA type I: a prospective analysis of 34 consecutive cases

    NARCIS (Netherlands)

    Cobben, J. M.; Lemmink, H. H.; Snoeck, I.; Barth, P. A.; van der Lee, J. H.; de Visser, M.

    2008-01-01

    Thirty-four children with genetically proven SMA type I (age at onset <6 months, unable to sit during study period) were included in a 3-year prospective cohort study and neurologically followed-up until death or the end of the study. At the end of the study period 31/34 children had died. The

  3. Survival in SMA type I : A prospective analysis of 34 consecutive cases

    NARCIS (Netherlands)

    Cobben, J. M.; Lernmink, H. H.; Snoeck, I.; Barth, P. A.; van der Lee, J. H.; de Visser, M.

    Thirty-four children with genetically proven SMA type I (age at onset <6 months, unable to sit during study period) were included in a 3-year prospective cohort study and neurologically followed-up until death or the end of the study. At the end of the study period 31/34 children had died. The

  4. A PROVISIONAL TRANSCRIPT MAP OF THE SPINAL MUSCULAR-ATROPHY (SMA) CRITICAL REGION

    NARCIS (Netherlands)

    VANDERSTEEGE, G; DRAAIJERS, TG; GROOTSCHOLTEN, PM; OSINGA, J; ANZEVINO, R; VELONA, [No Value; DENDUNNEN, JT; SCHEFFER, H; BRAHE, C; VANOMMEN, GJB; BUYS, CHCM

    1995-01-01

    YACs from the region containing the spinal muscular atrophy (SMA) locus at 5q12 have been used as probes in a direct screening of cDNA libraries to isolate 8 cDNAs, mapped to different YAC fragments. Three clones showed complete identity to the genes for cyclin B1 (CCNB1), the p44 subunit of the

  5. KREATIVITAS GURU BIOLOGI DALAM MEMETAKAN KOMODITAS HAYATI UNGGULAN LOKAL KE DALAM PEMBELAJARAN BIOLOGI SMA

    Directory of Open Access Journals (Sweden)

    Asep Agus Sulaeman

    2015-03-01

    Full Text Available Tujuan penelitian ini adalah untuk mengetahui kreativitas guru Biologi SMA dalam memetakan topik-topik dari berbagai aspek komoditas hayati unggulan lokal melalui penggunaan metode mind map dan mengetahui kemampuan guru dalam memetakan topik-topik komoditas hayati unggulan lokal ke dalam pembelajaran Biologi di SMA. Analisis data kreativitas guru Biologi SMA dilakukan secara deskriptif kuantitatif terhadap mind map dengan menggunakan kriteria sesuai instrumen yang dikembangkan. Adapun analisis data tentang jumlah topik-topik Biologi dan jenis kegiatan pembelajaran berbasis komoditas hayati unggulan lokal dilakukan secara deskriptif kuantatif dan kualitatif. Hasil kajian ini menunjukkan nilai aspek-aspek kreativitas guru Biologi yang tinggi, yaitu kemampuan berpikir asli (91,67, peka terhadap masalah (91,67, kemampuan berpikir lancar (90, kemampuan berpikir luwes (88,33, dan kemampuan berpikir terperinci (86,67. Berdasarkan hasil pemetaan yang dilakukan guru, dapat diidentifikasi 15 topik Biologi SMA yang berkaitan dengan komoditas hayati unggulan lokal di Kabupaten Majalengka. Adapun kegiatan pembelajaran berbasis komoditas hayati unggulan yang diusulkan oleh guru tersebar di masing-masing tingkatan kelas dan semesternya dengan jumlah yang berbeda-beda.

  6. iSmaRT: a toolkit for a comprehensive analysis of small RNA-Seq data.

    Science.gov (United States)

    Panero, Riccardo; Rinaldi, Antonio; Memoli, Domenico; Nassa, Giovanni; Ravo, Maria; Rizzo, Francesca; Tarallo, Roberta; Milanesi, Luciano; Weisz, Alessandro; Giurato, Giorgio

    2017-03-15

    The interest in investigating the biological roles of small non-coding RNAs (sncRNAs) is increasing, due to the pleiotropic effects of these molecules exert in many biological contexts. While several methods and tools are available to study microRNAs (miRNAs), only few focus on novel classes of sncRNAs, in particular PIWI-interacting RNAs (piRNAs). To overcome these limitations, we implemented iSmaRT ( i ntegrative Sm all R NA T ool-kit), an automated pipeline to analyze smallRNA-Seq data. iSmaRT is a collection of bioinformatics tools and own algorithms, interconnected through a Graphical User Interface (GUI). In addition to performing comprehensive analyses on miRNAs, it implements specific computational modules to analyze piRNAs, predicting novel ones and identifying their RNA targets. A smallRNA-Seq dataset generated from brain samples of Huntington's Disease patients was used here to illustrate iSmaRT performances, demonstrating how the pipeline can provide, in a rapid and user friendly way, a comprehensive analysis of different classes of sncRNAs. iSmaRT is freely available on the web at ftp://labmedmolge-1.unisa.it (User: iSmart - Password: password). aweisz@unisa.it or ggiurato@unisa.it. Supplementary data are available at Bioinformatics online. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  7. Stress Relaxation Effects in TiNi SMA During Superelastic Deformation: Experiment and Constitutive Model

    Science.gov (United States)

    Pieczyska, Elżbieta A.; Kowalewski, Zbigniew L.; Dunić, Vladimir Lj.

    2017-12-01

    This paper presents an investigation of thermomechanical effects related to the phenomena of stress relaxation occurring in TiNi SMA subjected to modified program of displacement-controlled tension. The deformation data were taken from testing machine, whereas the temperature changes accompanying the exothermic/endothermic martensite forward/reverse transformation were measured by infrared camera. At the advanced stages of the transformations, the strain was kept constant for a few minutes and the SMA load and temperature were recorded continuously. As a consequence, the stress and temperature changed significantly during the loading stops. A large stress drop, caused by the transformation, was observed during the relaxation stage in both courses of the SMA loading and unloading. Moreover, the non-uniform temperature distribution, reflecting macroscopically inhomogeneous transformation, lapsed while the strain was kept constant, yet restarted at the end of the relaxation stop and developed at the reloading stage. Along with the experimental results, the mechanical and thermal responses induced by the transformation were obtained by 3D coupled thermomechanical numerical analysis, realized in partitioned approach. Latent heat production was correlated with an amount of the martensitic volume fraction. The stress and temperature drops recorded during the experiment were satisfactorily reproduced by the model proposed for the SMA thermomechanical coupling.

  8. Metal muscles and nerves—a self-sensing SMA-actuated hand concept

    Science.gov (United States)

    Simone, F.; Rizzello, G.; Seelecke, S.

    2017-09-01

    Bio-inspired hand-like grippers actuated by Shape Memory Alloy (SMA) wires represent an emerging new technology with potential applications in many different fields, ranging from industrial assembly processes to biomedical systems. The inherently high energy density makes SMAs a natural choice for compact, lightweight, and silent actuator systems capable of producing a high amount of work, such as hand prostheses or robotic systems in industrial human/machine environments. In this work, a concept for a compact and versatile gripping system is developed, in which SMA wires are implemented as antagonistic muscles actuating an artificial hand with three fingers. In order to combine high gripping force with sufficient actuation speed, the muscle implementation pursues a multi-wire concept with several 0.1 mm diameter NiTi wires connected in parallel, in order to increase the surface-to-volume ratio for accelerated cooling. The paper starts with an illustration of the design concept of an individual 3-phalanx-finger, along with kinematic considerations for optimal placement of SMA wires. Three identical fingers are subsequently fabricated via 3D printing and assembled into a hand-like gripper. The maximum displacement of each finger phalanx is measured, and an average phalanxes dynamic responsiveness is evaluated. SMA self-sensing is documented by experiments relating the wires change in resistance to the finger motion. Several finger force measurements are also performed. The versatility of the gripper is finally documented by displaying a variety of achievable grasping configurations.

  9. The Effect of Animal Dissections on Student Acquisition of Knowledge of and Attitudes toward the Animals Dissected.

    Science.gov (United States)

    McCollum, Terry L.

    A conflict exists over the use of animals in the classroom. One aspect of this use involved the dissection of animals. Animal protection advocates report that dissections constitute abuse of the animals dissected. The advocates state that what is learned by dissection could be more effectively learned by other means. Some science educators state…

  10. Full-scale flight tests of aircraft morphing structures using SMA actuators

    Science.gov (United States)

    Mabe, James H.; Calkins, Frederick T.; Ruggeri, Robert T.

    2007-04-01

    In August of 2005 The Boeing Company conducted a full-scale flight test utilizing Shape Memory Alloy (SMA) actuators to morph an engine's fan exhaust to correlate exhaust geometry with jet noise reduction. The test was conducted on a 777-300ER with GE-115B engines. The presence of chevrons, serrated aerodynamic surfaces mounted at the trailing edge of the thrust reverser, have been shown to greatly reduce jet noise by encouraging advantageous mixing of the free, and fan streams. The morphing, or Variable Geometry Chevrons (VGC), utilized compact, light weight, and robust SMA actuators to morph the chevron shape to optimize the noise reduction or meet acoustic test objectives. The VGC system was designed for two modes of operation. The entirely autonomous operation utilized changes in the ambient temperature from take-off to cruise to activate the chevron shape change. It required no internal heaters, wiring, control system, or sensing. By design this provided one tip immersion at the warmer take-off temperatures to reduce community noise and another during the cooler cruise state for more efficient engine operation, i.e. reduced specific fuel consumption. For the flight tests a powered mode was added where internal heaters were used to individually control the VGC temperatures. This enabled us to vary the immersions and test a variety of chevron configurations. The flight test demonstrated the value of SMA actuators to solve a real world aerospace problem, validated that the technology could be safely integrated into the airplane's structure and flight system, and represented a large step forward in the realization of SMA actuators for production applications. In this paper the authors describe the development of the actuator system, the steps required to integrate the morphing structure into the thrust reverser, and the analysis and testing that was required to gain approval for flight. Issues related to material strength, thermal environment, vibration

  11. Evaluating dissection in the gross anatomy course: Correlation between quality of laboratory dissection and students outcomes.

    Science.gov (United States)

    Nwachukwu, Chika; Lachman, Nirusha; Pawlina, Wojciech

    2015-01-01

    Anatomy learned by active exploration through dissection has many proven benefits including improvement of anatomic knowledge. Decreased laboratory time may affect the quality of dissection and ultimately lower student performance in anatomy translating to lower knowledge acquisition. The aim of this study was to determine whether the quality of students' dissection in teams correlates with their performance in the gross anatomy course. Quality of dissections for each team enrolled in a gross anatomy course at Mayo Medical School was evaluated biweekly using a five-point rubric based on course learning objectives. Assessment of anatomic knowledge was based on sequential laboratory practice practical examination scores, achievements on daily audience response system (ARS) quizzes, and final practical, written, and National Board of Medical Examiners(®) (NBME(®) ) Gross Anatomy and Embryology Subject Examinations. Twelve teams comprising 48 students were included in the study. There was a positive correlation between dissection quality and practice practical examination score (R = 0.83) and a negative correlation between dissection quality and ARS quizzes (R = -0.985). Dissection teams with a passing score on their dissection evaluations (>70%) performed better on their final examinations. Based on an end of course survey, students agreed that dissection evaluations should continue to be a part of the course. This study showed that better quality of dissection was associated with higher scores on practice practical examinations, final practical, written, and NBME examinations. The study demonstrated a positive correlation between dissection evaluations, accompanied by formative feedback during the course, and higher scores on final course assessments. © 2014 American Association of Anatomists.

  12. Acute Aortic Dissection in a Third Trimester Pregnancy without Risk Factors

    Directory of Open Access Journals (Sweden)

    Elizabeth L Walters

    2011-05-01

    Full Text Available Spontaneous aortic dissection in pregnancy is rare and life threatening for both the mother and the fetus. Most commonly, it is associated with connective tissue disorders, cardiac valve variants, or trauma. We present the case of a 23-year-old previously healthy woman, 36 weeks pregnant with a syncopal episode after dyspnea and vomiting. She subsequently developed cardiac arrest and underwent aggressive resuscitation, emergent thoracotomy, and cesarean delivery without recovery. On autopsy, she was found to have an aortic dissection of the ascending aorta. This case is presented to raise awareness and review the literature and the clinical approach to critical care for pregnant patients. [West J Emerg Med. 2011;12(4:571–574.

  13. Seismic fragility analysis of lap-spliced reinforced concrete columns retrofitted by SMA wire jackets

    International Nuclear Information System (INIS)

    Choi, Eunsoo; Park, Sun-Hee; Chung, Young-Soo; Kim, Hee Sun

    2013-01-01

    The aim of this study is to provide seismic fragility curves of reinforced concrete columns retrofitted by shape memory alloy wire jackets and thus assess the seismic performance of the columns against earthquakes, comparing them with reinforced concrete columns with lap-spliced and continuous reinforcement. For that purpose, this study first developed analytical models of the experimental results of the three types of columns, (1) lap-spliced reinforcement, (2) continuous reinforcement and (3) lap-spliced reinforcement and retrofitted by SMA wire jackets, using the OpenSEES program, which is oriented to nonlinear dynamic analysis. Then, a suite of ten recorded ground motions was used to conduct dynamic analyses of the analytical models with scaling of the peak ground acceleration from 0.1g to 1.0g in steps of 0.1g. From the static experimental tests, the column retrofitted with SMA wire jackets had a larger displacement ductility by a factor of 2.3 times that of the lap-spliced column, which was 6% larger compared with the ductility of the continuous reinforcement column. From the fragility analyses, the SMA wire jacketed column had median values of 0.162g and 0.567g for yield and collapse, respectively. For the yield damage state, the SMA wire jacketed column had a median value similar to the continuous reinforcement column. However, for the complete damage state, the SMA wire jacketed column showed a 1.33 times larger median value than the continuously reinforcement column. (paper)

  14. Design and quasi-static characterization of SMASH (SMA stabilizing handgrip)

    Science.gov (United States)

    Pathak, Anupam; Brei, Diann; Luntz, Jonathan; LaVigna, Chris; Kwatny, Harry

    2007-04-01

    Due to physiologically induced body tremors, there is a need for active stabilization in many hand-held devices such as surgical tools, optical equipment (cameras), manufacturing tools, and small arms weapons. While active stabilization has been achieved with electromagnetic and piezoceramics actuators for cameras and surgical equipment, the hostile environment along with larger loads introduced by manufacturing and battlefield environments make these approaches unsuitable. Shape Memory Alloy (SMA) actuators are capable of alleviating these limitations with their large force/stroke generation, smaller size, lower weight, and increased ruggedness. This paper presents the actuator design and quasi-static characterization of a SMA Stabilizing Handgrip (SMASH). SMASH is an antagonistically SMA actuated two degree-of-freedom stabilizer for disturbances in the elevation and azimuth directions. The design of the SMASH for a given application is challenging because of the difficulty in accurately modeling systems loads such as friction and unknown shakedown SMA material behavior (which is dependent upon the system loads). Thus, an iterative empirical design process is introduced that provides a method to estimate system loads, a SMA shakedown procedure using the system loads to reduce material creep, and a final selection and prediction for the full SMASH system performance. As means to demonstrate this process, a SMASH was designed, built and experimentally characterized for the extreme case study of small arms stabilization for a US Army M16 rifle. This study successfully demonstrated the new SMASH technology along with the unique design procedure that can be applied to small arms along with a variety of other hand-held devices.

  15. Spontaneous spinal epidural abscess.

    LENUS (Irish Health Repository)

    Ellanti, P

    2011-10-01

    Spinal epidural abscess is an uncommon entity, the frequency of which is increasing. They occur spontaneously or as a complication of intervention. The classical triad of fever, back pain and neurological symptoms are not always present. High index of suspicion is key to diagnosis. Any delay in diagnosis and treatment can have significant neurological consequences. We present the case of a previously well man with a one month history of back pain resulting from an epidural abscess.

  16. Identification and Management of Iatrogenic Aortocoronary Dissection

    Directory of Open Access Journals (Sweden)

    Shao-Ping Nie, MD, PhD, FESC, FSCAI

    2016-05-01

    Full Text Available Iatrogenic aortocoronary dissection (IACD is a rare but potentially life-threatening complication during coronary catheterizations. Although the incidence was relatively low, the dissection often leads to procedure failure with increased risk of myocardial infarction and death. IACD is mainly caused by disruption of intima at the ostia of left or right coronary artery during interventional procedures, and appears as luminal filling defects or persistence of contrast (“extraluminal cap” or intimal tear outside the coronary lumen. Dissection could disseminate antegradely and lead to subtotal or total occlusion of the coronary lumen. Similarly, it could extend retrogradely into the sinus of Valsalva and cusp, or even the ascending aorta, aortic arch, or descending aorta, leading to hemodynamic collapse. Early identification and prompt management is crucial to the prognosis of patients with IACD. Immediate bail-out stenting should be performed as rapidly as possible in most cases of severe dissection, even when significant propagation has already occurred. Surgery should only be considered when stenting failed to seal the dissection and the patients had hemodynamic compromise.

  17. An experimental and analytical study on the feasibility of SMA spring driven actuation of an iris mechanism

    International Nuclear Information System (INIS)

    Rajan, Aravindh; Abouseada, Mostafa; Manghaipathy, Pavithra; Ozalp, Nesrin; Majid, Feras Abdul; Salem, Ayman; Srinivasa, Arun

    2016-01-01

    Highlights: • An iris mechanism proposed in response to fluctuations in solar energy. • Iris motion controlled with the use of Nickel–Titanium Shape Memory Alloy springs. • Variation of the force exerted by SMA spring w.r.t. temperature tested experimentally. • An analytical expression that relates the aperture area and crank rotation is given. • SMA springs showed promising actuation mechanism as a replacement to motor. - Abstract: Variation in incoming solar energy adversely affects the temperature inside a solar reactor and lowers its efficiency. Therefore, it is important to develop a mechanism that can maintain semi-constant temperatures inside the reactor from sunrise to sunset. In this paper, we present an iris mechanism that reduces or enlarges its circular opening with the use of Nickel–Titanium Shape Memory Alloy (SMA) springs. SMA springs possess memory of their shapes at certain temperatures. Hence, by controlling the temperature of the spring, it is possible to exert different forces that may then be transferred to the variable aperture mechanism. In this study, variation of the force exerted by an SMA spring with respect to temperature was experimentally tested and the viability of an SMA spring’s use in actuating an iris mechanism aperture was examined. In order to simulate conditions under fluctuating solar radiation, a 7 kW solar simulator was used in experiments at varying power levels. It was observed that SMA springs are promising as a replacement of the actuation mechanism driven by a motor.

  18. Electrical/Mechanical Monitoring of Shape Memory Alloy Reinforcing Fibers Obtained by Pullout Tests in SMA/Cement Composite Materials

    Directory of Open Access Journals (Sweden)

    Eui-Hyun Kim

    2018-02-01

    Full Text Available Self-healing is an essential property of smart concrete structures. In contrast to other structural metals, shape memory alloys (SMAs offer two unique effects: shape memory effects, and superelastic effects. Composites composed of SMA wires and conventional cements can overcome the mechanical weaknesses associated with tensile fractures in conventional concretes. Under specialized environments, the material interface between the cementitious component and the SMA materials plays an important role in achieving the enhanced mechanical performance and robustness of the SMA/cement interface. This material interface is traditionally evaluated in terms of mechanical aspects, i.e., strain–stress characteristics. However, the current work attempts to simultaneously characterize the mechanical load-displacement relationships synchronized with impedance spectroscopy as a function of displacement. Frequency-dependent impedance spectroscopy is tested as an in situ monitoring tool for structural variations in smart composites composed of non-conducting cementitious materials and conducting metals. The artificial geometry change in the SMA wires is associated with an improved anchoring action that is compatible with the smallest variation in resistance compared with prismatic SMA wires embedded into a cement matrix. The significant increase in resistance is interpreted to be associated with the slip of the SMA fibers following the elastic deformation and the debonding of the SMA fiber/matrix.

  19. Acute headache and persistent headache attributed to cervical artery dissection

    DEFF Research Database (Denmark)

    Schytz, Henrik W; Ashina, Messoud; Magyari, Melinda

    2014-01-01

    The criteria for headache attributed to cervical artery dissection have been changed in the new third edition of the International Classification of Headache Disorders (ICHD-III beta). We have retrospectively investigated 19 patients diagnosed from 2001 to 2006 with cervical artery dissection...... at onset and followed them up six months after dissection. At dissection onset 17/19 patients were classified as headache probably attributed to vascular disorder at the time of dissection using the ICHD second edition (ICHD-II) criteria. In contrast, 17/19 of patients fulfilled the ICHD-III beta criteria...... for Headache or facial or neck pain attributed to cervical carotid or vertebral artery dissection or Headache attributed to intracranial arterial dissection. Six months after dissection five of 19 patients still reported persistent headache attributed to dissection. The study demonstrates that the ICHD...

  20. [Acute type A aortic dissection with Birt-Hogg-Dubé syndrome; report of a case].

    Science.gov (United States)

    Sakaguchi, Masayuki; Gotou, Hirohisa; Nakahara, Takashi; Fuke, Megumi; Nishimura, Kazunori; Kuraishi, Hiroshi; Furuya, Mitsuko

    2014-05-01

    We describe a 76-year-old woman with cardiac tamponade who was admitted to our hospital. She underwent ascending and partial arch aortic replacement to treat acute type A aortic dissection. However, postoperative respiratory failure developed and a chest X-ray revealed right lung pneumothorax. The lung was finally expanded after difficulties with prolonged tube drainage. Chest computed tomography(CT) showed multiple cystic changes in the bilateral lungs. Her sister and her daughter also had a history of spontaneous pneumothorax. We finally diagnosed Birt-Hogg-Dube syndrome after deoxyribonucleic asid(DNA)sequencing of folliculin( FLCN) gene.

  1. Evaluation of SMN protein, transcript, and copy number in the biomarkers for spinal muscular atrophy (BforSMA clinical study.

    Directory of Open Access Journals (Sweden)

    Thomas O Crawford

    Full Text Available The universal presence of a gene (SMN2 nearly identical to the mutated SMN1 gene responsible for Spinal Muscular Atrophy (SMA has proved an enticing incentive to therapeutics development. Early disappointments from putative SMN-enhancing agent clinical trials have increased interest in improving the assessment of SMN expression in blood as an early "biomarker" of treatment effect.A cross-sectional, single visit, multi-center design assessed SMN transcript and protein in 108 SMA and 22 age and gender-matched healthy control subjects, while motor function was assessed by the Modified Hammersmith Functional Motor Scale (MHFMS. Enrollment selectively targeted a broad range of SMA subjects that would permit maximum power to distinguish the relative influence of SMN2 copy number, SMA type, present motor function, and age.SMN2 copy number and levels of full-length SMN2 transcripts correlated with SMA type, and like SMN protein levels, were lower in SMA subjects compared to controls. No measure of SMN expression correlated strongly with MHFMS. A key finding is that SMN2 copy number, levels of transcript and protein showed no correlation with each other.This is a prospective study that uses the most advanced techniques of SMN transcript and protein measurement in a large selectively-recruited cohort of individuals with SMA. There is a relationship between measures of SMN expression in blood and SMA type, but not a strong correlation to motor function as measured by the MHFMS. Low SMN transcript and protein levels in the SMA subjects relative to controls suggest that these measures of SMN in accessible tissues may be amenable to an "early look" for target engagement in clinical trials of putative SMN-enhancing agents. Full length SMN transcript abundance may provide insight into the molecular mechanism of phenotypic variation as a function of SMN2 copy number.Clinicaltrials.gov NCT00756821.

  2. Cervical arterial dissection: An overview and implications for manipulative therapy practice.

    Science.gov (United States)

    Thomas, Lucy C

    2016-02-01

    Cervical arterial dissection (CAD) is a common cause of stroke in young people under 55 years. It can occur spontaneously or subsequent to minor trauma or infection. The incidence is difficult to determine accurately as not all CAD progress to stroke. CAD is the most catastrophic adverse event associated with cervical manipulative therapy but it is rare. Early features of CAD can mimic a painful musculoskeletal presentation and a patient may present for treatment of neck pain and headache with a dissection in progress. Whether the manipulative technique is responsible for dissection or whether the diagnosis of CAD has been missed is unclear. Identification of individuals at risk, or early recognition of CAD could help expedite medical intervention and avoid inappropriate treatment. The aims of this masterclass are to outline current research into the pathophysiology, aetiology and clinical presentation of CAD, to place the risk in context in a manipulative therapy setting and to discuss its possible clinical recognition. For those patients presenting with recent onset, moderate to severe unusual headache or neck pain, clinicians should perform a careful history, in particular questioning about recent exposure to head/neck trauma or neck strain. Cardiovascular factors may not be particularly useful indicators of risk of dissection. Clinicians should also be alert to reports of transient neurological dysfunction such as visual disturbance and balance deficits, arm paraesthesia and speech deficits, as these may be subtle. If clinicians suspect arterial dissection is in progress patients should be urgently referred for medical evaluation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Renal Infarction from Type B Aortic Dissection

    Directory of Open Access Journals (Sweden)

    Marit Tweet

    2017-07-01

    Full Text Available History of present illness: A 69-year-old-female with a medical history of hypertension presented to the emergency department (ED complaining of sudden onset of lower back and abdominal pain. Eight hours prior to presentation she reported turning to grab something on another counter and felt a sudden onset sharp pain in her lower back. She began to notice ill-defined abdominal pain, although she denied any shortness of breath, chest pain, numbness, weakness, or urologic symptoms. Her vital signs on presentation to the ED were temperature 36.5˚C, blood pressure 143/88, heart rate 84, respiratory rate 14, and oxygen saturation 93% on room air. On arrival, the patient was in significant discomfort and was rolling on the bed due to pain. Although she appeared to be in moderate distress she had minimal, if any, tenderness on abdominal exam, and only mild left lower back tenderness to palpation. This disconnect between the patient’s apparent discomfort and the lack of physical exam findings prompted the ordering of a computed tomography angiography (CTA of the abdomen/pelvis with greatest suspicion for abdominal aortic aneurysm. Significant findings: Initial abdominal images demonstrated a dissection flap; therefore, a CTA of the chest was also obtained. These images revealed a Stanford type B aortic dissection beginning just distal to the left subclavian artery and extending to the origin of the inferior mesenteric artery. The right renal artery arose from the true lumen of the dissection while the left renal artery arose from the false lumen. This case is interesting as imaging shows the lack of perfusion to the left kidney, residing in the retroperitoneum, which correlates with her non-descript abdominal and left flank pain. Discussion: Aortic dissection is defined as a tear within the wall of the aorta that allows blood to track between intima and media layers. A dissection is classified as Stanford Type A if it involves any portion of the

  4. Digital substraction angiography in aortic dissection

    International Nuclear Information System (INIS)

    Khadzhidekov, V.; Mircheva, M.; Genov, P.

    1993-01-01

    Regardless of the technical progress in new noninvasive methods, aortography is still regarded as a method providing the necessary information for cases of aortic dissection, especially those requiring emergency operative management. Twenty-four DS-aortographies of patients suspected for aortic dissection are reviewed. Intraarterial DSA is less hazardous owing to the reduced flow rate and quantity of contrast medium required. The relative share of inadequate images is rather high, and conventional cineaortography cannot be invariably replaced by the digital subtracted one. However, angiographic examination in cases suspected for aortic dissection may start with intraarterial digital substraction, and provided the latter proves inconclusive, conventional cineaortography may be resorted to. 6 refs., 3 figs. (orig.)

  5. Design of SMA - 13 asphalt mixture ratio on Z3and Z18 of the capital airport

    Science.gov (United States)

    Tian, Shuaituan; Ye, Song; Kong, Fandong

    2017-12-01

    According to the demand of T2 terminal airlines to operate A380 models, to meet the smooth running of the A380 airliner at the west end of the Capital Airport, So Z3 and Z18 taxiway area of the transformation is imperative. According to the design, the upper layer of this project adopts SMA - 13 modified asphalt mastic macadam mixture. We design the SMA-13 modified asphalt mixture on Z3 and Z18 of the capital airport from any respects, including coarse and fine aggregate, filler, asphalt, fiber and anti-rutting agent, and we hope we can find the best SMA-13 modified asphalt mixture.

  6. Diagnostic imaging of acute aortic dissection

    International Nuclear Information System (INIS)

    Ohya, Tohru; Kumazaki, Tatsuo

    1991-01-01

    One hundred and nineteen patients with aortic dissection who underwent diagnostic imaging were reviewed and angiographic findings as well as those of CT were analysed. Thirty eight cases (43.1%) had non-contrast opacified false lumen, the type of which we call 'thrombosed type aortic dissection'. A comparative study of the thrombosed type with the patent type of false lumens was made particularly from the stand point of the characteristic diagnostic imagings (CT and angiography). At the same time, the pitfalls of these imagings in thrombosed type aortic dissection were studied. At the onset the average age of thrombosed type was 62.3 years old, while that of the patent type was 57.3. A statistical significance between the two groups was p<0.05. Thrombosed type in all cases was caused by atherosclerosis, whereas patent type was caused by the Marfan's syndrome in 11 cases. Other clinical findings, such as initial symptoms and blood pressure revealed no significant differences between the two groups. Pre-contrast CT in acute thrombosed type aortic dissection showed 'hyperdense crescent sign' in 89.4%. However, in 3 cases with thrombosed type in which the pre-contrast CT showed 'hyperdense crescent sign' contrast-enhanced CT detected no clear evidence of aortic dissection in the same site. This was due to obscurity induced by contrast medium. Angiographic findings of thrombosed type were classified into 3 groups: normal type, stenosed true lumen type and ulcer-like projection type. The incidence of normal type was estimated to be 48.4%, whereas stenosed true lumen type was 24.2% and ulcer-like projection was 27.7%. The present study concluded that thrombosed type is not rare in acute aortic dissection and contrast-enhanced CT as well as pre-contrast CT, is of great value in diagnosing thrombosed type. 'Hyperdense crescent sign' in pre-contrast CT is characteristic of intramural hematoma. (author)

  7. The nature of dissection: Exploring student conceptions

    Science.gov (United States)

    York, Katharine

    The model of conceptual change in science describes the process of learning as a complete restructuring of knowledge, when learners discover or are shown more plausible, intelligent alternatives to existing conceptions. Emotions have been acknowledged as part of a learner's conceptual ecology, but the effects of emotions on learning have yet to be described. This research was conducted to examine the role that emotions have on learning for thirteen high school students, as they dissected cats in a Human Anatomy and Physiology class. The project also investigated whether a student's emotional reactions may be used to develop a sense of connectedness with the nonhuman world, which is defined as ecological literacy. This study utilized a grounded theory approach, in which student responses to interviews were the primary source of data. Interviews were transcribed, and responses were coded according to a constant comparative method of analysis. Responses were compared with the four conditions necessary for conceptual change to occur, and also to five principles of ecological literacy. Students who had negative reactions to dissection participated less in the activity, and demonstrated less conceptual change. Two female students showed the strongest emotional reactions to dissection, and also the lowest amount of conceptual change. One male student also had strong negative reactions to death, and showed no conceptual change. The dissection experiences of the students in this study did not generally reflect ecological principles. The two students whose emotional reactions to dissection were the most negative demonstrated the highest degree of ecological literacy. These results provide empirical evidence of the effects that emotions have on learning, and also supports the opinions of educators who do not favor dissection, because it does not teach students to respect all forms of life.

  8. An electronic instructor for gross anatomy dissection.

    Science.gov (United States)

    Josephson, Eleanor M; Moore, Larry J

    2006-01-01

    Gross anatomy is time consuming to teach and to learn. Because the process of dissection takes up so much student time, assistance in the form of an in-lab instructional DVD program might improve student performance. The DVD could be viewed with a portable device by individual dissection groups at their tables. Groups could dissect at their own pace, with access to step-by-step demonstrations and answers to frequently asked anatomical questions. We created an instructional DVD program demonstrating dissection of the canine ventral neck and thoracic limb. The effect on student exam scores of using the DVD versus not using it was measured in a controlled, two-sample study using incoming first-year veterinary students as volunteers. Volunteers were told the study was of two different dissection methods; the DVD was not specifically mentioned until after the students were separated into two groups (Blue/DVD group and Orange/No DVD group), and then only to volunteers in the Blue group. Except for the DVD, the two groups had the same resources. The difference in scores on an exam given after a single dissection period did not differ sufficiently to conclude that DVD use raised the mean score; however, 73% of the DVD group scored 60% or higher, while only 38% of the No DVD group scored 60% or higher. The difference in mean scores overall was 2.3 points out of a possible 49, suggesting that the DVD helped students, especially those with lower scores, to earn two to three more points than they would have otherwise.

  9. Symptomatic Type B Intramural Aortic Hematoma as a Complication of Retrograde Right Common Iliac Artery Dissection.

    Science.gov (United States)

    Sonetto, Alessia; Gargiulo, Mauro; Gallitto, Enrico; Ancetti, Stefano; Faggioli, Gianluca; Stella, Andrea

    2018-02-16

    To report the endovascular treatment of a spontaneous iliac artery dissection (IAD) involving iliac bifurcation, complicated by a type B intramural aortic hematoma (IMH). A 38-year-old female patient came to our institution referring an acute ascending back pain. The angio computed tomography scan showed the presence of a retrograde right IAD with entry tear at the iliac bifurcation and a concomitant aortic IMH. After hypogastric embolization with a vascular plug, self-expanding stent graft was placed to cover the iliac entry tear. At 12 months, the patient was asymptomatic and the angio computed tomography scan showed the patency of the iliac graft without IMH. Endovascular treatment of spontaneous IAD is a safe and effective option in symptomatic patient complicated with type B IMH. Published by Elsevier Inc.

  10. Coronary artery dissection following chest trauma

    Directory of Open Access Journals (Sweden)

    Manoj K Agarwala

    2016-01-01

    Full Text Available Chest trauma has a high rate of mortality. Coronary dissection causing myocardial infarction (MI following blunt chest trauma is rare. We describe the case of an anterior MI following blunt chest trauma. A 39-year-old male was received in our hospital following a motorcycle accident. The patient was asymptomatic before the accident. The patient underwent craniotomy for evacuation of hematoma. He developed severe chest pain and an electrocardiogram (ECG revealed anterior ST segment elevation following surgery. Acute coronary event was medically managed; subsequently, coronary angiogram was performed that showed dissection in the left anterior coronary artery, which was stented.

  11. Experimental and numerical analysis of penetration/removal response of endodontic instrument made of single crystal Cu-based SMA: comparison with NiTi SMA instruments

    Science.gov (United States)

    Vincent, M.; Xolin, P.; Gevrey, A.-M.; Thiebaud, F.; Engels-Deutsch, M.; Ben Zineb, T.

    2017-04-01

    This paper presents an experimental and numerical study showing that single crystal shape memory alloy (SMA) Cu-based endodontic instruments can lead to equivalent mechanical performances compared to NiTi-based instruments besides their interesting biological properties. Following a previous finite element analysis (FEA) of single crystal CuAlBe endodontic instruments (Vincent et al 2015 J. Mater. Eng. Perform. 24 4128-39), prototypes with the determined geometrical parameters were machined and experimentally characterized in continuous rotation during a penetration/removal (P/R) protocol in artificial canals. The obtained mechanical responses were compared to responses of NiTi endodontic files in the same conditions. In addition, FEA was conducted and compared with the experimental results to validate the adopted modeling and to evaluate the local quantities inside the instrument as the stress state and the distribution of volume fraction of martensite. The obtained results highlight that single crystal CuAlBe SMA prototypes show equivalent mechanical responses to its NiTi homologous prototypes in the same P/R experimental conditions.

  12. Spontaneous Thigh Compartment Syndrome

    Directory of Open Access Journals (Sweden)

    Khan, Sameer K

    2011-02-01

    Full Text Available A young man presented with a painful and swollen thigh, without any history of trauma, illness, coagulopathic medication or recent exertional exercise. Preliminary imaging delineated a haematoma in the anterior thigh, without any fractures or muscle trauma. Emergent fasciotomies were performed. No pathology could be identified intra-operatively, or on follow-up imaging. A review of thigh compartment syndromes described in literature is presented in a table. Emergency physicians and traumatologists should be cognisant of spontaneous atraumatic presentations of thigh compartment syndrome, to ensure prompt referral and definitive management of this limb-threatening condition. [West J Emerg Med. 2011;12(1:134-138].

  13. Dynamical analysis and development of a biologically inspired SMA caterpillar robot.

    Science.gov (United States)

    Daily-Diamond, Christopher A; Novelia, Alyssa; O'Reilly, Oliver M

    2017-09-26

    With the goal of robustly designing and fabricating a soft robot based on a caterpillar featuring shape memory alloy (SMA) actuators, analytical and numerical models for a soft robot were created based on the forward crawling motion of the Manduca sexta caterpillar. The analytical model features a rod theory and the mechanics of undulation were analyzed using a motion pattern based on the 'Witch of Agnesi' curve. Complementing these models, experiments on a SMA actuator sample were performed in order to determine its flexural rigidity and curvature as a function of the actuation voltage. A series of these actuators can be modeled as a system of rigid bodies connected by torsional springs. As these bodies are actuated according to the motion pattern based on the individual caterpillar segments, ground contact forces are calculated and analyzed to determine the requirements of successful forward locomotion. The energetics of the analytical and numerical models are then compared and discussed.

  14. Twaróg i ser smażony – wczoraj i dziś

    OpenAIRE

    Chudy, Sylwia; Makowska, Agnieszka

    2015-01-01

    Zarówno twaróg jak i ser smażony wytwarzany zgodnie przekazywaną z pokolenia na pokolenie recepturą, cieszy się w Polsce ogromnym popytem. Z roku na rok przybywa konsumentów tych produktów także poza granicami kraju, głównie w Niemczech. Początki przerobu mleka na ziemiach polskich datuje się już na początek VI w.p.n.e. Pierwszym produktem pochodzącym z przerobu mleka był twaróg. W XVIII wieku rolnicy pochodzących z obszaru Niemiec i Holandii zapoczątkowali w Wielkopolsce smażenie dojrzałego ...

  15. ANFIS based modeling and inverse control of a thin SMA wire

    Science.gov (United States)

    Kilicarslan, Atilla; Song, Gangbing; Grigoriadis, Karolos

    2008-03-01

    In this work, we propose an Adaptive Neuro Fuzzy Inference System (ANFIS) based hysteresis modeling and control strategy for a thin Shape Memory Alloy (SMA) wire. Controlling the SMA wire is a challenging problem because of its dynamic hysteretic behavior. By using a hybrid learning procedure ANFIS architectures are powerful tools for many applications, such as identifying nonlinear parameters in a controlled system, predicting chaotic time series and modeling nonlinear functions. We tested our ANFIS model by making it predict major and minor hysteresis loops in different driving frequencies and compared them with the experimental data. To compensate the hysteretic effect, we used an inverse ANFIS model and used it directly as a controller. After dramatically reducing the hysteretic effect, we implemented a PI control to fine tune the response.

  16. CT muscle scanning in the evaluation of patients with spinal muscular atrophy (SMA)

    Energy Technology Data Exchange (ETDEWEB)

    Sambrook, P.; Rickards, D.; Cumming, W.J.K.

    1988-12-01

    One hundred with spinal muscular atrophy (SMA) were assessed by CT scanning using a standardised technique. The spectrum of CT abnormality occurring in SMA was observed and by overall analysis the patients were divided into 4 groups. While the CT appearances of these groups correlated well with clinical assessment of severity of disease, the disease process was usually much more widespread than clinical examination suggested. CT abnormality was first observed in the leg and gluteal muscles, progressing to the posterior spinal, thigh, shoulder girdle and sternomastoid muscles. Hypertrophy of sartorius and gracilis was observed in a significant number of patients. Fascial planes were preserved in involved muscles in over half of the patients, even in late-stage disease. Asymmetrical muscle involvement was seen with increasing frequency as the disease process increased in extent as evaluated by CT scanning. There was no discernible difference in the CT appearances in those patients who clinically had limb-girdle, facioscapulohumeral or scapuloperoneal distribution of weakness.

  17. PELATIHAN PENULISAN KARYA ILMIAH BIDANG SOSIAL ( HUKUM DI SMA NEGERI 3 DENPASAR

    Directory of Open Access Journals (Sweden)

    I KETUT SUDIARTA

    2012-09-01

    Full Text Available ABSRACT Training of Constructing Scientific Report on Social Major (Law has done on SMA Negeri 3 Denpasar, by the Guiding Team of the Lecturers of Law Faculty of Udayana University through a practice of constructing a report in a class through a workshop. Aproximately, 40% are for meanwhile, 60% are by practice of composing and providing some reference which is related to the constructing of a social-scientific report, and there all are done well so far. This fact was indicated by the responds which were given by the students of SMA Negeri 3 Denpasar, especially for those who join the KIR group.This activity has been done once a week.

  18. TINGKAT PENGETAHUAN TENTANG SEKS BEBAS PADA REMAJA KELAS XI DI SMA NEGERI 11 YOGYAKARTA TAHUN 2014

    Directory of Open Access Journals (Sweden)

    Suherni

    2018-01-01

    Full Text Available Background: Free sex has become more familiar to teenagers in today's life. This phenomenon occurs within many teenagers in junior and senior high schools, in big cities as well as in remote villages. Free sex may result in unwanted pregnancy, sexually transmitted infections, and social disruption in the society. Objective: This study aimed to determine the level of knowledge about free sex in adolescents. Methods: This research was conducted in April 2014, at SMA 11 Yogyakarta. The subjects were all students of class XI, consisted of 270 students. This study used a questionnaire as a measuring tool. Data analysis was performed with a univariate analysis. Results: Results showed that most respondents had adequate level of knowledge (81%, 17% had moderate level of knowledge and 2% have low level of knowledge about free sex. Conclusion: The level of knowledge about free sex in SMA Negeri 11 Yogyakarta students was majority adequate.

  19. PEMBINAAN KEBERAGAMAAN SISWA MELALUI PENGEMBANGAN BUDAYA AGAMA DI SMA NEGERI 16 PALEMBANG

    Directory of Open Access Journals (Sweden)

    Ermis Suryana

    2013-11-01

    Full Text Available AbstractThe purpose of the study was to describe the religious development student trought the development of religious culture at SMA Negeri 16 Palembang. The result of the study showed that the implementation of coaching student’s religious through the development of religious culture at SMA 16 Palembang has been going well and programmed, both conducted by the school as an educational institution that is intact with the wisdom which relate to the development of the religious culture in school and community activities undertaken by Rohis (The Spiritual of Islam as a kind of special school extracurricular activities shade other religious activities. This success can be achieved due to the efforts of the principal and the support of the entire school community by showing commitment each of which takes place together and support each other.Keywords: Religious development, Religious culture.

  20. Acute Type II Aortic Dissection with Severe Aortic Regurgitation and Chronic Descending Aortic Dissection in Pregnant Patient with Marfan Syndrome.

    Science.gov (United States)

    Lee, Seok-Soo; Jung, Tae-Eun; Lee, Dong Hyup

    2012-12-01

    Aortic dilatation and dissection are severe complications during pregnancy that can be fatal to both the mother and the fetus. The risks of these complications are especially high in pregnant patients with Marfan syndrome; however, incidents of descending aortic dissection are very rare. This case report involves a successful Bentall procedure for and recovery from a rare aortic dissection in a pregnant Marfan patient who developed acute type II aortic dissection with severe aortic regurgitation and chronic descending aortic dissection immediately after Cesarean section. Regular follow-up will be needed to monitor the descending aortic dissection.

  1. Pengaruh Self Esteem terhadap Aktivitas Belajar Kelas XI IPS di SMA Santo Fransiskus Asisi Pontianak

    OpenAIRE

    Julia, Yosie

    2017-01-01

    This research aim to know the effect of Self Esteem toward students learning activity ofXIIPSgrade on economic subject in SMA Santo Fransiskus Asisi the school year 2016/2017. This Method use descriptive quantitative design with correlational reseacrh form. the total of popultionare 150 students with the total of sampel are 60 student which determined by slovin formula, .Data taken by interect communication (questionnaire). Prerequisite test in this research is validity test and reliability t...

  2. Pengaruh Model Pembelajaran dan Kecerdasan Interpersonal Terhadap Hasil Belajar Sejarah Siswa SMA Negeri 3 Kabupaten Tangerang

    OpenAIRE

    Handayani, Eka Sari

    2017-01-01

    This research aims to know the effect of instructional model and interpersonal intelligence to history learning outcomes in SMA Negeri 3 Kabupaten Tangerang. This research is a quantitative research using experimental methods of treatment by level 2x2 design. Research instrument for measuring intepersonal intelligence is a questionnaire and Reseach instrument for measuring history learning outcomes is a multiple choice test. Population of research is all of student of SMAN 3 Kabupaten Tangera...

  3. Hubungan Facebook Addiction Disorder (Fad) dengan Perilaku Asertif Remaja di SMA Kristen 1 Tomohon

    OpenAIRE

    Polii, Gloria Gratia; Bidjuni, Hendro; Wowiling, Ferdinand

    2014-01-01

    : Facebook addiction berarti menghabiskan jumlah waktu yang berlebihan di facebook. Facebook merupakan situs jejaring sosial yang mudah digunakan, dan yang paling penting adalah mempunyai efek mencandu. Secara psikologis, dampak negatif kecanduan facebook dapat dibagi atas: Pribadi yang anti sosial dan Dualisme kepribadian. Tujuan penelitian ini untuk mengetahui hubungan Facebook Addiction Disorder (FAD) dengan Perilaku Asertif Remaja di SMA Kristen 1 Tomohon. Desain penelitian ini dilaksanak...

  4. Penerapan Student Teams Achievement Division dengan Peta Konsep terhadap Hasil Belajar Materi Plantae di SMA

    OpenAIRE

    Wahyudi; Ningsih, Kurnia; Marlina, Reni

    2015-01-01

    This study was aimed to know the application of learning by using the cooperative model of Student Teams Achievement Division (STAD) type throught concept mapstoward Achievement ofkingdom plantae material in class X of SMA Negeri 1 Sajad. The form of this research was a quasy experimental design with pattern in nonequivalent control group design. Intact group was used in the sampling technique. From the result of data analysis, the average score post-test of the achievement on experiment clas...

  5. Hubungan Penggunaan Media Sosial Dengan Kemampuan Interaksi Sosial Remaja di SMA Negeri 1 Kota Medan

    OpenAIRE

    Nugraheni, Auliya Tunnisaa

    2016-01-01

    Social media today is considered as an important daily need. The intensity of using it by adolescents is influenced by their need for information, either academic or non-academic information. The inclination of using it as a communication facility can directly effects one of the social interactions aspect among individual. The objective of this research was to find out the correlation of using social media with the capacity of social interaction in adolescents at SMA Negeri 1, Medan, using co...

  6. INFORMATION MANAGEMENT SPECIAL EVENT HUTTEL 62 By SMA NEGERI 3 JAKARTA

    Directory of Open Access Journals (Sweden)

    Syahidatia Chairunissa Aulia

    2017-07-01

    Full Text Available The purpose of this research is to know how to process information management special event conducted by organizers HUTTEL 62 ranging from research, design, planning, coordination, and evaluation in accordance with the concept special event belongs to Joe Goldblatt. Research methods a descriptive, qualitative data with the paradigm of positivism. The results of this study suggested that the management of the special event HUTTEL 62 categorized in five stages, namely research, design, planning, coordination, and evaluation. Research carried out in the form of informal research with secondary data searches ways be monitoring news coverage about SMA Negeri 3 Jakarta. Hasl research shows the overview of the situation of informing host HUTTEL 62 is the assumption that the community name of the example contained in the SMA Negeri 3 Jakarta not sesuaid with what happened at that school. The design of the color purple and blue created the Customize the theme carried HUTTEL 62 ‘ Return Teladanku ‘. Motion design elements and sounds indicated by performers in closing. 62 HUTTEL planning begins with setting goals to be achieved, namely restoring the image of ‘ exemplary ‘ to SMA Negeri 3 Jakarta Post acts of bullying incidents. Coordination is done by the Organizer HUTTEL 62 include coordination with internal and external parties the Committee involved in organizing HUTTEL 62. The communication is done by informal meetings and mandatory meetings and communications with online messenger. The evaluation was conducted to measure the achievement of HUTTEL 62, the evaluation is conducted in the Division and the Division of any series of events have been implemented and later serve as a report on liability. Hasl acquired evaluation of barriers in the internal Committee namely the barriers of communication and information in the internal Committee. A summary of this research menenujukan that special event management HUTTEL 62 made by SMA Negeri 3 Jakarta

  7. Hubungan Bermain Video Game Terhadap Kejadian Insomnia Pada Kalangan Remaja Di Sma Negeri 12 Medan

    OpenAIRE

    Pangaribuan, Hotman Parasian

    2015-01-01

    The number of adolescent who played video game was increased now days. This can cause many problems in social relationship, behavioral, and their sleep pattern like insomnia. This cross sectional study aimed to evaluate the relationship between playing video game with insomnia among the adolescent. Our total sample was 100 students in SMA Negeri 12 Medan. The sample was chosen by consequtive sampling. The data was taken by interview using questionnaire. From our result, the major...

  8. Penerapan Media Laboratorium Virtual Dalam Pembelajaran Fisika Di SMA Negeri 2 Sengkang

    OpenAIRE

    Purwati, Dewi; Yani, Abd; Haris, Abd

    2015-01-01

    Penelitian ini bertujuan untuk (1) mengetahui seberapa besar hasil belajar fisika sebelum diajar menggunakan media laboratorium virtual, (2) mengetahui seberapa besar hasil belajar fisika setelah diajar menggunakan media laboratorium virtual, (3) mengetahui bagaimana peningkatan hasil belajar fisika setelah diajar menggunakan media laboratorium virtual pada peserta didik kelas X.MIA 3 SMA Negeri 2 Sengkang tahun ajaran 2014/2015. Jenis penelitian ini adalah pra eksperimen menggunakan One grou...

  9. Kontribusi Etos Kerja Disiplin Kerja Dan Motivasi Kerja Terhadap Kinerja Guru SMA Negeri Se Kecamatan Karangasem

    OpenAIRE

    I MADE PUTRA; Prof. Dr. Nyoman Dantes; Dr. I Gusti Ketut Arya Sunu, M.Pd

    2014-01-01

    Penelitian ini bertujuan untuk mengetahui dan menganalisis : (1) besarnya kontribusi Etos kerja terhadap kinerja guru, (2) besarnya kontribusi disiplin kerja terhadap kinerja guru, (3) besarnya kontribusi motivasi kerja terhadap kinerja guru, (4) besarnya kontribusi etos kerja, disiplin kerja, motivasi kerja secara bersama sama terhadap kinerja guru SMA Negeri Se Kecamatan Karangasem. Penelitian ini termasuk penelitian ex-post facto yang berbentuk korelasional dengan populasi subyek men...

  10. Experiment feedbacks in micromechanics modeling of thermomechanical behaviour of SMA polycrystals

    Czech Academy of Sciences Publication Activity Database

    Šittner, Petr; Novák, Václav

    2004-01-01

    Roč. 51, - (2004), s. 321-326 ISSN 1359-6462 R&D Projects: GA AV ČR IAA1048107; GA ČR GA202/04/2016 Institutional research plan: CEZ:AV0Z1010914 Keywords : shape memory alloys (SMA) * martensitic phase transformation * micromechanical modeling * neutron diffraction Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 2.112, year: 2004

  11. Intracellular uptake and behavior of two types zinc protoporphyrin (ZnPP) micelles, SMA-ZnPP and PEG-ZnPP as anticancer agents; unique intracellular disintegration of SMA micelles.

    Science.gov (United States)

    Nakamura, Hideaki; Fang, Jun; Gahininath, Bharate; Tsukigawa, Kenji; Maeda, Hiroshi

    2011-11-07

    SMA-ZnPP and PEG-ZnPP are micellar drugs, encapsulating zinc protoporphyrin IX (ZnPP) with styrene maleic acid copolymer (SMA) and covalent conjugate of ZnPP with polyethylene glycol (PEG) respectively. Their intracellular uptake rate and subcellular localization were investigated. We found SMA-ZnPP showed higher and more efficient (about 2.5 times) intracellular uptake rate than PEG-ZnPP, although both SMA-ZnPP and PEG-ZnPP micelles were localized at endoplasmic reticulum (ER) and inhibited the target enzyme heme oxygenase 1 (HO-1) similarly. Both micellar ZnPP were taken up into the tumor cells by endocytosis. Furthermore SMA-ZnPP and PEG-ZnPP were examined for their drug releasing mechanisms. Liberation of ZnPP from the SMA micelle appears to depend on cellular amphiphilic components such as lecithin, while that for PEG-ZnPP depends on hydrolytic cleavage. These results indicate that these micelle formulations make water insoluble ZnPP to water soluble practical anticancer agents. Copyright © 2011 Elsevier B.V. All rights reserved.

  12. Force-Deformation Response of a SMA-Based Actuator Considering the Electric Current Intensity as Step-Input

    Directory of Open Access Journals (Sweden)

    Ion-Cornel Mituletu

    2015-06-01

    Full Text Available The goal of the paper is to accomplish the response regarding the force-displacement characteristic evolution, of a Shape Memory Alloy (SMA actuator element. This reveals the first research stage in controlling the SMA behavior, providing important information about the heating-cooling time intervals. Step excitation of the SMA is performed by few values of electric current intensity, which produces the heating of SMA element up to 90-95 oC. To meet the testing requirements, an adequate test stand has been set up, consisting of sensors for force, displacement and temperature. The analog values provided by sensors were acquired and afterwards analyzed. The values of temperature, displacement and force were achieved, and their characteristic evolution has been performed. Thus, the time intervals are resulted and some other important aspects have been observed, regarding the delay between parameters and the temperature overshoot

  13. Increased facilitatory connectivity from the pre-SMA to the left dorsal premotor cortex during pseudoword repetition

    DEFF Research Database (Denmark)

    Hartwigsen, Gesa; Saur, Dorothee; Price, Cathy J

    2013-01-01

    repetition. The optimal model was identified with Bayesian model selection and reflected a network with driving input to pre-SMA and an increase in facilitatory drive from pre-SMA to PMd during repetition of pseudowords. The task-specific increase in effective connectivity from pre-SMA to left PMd suggests......Previous studies have demonstrated that the repetition of pseudowords engages a network of premotor areas for articulatory planning and articulation. However, it remains unclear how these premotor areas interact and drive one another during speech production. We used fMRI with dynamic causal...... were common to repetition in both modalities. We thus obtained three seed regions: the bilateral pre-SMA, left dorsal premotor cortex (PMd), and left ventral premotor cortex that were used to test 63 different models of effective connectivity in the premotor network for pseudoword relative to word...

  14. Evaluation of Fatigue Life of CRM-Reinforced SMA and Its Relationship to Dynamic Stiffness

    Directory of Open Access Journals (Sweden)

    Nuha Salim Mashaan

    2014-01-01

    Full Text Available Fatigue cracking is an essential problem of asphalt concrete that contributes to pavement damage. Although stone matrix asphalt (SMA has significantly provided resistance to rutting failure, its resistance to fatigue failure is yet to be fully addressed. The aim of this study is to evaluate the effect of crumb rubber modifier (CRM on stiffness and fatigue properties of SMA mixtures at optimum binder content, using four different modification levels, namely, 6%, 8%, 10%, and 12% CRM by weight of the bitumen. The testing undertaken on the asphalt mix comprises the dynamic stiffness (indirect tensile test, dynamic creep (repeated load creep, and fatigue test (indirect tensile fatigue test at temperature of 25°C. The indirect tensile fatigue test was conducted at three different stress levels (200, 300, and 400 kPa. Experimental results indicate that CRM-reinforced SMA mixtures exhibit significantly higher fatigue life compared to the mixtures without CRM. Further, higher correlation coefficient was obtained between the fatigue life and resilient modulus as compared to permanent strain; thus resilient modulus might be a more reliable indicator in evaluating the fatigue life of asphalt mixture.

  15. Evaluation of fatigue life of CRM-reinforced SMA and its relationship to dynamic stiffness.

    Science.gov (United States)

    Mashaan, Nuha Salim; Karim, Mohamed Rehan; Abdel Aziz, Mahrez; Ibrahim, Mohd Rasdan; Katman, Herda Yati; Koting, Suhana

    2014-01-01

    Fatigue cracking is an essential problem of asphalt concrete that contributes to pavement damage. Although stone matrix asphalt (SMA) has significantly provided resistance to rutting failure, its resistance to fatigue failure is yet to be fully addressed. The aim of this study is to evaluate the effect of crumb rubber modifier (CRM) on stiffness and fatigue properties of SMA mixtures at optimum binder content, using four different modification levels, namely, 6%, 8%, 10%, and 12% CRM by weight of the bitumen. The testing undertaken on the asphalt mix comprises the dynamic stiffness (indirect tensile test), dynamic creep (repeated load creep), and fatigue test (indirect tensile fatigue test) at temperature of 25°C. The indirect tensile fatigue test was conducted at three different stress levels (200, 300, and 400 kPa). Experimental results indicate that CRM-reinforced SMA mixtures exhibit significantly higher fatigue life compared to the mixtures without CRM. Further, higher correlation coefficient was obtained between the fatigue life and resilient modulus as compared to permanent strain; thus resilient modulus might be a more reliable indicator in evaluating the fatigue life of asphalt mixture.

  16. Simulación basada en SMA de sistemas originalmente representados con EDO

    Directory of Open Access Journals (Sweden)

    Ekaitz Zulueta Guerrero

    2011-10-01

    Full Text Available Resumen: En el presente trabajo se expone una metodología para modelar mediante un Sistema Multi-Agente (SMA sistemas biológicos y fisiológicos dinámicos con variables cuantificadas discretas, como el crecimiento y decrecimiento de poblaciones o el modelado epidemiológico de enfermedades. Se muestra un procedimiento para transformar un sistema de Ecuaciones Diferenciales Ordinarias (EDO (que modela un entorno de forma correcta en un SMA equivalente mediante un esquema basado en el método de Monte Carlo. Se utiliza un caso práctico fundamentado en un modelo matemático de Leucemia Mieloide Crónica (LMC para comparar la metodología basada en agentes con el modelado tradicional basado en un sistema de EDO. Se realiza una simulación con cada modelo (SMA y EDO y se compara los resultados obtenidos con ambas metodologías. Palabras clave: Ecuaciones diferenciales, modelo basado en agentes, Monte Carlo

  17. Kajian Fisis Energi Terbarukan Panel Surya Melalui Eksperimen Sederhana untuk Siswa SMA

    Directory of Open Access Journals (Sweden)

    Sunaryo Sunaryo

    2015-12-01

    Full Text Available Abstract Has conducted research on the effects of light intensity on the output voltage, current, and power. Research conducted generate data in the form of quantitative and graphs that show a link between the intensity of light, the output voltage, current, and power. The data obtained were used as sources of learning in senior high school (SMA. The implication is capable of enhancing creativity, motivation and learning outcomes of Physics subject of high school students in future studies. Keywords: light intensity, current, voltage, solar panel Abstrak Telah dilakukan penelitian tentang pengaruh intensitas cahaya terhadap tegangan output, arus, dan daya listrik. Penelitian yang dilakukan menghasilkan data dalam bentuk kuantitatif dan grafik yang menunjukkan adanya kaitan antara intensitas cahaya, tegangan output, arus, dan daya listrik. Data yang diperoleh dijadikan sebagai sumber informasi dalam pembelajaran di Sekolah Menengah Atas (SMA. Implikasinya adalah mampu meningkatkan kreativitas, motivasi, dan hasil belajar Fisika siswa SMA pada penelitian selanjutnya. Kata-kata kunci: intensitas cahaya, arus, tegangan, panel surya

  18. Design and preliminary testing of a handheld antagonistic SMA actuator for cancellation of human tremor

    Science.gov (United States)

    Pathak, Anupam; Brei, Diann; Luntz, Jonathan

    2009-03-01

    Essential Tremor is a debilitating disorder that in the US alone is estimated to affect up to ten million people. Unfortunately current treatments (i.e. drug therapy and surgical procedures), are limited in effectiveness and often pose a risk of adverse side-effects. In response to this problem, this paper describes an active cancellation device based on a hand-held Shape Memory Alloy (SMA) actuated stabilization platform. The assistive device is designed to hold and stabilize various objects (e.g. eating utensils, tools, pointing implements, etc.) by sensing the user's tremor and moving the object in an opposite direction using SMA actuators configured in biologically inspired antagonistic pairs. To aid in the design, performance prediction and control of the device, a device model is described that accounts for the device kinematics, SMA thermo-mechanics, and the heat transfer resulting from electrical heating and convective cooling. The system of differential equations in this device model coupled with the controller gain can be utilized to design the operation given a frequency range and power requirement. To demonstrate this, a prototype was built and experimentally tested under external disturbances in the range of 1-5 Hz, resulting in amplitude reduction of up to 80%. The extent of cancellation measured for both single-frequencies and actual human tremor disturbances demonstrate the promise of this approach as a broadly used assistive device for the multitudes afflicted by tremor.

  19. A fuzzy PID-controlled SMA actuator for a two-DOF joint

    Directory of Open Access Journals (Sweden)

    Shi Zhenyun

    2014-04-01

    Full Text Available Shape memory alloy (SMA actuator is a potential advanced component for servo-systems of aerospace vehicles and aircraft. This paper presents a joint with two degrees of freedom (DOF and a mobility range close to ±60° when driven by SMA triple wires. The fuzzy proportional-integral-derivative (PID-controlled actuator drive was designed using antagonistic SMA triple wires, and the resistance feedback signal made a closed loop. Experiments showed that, with the driving responding frequency increasing, the overstress became harder to be avoided at the position under the maximum friction force. Furthermore, the hysteresis gap between the heating and cooling paths of the strain-to-resistance curve expanded under this condition. A fuzzy logic control was considered as a solution, and the curves of the wires were then modeled by fitting polynomials so that the measured resistance was used directly to determine the control signal. Accurate control was demonstrated through the step response, and the experimental results showed that under the fuzzy PID-control program, the mean absolute error (MAE of the rotation angle was about 3.147°. In addition, the investigation of the external interference to the system proved the controllable maximum output.

  20. English Standar Kompetensi, Kompetensi Dasar, & Ujian Nasional of SMA in Revised Bloom`s Taxonomy

    Directory of Open Access Journals (Sweden)

    Putri Kamalia Hakim

    2017-10-01

    Full Text Available Abstract: This study was conducted to investigate the coverage of Revised Bloom’s taxonomy in the English Standar Kompetensi (SK, Kompetensi Dasar (KD and the English test items of Ujian Nasional for SMA. Content analysis method was chosen as the research design for this study. The writer analyzed the data by categorizing the verbs and the nouns of the data in relation to the categories and dimension of Revised Bloom’s Taxonomy. The results of this study revealed that 53% of SKs and KDs cover Understand category and the rest cover Analyze category. All of the SKs and KDs cover conceptual knowledge and other knowledge dimensions are not covered. Moreover, the coverage of Revised Bloom’s Taxonomy in English test items of Ujian Nasional for SMA is not aligned with the coverage of Revised Bloom’s Taxonomy in English SK and KD. The SKs and KDs only cover Remember, Understand, Apply and Analyze categories while the test items were associated with Remember, Understand, Apply, Analyze, and Evaluate categories. More than 90% of English test items of Ujian Nasional for SMA only covered low order of cognitive categories (Remember, Understand, and Apply. Most of the test items covered factual knowledge and the rest of them covered conceptual knowledge and none of them covered procedural and metacognitive knowledge.

  1. Evaluation of Fatigue Life of CRM-Reinforced SMA and Its Relationship to Dynamic Stiffness

    Science.gov (United States)

    Mashaan, Nuha Salim; Karim, Mohamed Rehan; Abdel Aziz, Mahrez; Ibrahim, Mohd Rasdan; Katman, Herda Yati

    2014-01-01

    Fatigue cracking is an essential problem of asphalt concrete that contributes to pavement damage. Although stone matrix asphalt (SMA) has significantly provided resistance to rutting failure, its resistance to fatigue failure is yet to be fully addressed. The aim of this study is to evaluate the effect of crumb rubber modifier (CRM) on stiffness and fatigue properties of SMA mixtures at optimum binder content, using four different modification levels, namely, 6%, 8%, 10%, and 12% CRM by weight of the bitumen. The testing undertaken on the asphalt mix comprises the dynamic stiffness (indirect tensile test), dynamic creep (repeated load creep), and fatigue test (indirect tensile fatigue test) at temperature of 25°C. The indirect tensile fatigue test was conducted at three different stress levels (200, 300, and 400 kPa). Experimental results indicate that CRM-reinforced SMA mixtures exhibit significantly higher fatigue life compared to the mixtures without CRM. Further, higher correlation coefficient was obtained between the fatigue life and resilient modulus as compared to permanent strain; thus resilient modulus might be a more reliable indicator in evaluating the fatigue life of asphalt mixture. PMID:25050406

  2. Spliceosome integrity is defective in the motor neuron diseases ALS and SMA

    Science.gov (United States)

    Tsuiji, Hitomi; Iguchi, Yohei; Furuya, Asako; Kataoka, Ayane; Hatsuta, Hiroyuki; Atsuta, Naoki; Tanaka, Fumiaki; Hashizume, Yoshio; Akatsu, Hiroyasu; Murayama, Shigeo; Sobue, Gen; Yamanaka, Koji

    2013-01-01

    Two motor neuron diseases, amyotrophic lateral sclerosis (ALS) and spinal muscular atrophy (SMA), are caused by distinct genes involved in RNA metabolism, TDP-43 and FUS/TLS, and SMN, respectively. However, whether there is a shared defective mechanism in RNA metabolism common to these two diseases remains unclear. Here, we show that TDP-43 and FUS/TLS localize in nuclear Gems through an association with SMN, and that all three proteins function in spliceosome maintenance. We also show that in ALS, Gems are lost, U snRNA levels are up-regulated and spliceosomal U snRNPs abnormally and extensively accumulate in motor neuron nuclei, but not in the temporal lobe of FTLD with TDP-43 pathology. This aberrant accumulation of U snRNAs in ALS motor neurons is in direct contrast to SMA motor neurons, which show reduced amounts of U snRNAs, while both have defects in the spliceosome. These findings indicate that a profound loss of spliceosome integrity is a critical mechanism common to neurodegeneration in ALS and SMA, and may explain cell-type specific vulnerability of motor neurons. PMID:23255347

  3. Analysis on Factors Affecting the Self-Repair Capability of SMA Wire Concrete Beam

    Directory of Open Access Journals (Sweden)

    Li Sun

    2013-01-01

    Full Text Available Crack expansion of concrete is the initial damage stage of structures, which may cause greater damage to structures subject to long-term loads or under extreme conditions. In recent years, the application of intelligent materials to crack self-repair has become a hotspot among researchers. In order to study the influence of factors on the self-repair capability of shape memory alloy (SMA wire concrete beam, both theoretical and experimental methods were employed for analysis. For the convenience of experiment, composite materials (epoxy cement mortar and silicone polymer clay instead of concrete were used. The SMA wires were externally installed on and internally embedded in epoxy resin cement mortar beams and silicone polymer clay beams. Comparison of crack repair situation between two installation methods turns out that both methods possess their own advantages and disadvantages and should be employed according to the actual situation. The influence of unbonded length on the self-repair capability of embedded type SMA wire beams and the necessary minimum unbonded length to achieve self-repair function were studied. The results state clearly that the longer the unbonded length is, the better the crack repair situation is.

  4. Hubungan antara Aktivitas Fisik Terhadap Memori Kerja Murid SMA Don Bosco III Bekasi

    Directory of Open Access Journals (Sweden)

    Michelle Clarissa Junaidi

    2017-03-01

    Full Text Available Latar belakang. Memori kerja merupakan bagian dari memori jangka pendek yang berperan penting dalam membantu proses pembelajaran dan dipengaruhi oleh aktivitas fisik, memori kerja yang rendah akan menimbulkan kesulitan untuk menerima informasi baru serta penurunan prestasi belajar. Tujuan. Mengetahui pengaruh aktivitas fisik terhadap kapasitas memori kerja murid SMA Don Bosco III. Metode. Penelitian metode analitik dengan pendekatan potong lintang pada 113 murid SMA Don Bosco III, Bekasi, pada 18 – 20 Juli 2016. Penelitian dilakukan dengan menggunakan kuesioner demografi, kuesioner skrining gangguan mental dan penyakit kronis, Physical Acitivity Questionnaire of Adolescent (PAQ-A dan Operation Span (O-SPAN. Analisis data dengan univariat dan bivariat menggunakan uji korelasi Spearman. Hasil. Terdapat 113 murid SMA Don Bosco III dengan kisaran usia 14 – 17 tahun, usia terbanyak 15 tahun (47.8%, laki-laki 61,1%, murid kelas X 44.2%. Mayoritas responden memiliki aktivitas fisik “kurang baik” dan rerata memori kerja 6,16. Analisis Spearman menunjukkan terdapat hubungan bermakna (p<0,05 antara aktivitas fisik terhadap memori kerja dengan korelasi positif lemah (r=0,384. Kesimpulan. Terdapat korelasi positif antara aktivitas fisik dan memori kerja, aktivitas fisik yang semakin tinggi cenderung akan meningkatkan memori kerja.

  5. A starfish robot based on soft and smart modular structure (SMS) actuated by SMA wires.

    Science.gov (United States)

    Jin, Hu; Dong, Erbao; Alici, Gursel; Mao, Shixin; Min, Xu; Liu, Chunshan; Low, K H; Yang, Jie

    2016-09-09

    This paper describes the design, fabrication and locomotion of a starfish robot whose locomotion principle is derived from a starfish. The starfish robot has a number of tentacles or arms extending from its central body in the form of a disk, like the topology of a real starfish. The arm, which is a soft and composite structure (which we call the smart modular structure (SMS)) generating a planar reciprocal motion with a high speed of response upon the actuation provided by the shape memory alloy (SMA) wires, is fabricated from soft and smart materials. Based on the variation in the resistance of the SMA wires during their heating, an adaptive regulation (AR) heating strategy is proposed to (i) avoid overheating of the SMA wires, (ii) provide bending range control and (iii) achieve a high speed of response favorable to successfully propelling the starfish robot. Using a finite-segment method, a thermal dynamic model of the SMS is established to describe its thermal behavior under the AR and a constant heating strategy. A starfish robot with five SMS tentacles was tested with different control parameters to optimize its locomotion speed. As demonstrated in the accompanying video file, the robot successfully propelled in semi-submerged and underwater environments show its locomotion ability in the multi-media, like a real starfish. The propulsion speed of the starfish robot is at least an order of magnitude higher than that of those reported in the literature-thanks to the SMS controlled with the AR strategy.

  6. PROFIL KESULITAN BELAJAR FISIKA POKOK BAHASAN KELISTRIKAN SISWA SMA DI KOTA SEMARANG

    Directory of Open Access Journals (Sweden)

    Ani Rusilowati

    2012-01-01

    Full Text Available Tujuan penelitian ini adalah menentukan profil kesulitan belajar Fisika, khususnya pokok bahasan Kelistrikan yang dialami oleh siswa SMA di kota Semarang. Sampel penelitian adalah siswa SMA kelas X di kota Semarang, diambil secara cluster, dari SMA negeri dan swasta peringkat I, II, dan III, sebanyak 214 siswa. Kesulitan belajar didiagnosis dengan lima pendekatan, yaitu tujuan pembelajaran, pengetahuan prasyarat, profil materi, miskonsepsi, dan pengetahuan terstruktur. Kesulitan belajar Kelistrikan antara lain disebabkan oleh rendahnya penguasaan konsep, lemahnya kemampuan matematis, dan kekurangmampuan mengkonversi satuan. Penyebab kesulitan belajar dalam pengetahuan terstruktur adalah rendahnya kemampuan: verbal, menggunakan skema, membuat strategi pemecahan masalah, dan membuat algoritma. Hasil penelitian menunjukkan bahwa kesulitan belajar Kelistrikan rata-rata terjadi pada sub pokok bahasan: Kuat Arus Listrik, Hukum Ohm, Hambatan Penghantar, Hukum Kirchof II, Energi & Daya Listrik, dan Transformator. Sebagian siswa masih mengalami miskonsepsi terhadap konsep Hukum Ohm dan Hambatan Penghantar. Bagi siswa  sekolah peringkat III mengalami kesulitan belajar di semua aspek dan materi Kelistrikan Kata kunci : profil, kesulitan belajar, kelistrikan

  7. SMA-Based System for Environmental Sensors Released from an Unmanned Aerial Vehicle

    Directory of Open Access Journals (Sweden)

    Lorenzo Pellone

    2017-01-01

    Full Text Available In the work at hand, a shape memory alloy (SMA-based system is presented. The system, conceived for releasing environmental sensors from ground or small unmanned aerial vehicles, UAV (often named UAS, unmanned aerial system, is made of a door, integrated into the bottom of the fuselage, a device distributor, operated by a couple of antagonistic SMA springs, and a kinematic chain, to synchronize the deployment operation with the system movement. On the basis of the specifications (weight, available space, energy supply, sensors size, etc., the system design was addressed. After having identified the main system characteristics, a representative mock-up was manufactured, featuring the bottom part of the reference fuselage. Functionality tests were performed to prove the system capability to release the sensors; a detailed characterization was finally carried out, mainly finalized at correlating the kinematic chain displacement with the SMA spring temperature and the supplied electrical power. A comparison between theoretical predictions and experimental outcomes showed good agreement.

  8. PEMBELAJARAN BERBASIS MASALAH UNTUK MENINGKATKAN KEMAMPUAN DAN DISPOSISI BERPIKIR KRITIS MATEMATIK SISWA SMA

    Directory of Open Access Journals (Sweden)

    Fiki Alghadari

    2013-08-01

    Full Text Available Latar belakang penelitian ini adalah pentingnya kemampuan dan disposisi berpikir kritis matematiksiswa, sedangkan tujuannya untuk mengetahui perbedaan peningkatan kemampuan dan disposisi berpikir kritis matematik siswa yang mendapatkan pembelajaran berbasis-masalah dan pembelajaran konvensional. Penelitian ini merupakan penelitian eksperimen dengan disain kelompok kontrol non-ekivalen menggunakan teknik purposive sampling. Kelas eksperimen mendapat pembelajaran matematika berbasis-masalah dan kelas kontrol mendapat pembelajaran konvensional. Instrumen yang digunakan berupa tes kemampuan berpikir kritis, dan skala disposisi berpikir kritis. Penelitian ini dilakukan di salah satu sekolah menengah atas. Populasi penelitian ini adalah siswa SMA dengan sampel penelitian adalah siswa kelas X SMA Negeri di Tanjungpandan Bangka Belitung dengan responden penelitiannya adalah siswa kelas X sebanyak dua kelas yang dipilih secara acak dari enam kelas yang ada. Analisis data kemampuan dan disposisi berpikir kritis matematik menggunakan uji-t.Hasil penelitian menunjukkan bahwa peningkatan kemampuan berpikir kritis matematik siswa yang mendapat pembelajaran matematika berbasis- masalah lebih baik daripada siswa yang mendapat pembelajaran konvensional. Analisis data skala memperlihatkan bahwa peningkatan disposisi berpikir kritis matematik siswa yang mendapatkan pembelajaran berbasis-masalah tidak lebih baik daripada siswa yang mendapat pembelajaran konvensional. Pembelajaran berbasis-masalah memungkinkan sebagai alternatif pembelajaran untuk diimplementasikan di SMA.

  9. Implementasi Sistem Informasi Akademik Menggunakan Aplikasi Jibas pada SMA Negeri 9 Padang

    Directory of Open Access Journals (Sweden)

    Ricky Akbar

    2015-10-01

    Full Text Available SMA Negeri 9 Padang is one of the institutions engaged in the field of education, which requires the design of software to manage and run all school activities, one of which is the Academic Information System (SIA. SIA currently in SMA 9 Padang yet well integrated, so it still has many shortcomings in meeting the needs of the school or institution, in particular to deal with academic problems. Therefore, it needs to be implemented Academic Information System that can overcome the various shortcomings earlier. Implementation of this application starts with a preliminary study. Activities, the introduction of the school as a whole with interviews and observations, identify business processes academically at school is running and then make the proposed system as terkomputerisasinya, which is described by using the tools of Business Process Model Notation (BPMN, as well as the depiction of a working model of the system to be applied using use case diagram. The next stage is to study the literature of various books and journals to find the theoretical basis and related research. Then selecting software for SIA School, after the configuration and customization of the software modules, and the latter carry out the implementation and testing. These results indicate that the software SIA Schools that have been selected and applied that JIBAS applications, which can solve the problems on SMA Negeri 9 Padang

  10. Minimizing the Moisture Damage and Drain down of Iraqi SMA Mixtures Using Waste Additives

    Directory of Open Access Journals (Sweden)

    Ali Al-Hadidy

    2013-04-01

    Full Text Available This research deals with the viability of using polyester fiber (PF, crumb rubber tire (CRT and cellulose fiber (CF as stabilizing waste additives in producing Iraqi SMA mixtures that sustain drain down phenomenon and moisture damage sensitivity. Different ratios of these additives (0.1, 0.2, and 0.3% by weight of aggregate and filler were mixed with 40/50 paving asphalt by means of dry process. Unmodified and modified SMA mixtures were subjected to drain down, Marshall, static indirect tensile strength, tensile stiffness modulus, static compressive strength, tensile strength ratio and index of retained strength tests. A set of regression equations between these tests were established. In addition, an optimization table based on these tests, which can be used to select the type or amount of additive for any field applications has been determined and reported. The results indicated that the inclusion of these additives in SMA mixtures can satisfy the performance requirement of high temperature and much rain zone.

  11. Analysis of SMA Hybrid Composite Structures in MSC.Nastran and ABAQUS

    Science.gov (United States)

    Turner, Travis L.; Patel, Hemant D.

    2005-01-01

    A thermoelastic constitutive model for shape memory alloy (SMA) actuators and SMA hybrid composite (SMAHC) structures was recently implemented in the commercial finite element codes MSC.Nastran and ABAQUS. The model may be easily implemented in any code that has the capability for analysis of laminated composite structures with temperature dependent material properties. The model is also relatively easy to use and requires input of only fundamental engineering properties. A brief description of the model is presented, followed by discussion of implementation and usage in the commercial codes. Results are presented from static and dynamic analysis of SMAHC beams of two types; a beam clamped at each end and a cantilever beam. Nonlinear static (post-buckling) and random response analyses are demonstrated for the first specimen. Static deflection (shape) control is demonstrated for the cantilever beam. Approaches for modeling SMAHC material systems with embedded SMA in ribbon and small round wire product forms are demonstrated and compared. The results from the commercial codes are compared to those from a research code as validation of the commercial implementations; excellent correlation is achieved in all cases.

  12. Spontaneous Tumor Lysis Syndrome

    Directory of Open Access Journals (Sweden)

    Alicia C. Weeks MD

    2015-08-01

    Full Text Available Tumor lysis syndrome (TLS is a known complication of malignancy and its treatment. The incidence varies on malignancy type, but is most common with hematologic neoplasms during cytotoxic treatment. Spontaneous TLS is thought to be rare. This case study is of a 62-year-old female admitted with multisystem organ failure, with subsequent diagnosis of aggressive B cell lymphoma. On admission, laboratory abnormalities included renal failure, elevated uric acid (20.7 mg/dL, and 3+ amorphous urates on urinalysis. Oliguric renal failure persisted despite aggressive hydration and diuretic use, requiring initiation of hemodialysis prior to chemotherapy. Antihyperuricemic therapy and hemodialysis were used to resolve hyperuricemia. However, due to multisystem organ dysfunction syndrome with extremely poor prognosis, the patient ultimately expired in the setting of a terminal ventilator wean. Although our patient did not meet current TLS criteria, she required hemodialysis due to uric acid nephropathy, a complication of TLS. This poses the clinical question of whether adequate diagnostic criteria exist for spontaneous TLS and if the lack of currently accepted guidelines has resulted in the underestimation of its incidence. Allopurinol and rasburicase are commonly used for prevention and treatment of TLS. Although both drugs decrease uric acid levels, allopurinol mechanistically prevents formation of the substrate rasburicase acts to solubilize. These drugs were administered together in our patient, although no established guidelines recommend combined use. This raises the clinical question of whether combined therapy is truly beneficial or, conversely, detrimental to patient outcomes.

  13. Cadaver dissection: A positive experience among Saudi female medical students

    Directory of Open Access Journals (Sweden)

    Nisreen A. Rajeh, PhD

    2017-06-01

    Conclusions: Saudi female first-year undergraduate medical students at KAU showed positive attitudes toward cadaver dissection during their human anatomy course. This study prompts the need for exploration of gender differences in perception regarding cadaver dissection.

  14. Pythagoras and the Dissection of Polygons.

    Science.gov (United States)

    Mortimer, M. E.; Ball, R. W.

    1984-01-01

    Provides examples of proofs of the Pythagorean result. These proofs fall into three categories: using ratios, using dissection, and using other forms of transformation. Shows that polygons of equal area are equidecomposable and that the approach taken (via squares) is a new approach. (JN)

  15. Dissection in Pre-college Education

    OpenAIRE

    Buyukmihci, NC

    2017-01-01

    This paper discusses the educational and ethical issues surrounding dissection of non-human animals in pre-college education. It argues that this exercise has no benefits to students that could possibly be outweighed by the death of healthy animals killed for this purpose.

  16. Nested Dissection Interface Reconstruction in Pececillo

    Energy Technology Data Exchange (ETDEWEB)

    Jibben, Zechariah Joel [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-08-31

    A nested dissection method for interface reconstruction in a volume tracking framework has been implemented in Pececillo. This method provides a significant improvement over the traditional onion-skin method, which does not appropriately handle T-shaped multimaterial intersections and dynamic contact lines present in additive manufacturing simulations. The resulting implementation lays the groundwork for further re- search in numerical contact angle estimates.

  17. Partial axillary dissection in early breast cancer

    African Journals Online (AJOL)

    Tarek Abdel Halim El-Fayoumi

    ORIGINAL ARTICLE. Partial axillary dissection in early breast cancer. Tarek Abdel Halim El-Fayoumi *. Department of General Surgery, Faculty of Medicine, Alexandria University, Egypt. Received 16 October 2012; accepted 7 January 2013. Available online 7 March 2013. KEYWORDS. Breast cancer;. Axillary lymph nodes.

  18. New applicator improves waterjet dissection quality.

    Science.gov (United States)

    Tschan, Christoph A; Tschan, Konrad; Krauss, Joachim K; Oertel, Joachim

    2010-12-01

    Waterjet dissection is accomplished with Helix Hydro-Jet, but a new device with improved operative handling and potentially superior dissection qualities has been developed. Eighty-four fresh cadaveric pig brains were simultaneously cut with Helix Hydro-Jet and Erbejet 2. A commonly used applicator and a new applicator for the Helix Hydro-Jet were directly compared to the new Erbejet 2. Under standardised conditions, different pressure levels were applied to the brain surface without arachnoids. Technical features, cutting depth, tissue damage and differences of applicators were examined. Microscopic analysis of cutting depth revealed different dissection characteristics of both the devices. With the standard applicators, waterjet cutting depth was shown to be deeper and with more foaming using the Helix Hydro-Jet compared to that of the Erbejet 2. With the new applicators, less foaming and a lower and more linear increased cutting depth were observed with the Helix Hydro-Jet, very similar to the superior qualities shown by the Erbejet 2. The new developed applicator of the Erbejet 2 also improves the intraoperative results of the so far applied Helix Hydro-Jet. The new Erbejet 2 provides some advantages for practicability; but in combination with the new applicator, the Helix Hydro-Jet accomplished almost identical superior dissection qualities of the Erbejet 2.

  19. Shoulder complaints after nerve sparing neck dissections

    NARCIS (Netherlands)

    van Wilgen, CP; Dijkstra, PU; van der Laan, BFAM; Plukker, JTM; Roodenburg, JLN

    The purpose of the study was to analyse the prevalence of shoulder complaints after nerve sparing neck dissection at least I year after surgery, and to analyse the influence of radiation therapy on shoulder complaints. Patients were interviewed for shoulder complaints, and patients filled out the

  20. Squid Dissection: From Pen to Ink.

    Science.gov (United States)

    Brown, Cindy; Kisiel, Jim

    2003-01-01

    Introduces students to dissection, which is an important part of scientific discovery. Students not only gain an understanding of the anatomy of a squid, but also develop a sense of responsibility and respect for the animal that they are using as a learning tool. (Author/SOE)

  1. Dissection spontanée et isolée du tronc coeliaque | Mrad | Pan ...

    African Journals Online (AJOL)

    Pan African Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 22, No 1 (2015) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should ...

  2. Pengaruh Metode Pembelajaran Terhadap Pengetahuan Lingkungan Hidup Ditinjau Dari Kreativitas Siswa (Eksperimen Pada Siswa Kelas X SMA Negeri Surakarta)

    OpenAIRE

    WA., SUWARTO

    2010-01-01

    The development of knowledge and techonology increases the quality of human life. However, it may causeproblems of the environment is damaged due to the lack of environmental awareness. One of the ways toovercome the problems is by integrating environmental education in Biology subject for SMA students. Thisexperimental research was intended to study the effects of learning methodes and student creativity on studentenvironmental knowledge. The study was carried out at SMA Negeri Surakarta 200...

  3. PENGARUH METODE PEMBELAJARAN TERHADAP PENGETAHUAN LINGKUNGAN HIDUP DITINJAU DARI KREATIVITAS SISWA (Eksperimen pada Siswa Kelas X SMA Negeri Surakarta)

    OpenAIRE

    WA., Suwarto

    2017-01-01

    The development of knowledge and techonology increases the quality of human life. However, it may causeproblems of the environment is damaged due to the lack of environmental awareness. One of the ways toovercome the problems is by integrating environmental education in Biology subject for SMA students. Thisexperimental research was intended to study the effects of learning methodes and student creativity on studentenvironmental knowledge. The study was carried out at SMA Negeri Surakarta 200...

  4. Studi Kasus Tentang Siswi yang Memiliki Konsep Diri Negatif pada Kelas X SMA Mujahidin Pontianak Tahun 2017

    OpenAIRE

    Ningsih, Dwi Purwanti

    2017-01-01

    This research entitled case study about student who have negative self concept in class X SMA Mujahidin Pontianak. Common problem in this research is how effort to help student having negatif self concept in class X SMA Mujahidin Pontianak? As for the sub-problems: 1) How are the characteristics of student who have negative self concept?, 2) What psychological factors that cause student to have negative self concept?, 3) What physiological factors that cause student to have a negative self co...

  5. Emotional response of undergraduates to cadaver dissection.

    Science.gov (United States)

    Wisenden, Patricia A; Budke, Katherine J; Klemetson, Chelsea J; Kurtti, Tana R; Patel, Chandi M; Schwantz, Trenda L; Wisenden, Brian D

    2018-03-01

    The most effective way to learn human anatomy is through cadaver dissection. Historically, cadaver dissection has been the provenance of professional schools. Increasingly, cadaver-based courses in human anatomy are shifting to the undergraduate level, which creates both problems and opportunities because of differences between undergraduate and graduate student populations. Anxiety associated with dissecting cadavers can create a barrier to learning, and ultimately, entry into the health and medical sciences for some demographic subpopulations of undergraduates. We surveyed 76 students in 2007 and 51 students in 2009 at four times in the semester to investigate the timing and sociodemographic predictors of anxiety over cadaver dissection. We followed this with a second survey of 44 students in 2014 to test the effect of humanization of cadaver donors (providing information about donor occupation and cause of death) to reduce student anxiety. Students experienced anxiety upon first exposure to cadaver dissection. Female students experienced greater anxiety than male students upon first exposure to cadavers but this effect was short-lived. Self-identified non-white, non-Christian students experienced sustained anxiety throughout the semester, likely because cadaver stress compounded social and financial stressors unique to international students. Humanization was effective in reducing anxiety in non-white, non-Christian students but had the unexpected effect of increasing anxiety in female students. We recommend that humanizing information be offered to students who seek it out, but not forced upon students for whom the information would only add to their stress. Clin. Anat. 31:224-230, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  6. Positive family history of aortic dissection dramatically increases dissection risk in family members.

    Science.gov (United States)

    Ma, Wei-Guo; Chou, Alan S; Mok, Salvior C M; Ziganshin, Bulat A; Charilaou, Paris; Zafar, Mohammad A; Sieller, Richard S; Tranquilli, Maryann; Rizzo, John A; Elefteriades, John A

    2017-08-01

    Although family members of patients with aortic dissection (AoD) are believed to be at higher risk of AoD, the prognostic value of family history (FH) of aortic dissection (FHAD) in family members of patients with AoD has not been studied rigorously. We seek examine how much a positive FHAD increases the risk of developing new aortic dissection (AoD) among first-degree relatives. Patients with AoD at our institution were analyzed for information of FHAD. Positive FHAD referred to that AoD occurred in index patient and one or more first-degree relatives. Negative FHAD was defined as the condition in which only one case of AoD (the index patient) occurred in the family. The age at AoD, exposure years in adulthood before AoD, and annual probability of AoD among first-degree relatives were compared between patients with negative and positive FHADs. FHAD was positive in 32 and negative in 68 among the 100 AoD patients with detailed family history information. Mean age at dissection was 59.9±14.7years. Compared to negative FHAD, patients with positive FHAD dissected at significantly younger age (54.7±16.8 vs 62.4±13.0years, p=0.013), had more AoD events in first-degree relatives (2.3±0.6 vs 1.0±0.0, pfamily members, with a higher annual probability of aortic dissection, a shorter duration of "exposure time" before dissection occurs and a lower mean age at time of dissection. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  7. Superior mesenteric artery (SMA) resection during pancreatectomy for malignant disease of the pancreas: a systematic review.

    Science.gov (United States)

    Jegatheeswaran, Santhalingam; Baltatzis, Minas; Jamdar, Saurabh; Siriwardena, Ajith K

    2017-06-01

    Resection of the superior mesenteric artery (SMA) during pancreatectomy is performed infrequently and is undertaken with the aim of removing non-metastatic locally advanced pancreatic tumours. SMA resection reports also encompass resection of other visceral vessels. The consequences of resection of these different arteries are not necessarily equivalent. This is a focused systematic review of the outcome of SMA resection during pancreatectomy for cancer. A computerized search of the English language literature was undertaken for the period 1st January 2000 through 30th April 2016. The keywords "Pancreatic surgery" and "Vascular resections" were used. Thirteen studies reported 70 patients undergoing pancreatectomy with SMA resection from 10,726 undergoing pancreatectomy. Individual patient-level outcome data were available for 25. Median (range) accrual period was 132 (48-372) months. Reported peri-operative morbidity ranged from 39% to 91%. There were 5 peri-operative deaths in the 25 patients with individual-outcome data. Median survival was 11 months (95% Confidence interval 9.5-12.5 months; standard error 0.8 months). SMA resection during pancreatectomy is undertaken infrequently incurring high peri-operative morbidity and mortality. Median survival is 11 (95% CI 9.5-12.5) months. In contemporary practice there is no evidence to support SMA resection during pancreatectomy. Copyright © 2017 International Hepato-Pancreato-Biliary Association Inc. All rights reserved.

  8. MEDIA FOTO UNTUK MENINGKATKAN KETERAMPILAN MENULIS DESKRIPSI SISWA SMA NEGERI 2 KEBUMEN

    Directory of Open Access Journals (Sweden)

    Rina Tri Indrianingrum

    2015-05-01

    Full Text Available Penelitian ini bertujuan untuk menjelaskan meningkatnya keterampilan menulis deskripsi berbahasa Jawa siswa kelas X SMA N 2 Kebumen dengan menggunakan pendekatan proses dan media foto. Penelitian ini merupakan penelitian tindakan kelas atau classroom action research. Desain yang digunakan dalam penelitian ini adalah desain penelitian tindakan Kemmis dan Taggart. Penelitian ini dilaksanakan dua siklus. Subjek penelitian ini adalah siswa kelas X2 SMA Negeri 2 Kebumen tahun pelajaran 2011/2012 yang berjumlah 32 siswa. Pengumpulan data dilakukan dengan menggunakan observasi, catatan lapangan dan tes. Validitas yang digunakan adalah validitas demo-krasi, validitas proses dan validitas dialogis. Teknik yang digunakan untuk menganalisis data dalam penelitian tindakan ini adalah deskriptif. Hasil penelitian menunjukkan (1 siswa dapat menemukan ide lebih cepat, (2 siswa dapat membuat kerangka karangan, (3 siswa dapat mengembangkan kerang-ka karangan, (4 siswa dapat berpikir sistematis, (5 siswa semakin antusiasnya dalam mengikuti pembelajaran menulis karangan, (6 siswa paham melakukan proses mengarang. _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ PHOTOGRAPH MEDIA TO IMPROVE THE DESCRIPTION WRITING SKILL OF THE STUDENTS AT SMA NEGERI 2 KEBUMEN   Abstract This research is aimed to describe and to explain the improvement in the description writing skill of the tenth grade students at SMA N 2 Kebumen by using  approach process and photography media. This research is classroom action research or classroom action research. The design used in this research was action research design by Kemmis and Taggart. The subject of the research was X2 class students at SMA Negeri 2 Kebumen in the academic year of 2011/2012, consisted of 32

  9. Perception to Cadaver Dissection and Views on Anatomy as a ...

    African Journals Online (AJOL)

    Cadaver dissection has been used as the main method of teaching human anatomy for the last five centuries. There are emerging concerns on the negative consequences of cadaver dissection on medical students, leading to suggestions on use of alternative technological advancements to cadaver dissection. However ...

  10. Is cadaveric dissection vital in anatomy education? Perceptions of 1 ...

    African Journals Online (AJOL)

    Introduction: The use of innovative ways of teaching anatomy as well as shortage of cadavers for dissection have raised questions as to whether dissection should continue to be used in teaching anatomy. This study aimed to assess the views of medical and dental students on the importance of dissection in learning gross ...

  11. "Shiatsu sympathectomy": ICA dissection associated with a shiatsu massager.

    Science.gov (United States)

    Elliott, Michael A; Taylor, Lynne P

    2002-04-23

    Carotid dissection is a well-described complication of head and neck trauma. Two cases of carotid dissection that occurred after use of shiatsu-type massagers are described. This potential cause should be considered when evaluating patients with idiopathic carotid dissection.

  12. Expertise concerning the request of a basic license for a SMA final repository at Wellenberg; Gutachten zum Gesuch um Rahmenbewilligung fuer ein SMA-Endlager am Wellenberg

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-05-15

    In January 1994, the Association for Nuclear Disposal Wellenberg (GNW) sent a request to the Swiss Federal Council for the granting of a basic license for a repository for low- and intermediate-level (SMA) radioactive wastes under the Wellenberg mountain in Wolfenschiessen. SMA wastes are continuously produced during the operation and dismantling of Swiss nuclear power plants, reprocessing of spent fuel assemblies as well as from medicine, industry and research. They have to be safely disposed of. The Federal Agency for the Safety of the Nuclear Installations (HSK) has to examine the project from the point of view of nuclear safety and protection from radioactivity. For its part the Federal Commission for the Safety of Nuclear Installations (KSA) has also to state its opinions on the project and on the HSK's report. The project presented is the only one which is foreseen in Switzerland for the storage of already existing radioactive wastes and for those which will be produced during the next decades. The maximum capacity of 150,000 m{sup 3} represents a sufficient reserve; the storage caves, however, will be excavated according to effective needs. The repository serves exclusively to the disposal of radioactive wastes with a very low content of long-life radionuclides. Previously, the HSK recognised the choice of Wellenberg as an appropriate site, which should, however, be more intensively analysed as far as the construction of an SMA final storage repository is concerned. The geographical characteristics of the site are favourable because of the presence of a cantonal road and a railway in the neighbourhood, which should make the transport of heavy loads easy. The Wellenberg site lies in a geologically complex region of the Alps. The geology and hydro-geology of the region were accurately defined as a result of drilling. The present knowledge of the site's properties allows a positive judgement of the projected repository. Many questions still remain

  13. Identification of internal carotid dissection in patients with migraine--case report and literature review

    International Nuclear Information System (INIS)

    Sharif, M.; Trinick, T.; Khan, H.Y.

    2010-01-01

    Although patho-physiology of spontaneous internal carotid artery dissection (sICAD) is largely unknown, an association with migraine has been suggested but not proven. Migraine is a condition which is worth considering while one is hunting a possible cause for internal carotid artery dissection (ICAD) and it may be found more often than expected.2 To date it remains a diagnosis of exclusion in patients with migraine. As opposed to migraine with aura, migraine without aura is significantly more frequent among patients with SICAD. It has been suggested that ICAD produces stroke in 36-68% of patients as a result of occlusion of the artery at or near the site of the dissection, or embolization occurring distally from a dislodged fragment of thrombus. We report a 31-year old woman with headache and ptosis as initial symptoms. Magnetic resonance imaging (MRI) confirmed the diagnosis. Prompt treatment was instituted with anti-platelet agents and the patient had complete resolution of symptoms. Our case report highlights the importance of identifying the patients with ICD with history of migraine, in the absence of other risk factors and adds to the sparse literature currently available on the subject. (author)

  14. S&MA Internship to Support Orion and the European Service Module

    Science.gov (United States)

    Hutcheson, Connor

    2016-01-01

    As a University Space Research Association (USRA) intern for NASA Johnson Space Center (JSC) during the summer 2016 work term, I worked on three main projects for the Space Exploration Division (NC) of the Safety and Mission Assurance (S&MA) Directorate. I worked on all three projects concurrently. One of the projects involved facilitating the status and closure of technical actions that were created during European Service Module (ESM) safety reviews by the MPCV Safety & Engineering Review Panel (MSERP). The two main duties included accurately collecting and summarizing qualitative data, and communicating that information to the European Space Agency (ESA) and Airbus (ESA's prime contractor) in a clear, succinct and precise manner. This project also required that I create a report on the challenges and opportunities of international S&MA. With its heavy emphasis on soft skills, this project taught me how to communicate better, by showing me how to present and share information in an easy-to-read and understandable format, and by showing me how to cooperate with and culturally respect international partners on a technical project. The second project involved working with the Orion Thermal Protection System (TPS) Process Failure Modes and Effects Analysis (PFMEA) Working Group to create the first full version of the Orion TPS PFMEA. The Orion TPS PFMEA Working Group met twice a week to analyze the Avcoat block installation process for failure modes, the failure modes effects, and how such failure modes could be controlled. I was in charge of implementing changes that were discussed in meeting, but were not implemented real time. Another major task included creating a significant portion of the content alongside another team member outside the two weekly meetings. This project caused me to become knowledgeable about TPS, heatshields, space-rated manufacturing, and non-destructive evaluation (NDE). The project also helped me to become better at working with a small

  15. Acute Type II Aortic Dissection with Severe Aortic Regurgitation and Chronic Descending Aortic Dissection in Pregnant Patient with Marfan Syndrome

    OpenAIRE

    Lee, Seok-Soo; Jung, Tae-Eun; Lee, Dong Hyup

    2012-01-01

    Aortic dilatation and dissection are severe complications during pregnancy that can be fatal to both the mother and the fetus. The risks of these complications are especially high in pregnant patients with Marfan syndrome; however, incidents of descending aortic dissection are very rare. This case report involves a successful Bentall procedure for and recovery from a rare aortic dissection in a pregnant Marfan patient who developed acute type II aortic dissection with severe aortic regurgitat...

  16. Spontaneous Intracranial Hypotension

    International Nuclear Information System (INIS)

    Joash, Dr.

    2015-01-01

    Epidemiology is not only rare but an important cause of new daily persistent headaches among young & middle age individuals. The Etiology & Pathogenesis is generally caused by spinal CSF leak. Precise cause remains largely unknown, underlying structural weakness of spinal meninges is suspected. There are several MR Signs of Intracranial Hypotension that include:- diffuse pachymeningeal (dural) enhancement; bilateral subdural, effusion/hematomas; Downward displacement of brain; enlargement of pituitary gland; Engorgement of dural venous sinuses; prominence of spinal epidural venous plexus and Venous sinus thrombosis & isolated cortical vein thrombosis. The sum of volumes of intracranial blood, CSF & cerebral tissue must remain constant in an intact cranium. Treatment in Many cases can be resolved spontaneously or by use Conservative approach that include bed rest, oral hydration, caffeine intake and use of abdominal binder. Imaging Modalities for Detection of CSF leakage include CT myelography, Radioisotope cisternography, MR myelography, MR imaging and Intrathecal Gd-enhanced MR

  17. Spontaneous wave packet reduction

    International Nuclear Information System (INIS)

    Ghirardi, G.C.

    1994-06-01

    There are taken into account the main conceptual difficulties met by standard quantum mechanics in dealing with physical processes involving macroscopic system. It is stressed how J.A.Wheeler's remarks and lucid analysis have been relevant to pinpoint and to bring to its extreme consequences the puzzling aspects of quantum phenomena. It is shown how the recently proposed models of spontaneous dynamical reduction represent a consistent way to overcome the conceptual difficulties of the standard theory. Obviously, many nontrivial problems remain open, the first and more relevant one being that of generalizing the model theories considered to the relativistic case. This is the challenge of the dynamical reduction program. 43 refs, 2 figs

  18. Which Comes First: The Use of Computer Simulation of Frog Dissection or Conventional Dissection as Academic Exercise?

    Science.gov (United States)

    Akpan, Joseph; Strayer, Jeremy

    2010-01-01

    Science educators and school administrators are reexamining the educational value of animal dissection in the nation's schools and are focusing on simulation as an instructional alternative. One implication of the debate is that simulations can lead to equivalent learning to hands-on dissection. The second implication is whether dissection is…

  19. Spontaneous compactification to homogeneous spaces

    International Nuclear Information System (INIS)

    Mourao, J.M.

    1988-01-01

    The spontaneous compactification of extra dimensions to compact homogeneous spaces is studied. The methods developed within the framework of coset space dimensional reduction scheme and the most general form of invariant metrics are used to find solutions of spontaneous compactification equations

  20. Screening for spontaneous preterm birth

    NARCIS (Netherlands)

    van Os, M.A.; van Dam, A.J.E.M.

    2015-01-01

    Preterm birth is the most important cause of perinatal morbidity and mortality worldwide. In this thesis studies on spontaneous preterm birth are presented. The main objective was to investigate the predictive capacity of mid-trimester cervical length measurement for spontaneous preterm birth in a

  1. Spontaneous Pneumomediastinum: Hamman Syndrome

    Directory of Open Access Journals (Sweden)

    Tushank Chadha, BS

    2018-04-01

    significant fat stranding. The image also showed an intraluminal stent traversing the gastric antrum and gastric pylorus with no indication of obstruction. Circumferential mural thickening of the gastric antrum and body were consistent with the patient’s history of gastric adenocarcinoma. The shotty perigastric lymph nodes with associated fat stranding, along the greater curvature of the distal gastric body suggested local regional nodal metastases and possible peritoneal carcinomatosis. The thoracic CT scans showed extensive pneumomediastinum that tracked into the soft tissues of the neck, which given the history of vomiting also raised concern for esophageal perforation. There was still no evidence of mediastinal abscess or fat stranding. Additionally, a left subclavian vein port catheter, which terminates with tip at the cavoatrial junction of the superior vena cava can also be seen on the image. Discussion: Spontaneous Pneumomediastinum, also known as Hamman syndrome, is defined by the uncommon incidence of free air in the mediastinum due to the bursting of alveoli, as a result of extended spells of shouting, coughing, or vomiting.1,2 The condition is diagnosed when a clear cause (aerodigestive rupture, barotrauma, infection secondary to gas-forming organisms3 for pneumomediastinum cannot be clearly identified on diagnostic studies. Macklin and Macklin were the first to note the pathogenesis of the syndrome and explained that the common denominator to spontaneous pneumomediastinum was that increased alveolar pressure leads to alveolar rupture.3 Common clinical findings for spontaneous pneumomediastinum include: chest pain, dyspnea, cough, and emesis.4 The condition is not always readily recognized on initial presentation in part for its rare incidence, estimated to be approximately 1 in every 44,500 ED patients3and also because of the non-specific presenting symptoms. For this patient, there was no clear singular cause, and therefore she received care for spontaneous

  2. CT versus MR Techniques in the Detection of Cervical Artery Dissection.

    Science.gov (United States)

    Hanning, Uta; Sporns, Peter B; Schmiedel, Meilin; Ringelstein, Erich B; Heindel, Walter; Wiendl, Heinz; Niederstadt, Thomas; Dittrich, Ralf

    2017-11-01

    Spontaneous cervical artery dissection (sCAD) is an important etiology of juvenile stroke. The gold standard for the diagnosis of sCAD is convential angiography. However, magnetic resonance imaging (MRI)/MR angiography (MRA) and computed tomography (CT)/CT angiography (CTA) are frequently used alternatives. New developments such as multislice CT/CTA have enabled routine acquisition of thinner sections with rapid imaging times. The goal of this study was to compare the capability of recent developed 128-slice CT/CTA to MRI/MRA to detect radiologic features of sCAD. Retrospective review of patients with suspected sCAD (n = 188) in a database of our Stroke center (2008-2014), who underwent CT/CTA and MRI/MRA on initial clinical work-up. A control group of 26 patients was added. All Images were evaluated concerning specific and sensitive radiological features for dissection by two experienced neuroradiologists. Imaging features were compared between the two modalities. Forty patients with 43 dissected arteries received both modalities (29 internal carotid arteries [ICAs] and 14 vertebral arteries [VAs]). All CADs were identified in CT/CTA and MRI/MRA. The features intimal flap, stenosis, and lumen irregularity appeared in both modalities. One high-grade stenosis was identified by CT/CTA that was expected occluded on MRI/MRA. Two MRI/MRA-confirmed pseudoaneurysms were missed by CT/CTA. None of the controls evidenced specific imaging signs for dissection. CT/CTA is a reliable and better available alternative to MRI/MRA for diagnosis of sCAD. CT/CTA should be used to complement MRI/MRA in cases where MRI/MRA suggests occlusion. Copyright © 2017 by the American Society of Neuroimaging.

  3. Candidate proteins, metabolites and transcripts in the Biomarkers for Spinal Muscular Atrophy (BforSMA clinical study.

    Directory of Open Access Journals (Sweden)

    Richard S Finkel

    Full Text Available Spinal Muscular Atrophy (SMA is a neurodegenerative motor neuron disorder resulting from a homozygous mutation of the survival of motor neuron 1 (SMN1 gene. The gene product, SMN protein, functions in RNA biosynthesis in all tissues. In humans, a nearly identical gene, SMN2, rescues an otherwise lethal phenotype by producing a small amount of full-length SMN protein. SMN2 copy number inversely correlates with disease severity. Identifying other novel biomarkers could inform clinical trial design and identify novel therapeutic targets.To identify novel candidate biomarkers associated with disease severity in SMA using unbiased proteomic, metabolomic and transcriptomic approaches.A cross-sectional single evaluation was performed in 108 children with genetically confirmed SMA, aged 2-12 years, manifesting a broad range of disease severity and selected to distinguish factors associated with SMA type and present functional ability independent of age. Blood and urine specimens from these and 22 age-matched healthy controls were interrogated using proteomic, metabolomic and transcriptomic discovery platforms. Analyte associations were evaluated against a primary measure of disease severity, the Modified Hammersmith Functional Motor Scale (MHFMS and to a number of secondary clinical measures.A total of 200 candidate biomarkers correlate with MHFMS scores: 97 plasma proteins, 59 plasma metabolites (9 amino acids, 10 free fatty acids, 12 lipids and 28 GC/MS metabolites and 44 urine metabolites. No transcripts correlated with MHFMS.In this cross-sectional study, "BforSMA" (Biomarkers for SMA, candidate protein and metabolite markers were identified. No transcript biomarker candidates were identified. Additional mining of this rich dataset may yield important insights into relevant SMA-related pathophysiology and biological network associations. Additional prospective studies are needed to confirm these findings, demonstrate sensitivity to change with

  4. Clinical analysis of neck dissection patients

    International Nuclear Information System (INIS)

    Sato, Katsuro; Takahashi, Sugata

    2008-01-01

    Neck dissection is a highly important surgical procedure in the treatment of squamous cell carcinoma (SCC) of the head and neck since the control of the nodal disease is highly important in these patients. In this paper, 131 patients (210 necks) treated in our department were analyzed. The most frequent primary lesion site was the oral cavity, followed by larynx, hypopharynx and mesopharynx, and treatment of metastatic nodes was considered important especially in patients with SCC in those regions. As the surgical procedure for neck dissection, (modified) radical neck dissection was chosen for higher N stage cases, although it was also applied to lower N stage cases. Postoperative irradiation was performed for 70% of the patients, and control of the neck was considered good as recurrent neck disease occurred in 8% of the patients, and only 20% of those died of recurrent neck disease. The most common primary site showing cervical recurrence was the oral cavity, and control of neck disease is considered important, especially in patients with SCC of the oral cavity. Patients with ≤number of pN 1 receiving postoperative irradiation, and patients with pN (-) and ≤number of pN 1 without postoperative irradiation showed significantly higher survival rates. Postoperative irradiation should be done for patients with ≥number of pN 2, and follow-up without postoperative treatment should be considered for the cases of ≤number of pN 1. Further consideration of patient selection with regard to the area of dissection and the indication for postoperative irradiation without decreasing the survival rate is needed to further improve the treatment of head and neck SCCs. (author)

  5. Nested Dissection Interface Reconstruction in Pececillo

    Energy Technology Data Exchange (ETDEWEB)

    Jibben, Zechariah Joel [Los Alamos National Lab. (LANL), Los Alamos, NM (United States). Computer, Computational, and Statistical Sciences Division; Carlson, Neil N. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States). Computer, Computational, and Statistical Sciences Division; Francois, Marianne M. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States). Computer, Computational, and Statistical Sciences Division

    2016-09-13

    A nested dissection method for interface reconstruction in a volume tracking framework has been implemented in Pececillo, a mini-app for Truchas, which is the ASC code for casting and additive manufacturing. This method provides a significant improvement over the traditional onion-skin method, which does not appropriately handle T-shaped multimaterial intersections and dynamic contact lines present in additive manufacturing simulations. The resulting implementation lays the groundwork for further research in contact angle estimates and surface tension calculations.

  6. Cure SMA

    Science.gov (United States)

    ... 2, 2017 New Clinical Trial Data Published in New England Journal of Medicine Two new papers of clinical trial data for spinal muscular atrophy were published today in the November issue of the New England Journal of... READ MORE October 25, 2017 Fall 2017 ...

  7. Whole vitreous humor dissection for vitreodynamic analysis.

    Science.gov (United States)

    Murali, Karthik; Kashani, Amir H; Humayun, Mark S

    2015-05-24

    The authors propose an effective technique to isolate whole, intact vitreous core and cortex from post mortem enucleated porcine eyes. While previous studies have shown the results of such dissections, the detailed steps have not been described, precluding researchers outside the field from replicating their methods. Other studies harvest vitreous either through aspiration, which does not maintain the vitreous structure anatomy, or through partial dissection, which only isolates the vitreous core. The proposed method isolates the whole vitreous body, with the vitreous core and cortex intact, while maintaining vitreous anatomy and structural integrity. In this method, a full thickness scleral flap in an enucleated porcine eye is first created and through this, the choroid tissue can be separated from the sclera. The scleral flap is then expanded and the choroid is completely separated from the sclera. Finally the choroid-retina tissue is peeled off the vitreous to leave an isolated intact vitreous body. The proposed vitreous dissection technique can be used to study physical properties of the vitreous humor. In particular, this method has significance for experimental studies involving drug delivery, vitreo-retinal oxygen transport, and intraocular convection.

  8. Acute aortic dissection: be aware of misdiagnosis

    Directory of Open Access Journals (Sweden)

    Asteri Theodora

    2009-02-01

    Full Text Available Abstract Background Acute aortic dissection (AAD is a life-threatening condition requiring immediate assessment and therapy. A patient suffering from AAD often presents with an insignificant or irrelevant medical history, giving rise to possible misdiagnosis. The aim of this retrospective study is to address the problem of misdiagnosing AD and the different imaging studies used. Methods From January 2000 to December 2004, 49 patients (41 men and 8 women, aged from 18–75 years old presented to the Emergency Department of our hospital for different reasons and finally diagnosed with AAD. Fifteen of those patients suffered from arterial hypertension, one from giant cell arteritis and another patient from Marfan's syndrome. The diagnosis of AAD was made by chest X-ray, contrast enhanced computed tomography (CT, transthoracic echocardiography (TTE and coronary angiography. Results Initial misdiagnosis occurred in fifteen patients (31% later found to be suffering from AAD. The misdiagnosis was myocardial infarction in 12 patients and cerebral infarction in another three patients. Conclusion Aortic dissection may present with a variety of clinical manifestations, like syncope, chest pain, anuria, pulse deficits, abdominal pain, back pain, or acute congestive heart failure. Nearly a third of the patients found to be suffering from AD, were initially otherwise diagnosed. Key in the management of acute aortic dissection is to maintain a high level of suspicion for this diagnosis.

  9. Pengembangan Set Praktikum Fluida Dinamis untuk Sekolah Menengah Atas (SMA Kelas XI

    Directory of Open Access Journals (Sweden)

    Sifa Alfiyah

    2016-12-01

    Full Text Available Abstract This research aims to develop and produce a practicum set of dynamic fluid as a media lab practicum teaching high school physics class XI. The research was conducted in 81 Senior High School Jakarta, 89 Senior High School Jakarta and 115 Senor High School Jakarta. The method used, methods of Research and Development which refers to the process of development research Dick and Carey. This research was conducted through several phases, namely (1 assess the demands of curriculum standards in 2013, (2 designing media and manufacturing, (3 the development, test legibility or small scale test, test experts, tested against a teacher in physics and high school students in class XI. The instrument uses a Likert scale ratings. The result of the development of fluid dynamic lab set to produce a tool that consists of a large tank of small holes (TBLK of the inner diameter of 0.8 cm and 1.6 cm in five holes with a height variation, TBLK diameter of the inner circumference of 0.8 cm with a variation of the angle 20,5o and 30o five holes with a height variation, venturimeter with manometer fluid containing oil, venturimeter without manometer, large fluid capacity tubs, manual book and the Student Activity Sheet (LKS. The test results set against the dynamic fluid lab experts and students gain excellent assessment level is in the range of interpretation score of 81-100%. Keywords: Practicum Set of Dynamic Fluid, Development Research, and XI Grade of High School Abstrak Penelitian ini bertujuan untuk mengembangkan dan menghasilkan set praktikum fluida dinamis sebagai media praktikum pembelajaran fisika SMA kelas XI. Penelitian dilakukan di SMA N 81 Jakarta, SMA N 89 Jakarta, dan SMA N 115 Jakarta. Metode penelitian yang digunakan, metode penelitian dan pengembangan (Research and Development yang mengacu pada proses penelitian pengembangan Dick dan Carey. Penelitian ini dilakukan melalui beberapa tahapan, yaitu (1 mengkaji tuntutan standar kurikulum 2013

  10. Advanced methods for the analysis, design, and optimization of SMA-based aerostructures

    Science.gov (United States)

    Hartl, D. J.; Lagoudas, D. C.; Calkins, F. T.

    2011-09-01

    Engineers continue to apply shape memory alloys to aerospace actuation applications due to their high energy density, robust solid-state actuation, and silent and shock-free operation. Past design and development of such actuators relied on experimental trial and error and empirically derived graphical methods. Over the last two decades, however, it has been repeatedly demonstrated that existing SMA constitutive models can capture stabilized SMA transformation behaviors with sufficient accuracy. This work builds upon past successes and suggests a general framework by which predictive tools can be used to assess the responses of many possible design configurations in an automated fashion. By applying methods of design optimization, it is shown that the integrated implementation of appropriate analysis tools can guide engineers and designers to the best design configurations. A general design optimization framework is proposed for the consideration of any SMA component or assembly of such components that applies when the set of design variables includes many members. This is accomplished by relying on commercially available software and utilizing tools already well established in the design optimization community. Such tools are combined with finite element analysis (FEA) packages that consider a multitude of structural effects. The foundation of this work is a three-dimensional thermomechanical constitutive model for SMAs applicable for arbitrarily shaped bodies. A reduced-order implementation also allows computationally efficient analysis of structural components such as wires, rods, beams and shells. The use of multiple optimization schemes, the consideration of assembled components, and the accuracy of the implemented constitutive model in full and reduced-order forms are all demonstrated.

  11. Experimental study on tunnel lining joints temporarily strengthened by SMA bolts

    International Nuclear Information System (INIS)

    Wu, Bo; Ou, Yunlong

    2014-01-01

    Shield tunnels have been widely used in city metros all over the world. During the long-term period of the metro operation, the joints of shield tunnel’s neighboring segments may degrade due to some environmental factors, leading to the increasing of the joint opening and some resulting adverse consequences. In this paper, a temporary strengthening method by using shape memory alloy (SMA) bolts is proposed and experimentally studied for the joints of neighboring segments, and a revised electric heating method which suits with the strengthening method is presented and experimentally validated for the SMA bolts. The purpose of the proposed temporary strengthening method is to create favorable conditions for the following permanent strengthening. Test results show that: (a) for the joints of shield tunnel’s neighboring segments, the strengthening method can effectively reduce the joint opening, joint deflection, concrete strain in joint’s compression zone, and strain of joint’s steel bolts; (b) the revised electric heating method can be used to heat the SMA rod to a temperature higher than the SMA’s austenite finish temperature quickly, and the average heating rate related to Type 2 inner resistance element is larger than that related to Type 1 inner resistance element; and (c) the reduction percentages of the joint opening increment, joint deflection, concrete strain in joint’s compression zone, and strain of joint’s steel bolts for Specimen I are all larger than those for Specimen II, implying that the less the joint opening is, the more significant the strengthening effect is. (paper)

  12. Profil Problem Emosi/ Perilaku Pada Remaja Pelajar SMP-SMA Di Kota Semarang

    Directory of Open Access Journals (Sweden)

    Annastasia Ediati

    2015-10-01

    Full Text Available The aims of this study is to identify the profile of emotional/behavioral problems on adolescents students of junior and senior high school (SMP-SMA in Semarang, Central Java. The subjects comprised 568 students (grade VII and X; males and females, aged between 13-17 years. Data were collected using the Indonesian translation of the Youth Self Report (YSR. The results of data analysis showed that adolescents in the junior high school/SMP reported emotional/behavioral problems more frequently than the adolescents in the senior high school/SMA (t (566 = 2.08, p = .038, especially in terms of social relations (t (566 = 2.92, p = .004, thought problems (t (566 = 2.47, p = .014, somatic complaints (t(566 = 2.98, p = .002, rule-breaking behavior (t (566 = 6.63, p < .001, and externalizing problems (t(566 = 3,37; p = .001. Gender differences was found in the adolescents’ emotional/behavioral problems. In group of junior high school students (SMP, girls reported more emotional problems than boys (t(335 = -3.55; p < .001, particularly in anxiety/depression (t(335 = -6.51; p < .001; withdrawal (t(335 = -4.26; p < .001, somatic complaints (t(335 = -2.86; p = .004; social problems (t(335 = -3.30; p = .001, attention problems (t(335 = -2.39; p = .017; and internalizing problem (t(335 = -5.76; p < .001. In group of senior high school students (SMA, boys reported more externalizing problems (t(229 = 2.10; p = .037 and rule-breaking behavior (t(229 = 4.44; p < .001 than girls. In contrasts, girls reported more somatic complaints than boys (t(229 = -3.09; p = .001. Adolescents’ emotional/behavioral problems should gained more attention. Preventive as well as curative intervention is needed, particularly intervention that sensitive to gender and age, which also involve significant figures for adolescents (parents, school teachers, and peers.

  13. Advanced methods for the analysis, design, and optimization of SMA-based aerostructures

    International Nuclear Information System (INIS)

    Hartl, D J; Lagoudas, D C; Calkins, F T

    2011-01-01

    Engineers continue to apply shape memory alloys to aerospace actuation applications due to their high energy density, robust solid-state actuation, and silent and shock-free operation. Past design and development of such actuators relied on experimental trial and error and empirically derived graphical methods. Over the last two decades, however, it has been repeatedly demonstrated that existing SMA constitutive models can capture stabilized SMA transformation behaviors with sufficient accuracy. This work builds upon past successes and suggests a general framework by which predictive tools can be used to assess the responses of many possible design configurations in an automated fashion. By applying methods of design optimization, it is shown that the integrated implementation of appropriate analysis tools can guide engineers and designers to the best design configurations. A general design optimization framework is proposed for the consideration of any SMA component or assembly of such components that applies when the set of design variables includes many members. This is accomplished by relying on commercially available software and utilizing tools already well established in the design optimization community. Such tools are combined with finite element analysis (FEA) packages that consider a multitude of structural effects. The foundation of this work is a three-dimensional thermomechanical constitutive model for SMAs applicable for arbitrarily shaped bodies. A reduced-order implementation also allows computationally efficient analysis of structural components such as wires, rods, beams and shells. The use of multiple optimization schemes, the consideration of assembled components, and the accuracy of the implemented constitutive model in full and reduced-order forms are all demonstrated

  14. Pola Pembinaan Kompetensi Kepribadian dan Kompetensi Sosial Guru di SMA Muhammadiyah 1 Ponorogo

    Directory of Open Access Journals (Sweden)

    Bambang Wahrudin

    2017-11-01

    Full Text Available This research is motivated by the importance of personal competence and social competence teacher as the spirit of education. The focus of reasearch is know the program fostering personal competence and social competence teacherin SMA Muhammadiyah 1 Ponorogo . Deep observation and interview used in this research by qualitative aproach. The result shows that personality competence development programs conducted in six (6 forms include: 1 Dhuhr and Asr prayers in congregation, 2 Baitul Arqom for teachers and employees, 3 Course / tahsin read the Koran for teachers and employees, 4 Pray tahajud ahad congregation every morning, and 5 Training Motivation and 6 Counseling, whereas social competence training program conducted by three (3 forms, namely: 1 Piket Sympathetic, 2 MGMPs and 3 Sinergy Building. These patern have made theacher have stong  professionaly and  authority Abstrak Penelitian ini dilatarbelakangi oleh pentingnya kompetensi kepribadian dan kompetensi sosial bagi guru sebagai ruh pendidikan. Penelitian ini bertujuan untuk mengetahui program pembinaan kompetensi kepribadian dan kompetensi sosial guru di SMA Muhammadiyah 1 Ponorogo. Reset mendalam dilakukan secara kualitatif. Hasil penelitian menunjukkaan bahwa Program pembinaan kompetensi kepribadian dan kompetensi sosial sumber daya manusia di SMA Muhammadiyah 1 Ponorogo menggunakan 6 (enam bentuk meliputi: 1. sholat Dhuhur dan Ashar berjamaah, 2. baitul Arqom untuk guru dan karyawan, 3. kursus/tahsin baca al-Qur’an untuk guru dan karyawan, 4. sholat tahajud berjamaah setiap ahad dini hari, dan 5. training motivasi dan 6. konseling, sedangkan program pembinaan kompetensi sosial dilakukan dengan 3 (tiga bentuk, yaitu: 1. paket Simpatik, 2.  MGMP dan 3. sinergy Building. Pola ini telah berhasil menghantarkan guru sebagai guru yang profesional yang kuat dan berwibawa.

  15. Spontaneous breaking of supersymmetry

    Energy Technology Data Exchange (ETDEWEB)

    Zumino, B.

    1981-12-01

    There has been recently a revival of interest in supersymmetric gauge theories, stimulated by the hope that supersymmetry might help in clarifying some of the questions which remain unanswered in the so called Grand Unified Theories and in particular the gauge hierarchy problem. In a Grand Unified Theory one has two widely different mass scales: the unification mass M approx. = 10/sup 15/GeV at which the unification group (e.g. SU(5)) breaks down to SU(3) x SU(2) x U(1) and the mass ..mu.. approx. = 100 GeV at which SU(2) x U(1) is broken down to the U(1) of electromagnetism. There is at present no theoretical understanding of the extreme smallness of the ratio ..mu../M of these two numbers. This is the gauge hierarchy problem. This lecture attempts to review the various mechanisms for spontaneous supersymmetry breaking in gauge theories. Most of the discussions are concerned with the tree approximation, but what is presently known about radiative correction is also reviewed.

  16. Spontaneous intracranial hypotension

    International Nuclear Information System (INIS)

    Haritanti, A.; Karacostas, D.; Drevelengas, A.; Kanellopoulos, V.; Paraskevopoulou, E.; Lefkopoulos, A.; Economou, I.; Dimitriadis, A.S.

    2009-01-01

    Spontaneous intracranial hypotension (SIH) is an uncommon but increasingly recognized syndrome. Orthostatic headache with typical findings on magnetic resonance imaging (MRI) are the key to diagnosis. Delayed diagnosis of this condition may subject patients to unnecessary procedures and prolong morbidity. We describe six patients with SIH and outline the important clinical and neuroimaging findings. They were all relatively young, 20-54 years old, with clearly orthostatic headache, minimal neurological signs (only abducent nerve paresis in two) and diffuse pachymeningeal gadolinium enhancement on brain MRI, while two of them presented subdural hygromas. Spinal MRI was helpful in detecting a cervical cerebrospinal fluid leak in three patients and dilatation of the vertebral venous plexus with extradural fluid collection in another. Conservative management resulted in rapid resolution of symptoms in five patients (10 days-3 weeks) and in one who developed cerebral venous sinus thrombosis, the condition resolved in 2 months. However, this rapid clinical improvement was not accompanied by an analogous regression of the brain MR findings that persisted on a longer follow-up. Along with recent literature data, our patients further point out that SIH, to be correctly diagnosed, necessitates increased alertness by the attending physician, in the evaluation of headaches

  17. Spontaneous lateral temporal encephalocele.

    Science.gov (United States)

    Tuncbilek, Gokhan; Calis, Mert; Akalan, Nejat

    2013-01-01

    A spontaneous encephalocele is one that develops either because of embryological maldevelopment or from a poorly understood postnatal process that permits brain herniation to occur. We here report a rare case of lateral temporal encephalocele extending to the infratemporal fossa under the zygomatic arch. At birth, the infant was noted to have a large cystic mass in the right side of the face. After being operated on initially in another center in the newborn period, the patient was referred to our clinic with a diagnosis of temporal encephalocele. He was 6 months old at the time of admission. Computerized tomography scan and magnetic resonance imaging studies revealed a 8 × 9 cm fluid-filled, multiloculated cystic mass at the right infratemporal fossa. No intracranial pathology or connection is seen. The patient was operated on to reduce the distortion effect of the growing mass. The histopathological examination of the sac revealed well-differentiated mature glial tissue stained with glial fibrillary acid protein. This rare clinical presentation of encephaloceles should be taken into consideration during the evaluation of the lateral facial masses in the infancy period, and possible intracranial connection should be ruled out before surgery to avoid complications.

  18. Analisis Dampak Negatif Facebook pada Remaja Kelas X IPS SMA Kemala Bhayangkari Kubu Raya

    OpenAIRE

    Malindo, Hari

    2017-01-01

    The negative impact of the use of facebook is a result caused the use of facebook excessively that can give rise to abuse and diversion to brpengaruh directly to the consumer, and often waste time just to tamper with his facebook account, if not used wisely facebook will have a negative impact to pengggunanya it sendiri..Oleh because the researchers wanted to know more profound analysis of the negative impact on teenagers facebook IPS class X SMA Kemala Bhayangkari Kubu Raya.A common problem ...

  19. FAKTOR GENDER DAN RESILIENSI DALAM PENCAPAIAN KEMAMPUAN BERPIKIR KREATIF MATEMATIS SISWA SMA

    Directory of Open Access Journals (Sweden)

    Siska Chindy Dilla

    2017-12-01

    Full Text Available Penelitian ini bertujuan untuk mengetahui secara mendalam tentang pengaruh positif dari faktor gender dan resiliensi matematis dalam pencapaian kemampuan berpikir kreatif matematis siswa SMA. Metode dalam penelitian ini menggunakan metode korelasional dengan pendekatan kuantitatif. Populasi penelitian ini adalah semua siswa SMA di Bandung dengan sampel dipilih siswa kelas XII Sekolah Menengah Atas di suatu SMA Swasta di Bandung sejumlah 33 siswa. Instrumen yang digunakan dalam penelitian ini yaitu tes untuk mengukur kemampuan berpkir kreatif matematis berupa soal uraian sebanyak 4 soal, sedangkan instrument non tes untuk mengukur tingkat Resiliensi matematis berupa skala dalam kuesioner. Analisis data yang digunakan pada penelitian ini adalah uji Analisis Kovarian (Ancova. Hasil penelitian ini menunjukkan pada tingkat kepercayaan 95% terdapat hubungan positif faktor gender dan resiliensi matematis siswa terhadap pencapaian kemampuan berpikir kreatif matematis siswa SMA. Koefisien Determinasi Berganda semua variabel independen secara simultan terhadap variabel dependen. Diperoleh nilai R Squared 0,866 artinya 86,6% dari pencapaian kemampuan berpikir kreatif siswa dipengaruhi oleh faktor gender dan resiliensi siswa. Sisanya 13,4% dipengaruhi oleh faktor lain. This study aims to find out in depth about the positive effects of gender factors and mathematical resilience in the achievement of mathematical creative thinking ability of high school students. The method in this research using correlational method with quantitative approach. The population of this study is all high school students in Bandung with a sample of students selected class XII High School in a private high school in Bandung a number of 33 students. The instrument used in this research is a test to measure of mathematical creative thinking ability in the form of a description of 4 questions, while the non-test instrument to measure the level of mathematical resilience in the form

  20. Analisis pengelolaan peralatan praktikum fisika kelas XI SMA Muhammadiyah 1 Yogyakarta menggunakan model countenance stake

    Directory of Open Access Journals (Sweden)

    Hanin Fathan Nurfina Istiqomah

    2016-11-01

    Full Text Available Penelitian ini bertujuan untuk mengetahui ketersediaan dan pengelolaan peralatan praktikum serta mengetahui hasil dari pengelolaan dan penggunaan peralatan praktikum fisika kelas XI di laboratorium fisika SMA Muhammadiyah 1 Yogyakarta. Penelitian ini merupakan penelitian evalusi model countenance stake. Subjek penelitian meliputi penanggungjawab laboratorium fisika, guru, laboran, dan siswa kelas XI MIA SMA Muhammadiyah 1 Yogyakarta. Penelitian dilakukan pada akhir pelaksanaan praktikum pada semester genap tahun pelajaran 2015-2016. Data dikumpulkan dengan wawancara terstruktur, pengamatan (observasi, angket, dokumentasi. Hasil penelitian menunjukkan bahwa ketersediaan peralatan praktikum (masukan [antecedents] yang terdiri dari sarana, prasarana dan alat praktikum tersedia sangat baik dengan persentase sebesar 78,16%. Pengelolaan laboratorium fisika (proses [transaction] yang terdiri dari persiapan pelaksanaan praktikum; kesiapan siswa, guru, laboran; dan pelaksanaan praktikum mendapatkan hasil sangat baik dengan persentase sebesar 81,78%. Hasil yang diperoleh (outcomes dari ketersediaan dan pengelolaan peralatan praktikum di laboratorium fisika termasuk kategori baik (B+ dengan pencapaian Kriteria Ketuntasan Minimal (KKM 100% dari total 233 siswa kelas XI MIA (Matematika dan Ilmu Alam dan beberapa siswa berhasil meraih juara 1 Olimpiade Fisika. This research is aimed to know the availability, management of the laboratory equipment’s and also the result of maintaining and using physics laboratory equipment’s in 11th class of MIA SMA 1 Muhammadiyah Yogyakarta. And this evaluation research used “countenance stake” approach, hence, such as the objects of it is the physics laboratory care taker, teachers, laboratory assistant, and the students. This research was conducted in the last meeting of practicum on last semester 2015-2016 periods. The data was assembled by interview, observation, questionnaire and documentation. The result of this

  1. Hubungan Merokok Dengan Kejadian Insomnia Pada Remaja Di SMA Negeri 1 Remboken Kabupaten Minahasa

    OpenAIRE

    Kairupan, Juwinda Meini Ayu; Rottie, Julia; Malara, Reginus

    2016-01-01

    : Insomnia is difficulty initiating and maintaining sleep so can not meet the need for adequate sleep , both quantity and quality. Smoking is one of the causes of insomnia. Smoking is an act of burning a tabacco which inhaled the smoke from the burning process in a form of cigarette or a pipe. The purpose of this study was to analyze the relationship of smoking with the incidence of insomnia in adolescents at SMA N 1 Remboken Minahasa District. The research method is used observational analy...

  2. Self-repairing performance of concrete beams strengthened using superelastic SMA wires in combination with adhesives released from hollow fibers

    International Nuclear Information System (INIS)

    Kuang Yachuan; Ou Jinping

    2008-01-01

    By taking advantage of the superelastic effect of shape memory alloy (SMA) and the cohering characteristic of repairing adhesive, a smart self-repairing concrete beam with damage self-repairing performance has been developed. In order to verify the potential self-repairing capacity of smart concrete beams reinforced with SMA wires and brittle fibers containing adhesives, static loading tests were conducted. Experimental results show that the superelastic SMA wires added self-restoration capacity to concrete beams, the deflection of the beams reversed and the crack closed almost completely after unloading. After the release of adhesive from the broken-open fibers into the cracks from the first loading, stress was redistributed to the uncracked section where a new crack was formed, while the sealed crack remained closed during reloading for the smart concrete beams reinforced with SMA wires and brittle fibers containing adhesives. While the original cracks experienced reopening, the load was carried directly by the wires during reloading for concrete beams reinforced with SMA wires

  3. MR imaging of the entry, the abdominal communicating orifice, and the retrograde dissection in aortic dissections

    International Nuclear Information System (INIS)

    Yoshida, Y.; Mukohara, N.; Nakamura, K.; Sugimura, K.; Kono, M.

    1986-01-01

    MR imaging (1.5 T) was performed on 41 patients with aortic dissection. Entries were clearly visualized on the MR images as partial defects of the intimal flap in 18 of 21 patients (85.7%). In eight of ten patients, the locations of abdominal communicating orifices corresponded to the lowest signal intensities of the false lumina. Retrograde disections were diagnosed in all six patients from gradual increases in signal intensities of the false lumina toward the heart. MR imaging was very useful in diagnosing entries of the thoracic aorta, abdominal communicating orifices between true and false lumina, and retrograde dissections

  4. Spontaneous intraorbital hematoma: case report

    Directory of Open Access Journals (Sweden)

    Vinodan Paramanathan

    2010-12-01

    Full Text Available Vinodan Paramanathan, Ardalan ZolnourianQueen's Hospital NHS Foundation Trust, Burton on Trent, Staffordshire DE13 0RB, UKAbstract: Spontaneous intraorbital hematoma is an uncommon clinical entity seen in ophthalmology practice. It is poorly represented in the literature. Current evidence attributes it to orbital trauma, neoplasm, vascular malformations, acute sinusitis, and systemic abnormalities. A 65-year-old female presented with spontaneous intraorbital hematoma manifesting as severe ocular pains, eyelid edema, proptosis, and diplopia, without a history of trauma. Computer tomography demonstrated a fairly well defined extraconal lesion with opacification of the paranasal sinuses. The principal differential based on all findings was that of a spreading sinus infection and an extraconal tumor. An unprecedented finding of a spontaneous orbital hematoma was discovered when the patient was taken to theater. We discuss the rarity of this condition and its management.Keywords: hemorrhage, ophthalmology, spontaneous, intra-orbital, hematoma

  5. Design, development, and evaluation of an MRI-guided SMA spring-actuated neurosurgical robot.

    Science.gov (United States)

    Ho, Mingyen; Kim, Yeongjin; Cheng, Shing Shin; Gullapalli, Rao; Desai, Jaydev P

    2015-07-01

    In this paper, we present our work on the development of a magnetic resonance imaging (MRI)-compatible Minimally Invasive Neurosurgical Intracranial Robot (MINIR) comprising of shape memory alloy (SMA) spring actuators and tendon-sheath mechanism. We present the detailed modeling and analysis along with experimental results of the characterization of SMA spring actuators. Furthermore, to demonstrate image-feedback control, we used the images obtained from a camera to control the motion of the robot so that eventually continuous MR images could be used in the future to control the robot motion. Since the image tracking algorithm may fail in some situations, we also developed a temperature feedback control scheme which served as a backup controller for the robot. Experimental results demonstrated that both image feedback and temperature feedback can be used to control the motion of MINIR. A series of MRI compatibility tests were performed on the robot and the experimental results demonstrated that the robot is MRI compatible and no significant visual image distortion was observed in the MR images during robot operation.

  6. Recent developments on SMA actuators: predicting the actuation fatigue life for variable loading schemes

    Science.gov (United States)

    Wheeler, Robert W.; Lagoudas, Dimitris C.

    2017-04-01

    Shape memory alloys (SMAs), due to their ability to repeatably recover substantial deformations under applied mechanical loading, have the potential to impact the aerospace, automotive, biomedical, and energy industries as weight and volume saving replacements for conventional actuators. While numerous applications of SMA actuators have been flight tested and can be found in industrial applications, these actuators are generally limited to non-critical components, are not widely implemented and frequently one-off designs, and are generally overdesigned due to a lack of understanding of the effect of the loading path on the fatigue life and the lack of an accurate method for predicting actuator lifetimes. In recent years, multiple research efforts have increased our understanding of the actuation fatigue process of SMAs. These advances can be utilized to predict the fatigue lives and failure loads in SMA actuators. Additionally, these prediction methods can be implemented in order to intelligently design actuators in accordance with their fatigue and failure limits. In the following paper, both simple and complex thermomechanical loading paths have been considered. Experimental data was utilized from two material systems: equiatomic Nickel-Titanium and Nickelrich Nickel-Titanium.

  7. Biomechanics of smart wings in a bat robot: morphing wings using SMA actuators

    International Nuclear Information System (INIS)

    Colorado, J; Barrientos, A; Rossi, C; Breuer, K S

    2012-01-01

    This paper presents the design of a bat-like micro aerial vehicle with actuated morphing wings. NiTi shape memory alloys (SMAs) acting as artificial biceps and triceps muscles are used for mimicking the morphing wing mechanism of the bat flight apparatus. Our objective is twofold. Firstly, we have implemented a control architecture that allows an accurate and fast SMA actuation. This control makes use of the electrical resistance measurements of SMAs to adjust morphing wing motions. Secondly, the feasibility of using SMA actuation technology is evaluated for the application at hand. To this purpose, experiments are conducted to analyze the control performance in terms of nominal and overloaded operation modes of the SMAs. This analysis includes: (i) inertial forces regarding the stretchable wing membrane and aerodynamic loads, and (ii) uncertainties due to impact of airflow conditions over the resistance–motion relationship of SMAs. With the proposed control, morphing actuation speed can be increased up to 2.5 Hz, being sufficient to generate lift forces at a cruising speed of 5 m s −1 . (paper)

  8. Biomechanics of smart wings in a bat robot: morphing wings using SMA actuators.

    Science.gov (United States)

    Colorado, J; Barrientos, A; Rossi, C; Bahlman, J W; Breuer, K S

    2012-09-01

    This paper presents the design of a bat-like micro aerial vehicle with actuated morphing wings. NiTi shape memory alloys (SMAs) acting as artificial biceps and triceps muscles are used for mimicking the morphing wing mechanism of the bat flight apparatus. Our objective is twofold. Firstly, we have implemented a control architecture that allows an accurate and fast SMA actuation. This control makes use of the electrical resistance measurements of SMAs to adjust morphing wing motions. Secondly, the feasibility of using SMA actuation technology is evaluated for the application at hand. To this purpose, experiments are conducted to analyze the control performance in terms of nominal and overloaded operation modes of the SMAs. This analysis includes: (i) inertial forces regarding the stretchable wing membrane and aerodynamic loads, and (ii) uncertainties due to impact of airflow conditions over the resistance-motion relationship of SMAs. With the proposed control, morphing actuation speed can be increased up to 2.5 Hz, being sufficient to generate lift forces at a cruising speed of 5 m s(-1).

  9. Design, fabrication, and testing of a SMA hybrid composite jet engine chevron

    Science.gov (United States)

    Turner, Travis L.; Cabell, Randolph H.; Cano, Roberto J.; Fleming, Gary A.

    2006-01-01

    Control of jet noise continues to be an important research topic. Exhaust nozzle chevrons have been shown to reduce jet noise, but parametric effects are not well understood. Additionally, thrust loss due to chevrons at cruise suggests significant benefit from deployable chevrons. The focus of this study is development of an active chevron concept for the primary purpose of parametric studies for jet noise reduction in the laboratory and technology development to leverage for full scale systems. The active chevron concept employed in this work consists of a laminated composite structure with embedded shape memory alloy (SMA) actuators, termed a SMA hybrid composite (SMAHC). The actuators are embedded on one side of the middle surface such that thermal excitation generates a moment and deflects the structure. A brief description of the chevron design is given followed by details of the fabrication approach. Results from bench top tests are presented and correlated with numerical predictions from a model for such structures that was recently implemented in MSC.Nastran and ABAQUS. Excellent performance and agreement with predictions is demonstrated. Results from tests in a representative flow environment are also presented. Excellent performance is again achieved for both open- and closed-loop tests, the latter demonstrating control to a specified immersion into the flow. The actuation authority and immersion performance is shown to be relatively insensitive to nozzle pressure ratio (NPR). Very repeatable immersion control with modest power requirements is demonstrated.

  10. KAJIAN PRESTASI BELAJAR SISWA SMA DENGAN METODE STUDENT TEAMS ACHIEVEMENT DIVISIONS MELALUI PENDEKATAN CHEMO-ENTREPRENEURSHIP

    Directory of Open Access Journals (Sweden)

    Supartono -

    2011-12-01

    Full Text Available Metode pembelajaran yang umum dilakukan oleh guru yaitu ceramah.Penggunaan metode STAD melalui pendekatan CEP, siswa dapat belajar danbekerjasama dalam pembelajaran untuk memecahkan suatu masalah sehingga siswadapat memahami suatu materi secara mendalam serta memupuk daya kreatifi tas dankeaktifan siswa. Permasalahan dalam penelitian ini adalah “Apakah dalam metodepembelajaran STAD melalui pendekatan CEP dapat meningkatkan prestasi belajarkimia SMA kelas XI IA SMA Negeri 1 Blora. Teknik yang digunakan untuk mengambilsampel yaitu cluster random sampling. Metode yang digunakan untuk mengambil datayaitu metode observasi, metode angket, metode tes, metode dokumentasi. Data hasiltes kognitif yang diperoleh akan dianalisis melalui 2 tahap yaitu uji tahap awal dan ujitahap akhir. Dari analisis data pada uji tahap awal diperoleh bahwa rata-rata pre testantara kelas eksperimen dan kelas kontrol mempunyai kesamaan rata-rata yang sama.Berdasarkan analisis data pada uji tahap akhir diperoleh bahwa antara kelas eksperimendan kelas kontrol ada perbedaan hasil belajar yang signifi kan. Berdasarkan hasil analisisini dapat disimpulkan bahwa dengan metode STAD melalui pendekatan CEP dapatmeningkatkan prestasi belajar siswa pada pokok bahasan larutan asam basa. Kata Kunci: student teams achievement divisions, chemo-entrepreneurship

  11. Natural history of SMA IIIb: muscle strength decreases in a predictable sequence and magnitude.

    Science.gov (United States)

    Deymeer, Feza; Serdaroglu, Piraye; Parman, Yesim; Poda, Mehves

    2008-08-26

    To assess the natural progression of muscle weakness in spinal muscular atrophy (SMA) IIIb. Ten patients with SMA IIIb were followed for at least 10 years. Age at disease onset varied between 9 and 18 years. Patients were initially seen 2 to 10 years after disease onset. They were evaluated at approximately 2, 5, 10, 15, and 20 years of disease duration depending on the timing of their initial visit after onset. Medical Research Council (MRC) scale was used with particular attention to proximal muscles. The MRC grade declined with years in all of the muscles. The decline was usually not more than by one MRC grade for each 5-year period. There were 5-10 year periods when some muscles appeared to remain stationary. The succession of weakness was first triceps, then biceps and deltoid for upper extremity muscles and first thigh adductors, then iliopsoas, then quadriceps femoris, then hamstrings, thigh abductors, and gluteus maximus for lower extremity muscles. There was a remarkable uniformity between patients in the MRC grade for each muscle at each stage: in the first 5 years of the disease, triceps, iliopsoas, thigh adductors, and quadriceps femoris were the muscles which had noticeable weakness. These findings show that strength in spinal muscular atrophy IIIb decreases over time, explaining the progressive functional loss. The sequence of weakness in the lower extremities suggests that the disease starts segmentally involving the upper lumbar segments of the medulla spinalis initially. The slowness of the deterioration may have implications for clinical trials.

  12. PENGARUH INTELEGENSI, TASK COMMITMENT DAN SELF EFFICACY TERHADAP HASIL BELAJAR MATEMATIKA SISWA SMA

    Directory of Open Access Journals (Sweden)

    Nur Qalbi Tayibu

    2016-12-01

    Full Text Available This study aims to determine the effect of intelligence, task commitment and self efficacy towards learning outcomes math class X SMA country Bulukumba District of Bulukumba. This type of research is ex-post facto nature of causality. The population in the study were students of Class X SMAN in District Bulukmpa Bulukumba 2014/2015 school year as many as 420 students and 201 students sample, taken by using proportional random sampling. The instrument used consisted of intelligence tests (tests of verbal linguistic intelligence, logical mathematical intelligence and visual-spatial, self-efficacy scale and the scale of task commitment and math achievement test. Data were analyzed using descriptive statistics and inferential statistics that path analysis (path anlysis. The research concludes that: (i Most students of class X SMA in Bulukumba, have intelligence with the category average, task commitment in learning mathematics with high category, self-efficacy in mathematics with high category and yield learning mathematics are the very low category. (Ii a variable that significantly that intelligence directly influence the outcome of learning mathematics, self-efficacy directly influence learning outcomes and task commitment directly influence the results of students' mathematics learning, intelligence indirect effect on the result of learning mathematics through task commitment and self-efficacy influential indirectly of mathematics learning outcomes through task commitment.

  13. KONTRIBUSI MEDIA PEMBELAJARAN INTERAKTIF UNTUK MEMBANTU MENINGKATKAN PEMAHAMAN KONSEP PEMBIASAN CAHAYA PADA SISWA KELAS X SMA

    Directory of Open Access Journals (Sweden)

    E. Bambang Saputro, A. Sopyan, B. Subali

    2016-02-01

    Full Text Available Dalam mengajarkan pokok bahasan pembiasan cahaya, terdapat kendala yang mendasar di SMA Negeri 1 Mijen Demak, yaitu visualisasi tentang jalannya sinar pada peristiwa pembiasan. Oleh karena itu untuk meningkatkan pemahaman konsep fisika perlu dilakukan terobosan baru dalam menyajikan pokok bahasan ini, salah satunya adalah dengan menggunakan media pembelajaran interaktif. Tujuan dari penelitian ini adalah untuk mengetahui kontribusi media pembelajaran interaktif dengan macromedia flash profesional 8 terhadap peningkatkan pemahaman konsep pembiasan cahaya. Subyek dalam PTK ini adalah siswa kelas X-1 SMA Negeri 1 Mijen Demak Tahun 2008/2009. Hasil penelitian menunjukkan bahwa media pembelajaran interaktif program macromedia flash professional 8 dapat meningkatkan pemahaman konsep pembiasan cahaya. Pada siklus I nilai rata-rata adalah 63,07 dan ketuntasan klasikal 64,10 %. Setelah siklus II nilai rata-rata meningkat  menjadi 74,10 dan ketuntasan klasikal  menjadi 92,31 %.. Dari hasil uji t diperoleh nilai thitung sebesar 4,66 dan ttabel sebesar 1,68. Nilai thitung >ttabel, berarti terjadi peningkatan yang signifikan untuk pemahaman siswa dari siklus I ke siklus II. Simpulan dari penelitian adalah media pembelajaran interaktif berkontribusi positif dalam meningkatkan pemahaman siswa.

  14. SMA foil-based elastocaloric cooling: from material behavior to device engineering

    Science.gov (United States)

    Bruederlin, F.; Ossmer, H.; Wendler, F.; Miyazaki, S.; Kohl, M.

    2017-10-01

    The elastocaloric effect associated with the stress-induced first order phase transformation in pseudoelastic shape memory alloy (SMA) films and foils is of special interest for cooling applications on a miniature scale enabling fast heat transfer and high cycling frequencies as well as tunable transformation temperatures. The focus is on TiNi-based materials having the potential to meet the various challenges associated with elastocaloric cooling including large adiabatic temperature change and ultra-low fatigue. The evolution of strain and temperature bands during tensile load cycling is investigated with respect to strain and strain-rate by in situ digital image correlation and infrared thermography with a spatial resolution in the order of 25 µm. Major design issues and challenges in fabrication of SMA film-based elastocaloric cooling devices are discussed including the efficiency of heat transfer as well as force recovery to enhance the coefficient of performance (COP) on the system level. Advanced demonstrators show a temperature span of 13 °C after 30 s, while the COP of the overall device reaches almost 10% of Carnot efficiency.

  15. Epidemiology and cerebrovascular events related to cervical and intracranial arteries dissection: the experience of the city of Pisa.

    Science.gov (United States)

    Giannini, N; Ulivi, L; Maccarrone, M; Montano, V; Orlandi, G; Ferrari, E; Cravcenco, C; Bonuccelli, U; Mancuso, M

    2017-11-01

    Spontaneous dissection of cervical arteries (sCAD) is a major cause of ischemic stroke in young patients, with an incidence varying from 1.7 to 3/100,000/year for extracranial internal carotid artery (ICAD) and 1 to 1.9/100,000/year for extracranial vertebral artery (VAD). Reliable epidemiological data on stroke incidence related to sCAD are scarce in Italy. This study aims to evaluate the incidence, clinical features, and outcome of cerebrovascular events related to sCAD and spontaneous intracranial arteries dissections (sIAD) in the city of Pisa (Italy). We retrospectively analyzed consecutive patients admitted between December 1997 and June 2015 with a diagnosis of stroke, TIA, or Bernard-Horner syndrome due to acute cervical or intracranial artery dissection. Considering that our hospital collects presumptively all patients hospitalized with sCAD coming from the referral geographical area, data may provide a good approximation to real incidence of sCAD in our population. Clinical and radiological features, acute treatment and outcome were collected. Seventy-seven cases were included (mean age 48.1±10.4 years, range 23-77,72.7% males), 66 residents in the district of Pisa. Crude incidence rate of cerebrovascular events due to intra or extracranial dissection was 1.88/100,000/year. The incidence of ICAD was 0.80/100,000/year and 0.43/100,000/year for VAD. Stroke occurred in 76.6% of patients. VAD was more prone to cause ischemic stroke and present with cervical pain or focal signs (p sCAD and sIAD in Italy.

  16. Spontaneous ischaemic stroke in dogs

    DEFF Research Database (Denmark)

    Gredal, Hanne Birgit; Skerritt, G. C.; Gideon, P.

    2013-01-01

    Translation of experimental stroke research into the clinical setting is often unsuccessful. Novel approaches are therefore desirable. As humans, pet dogs suffer from spontaneous ischaemic stroke and may hence offer new ways of studying genuine stroke injury mechanisms.......Translation of experimental stroke research into the clinical setting is often unsuccessful. Novel approaches are therefore desirable. As humans, pet dogs suffer from spontaneous ischaemic stroke and may hence offer new ways of studying genuine stroke injury mechanisms....

  17. Spontaneity and international marketing performance

    OpenAIRE

    Souchon, Anne L.; Hughes, Paul; Farrell, Andrew M.; Nemkova, Ekaterina; Oliveira, Joao S.

    2016-01-01

    The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link. Purpose – The purpose of this paper is to ascertain how today’s international marketers can perform better on the global scene by harnessing spontaneity. Design/methodology/approach – The authors draw on contingency theory to develop a model of the spontaneity – international marketing performance relationship, and identify three potential m...

  18. MODEL PERMAINAN AKTIVITAS LUAR KELAS UNTUK MENGEMBANGKAN RANAH KOGNITIF, AFEKTIF, DAN PSIKOMOTORIK SISWA SMA

    Directory of Open Access Journals (Sweden)

    Hendra Setyawan

    2015-10-01

    Full Text Available Penelitian ini bertujuan menghasilkan model-model permainan Aktivitas Luar kelas (ALK yang layak digunakan sebagai materi pembelajaran penjas, serta efektif untuk mengembangkan ranah kognitif, afektif, dan psikomotorik siswa SMA. Penelitian ini dilakukan dengan langkah-langkah sebagai berikut: (1 pengumpulan informasi di lapangan, (2 menganalisis informasi yang telah dikumpulkan, (3 mengembangkan produk awal, (4 validasi ahli dan revisi, (5 uji coba skala kecil dan  revisi, (6 uji coba skala besar dan revisi, dan (7 pembuatan produk final. Uji coba skala kecil dilakukan terhadap siswa kelas X-D dan XI-IPA 4 dari SMA N I Prambanan berjumlah 66 orang. Uji coba skala besar dilakukan terhadap siswa kelas X-G, X-H, XI-IPS 3, dan XI-BHS dari SMA N I Prambanan berjumlah 132 orang. Instrumen pengumpulan data yang digunakan yaitu; (1 pedoman wawancara, (2 skala nilai, (3 pedoman observasi permainan, (4 pedoman observasi keefektifan permainan, (5 pedoman observasi terhadap guru pelaku uji coba, dan (6 rubrik penilaian siswa. Teknik analisis data dengan analisis deskriptif kuantitatif dan kualitatif. Hasil penelitian berupa tujuh model permainan yang layak dan efektif digunakan dalam pembelajaran penjas, hal ini dibuktikan dengan perolehan persentase sebesar 100% dari data hasil kuesioner skala nilai, observasi model permainan, observasi keefektifan permainan, dan observasi guru pelaku uji coba. Model permainan juga efektif untuk mengembangkan ranah kognitif, afektif, dan psikomotorik, yang dibuktikan dengan terjadinya peningkatan persentase nilai rata-rata siswa sebesar 21%. Kata kunci: model, permainan, aktivitas luar kelas, kognitif, afektif, psikomotorik THE OUTDOOR ACTIVITY GAME MODEL TO DEVELOP THE ASPECT OF COGNITIVE, AFFECTIVE, AND PSYCHOMOTOR OF THE SENIOR HIGH SCHOOL STUDENTS Abstract This study aims at producing outdoor activity game models which are proper to be used for physicall education learning and developing cognitive, affective, and

  19. Pengembangan Instrumen Ranah Kognitif pada Pokok Bahasan Fluida Statis SMA/MA

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    Mukarramah Mustari

    2016-04-01

    Full Text Available This study aims to: 1 Develop Instrument Domains Cognitive at Static Fluid material in SMA / MA, 2 determine the validity of the instrument of cognitive tests on the static fluid material, 3 determine the reliability of cognitive principal static fluid discussion, 4 determine the level of difficulty of the cognitive tests on the static fluid material, 5 determine distinguishing cognitive test on static fluid material. The result products include cognitive aspects such instruments multiple choice tests and essay tests. Instrument developed on cognitive aspects in the form of multiple choice tests and a description to the extent of competence Bloom C1 to C6 on the material of Static Fluid. The Design of this study is used the development procedure Reasearch and Depelopment (R & D from Borg and Gall adopted by Sugiono ie; up to the stage seven form consisting of: the potential and problems, data collection, product design, design validation, design revisions, product trials, product revision. The data collecting is obtained from the results of expert validation instrument, the response of teachers, and product trials, and then analyzed by quantitative descriptive. The results of the analysis of the development of the instrument can be concluded that the cognitive instruments on the material of static fluid SMA / MA is excellent to be used by teachers in the assessment of competence of learners. Penelitian Pengembangan Instrumen Ranah Kognitif pada Pokok Bahasan Fluida Statis SMA/MA Ini dilakukan bertujuan;1 mengembangkan Instrumen Ranah Kognitif pada Pokok Bahasan Fluida Statis SMA/MA, 2 mengetahui validitas instrumen tes kognitif pokok bahasan fluida statis, 3 mengetahui reliabilitas kognitif pokok bahasan fluida statis, 4 mengetahui tingkat kesukaran tes kognitif pokok bahasan fluida statis, 5 mengetahui daya pembeda tes kognitif pada pokok bahasan fluida statis. Produk yang dihasilkan meliputi instrumen aspek kognitif berupa

  20. CT and MR angiographic findings in dissection of cervical vessels

    International Nuclear Information System (INIS)

    Link, J.; Brinkmann, G.; Heuser, K.; Heller, M.

    1996-01-01

    Purpose: To determine the usefulness of CT angiography (CTA) and MR angiography (MRA) for evaluation of dissection in cervical vessels. Material and methods: Dissection of cervical vessels was revealed by conventional angiography in 4 patients (two female, two male) of 30-62 years of age. Dissection was located in the carotid artery (n=3) and in the vertebral artery (n=1). In two patients CTA and in two patients MRA was performed. Results: Diagnosis of dissection was possible by CTA (internal carotid artery: n=2) and by MRA (internal carotid artery and vertebral artery). Imaging of the dissection membrane of the vessel wall was possible in one case with MRA. Conclusion: CT and MR angiography was successful for detection of typical morphology of dissection in all cases. If results in a greater number can be obtained it seems to be conceivable that both methods can be used in primary diagnosis. (orig.) [de

  1. Metabolic signature of electrosurgical liver dissection.

    Directory of Open Access Journals (Sweden)

    Witigo von Schönfels

    Full Text Available BACKGROUND AND AIMS: High frequency electrosurgery has a key role in the broadening application of liver surgery. Its molecular signature, i.e. the metabolites evolving from electrocauterization which may inhibit hepatic wound healing, have not been systematically studied. METHODS: Human liver samples were thus obtained during surgery before and after electrosurgical dissection and subjected to a two-stage metabolomic screening experiment (discovery sample: N = 18, replication sample: N = 20 using gas chromatography/mass spectrometry. RESULTS: In a set of 208 chemically defined metabolites, electrosurgical dissection lead to a distinct metabolic signature resulting in a separation in the first two dimensions of a principal components analysis. Six metabolites including glycolic acid, azelaic acid, 2-n-pentylfuran, dihydroactinidiolide, 2-butenal and n-pentanal were consistently increased after electrosurgery meeting the discovery (p<2.0 × 10(-4 and the replication thresholds (p<3.5 × 10(-3. Azelaic acid, a lipid peroxidation product from the fragmentation of abundant sn-2 linoleoyl residues, was most abundant and increased 8.1-fold after electrosurgical liver dissection (preplication = 1.6 × 10(-4. The corresponding phospholipid hexadecyl azelaoyl glycerophosphocholine inhibited wound healing and tissue remodelling in scratch- and proliferation assays of hepatic stellate cells and cholangiocytes, and caused apoptosis dose-dependently in vitro, which may explain in part the tissue damage due to electrosurgery. CONCLUSION: Hepatic electrosurgery generates a metabolic signature with characteristic lipid peroxidation products. Among these, azelaic acid shows a dose-dependent toxicity in liver cells and inhibits wound healing. These observations potentially pave the way for pharmacological intervention prior liver surgery to modify the metabolic response and prevent postoperative complications.

  2. Contemporary Management of Acute Type B Dissection.

    Science.gov (United States)

    Scott, A J; Bicknell, C D

    2016-03-01

    Growing confidence in thoracic endovascular aortic repair (TEVAR) for the management of acute type B aortic dissection has resulted in controversies regarding optimum patient selection and the timing of intervention. In this review a clinical vignette to present a practical perspective on the contemporary management of acute type B dissection (ABAD) in a specialist vascular centre with particular focus on areas of debate is used. This is a narrative clinical review. Aggressive anti-impulse therapy is the cornerstone of management of all patients with ABAD. However, 20-30% of patients develop complicated ABAD defined by the presence of malperfusion syndromes, acute aortic dilatation, dissection extension, or persistent pain and hypotension. These complicated patients typically require intervention, and non-randomised series suggest TEVAR to be an effective alternative to open repair with a lower morbidity. There is considerable interest and controversy surrounding the use of TEVAR in uncomplicated ABAD patients for whom the intervention-free survival at 6 years is less than 50% for patients managed with anti-impulse therapy. Data regarding this question are sparse, but two randomised trials (ADSORB and INSTEAD) both demonstrated a higher rate of favourable aortic remodelling in patients managed with TEVAR than medical therapy alone. However, it is unclear whether this positive remodelling translates into a reduction in long-term mortality sufficient to balance the early perioperative hazards of endografting. Despite increasing adeptness at endovascular stenting, the long-term outcomes of patients with ABAD leave significant room for improvement. In particular, the optimum management of patients with uncomplicated disease is unclear and guidance from trials powered for long-term mortality is awaited. Until then, the principals of management of ABAD remain aggressive medical therapy for all patients, with TEVAR primarily reserved for those who develop complications

  3. Aortic dissection. Basic aspects and endovascular management

    International Nuclear Information System (INIS)

    Jaramillo, Nicolas I; Alviar, Carlos I

    2005-01-01

    Treatment of thoracic aortic pathology is complicated by the morbidity associated to the surgical procedure and to the frailty of an elderly and difficult population. Surgical operation in this kind of population frequently bears a significant incidence of death and long-term disability. In an effort to reduce the incidence of negative outcomes, minimally invasive techniques in the form of endovascular stenting have been introduced during the past decade. The technology, originally described by Parodi, and initially designed for its use in abdominal aortic aneurysms, has been adapted for the treatment of thoracic aortic aneurysms. Furthermore, an improved understanding of the pathophysiology and the natural history of thoracic aortic disease as well as the analysis of the outcomes have facilitated our treatment decisions in terms of the timing for an appropriate intervention. Treatment of thoracic aortic dissection using endovascular Stent is one of the more recent advances in this condition and is receiving increasing attention, as it is a less invasive alternative to an open surgical repair. Although this technology is still innovative, significant improvements have been made lately in the design and deployment of the endovascular Stent-grafts. These prostheses have been increasingly used to treat aneurysms, dissections and traumatic ruptures, as well as giant penetrating ulcers and intramural hematomas of the descending thoracic aorta with good early and mid-term outcomes. The rareness, complexity and severity of the pathology and the theoretically high risk of complications should render the surgeon extremely cautious especially with young patients. Conceptually, the endo luminal treatment in the acute phase seems to be the solution and will probably become a preferred therapy while technical refinement is under way. Worldwide experience is growing and with this a better understanding of the indications and limitations of this innovative therapy will be

  4. Expression of Muscle-Specific MiRNA 206 in the Progression of Disease in a Murine SMA Model.

    Directory of Open Access Journals (Sweden)

    Valeria Valsecchi

    Full Text Available Spinal muscular atrophy (SMA is a severe neuromuscular disease, the most common in infancy, and the third one among young people under 18 years. The major pathological landmark of SMA is a selective degeneration of lower motor neurons, resulting in progressive skeletal muscle denervation, atrophy, and paralysis. Recently, it has been shown that specific or general changes in the activity of ribonucleoprotein containing micro RNAs (miRNAs play a role in the development of SMA. Additionally miRNA-206 has been shown to be required for efficient regeneration of neuromuscular synapses after acute nerve injury in an ALS mouse model. Therefore, we correlated the morphology and the architecture of the neuromuscular junctions (NMJs of quadriceps, a muscle affected in the early stage of the disease, with the expression levels of miRNA-206 in a mouse model of intermediate SMA (SMAII, one of the most frequently used experimental model. Our results showed a decrease in the percentage of type II fibers, an increase in atrophic muscle fibers and a remarkable accumulation of neurofilament (NF in the pre-synaptic terminal of the NMJs in the quadriceps of SMAII mice. Furthermore, molecular investigation showed a direct link between miRNA-206-HDAC4-FGFBP1, and in particular, a strong up-regulation of this pathway in the late phase of the disease. We propose that miRNA-206 is activated as survival endogenous mechanism, although not sufficient to rescue the integrity of motor neurons. We speculate that early modulation of miRNA-206 expression might delay SMA neurodegenerative pathway and that miRNA-206 could be an innovative, still relatively unexplored, therapeutic target for SMA.

  5. The risk for type B aortic dissection in Marfan syndrome.

    Science.gov (United States)

    den Hartog, Alexander W; Franken, Romy; Zwinderman, Aeilko H; Timmermans, Janneke; Scholte, Arthur J; van den Berg, Maarten P; de Waard, Vivian; Pals, Gerard; Mulder, Barbara J M; Groenink, Maarten

    2015-01-27

    Aortic dissections involving the descending aorta are a major clinical problem in patients with Marfan syndrome. The purpose of this study was to identify clinical parameters associated with type B aortic dissection and to develop a risk model to predict type B aortic dissection in patients with Marfan syndrome. Patients with the diagnosis of Marfan syndrome and magnetic resonance imaging or computed tomographic imaging of the aorta were followed for a median of 6 years for the occurrence of type B dissection or the combined end point of type B aortic dissection, distal aortic surgery, and death. A model using various clinical parameters as well as genotyping was developed to predict the risk for type B dissection in patients with Marfan syndrome. Between 1998 and 2013, 54 type B aortic dissections occurred in 600 patients with Marfan syndrome (mean age 36 ± 14 years, 52% male). Independent variables associated with type B aortic dissection were prior prophylactic aortic surgery (hazard ratio: 2.1; 95% confidence interval: 1.2 to 3.8; p = 0.010) and a proximal descending aorta diameter ≥27 mm (hazard ratio: 2.2; 95% confidence interval: 1.1 to 4.3; p = 0.020). In the risk model, the 10-year occurrence of type B aortic dissection in low-, moderate-, and high-risk patients was 6%, 19%, and 34%, respectively. Angiotensin II receptor blocker therapy was associated with fewer type B aortic dissections (hazard ratio: 0.3; 95% confidence interval: 0.1 to 0.9; p = 0.030). Patients with Marfan syndrome with prior prophylactic aortic surgery are at substantial risk for type B aortic dissection, even when the descending aorta is only slightly dilated. Angiotensin II receptor blocker therapy may be protective in the prevention of type B aortic dissections. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  6. Background Music in the Dissection Laboratory: Impact on Stress Associated with the Dissection Experience

    Science.gov (United States)

    Anyanwu, Emeka G.

    2015-01-01

    Notable challenges, such as mental distress, boredom, negative moods, and attitudes, have been associated with learning in the cadaver dissection laboratory (CDL). The ability of background music (BM) to enhance the cognitive abilities of students is well documented. The present study was designed to investigate the impact of BM in the CDL and on…

  7. An easy miss: aortic dissection in a 'healthy' male.

    Science.gov (United States)

    Co, Michael Lawrenz F; Agdamag, Arianne Clare; Mateo, Roselyn Cristelle; Williams, Kim A

    2017-08-07

    Aortic dissection is an uncommon cause of chest discomfort that can be rapidly fatal without early diagnosis and prompt treatment. In this report, we present a man with no risk factors who presented with chest discomfort not typical of a dissection, absent pulse and blood pressure differential and a normal chest radiograph. He eventually was diagnosed with an extensive Type-A aortic dissection. We discuss diagnostic clues, classification of aortic dissection and possible treatment options. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. Dissection videos do not improve anatomy examination scores.

    Science.gov (United States)

    Mahmud, Waqas; Hyder, Omar; Butt, Jamaal; Aftab, Arsalan

    2011-01-01

    In this quasi-experimental study, we describe the effect of showing dissection videos on first-year medical students' performance in terms of test scores during a gross anatomy course. We also surveyed students' perception regarding the showing of dissection videos. Two hundred eighty-seven first-year medical students at Rawalpindi Medical College in Pakistan, divided into two groups, dissected one limb in first term and switched over to the other limb in the second term. During the second term, instruction was supplemented by dissection videos. Second-term anatomy examination marks were compared with first-term scores and with results from first-year medical students in previous years. Multiple linear regression analysis was performed, with term scores (continuous, 0-200) as the dependent variable. Students shown dissection videos scored 1.26 marks higher than those not shown. The relationship was not statistically significant (95% CI: -1.11, 3.70; P = 0.314). Ninety-three percent of students favored regular inclusion of dissection videos in curriculum, and 50% termed it the best source for learning gross anatomy. Seventy-six percent of students did not perform regular cadaver dissection. The most frequent reason cited for not performing regular dissection was high student-cadaver ratio. Dissection videos did not improve performance on final examination scores; however, students favored their use. Copyright © 2011 American Association of Anatomists.

  9. Acute aortic dissection diagnosed after embalming: macroscopic and microscopic findings.

    Science.gov (United States)

    Savall, Frédéric; Dedouit, Fabrice; Piercecchi-Marti, Marie-Dominique; Leonetti, Georges; Rougé, Daniel; Telmon, Norbert

    2014-09-01

    A 58-year-old man died suddenly in Madagascar and poisoning was suspected. The body was embalmed after death and the general state of preservation was good. We found a major aortic dissection with a large false lumen from the aortic root to the common iliac arteries and a hemopericardium with formalinized blood clot. The intimal tear was on the ascending aorta, and an intramural hemorrhage was noted at the right coronary artery, attesting to a retrograde dissection. Microscopic studies confirmed aortic dissection with extensive intramural hemorrhage and also confirmed the retrograde dissection to the right coronary artery with a reduction of 90% of the true lumen. Classically, aortic dissection occurs in individuals with hypertension and individuals with genetic disorders of collagen formation. The diagnosis is often first established at the postmortem examination. Aortic dissection is therefore dealt with largely in necropsy studies. The usual cause of death is rupture into the pericardial sac. One case of bloodless dissection has been reported but the sudden death was explained by acute myocardial ischemia secondary to dissection of the left coronary artery. In our case, we found major hemopericardium and also intramural hemorrhage at the right coronary artery. We were able to make the diagnosis of aortic dissection and exclude the suspicion of homicide 15 days after death and after embalming. © 2014 American Academy of Forensic Sciences.

  10. Idiopathic, Serial Coronary Vessels Dissection in a Young Woman with Psychological Stress: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Alessio Arrivi

    2012-01-01

    Full Text Available Spontaneous coronary artery dissection (SCAD is a very rare disease, associated with high mortality rate, whose etiology and pathogenesis are poorly understood. Its sporadic nature and the varied angiographic extent make firm recommendations regarding revascularization impossible. The case described is that of a young, otherwise healthy woman, without a known underlying condition which may lead to SCAD, but with a history of intense psychological stress. We managed the patient with a conservative approach based on watchful waiting, medical therapy, and plain old balloon angioplasty (POBA with low inflation atmospheres.

  11. Dissection and Culture of Mouse Embryonic Kidney.

    Science.gov (United States)

    Aresh, Bejan; Peuckert, Christiane

    2017-05-17

    The goal of this protocol is to describe a method for the dissection, isolation, and culture of mouse metanephric rudiments. During mammalian kidney development, the two progenitor tissues, the ureteric bud and the metanephric mesenchyme, communicate and reciprocally induce cellular mechanisms to eventually form the collecting system and the nephrons of the kidney. As mammalian embryos grow intrauterine and therefore are inaccessible to the observer, an organ culture has been developed. With this method, it is possible to study epithelial-mesenchymal interactions and cellular behavior during kidney organogenesis. Furthermore, the origin of congenital kidney and urogenital tract malformations can be investigated. After careful dissection, the metanephric rudiments are transferred onto a filter that floats on culture medium and can be kept in a cell culture incubator for several days. However, one must be aware that the conditions are artificial and could influence the metabolism in the tissue. Also, the penetration of test substances could be limited due to the extracellular matrix and basal membrane present in the explant. One main advantage of organ culture is that the experimenter can gain direct access to the organ. This technology is cheap, simple, and allows a large number of modifications, such as the addition of biologically active substances, the study of genetic variants, and the application of advanced imaging techniques.

  12. Challenges to genome sequence dissection in sweetpotato

    Science.gov (United States)

    Isobe, Sachiko; Shirasawa, Kenta; Hirakawa, Hideki

    2017-01-01

    The development of next generation sequencing (NGS) technologies has enabled the determination of whole genome sequences in many non-model plant species. However, genome sequencing in sweetpotato (Ipomoea batatas (L.) Lam) is still difficult because of the hexaploid genome structure. Previous studies suggested that a diploid wild relative, I. trifida (H.B.K.) Don., is the most possible ancestor of sweetpotato. Therefore, the genetic and genomic features of I. trifida have been studied as a potential reference for sweetpotato. Meanwhile, several research groups have begun the challenging task of directly sequencing the sweetpotato genome. In this manuscript, we review the recent results and activities of large-scale genome and transcriptome analysis related to genome sequence dissection in sweetpotato under the sections as follows: I. trifida genome and transcript sequencing, genome sequences of I. nil (Japanese morning glory), transcript sequences in sweetpotato, chloroplast sequences, transposable elements and transfer DNA. The recent international activities of de novo whole genome sequencing in sweetpotato are also described. The large-scale publically available genome and transcript sequence resources and the international genome sequencing streams are expected to promote the genome sequence dissection in sweetpotato. PMID:28465666

  13. RELEVANSI KURIKULUM PRODI PENDIDIKAN SOSIOLOGI ANTROPOLOGI DENGAN KEBUTUHAN MENGAJAR GURU SMA

    Directory of Open Access Journals (Sweden)

    Totok Rochana

    2013-04-01

    Full Text Available Materi pembelajaran  Sosiologi dan Antropologi yang diajarkan di SMA senantiasa mengalami perubahan. Sementara  kurikulum Program Studi Pendidikan Sosiologi dan Antropologi FIS UNNES tidak banyak mengalami perubahan. Dalam penelitian ini, penulis membahas bagaimana relevansi antara Kurikulum Prodi Pendidikan Sosiologi dan Antropologi FIS UNNES dengan kebutuhan mengajar bagi guru Sosiologi dan Antropologi SMA Negeri di Jawa Tengah. Penelitian ini menggunakan pendekatan kualitatif dan  bersifat kasus, pengumpulan data menggunakan metode wawancara tertutup dan terbuka, dan analisis data  menggunakan metode deskriptif kualitatif. Berdasarkan hasil penelitian  disimpulkan bahwa kurikulum  Program Studi Pendidikan Sosiologi dan Antropologi FIS UNNES, masih relevan dengan materi pembelajaran Sosiologi dan Antropologi yang diajarakan di SMA. Saran yang diajukan adalah: perlu diselenggarakan penataran-penataran/diklat-diklat peningkatan penguasaan materi pembelajaran Sosiologi dan Antropologi bagi guru-guru Sosiologi dan Antropologi yang bukan berlatar belakang Pendidikan Sosiologi dan Antropologi. Pengangkatan CPNS Guru Sosiologi dan Antropologi perlu diprioritaskan dari lulusan Prodi Pendidikan Sosiologi dan Antropologi. Pengembangan kurikulum Program Studi Pendidikan Sosiologi dan Antropologi tetap mengacu pada relevansinya dengan kebutuhan di lapangan.Sociology and Anthropology instructional materials taught in high school are constantly changing, though the curriculum of Sociology and Anthropology FIS Unnes does not change much. In this study, the author discusses the relevance of the curriculum of Sociology and Anthropology of Education Unnes FIS to the needs of teaching for teachers of Sociology and Anthropology Senior high school in Central Java. The method used in this study is a qualitative approach using descriptive methods. Based on the results of the study it is concluded that the curriculum of Sociology and Anthropology

  14. Embedded SMA wire actuated biomimetic fin: a module for biomimetic underwater propulsion

    International Nuclear Information System (INIS)

    Wang Zhenlong; Hang Guanrong; Wang Yangwei; Li Jian; Du Wei

    2008-01-01

    An embedded shape memory alloy (SMA) wire actuated biomimetic fin is presented, and based on this module for biomimetic underwater propulsion, a micro robot fish (146 mm in length, 30 g in weight) and a robot squid (242 mm in length, 360 g in weight) were developed. Fish swim by undulating their body and/or fins. Squid and cuttlefish can also swim by undulating their fins. To simplify engineering modeling, the undulating swimming movement is assumed to be the integration of the movements of many flexible bending segments connected in parallel or in series. According to this idea, a biomimetic fin which can bend flexibly was developed. The musculature of a cuttlefish fin was investigated to aid the design of the biomimetic fin. SMA wires act as 'muscle fibers' to drive the biomimetic fin just like the transverse muscles of the cuttlefish fin. During the bending phase, elastic energy is stored in the elastic substrate and skin, and during the return phase, elastic energy is released to power the return movement. Theorem analysis of the bending angle was performed to estimate the bending performance of the biomimetic fin. Experiments were carried out on single-face fins with latex rubber skin and silicone skin (SF-L and SF-S) to compare the bending angle, return time, elastic energy storage and reliability. Silicone was found to be the better skin. A dual-face fin with silicone skin (DF-S) was tested in water to evaluate the actuating performance and to validate the reliability. Thermal analysis of the SMA temperature was performed to aid the control strategy. The micro robot fish and robot squid employ one and ten DF-S, respectively. Swimming experiments with different actuation frequencies were carried out. The speed and steering radius of the micro robot fish reached 112 mm s −1 and 136 mm, respectively, and the speed and rotary speed of the robot squid reached 40 mm s −1 and 22° s −1 , respectively

  15. PENGEMBANGAN BUDAYA SEKOLAH BERPRESTASI: STUDI TENTANG PENANAMAN NILAI DAN ETOS BERPRESTASI DI SMA KARANGTURI

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    Agus Yuliono

    2013-04-01

    Full Text Available Tujuan penelitian ini adalah untuk mendeskripsikan bentuk budaya sekolah berprestasi, proses penanaman nilai dan etos berprestasi kepada peserta didik dan mengetahui implikasi dari pengembangan budaya sekolah berprestasi di SMA Karangturi. Penelitian ini menggunakan pendekatan deskriptif kualitatif. Pengumpulan data menggunakan teknik observasi, wawancara dan dokumentasi. Hasil penelitian menunjukkan bahwa bentuk budaya sekolah berprestasi di SMA Karangturi mencakup empat poin yaitu: keseimbangan antara pembinaan akademik dan nonakademik, penanaman karakter melalui pelajaran, budaya mencintai almamater dan pentingnya nilai kerokhanian. Penanaman nilai dan etos berprestasi pada peserta didik dilakukan melalui kegiatan orientasi sekolah, proses pembelajaran, evaluasi belajar, ekstrakurikuler, penghargaan prestasi, kecintaan terhadap almamater, keteladanan guru, kerjasama dengan orangtua peserta didik dan seragam patriot sebagai media penanaman budaya berprestasi. Implikasi penanaman pengembangan budaya sekolah berprestasi di SMA Karangturi terdapat dalam input (penerimaan siswa baru dan pencarian siswa berpotensi, proses (pengembangan program sekolah serta pengembangan kerjasama dan output (prestasi akademik dan nonakademik serta jumlah alumni yang melanjutkan ke perguruan tinggi. The objective of this study is to describe a model of school achievement culture, the cultivation of values ​​and ethos of achievement to students and know the implications of the development of school culture on students’ achievement in Karangturi high school. This study used a qualitative descriptive approach. Techniques of collecting data were observation, interviews and documentation. This study uses sources and methods triangulation for data validation. The results show that the  school achievement culture in Karangturi high school contains four pillars, namely: a balance between academic and non-academic achievement, building character

  16. PENGARUH MODEL PROBLEM BASED LEARNING DENGAN PENDEKATAN INQUIRY TERHADAP HASIL BELAJAR SISWA SMA

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    Moch. Zainuddin

    2016-12-01

    Full Text Available The design used in this study is a quasi-experimental (quasi experiment. Subjects in this study were students of class X SMA Negeri 1 Sakra Timur Semester 2 academic year 2015/2016. independent variables in this study is a model of problem-based learning approach to inquiry and the dependent variable in this study is the student learning outcomes. The data in this study a number or score learning outcomes. Learning outcomes in question is gain score derived from the difference between pretest scores and posttes. The results of data analysis score geography student learning outcomes, showing that there was an increase in average achieved experimental classes from 77.82 to 59.08 into a 18.74 increase. Although the control group also increased score of 56.75 into 70.25 with an increase of 13.5, but when compared with the experimental class, increase in the average score belajaranya results higher than the increase in the control class. The difference increased scores kelase ksperimen learning outcomes with the controls is at 7. 57. Thus, it can be concluded that the learning model based inquiry approach an issue with significant effect on student learning outcomes in high school. This is proven by the results of the calculation of the value of gain score statistic 0.4758 to 0.02787 and the standard error of the mean of 5%. Rancangan yang digunakan dalam penelitian ini adalah eksperimental semu (quasi experiment. Subjek dalam penelitian ini adalah siswa kelas X Semester 2 SMA Negeri 1 Sakra Timur tahun ajaran 2015/2016. variabel bebas dalam penelitian ini adalah model pembelajaran berbasis masalah dengan pendekatan inkuiri dan variabel terikat dalam penelitian ini adalah hasil belajar siswa. Data dalam penelitian ini berupa angka atau skor hasil belajar. Hasil belajar yang dimaksud adalah gain score yang diperoleh dari selisih skor pretes dan posttes. Hasil analisis data skor hasil belajar geografi siswa, menunjukkan bahwa ada terjadi peningkatan

  17. A SUBLOCUS OF THE MULTICOPY MICROSATELLITE MARKER CMS1 MAPS PROXIMAL TO SPINAL MUSCULAR-ATROPHY (SMA) AS SHOWN BY RECOMBINANT ANALYSIS

    NARCIS (Netherlands)

    VANDERSTEEGE, G; COBBEN, JM; OSINGA, J; SCHEFFER, H; VANOMMEN, GJB; BUYS, CHCM

    1995-01-01

    The critical region containing the spinal muscular atrophy (SMA) gene is flanked by the 5q11-q13 markers, D5S435 and D5S557, as determined by linkage analysis. Here we present the results of an analysis of a Dutch SMA family with the multicopy microsatellite marker CMS1. A crossover is revealed in

  18. Diagnosis of Aortic Dissection in Emergency Department Patients is Rare

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    Scott M. Alter

    2015-10-01

    Full Text Available Introduction: Aortic dissection is a rare event. While the most frequent symptom is chest pain, that is a common emergency department (ED chief complaint and other diseases causing chest pain occur much more often. Furthermore, 20% of dissections are without chest pain and 6% are painless. For these reasons, diagnosing dissections may be challenging. Our goal was to determine the number of total ED and atraumatic chest pain patients for every aortic dissection diagnosed by emergency physicians. Methods: Design: Retrospective cohort. Setting: 33 suburban and urban New York and New Jersey EDs with annual visits between 8,000 and 80,000. Participants: Consecutive patients seen by emergency physicians from 1-1-1996 through 12-31-2010. Observations: We identified aortic dissection and atraumatic chest pain patients using the International Classification of Diseases 9th Revision and Clinical Modification codes. We then calculated the number of total ED and atraumatic chest pain patients for every aortic dissection, along with 95% confidence intervals (CIs. Results: From a database of 9.5 million ED visits, we identified 782 aortic dissections or one for every 12,200 (95% CI [11,400-13,100] visits. The mean age of dissection patients was 66±16 years and 38% were female. There were 763,000 (8% with atraumatic chest pain diagnoses. Thus, there is one dissection for every 980 (95% CI [910-1,050] atraumatic chest pain patients. Conclusion: The diagnosis of aortic dissections by emergency physicians is rare and challenging. An emergency physician seeing 3,000 to 4,000 patients a year would diagnose an aortic dissection approximately every three to four years.

  19. A case of spontaneous ventriculocisternostomy

    International Nuclear Information System (INIS)

    Yamane, Kanji; Yoshimoto, Hisanori; Harada, Kiyoshi; Uozumi, Tohru; Kuwabara, Satoshi.

    1983-01-01

    The authors experienced a case of spontaneous ventriculocisternostomy diagnosed by CT scan with metrizamide and Conray. Patient was 23-year-old male who had been in good health until one month before admission, when he began to have headache and tinnitus. He noticed bilateral visual acuity was decreased about one week before admission and vomiting appeared two days before admission. He was admitted to our hospital because of bilateral papilledema and remarkable hydrocephalus diagnosed by CT scan. On admission, no abnormal neurological signs except for bilateral papilledema were noted. Immediately, right ventricular drainage was performed. Pressure of the ventricle was over 300mmH 2 O and CSF was clear. PVG and PEG disclosed an another cavity behind the third ventricle, which was communicated with the third ventricle, and occlusion of aqueduct of Sylvius. Metrizamide CT scan and Conray CT scan showed a communication between this cavity and quadrigeminal and supracerebellar cisterns. On these neuroradiological findings, the diagnosis of obstructive hydrocephalus due to benign aqueduct stenosis accompanied with spontaneous ventriculocisternostomy was obtained. Spontaneous ventriculocisternostomy was noticed to produce arrest of hydrocephalus, but with our case, spontaneous regression of such symptoms did not appeared. By surgical ventriculocisternostomy (method by Torkildsen, Dandy, or Scarff), arrest of hydrocephalus was seen in about 50 to 70 per cent, which was the same results as those of spontaneous ventriculocisternostomy. It is concluded that VP shunt or VA shunt is thought to be better treatment of obstructive hydrocephalus than the various kinds of surgical ventriculocisternostomy. (J.P.N.)

  20. Optical antenna enhanced spontaneous emission.

    Science.gov (United States)

    Eggleston, Michael S; Messer, Kevin; Zhang, Liming; Yablonovitch, Eli; Wu, Ming C

    2015-02-10

    Atoms and molecules are too small to act as efficient antennas for their own emission wavelengths. By providing an external optical antenna, the balance can be shifted; spontaneous emission could become faster than stimulated emission, which is handicapped by practically achievable pump intensities. In our experiments, InGaAsP nanorods emitting at ∼ 200 THz optical frequency show a spontaneous emission intensity enhancement of 35 × corresponding to a spontaneous emission rate speedup ∼ 115 ×, for antenna gap spacing, d = 40 nm. Classical antenna theory predicts ∼ 2,500 × spontaneous emission speedup at d ∼ 10 nm, proportional to 1/d(2). Unfortunately, at d antenna efficiency drops below 50%, owing to optical spreading resistance, exacerbated by the anomalous skin effect (electron surface collisions). Quantum dipole oscillations in the emitter excited state produce an optical ac equivalent circuit current, I(o) = qω|x(o)|/d, feeding the antenna-enhanced spontaneous emission, where q|x(o)| is the dipole matrix element. Despite the quantum-mechanical origin of the drive current, antenna theory makes no reference to the Purcell effect nor to local density of states models. Moreover, plasmonic effects are minor at 200 THz, producing only a small shift of antenna resonance frequency.

  1. ANALISIS PENGARUH KOMPENSASI DAN LINGKUNGAN KERJA TERHADAP KINERJA GURU DI SMA NEGERI 1 KLATEN

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    Rina Oktaviani

    2016-10-01

      Kompensasi merupakan faktor yang penting untuk meningkatkan kinerja karyawan. Lingkungan kerja, baik fisik maupun non-fisik juga merupakan variabel penting yang mempengaruhi secara langsung maupun tidak langsung terhadap kinerja karyawan dalam melaksanakan tugasnya. Penelitian ini dilakukan di SMA Negeri 1 Karangdowo Klaten Jawa Tengah, menggunakan penelitian kuantitatif. Sampel penelitian ini sama dengan populasi yaitu 62 guru. Metode analisis regresi berganda digunakan untuk menganalisis dampak kompensasi dan lingkungan kerja terhadap kinerja guru. Hasil analisis menunjukkan bahwa terdapat pengaruh yang signifikan dari kompensasi dan kondisi kerja terhadap kinerja guru dengan nilai R2 sebesar 0,642. Hal ini menunjukkan bahwa peningkatan kompensasi dan kondisi kerja akan meningkatkan kinerja guru.   Kata kunci: Kompensasi, Lingkungan Kerja, Dan Kinerja.

  2. EFEKTIVITAS TEKNIK RELAKSASI DALAM KONSELING KELOMPOK BEHAVIORAL UNTUK MENURUNKAN STRES BELAJAR SISWA SMA

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    Istiana Nurcahyani

    2016-03-01

    Full Text Available Abstract: This research purpose to know the effectiveness of relaxation technique in behavioral group counseling to reducing academic stress at senior high school students. Research use one-group pretest-posttest design. The subject are selected 5 students based on high scores academic stress scale. Instruments used the scale academic stress was developed from various theories stress by Hans Selye (1976, Lazarus and Folkman (1984 with reliability is 0.898 and item validity > 0.3. Data were analyzed using wilcoxon signed ranks test. The analysis showed the Z count value is -2.032 with significance level of 0.042 0.3. Data dianalisis dengan uji beda wilcoxon signed ranks test. Hasil analisis menunjukkan nilai Z hitung -2,032 dengan taraf signifikansi 0.042 < 0.05 yang dapat disimpulkan bahwa teknik relaksasi efektif untuk menurunkan stres belajar siswa SMA.

  3. Pendekatan Pengajaran Reciprocal Teaching Berpotensi Meningkatkan Ketuntasan Hasil Belajar Biologi Siswa SMA

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    Nur Efendi

    2013-02-01

    Full Text Available Mutu pembelajaran Biologi masih rendah. Rendahnya mutu pembelajaran ini disebabkan oleh faktor pembelajaran yang masih berpusat pada guru (teacher centered tanpa melibatkan siswa untuk berpatisipasi pada proses untuk mendapatkan informasi dari kegiatan pembelajaran tersebut. Pengajaran Resiprok (Reciprocal Teaching merupakan salah satu strategi pendekatan pembelajaran yang dapat diterapkan untuk meningkatkan ketuntasan belajar siswa pada mata pelajaran biologi SMA, sehingga mutu pembelajaran mengalami ketercapaian ketuntasan hasil belajar yang ditetapkan. Tahapan Pengajajaran Resiprok adalah: (1 membaca  dan mencari ide pokok bacaan berdasarkan teks bacaan yang disediakan, (2 membuat pertanyaan, (3 menjawab pertanyaan, (4 merangkum informasi yang penting, (5 memprediksi, (6 mengidentifikasi hal-hal yang tidak jelas dari teks bacaan, (7 mengklarifikasi hal-hal yang tidak jelas tersebut.

  4. Design of a quick response SMA actuated segmented nut for space release applications

    Science.gov (United States)

    Zhang, Xiaoyong; Yan, Xiaojun; Yang, Qiaolong

    2010-04-01

    Spacecrafts require a variety of separation and release devices to accommodate separation from the launch vehicle or deployment of heat radiation panels, solar arrays and other appendages. In order to overcome drawbacks of the current release devices, this paper proposes a design scheme of release device with a form of segmented nut and actuated with SMA (Shape Memory Alloy) wire. In order to validate the release device's function and performance, ground tests including single device response time tests, synchronous tests of two devices, fatigue life tests were carried out. Tests results show that the innovative space release device developed in this paper owning the advantages of small size, quick response, long fatigue life, high simultaneity and auto-reset has a potential use in space engineering.

  5. Spontaneous subcapsular and perirrenal hemorrhage

    International Nuclear Information System (INIS)

    Fuster, M.J.; Saez, J.; Perez-Paya, F.J.; Fernandez, F.

    1997-01-01

    To assess the role of CT in the etiologic diagnosis of spontaneous subcapsular and perirrenal hemorrhage. The CT findings are described in 13 patients presenting subcapsular and perirrenal hemorrhage. Those patients in whom the bleeding was not spontaneous were excluded. Surgical confirmation was obtained in nine cases. In 11 of the 13 cases (84.6%), involving five adenocarcinomas, five angiomyolipoma, two complicated cysts and one case of panarterities nodosa, CT disclosed the underlying pathology. In two cases (15.4%), it only revealed the extension of the hematoma, but gave no clue to its origin. CT is the technique of choice when spontaneous subcapsular and perirrenal hemorrhage is suspected since, in most cases, it reveals the underlying pathology. (Author)

  6. HUBUNGAN KETERPAPARAN MEDIA MASSA, PERAN TEMAN SEBAYA TERHADAP TINDAKAN SEKSUAL DI SMA AN-NAAS

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    rika istawati

    2017-06-01

    Full Text Available Masa remaja merupakan masa peralihan antara tahap anak dan dewasa dimana pada masa ini mereka sangat rentan terpapar informasi dari media massa dan teman sebaya terutama seks bebas. Data SKRRI mempunyai teman yang pernah berhubungan seksual pada usia 14-19 tahun dengan persentasi perempuan 37,7% dan laki-laki 30,9% dan Kementerian Komunikasi dan Informasi menyebut 62,1% siswa mengaku penah melakukan hubungan seks. Observasi yang di lakukan oleh peneliti di SMA AN-NAAS Pekanbaru diketahui adanya 2 siswa  yang tertangkap menyimpan dan menonton video porno di handphone dan melalui wawancara peneliti dengan 8 siswi mereka mengatakan adanya 1 siswi yang hamil diluar nikah dan 2 siswi diantaranya mengaku sering datang ketempat yang berisiko terhadap tindakan seksual. Tujuan Penelitian ini untuk mengetahui hubungan keterpaparan media massa dan peran teman sebaya terhadap tindakan seksual. Desain penelitian yang digunakan adalah cross sectional, populasi penelitian adalah seluruh siswa kelas SMA AN-NAAS Pekanbaru yaitu 123 responden. Sampel penelitian 94 orang dengan teknik stratified random sampling. Alat ukur yang digunakan adalah angket, data diolah menggunakan komputer. Analisa data secara univariat dan bivariat dengan uji chi square dengan ketentuan α (0,5. Hasil penelitian didapatkan uji statistik menunjukkan adanya hubungan keterpaparan media massa dengan tindakan seksual dimana nilai p value 0,000 < 0,05, terdapat hubungan yang bermakna antara peran teman sebaya dengan tindakan seksual, dimana p value  0,001 < 0,05. Bagi pihak sekolah diharapkan untuk meningkatkan kegiatan di sekolah seperti ekstrakurikuler dan guru membimbing serta memberi pengawasan yang ketat terhadap siswanya.   

  7. ANALISIS POLA WACANA PEDAGOGIS GURU BIOLOGI DI SMA NEGERI 7 CIREBON

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    Edy Chandra

    2013-04-01

    Full Text Available Permasalahan yang berkembang di kalangan pengajar muda yang belum memiliki pengalaman dalam dunia pengajaran adalah membutuhkan profil seorang guru ideal  yang disenangi oleh siswa.Analisis wacana pedagogis guru tidak hanya dapat mengungkap kualitas pengajaran seorang guru di kelas, tetapi merupakan salah satu pendekatan yang dapat digunakan untuk mengungkap proses belajar mengajar secara totalitas.Penelitian ini bertujuan untuk mengetahui profil seorang guru Biologi yang terbaik di salah satu SMA Negeri di Cirebon berdasarkan kemampuannya dalam menyampaikan materi dan memberikan pemahaman kepada siswa. Masalah yang diangkat dalam penelitian ini adalah dengan mengamati tingkat relevansi penguasaan materi guru biologi pada indikator RPP, tingkat analisis wacana pedagogis guru menggunakan model representasi, tingkat analisis wacana pedagogis guru berdasarkan penyajian motif dan tingkat analisis wacana pedagogis guru berdasarkan level penyajian konsep.Metode penelitian yang digunakan oleh penulis adalah metode Kualitatif Deskriptif. Prosedur pengumpulan data dilakukan oleh peneliti sendiri dengan melakukan observasi, wawancara, penyebaran angket dan dokumentasi. Subjek penelitian adalah seorang guru biologi yang dianggap guru biologi terbaik di SMA Negeri 7 Cirebon.Data utama yang diperoleh berupa rekaman audio visual, diubah kedalam bentuk teks atau transkripsi untuk dapat dianalisis lebih lanjut.Hasil penelitian ini menunjukan tingkat relevansi penguasaan materi guru terhadap RPP yang dibuatnya dikatakan baik karena sebagian besar sudah teraktualisasi. Hal ini dapat dilihat dari hasil persentase tingkat relevansi indikator 90% materi terakomodasi, dan 10% tidak terakomodasi. Sementara itu, hasil analisis wacana pedagogis guru pada representasi teks mencapai struktur 5 level. Artinya semakin banyak konsep yang disampaikan guru dan semakin tinggi kompleksitas penguasaan materi guru. Analisis wacana pedagogis berdasarkan penyajian motif menunjukan

  8. IDENTIFIKASI KESULITAN GURU BIOLOGI DALAM MELAKSANAKAN PEMBELAJARAN KURIKULUM 2013 DI SMA NEGERI 1 SUSUKAN

    Directory of Open Access Journals (Sweden)

    Usfatul Aeni

    2016-12-01

    Full Text Available Identifikasi bertujuan untuk memperoleh informasi yang dapat digunakan sebagai landasan dalam menyusun program intervensi yang diharapkan dapat mencegah masalah di sekolah. Proses pembelajaran dalam kurikulum 2013 dilaksanakan dengan menggunakan pendekatan ilmiah. Pembelajaran biologi berdasarkan kurikulum 2013 harus mencapai 5 ranah pembelajaran diantaranya mengamati, menanya, mengumpulkan, mengasosiasikan, dan mengkomunikasikan. Tujuan dari penelitian ini adalah untuk mengkaji (1 kesulitan guru biologi dalam tahapan perencanaan, (2 kesulitan guru biologi dalam tahapan pelaksanaan proses pembelajaran, (3 respon siswa terhadap proses pembelajaran biologi yang diterapkan oleh guru biologi di SMA Negeri 1 Susukan.Pendekatan penelitian ini menggunakan pendekatan kualitatif. Penelitian ini bertempat di SMA Negeri 1 Susukan dengan objek penelitian Guru Biologi dikelas X. Teknik pengumpulan data dilakukan dengan menggunakan dokumentasi, observasi, wawancara dan angket, adapun teknik analisis data diantaranya transkripsi, organisasi data, tahapan interprestasi, temuan, dan penarikan kesimpulan. Berdasarkan hasil analisis dan pembahasan yang telah dilakukan, ada beberapa beberapa kesulitan diantaranya: 1 kesulitan pada tahap perencanaan yaitu guru biologi, kesulitan yang terdapat pada penyusunan RPP yaitu apek Perangkat awal, alokasi waktu, metode, sumber belajar, dan penilaian (Rubrik, 2 Kesulitan pada tahap proses pembelajaran, pada aspek kegiatan pendahuluan Guru sulit membuat peserta didik untuk berkonsentrasi dalam proses pembelajaran, Guru sulit untuk menyampaikan tujuan pembelajaran. Aspek kegiatan inti diantaranya guru sulit untuk menerapan pendekatan scientific, Guru masih mengalami kesulitan dalam pendekatan berbasis sainstifik (5M, Guru masih kesulitan menggunakan metode pembelajaran, Guru kurang aktif dalam proses pembelajaran. Aspek kegiatan penutup meliputi Guru sulit untuk membimbing siswa untuk menyimpulkan pembelajaran, Guru jarang

  9. PEMBELAJARAN MENULIS TEKS PIDATO DAN BERPIDATO KELAS X DI SMA NEGERI 3 SUKOHARJO

    Directory of Open Access Journals (Sweden)

    Jaka Santosa

    2016-02-01

    Full Text Available This study has four aims, (1 the procedure of learning to write text to speech and speech in the classroom, (2 learning strategies and what the media writes text to speech and speech in the classroom, (3 student activity in learning to write text to speech and speech in the classroom, and (4 learning outcomes writing text to speech and speech. This includes descriptive qualitative research which took place in SMA Negeri 3 Sukoharjo. Data in the form of words and actions. Sources of data obtained from sources, events, and documents. Informant is Indonesian teachers and students. Events are learning activities Indonesian X1 class 2nd semester of academic year 2012/2013. The document in question is a document relating to the teaching of writing. Data collection techniques were interviews, observation, and documentary. Research findings in the field, among others, (1 the learning procedure by submitting a text to speech material on speech. Then compose the theme is developed into a framework and final drafting speeches, (2 application of learning strategies to write text to speech and speech with the approach that has been programmed patterns , the approach of process skills and communicative approach, (3 students activate in learning writing text to speech and speech have been carried out by providing learning facilities and trust management using effective learning infrastructure, (4 learning to write text to speech and speech by using the approach of process skills and communicative approaches undertaken by teachers Indonesian subjects in SMA Negeri 3 Sukoharjo obtain following result, students who earn good grades for writing text to speech 80 % and 88 % speech practice, then students who received grades enough to write the speech 20 % and 3 % speech practice, and students who obtain less value to the writing of the speech is not there, to practice speech while there were 9 % .

  10. PENGARUH KOMPETENSI MANAJERIAL KEPALA SEKOLAH, LINGKUNGAN, MOTIVASI GURU, TERHADAP PRESTASI SISWA SMA MUHAMMADIYAH KOTA YOGYAKARTA

    Directory of Open Access Journals (Sweden)

    Arif Jamali

    2013-04-01

    Full Text Available Penelitian ini bertujuan untuk mengungkapkan: (1 pengaruh langsung dan tidak langsung kompetensi manajerial kepala sekolah dengan prestasi belajar siswa kompetensi manajerial kepala sekolah dengan prestasi belajar siswa melalui motivasi berprestasi guru; (2 pengaruh langsung dan tidak langsung antara lingkungan sekolah dengan prestasi belajar siswa melalui motivasi berprestasi guru; (3 pengaruh langsung antara motivasi berprestasi guru dengan prestasi belajar siswa. Penelitian ini merupakan penelitian ex-post facto, dengan populasi 318 guru SMA Muhammadiyah Kota Yogyakarta dan sampel 200 orang yang dipilih dengan teknik proportional sampling. Instrumen pengumpulan data berupa kuesioner. Analisis data menggunakan teknik analisis jalur untuk menguji hipotesis penelitian. Hasil penelitian menunjukkan bahwa: (1 terdapat pengaruh langsung dan tak langsung kompetensi manajerial kepala sekolah dengan prestasi belajar siswa, dengan sumbangan efektif 5,52% dengan prestasi belajar siswa melalui motivasi berprestasi guru, (sumbangan efektif sebesar 32,09%; (2 tidak terdapat pengaruh langsung antara lingkungan sekolah dengan prestasi belajar siswa; (3 terdapat pengaruh tidak langsung antara lingkungan sekolah dengan prestasi belajar siswa melalui motivasi berprestasi guru, (sumbangan efektif sebesar 1,04%; (4 terdapat pengaruh langsung antara motivasi berprestasi guru dengan prestasi belajar siswa, (sumbangan efektif sebesar 47,06%. Jadi secara keseluruhan sumbangan yang diberikan oleh kompetensi manajerial kepala sekolah, lingkungan sekolah, motivasi berprestasi guru baik secara langsung maupun tidak terhadap prestasi belajar siswa sebesar 85,71%. Hal ini berarti jika kompetensi manajerial kepala sekolah, lingkungan sekolah dan motivasi berprestasi guru ditingkatkan kualitasnya maka akan berkontribusi positif terhadap peningkatan prestasi belajar siswa SMA Muhammadiyah Kota Yogyakarta. Kata Kunci: kompetensi manajerial kepala sekolah, lingkungan sekolah

  11. Diagnostic imaging of acute aortic dissection; Evaluation of thrombosed type aortic dissection by CT and angiography

    Energy Technology Data Exchange (ETDEWEB)

    Ohya, Tohru; Kumazaki, Tatsuo (Nippon Medical School, Tokyo (Japan))

    1991-01-01

    One hundred and nineteen patients with aortic dissection who underwent diagnostic imaging were reviewed and angiographic findings as well as those of CT were analysed. Thirty eight cases (43.1%) had non-contrast opacified false lumen, the type of which we call 'thrombosed type aortic dissection'. A comparative study of the thrombosed type with the patent type of false lumens was made particularly from the stand point of the characteristic diagnostic imagings (CT and angiography). At the same time, the pitfalls of these imagings in thrombosed type aortic dissection were studied. At the onset the average age of thrombosed type was 62.3 years old, while that of the patent type was 57.3. A statistical significance between the two groups was p<0.05. Thrombosed type in all cases was caused by atherosclerosis, whereas patent type was caused by the Marfan's syndrome in 11 cases. Other clinical findings, such as initial symptoms and blood pressure revealed no significant differences between the two groups. Pre-contrast CT in acute thrombosed type aortic dissection showed 'hyperdense crescent sign' in 89.4%. However, in 3 cases with thrombosed type in which the pre-contrast CT showed 'hyperdense crescent sign' contrast-enhanced CT detected no clear evidence of aortic dissection in the same site. This was due to obscurity induced by contrast medium. Angiographic findings of thrombosed type were classified into 3 groups: normal type, stenosed true lumen type and ulcer-like projection type. The incidence of normal type was estimated to be 48.4%, whereas stenosed true lumen type was 24.2% and ulcer-like projection was 27.7%. The present study concluded that thrombosed type is not rare in acute aortic dissection and contrast-enhanced CT as well as pre-contrast CT, is of great value in diagnosing thrombosed type. 'Hyperdense crescent sign' in pre-contrast CT is characteristic of intramural hematoma. (author).

  12. Pre-SMA graymatter density predicts individual differences in action selection in the face of conscious and unconscious response conflict.

    Science.gov (United States)

    van Gaal, Simon; Scholte, H Steven; Lamme, Victor A F; Fahrenfort, Johannes J; Ridderinkhof, K Richard

    2011-02-01

    The presupplementary motor area (pre-SMA) is considered key in contributing to voluntary action selection during response conflict. Here we test whether individual differences in the ability to select appropriate actions in the face of strong (conscious) and weak (virtually unconscious) distracting alternatives are related to individual variability in pre-SMA anatomy. To this end, we scanned 58 participants, who performed a masked priming task in which conflicting response tendencies were elicited either consciously (through primes that were weakly masked) or virtually unconsciously (strongly masked primes), with structural magnetic resonance imaging. Voxel-based morphometry revealed that individual differences in pre-SMA gray-matter density are related to subjects' ability to voluntary select the correct action in the face of conflict, irrespective of the awareness level of conflict-inducing stimuli. These results link structural anatomy to individual differences in cognitive control ability, and provide support for the role of the pre-SMA in the selection of appropriate actions in situations of response conflict. Furthermore, these results suggest that flexible and voluntary behavior requires efficiently dealing with competing response tendencies, even those that are activated automatically and unconsciously.

  13. PENGARUH PERHATIAN DAN TINGKAT PENDAPATAN ORANG TUA TERHADAP HASIL BELAJAR EKONOMI SISWA KELAS XI DI SMA NEGERI 12 SIJUNJUNG

    Directory of Open Access Journals (Sweden)

    Asli Darnis

    2013-10-01

    Full Text Available Tujuan penelitian ini adalah untuk melihat pengaruh perhatian orang tua dan tingkat pendapatan orang tua terhadap hasil belajar ekonomi siswa kelas XI di SMA Negeri 12 Sijunjung tahun pelajaran 2012/2013. Jenis penelitian yang digunakan adalah kuantitatif. Populasi pada penelitian ini adalah seluruh siswa kelas XI di SMA Negeri 12 Sijunjung sebanyak 49 orang. Instrumen yang digunakan dalam penelitian ini adalah berupa angket. Analisis data digunakan dengan dua cara yaitu: 1 analisis deskriptif, dan 2 analisis induktif. Hasil penelitian menunjukan bahwa: pertama perhatian orang tua terhadap hasil belajar ekonomi siswa kelas XI di SMA Negeri 12 Sijunjung berpengaruh signifikan dengan nilai yaitu 2,819 > 2,021, dan sig 0,072 2,021, dan sig 0,000 yaitu 39,276 > 3,23 dan sig 0,000 < 0,05 maka Ho ditolak dan Ha diterima. Sumbangan yang diberikan oleh perhatian dan pendapatan orang tua terhadap hasil belajar ekonomi siswa kelas XI di SMA Negeri 12 Sijunjung adalah 0,631 atau 63,1%. Perhatian orang tua dan tingkat pendapatan orang tua merupakan faktor penting yang dapat mempengaruhi hasil belajar siswa dalam mata pelajaran ekonomi. Kontribusi dari penelitian ini adalah agar orang tua siswa lebih memperhatikan anaknya mengenai masalah kependidikannya, agar hasil belajar siswa dapat meningkat.

  14. Evaluation of SAC-SMA and HSPF rainfall-runoff simulations in upper parts of Vltava basin

    Czech Academy of Sciences Publication Activity Database

    Košková, Romana; Buchtele, Josef; Vološ, B.

    2005-01-01

    Roč. 7, - (2005), nestr. ISSN 1029-7006 R&D Projects: GA AV ČR KJB3060302; GA AV ČR(CZ) IAA3017301 Keywords : rainfall-runoff simulations * Vltava basin * SAC-SMA and HSPF model Subject RIV: DA - Hydrology ; Limnology

  15. Sense of agency is related to gamma band coupling in an inferior parietal-preSMA circuitry

    DEFF Research Database (Denmark)

    Ritterband-Rosenbaum, Anina; Nielsen, Jens Bo; Christensen, Mark Schram

    2014-01-01

    In the present study we tested whether sense of agency (SoA) is reflected by changes in coupling between right medio-frontal/supplementary motor area (SMA) and inferior parietal cortex (IPC). Twelve healthy adult volunteers participated in the study. They performed a variation of a line-drawing t......In the present study we tested whether sense of agency (SoA) is reflected by changes in coupling between right medio-frontal/supplementary motor area (SMA) and inferior parietal cortex (IPC). Twelve healthy adult volunteers participated in the study. They performed a variation of a line...... as to the agent of the movement and they reported SoA in approximately 50% of trials when the movement was computer-generated. We tested whether IPC-preSMA coupling was associated with SoA, using dynamic causal modeling (DCM) for induced responses (Chen et al., 2008; Herz et al., 2012). Nine different DCMs were...... with no SoA in the late task phase, but the test of the early task phase did not reveal any differences between presence and absence of SoA. We show that SoA is associated with a directionally specific between frequencies coupling from IPC to preSMA in the higher gamma (ɣ) band in the late task phase...

  16. Arterial occlusion to treat basilar artery dissecting aneurysm

    NARCIS (Netherlands)

    Cui, Qing Ke; Liu, Wei Dong; Liu, Peng; Li, Xue Yuan; Zhang, Lian Qun; Ma, Long Jia; Ren, Yun Fei; Wu, Ya Ping; Wang, Zhi Gang

    2015-01-01

    Object: To explore the clinical feasibility of employing occlusion to treat basilar artery dissecting aneurysm. Methods: One patient, male and 46 years old, suffered transient numbness and weakness on the right limbs. Cerebral angiography indicated basilar artery dissecting aneurysm. The patient

  17. Cold versus hot dissection tonsillectomies: The Nigerian experience ...

    African Journals Online (AJOL)

    Background: Tonsillectomy is performed by various techniques but the commonest used in Nigeria is the cold dissection method. Our study highlights our experience from comparing the cold and hot dissection methods of tonsillectomy. Methods: This is a prospective randomized single-blind study spanning fifty seven ...

  18. THE IMPACT OF DIAGNOSTIC DISCREPANCIES IN AORTIC DISSECTION MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Abdalla Hassan

    2016-01-01

    Full Text Available Aortic dissection is uncommon with high mortality rate if untreated. We report a challenging case of long segment aortic dissection in which the dissection type was very difficult to identify due to limitations of the available imaging studies. 66-year-old male presented to us with 3 days history of chest pain and difficulty breathing. He is known to be hypertensive. In the emergency room, patient has systolic blood pressure >190. Chest X-ray showed widening of mediastinum. CT angiography of chest and abdomen showed an acute dissection of the thoracic aorta extending from the mid ascending aorta to the infra-renal aorta suggestive of Stanford type A aortic dissection. Transthoracic and Trans-esophageal echocardiography revealed a partially calcified intimal flap in the distal portion of the arch and in the descending thoracic aorta suggestive of Stanford type B aortic dissection. Medical treatment started, and repeated CT angiography was obtained and it confirmed type B aortic dissection. One week after discharge, patient was readmitted with severe neck pain and difficulty breathing. CT chest without contrast showed grossly stable appearance of type A dissection consistent with the first CT angiography. Cardiothoracic surgery immediately reevaluated the situation and recommended surgical intervention.

  19. Reaction of Medical Students to Experiences in Dissection Room ...

    African Journals Online (AJOL)

    Conclusion: The present study findings show that smell of the dissection room, touch and fear of cadaver were the commonest cause of their symptoms experienced while study in dissection room for the majority of students. Thus, instructors are should give awareness raising education before the commencement of the ...

  20. Local repair of distal thoracal aortic dissections (Locus minoris resistencia).

    Science.gov (United States)

    Belov, Iu V; Komarov, R N; Stepanenko, A B; Gens, A P; Charchian, E R

    2007-01-01

    The paper presents the method of local repair of distal aortic dissections. Local aortic grafting for surgical correction of type B dissecting aortic aneurysms helped to decrease hospital mortality up to 15.4%, the rate of paraparesis and multiorgan failure - up to 11.5%.